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Pro-Life Philippines posted an open letter on their website, addressed to supporters of the Reproductive Health Law. Mr. Garrick Bercero of the Filipino Freethinkers replies to it on their website here.

I found it necessary to write a rejoinder to Mr. Bercero to correct some “misunderstandings” or “wrong perceptions” he has regarding the said open letter. My response is in BLUE:

BERCERO: “It is totally unnecessary to lie about cancer links to oral contraceptives, since your opposition to the RH Law is founded on dogma, not medicine or scientific research.”

We are starting off on the wrong foot aren’t we? First of all a decent and reasonable person who is supposed to be open to discussion should not assume bad faith on the part of their opponent by accusing them of lying! It is hypocrisy to say “…I do not doubt at all that the anti-RH mean well.” then accuse that the Pro-Life advocates are lying to convince others of their position. In the scheme of things, Mr. Bercero, Pro-Life advocates claim to be Christians and will therefor not use lies to show their point because that is not the way of our faith. Perhaps those who don’t believe in anything but themselves may be more inclined to do so for they do not fear any accountability for their actions.

BERCERO: “You would oppose the law even if it would only provide for barrier contraceptive methods, such as condoms. If you want a civil discussion, let us not pretend that the argument is really about abortion or about cancer concerns.”

In addition to my above reply, yes we would oppose even if barrier forms of contraceptives are purveyed and yes we are serious about the abortion issue (much better things have been written about that by other Pro-Lifers, here, here and here) and the cancer issue (see my retort below).

BERCERO: “Citing cancer links only serve to weaken your position, when better studies have refuted then. You cite the International Agency for Research on Cancer’s classification of oral contraceptive pills as group 1 carcinogens.

As the Mayo Clinic clarifies, this classification was based on studies on old OCP formulations. While studies did show links between breast cancer and OCPs, these links completely disappear in studies on modern formulations. In the largest modern study on current lower estrogen and new progestin formulation oral contraceptive pills involving over 9000 women, no breast cancer links were found. It is plainly intellectually dishonest to pass off old data as current.”

Let me first state that your claim that the IARC data is old data is entirely a misunderstanding of how the IARC works (I hope it is a misunderstanding and not plain ignorance). I would like to call your attention to the fact that the IARC monograph is dated 2013 and is not based on single studies but on consolidated worldwide reviews of studies on OCP’s and Cancer. Consolidating data is an on-going project of the IARC which means that it is always current and updated. If indeed there is conclusive evidence that OCP’s are not carcinogenic, they would have deleted that from their classification or at least re-classified it to Class2b.

The cancer risk in the IARC classification, in contrast to the Mayo Clinic link he cited, does not specifically point only to Breast Cancer. Here are some pertinent facts from the 2007 IARC Monograph that evaluates Combined Estrogen-Progestogen Contraceptives and its relation to different cancers. Please take note that these data are 2005 and published by the working group in 2007 whereas Bercero’s NCBI study link is dated 2002.

Breast Cancer: “The Working Group further noted that the preponderance of the evidence suggests that use of oral contraceptives is associated with an increased risk of breast cancer in carriers of BRCA1 or BRCA2 mutations… that if this association reflects a causal relationship, then it could, at least in part, explain the observation summarized in the 2005 IARC Monograph (IARC, 2007) that risk of breast cancer was increased in women under the age of 35 years who had begun using oral contraceptives at a young age and who were current or recent users.”

Cervical Cancer: “…the risk of in-situ disease was increased in users of less than 5 years’ duration, but the risk of invasive disease was increased only after 5 years of use.”

2.17 Synthesis
“There are increased risks for cancer of the breast in young women among current and recent users only, for in-situ and invasive cancer of the uterine cervix, and for cancer of the liver in populations that are at low risk for HBV infection (this risk is presumably masked by the large risk associated with HBV infection in HBV-endemic populations). In addition, for cancer of the uterine cervix, the magnitude of the associations is similar for in-situ and invasive disease, and the risks increase with duration of use, and decline after cessation of use.”

4.2.1 Direct genotoxicity

“Since the previous IARC Monograph (IARC, 2007), there is additional evidence to support the hypothesis that certain estrogens are carcinogenic through genotoxic effects in addition to their presumed action via a receptor-mediated mechanism

4.3 Synthesis
“Hormone-receptor-mediated responses are probably a necessary mechanism for hormonal carcinogenesis by combined estrogen–progestogen oral contraceptives. Progestogens including those used for combined estrogen–progestogen oral contraceptives appear to have the capacity to stimulate cell proliferation in human breast cells and to inhibit proliferation in human endometrial cells. The magnitude of these effects vary for different synthetic progestogens. Because
estrogen mediates the expression of progesteronereceptor expression, the presence of estrogen in these combined estrogen–progestogen oral
contraceptives may be essential …In animal models, estrogen potentiated cervical cancer, and inhibited colon cancer development.”

Mayo Clinic (Bercero’s reference): “Breast cancer risks with the newest formulations of OCs are still unknown but are predicted to show no association with the dose and composition of the estrogens and progestins being used. However, future studies will need to evaluate this empirically.” Translation: We still don’t know

What does this IARC Study and the Mayo Clinic Proceedings tell you? They basically say that the risk of developing cancer from Estrogen-Progestogen (OCP) drugs either exists or is uncertain and varies depending on certain critical factors present in an individual’s genes, i.e., receptor mutations within certain cells. The question is, does the RH Law even provide for such screening of people who will be receiving this? I don’t think so. Because cancer development also suffers from an error called lag-time from discovery, one may never know that a person who does develop cancer got it from their use of OCP’s or not. The point of those in the Pro-Life apostolate is, if you are going to err, do so on the side of safety, DON”T GIVE IT!

BERCERO: “Science improves through time, and old positions are discarded in the face of contradictory evidence. I understand that this method of revising and improving ideas is foreign to faith, but it is no excuse for when anti-choice advocates try to speak on matters of science.”

The IARC chose to label OCP”s as carcinogenic to humans because they have been found to be so both in reproductive-age users and menopausal users. Bercero’s assumption that Pro-Life advocates cannot use science properly flies in the face of the evidence cited above (which he apparently did not bother to read). Perhaps he is not familiar with medical research and the reading of medical literature (I doubt since I think he has a degree in Genetics) so my advice to Mr. Bercero is to avoid character assassination and just read what has been scientifically cited and presented. He forgets that there are actual doctors within the Pro-Life movement who are familiar with scientific inquiry. Science does improve with time and as a person of faith, I agree with that. Unfortunately Mr. Bercero chooses to ridicule men of faith as closed and narrow without pausing for a moment to consider that the greatest scientific discoveries were made by men of faith precisely because that faith knew well to recognize that an ordered universe follows certain physical laws. No matter what Mr. Bercero says, his science stands on the shoulders of Christians!

“There is sufficient evidence in humans for the carcinogenicity of combined estrogen– progestogen oral contraceptives. Combined estrogen–progestogen oral contraceptives cause cancer of the breast, in-situ and invasive cancer of the uterine cervix, and cancer of the liver.”