Feb 25 2016

The Johnson and Johnson Talc Cancer Case

A jury has recently found for the plaintiff against the company Johnson and Johnson over the claim that their talc powder may have caused ovarian cancer in an Alabama woman who died of the cancer at 62. They awarded her family $72 million.

This story has had a great deal of attention because it raises two questions: what is the scientific evidence for a link between talc use and ovarian cancer, and how should the courts rule in such cases when the science is ambiguous?

Talc and Cancer

Concerns about the cancer causing effect of regular talc use stem from a time when talc contained asbestos. Since the 1970s, however, talc has been asbestos-free. Asbestos is clearly linked to cancer, but for the asbestos-free talc the link is not as clear.

There have been a number of large epidemiological studies looking at the association of talc use and risk of ovarian cancer, with some mixed results, but overall not impressive.

First, there is no association between use of talc but not on the genitals and ovarian cancer. Some studies do show a small association between regular talc use on the genital area and some types of ovarian cancer, but this association is uncertain.

A 2003 meta-analysis involving 11,933 subjects found a 33% relative risk increase of ovarian cancer for regular genital talc use. However since the baseline risk of ovarian cancer is 0.0121%. per year, that results in an increase to 0.0161%, so the absolute risk increase, if real, is tiny (0.004%).

The authors, however, concluded that this increased risk is likely not real because their data did not show any dose response relationship. Exposure risks generally follow a dose-response curve. The more years you smoke, the greater your increased risk of lung cancer. But this relationship was not seen for genital talc use and ovarian cancer.

Further, when they looked at the hospital-based studies there was no effect. The effect was only seen in the population-based studies. Since these are observational studies that raises the possibility of confounding factors. For example, it is likely that women who do develop ovarian cancer may report increased talc use in the past. That is how these studies are generally done – they rely upon memory for past use, leading to a recall bias.

A large 2013 case-control study, looking at 8,525 cases and 9,859 controls, found a 24% relative risk increase in genital talc users. However, they also found no dose-response.

A somewhat smaller 2015 case-control study looking at “2041 cases with epithelial ovarian cancer and 2100 age-and-residence-matched controls” also found a 33% relative risk increase for genital talc use. They also found a “trend” for increasing risk with increased talc-years – “trend” means not statistically significant.

What all of this evidence means is that the likely upper limit of increased risk for ovarian cancer from regular genital talc use is an absolute risk increase of 0.004%. That translates to 4 extra cases of ovarian cancer for every one million genital talc users.

Even this small risk is questionable due to the lack of a consistent dose-response effect seen in the clinical trials.

Legal Implications

As a society what should our stance be toward corporate responsibility in the face of ambiguous scientific evidence? Clearly corporations should follow regulations. They should do due diligence in ensuring their products are safe and effective. They should have transparency and not hide possible risks of their products.

Nothing, however, is risk free. At what point are possible risks so low that they are below the radar, in the background noise of life? What is the responsibility of corporations to disclose possible but not proven tiny risks?

This is why product labels are often full of disclosures and warnings. There is a downside, however, to setting the bar incredibly low (warning about every possible risk, and every possible misuse of a product), it creates “alarm fatigue.” Such warnings become part of the background, and consumers learn to ignore them.

The other issue is this – who should be favored when the science is preliminary or ambiguous, the defendant or plaintiff? If a consumer may have been harmed, should the courts give them millions of dollars? Or should corporations be innocent until proven guilty? I don’t think there is any simple answer here.

I do think, however, that the courts are perhaps biased a bit too much toward the plaintiff. Dow chemical, for example, had to file bankruptcy after a massive settlement against them for their silicone breast implants causing autoimmune disease based upon dubious scientific evidence. Eventually the scientific evidence worked itself out and it was determined there was no risk, but the damage had been done.

In the early 20th century there were numerous court awards based on the theory that minor trauma could result years later in cancer. The trauma-cancer link was eventually disproved, but decades of court cases had already awarded damages based on this flawed theory.

The courts generally take the position that alleged victims should not be penalized because the science has not yet caught up and proven they are victims.

It also seems that juries are more sympathetic toward victims than large corporations, and perhaps that is reasonable, but does it result in the most just outcome? Perhaps juries are not the best option in determining such cases, which depend heavily on expert interpretation of scientific data.

Conclusion

Ideally court decisions would be based on a reasonable interpretation of the best scientific evidence. This then has to be applied in individual cases, balancing the need to compensate genuine victims, but also not unduly and unjustly burden businesses with liability that is ultimately not real.

There is no one simple answer to this dilemma – courts just have to make the best balance in each individual case.

In the case of the Johnson and Johnson award, they are likely to appeal and the size of the judgment is not likely to stand.

It is an interesting question – how much is a possible (but not proven) 0.004% increased risk of ovarian cancer worth?

44 responses so far

44 Responses to “The Johnson and Johnson Talc Cancer Case”

  1. carbonUniton 25 Feb 2016 at 9:00 am

    The other issue is this – who should be favored when the science is preliminary or ambiguous, the defendant or plaintiff?

    Perhaps time should be favored, allowing minimal or no settlement but also allowing the case to be revisited at a later date if the scientific evidence becomes more conclusive.

  2. Steven Novellaon 25 Feb 2016 at 9:08 am

    CU – I think that approach inherently favors the plaintiff. That is essentially dismissing the case without prejudice. If a victim is made to wait 20-30 years for compensation, that compensation loses tremendous value.

  3. locutusbrgon 25 Feb 2016 at 9:29 am

    I think the extrapolation of the jury system to civil lawsuits is in itself a mistake. I understand the methodology behind the idea for criminal cases which are often the state vs defendant situations. Civil suits are not criminal lawsuits. In my opinion civil cases with juries are extensively manipulated by the legal system. It is a huge cost in the US. I do work as an expert medical witness on occasion and I see the money involved in this system. The bigger the monetary stakes the more corrupt the system seems to become. Civil suits should be em-paneled based up on expertise. IE medical courts, corporate courts and/ or industrial courts Ect. Instead of random juries it should be similar to the supreme court requiring a group of experienced judges. That system would by no means be perfect. It would be much better than the current mess. It would also allow for quicker trials with less side show removing the time effort and manipulation for jury selection.

  4. carbonUniton 25 Feb 2016 at 10:07 am

    Steve – Assuming the victim/plaintiff really is suffering an injury as a result of the defendant’s product, the delay in a just settlement can be extraordinarily harmful. The victim may suffer serious, uncompensated medical expenses, perhaps go bankrupt. The victim may not be able to afford the best care, particularly if the condition the victim is experiencing is in medically unknown territory. The victim may not survive. I’m not sure if delay benefits the defendant, except in the case of accumulating medical evidence clearing them of wrongdoing.

  5. Steven Novellaon 25 Feb 2016 at 10:43 am

    Ack – I meant it favors the defendant. I agree with your assessment.

  6. dawso007on 25 Feb 2016 at 10:50 am

    The actual analysis of the suspected compound would seem like the most important aspect of the case. This FDA page of recent analyses is instructive showing the results of triplicated analyses of talc containing products:

    http://www.fda.gov/Cosmetics/ProductsIngredients/Ingredients/ucm293184.htm

    TEM analysis of the product would be exonerating but I always remind myself that the law is not science. In a forensics course I took during residency, we reviewed the case of a sea captain was successfully sued for paternity even though the ship logs showed him to be at sea at the time of conception. Despite that evidence the judge awarded damages to the plaintiff. I guess the lesson is that deep pockets are deep pockets.

  7. ccbowerson 25 Feb 2016 at 10:52 am

    “I do think, however, that the courts are perhaps biased a bit too much toward the plaintiff. ”

    How are you determining this? Relying on the most salient examples almost certainly results in bias. These are the situations in which the availability heuristic is most problematic. Other than the most egregious examples, we do not hear of the vast majority of these cases. The cases make the news for many reasons, but representativeness is not one of them.

    The McDonald’s ‘hot coffee’ case is an example where the narrative did not match reality. It resonated with people, but the things that people remember from that story are misleading at best or often simply incorrect.

    I’m not saying that you are wrong (about the thumb being on the scale for plaintiffs), I just have no clue if that is true, or how one would determine that. I can see many situations in which individuals are at a disadvantage, due to the cost of litigation, relative to large corporations. Only when the stakes are high, or when many people get involved does your assessment ring true. And these may not be the most important situations with which to assess the balance.

  8. daedalus2uon 25 Feb 2016 at 12:07 pm

    It was Dow Corning that filed for bankruptcy from silicone lawsuits, not Dow Chemical.

    Bendectin was also removed from the market because of legal issues, and later research found no evidence that it caused birth defects. This was the legal case that established the Daubert standard.

    The main problems with cases like this is that it assumes a linear-no-threshold dose response. That is if a dose X causes cancer in 1% of cases that 0.01*X will cause cancer in 0.01*X cases.

    There is no theory or data to support a linear-no-threshold dose response. All of the data (that I am aware of) is consistent with a hormesis-type dose-response where low doses produce apparently positive health effects (compared to zero) and adverse effects are observed only at above “low doses”. There is good theoretical support that in the “low dose range”, all toxic materials exhibit hormesis-type effects. This relates to my work on understanding physiology from the perspective of control. That is actually how I define a “low dose”, a dose of something that produces hormesis-like effects.

    Cancer is something that is quite complicated, and cancer causation is very poorly understood. It occurs due to genetic changes in a single cell, where that cell then exhibits clonal expansion. These are stochastic-type events which likely depend on other things as well, not just the “causation agent”.

    Inflammation causes cancer, so using very high doses that cause cell death (which itself causes inflammation) are expected to cause cancer simply due to the induced inflammation. The dose-response (for cancer causation) where there is cell death (and resulting inflammation) is expected to be very different than the dose-response where there is no cell death.

    Talc is an insoluble particulate material. Talc is going to sit on the outside of a cell, mostly. If a talc particle gets inside, cells can’t break it down because it is insoluble in everything that the cell can produce.

    Talc is a “natural” material, and so it has “natural” impurities, which complicates understanding its dose-response effects. Some impurities (like quartz) are extremely common in the environment (most sand is mostly quartz) and quartz causes silicosis.

  9. Steve Crosson 25 Feb 2016 at 12:59 pm

    ccbowers,

    Regarding “bias towards the plaintiff”, let me propose a different metric which I think is far more likely to be indicative of the actual truth of the matter:

    Advertisements for ‘Ambulance Chasers’

    I suppose that this is also an availability heuristic to a certain extent, but I think the huge number of “You don’t pay unless you win” type of ads strongly supports the premise. In the dozen or so different media markets that I’m familiar with, the number of ads for lawyers willing to work on contingency is far larger than that for any other law speciality. I don’t see how that could be the case if the odds weren’t strongly (and lucratively) in favor of the plaintiff.

  10. Karl Withakayon 25 Feb 2016 at 1:22 pm

    As daedalus2u said, Dow Corning and Dow Chemical were and are different companies.

    Dow Corning was the company that made silicone breast implants and filed for bankruptcy due to the silicone breast implant litigation.

  11. mumadaddon 25 Feb 2016 at 1:53 pm

    I know this sounds naive, but this seems like something that should never have made it to court — aren’t there mechanisms in place to prevent frivalous suits?

    On the wider question — maybe something like the Vaccine Injury Compensation Program would be appropriate?

  12. mumadaddon 25 Feb 2016 at 2:06 pm

    I should expand on what I said, at least slightly. It seems highly likely that at some point a company acting in good faith and according to industry regulations is going to inadvertently introduce some chemical into some product that will have adverse health effects for the people who use the product — there are so many products and so many producers that it’s pretty much inevitable. But if these companies are sticking to the regulations — which should be designed to minimise the risk of harm to the consumer — and the problem is not caused by some sort of malfeasance or corner cutting on their part, then they clearly don’t deserve to get hit with multi-million dollar suits when something does go wrong. However, clearly the victims do need to be compensated, but I would say the figure in this case is clearly unrealistic. Hence — set up some sort of program that might ease the burden of proof on the claimant and reduce the costs and stress of gaining compensation, but keep the figures realistic.

  13. Willyon 25 Feb 2016 at 4:20 pm

    Mumadadd–Creationism, ambulance chasing lawyers, Trump–these are sadly features of America.

  14. zorrobanditoon 25 Feb 2016 at 5:19 pm

    @Steve Cross

    “I think the huge number of “You don’t pay unless you win” type of ads strongly supports the premise. In the dozen or so different media markets that I’m familiar with, the number of ads for lawyers willing to work on contingency is far larger than that for any other law speciality. I don’t see how that could be the case if the odds weren’t strongly (and lucratively) in favor of the plaintiff.”

    You are disregarding an important factor. The ads do say you don’t pay unless you win. What they do NOT say is that the lawyer will not take every case. Lawyers who work on contingency review those cases very closely before agreeing to become involved. I will agree that among the cases such a lawyer takes there is (at least in the estimation of the particular lawyer) a better than even chance of recovery for the plaintiff.

    That is almost certainly NOT true if you consider all cases.

  15. Fair Persuasionon 25 Feb 2016 at 7:08 pm

    Ovarian cancer is a leading cause of death for menopausal women. Jackie Fox died at age 62. What is the cancer history of the Fox family in Alabama? What is the general rate of Alabama’s female deaths from ovarian cancer? Was the family’s cost for Johnson and Johnson talc over the decades excessive compared to soap?

  16. Steve Crosson 25 Feb 2016 at 7:57 pm

    @zorrobandito,

    Fair point … I already mentioned that my observation was also based on the availability heuristic.

    Nevertheless, I don’t think you have enough evidence to claim “That is almost certainly NOT true if you consider all cases.”

    I have no doubt that lawyers will try to select cases that are the easiest to win and require the least amount of work. But the fact that some cases are easier than others doesn’t necessarily imply that the majority are biased against the plaintiff — it just means that lawyers grab the low hanging fruit. And there does seem to be a LOT of fruit available.

    I think the point made above by locutusbrg is probably the most accurate. Juries tend to allow emotion to overshadow facts. There certainly does seem to be a widespread sympathy for “the little guy victimized by the big evil, rich corporation”.

    The case in point is a perfect example. $62,000,000 in punitive damages seems completely unjustified when there is virtually no evidence that J&J was even negligent, let alone actively obstructing justice. Even the $10,000,000 in “actual” damages seems to be a little hard to believe. IANAL, but I doubt a 62 year old woman was likely to have that much in future earnings, and there wouldn’t be ongoing medical costs.

    Obviously I’m guessing, but I imagine that a bunch of tearful testimony from spouse and children about how their wife/mother was taken too soon caused the jury to completely ignore the paucity of evidence.

    I don’t mean to disparage their genuine pain and suffering, but there are legitimate cases of negligence and this doesn’t even seem close.

  17. zorrobanditoon 25 Feb 2016 at 10:16 pm

    @SteveCross You may or may not be right about the slant among “all available cases.” There’s no way to know that I can think of. There certainly are a lot of un-winable cases in this area.

    Many of these jury verdicts seem out of line to me too, but I have not heard the evidence in any of them so I cannot even hazard a guess.

  18. ccbowerson 26 Feb 2016 at 9:47 am

    “the number of ads for lawyers willing to work on contingency is far larger than that for any other law speciality. I don’t see how that could be the case if the odds weren’t strongly (and lucratively) in favor of the plaintiff.”

    Zorrobandito addressed this somewhat, but I will elaborate a bit. My original point was not that it was imbalanced in either direction, but that to use salient examples to assume that there is a thumb on the scale in favor of the paintiffs is likely misleading. Actually, I think a comprehensive approach to this issue is not really a dichotomy, as there are many steps involved. Only a very tiny percentage of potential cases ever reach a point in which a lawyer will actually meaningfully get involved, then there are financial and many legal hurdles to winning a case so there is a huge selection process before the general public hears of these cases.

    The commercials on TV are a way for lawyers to advertise, while attempting to win the “lottery,” or at least potential clients. But that doesn’t mean that for a given person who was harmed due to the negligence of large corporation, that they have a built-in advantage. I actually think that it says little about that question. It may be that it is too hard for the individual or few, but too easy once a case involves many people and big name lawyers get involved. I don’t know, but that would fit the common perception.

    “$62,000,000 in punitive damages seems completely unjustified when there is virtually no evidence that J&J was even negligent, let alone actively obstructing justice. ”

    Two things here. One is that although you say ‘there is virtually no evidence that J&J was even negligent,” the jury found otherwise, and then some. Unless you’ve heard detailed facts of the case that the jury heard, I’m not sure how you concluded that so definitively. I’m not saying that they were negligent, but that it was partly based upon a finding of negligence.

    The other point, is that in nearly all of the cases like this, there will be an appeal, and these million dollar figures will be significantly reduced in the appellate courts. I agree that this process is ridiculous, but this is the legal system we have created, because we have lawyers creating our laws. It is not made for efficiency.

  19. Steve Crosson 26 Feb 2016 at 10:01 am

    @zorrobandito,

    I agree completely. I don’t think it is possible to know if the majority of cases is biased either for or against the plaintiff. Even where you draw the line is going to be subjective.

    In any event, I think that most of us agree that emotions cloud the issues in far too many cases. We need to encourage everyone to learn more science and use critical thinking — skills which are important to overcome bias in EITHER direction.

    Props to Steve N and SGU for raising these issues.

  20. Steve Crosson 26 Feb 2016 at 10:11 am

    @ccbowers,

    Well crap … I also agree completely with you. I’m going to have to give back my “cranky old man hat” if this keeps up.

    I do think that our legal system would benefit from a complete overhaul — by someone other than the primary beneficiaries, i.e. Lawyers.

  21. RCon 26 Feb 2016 at 10:44 am

    “Two things here. One is that although you say ‘there is virtually no evidence that J&J was even negligent,” the jury found otherwise, and then some”

    The problem, as locutusbrg stated above, is that the jury most certainly doesn’t have the understanding, knowledge, or ability to come to such a decision. The average American has almost no grip on basic statistics.

    One of the things I’ve noticed with people is that they seem to conflate the damage done to the victim with the likelihood of guilt in the accused. The more heinous the crime/damage, the less important the accused rights become, the more incensed people become, and the more likely to convict/rule. Emotion completely clouds logic, and someone “HAS TO PAY”.

    The people making these sort of decisions should really be a panel that understands the science involved, understands statistics, and has no emotional attachment to the plaintiff or defendant.

  22. ccbowerson 26 Feb 2016 at 11:10 am

    “The people making these sort of decisions should really be a panel that understands the science involved, understands statistics, and has no emotional attachment to the plaintiff or defendant.”

    I understand this sentiment, but I have not come to any strong opinions about this. It is a fairly complicated issue that has many tradeoffs, and I think a careful study of the legal procedures around the world would be instructive. I suspect for some cases, an expert panel would be an improvement, yet in nontechnical situations it may be less desirable.

  23. mumadaddon 26 Feb 2016 at 11:17 am

    “One of the things I’ve noticed with people is that they seem to conflate the damage done to the victim with the likelihood of guilt in the accused. The more heinous the crime/damage, the less important the accused rights become, the more incensed people become, and the more likely to convict/rule. Emotion completely clouds logic, and someone “HAS TO PAY”.”

    I’d say this is a problem with Jury trials in general. E.g. how does showing pictures of a victim’s injuries to a jury provide any evidence that the accused is guilty? Surely this should be kept back until sentencing, if not excluded altogether. There’s a complex conversation to be had about the purpose of the justice system and what it should be, and I’m not suggesting I’ve cracked it, but I would really like to see focus shifted away from retribution and more towards minimising future harm.

  24. daedalus2uon 26 Feb 2016 at 11:45 am

    I think the problem for J&J was that there was a letter in its files from some “expert” that said “talc causes ovarian cancer” and warning J&J to not use talc in its products, and (by implication) to continue to pay this “expert” for his “expert” advice” to mitigate any ongoing risk.

    Having a damning letter in your files that can be read in court to a sympathetic jury is a serious liability issue. It doesn’t matter what the science says if the corporation can be made to look cruel and heartless. What killed Dow Corning wasn’t that silicone caused problems, but they didn’t have enough data showing that silicone didn’t cause problems.

    That silicone breast implants were a tiny part of the silicone market, and didn’t justify the expense of doing the safety studies didn’t matter.

    There isn’t good data on talc exposure causing ovarian cancer. What this lawsuit means is that talc will be taken out of everything. No more talc in any products that come in contact with the body. Talc is commonly used in ingested tablets. I bet a lot of companies are looking at reformulating vitamins, drugs and other things to get rid of talc.

    http://www.eurotalc.eu/hsefacts.html

  25. Fair Persuasionon 26 Feb 2016 at 3:22 pm

    The risk of Jackie Fox’s death from baby powder has been rated as an equivalent risk to drinking coffee. A question of importance is whether Jackie Fox smoked, or lived in an environment with second hand smoke for 62 years.

  26. RCon 26 Feb 2016 at 3:43 pm

    @daedalus2u
    “I think the problem for J&J was that there was a letter in its files from some “expert” that said “talc causes ovarian cancer” and warning J&J to not use talc in its products, and (by implication) to continue to pay this “expert” for his “expert” advice” to mitigate any ongoing risk. ”

    This sounds an awful lot like the FoodBabe methodology – you ‘out’ a company, and keep harassing them until you get them to pay you for ‘image consulting’ or some such – it’s terrifying that there’s essentially legal enforcement of this stuff.

    I really think that US’s current form of government (everything from tort, to criminal justice, to the way we vote) needs a serious overhaul – things that worked well for 2 million people 250 years ago aren’t effective, let alone optimal, for 300M today – especially with modern communication and information sharing.

  27. mumadaddon 26 Feb 2016 at 4:44 pm

    Big mineral deposit has been keeping us down for too long…

  28. mumadaddon 26 Feb 2016 at 6:54 pm

    d2u,

    “I think the problem for J&J was that there was a letter in its files from some “expert” that said “talc causes ovarian cancer” and warning J&J to not use talc in its products, and (by implication) to continue to pay this “expert” for his “expert” advice” to mitigate any ongoing risk. ”

    Do you have a link for that? (The other one just links to a tree of seemingly unrelated links.)

  29. BillyJoe7on 26 Feb 2016 at 11:44 pm

    D2u,

    Where’s the logic in convicting a company for a harm their product didn’t cause just because they didn’t do enough testing to see what harm their product might have caused.

  30. BillyJoe7on 26 Feb 2016 at 11:46 pm

    ….referring to the silicone implants in the above

  31. daedalus2uon 27 Feb 2016 at 1:41 pm

    It is the “logic” behind big payouts based on emotional appeals to jurors. When there is a sympathetic “victim” who needs income to survive, and there is a “deep pocketed” corporation that can be tapped to pay for that, it makes perfect emotional sense.

    It isn’t about logic, it is about the adversarial legal system that is the basis for English and US law. It is actually a holdover from the days when there was “trial by combat”. Litigants would fight each other, sometimes to the death. The “reasoning” was that God would protect the person who was right. Then wealthy people would hire professionals to fight for them and God seemed to favor the wealthy, now wealthy people hire professionals called “lawyers” to litigate for them.

    The bankruptcy of Dow Corning was “voluntary” in that it was a “voluntary” settlement. The legal team decided that settlement made more sense than continuing to litigate. Dow Corning was a joint venture (as I recall), between Dow and Corning. Continuing the litigation might have meant the involvement of Dow and Corning in the liability.

    Sometimes innocent people plead guilty. Sometimes blackmail victims pay ransom. Sometimes people being tortured confess to things they didn’t do. Sometimes abused people develop Stockholm Syndrome.

    The legal system doesn’t decide who is “correct”, it decides who “wins”. These are very different things.

  32. daedalus2uon 27 Feb 2016 at 2:19 pm

    News reports of the J&J case include reports of a letter from 1997.

    https://www.lawyersandsettlements.com/articles/johnson-lawsuit-body-powder-talcum/Johnson-and-Johnson-talcum-powder-settlement-21296.html

    That may have been around the time that all “asbestiform” talc was removed from cosmetic products (although other reports say the 1970’s). Talc used before then may not have been analyzed for “asbestiform” minerals, so whether it was asbestiform or not is unknown. Maybe J&J thought that the limited association of ovarian cancer with talc was due to “asbestiform” talc of other manufacturers and not from their non-asbestiform talc.

    I suspect that the letter included a bit of “hype” to get funding to do more health studies. Maybe J&J did those health studies and found that non-asbestiform talc didn’t have health problems.

    Maybe what J&J should have done is close out their talc products that used talc that might have been asbestiform, from their “new and improved” products that were not asbestiform. But blocking liability from products that cause cancer is pretty difficult to do while retaining ownership and branding.

    I suspect that talc does not cause ovarian cancer. No matter what the relative incidence of people using talc and people getting ovarian cancer, there is likely to be some overlap, even if there is no causal relationship. Proving there is no causal relationship is extremely difficult. If there is “data” in the literature that asserts a causal relationship, it is legally imprudent for a manufacturer to not disclose that.

    People are easily frightened, and there is so much money to be made by playing on the fears of frightened people who are ignorant of the real risks. I saw a recent item that the manufacturers of Soylent (the complete food product that is supposed to be usable as your sole food source) were being sued for not labeling their “industrial product” with the California cancer warning (this product contains chemicals known by the State of California to cause cancer). The warning does not apply to “food”, and the sources of all the ingredients of Soylent are “food grade” materials, but because Soylent is not a “traditional food”, it is claimed to require the industrial product label because it is not “exempt”.

  33. Fair Persuasionon 27 Feb 2016 at 5:30 pm

    Why would an adult woman, like Jackie Fox use a Johnson and Johnson baby powder throughout her adulthood? The product was developed and meant to be used with babies with diapering problems.

  34. BillyJoe7on 27 Feb 2016 at 8:15 pm

    Maybe J&J could use that in their defense:
    What is a grown woman like you doing using baby powder? 😀
    However, it may interest you to know that some babies also have vaginas and ovaries! 😉

  35. Fair Persuasionon 28 Feb 2016 at 6:58 pm

    Female ovarian cancer is most often diagnosed after age 50; hormone therapy treatment associated with menopause has a risk rate for cancer.

  36. BillyJoe7on 28 Feb 2016 at 10:20 pm

    Well you never know the long term consequences of using nappy powder on infants. 😉

  37. Bill Openthalton 29 Feb 2016 at 7:12 am

    daedalus2u —

    The legal system doesn’t decide who is “correct”, it decides who “wins”. These are very different things.

    This is the case in less adversarial legal systems as well — for example, Belgium and France have the concept of “vérité judiciaire” (legal truth), which is not (and does not have to be) the same as the actual, real truth (whatever that means). Thus, in the case of a murderer who is found not guilty because the police bungled the search of his car, the judicial truth (which is meant to be accepted by all of society, including the victim’s relatives) is that he is innocent, even though “the truth” is that he did commit the murder.

  38. BillyJoe7on 29 Feb 2016 at 3:11 pm

    The police are punished for their ineptitude by letting a murderer go free.
    The victim’s family and friends and any future victims’ families and friends are collateral damage.

  39. Fair Persuasionon 09 Mar 2016 at 2:10 pm

    Recently, a national television network in the USA put out a scare story about ovarian cancer in females. Though it is true that there is not an official screening test for it as yet, annual gynecological exams and procedures will assist in its detection. For example, benign ovarian cysts can be palpated by the gynecologists at the annual exam. Ordered ultrasounds can and do detail cysts location and size.

    Given this basic knowledge about gynecological exams and procedures, it is necessary to make another inquiry into the talc cases. How many women with current talc complaints had annual pelvic exams by a board certified, licensed gynecologist and followed up with periodic, routine ultrasounds by a licensed ultrasonographer?
    This is part of a patient’s due diligence.

  40. Fair Persuasionon 09 Mar 2016 at 2:35 pm

    A dynamic end-of-life legal deposition is no match to a lifetime of proper gynecological healthcare.

  41. BillyJoe7on 09 Mar 2016 at 3:50 pm

    FP,

    Google is your friend:

    http://www.ncbi.nlm.nih.gov/pubmed/25595604

    The bimanual pelvic examination lacks accuracy as a screening test for ovarian cancer and as a way to distinguish benign from malignant lesions. In a typical screening population, the positive predictive value of an abnormal pelvic examination is only 1% (95% CI=0.67%, 3.0%). Its inclusion in a health maintenance examination cannot be justified on the basis of using it to screen for ovarian cancer.

  42. Fair Persuasionon 09 Mar 2016 at 8:56 pm

    I just received in my spam folder a solicitation for a law firm out of Laguna Niguel, California looking for clients regarding the Johnson and Johnson lawsuit, promising big money for my efforts. $72,000,000 to be exact.

    The studies in Pub Med were interesting. Only a little over 700 subjects were symptomatic. Palpating cysts/tumors is a first step in diagnosis. But remember, radiology is your friend too. Ultrasonography is accessible in the USA. It is a commonly known procedure, and is currently used as an expensive stalling factor in states to slow the right of women to choose abortions.

  43. BillyJoe7on 09 Mar 2016 at 10:18 pm

    FP,

    Google is still your friend:

    https://canceraustralia.gov.au/publications-and-resources/position-statements/population-screening-and-early-detection-ovarian-cancer-asymptomatic-women

    Population screening and early detection of ovarian cancer in asymptomatic women

    There is currently no evidence that any test, including pelvic examination, CA125or other biomarkers, ultrasound (including transvaginal ultrasound), or combination of tests, results in reduced mortality from ovarian cancer.

    There is no evidence to support the use of any test, including pelvic examination, CA125, or other biomarkers, ultrasound (including transvaginal ultrasound), or combination of tests, for routine population based screening for ovarian cancer.

    Further validation in large clinical trials is required before current or new biomarkers could be recommended for routine use in a population screening setting.

  44. Fair Persuasionon 10 Mar 2016 at 10:52 am

    The Australian publication was dated 2009. Is there more recent information about clinical trials?

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