Johnson & Johnson appeals the Talcum Powder verdict – is the Big Pharma still in denial?

NBC News reports that Johnson & Johnson is going to appeal the court’s latest decisions about the Talcum Powder lawsuits. The pharmaceutical giant was recently ordered to pay almost $130 million in compensatory and punitive damage to the families of two women. More than 1,200 total litigations have been filed by people who claim they developed ovarian cancer after using J&J’s Talcum Powder to sprinkle their genital area and underwear. The jury held J&J responsible of conspiracy, negligence, and fraud since they never informed customers about the possible dangers they were aware of. Ovarian cancer’s mortality rate is, in fact, the highest among the various gynecologic malignancies.  One of the attorneys of Jackie Fox, an Alabama woman whose family the St. Luis Jury awarded $72 million after she died of ovarian cancer, introduced a disturbing evidence that allegedly proved how J&J intentionally concealed the truth. In a September 1997 internal letter, a medical consultant suggested that denying the obvious risks could be detrimental to the company public image. So well, even if they weren’t found with a smoking gun in their hands, it’s still safe to assume that they were well aware of these dangers.

However, the huge Big Pharma still wants to fight back and refused to accept the verdicts that keep pinning it to the wall. Carol Goodrich, Johnson & Johnson’s spokeswoman, explained that the company still wants to defend its product, whose safety has been confirmed by more than 30 years of research. Several agencies such as the International Agency for Research on Cancer (IARC) and the American Cancer Society, did, in fact, note that the evidence that links talc with ovarian cancer is somewhat sketchy. J&J also noted how the epidemiological data showed in a recent study from the Harvard School of Public Health found no association between cancer and talc use. On the other hand, other large studies that substantiated talcum dangerousness have been published, and not only they proved to be sufficient to convince the jury, but J&J also ignored them over the course of the last decades.

 

Is talcum dangerous or not? The reasons why there’s still no scientific consensus

 

Then what’s the truth, and why science can’t provide a final answer? It should be noted that seldom, if ever, things are either black or white in the scientific world, especially when talking about medicine. Before a claim can be asserted as a final, universally acknowledged truth, the data that needs to be thoroughly examined is often overwhelming. It’s not uncommon that various studies may end up finding significantly different results, especially when the topic investigated is so impalpable (just like talcum powder). To assess a proper correlation between talcum use and ovarian cancer, in fact, researchers had to fight many technical challenges. Talc is not a drug, so there are no properly redacted medical reports available. Patient self-reporting is often unreliable and generates a strong bias that led to the exclusion of many observational studies. It’s also very difficult to provide an adequate quantification of the talcum dose exposure, as its concentration often differs significantly among the various cosmetic formulations. The powder’s application method (sprinkling, spraying, application through sanitary diapers or swabs, etc.) may also considerably affect the quantity of the substance that will reach the genitals.

Sometimes final proof is not even mandatory to assess the dangerousness of a substance when a reasonable risk suspect is still present. According to data published in the International Journal of Gynecological Cancer, the sole elimination of talc use may avert at least one-quarter of ovarian cancer cases. Science’s final verdict may require many more years to be expressed, yet a very real health risk is still lingering over many woman’s heads if that product is not recalled. Even J&J is now producing and selling a cornstarch-based surrogate powder, showing that they were, at least, aware of the public fears about the cancer risk.

 

Article by Dr. Claudio Butticè, Pharm.D.

 

REFERENCES

  1. Karageorgi S, et al. Perineal use of talcum powder and endometrial cancer risk. Cancer Epidemiol Biomarkers Prev. 2010 May; 19(5): 1269–1275.
  2. American Cancer Society. Talcum Powder and Cancer – What is talcum powder? www.cancer.org
  3. Gertig DM, et al. Prospective Study of Talc Use and Ovarian Cancer.JNCI J Natl Cancer Inst (2000) 92 (3): 249-252. doi: 10.1093/jnci/92.3.249
  4. Dye J., Johnson & Johnson ordered to pay $55 mln in talc-powder trial. Reuters. May 3, 2016.
  5. Fox M., Johnson & Johnson Case: Can Talcum Powder Really Cause Cancer? NBC News. May 3, 2016
  6. Welch A. Johnson & Johnson verdict: Can talcum powder really cause cancer? CBS News. February 25, 2016
  7. Wentzensen N., Wacholder S., Talc Use and Ovarian Cancer: Epidemiology Between a Rock and a Hard Place. JNCI J Natl Cancer Inst (2014) 106 (9): dju260 doi: 10.1093/jnci/dju260