{"id":28754,"date":"2023-04-05T12:00:00","date_gmt":"2023-04-05T12:00:00","guid":{"rendered":"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2023\/cancer-climate-change-impact"},"modified":"2024-11-03T15:12:48","modified_gmt":"2024-11-03T15:12:48","slug":"cancer-and-climate-change-the-health-threats-of-unnatural-disasters","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/cancer-and-climate-change-the-health-threats-of-unnatural-disasters\/","title":{"rendered":"Cancer and Climate Change: The Health Threats of Unnatural Disasters"},"content":{"rendered":"

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A satellite image of Hurricane Irma, which in 2017 caused billions in damage in Puerto Rico and Florida. Hurricanes strengthened by warming ocean waters can damage medical buildings and equipment used for cancer care.<\/p>\n

Credit: NASA\/NOAA GOES Project<\/p>\n<\/p><\/div>\n<\/figcaption><\/figure>\n<\/p><\/div>\n

Over a span of four months in 2017, the United States experienced four deadly disasters that were likely worsened by climate change\u2014Hurricanes Harvey, Irma, and Maria and wildfires in California.<\/p>\n

At the time, knowledge about possible connections between climate change and cancer was limited. But after these disasters, researchers began to study how people with cancer had been affected by the events. <\/p>\n

Today, a growing body of evidence suggests that the consequences of climate change, such as more frequent wildfires, sustained droughts and heat waves, and stronger and more intense tropical storms, may influence many aspects of cancer. <\/p>\n

\u201cWe believe that climate change may have direct and indirect effects on the development of cancer and on cancer care,\u201d said Gwen Collman, Ph.D., of the National Institute of Environmental Health Sciences (NIEHS), who helps coordinate NIH research on climate change and health.<\/p>\n

For instance, climate change-related disasters can expose people to cancer-causing substances, or carcinogens, in the environment. Wildfire smoke contains several carcinogens, such as formaldehyde<\/a> and benzene<\/a>.  <\/p>\n

Hurricanes strengthened by warming ocean waters can destroy medical buildings and equipment used to treat, diagnose, and detect cancer. People\u2019s access to care\u2014and the ability of health care providers to deliver care\u2014can be disrupted, often for long periods of time.
    
Extreme weather may also disrupt efforts to prevent cancer. Droughts and floods can affect the food supply, potentially reducing access to fresh fruits and vegetables. And prolonged heat waves or storms associated with climate change may discourage people from being active outdoors. <\/p>\n

\u201cCertainly, extreme weather events could affect the risk of cancer and efforts to prevent and control the disease in many ways,\u201d said Curt DellaValle, Ph.D., of the Environmental Epidemiology Branch in NCI\u2019s Division of Cancer Control and Population Sciences (DCCPS). <\/p>\n

\u201cMeasuring and assessing these weather events will be important for understanding and addressing the impacts of climate change on health,\u201d added Dr. DellaValle, who is a member of the NCI Climate Change and Cancer Working Group. <\/p>\n

Connecting hurricanes and survival among people with cancer<\/h2>\n

Much of the research on climate change and cancer has focused on how hurricanes and wildfires affect cancer care.<\/p>\n

One of the first studies to measure the impact of climate change on cancer involved people who received radiation to treat lung cancer. Being treated in an area where a hurricane disaster had been declared was associated with poorer overall survival<\/a>, the 2019 study found. The researchers attributed the worse survival at least in part to hurricane-related delays in treatment. <\/p>\n

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Hurricane Maria dumped more rain on Puerto Rico than any storm to hit the island since 1956\u2014an event that human-caused climate change made much more likely. After the disaster, researchers documented the experiences of survivors who had cancer.<\/p>\n

Credit: FEMA<\/p>\n<\/p><\/div>\n<\/figcaption><\/figure>\n<\/div>\n

\u201cIt should not be surprising that natural disasters are going to disrupt cancer care and lead to worse outcomes for patients,\u201d said the study\u2019s lead investigator, Leticia Nogueira, Ph.D., a scientific director at the American Cancer Society and one of the inaugural NIH Climate and Health Scholars<\/a>. <\/p>\n

But when Dr. Nogueira proposed the study 5 years ago, her colleagues initially dismissed the idea. \u201cBack then, few researchers were thinking about how climate change and cancer might be connected,\u201d she recalled.  <\/p>\n

Times have changed. Dr. Nogueira now leads sessions on climate change and cancer at scientific conferences. And she is frequently contacted by cancer researchers who are interested in climate change research. Most have themselves been affected in some way by a climate-related disaster, she noted. <\/p>\n

\u201cA common view of climate change is that it will happen in the future and will primarily affect island nations far away,\u201d Dr. Nogueira said. \u201cBut we are all experiencing the health consequences of climate change right here, right now.\u201d<\/p>\n

Listening to the voices of people affected by climate change<\/h2>\n

Stories from people with cancer who have been affected by extreme weather associated with climate change have begun to emerge. After Hurricanes Irma and Maria, researchers held focus groups with women who had been undergoing treatment for gynecologic cancers when the back-to-back storms struck Puerto Rico.<\/p>\n

The women\u2019s accounts of their experiences reveal the challenges they faced<\/a>. Several climbed onto the roofs of their homes to try to obtain a cell phone signal to call their doctors. The calls failed, however, because nearly all of the island\u2019s cell towers had been destroyed by the storms.<\/p>\n

Maria dumped more rain on Puerto Rico than any storm to hit the island since 1956\u2014an event that human-caused climate change made much more likely. Most of the women in the focus groups said their cancer treatments had been postponed or cancelled. <\/p>\n

The women\u2019s stories are a reminder that, although climate change affects everyone, the most vulnerable groups, including people with few resources who have diseases such as cancer, will be hit the hardest, noted Gila Neta, Ph.D., an epidemiologist with the Implementation Science Team in DCCPS.
 
\u201cCommunities that are marginalized tend to have a greater burden of cancer than other communities, and climate change may worsen vulnerabilities that already exist,\u201d said Dr. Neta.<\/p>\n

The health effects of a disaster, she noted, may persist long after that disaster has ended. A decade after Hurricane Katrina, the survival of women with breast cancer was worse among those who experienced Katrina<\/a> than among those who had not been through it.<\/p>\n

The unexpected problems of climate disasters<\/h2>\n

Extreme weather can have unpredictable and far-reaching effects for people with cancer beyond hindering access to treatment for those in the path of the storm. <\/p>\n

For example, Hurricane Maria forced the closure of a factory in Puerto Rico that manufactured small intravenous (IV) fluid bags for hospitals. Not long after, health care facilities on the US mainland experienced a shortage of these products<\/a>. <\/p>\n

\u201cWho would have thought that a hurricane in Puerto Rico would affect the availability of critical IV fluids for patients with cancer across the United States?\u201d asked Robert Hiatt, M.D., Ph.D., of the UCSF Helen Diller Family Comprehensive Cancer Center, who has written about climate change and cancer. 
  
\u201cThis example shows the complex and interconnected nature of cancer care, which is vulnerable to supply chain issues,\u201d Dr. Hiatt continued. <\/p>\n

He noted that the COVID-19 pandemic and major climate disasters such as Hurricane Harvey have shown \u201chow the US health care systems are susceptible to shocks.\u201d And, he added, \u201cas the climate continues to change, disruptions to health care may become increasingly common.\u201d<\/p>\n

Exploring connections between wildfires and lung cancer<\/h2>\n

Dr. Hiatt became interested in climate change in part because of his experiences with wildfires in California. He was living in the San Francisco Bay Area in 2020, when smoke from these fires obscured the sun and lent the city an orange cast. <\/p>\n

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A satellite image of wildfire smoke crossing the United States on September 4, 2017. Extended droughts and heat waves associated with climate change have increased the risk and extent of large forest fires.<\/p>\n

Credit: Jeff Schmaltz LANCE\/EOSDIS MODIS Rapid Response Team, GSFC (CC BY 2.0)<\/p>\n<\/p><\/div>\n<\/figcaption><\/figure>\n<\/div>\n

Extended droughts and heat waves associated with climate change have increased the risk and extent of large forest fires<\/a> in the western United States. And one study has found that firefighters who have been exposed to smoke from these fires may have an increased risk of lung cancer<\/a>.<\/p>\n

In addition to carcinogens, wildfire smoke includes tiny particles called fine particulate matter. Exposure to these particles, which are also found in vehicle exhaust and smoke from the burning of fossil fuels, can affect the lungs and the heart<\/a>. <\/p>\n

Scientists have been exploring connections between fine particulate matter and cancer in the context of climate change<\/a>. One study, for instance, has found that the global burden of lung cancer deaths attributable to fine particulate matter in the air has increased in recent decades<\/a>. <\/p>\n

Collecting data on exposures over decades<\/h2>\n

The biggest climate change-related threats for the development of cancer are likely to be from exposure to air pollution and other carcinogens, as well as disruptions to the food and water supplies, according to Dr. DellaValle.<\/p>\n

Researchers may need to collect data on exposures over the course of a lifetime to learn how exposures to climate-related disasters affect cancer risk, Dr. DellaValle said. <\/p>\n

Dr. Nogueira agreed. \u201cRight now, there is a paucity of data on exposures to carcinogens released during extreme weather events,\u201d she said. \u201cBut there is an opportunity for researchers, funding agencies, and government organizations to do better in this area.\u201d <\/p>\n

New technologies and approaches could help capture data on extreme weather events for health studies. For example, after a disaster, electronic questionnaires could be sent to people who were living in the affected area to collect information about their experiences, Dr. DellaValle said.<\/p>\n

Looking to the past to understand the future<\/h2>\n

A long-running health study has recently begun to add climate change-related information to its database. The Nurses\u2019 Health Study (NHS) is adding data on such measures as temperature, precipitation, and humidity, to each participant\u2019s record based on the person\u2019s zip code.<\/p>\n

Since 1976, the NHS has collected health information from a group of nurses every 2 years. Approximately 350,000 people have been involved in the original NHS study and two subsequent NHS studies.<\/p>\n

The expanded database could be used to explore how interactions among multiple environmental factors might affect human health, according to Jaime Hart, Sc.D., an environmental health researcher at the Harvard T.H. Chan School of Public Health and an NHS investigator. <\/p>\n

Many previous studies, she noted, have looked at the health effects of air pollution separately from temperature and precipitation. Now, Dr. Hart and her colleagues hope to look at these types of variables together to gain insights into the complex ways that they affect human health. <\/p>\n

\u201cThe environment is a complex system, and we\u2019d like to look at multiple interactions,\u201d she said. <\/p>\n

The Nurses\u2019 Health Study includes a team focused on cancer. These investigators plan to study such questions as whether exposure to wildfires has affected survival among people with breast or other cancers. <\/p>\n