Cell Phones and Brain Cancers

8/14/2019 Cell Phones and Brain Cancers

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"We have had zero reaction from the industry about the paper," Lloyd Morgan, a retiredelectronics engineer, an active member of several international science organizations, andthe report's lead author, told Medscape Oncology. "What they're doing is a nonresponseresponse; they haven't challenged anything in it."

This report has intensified a controversy that has been brewing for nearly 2 decades andstill remains largely unresolved. Approximately 30 epidemiologic studies have attemptedto evaluate a possible association between cell phone use and the risk for brain andsalivary gland tumors. There have also been a number of experimental studies involvingcell cultures and animal models.

Results, however, have been inconclusive or even contradictory. But studies independentof industry funding have more consistently found higher risks for brain tumors whenexposure was 10 or more years, explained Mr. Morgan, adding that "even some industry-funded studies show that there is a connection between cell phone use and the risk ofbrain tumors."

Interphone Results Flawed

The issue of cell phone safety was to have been settled once and for all by the huge 13-nation industry-funded Interphone study, which was begun nearly 10 years ago. Eventhough data collection was completed in 2004, the results have still not been published.The European Parliament has called the delay "deplorable," and has demanded anexplanation for it. Although the combined results have not yet been released, 14Interphone studies (11 single country and 3 multicountry studies) with partial results havebeen published.

"Results of Interphone have been delayed by about 4 years," said Elizabeth Barris,founder of the nonprofit People's Initiative Foundation and coauthor of the new report, inan interview. "It was supposed to be released this September. We wanted to make surethat our report was released before Interphone. We wanted to bring attention to the issue,including the fact that Interphone has been delayed for so long."

With only 4 exceptions, the industry-funded Interphone studies found no increased riskfor brain tumors from cell phone use, explained Mr. Morgan. In contrast, a series ofSwedish studies, led by Lennart Hardell, MD, PhD, from the Department of Oncology,Orebro Medical Center, in Sweden, which were independent of industry funding,reported numerous findings of significantly increased brain tumor risk from cell phone

and cordless phone use.

As you review these studies, you begin to get strong evidence of extremely

improbable results.

An analysis of the results from the Interphone studies suggests that the use of a cell phoneactually protects the user from a brain tumor, or that the studies had serious design flaws."In any one study, you can see this incredibly skewing toward protection," said Mr.


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Morgan. "As you review these studies, you begin to get strong evidence of extremelyimprobable results."

In fact, Mr. Morgan and his coauthors identified 11 flaws in the Interphone studies:selection bias, insufficient latency time, definition of "regular" cell phone use, exclusion

of young adults and children, no investigation of brain tumor risk from cell phonesradiating higher power levels in rural areas, exclusion of exposure to other transmittingsources, exclusion of some brain tumor types, exclusion of tumors outside the cell phoneradiation plume, exclusion of brain tumor cases because of death or illness, recallaccuracy of cell phone use, and funding bias.

"Almost all flaws caused an underestimation of risk," he said, "and for exposure under 10years, they found protection for cell phones."

The Cellular Telecommunications Industry Association (CTIA), the wireless association'sindustry trade group, has not specifically responded to the new report, according to Mr.

Morgan. However, John Walls, vice president of public affairs at CTIA, told MedscapeOncology that "since we are not a scientific organization, with respect to the matter ofhealth effects associated with wireless base stations and the use of wireless devices,CTIA and the wireless industry have always been guided by science and the views ofimpartial health organizations."

Peer-reviewed scientific evidence has overwhelmingly indicated that wireless devices donot pose a public health risk, Mr. Walls said. "In addition, there is no known mechanismfor microwave energy within the limits established by the [Federal CommunicationsCommission] to cause any adverse health effects," he said. "That is why the leadingglobal heath organizations, such as the American Cancer Society, the National Cancer

Institute, the World Health Organization, and the US Food and Drug Administration, allhave concurred that wireless devices are not a public health risk."

Initial Red Flags

In the United States, the possible connection between tumors and cell phone use becamehighly publicized in 1993, when Florida resident David Reynard appeared on the populartelevision show Larry King Live and blamed cell phones for causing his wife's lethalbrain tumor. Mr. Reynard filed a lawsuit against the manufacturer; he ultimately lost thecase, but dozens of other lawsuits followed in its wake, along with numerous scientificstudies that attempted to find or disprove a link. Most of the lawsuits have been

dismissed, and thus far, none have gone to trial.

But the subject was picked up by the media, and scientists and experts argued publicly onopposing sides of the issue. Reports in the popular media prompted Congressionalhearings on the safety of cell phone use, and during those sessions, it became clear thatcell phones had not been tested for "safety prior to going into commerce," said GeorgeCarlo, PhD, MS, JD, during a 2008 radio interview with CFRO, a co-op radio station


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based in Vancouver, British Columbia. "Because the food and drug industry had notrequired that testing, Congress asked the industry to fill in those data gaps."

The industry invested $28.5 million and launched the first telecommunications industry-backed studies to investigate possible health risks stemming from cell phone use. Dr.

Carlo, who is a Fellow of the American College of Epidemiology and has served on thefaculty of several medical schools, headed the Wireless Technology Research program,which ran from 1993 to 1999. It was the largest program in the world to look at thepotential dangers of cell phone use and electromagnetic radiation.

"In the middle of 1998, we began to have some of our long-term studies completed and itbecame clear that we were seeing things that no one expected," said Dr. Carlo. "Wefound that cell phone radiation caused leakage in the bloodbrain barrier, it causedgenetic damage in the form of disruption of normal DNA repair, and it caused more thana doubling of the risk of rare neuroepithelial tumors."

"After 6 years," he continued, "we found that cell radiation caused an increased risk ofacoustic neuromas."

During the time these Wireless Technology Research studies were being carried out, theuse of cell phones mushroomed. In 1993, there were 15 million cell phone users in NorthAmerica; by 1999, there were more than 100 million.

"We went back to the industry and suggested that they issue warnings, but they promptlysaid no," Dr. Carlo said in the interview. "Those of us running the research program knewwe had an ethical responsibility to go public with those findings, and we did go public,independent of the industry and independent of the government agencies that were

overseeing the work."

In 2001, Dr. Carlo coauthored a book entitled Cell Phones. Invisible Hazards in theWireless Age: An Insider's Alarming Discoveries, which discussed the findings.

I don't think they ever really expected to find that cell phones were dangerous.

Dr. Carlo felt that part of the reason for the refusal to issue warnings was that thetelecommunications industry was not prepared for the results of the research. "I don'tthink they ever really expected to find that cell phones were dangerous, and when wepresented our findings, they were ill prepared for them. They also didn't want to

compromise their industry."

As for the lack of action on the part of government regulatory agencies, Dr. Carlo pointedout that agencies in the United States and Canada did not require any premarket testing ofcell phones. "The only legal jurisdiction step that they had available in 1999 was to bancell phones. And from a political point of view, banning cell phones would not be an easything to do, especially since our findings were the first ones of their type," he said.


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These were "red flags of risk"; there weren't enough data at the time to actually prove thatthe risk was real, Dr. Carlo emphasized. "That is not the case now; there has beenconfirmatory evidence. But in 1999, regulatory agencies did not have the scientificevidence to be able to sustain the types of legal challenges that would have come fromthe industry had they tried to ban cell phones."

Trail of Research

Much of the more recent research on the safety of cell phones has not specifically found ahealth risk; however, researchers have pointed out the limitations of their studies and leftthe door open. Part of the problem in assessing the potential connection between braintumors and cell phone use is the relatively short period of time that the devices have beenheavily in use in a large population and the long latency period for many tumors.

A National Cancer Institute study published in 2001, for example, did not support thehypothesis that the use of cell phones caused brain tumors, but the researchers noted that

a limitation of their work was that they did not assess risks after a potential inductionperiod of more than several years or among people with very high levels of daily orcumulative use (N Engl J Med. 2001;344:79-86).

A 2009 review from researchers at the Karolinska Institutet in Stockholm, Sweden,reported that studies published to date do not demonstrate an increased risk afterapproximately 10 years of use for any brain tumor or other head tumor (Epidemiology.2009;20:639-652). Thus far, data do not suggest a causal association between cell phoneuse and fast-growing tumors, but they note that for slow-growing tumors, such asmeningioma and acoustic neuroma, "the absence of association reported thus far is lessconclusive because the observation period has been too short."

Another recent review, the third in a series of updates to an original report issued by theRoyal Society of Canada, concluded that although there is no clear evidence of adversehealth effects associated with radiofrequency fields during the period from 2004 to 2007,continued research is recommended to address specific areas of concern, including theuse of cell phones by children (J Toxicol Environ Health B Crit Rev. 2009;12:250-288).

The Interphone studies to date have largely reported negative results, finding noassociation between tumors and cell phone use. One study did not find a link between anincreased risk for malignant or benign parotid gland tumors and exposure toradiofrequency electromagnetic fields, but the authors concluded that cell phones "have

not been used long enough to exclude their possible carcinogenic effect after long-termuse, and more epidemiologic studies including long-term users are clearly warranted"(Am J Epidemiol. 2006;164:637-643).

However, the results of an Israeli Interphone study suggest a positive association betweencell phone use and the development of parotid gland tumors ( Am J Epidemiol.2008;167:457-467). The authors noted that this was a single study, and therefore did notprovide enough evidence to assume causality. They recommend additional investigations


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of this association, with longer latency periods and large numbers of heavy users, toconfirm the findings. "Until more evidence becomes available, we believe that theprecautionary approach currently adopted by most scientific committees and applied bymany governments should continue to be used," they wrote.

Some of the strongest evidence supporting a link between brain tumors and cell phoneuse comes from a series of Swedish studies, led by Dr. Hardell. Overall, the reserachersfound that risk increased with the number of cumulative hours of use, higher radiatedpower, and length of cell phone use. They also reported that younger users had a higherrisk. In fact, the highest risk was among people who were younger than 20 years at thetime of first use ( Int J Oncol. 2006;28:509-518; Int Arch Occup Environ Health.2006;79:630-639; Arch Environ Health. 2004;59:132-137; Pathophysiology.2009;16:113-122).

A meta-analysis that incorporated 11 long-term epidemiologic studies in this field alsoreported a link between cell phone use and brain tumors. Using a cell phone for 10 years

or longer was positively associated with the development of an ipsilateral brain tumor; infact, it doubled the risk (Surg Neurol.2009;72:205-214).

Melange of Reactions

As in the literature, there is no consensus among physicians and scientists about theseverity of risk, or even if it exists. On its Web site, the National Cancer Institute notesthat although a consistent link has not been demonstrated between cell phone use andcancer, "scientists feel that additional research is needed before firm conclusions can bedrawn." Likewise, the American Cancer Society points out that although the weight ofthe evidence has shown no association between cell phone use and brain cancer,

information on the potential health effects of very long-term use, or use in children, is notavailable.

Sam Milham, Jr. MD, MPH, former chronic disease epidemiologist at the WashingtonState Department of Health and clinical associate professor at the University ofWashington School of Public Health in Seattle, has published several critiques on cellphones and health risks. "I personally think there is a real risk, and have felt this wayeven before the studies were published, based on animal work," he told MedscapeOncology.

Dr. Milham contends that all of the negative studies have been seriously flawed. "The

fact that same-sided tumors with long latency are showing increased risks is bad news,since brain tumors have very long latencies," he said. "The same-sided risks are veryimportant since dose is important. The most worrisome fact is the number of people whoare being exposed."

Putting a cell phone against your head is like putting one side of your head against a

microwave oven.
http://www.cancer.gov/cancertopics/factsheet/Risk/cellphones#r21http://www.cancer.gov/cancertopics/factsheet/Risk/cellphones#r21http://www.cancer.org/docroot/PED/content/PED_1_3X_Cellular_Phones.asphttp://www.cancer.gov/cancertopics/factsheet/Risk/cellphones#r21http://www.cancer.org/docroot/PED/content/PED_1_3X_Cellular_Phones.asp


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"Putting a cell phone against your head is like putting one side of your head against amicrowave oven," he added.

Last year, Ronald B. Herberman, MD, director of the University of Pittsburgh CancerInstitute and UPMC Cancer Centers in Pennsylvania, sent a memo to faculty and staff

advising them to limit cell phone use based on his interpretation of recent research. In2008, he testified before a Congressional Subcommittee on the subject of tumors and cellphones, and urged more independent and definitive research.

However, many experts are not convinced that there is a link. Currently, there is noevidence that cell phones cause brain cancer, said John Moulder, PhD, professor anddirector of radiation biology at the Medical College of Wisconsin in Milwaukee.

"The published data have rather consistently shown the absence of evidence for a humanhealth hazard," he told Medscape Oncology. "Conclusive cancer epidemiology requireslong follow-up time and accurate exposure assessment. The exposure assessment in this

field has been very weak, as it depends on peoples' memories of how they were usingmobile phones 10 or more years ago."

He emphasized that the studies based on what side of the head people used their phonesare particularly weak, since most people use them on both sides, at least some of the time.

"Until we can find a way to measure actual exposure over long periods of time, theepidemiology will never be conclusive," he added.

Dr. Moulder pointed out a number of flaws in the new report. "The authors seem to havecombed the literature for reports that support their concerns, and have ignored everything

that would contradict their views," he said. "A scientific risk assessment needs to looks atall the evidence."

Although the report states that cell phone radiation has been shown to cause the bloodbrain barrier to leak, Dr. Moulder noted that only 1 group has found that effect. "Othergroups have been unable to replicate the effect."

Part of the problem with this research is that it is nearly impossible to prove thatsomething doesn't cause cancer. "The closest you can come is to repeatedly try to showthat it does and repeatedly fail," he said.

The Road Ahead

On the heels of the release of the new cell phone report, a Senate hearing on the healtheffects of cell phone use was held in September, and chaired by Sen. Tom Harkin (D-Iowa). The take-away message from expert testimony was that more and better researchis needed to determine if there is a risk to human health. And nearly all of the researchersand scientists who spoke at the hearing advocated a precautionary approach in themeantime.


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We just don't know what the answer is.

"We just don't know what the answer is," said Sen. Arlen Specter (D-Pennsylvania)during the hearing. "Precautions are not a bad idea. They may not be a good idea, butthey are not a bad idea. And the issue of children is something we should look at a little

more closely."

Several countries, including Israel, France, and Finland, and the United Kingdom havedecided not to wait for additional data; instead, they have issued warnings about the useof cell phones and advise taking precautionary measures, especially for children. Newlegislation in France, for example, will ban advertising of cell phones that is directed tochildren younger than 12 years of age and the sale of cell phones designed for childrenyounger than 6 years. In addition, France will introduce new limits for radiation from thephones and require cell phones to be sold with earphones.

Realistically, it is going to be difficult to change behaviors now that cell phones are so

entrenched in daily use, explained Mr. Morgan. "In some parts of the world, it is nearlyimpossible to get a land-line telephone, so cell phones are the only option."

Cell phones can be made safer, and the technology to do so exists right now. Forexample, said Mr. Morgan, "you can get a 10,000-fold reduction in exposure simply bykeeping the phone 6 inches away from the head."

There are also steps that can be taken right now to make cell phones safer to use, he said.These include using a wired headset (not a wireless headset such as a Bluetooth), usingspeaker-phone mode, or sending text messages; keeping the phone away from the bodywhen not in use; avoiding use in a moving car, train, or bus, or in rural areas at some

distance from a cell tower, because any of these uses will increase the power of the cellphone's radiation; and keeping the cell phone turned off until you need to use it.

The authors also recommend using a corded land-line phone whenever possible, insteadof a wireless phone, and to avoid cell phones when inside buildings, particularly withsteel structures. Since children face a greater health risk, they should not be allowed tosleep with a cell phone under their pillows or at the bedside, said Mr. Morgan. Ideally,those younger than 18 years should not use a cell phone at all, except for emergencies.

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Cell Phones and Brain Cancers