by Samuel S. Epstein, MD, Chairman of the Cancer Prevention Coalition, Professor
Emeritus of Environmental & Occupational Medicine at the University of Illinois
at Chicago School of Public Health, and NOHA Professional Advisory Board Member
Phone 312-996-2297; web http://www.preventcancer.com ; e-mail firstname.lastname@example.org.
and Quentin D. Young, MD, Chairman of the Health and Medicine Policy Research
Group, and Past President of the American Public Health Association.
Phone 312-372-4292; web http://www.hmprg.org ; e-mail email@example.com .
In politics, spinning is an art form. Most accept spinning as a fact of life, whether choosing a politician or merely a bar of soap. However, few would accept this gamesmanship for life and death issues of cancer, particularly if the spinning is underwritten by taxpayers. But, when it comes to the cancer war, the Pollyannaish promises of the federal National Cancer Institute (NCI) and the non-profit American Cancer Society (ACS) are no more reliable than political flack.
The President has finally conceded the need for an independent commission to investigate misrepresentations that led us into the war on Iraq. We should use a similar commission to investigate the much more lethal failure of the cancer war.
Recent headlines in national newspapers, based on NCI and ACS assurances, report that the "Rate of Cancer Deaths Continues to Drop." This reinforces longstanding claims of miracle "breakthrough" treatments, that mortality would be halved by 2000, that the nation had "turned the corner" in the cancer war, and that "considerable progress has been made in reducing the burden of cancer." However, these claims don't even pass the laugh test. Cancer death rates have remained unchanged since President Nixon declared the 1971 War Against Cancer. Nearly one in two men and more than one in three women are now struck by cancer. Cancer has become a disease of "mass destruction."
Contrary to the NCI and ACS, the current cancer epidemic is not due to faulty lifestylesmoking, unhealthy diet, and obesity. American men smoke less today, and lung cancer rates are steadily dropping. In striking contrast, the incidence of environmentally and non-smoking related cancers has escalated sharply: non-Hodgkin's lymphoma by 71 percent, testes and thyroid cancers by 54 percent each, post-menopausal breast cancer by 37 percent, and myeloid leukemia by 15 percent; various childhood cancers have increased from 20 to 60 percent. For African Americans, the news is worse: incidence rates have increased by up to 120 percent.
The escalating incidence of non-smoking adult cancers and childhood cancers
is paralleled by the 30-fold increase in NCI's budget from $220 million in 1972
to the current $4.6 billion. The ACS budget has increased from $130 to $800
million, with about $1 billion in reserves. It seems that the more we spend
on cancer, the more cancer we get.
The reason we are losing this winnable war is because NCI and ACS priorities remain fixated on damage controlscreening, diagnosis, and treatmentand related basic research. All merit substantial funding. However, less funding would be needed if more cancer was prevented, with less to treat.
Responding to criticisms of such imbalanced priorities, NCI now allocates 12% of its budget to "prevention and control," and requires its nationwide Centers to have a "prevention component." However, cancer prevention continues to be narrowly defined in terms of faulty lifestyle, and screening, and excludes any reference to avoidable causes of cancer from exposures to industrial carcinogens. These include: contaminants of air, water, food, and the workplace; ingredients in cosmetics and toiletries, and household productsparticularly pesticides.
The reason we are losing this winnable war is because NCI and ACS priorities remain fixated on damage control-screening, diagnosis, and treatment-and related basic research. All merit substantial funding. However, less funding would be needed if more cancer was prevented, with less to treat.
NCI's indifference to such avoidable causes of cancer extends to denial. For example, NCI claims that, "The causes of childhood cancer are largely unknown," in spite of substantial contrary evidence. Similarly, ACS reassures that carcinogenic exposures from dietary pesticides, "toxic wastes in dump sites," and radiation from "closely controlled" nuclear power plants are all "at such low levels that risks are negligible."
Not surprisingly, Congressman John Conyers (D-MI), Ranking Member of the House Judiciary Committee and Dean of the Congressional Black Caucus, recently warned that so much cancer carnage is preventable. "Preventable, that is if the NCI gets off the dime and does its job."
NCI and ACS policies are compounded by conflicts of interest, particularly with the cancer drug industry. In a 1998 Washington Post interview, Dr. Samuel Broder, NCI's former Director, dropped a bombshell: "The NCI has become what amounts to a government pharmaceutical company." Broder resigned from the NCI to become successive Chief Officer of two major cancer drugs companies.
The ACS has a fund raising apparatus, which would make any Presidential candidate
blush. Apart from public donations, the ACS swims in the largesse of over 300
Excalibur industry donors, each contributing over $100,000 annually. These include
over 25 drug and biotech companies, and petrochemical and oil industries. Unbelievably,
ACS legislative initiatives are handled by Edelman PR, the major lobbyist of
the tobacco industry, and fast food and beverage companies, now targeted by
anti-obesity litigation. Not surprisingly, The Chronicle of Philanthropy,
the nation's leading
charity watchdog, has charged: "The ACS is more interested in accumulating wealth than saving lives."
. . . cancer prevention continues to be narrowly defined in terms of faulty lifestyle, and screening, and excludes any reference to avoidable causes of cancer from exposures to industrial carcinogens. These include: contaminants of air, water, food, and the workplace; ingredients in cosmetics, toiletries, and household productsparticularly pesticides.
The cancer war is certainly winnable, given radical changes in its high command
and priorities, and given that information on avoidable industrial causes of
cancer is provided to the public and Congress. The President has finally conceded
the need for an independent commission to investigate misrepresentations that
led us into the war on Iraq. We should use a similar commission to investigate
the much more lethal failure of the cancer war.
*Reprinted with permission from the Cancer Prevention Coalition (CPC), www.preventcancer.com
Article from NOHA NEWS, Vol. XXIX, No. 4, Fall 2004, page 1