Monica studies clarinet as her performance medium, although she is learning to play all orchestral instruments. Her great interest in oncology stems from a history of cancer in her family.

As the epidemic of cancer spreads rapidly throughout the world, so do misconceptions about its causes. In a large percentage of cancer cases, when a person is diagnosed with the frightening disease, his or her first impulse is to associate the illness with heredity. Public interpretation of medical science has taught people to do so. However, such interpretations are progressively misleading mankind about the origins of cancer. As more and more oncology studies are performed, the majority of cancer cases are not being attributed to genetics and heredity, but to harmful environmental influences on the human body brought about by individual behaviors or environmental factors. Examples of such environmental factors are: what humans eat, drink, breathe, smoke, what lifestyle patterns humans exercise, and the chemicals to which humans expose themselves (Begley 2000).

Cancer rates are increasing steadily around the world. The statistics associated with the disease are mind-boggling: 560,000 people die of cancer every year in the United States (6.6 million worldwide), and almost 1.4 million new cases are diagnosed in the United States annually (Perara 1997). Scientists have been researching the deadly disease for years and have largely pursued the explanation that cancer is passed on genetically. Many people have accepted that theory and believe that cancer is passed on entirely through heredity. However, with the rapid cancer rate increase, it is no wonder that many Americans are becoming more and more attentive to their exposure to pollution in their environment. This growing suspicion that the environment plays a role in cancer has spurred scientists to investigate the link between environmental influences and cancer. Even though it is still being researched heavily, the results from recent tests validate suspicions. Most cancers are caused by the interaction of genetics and the environment. That is to say, genetic factors by themselves are believed to explain only five percent of all cancer cases. The remainder of cancer cases can be attributed to behavioral or environmental factors that act in conjunction with both genetic and acquired susceptibility (Perara 1997). This new information represents an exciting breakthrough in the field of oncology, but it also poses a considerable number of questions.

One of the most intriguing questions resulting from new research concerns determining what agents in the environment are actually making people susceptible. If the environment has a significant influence on the development of cancer, some kind of contamination must exist in the environment that produces hazardous effects upon living organisms.

Researchers have fingered three core environmental contaminants as major cancer-related culprits. The first of these three hazards is the prolonged exposure to ionizing radiation. In the case of breast cancer, specifically, questions have been raised concerning the Pilgrim Nuclear Power Plant in Plymouth, Massachusetts, because this area of the state has had a higher incidence of breast cancer than other areas in the state (Brody et. al 1996). This type of radiation exposure, however, is not the only type that is suspected to be carcinogenic, or cancer-causing. There have been a great many instances of cancer occurring as a result of intense, short-term exposure to radiation. Examples include exposure to the aftermath of atomic bombs, and environmental contamination caused by nuclear reactor malfunction - Chernobyl, Russia being a prime example.

A second hazard is the exposure to synthetic chemicals not naturally present in the environment. These agents include pesticides, wastewater, and gaseous pollutants, whose increasing presence in the environment is making it more and more difficult to prevent instances of human contact with them. Out of approximately 1000 chemicals tested in laboratories internationally, scientists have identified nearly 150 as causing different types of cancer in animals. In breast cancer tests alone, the National Toxicology Program identified 36 of 425 synthetic chemicals studied as causing mammary gland cancer in rodents (Brody et. al 1996). Recent studies have also shown that the reason many of these chemicals become such a threat is that the chemicals persist in their environments and bioaccumulate in organisms as a result of extensive exposure. Thus, many humans worldwide harbor dangerous levels of chemical residues in their bodies that can potentially lead to cancer if exposure is not decreased.

The last of these potentially lethal contaminants is a group of agents called endocrine disruptors. An endocrine disruptor is a compound that acts as a hormone or interferes with hormone metabolism. This hormonal interference often signals body tissue cells to divide more rapidly, which may cause pre-cancerous or cancerous cells to multiply as well, dramatically increasing a person's cancer risk with even the subtlest exposure. Endocrine disruptors comprise a broad class of chemical agents that include natural substances within the body, pharmaceuticals, phytoestrogens in plants, and manufactured chemicals in pesticides, detergents, and plastics. Since human exposure to these persistent disruptors has been widespread, scientists have made the study of possible links between these agents and cancer a top priority (Brody et. al 1996).

Though the complex, laboratory-based proof medical science has to offer about the link between the environment and cancer may be convincing to some non-scientists, real-life personal instances of linkage may be more convincing to the "average Joe." Two specific examples of this disputed relationship illustrate the validity of the argument at hand: the chart-topping breast cancer outbreak in Cape Cod, Massachusetts, and the high incidence of brain tumors in a community surrounding a BP Amoco Chemical refinery in Sugar Creek, Missouri. In both of these instances, cancer development exceeded demographic predictions, which led the general public and scientists alike to believe that environment, rather than genetics, played a key role in the increased cancer rate.

In the case of Cape Cod, Massachusetts, the dramatic increase of cancer became apparent when town-by-town cancer statistics were published for 1982-1990. Breast cancer rates in eight communities in the Cape Cod area were at least 25 percent higher than the rest of the state's 351 cities and towns (Brody et. al 1996), which led scientists to suspect that demographic or environmental factors might explain the occurrence. Upon reviewing the area's demographic information, scientists determined that the data was comparable to other areas of the state, which ruled out normal demographic fluctuations as a possible cause for the abnormal rates.

Cape Cod's environment, however, is very unique to the area. The same sandy beaches that comprise the area's primary tourist attraction are also part of a fragile ecosystem. Since the area relies on a single groundwater aquifer as its sole water supply, the porous, sand-like soil directly above the aquifer makes it especially vulnerable to hazardous contamination from wastewater flow and synthetic chemicals such as pesticides. Furthermore, strict environmental regulations are imposed to protect the marine life of the area; enforcing the policy that wastewater must be discharged on land, where it is highly possible that it could leak into the aquifer. These facts, coupled with the scientific knowledge that synthetic chemicals have been known to contribute to the development of cancer, arouse suspicions about the link between the environment and the high cancer rate. The possible link between groundwater pollution and cancer spurred development of The Cape Cod Breast Cancer and Environment Study, an official large-scale project with research still in-progress. Through this study, scientists hope to pinpoint specific cancer-causing elements of the environment of Cape Cod, in order to reduce the rates of contracted breast cancer among the women and men of the area (Brody et. al 1996).

The second inexplicable emergence of cancer occurred in Sugar Creek, Missouri in a community adjoining BP Amoco Chemicals' large refinery. The elevated level of cancer incidence was brought to the state's attention when a Missouri Department of Health report found 20 cases of brain cancer, 5 fatal, in an area where demographic analysis would have predicted far fewer cases. University of Alabama (Birmingham) and Johns Hopkins University (Baltimore, MD) personnel were hired to investigate the unusual situation. The results they found were mind-boggling. The brain cancer rates among white men who worked in the 500 Building at the BP Amoco plant were eight times higher than that of the general population. They also discovered seven cases of a rare and deadly brain cancer, glioma, among employees of building 500. Though no legal blame has yet been placed, most employees blame the poor ventilation system and the metal catalysts with which they worked on a daily basis. Many employees are suing for damages, claiming that Amoco turned off the ventilation system for periods during evening hours to cut costs (Orshal 1999).

As the battle against cancer-causing circumstances rages within the plant, the community is seeking explanations for its misfortunes as well. Many community citizens suspect groundwater contamination by the refinery as a possible source of the cancer epidemic. BP Amoco began cleaning up the site in 1990, a process that required a full removal of benzene-contaminated groundwater 20-30 feet below the site and in adjacent neighborhoods. Even so, Amoco claims that the groundwater has never posed a health risk, as hazardous agents have never been detected in drinking water. Scientists and state officials will be conducting a more detailed study of the cancers over the next few years (Orshal 1999).

The final argument in support of the linkage between environmental hazards and cancer concerns specific evidence that cancer incidence varies according to geographical location. This point is possibly one of the simplest, yet most convincing, arguments against the standpoint that most cancers originate through genetic predisposition. The core point is illustrated through studies of people who move from one geographic area to another. One of the most vivid examples is a study of women with regard to the development of breast cancer. When women move from Asia, a continent with low breast cancer rates, to the United States, a country with much higher breast cancer rates, their breast cancer rates increase successively over generations until they equal or approximate the rates for white women in the United States (Brody et. al 1996). Another study conducted on women moving to Australia and Canada found that breast cancer mortality rates for women from lower and higher risk countries shifted toward rates in their new homes (Brody et. al 1996).

Even though there is research which supports the argument that cancer's origin is rooted in behavioral and environmental factors acting in conjunction with genetics, the evidence is still of little use if its significance is not made clear. Not only can we conclude that cancer may be largely caused by environmental factors instead of strictly genetic ones, the evidence suggests that cancer itself could possibly be preventable. Some questions that science should strive to answer in the years to come are: What do we know about risks to specific populations? Is this deadly disease preventable? How can our knowledge of environmental effects upon the growth of cancer be applied to cancer prevention? If the knowledge of the link between cancer and environmental factors is put to use, the exposure to identified cancer-causing agents could possibly be reduced, if not eventually eliminated. Though research about the links between cancer and environmental factors can be taken as an optimistic message, it must further challenge science to rapidly translate research into public health interventions. It is time for society to get to the true root of this fatal epidemic.