The state is known as the agricultural powerhouse of the United States.
But recently, Iowa has gained even more bad press after becoming the state with the highest rate of new cancers.
It is estimated that 21,000 new cases of cancer will be diagnosed in Iowa this year, and 6,100 residents will die from cancer.
This is more than double the rate of new cancers 40 years ago, despite the population increasing by only 11 percent.
The trend has been widely blamed on rising alcohol consumption in the state, but local doctors say the very chemicals used to support Iowa’s agriculture may be partly fueling the state’s cancer crisis.
DailyMail.com traveled to Iowa to speak with cancer patients, locals whose communities have been shaken by the disease, and doctors and health care workers on the front lines of what they call an “epidemic.”
Surrounded by cancer: Maureen Reeves-Horsley, a nurse in northern Iowa, said she knows six people with pancreatic cancer who live in her neighborhood.
Vicious Cycle: Maria Steele is a retired nurse and avid cyclist living in central Iowa who was diagnosed with stage 4 lung cancer and given only a year to live.
Maureen Reeves Horsley, 71, is a senior registered nurse in Palo Alto County, which had the highest cancer incidence rate in the entire state of Iowa and the second-highest rate of any county in the U.S. from 2016-2020.
She said she has been treating local people since the 1980s and knows the disease well.
Her sister died of breast cancer at age 27, a rare tragedy at the time but one that seems to be becoming a more common story in recent years, she said.
Six of her neighbors have pancreatic cancer, one of the deadliest types, and some have already died. Pancreatic cancer is linked to alcohol use, but Horsley said none of her neighbors drink alcohol.
She knows of about two dozen people currently being treated for other types of cancer, and her community fears pesticides may be part of the cause.
Dr. Richard Deming, medical director of Mercy Cancer Center in Des Moines, who sees patients from across the state, told DailyMail.com that Iowa stands out for “the amount of (agricultural) chemicals per square inch compared to other states” and the number of residents who work in agriculture.
Iowa’s 30.5 million acres of farmland employ an estimated 153,000 farmers and generate $783 million in revenue, according to the 2022 Census.
The state uses 237 million pounds of herbicides and 11.6 billion pounds of fertilizer annually, more than any other state and about one-third of the nation’s annual pesticide use.
The state’s two largest crops are corn and soybeans, which require large amounts of pesticides and fertilizers.
Iowa also leads the nation in hog-raising, the USDA reports, which means the state produces a lot of fertilizer and, as a result, a lot of nitrates, a chemical that has been linked to cancer.
“So some of us wonder if there’s some connection between these things,” Dr. Deming said.
He added: “We are in an age where tobacco manufacturers can deny direct causation. I think many people believe that some kind of causal link will be found over time. We wouldn’t be surprised if it turns out that tobacco causes cancer.”
Maria Steele, 67, is a lifelong Iowa nurse based in Cedar Rapids, the state’s second largest city.
She had a career in emergency medicine but was diagnosed with stage four lung cancer a week before Christmas 2019, which led to her immediate retirement.
Doctors told her the tumor had spread to her brain and bones and was inoperable and incurable.
She was told she only had about a year left to live.
Mrs. Steele did not smoke, did not grow up around smokers and led a healthy, active lifestyle.
“To be honest, it was quite a shock,” she told DailyMail.com.
Handling a surge in patients: Dr. Richard Deming runs his oncology practice and charity work in Iowa’s state capital, seeing patients from across the state.
She and her husband are avid bikers and have completed a bike trip across the United States from Florida to California.
They had no idea what had caused her cancer diagnosis, but her daughter did a Google search and discovered radon.
Radon is a colorless, odorless radioactive gas that is emitted from the earth from areas rich in uranium, a chemical element found in rocks and soil.
Iowa has the highest average radon levels in the nation – six times the national average – and an estimated 72 percent of homes are affected, according to the Iowa Cancer Association.
As the state’s native uranium begins to break down in the ground, it seeps into the soil.
From there, it seeps through small holes for wiring or plumbing, or even cracks in a building’s foundation, and accumulates without you noticing.
Inhaling radioactive gases irritates and mutates cells in the lungs, which is the leading cause of lung cancer in non-smokers in the United States, according to the EPA.
Lung cancer is the third most common cancer in Iowa, behind breast and prostate cancer.
After receiving the diagnosis, Mrs. Steele purchased testing equipment and discovered that the radon gas levels in her home were twice what the EPA considers safe indoors.
Since her initial diagnosis, Steele has undergone radiation treatment and targeted therapy, which she says she plans to take for the rest of her life.
Mrs Steele survived for almost five years despite the dire prognosis, and is now preparing for a second cycle trip across the country with her husband.
“I’m feeling great and most people are shocked when they see me and find out I have stage four cancer,” she told DailyMail.com.
Private well: The farm in northwest Iowa where Horsley grew up. Like many in the state, she grew up drinking water from a private well on her property.
About 210 miles from Steele, Horsley grew up, along with his seven brothers and sisters, drinking water from a private well on his family’s farm.
She’s since moved several times, and in her previous home, well tests showed arsenic, a natural by-product of collapsing rock and a known carcinogen.
This made her realise how easy it is to drink contaminated water without knowing it – and she said this also applies to pesticides.
Pesticides sprayed on crops can potentially wash into groundwater sources, David Kwartney, professor of civil and environmental engineering at the University of Iowa and director of the Center on Health Effects of Environmental Pollution, told DailyMail.com.
According to the Canadian Cancer Society, “Studies have found that exposure to pesticides is commonly associated with several types of cancer, including non-Hodgkin’s lymphoma, multiple myeloma, prostate cancer, kidney cancer and lung cancer.”
However, US scientists have repeatedly said there is a lack of evidence to prove that pesticides cause disease and have maintained that they are safe.
An EPA representative told DailyMail.com that it’s possible for pesticides to get into tap water, but national guidelines tightly regulate what chemicals are allowed.
They said: “EPA regularly reviews existing registered pesticides to ensure that they can be used without undue risks to human health and the environment.”
“The registration review program is intended to ensure that all registered pesticides continue to meet the statutory standard of being free of unreasonable adverse effects as risk assessment capabilities evolve and policies and practices change.”
In addition to pesticides, fertilizers and compost from farms react with the air to produce nitrates, Prof Kwiertony said it could build up in water and soil and be carried away from fields by rain and drainage systems.
According to the National Cancer Institute, consuming nitrates may increase the risk of developing colon, kidney, stomach, thyroid, and ovarian cancer.
Horsley said he understands that farmers want to protect their livelihoods and may react defensively when questions are raised about the chemicals they use.
She doesn’t want to stop farmers from working, she just wants them to be better informed so they can do their jobs.
She told the website: “People have a right to know the truth, and if they choose to indulge in toxicity, I think that’s their choice.”
“They can smoke, they can drink, they can be into chemicals if they want, but in my opinion, they need to be educated.”
She hopes elected officials will devote more budget and attention to the issue and its impact on rural areas.
Dr Deming warned that while more attention needs to be paid to pesticides, they are not the only cause of the cancer surge.
The Silent Killer: Radon levels in Iowa are six times the national average, affecting an estimated 72% of homes. Radon is a colorless, odorless and nearly undetectable gas.
Living Through Cancer: Dr. Deming’s weekly spin classes allow cancer patients to exercise for free, and after class, the group meets for smoothies.
Radon exposure, unhealthy diet and excessive alcohol consumption also contributed to the increased death rate in Iowa.
Diet and exercise are the final pieces of the puzzle in Iowa’s cancer prevention strategy.
These habits are second only to smoking in increasing the risk of cancer, Deming said, adding that despite producing 10 percent of the nation’s food supply, many Iowans eat convenience foods and get little exercise.
Poverty is also widespread in many of the state’s rural counties, making fresh food difficult to buy, and some doctors blame highly processed foods for rising cancer rates among young people nationwide.
Alcohol consumption has also been linked to laryngeal, breast, colon and liver cancer. Iowa ranked fourth in the nation for heavy drinking in 2022.
In addition to dietary habits, more than a quarter of Iowans report not being physically active outside of their regular work schedule, according to a 2022 report from the United Health Foundation.
The state has the 11th highest adult obesity rate in the nation, with more than 35 percent of the population considered obese.
Approximately one-third of cancers in the United States can be attributed to excess weight, and the CDC has noted links between obesity and cancer of the colon, uterine, stomach, kidney, liver, pancreas, ovary and thyroid.
Colorectal cancer is the fourth most common cancer in Iowa.
Deming said diet and exercise are powerful tools even after a cancer diagnosis, and how you eat and exercise can influence your outcome. Steele is proof of this.
To help manage the burden cancer patients face and improve treatment outcomes, Dr. Deming founded Above and Beyond Cancer, a charity that provides patients with free holistic health and exercise classes.
For many patients, the goal is no longer to cure the cancer, as it is impossible, but instead to live as full a life as possible with the disease.
“Gratitude and finding your own strength is something we can cultivate, and that can happen even for someone with an incurable cancer that will ultimately kill them,” he said.
