Hi Everyone, Dr. Bernard here. Proceeds from this video will be donated to
Burn Pits 360, a non profit entirely dedicated to improving post-deployment health outcomes
for current and former US military personnel. If you would like to donate with me, I have
included a link to their website, in the description below. KT is a 38 year old woman, presenting to her
primary care doctor, feeling great. But, something’s wrong. You see, KT was born in to a military family. I grew up in a family that was military. So we always lived on Marine Corps bases,
and we moved following our Marine Corps Father every 2 years. I like to joke that it was the 11th commandment
in our family that Thou Shalt Join The Marine Corps. When she finished high school, she joined
the Reserve Officers' Training Corps program, ROTC, for the United States Marines. In this program, KT would get a scholarship
to go to college first, and then go on active duty for a number of years. When she started college, it was years before
the day September 11 2001. And by the year 2005, KT found herself in
the Middle East. I spent 2005 with the 2nd Military Police
Battalion over in Fallujah Iraq. In these days, where US Armed Forces were,
didn’t have infrastructure to easily dispose of waste. In an effort to more simply manage that waste
to keep things clean and prevent contamination and disease, soldiers would dig a pit in to
the ground, throw the trash in, and then light it all on fire, with jet fuel. We dug a large pit. And lit it on fire with jet fuel. Which now that I say it out loud, sounds like
a crazy thing to do. But we absolutely did, we dumped everything
in there. Old uniforms. Old batteries, car tires. The burn pits were the way we disposed of
anything on the Forward Operating Base. Clearly, burning military waste with jet fuel
to keep things clean while unleashing toxic chemicals in to the air for everyone to breathe
may seem contradictory, but at the time, the claim was— there is no evidence yet that
these fumes have adverse long term health effects. To the people nearby, they wouldn’t just
be breathing in smoke, but also particulate matter, tar, industrial chemicals, heavy metals,
gasoline and jet fuel itself. At the time, it may not have fully registered
in the minds of leadership that bad things may happen in those soldiers’ bodies later
in life because of this exposure. And while she was in Fallujah in the year
2005, KT was exposed to this burn pit. We all noticed there was particulate matter
in the air and that it was in our air conditioning filters. It was something we joked about. It was something we said was gross, but we
didnt think more about it than that. KT’s primary care doctor was aware of her
deployment and previous burn pit exposure. Breathing in toxic burning garbage might not
only cause immediate illness, but more and more evidence shows now that the chemicals
observed from those pits have been linked to long term damage. And people who otherwise had no risk factors
to develop these health issues, are now developing them. KT’s primary care doctor referred her to
get a mammogram, an X-ray of the breasts to check for early signs of cancer because of
her prior burn pit exposure. At 38 years old, and feeling great, KT thought
there was no point. Her son was 3 years old, her family life was
going well, and her post military career as a tenure track professor was going well. And so, she skipped her appointment for the
mammogram. I thought it was unnecessary because of my
age, but also because I felt wonderful. I didnt have any symptoms of breast cancer. I didnt have any history of it in my family. I just truly wasn’t concerned about the
issue. I didnt realize at the time, how high the
incidence rate of breast cancer in military people is. I didnt know that I was at risk. But at the reschedule just a couple weeks
later, KT did get that mammogram. And something showed up on the images. Doctors looked deeper and a breast MRI revealed
not only a large tumor, but also smaller tumors next to it, meaning primary care was right—
KT did have breast cancer. Based on the images and physical tumor samples
collected at this appointment, it looked like KT had Stage 2B cancer, meaning it may not
have been too advanced. They caught it early and that makes sense
because she was only 38 years old. Younger people don’t typically have advanced
cancer, so everything didnt seem too bad. Except, doctors did one final test. They sent radiolabeled sugar into her body
to trace metabolic activity. Cancers can grow fast and aggressively, meaning
they would use a lot more sugar and have more metabolism than regular body parts. And when THIS scan came back, doctors realized
that KT’s cancer wasn’t just in her right breast. It wasn’t just early stage disease. It was all over her bones. The cancer had spread to her lower back, her
hips, and the bones of her thighs. All of this meaning she had advanced, Stage
4 cancer. If you do have Stage 2B, nothing else, scans
clean, your survival could be way greater than 93% in 5 years. Many of them are ending up cured. If you do have a Stage 4, it's a completely
different story of course. Still as of today, the survival of stage 4
breast cancer in 5 years is around 30% or so. In the bell curve, majority of my patients
who I say you know, you do have Stage 4 hormone receptor positive disease, 5 years from now,
they’ll be gone. I said, “So how long does someone with this
condition have?” I now know that she hedged her bets. She said “I Think you might live 6-10 years.” I now know that the statistics say 3-5 years
but she was thinking I was young, strong and could tolerate treatments pretty well, so
she thought I might get a couple of additional years. Typically in a 38 year old, previously healthy
woman, you don’t see advanced cancer. In some cases, we know some people may have
genes that could cause them to develop breast cancer later in life, but KT didn’t have
those genes. And she wasn’t in later life. She didn’t have a family history of cancer. Her living environment at the time of diagnosis
wasn’t any different than anyone else, she was living in South Carolina. She did have a past medical history of squamous
and basal cell carcinoma, that is a mild skin cancer that has nothing to do with breast
cancer. She just didn’t have the known risk factors
to develop aggressive cancer like this at this age. But what she did have, 13 years earlier, was
that she breathed in toxic fumes and particulate matter every single day, from burning garbage
incinerated by jet fuel in a burn pit. When I was in Iraq, we had burn pits everywhere
and we had ash, smoke and black clouds in our living spaces, in our eating spaces. It was it was really common. And now they're finding out that in these
burn pits, we were not just burning jet fuel, but we were burning batteries and all kinds
of carcinogenic chemicals. So there's a risk that a great many service
members have been exposed because we were living on top of it. I used to run laps around our burn pit in
Fallujah. That was my run route. I thought nothing of it because at the time
I was 25 and invincible, which is the way you have to convoy around Iraq. Interestingly, I was stationed with one other
woman in Iraq and I ran into her about a year ago and hadn't spoken to her in a long time. She has the exact same kind of aggressive
breast cancer that I do, the exact same kind. And it's incredibly rare. Anecdotally to me that that told me that the
burn pits and then contaminated water were potential exposure risks for me. When the doctors told KT about her stage 4
breast cancer that had spread to her bones, she tried to make a claim that her cancer
was service related. That had she not been right next to a pit
of burning garbage 24 hours a day, 7 days a week in 2005, that this probably wouldn’t
have happened. Two oncologists who specialize in breast cancer
treatment agreed with this and wrote letters supporting her claim. A few years earlier, a registry was established
for veterans to place their name on a list to indicate that they were exposed to burn
pits while they were deployed. But for KT, more evidence was needed on her
claim. More scans over several weeks were needed. But KT’s terminal cancer was spreading and
growing and mutating all throughout her body. She didn’t have those weeks to wait. I got a scan. And they wanted follow up scans as a result
of something they say growing. And they called me and said “we can see
you in 6 weeks.” In the stage 4 environment, 6 weeks is an
eternity. That’s way too long to be waiting for scans. You can have all kinds of cancer growth going
on. At the hospital, where KT’s private insurance
was covering her care, doctors immediately start treatment. Surgery won’t work because it had spread
all over her bones. Cutting it out of her breast won’t do anything,
because it would just spread further from her bones, if it hasn’t spread already. Because she’s 38, KT’s premenopausal meaning
every month the hormone levels in her body fluctuate. Breast cancer is different from other cancers,
partly because breast tissue is sensitive to those hormones. We know cancer is an overgrowth. That something happened to the cells, to cause
them to grow uncontrollably. Cancer growth isn’t natural. Those cells must have mutated their genes
in a way to escape nature. To acquire some ability to just keep growing
and never stop growing. Or to lose the ability to die when it’s
time. These superpowers mean that cancer cells are
similar, but just a little different from the original regular cells, at least at first. So if regular breast cells respond to hormones,
then the superpower cancer versions of those cells might still respond to hormones too. Meaning they can grow even more, because of
those hormones, hijacking normal function for their own benefit and making things worse
for the patient. And in KT, her breast cancer was responsive
to hormones. If KT’s hormones fluctuate every month,
and her cancer grows because of those hormones, then one part of treatment would be to stop
the hormone fluctuation. And that would be done by forcing KT in to
menopause using medicines in an effort to starve her cancer of growth signals. Around this time, her claim was not accepted,
and so she sent in an appeal. Additional medicines to lock her cancer cells
so they couldn’t reproduce any more were given in an attempt to prevent any more spread
and growth. And things were going well for KT. Her cancer appeared to be stable disease. She didn’t need to be on something like
chemotherapy, so she wouldn’t lose all her hair, she thought. But 10 months later, a scan at checkup found
that her cancer was spreading and growing again, but even worse, the nature of her cancer
had changed. In acquiring superpowers, cancer cells start
to change quickly. The rules of nature just don’t apply to
them anymore. In locking cancer cells with medicine, it’s
possible that not all of them would get locked. Those would survive the medicine, and reproduce,
passing on their medicine resistant genes. But if KT’s cancer was also starved of hormones
that were used to grow, well, those cells that didn’t need hormones in the first place
would start to grow too. And at this first disease progression, KT’s
cancer didn’t need hormones to grow anymore. The cancer couldn’t be locked with that
medicine anymore. All of this meaning doctors switched her to
chemotherapy as a way to catch as many cancer cells as possible. And everything goes well again for KT. Her disease is stable again. Chemotherapy especially targets cells that
divide quickly in the body, which are not only cancer cells, but also hair matrix cells. And as she was on this chemotherapy, KT lost
her hair. And I asked him, I said, “Do you want mommy
to coach your soccer team” he goes, “yes, but I’d like you to wear your wig.” And I cried after he said that. I thought he was embarrassed that I didn’t
have hair. When really what he was saying was, “I Just
want my mom to be normal.” As the months passed, KT was doing well. But 10 months later, her cancer had progressed
again. It had started spreading, and parts of it,
had mutated again. So when you think about how this breast cancer
cells disperse, it comes from the original destinations and then it goes to most likely
to the bone, lung or liver or lymph node or whatever the destination might be. Many of these metastatic breast cancer that
happens from the get go already have formed a number of mutations potentially to make
the cells smart enough to be able to do that. So that's what happens a lot of times within
the breast cancer cell. We call it tumor heterogeneity. And then when these cells actually spread,
they also take a different route. So some cells may have gotten into the bone,
some cells may have jumped to the lymph node, and then they may not have come back, although
we think that they're still communicating. Doctors start different chemotherapies for
this mutated version of KT’s cancer, again. And things were going OK again, until the
cancer was found spreading to her liver. And doctors start her on different medicines,
all down these subsequent lines of therapy, as she’s put on experimental medicine known
as clinical trials. This antibody attaches to a cancer cell and
delivers a cytotoxic load of chemotherapy into the cell. If it works for people in breast cancer, which
is a question mark right now, there’s a chance that I could see a beating back of
the current progression I have in my liver. Right now, my liver is at risk in terms of
function. Because I have really big tumors in there. I’m starting to have pain in my sides and
actually know that I have cancer in my liver. It was hard doing this because we had naturally
assumed clinical trials are the last Hail Mary. You got no options left. You’re buying as minutes as what you got. It looks like this is just gonna be the best
option. Hopefully, one that we can tolerate for a
very long time. When something is burning, general rule of
thumb is to stay away. Because solid waste is getting turned into
a gas, of which, you are breathing in part of it. The gas exchanges in your lungs, to your blood,
and then distributes in to human tissue. We know from the 9 11 first responders that
burning building material was linked to long term, adverse health effects. But when it comes to burn pits, the toxins
released from the waste into the air vary widely. And of the chemicals that have been identified,
we know that many of them are known carcinogens. So there was about 18 months of the investigation
between the VA and the National Academy of Science. What are the chemical materials that actually
could be produced by this type of burn pit? And they discovered more than 20 different
chemicals, including benzene, which is like a big no no from the cancer view that you
should not never, ever been exposed to this, including dioxin, benzenes, and all these
chemical particles were generated from the burn pit. And nobody even knows that how high all of
this exposure actually was. So if you say in the cancer cell model that
if you have a just daily exposure of certain particles, very, very low, if you have a slight
increase of like maybe double even to quadruple your cancer risk over time really goes up. But basically what I learned from listening
to some of the stories, is they actually had this kind of raining shower of particles,
so these people were inhaling this, on a daily basis! So we dont even know what’s the exposure
level of the soldiers from these chemicals from the burn pit. So to me, it is a seriously health hazard,
and even before you go in to the cancer, there must have been very serious respiratory illness,
and some of them may not be reversible. And the question is, how do we know these
chemicals cause cancer? This brings us back to cancer cells gaining
super powers. Many of the chemicals found in this study
have been demonstrated in laboratory cell models to cause DNA strand breaks. Have been shown to cause deletions and translocations
in the genes, and impair the cell’s ability to repair this damage. Some of these chemicals are known to damage
the chromosomes, where DNA is tightly bound. All of this meaning the genes of the cells
are broken. In the best case, the cell dies, and the body
cleans it up. But in the worst case, the cell can’t die,
because it gained that super power from mutated and shifted genes in the body, where it starts
to divide and multiply, and its descendants keep that legacy of defying nature and escaping
the body’s defenses. It becomes a tumor, and then grows in places
like KT’s right breast, before spreading to nearby lymph nodes, then to distant sites
like her bones, and then her liver. And while many of these specific chemicals
from burn pits are known carcinogens, there’s still the particulate matter that was once
in the air, but by now 15 years later, has likely deposited in to the ground. In Iraq, it’s the desert. So these particles might have deposited in
to sand. But the thing about sand, is that it blows
easily in to the wind. So, what happens to the local people in these
regions when it’s not just sand blowing around in a dust storm, but possibly toxic
particulate matter from burning waste 15 years earlier? For KT, her appeal for care, after the first
rejection, was again denied. She was able to continue her care through
her private insurance, but her considerations for her son and her husband have been her
#1 priority since her diagnosis. I am not sure how to prepare a seven year
old for losing his mom. I don’t know how to get him ready. I worry and I actually have thought all kinds
of crazy things, like maybe it would be better for me to die when he's 10 than when he's
13. Because at 13 maybe he gets in to rebellion. So crazy thoughts go through your head. Every year when he starts school, I have to
tell my son's teachers, you know, his mom has terminal cancer and he might suffer a
bereavement this year. So I really I want them to be aware and be
looking for what he needs. But in terms of how to really prepare him
for it, I don't know how to. I was absolutely willing to die for my country
when I joined the Marine Corps. I just didn't think it would be like this. Thank you so much for watching. Take care of yourself. And be well.
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You should've seen the burn pit we had in Afghanistan. . Fucking massive. Whem we left we threw everything in there. You could probably see that shit burning for miles away. People through live ammo in there and everything