Did talcum powder cause the cancer that killed Maureen?

06/02/2023 Health News

Did talcum powder cause the cancer that killed Maureen? Her widower is one of more than 200 people planning a group action against the manufacturers. They allege that talc – contaminated with asbestos – triggered tumours. Here, we examine the evidence

When Maureen Wright was diagnosed with ovarian cancer, both she and her husband Jeffrey were left reeling in disbelief.

Maureen simply did not fit the profile of someone at risk of the disease.

There was no family history — and as for other risk factors, such as being over 50 and not having carried a full-term pregnancy, Maureen was just 35 and a mother of three.

She was also slim and extremely fit. In fact, the first indication anything was wrong came when she felt a lump in the left side of her stomach during a fitness class.

But Maureen died from the disease five years later, leaving Jeffrey and their sons, then aged 17, 12 and five, shocked and bereaved. Today, more than 30 years after her death in 1991, the family remain devastated by her untimely death.

When Maureen Wright was diagnosed with ovarian cancer , both she and her husband Jeffrey were left reeling in disbelief

Now her family believe this could have been avoided, had she not habitually used talcum powder

This is compounded by their belief that it could have been avoided, had she not habitually used talcum powder.

Now Jeffrey is one of more than 200 claimants involved in a group action against manufacturers of mineral-based talcum powder, such as Johnson & Johnson, in what will be the first such case in an English court — alleging that regular use of talc materially increased the risk of developing cancer.

In legal documents seen exclusively by Good Health, the claimants allege that talc caused cancers — variously, of the ovaries, fallopian tubes, primary peritoneal cancer (of tissue that lines the abdominal wall) and mesothelioma (cancer of the lung lining — allegedly caused by inhaling talc).

The claimants include a woman who used talcum powder for 40 years, who was diagnosed with ovarian cancer in 2002, which returned in 2007. Although in remission, she still feels the effects of the many surgeries and chemotherapy, says barrister Tom Longstaff, a partner at Lanier, Longstaff, Hedar & Roberts LLP, the law firm leading the case.

A second claimant, diagnosed with ovarian cancer in 2022, had used talc for more than 20 years, both on herself and on her children.

Some claims, such as the one for Maureen Wright, are being made posthumously, by loved ones. Jeffrey says he is doing it ‘for my sons’ — Robert, now 49, Richard, 44, and Michael, 38.

‘They were deprived of their mother and it had a huge impact,’ he says. ‘They all left school without any meaningful qualifications because they couldn’t settle down to study, sometimes walking out of class in the middle of the day because they were angry about the loss.’

Jeffrey, who lives in Essex and is now a grandfather, recalls Maureen liberally using talc. ‘For as long as I can remember there was always talc in our bathroom — Maureen would use it all over her body after showering,’ says Jeffrey, 76, who ran his own retail business before he retired.

‘If I kissed her just afterwards, I would say to her that I could smell the talc on her lips,’ he says.

‘We had no idea why she developed ovarian cancer, it just seemed one of those tragically unlucky things. Then about five years ago, I began reading emerging stories about a link to cancer and I couldn’t believe it.

‘So when I heard about the potential to bring talc companies to justice in the UK, I contacted the legal firm involved.’

The group action is based on the claim that the natural mines which produced the main ingredient of talc — hydrated magnesium silicate — were contaminated with asbestos, a known carcinogen.

‘Talc is sourced from various mines around the world which have been linked with asbestos contamination,’ says Tom Longstaff. ‘Mineral talcum powder sold in the UK for decades has contained asbestos, which when ingested can cause cancer.’

He says a growing body of research supports the basis of the joint action — including a study by researchers from the U.S., who examined data from 166 people with mesothelioma. The cancer is usually linked to asbestos exposure but in 122 cases ‘the only known exposure to asbestos was from cosmetic talc’, it was reported last month in the Journal of Occupational Medicine and Toxicology.

The UK action has yet to be formally lodged with a court, and Johnson & Johnson is adamant that its products are safe.

However, in the U.S. there have already been actions successfully brought against talc makers.

In 2018, in the largest payout to date, Johnson & Johnson was ordered to pay $4.69 billion (£3.88 billion) to 22 women and their families who had claimed that asbestos in the company’s talc-based products caused the women — six of whom died before completion of the case — to develop ovarian cancer.

READ MORE: REVEALED: Doctors are now advising women who are ‘done having kids’ to get their fallopian tubes REMOVED to reduce their risk of ovarian cancer

A potential link between cancer and talcum powder was first raised in studies dating back more than 50 years. In 1971, scientists at the Tenovus Institute for Cancer Research, in Cardiff, wrote of finding talc particles embedded in ovarian and cervical tumour tissue.

Then in 1982, a study in the journal Cancer found that women who reported using talc around the genital area were three times more likely to develop ovarian cancer.

Daniel Cramer, a professor of obstetrics, gynaecology and reproductive biology at Brigham and Women’s Hospital in the U.S., who led the study, is in no doubt there is a cancer risk.

‘The evidence that long-term use of talc in the genital area may cause ovarian cancer is far stronger than appreciated by the general scientific community,’ he told Good Health.

‘This includes indisputable evidence that talc present in the vagina can migrate to the upper genital tract, that talc induces inflammation, and that inflammation can lead to cancer by causing DNA damage. I have consistently advised women not to use talc in the genital area.’

Talcum powder is made from talc — or hydrated magnesium silicate — a naturally occurring clay mineral mined from rock.

Finely ground, it produces a silky, fragrant powder which can absorb moisture and reduce friction or chafing — which is why it has been a staple of products such as baby powder and was traditionally used to tackle nappy rash.

Talc has been used for centuries. It was first commercialised in the 1890s and is today used not only in baby products but in cosmetics and industry.

Experts believe it isn’t talc itself that causes the problems, but the asbestos it may be contaminated with. Asbestos is formed of tiny fibres which, when they are inhaled or enter the reproductive tract, can cause irritation that triggers inflammation and may bring about genetic changes and cancer.

‘When there is inflammation, this causes some cells to multiply that might not normally multiply,’ says Professor Gordon Jayson, a consultant medical oncologist at the Christie Hospital in Manchester.

‘And when this happens,’ he explains, ‘there is a chance that one cell gets a genetic mutation and an error is generated. If the cell doesn’t die and continues to multiply, this can lead to cancer.’

In the U.S., Johnson & Johnson currently faces 37,515 cases from cancer patients or their representatives claiming the diseases were caused by talcum powder.

One of the plaintiffs is Thomas McHattie, 78, an obstetrician-gynaecologist who was diagnosed with mesothelioma in March 2020.

He says he recommended the company’s Baby Powder to ‘countless pregnant women’ and used it himself. Thomas has been through five courses of chemotherapy to treat tumours in his abdomen and has suffered from pronounced fatigue and shortness of breath.

However, the evidence linking talc to cancer isn’t straightforward. Some studies have suggested talcum powder applied directly to a woman’s genital area or on sanitary towels, diaphragms or condoms could cause cancer of the ovaries.

In 2003, a review by the Johns Hopkins school of Medicine in the U.S., which looked at 16 studies involving 12,000 women, found that using talc increased the risk of ovarian cancer by around a third.

And in 2013 a review of U.S. studies, published in the journal Cancer Prevention Research, involving 18,000 women, had similar results, concluding that its use in the genital area was associated with a 20 to 30 per cent increase in the risk of developing epithelial ovarian cancer — cancer of the lining that covers the outside of an ovary.

Yet in 2020, researchers at the U.S. National Institute of Environmental Health Sciences pooled data from 252,745 women and found no evidence that talc was dangerous when used as a feminine hygiene product.

For Professor Jayson, this is not surprising: ‘If a woman was using talc as a feminine hygiene product, the more likely area of irritation, and therefore cancer, would be the vagina, as the ovaries are a long way up the reproductive tract. So anatomically, it doesn’t make sense,’ he says.

A problem with studying the potential risk is that ovarian cancer is not common. Around 7,400 women are diagnosed with this cancer in the UK each year — compared with around 45,000 cases of breast cancer, so even the largest studies might not have been big enough to detect a very small increase in risk.

Dr Anita Raja, a GP based in Birmingham who specialises in women’s health, says researchers have tried to address this by combining the results of different studies (known as a meta-analysis), but even this type of research has had mixed results.

‘For example, in an analysis combining the results of the major cohort studies [which follow the progress of participants over many years] there was no overall increased risk of ovarian cancer, while in an analysis of both case-control studies [which compare two groups] and cohort studies, frequent talcum powder use [at least twice a week] was linked with an increased risk.’

Paul Pharoah, who until recently was a professor of cancer epidemiology at Cambridge University, who has also been a paid adviser to one of the law firms representing Johnson & Johnson during the 2018 trial that led to the record-breaking damages being awarded, told Good Health: ‘There is clear evidence of an increased risk of epithelial ovarian cancer — cancer of the lining that covers the outside of an ovary — in women who used talc in the genital region.

‘But that practice was much more common in the 1960s and 1970s than it is today. Even so, there is little good evidence that this association is causal [that is, a contributory factor].

‘My mother died from ovarian cancer in 2020,’ he adds. ‘I don’t think her previous use of talc was a material factor.’

Professor Pharoah told the U.S. court that even if the association between talc and cancer were true, the strength of the association ‘is too small to be able to say on the balance of probabilities that any cancer arising in a woman who used talc had been caused by the talc’.

The court rejected this evidence and made the multi-billion-dollar award in favour of the women.

The International Agency for Research on Cancer (IARC) — part of the World Health Organisation — classifies talc that contains asbestos as being ‘carcinogenic to humans’.

A spokesperson for Johnson & Johnson told Good Health: ‘We stand behind the safety of our products, which do not contain asbestos, do not cause cancer and are safe for consumers to use.’

However, in 2018 an investigation by Reuters uncovered company documents suggesting that from as early as 1971 to the early 2000s, Johnson & Johnson talc products had on occasion tested positive for asbestos traces.

In a separate development, Johnson & Johnson had tried to have a subsidiary company that shoulders litigation declared bankrupt — but last week it was reported that this was rejected by a U.S. appeals court.

Behind the claims and counter- claims are people like Jeffrey Wright and his children.

When Maureen first saw her GP in 1983 about the lump at the side of her stomach, she was told she was merely constipated.

But the lump and constipation remained and two years later, three months after Maureen had given birth to their third son in December 1985, Jeffrey insisted his wife see a private doctor.

She underwent scans which revealed the lump was a mass of fatty tissue that Maureen opted to have surgically removed.

Not only did removing the mass lead to a major artery being severed, requiring an extensive blood transfusion, but surgeons found the mass was actually a fist-sized cancer.

After undergoing chemotherapy, Maureen was determined to return to normal — but two years later, searing backache turned out to be cancer in her spine — which had also spread to her liver and a kidney.

‘I had to close my business to look after my wife and our three young children,’ says Jeffrey. ‘It was a really awful time for all the family, and of course Maureen, who was suffering so much.’

She died at home in July 1991, leaving Jeffrey with the children, himself bereft and unable to work. His eldest son, then 17, left school to get a job and help with the family finances.

‘Maureen was so full of life,’

says Jeffrey. ‘I used to joke that when she married me, I was punching above my weight. She was also a fighter. It’s still so hard to believe what happened to her. But it should act as a warning for others.’

The question is: is it safe for women to use talc on their bodies? Dr Raja says: ‘For any individual woman, if there is an increased risk of cancer it’s likely to be very small. Still, talc is widely used in many products [such as some eyeshadows] so it’s important to determine if the increased risk is real.’

But Leila Hanna, a consultant gynaecologist and obstetrician at Queen Mary’s Hospital in London, believes it might be better to err on the side of caution. ‘It is not necessary to use it around the genital area,’ she says. ‘If you want to freshen up, use dedicated products or water.’

Dr Sharon Tate, head of primary care development at Target Ovarian Cancer, said the charity suggests women avoid certain talc use: ‘Studies have not shown conclusive evidence that talcum powder links to ovarian cancer. However, some have suggested there could be a link.

‘Although the increased risk may be small or non-existent, we know the devastating impact ovarian cancer can have, so it continues to advise generally not using talc between the legs.’

Johnson & Johnson announced last year that it will stop selling talc-based Baby Powder globally this year, switching to a formulation based on cornstarch.

The decision was purely financial, it said in a statement at the time: ‘As part of a worldwide portfolio assessment, we have made this commercial decision to transition to an all-cornstarch-based baby powder portfolio.

‘This will help simplify our product offerings, deliver sustainable innovation and meet the needs of our consumers, customers and evolving global trends.

‘Our position on the safety of our cosmetic talc remains unchanged. We stand firmly behind the decades of independent scientific analysis by medical experts around the world that confirms talc-based Baby Powder is safe, does not contain asbestos, and does not cause cancer.’

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Under the microscope

Chef and TV presenter Prue Leith, 82, answers our health quiz

Can you run up the stairs?

Of course not! I can barely walk up the stairs these days. Every once in a while I test myself to see if I can still run at all! I’m particularly unfit at the moment because I got out of the habit of exercise last year.

Get your five a day?

Oh, easily. We have a fantastic farm shop near us. John [Playfair, Prue’s husband] and I buy far too much there. We eat a lot of veg and vegetarian meals.

Ever dieted?

All the time. I wish I could say it was just a question of maintaining my weight, but I’m 3st heavier than I was when I opened my restaurant when I was 29. I should probably lose at least a stone but I find dieting difficult.

Chef and TV presenter Prue Leith, 82, pictured, answers our health quiz

Any vices?

I have a slight addiction to Bounty bars. My husband occasionally sticks one in my handbag just to test my willpower. Of course, I always eat it.

Pop any pills?

I Challenge you to find an 82-year-old who doesn’t. I take levothyroxine for an underactive thyroid, a statin to lower my cholesterol and a beta-blocker to stop my heart beating erratically [atrial fibrillation].

Worst injury?

About 25 years ago I was in a car crash in New York when the taxi I was in went through a red light and was hit by a lorry. I broke five ribs and it was serious because one of them was very close to my lungs. I was in hospital for a week.

Cope well with pain?

Not well. I take lots of painkillers if I need them.

Tried alternative remedies?

Yes, arnica for bruises. It didn’t help.

Ever been depressed?

I’ve been sad. And I think that’s reasonable. If you lose your husband like I did in 2002 [her first husband died of emphysema], you should be sad. I wouldn’t call it a depression.

Hangover cure?

Hair of the dog. And a piece of toast and a couple of paracetamol.

Ever have cosmetic surgery?

When I was about 45, I had really baggy eyes and I got them done. I wouldn’t have it now because I think, at my age, when you start stretching your skin you look like an alien.

What keeps you awake?

Caffeine. A friend once talked me into having an affogato [a coffee-based dessert]. I lay there that night wondering why I couldn’t sleep, then remembered it has two shots of espresso in it! Also, I can’t sleep if I’ve quarrelled with anybody.

Like to live for ever?

Absolutely not, because all your friends will be dead. I’m rather keen I should be allowed to ask for medical assistance to help me die when I’ve had enough of life. The law needs to change on that.

For tickets to Prue Leith’s 34-date tour, Nothing In Moderation, go to mickperrin.com.

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