Molecular Basis Supporting the Association of Talcum Powder Use with Increased Risk of Ovarian Cancer
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LETTER TO THE EDITOR
Molecular Basis Supporting the Association of Talcum Powder Use with Increased Risk of Ovarian Cancer Nicole M. Fletcher 1 & Amy K. Harper 1 & Ira Memaj 1 & Rong Fan 1 & Robert T. Morris 2 & Ghassan M. Saed 1,2,3 Published online: 19 August 2020 # Society for Reproductive Investigation 2020
I have reviewed the Letter to the Editor of Dr. Brooke Mossman. Although Dr. Mossman states that “she received no financial support for the authorship of this letter”, the opinions expressed by Dr. Mossman reflect those that she offered as a paid consultant for Johnson & Johnson in the ongoing talcum powder litigation. Of note, Dr. Mossman has testified on behalf of asbestos defendants in numerous lawsuits over several decades. Firstly, Dr. Mossman appears to be conflating the results of my in vitro experiments with “causation.” As stated in my article, my findings “confirm the cellular effect of talc and provide a molecular mechanism to previous reports linking genital use to increased ovarian cancer risk” and describe the “prooxidant states caused by talc” [1]. Despite Dr. Mossman’s attempt to assert otherwise, oxidative stress and inflammation do, in fact, play an essential role in the pathogenesis of epithelial ovarian cancer [2]. This association is considered a “hallmark” of cancer development [3] and is well-described in ovarian cancer [2, 4–7]. Dr. Mossman states that the Reuter (2010) article [8] cited in my paper “does not discuss ovarian cancer”. She is mistaken. Reuter specifically lists ovarian cancer as a cancer that has “been linked to reactive oxygen species” and describes signaling pathways leading to the production of pro-inflammatory cytokines in ovarian cancer cell lines. Clinically, the genital use of talcum powder products is recognized as an inflammatory risk factor for ovarian cancer [7, 9, 10]. Dr. Mossman further claims “the feasibility of the experiments described is also questionable” due to the * Ghassan M. Saed [email protected] 1
Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
2
Department of Gynecologic Oncology, Karmanos Cancer Institute, Detroit, MI, USA
3
Departments of Obstetrics and Gynecology and Oncology, Wayne State University School of Medicine, Detroit, MI 48201, USA
“limited passaging and doubling capacity of the normal ovarian cell lines”. Indeed, normal ovarian epithelial cells do grow slowly. However, we purchased and plated multiple vials of the same cell line at the same time to overcome this issue. The assays were meticulously performed according to accepted standards. DMSO, used in these experiments to partially dissolve the talcum powder, is a universal solvent frequently utilized in in vitro experiments of this type. Talc has been reported to dissolve in DMSO at 0.1 mg/mL (https://www.selleckchem.com/ datasheet/Talc-S190001-DataSheet.html). The concentrations of DMSO were controlled over all talcum powder dosages. If the biologic effects in these experiments were due to DMSO, there would not have
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