Planetary care is good cancer care

To the Editor: Recently, more than 400 Australian doctors (including both authors) signed an open letter published in The Australian,¹ calling on our federal government to protect the health of Australians by banning any new fossil fuel projects.

From the perspective of clinicians treating cancer, there are many reasons that this is an urgent request. Aside from their contribution to greenhouse gas emissions, fossil fuel projects increase air pollution and particulate matter less than or equal to 2.5 μm in diameter (PM_2.5), which are both risk factors for lung cancer.² This includes EGFR-mutated lung cancer, which is classically associated with never smoking or light smoking.³ Disturbingly, air pollution is linked to increased mortality in paediatric and young adults with cancer.⁴ Air and wastewater pollution generated by fossil fuel projects contains multiple carcinogens. This includes benzene, which is associated with haematological malignancies; additional studies demonstrate a positive association between residential proximity to petrochemical facilities and leukaemia.^5-8

While new projects have been recently approved across the nation, the Beetaloo Basin and Middle Arm project are the most notable, with echoes of the distressing Louisiana petrochemical corridor (United States), which is also referred to as “cancer alley” due to residents’ disproportionate exposure to toxic industrial by-products.^{8, 9} Australia risks creating its own “sacrifice zone”, harming the health of its people and contributing irrevocably to the climate crisis.

Natural disasters and extreme weather events amplified by climate change also disrupt access to care, which is critical for patients undergoing cancer treatment and translates to poorer outcomes.

Aside from cancer, there are various other risks, including asthma, cardiovascular disease and pre-term birth. These are avoidable and unacceptable illnesses, which can lead to deaths.

When the evidence that smoking harmed health was overwhelming, doctors championed this message and took action. In 2024, we — as physicians — need to convey the message that banning new fossil fuel projects is not a political ask, rather is essential to protect the health of our nation.

Both authors are active members of Doctors for the Environment Australia, and signed the open letter, which is referenced in this manuscript.