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Ovarian Cancer and Talcum Powder

On August 21, 2017, a Los Angeles jury ordered Johnson & Johnson to pay $417 million to a woman who claimed that talcum in J&J's baby powder caused her ovarian cancer. This is the largest jury award so far in the more than 1,200 lawsuits filed against J&J, alleging that the company knew about cancer risks but did not warn consumers. Juries have already awarded $110.5 million, $72 million, $70.1 million and $55 million in four of the lawsuits, for a total of $724.6 million in awards to date. On the other hand, a St. Louis jury rejected a similar lawsuit and at least two other lawsuits have been thrown out of court because there is no good scientific evidence that talcum powder causes ovarian cancer and extensive reviews of the scientific literature have shown no association between talcum powder and ovarian cancers (Eur J of Cancer Prevention, November 2011;20(6):501–507).

Ovarian cancer strikes about 21,000 North American women each year, but nobody knows the cause. Because it rarely causes symptoms until it has spread beyond the ovaries, it kills most of the patients and is the fifth leading cause of cancer death among women today.

Some early studies showed that using talcum powder regularly for many years was associated with increased risk for ovarian cancer (American Journal of Epidemiology, March 1997), but larger and more recent studies show no association between talcum powder use and ovarian cancer. The Nurses' Health Study followed more than 120,000 women for 20 years and found no association between talcum powder and ovarian cancer (J Natl Cancer Inst, 2000 Feb 2;92(3):249-52). A follow-up study also showed no association (J Natl Cancer Inst, 2014 Sep 10;106(9)).

Why is Talcum a Cancer Suspect?
Many women used talcum powder on themselves or on their babies, or sprinkled it on personal products such as sanitary napkins, diaphragms or condoms, and the powder can pass through the vagina, uterus and fallopian tubes to the ovaries. A 1971 paper found particles of talc embedded in 75 percent of the ovarian tumors studied (J Obstet Gynaecol Br Commonwealth, 1971;78(3):266–272).The mineral, talc, that is mined to make talcum powder can be contaminated with asbestos, which is a known carcinogen.

The lawsuits blaming talcum powders for causing ovarian cancer cite the potential for asbestos contamination, but this danger was removed from the powders by law more than 40 years ago. Strict quality controls for cosmetic-grade talcum were put in place in 1976, and the American Cancer Society states that "All talcum products used in homes in the United States have been asbestos-free since the 1970s."

The Asbestos-Cancer Connection
During World War II, shipbuilders fireproofed the ships by spraying them with asbestos and as a result, these workers suffered a very high incidence of lung cancer years later. When asbestos gets into your lungs, glands lining the bronchial tubes that carry air to and from your lungs produce large amounts of mucus. Then small hairs called cilia, lining the bronchial tubes, sweep in rhythm and move the particles and the mucus up to your mouth where you swallow both so they are cleared from your body. Asbestos and talcum particles both look like barbed wire under a microscope. Their particles stick to the linings of the lungs by their barbs, which prevent the cilia from sweeping the asbestos to your mouth where you swallow it. Workers who smoked were the ones most likely to get lung cancer. Smoking paralyzes the cilia and then destroys them so you have even less chance of removing the barbed particles from your lungs. Theoretically, it is possible that breathing in talcum powder could cause lung cancer even if it has not been contaminated with asbestos, but the American Cancer Society correctly states that, "No increased risk of lung cancer has been reported with the use of cosmetic-grade talcum powder."

Nobody Needs to Use Baby Powder or Body Powder
Today, most baby powders and body powders do not contain talc. Most are made from cornstarch, which has not been linked in any way with cancer (Am J Obstet Gynecol, March 2000;182(3):720-4). However, the American Academy of Pediatrics recommends that parents not use any kind of baby powder because it can be inhaled to cause respiratory problems. They advise that zinc oxide-based ointments are safer and more effective.

Baby powder has no beneficial use for adults as it does not keep you from sweating and it will not keep your skin dry for more than a few minutes when you do sweat. Cosmetic powders such as face powder and powdered eye makeup do not even need to be inspected or approved by the FDA. Even though there is no data to show that asbestos-free talcum powders or cornstarch powders cause ovarian cancer, I cannot think of any reason why you would want to use them. Breathing any type of powder into your lungs increases your risk for chronic lung diseases. 

August 27th, 2017
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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