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Message SILENTSPRING.ORGAN URGENT NEW INITIATIVEHow You CanChange the StoryABOUT BREAST CANCER

2Your mom, your daughter, your sister, your friend. You’d do anything for them. Especially when the stakes are so high, as they are with the threat of breast cancer.THE STORY WOMEN are hearing about reducing breastcancer risk factors is incomplete. Doctors are not telling the full story because they don’t have the science. (Who can blame them? Medical school cancer prevention training is limited.)Consider these 4 truths missing from the usual story aboutbreast cancer: Breast cancer is not simply a matter of bad luck Breast cancer is not mostly caused by high-risk genes You can eat well and exercise and still get breast cancer Treatments are painful, devastating, and costlyAlthough treatments are important for those with cancer, if we really want to save lives, we need to stop people from getting cancer in the first place. So the question is: Are we ready to change the story and save more lives?Change happens when we are ready to change . . .3Changing thestory about breast cancerDR. MARGARET KRIPKEUNIVERSITY OF TEXAS MD ANDERSON CANCER CENTER,MEMBER OF PRESIDENT’SCANCER PANEL, 2003-2011 Silent Spring Institute is the leader in producing high-quality scientific evidence on cancer-causing agents in the environment.“”A PARADIGM SHIFT IN 2 STEPS

2UNLIKE WITH TREATMENT, “prevention has no face.” We can’t see whose lives have been saved. The urgency of preven-tion is invisible. And every day that the story about cancer prevention goes untold, our loved ones are at risk. This needless risk needs to end today. You can help make this happen. You can be a part of history. In 2022, the White House re-launched the Cancer Moonshot Initiative with a new focus on prevention. Its goal is to reduce cancer death rates by 50 percent by 2047. This is not just a big number. It’s real lives — real families — real hearts full of love and promise and potential — all waiting for you. Why you are essential to this initiative You are quite rare. You’ve shown how committed you are to women’s health, especially breast cancer prevention. We believe you’ll see this new initiative as an opportunity to extend your compassion in a special way. It’s caring people like you who can change the story about breast cancer.3It’s time for us to prioritize preventionThe best way to reduce cancer deaths is to reduce cancer cases in the first place.

5THE STORY ABOUT BREAST CANCER is mostly told by the medical establish-ment. Therefore, the story won’t change until the medical establishment recognizes prevention as a top priority. For this, we first need to ensure ongoing, continuing medical education aimed especially at engaging doctors and nurses in environmental risk factors for cancer as well as strategies for prevention.4The trends+ the scienceTREND #1: Patients are increasingly asking their health care providers about chemicals that may cause cancer.TREND #2: Health care providers are feeling ill-equipped to answer these cancer prevention questions.When it comes to cancer prevention information, patients are feeling frus-trated and health care providers are feeling left in the dark. With your help, Silent Spring Institute will solve this problem. Because we do the science that health care providers need to know to tell the full story about breast cancer. THE SCIENCE: Through Silent Spring Institute’s many scientific research initiatives, we find links between environmental chemicals and women’s health. We provide the science to keep toxic chemicals out of products. We develop innovative methods for identi- fying cancer-causing chemicals. Our research strengthens chemical safety regulations. These solutions hold great promise for preventing breast cancer and other diseases, while also creating a healthier and more sustainable environment for generations to come. WE MUST CHANGE THE STORY: A paradigm shift in 2 steps . . .UPSHOT: Health care providers need to know the science in order to meet this urgent need.

A PARADIGM SHIFT IN 2 STEPS5SILENT SPRING INSTITUTE — along with partner organizations and collaborators at major cancer centers — has already begun leading in the area of continuing medical education with a series known as the Cancer & Environment Forums. The Forums are a collaborative eort among many kinds of cancer groups. In addition to organizing the forums, Silent Spring contributes its expertise in identifying breast carcino-gens and reducing our exposures. More than 950 participants attended our first two forums — the first in 2022, co-hosted with Dana-Farber Cancer Institute; the second in 2023, co-hosted with Columbia University Medical School. Reviews were highly positive. One nurse called the 2022 Forum, “the best continuing education I’ve ever seen.” Topics covered by nationally prominent physicians and scientists included: The biological characteristics of carcinogens How inherited genes interact with air pollutants Strategies for doctors to advance cancer prevention policies Strategies for care providers to talk (blame-free) with cancer patients about exposure reduction How to recognize industry strategies that use biased science to create doubt about environmental carcinogenesisWe propose building on the success of the first two Forums by continuing to collaborate with other cancer centers across the country to host new Forums featuring continually updated science, tailored topics, and regionally relevant case studies. Extending the Forums is Step 1 in the paradigm shift that will change the story about breast cancer. That’s because this successful education series is designed to enlighten health care providers so they can fully grasp the need to put prevention on the radar and keep it there. Rather than talk only of the treatment half of the story, doctors and nurses will be convinced of the need to tell the whole story, beginning with the life-saving power of prevention.4TREND #2: Health care providers are feeling ill-equipped to answer these cancer prevention questions.Step 1: Forums

A PARADIGM SHIFT IN 2 STEPS6WE CREATED INFO CARDS to support conversations between patients and their clinicians, and piloted their use at Brigham and Women’s Hospital breast clinic. We plan to make these cards broadly available through breast cancer and environmental health organizations; primary care providers; OB/GYN, nutrition, mammography clinics; and other healthcare settings. These cards feature: Quick tips on how patients can open a cancer prevention conversation with clinicians Powerful, shareable science-based points about links between chemicals and breast cancer A call to action for stronger policies to keep harmful chemicals out of products and the environment Strategies for responding to skeptics Links to learn more about peer-reviewed science A Top 10 list of tips for reducing harmful exposures Information about Silent Spring’s free Detox Me app which contains a wealth of tips and takeaways for reducing exposures, based on over 25 years of scientific researchThese Info Cards are Step 2 in the paradigm shift that will change the story about breast cancer. They will empower patients with useful information. And they will empower clinicians who want to give their patients the information they need while being sensitive to the potential diculty of such emotionally charged discussions.Step 2: Info CardsDo either of the following scenarios sound familiar to you?SCENARIO #1 A clinician sees a chance to talk to a patient about environmental risk factors for cancer but holds back for fear of upsetting the patient.SCENARIO #2 A clinician knows environmental risk factors are important but feels unprepared for an intelligent discussion of the latest research.7

6Scientific discoveries from the past 25 years have revolutionized our understanding of the many pathways to cancer — expanding beyond chemicals that cause genetic mutations to include eects such as hormone-driven cancer growth, inflammation, and immune suppression. We have learned that there are hundreds ofchemicals used in consumer products or otherwise released into the environment that can trigger these eects. THE GOOD NEWS is that many cancers can be prevented by reducing harmful exposures. It’s time for doctors and patients to talk about these opportunities to stop cancer before it starts. It’s time to make these conversations an integral part of routine care.Together with you, we can tell the whole story. We can shift the paradigm. We can save more lives.Sounds wonderful, don’t you think?Your extraordinary trust and support of the work of Silent Spring Institute is not something we take lightly. Thank you for being someone who cares beyond normal measure. And thank you for your consideration of this urgent initiative.You can write this happy endingDR. MARY BETH TERRYEXECUTIVE DIRECTORSILENT SPRING INSTITUTE Women deserve to hear the whole story about breast cancer. With your help, we can equip clinicians to understand, appreciate, and share the whole story… beginning with prevention. And together, we can write a happy ending. “”7

For more information and to make a gi, contactRachel d’Oronzio Sarvey 617.332.4288 ext. 215sarvey@silentspring.orgFor media inquiries, contactAlexandra Goho 617.332.4288 ext. 232goho@silentspring.org 320 NEVADA STREET, SUITE 302 | NEWTON, MA 02460 | SILENTSPRING.ORG