HJNO Jul/Aug 2021

INSIDE LOUISIANA’S WAR ON CANCER 22 JUL / AUG 2021 I  HEALTHCARE JOURNAL OF NEW ORLEANS Editor Do you believe chemicals that flow through our land via the Mississippi from farming practices and other sources upstream are affecting the health and cancer rates of our citizens? Fontenot I would say that there are known associations between certain chemicals and carcinogenesis, which is the development of malignant cancer in the human body. There are known relationships between certain chemicals or environmental agents and the development of cancer. Many of those links are already known in the scientific litera- ture and in the commercial and industrial space, and I know that a lot of steps have been taken to try to mitigate risks associ- ated with those chemicals when it comes to cancer development in humans. I think both of those things are true. The extent to yes, but because of the challenges associ- ated with the different risk factors that are involved, and then also controlling for our underlying human genetics, it’s really dif- ficult to tease out exactly what the effect is. Because of all the different risk factors and because of our baseline risk of developing cancer, just from our genetics, it turns out that you need a huge amount of data in a very long period of collecting it in order to start to understand if there are specific material attributions to say, “petrochemical.” So, to answer your question, I think eventu- ally, yes, we’ll know the answer to that. But we’re going to need to collect a lot of data for a very long time in order to understand it better, just because of the diversity that’s associated with the development of cancer in the human body. which that is a specific contributor to the comparatively high incidents of cancer in Louisiana, I think is impossible to say right now for the reasons that I mentioned in the previous question. Editor Do you think that we’re working on figuring that out? Do we have the resources in place right now as a community to make that happen? Fontenot I think we certainly have the data to be able to understand the breadth and depth and scope of cancer incidents in Loui- siana. What I’m less clear on — and this is just starting to get into an area that’s a little bit out of my specific domain expertise and is now getting into areas like epidemiol- ogy — is if we have the underlying informa- tion related to chemical concentrations and their distributions throughout, say, water supplies throughout Louisiana, just as an example. Some of those risk factors and detailed information that you need to have access to to be able to put together the type of understanding or model that I was talk- ing about earlier, I’m not sure if those exist just because of my specific focus. Fontenot These are questions that I chat with my own family and friends about. These things come up all the time when you talk about cancer in Louisiana. Editor It is interesting, and they’re using the term worldwide now — the U.N. is now declaring it Cancer Alley. Fontenot My feedback on that declaration should be not only related to making sure that we understand that petrochemical- related risks are appropriately managed, but all of the other things that factor into can- cer development that I mentioned — obesity, smoking incidents, alcohol consumption, our reliance on high-fat diets that has a rela- tionship with colorectal cancer — all of those things are factors that contribute to creating