Friday Favorites: Talcum Powder and Fibroids

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

If you randomly select a group of women and ultrasound their uterus, the majority of them have fibroid tumors by age 50. And by most, I mean, more than 80% of black women, and about nearly 70% of white women. Half of white women already have fibroids by their early 40s, and the same could be said for African-American women in their mid-30s.

After getting over the shock of how widespread fibroids are, the next question becomes, why the racial disparity? Is it “diet, stress,…environmental exposures”? Maybe, whatever it is could offer a clue as to what causes fibroids. For example, African-Americans tend to have a “lower intake…of fruits [and] vegetables,” and fruits and vegetables appear protective against fibroids—particularly citrus, here in the Black Women’s Health Study; though not, apparently, just citrus juice.

It’s interesting; if you measure the levels of beta-carotene in fresh surgical tissue samples of uterine fibroids, and “adjacent normal [uterus tissue] obtained” during hysterectomies, you find “significantly…lower” concentrations in the fibroids. In fact, beta-carotene was not even detectable in half the fibroid specimens. The same thing is actually found in cancer. Most cancerous tissues tested had undetectable levels of beta carotene, compared to the normal tissue right next to the tumor. So, maybe “decreased levels of [beta]-carotene” somehow play a role in causing these conditions? Sounds like a bit of a stretch, but you don’t know until you put it to the test. But, there had never been a randomized, controlled, clinical trial of fruits and vegetables for fibroids, until… never! They did do a randomized, controlled trial of kind-of-a-fruit-and-vegetable-at-the-same-time—tomatoes—but for the prevention of fibroids in Japanese quail, and most of my patients are not Japanese, nor quail.

The action of lycopene, the red pigment in tomatoes, “in an animal model may not accurately represent lycopene action in humans.” And indeed, the Harvard Nurses’ study found no apparent link between lycopene consumption and fibroids. So, yeah; fruits and at least green vegetables may have a “protective effect.” But we won’t know for sure, until they’re properly put to the test.

Vitamin D is another possibility as to why African-Americans disproportionately suffer from fibroids. “Women with darker skin are…more likely to be Vitamin D-deficient;” as many as 80% of black women may have “inadequate levels of Vitamin D,” compared to only one in five white women.

Vitamin D does inhibit fibroid cell proliferation—in a petri dish. It may be able to shrink tumors in your pet rat; but what about people? A population study did find that “[w]omen with sufficient vitamin D” levels in their blood had about a third “lower odds of fibroids”—consistent with the finding that women who report lots of sun exposure also appear to be protected. But, until there’s an interventional trial where women are randomized to vitamin D or placebo, we won’t know for sure if vitamin D plays a role in fibroid prevention or treatment, or not.

African-American women are also more likely to sprinkle baby powder on their genitals, which may not only double the odds of fibroids, but may increase the risk of ovarian cancer—the deadliest gynecological cancer. Internal memos show Johnson & Johnson knew about the cancer risk, but still decided to target African-Americans. “Think of us”, Johnson & Johnson said, “as a lifetime friend of the family”—a lifetime cut short, perhaps, by its baby powder, or at least so said a jury, which recently awarded a family $110 million in damages—on top of the $200 million in verdicts from last year, with thousands of lawsuits pending after internal memos revealed that decades ago, their own contracted toxicologists were warning the company that there are multiple studies showing a cancer link, and anyone who denies this risk “will be perceived by the public” in the same light as those who denied a link between smoking cigarettes and cancer: “denying the obvious in the face of all evidence to the contrary.”

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• [author unknown] Johnson's Baby Powder 8/5/92.
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Image credit: Mike Mozart via Flickr. Image has been modified.

Motion graphics by Avocado Video.