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GUEST POINT OF VIEW

An Epidemic Of Deception: Why We Can't Trust The Cancer Establishment

An Interview With Samuel Epstein

by Derrick Jensen

Originally published in The Sun, March 2000. Reproduced with permission

A thousand Americans die every day from cancer. Almost everyone knows at least one casualty. My grandfather died of bladder cancer, my great-aunt of stomach cancer. I’ve lost several cousins and family friends to breast cancer. Just today, I heard that an old acquaintance has skin cancer.

According to Dr. Samuel Epstein, one of the world’s foremost authorities on the carcinogenic effects of toxic and industrial pollutants in air, water, the workplace, and consumer products, most of these deaths are preventable. But cancer prevention in this society has, according to Epstein, come to mean primarily two things: (1) stopping smoking; and (2) chemoprevention, such as taking the highly profitable prescription drug tamoxifen to try to prevent breast cancer. Sometimes it includes diet and exercise. But missing from most discussions of prevention -- intentionally missing, says Epstein -- is any mention of the probable cause of the current cancer epidemic: the poisoning of our entire planet.

It isn’t really news that the air we breathe, the water we drink, and the foods we eat are all contaminated with carcinogens. Some toxicologists are predicting that the future of humankind could be slow suicide by poison. Yet, Epstein asserts, environmental toxins are ignored in cancer research, because reducing them doesn’t serve the interests of chemical and pharmaceutical companies and the "cancer establishment" -- mainly the National Cancer Institute and the American Cancer Society.

Epstein has been fighting the cancer establishment for more than thirty years. His prize-winning 1978 book The Politics of Cancer (Sierra Club Books), a 770-page tome, has become something of a holy text to many who are combating polluting industries. An updated version appeared in 1998 from East Ridge Press. He is also the author of The Safe Shopper’s Bible (Macmillan, 1995) and The Breast Cancer Prevention Program (Macmillan, 1998), among others. He has worked closely with many Congressional committees and provided key expert testimony that helped to ban such hazardous pesticides as DDT, Aldrin, and Chlordane.

Epstein says there was no single moment when he decided to become an advocate; it just runs in his family. His father -- a leading Talmudic scholar of this century and author of a seminal book on Jewish ethics, Faith of Judaism -- "had a fanatic obsession with justice and human rights."

Epstein’s own passion for justice became evident early in his career as an M.D., when his boss, a prominent research doctor at a leading pediatric hospital in London, England, claimed to have discovered that massive doses of vitamin B12 cured one of the childhood cancers of the nervous system. Epstein was skeptical of the claim and, when unable to get the raw data any other way, waited till late at night, then broke into the safe containing the patients’ charts. His suspicions proved correct: the claim was bogus. When the hospital refused to stop the research, citing potential damage to its reputation, Epstein threatened to go public. Research was halted, but he resigned from his job to leave for the United States, where he established the first laboratories of environmental toxicology and carcinogenesis at Harvard in 1960.

In 1996, Epstein represented the European Union at World Trade Organization talks about the use of genetically engineered hormones in meat production. He has been president or chair of many organizations, including the Rachel Carson Council (for nearly two decades), the Society of Occupational and Environmental Health, and at present the Cancer Prevention Coalition, and he recently won the Right Livelihood Award, commonly known as the Alternative Nobel Prize. He is currently professor emeritus of environmental and occupational medicine at the University of Illinois School of Public Health in Chicago.

Because Epstein is so busy, I had a difficult time scheduling this interview. We finally met at his Chicago apartment on a hot Labor Day morning, a day after he flew in from Los Angeles and a day before he was scheduled to fly off to London. Epstein is courteous in the extreme and speaks with a clipped British accent. We talked in his spotless office, which was beautifully decorated and lined with bookshelves. From a window, I could see Lake Michigan.

Jensen: You have written that, in the last few decades, "the incidence of cancer, including a wide range of nonsmoking cancers, has escalated to epidemic proportions, with lifetime cancer risks now approaching 50 percent." That’s a pretty startling statistic.

Epstein: To be precise, the risk is approaching one in two for men and one in three for women. And that’s true not only in the United States, but in all major industrialized nations. If similar numbers of people contracted cholera or dysentery, the entire country would mobilize against the disease. Yet the extent of this epidemic has consistently been hidden -- as well as it is possible to hide something so monumental -- and its causes have routinely been mystified.

A hundred years ago, pneumonia and influenza were the top two causes of death in this country, followed by tuberculosis, infectious gastrointestinal diseases, and heart disease. Cancer was number eight, accounting for less than 4 percent of all deaths. Today, cancer is the second leading cause of death (after heart disease) and accounts for about 20 percent of deaths.

Now, some of this increase is due to a decrease in the number of deaths from the flu, tuberculosis, and so on. There is also the factor of increased longevity: living longer increases one’s chance of developing cancer. But these factors don’t come near to accounting for the total rise. Even within specific age groups, there is a greater cancer risk today than there was fifty years ago. In other words, a sixty-year-old man is much more likely to die of cancer today than was his counterpart fifty years ago. Cancer is now the only major deadly disease whose incidence is on the rise. Just between 1973 and 1994, the rate of cancer incidence increased by 23 percent -- more than 1 percent per year. This increase is very real, and it persists even after statistically adjusting for an aging population and for smoking.

Jensen: So why are cancer rates increasing?

Epstein: I think the answer is terribly simple. Parallel to the escalating incidence of cancer, there has been an explosive expansion of technologies -- particularly in the petrochemical industry, which really took off in the early forties. Between 1940 and 1990, the total annual production of synthetic organic chemicals increased from 1 billion to more than 600 billion pounds.

Over the last few decades, our total environment has become pervasively contaminated with a wide range of toxic and carcinogenic chemicals, some of which are persistent -- that is, long-lived. When I say "total environment," I mean our air, water, soil, consumer products, food, and workplace. Even our own body fats have become contaminated. This is true from the North Pole to the South, not only for humans but for a wide range of marine life and wildlife, as well.

Jensen: I remember reading that polar-bear fat is now contaminated with dioxin.

Epstein: Precisely. And at the same time that the total environment has become contaminated, multiple lines of evidence have linked different cancers with exposure to these various chemicals. First, there is evidence from rodent tests that the chemicals are carcinogenic. Second, we have seen major increases in cancer rates for domestic pets and among fish and wildlife populations. Finally, we have substantial evidence of increased cancer rates in human populations exposed to various carcinogenic products or processes -- especially in the workplace.

There are innumerable ways in which the general public is exposed involuntarily and unknowingly to avoidable industrial carcinogens, but workplace exposure is often the most clear-cut. There is usually well-documented knowledge of the hazards of working in certain industries, though the specific nature of these hazards, and their extent, sometimes remains poorly defined.

Although we have a massive escalation of the incidence of nonsmoking cancers, the extent of these increases is consistently trivialized by a variety of statistical manipulations, with the public’s attention focused on allegedly decreasing mortality rates that are largely accounted for by decreasing cancer mortality in smoking-related lung cancer in men. And the public is denied access to accurate information about the causes of nonsmoking cancers, which lies buried in government and industry files and in relatively inaccessible scientific literature.

Jensen: But everybody knows viscerally that cancer rates are up, because we all know someone who has died of cancer.

Epstein: That perception may be common among people you talk to, but in the wider society, I think the cheerleaders at the New York Times, the American Cancer Society, the National Cancer Institute, and the various carcinogenic industries are all doing an extraordinary job of keeping the lid on information about this epidemic.

Jensen: You may have a point. My grandfather died of bladder cancer when I was four, but until I read your book, I never really considered that saccharin probably killed him. He was a diabetic and ate saccharin at every meal.

Epstein: Saccharin has been extensively tested over the last five decades, but most of those studies are still unpublished, because they were done by industry or government. Nonetheless, the animal tests and human studies to which we do have access show a clear connection between bladder cancer and saccharin.

Overall, the public is tragically misinformed about the causes of cancer. People are under the impression that the overwhelming cause of cancer is smoking. While there’s no question that smoking is the single most important cause of cancer, lung cancer accounts for only about one quarter of the overall cancer increase since 1950. And at least 20 percent of lung cancers are caused by factors other than smoking. The really major increases in cancer incidence have been in a wide range of non-smoking-related cancers, such as prostate cancer, multiple myeloma, and non-Hodgkin’s lymphomas, with rates having gone up 200 percent for each. Brain cancer in adults is up 80 percent; testicular cancer, up 110 percent (up nearly 300 percent in men aged twenty to thirty-five); breast cancer and male colon cancer, each up about 60 percent; and childhood brain cancer, up about 40 percent. And while the number of deaths from smoking-related cancers is in a fairly substantial decline for men, it’s still on the increase for women.

These figures apply to major industrialized nations. In less-industrialized countries, the danger is probably even greater. The major industrialized nations at least have the basis of a regulatory structure, however grossly imperfect. But the less-industrialized countries are now faced with two problems: major increases in smoking, and the rush to cash in on the global economy. So there’s a headlong move toward industrialization without any recognition of the hazards involved.

Europe provides a powerful example of this dynamic. In many ways, Europe can be divided into three economic tiers: At the top of the heap are the Nordic countries. France and Germany are in the middle. And at the bottom of the pile, you’ve got Greece, Portugal, and their peers. In Greece and Portugal, the pressure to industrialize is so heavy that we’re now seeing a major -- and, so far, successful -- effort by the Canadian asbestos industry to establish large asbestos-manufacturing and -processing facilities there.

Asbestos, of course, is a major carcinogen, and debate about its use is the prototypical example of industry evasion concerning the carcinogenic effects of a profitable product. Asbestos is virtually indestructible, highly resistant to fire, and has great tensile strength. It’s used in cement, asphalt, wallboard, pipes, textiles, insulation, food and beverage processing, brake linings, and so on. Unfortunately, its use leads to about fifty thousand deaths per year, in the U.S. alone, from cancer and lung diseases.

As long ago as 1918, enough was known about the dangers of asbestos to lead U.S. and Canadian insurance companies to stop selling life insurance to asbestos workers. Since then, numerous studies have linked exposure to asbestos with asbestosis, lung cancer, and a host of other deadly diseases. Yet, from the beginning, the asbestos industry fought any sort of regulation of workplace conditions, stating (and this tactic will be familiar to anyone who has paid attention to the tobacco industry) that asbestos doesn’t really cause cancer or other diseases -- and that, even if it did, getting rid of the cancer risk would result in severe economic dislocation and unemployment. Then, during a lawsuit in the 1970s, a series of industry documents was discovered -- the "Asbestos Pentagon Papers," I dubbed them -- showing that the industry had known all along how dangerous asbestos is and had worked tirelessly to suppress studies and spread disinformation.

The danger, by the way, is not only to asbestos workers. Mine wastes have contaminated drinking water, construction sites are often heavily contaminated, and the use of asbestos in so many products virtually guarantees that everyone will be exposed to it.

Against this backdrop, the asbestos industry is moving aggressively into less-industrialized countries, which, in the global economy, are put in a position of valuing industrial growth over the health of their citizens. Because of their lesser wealth, the governments of Portugal and Greece will willingly expose their workers to risks the Scandinavians would never accept.

Jensen: That reminds me of an infamous quote by Lawrence Summers, then chief economist for the World Bank and now U.S. secretary of the treasury: "I think the economic logic behind dumping a load of toxic waste in the lowest-wage country is impeccable, and we should face up to that."

Epstein: We see this attitude again and again, the world over.

Jensen: You mentioned the American Cancer Society and the National Cancer Institute. What are their roles in dealing with the cancer epidemic?

Epstein: The American Cancer Society (ACS) is the world’s largest nonreligious charity. It takes in more than $600 million a year, ostensibly to fight cancer, and its cash reserves approach a billion dollars. But the vast majority of the ACS’s budget goes for salaries, executive benefits, overhead, and other administrative expenses. Less than 16 percent of all the money raised is spent on direct services, such as driving cancer patients home from the hospital after chemo, or providing pain medication. And the ACS’s money -- even that used for research -- is spent in ways guaranteed not to offend either big polluters or big pharmaceutical companies. Why? In part, because the board of the ACS is closely interlocked with those same companies. So the ACS has consistently come out in support of the pesticide industry, has actively campaigned against the Delaney Clause (a federal regulation banning the deliberate addition to food of any substance shown to cause cancer), and has refused to support the Clean Air Act. It’s shocking -- or it would be, if it weren’t so consistent.

The National Cancer Institute (NCI) was founded by Congress in 1937. Its budget remained modest until 1971, when President Nixon declared a "war against cancer." At that time, Congress was led to believe that a massive infusion of funding for cancer research could produce a cure within five years. Not surprisingly, the NCI, too, spends its money in ways guaranteed not to ruffle the feathers of anyone in the pharmaceutical or polluting industries. There are many reasons for this, but the most obvious is the old revolving door: the director of the NCI’s Division of Cancer Treatment left to become the head of drug research and development at Bristol-Myers Squibb; the director of the Division of Cancer Etiology became the head of the National Soft Drinks Association, where he vigorously promotes the use of artificial sweeteners, including saccharin; and the NCI’s past director became vice-president and chief scientific officer of IVAX, a major manufacturer of cancer drugs. This is an old pattern.

Something else the ACS and the NCI have in common, both with each other and with the industries they strive not to offend, is the overwhelming use of "blame the victim" tactics. The standard position of the cancer establishment is that environmental and occupational exposures to carcinogens are relatively trivial. If you get cancer, you’ve either chosen it through your lifestyle, or else you got it because of genetic factors. Let’s address the latter assertion first.

A tremendous amount of money is being spent searching for the "cancer-susceptibility gene," even though genetic factors are directly involved in less than 10 percent of all cancers. And genetics can’t possibly be implicated as a factor in the escalating incidence of cancer in recent decades: it takes tens of thousands of years for a population’s genetic makeup to change.

As for lifestyles, smoking obviously causes cancer, but even with it factored in, cancer rates are still exploding. Fat is another suggested factor. Actually, the way that fat is suggested is very revealing. For thirty or forty years, the NCI and the ACS have been funding studies attempting to show that people with high-fat diets are at risk for a wide range of cancers, but there is just no evidence that a high-fat diet by itself causes cancer. Now, this is where the choice of studies funded by these organizations gets interesting. The NCI and the ACS have never studied -- and probably never will -- precisely what is in the fat. Diets in the Mediterranean countries, where cancer rates are significantly lower than in the U.S., can be up to 40 to 45 percent fat, because of the prevalent use of olive oil. But the fats we eat in this country are primarily animal and dairy fats, which are sinks for carcinogenic substances: pesticides, industrial chemicals, dioxin, and so on. The NCI and the ACS have never studied this; I’m sure you can guess why.

Jensen: Just yesterday, I read a quote from an NCI spokesperson on the front page of a Chicago newspaper: "It’s proven we can prevent cancer. It used to be a theory. We need more funding to expand the field."

Epstein: That’s so typical. We’ve been hearing this line for decades now. Claims that the cure for cancer is around the corner -- we just need more money -- date back to the 1960s. But for the majority of cancers, there’s been no improvement in survival rates, other than what’s called "lead-time bias": if you can diagnose a lung-cancer tumor early on, for example, there is a slight improvement in the survival rate. But if you factor in this lead-time advantage, you find there’s been no improvement for the overwhelming majority of cancers. For most patients, with most cancers, chemotherapy is, at best, nothing more than a placebo.

There are, I must say, some notable exceptions: testicular cancer has a pretty good response to treatment and an 80 percent regression rate, with very prolonged regressions. Similarly, there are very good results in treating childhood cancers. But even these results are overstated, for three reasons: First, there’s a high incidence of second cancers due to the treatment, which is itself carcinogenic. Second, in the children who survive treatment, there is often a recurrence of the original cancer. And third, among the children who survive -- and a significant number do -- there’s a high instance of neurological, behavioral, reproductive, and other problems because of the toxicity of the treatment. That’s not to say that these aren’t very real improvements. But we have to keep in mind that for the great majority of cancers there has been no improvement whatsoever.

Jensen: So why the constant claims that we’re on the verge of curing cancer?

Epstein: Funding. What did that quote say? "We need more funding to expand the field." That’s what they always say. And the funding they seek is always for chemotherapy and "chemoprevention" -- products that supposedly limit cancer risks for those who take them. There is virtually no funding for limiting people’s exposure in the first place. Why? Because that doesn’t make money for pharmaceutical companies.

Right now, funding for the NCI is about $2.8 billion annually. Both the NCI and the ACS are putting pressure on the administration to increase that to nearly $5 billion by the year 2003. The overwhelming emphasis is going to be on damage control -- diagnosis and treatment -- rather than on prevention. This is absurd. You don’t just expose people to carcinogens and then try to repair the damage by giving them a pill.

Take breast cancer, for example. The ACS asserts that there is "nothing a woman can do to reduce her risk of developing breast cancer." This, despite ample evidence that many causes are largely, if not entirely, avoidable -- among them: prolonged use of birth-control pills and estrogen-replacement therapy; ingestion of high-fat animal and dairy products, which are heavily contaminated with chlorinated pesticides; consumption of hormone-contaminated meat; exposure to petrochemical carcinogens in the workplace (putting about one million women at risk); exposure to carcinogenic chemicals from hazardous-waste sites and petrochemical plants; prolonged use of black and dark brown permanent or semi-permanent hair dyes; insertion of silicone-gel breast implants; heavy smoking and drinking commencing in adolescence; inactivity and obesity. So there is plenty that a woman can do to lower her risk.

But let’s presume that we’re going to take a pharmacological approach. If so, what would be the best drug to take? In my 1998 book The Breast Cancer Prevention Program, I recommend a drug that has been shown in five independent studies to reduce the incidence of breast cancer by about 30 percent. It’s cheap and readily available. But information on its breast-cancer-prevention capability hasn’t reached the general public. Can you guess what the drug is?

Jensen: I don’t know.

Epstein: Aspirin. And why haven’t women been informed that aspirin, in addition to reducing the incidence of heart disease and colon cancer, also reduces the incidence of breast cancer? Because it’s not patentable, which means there’s no money to be made off aspirin as a cancer-prevention drug.

Contrast this with tamoxifen, which is the subject of the newspaper article you mentioned. The world’s top-selling cancer drug, tamoxifen is manufactured solely by Zeneca, a spinoff of Imperial Chemical Industries, one of the world’s largest petrochemical manufacturers. Tamoxifen is expensive, and while it is modestly successful in treating breast cancer, its claims of prevention are dubious, to say the least. What’s more, tamoxifen is an extremely dangerous drug. It triples the risk of uterine cancer. (One tamoxifen supporter characterizes this as "no big deal," since uterine cancer can be cured by hysterectomy.) It’s one of the most potent known liver carcinogens, making it likely that a significant number of healthy women receiving tamoxifen will die from liver cancer within a decade or so, without any warning of this very grave risk. And there are other problems as well, including blood clots and pulmonary embolism.

So here we have an extraordinarily dangerous drug being given to healthy women on the premise that it will cut their breast-cancer rates significantly, yet it’s been shown that the incidence of tamoxifen-induced complications in healthy women is higher even than the drug’s alleged reduction in breast-cancer rates. In fact, that alleged reduction was almost certainly due to small, as-yet-undetected tumors being treated by tamoxifen. And two long-term European trials turned up no evidence that tamoxifen reduced rates of breast cancer at all. So, at best, tamoxifen is an exercise in disease substitution, not disease prevention. Nevertheless, it’s being pushed by the ACS, the NCI, the New York Times, and, more broadly, the federal government, while aspirin is being ignored.

Well, maybe ignored is too strong a word. One of the things aspirin does is inhibit an enzyme known as cyclooxygenase 2, or cox-2. Cox-2 inhibitors like aspirin block the formation of new blood vessels, thereby discouraging cancerous tumors from growing. This effect of aspirin is not exactly being ignored, because we’re now seeing a variety of pharmaceutical companies racing to develop patented cox-2 inhibitors, all of which will do the same thing as aspirin, but can, of course, be sold at enormous profits.

And this actually points to another problem. One of the excuses the ACS uses for not advocating many common-sense prevention measures is the need to study mechanisms -- in other words, exactly how a carcinogen operates -- before it can make recommendations. But mechanisms are irrelevant in public health: what’s important is the weight of evidence of causation. As a scientist, I am extraordinarily interested in mechanisms and have spent a substantial portion of my life investigating the specifics of carcinogenesis. But from a pragmatic public-health standpoint, it makes no difference what the mechanisms are, provided you block or interrupt the exposure and prevent the resulting cancer.

Jensen: I work a lot on forest and salmon issues, and I see that delaying tactic used all the time there, as well. We always hear, "We need to study for another five years whether dams kill salmon," or, "We need to study for another five years whether clear-cutting silts up streams." Of course, it’s just an excuse to continue business as usual.

Epstein: That’s a good analogy, but I believe it understates the seriousness of the problem with the cancer establishment-industrial complex. The timber industries are merely making money through their destructive practices, whereas there is a vast research industry built around studying cancer mechanisms ad infinitum. For example, a major impetus for the genetic-research industry -- which feeds into gene therapy for cancer -- would be reduced simply by shifting emphasis to prevention of exposure. So it’s obviously in the interest of that industry never to let that shift happen.

Jensen: This makes me very angry, because what we’re really talking about is death: people are dying because some effective methods of cancer prevention don’t convert into high profits.

Epstein: Time and again, we see that government and industry are both willing to sacrifice human lives on the altar of profits, with the mainstream media there to support them all the way. Tamoxifen is just one of a vast number of examples, which include food additives (many of which are purely cosmetic), pesticides, genetically engineered foods, and female sex hormones. A vice-president of Ayerst Laboratories, maker of the hormonal drug Premarin, had the effrontery and ignorance to claim, "Nobody has shown a cause-and-effect relationship between Premarin and cancer. It does not cause cancer. It just accelerates it."

Jensen: It’s criminal.

Epstein: Indeed. I was recently on a TV talk show where I debated the safety of genetically modified food with someone representing the Food Technology Association. I began with a brief statement on the hazards of rBGH, the synthetic bovine-growth hormone that is now present in nearly all U.S. dairy products. I described how, in 1989, someone dropped off at my office a batch of documents that had been stolen from the Food and Drug Administration’s files on Monsanto, the company that manufactures rBGH. Included was a Monsanto document from 1987 indicating that the company was fully aware of rBGH’s danger and was conspiring with the FDA to suppress information critical to veterinary and public health.

The industry representative responded: "We’ve researched this question of genetically modified foods very closely, and you don’t think we’d sell any product that would be harmful, do you? We’d be shooting ourselves in the foot. We’ve done every conceivable study, and we’re convinced it’s perfectly safe."

I said, "I hate to be direct, but can you cite me a single study that Monsanto, or anybody else in the industry, has published documenting what questions they’ve asked, what tests they’ve done, and what are the results of those tests?"

She hemmed and hawed, saying, "You can’t expect us to publish every study," and finally admitted that, no, she couldn’t cite a single study. Basically, she was saying, "Trust us."

In spite of clear evidence that Monsanto and the FDA have suppressed and manipulated information on genetically modified milk since the 1980s, in 1994 they introduced a new technology into the market, about which they have published minimal information, particularly in regard to cancer risks for which there is well-documented, independent scientific evidence. I see no difference between these groups and the tobacco industry, which gave us these same assurances for decades.

Jensen: In your books, you’ve introduced the idea of public-health-crimes trials.

Epstein: That idea got its start about twenty years ago, when I got a call from John Conyers, then chairman of the House Judiciary Committee, saying that he was drafting legislation on white-collar crime. He was wondering if there was something in the environmental/public-health field that he could possibly bring into his bill. I told him that, if he was serious about it, I would draft legislation covering crimes with economic motivation and public-health consequences.

That initially took him aback, but eventually I drafted something and went to Washington, D.C., to testify. I presented examples of manipulation, suppression, distortion, and destruction of data in half a dozen industries, and recommended that criminal penalties be imposed on executives, CEOs, managers, and scientists who perpetrated this conduct.

Henry Hyde was minority chairman when I testified. As I read my testimony, he started getting red in the face. Unable to rebut my arguments, he said, "I gather from your accent that you’re not an American citizen."

I paused a moment and said, "Sir, I’m more American than you are. You were born here and are American by accident of birth. I chose to live in this country."

Hyde was furious. He said, "You’re coming here to tell us that a law-abiding CEO of a company, who goes to church and provides community services, should be thrown in jail because somebody on his staff makes a mistake?"

I said, "You’ve misrepresented what I said, but the answer, in principle, is yes. And, furthermore, if for economic gain that CEO puts in place practices that damage public health -- in other words, kills or injures innocent people -- I think we should lock him up and throw away the key."

At this point, Hyde said, "I’m not going to listen to this nonsense," and stomped out.

I’ve now come to believe that we need Nuremberg-type trials to hold industries accountable for these sorts of public-health crimes. The tobacco industry would be one example, but there is a wide range of other industries whose executives we need to begin holding accountable. Scientists, too. There are a vast number of indentured scientists in this country willing to jump through any hoop for the sake of profit. In addition, we need to bring to account regulatory officials and members of expert advisory committees -- all the people who are supposed to be overseeing public health but are instead facilitating the poisoning of the American people, and, in fact, the people of the world.

I am dead serious about this. I would like to see an international forum on public-health crimes, where those responsible could be tried by jurists. We’re now seeing enormous publicity for the International War Crimes Tribunal in The Hague. If we are able to assemble a collection of distinguished jurists and focus the world’s attention on war crimes in remote Kosovo, how is it that we can do nothing similar about the massive, premeditated withholding of information on carcinogens by major multinational corporations?

Jensen: After the Gulf War, former U.S. Attorney General Ramsey Clark helped assemble a war-crimes trial, which tried George Bush, Norman Schwarzkopf, Colin Powell, and a number of others for war crimes and crimes against humanity. They were found guilty.

Epstein: One of the reasons that tribunal didn’t get more press is that Bush and the others claimed they were trying to prevent even greater disasters.

Jensen: Couldn’t industries make essentially the same argument? "We’re making the world a better place," they might say. "Without formaldehyde, you’re not going to have plywood."

Epstein: I wouldn’t consider that a reasonable argument, because if you expect people to take risks in exchange for certain specified benefits, then you have to provide them with adequate information concerning the risks. Also, for every hazardous technology, there are nonhazardous alternative technologies.

I think it’s helpful to look at cancer not just as a disease, not just as an epidemic, but also as a paradigm. Cancer is a paradigm for failed democracy, because it’s an expression of the devastating impacts on human beings of a series of allegedly beneficial technologies that continue to be imposed on society without disclosure of their known adverse effects. Cancer is also a paradigm for runaway technology, and for the impact of toxins on the environment.

Jensen: Besides putting people on trial, what can we do about all this?

Epstein: I think there are a number of straightforward things we can do. The first is the vigorous pursuit of the "right to know." This is a fundamental democratic right, and to call for its implementation is the perfect political strategy, because not even the most corporate-enslaved politician can look you in the eye and say, "You don’t have the right to information that affects your health and that lies buried in government and industry files."

Another obvious step is to ban hazardous new technologies, or technologies for which we don’t have adequate information. This, of course, is predicated on first enacting the right to know.

The next step would be to phase out a variety of hazardous products and processes already on the market. Interestingly enough, there’s good evidence that this is both practical and cost-effective. For example, in 1989, the Commonwealth of Massachusetts enacted a Toxic Use Reduction Act. This legislation was put together by a coalition of activist groups, the University of Lowell (which has a good school of industrial engineering), and some fairly reasonable industries.

Jensen: Define reasonable.

Epstein: These industries said, "Look, if you can show us how to go on about our business without losing money, then we’ll work with you." The results of the law have been phenomenal. Over the past decade, for example, hazardous organic solvents have been substantially phased out and replaced by safer alternatives.

Here’s another example of cost-effective cleanup: Xerox no longer focuses on selling copying machines; instead, it largely leases them, effectively selling services rather than products. When your machine wears out, the company replaces it for you and recycles the old machine into a lower grade of copier. The leasing strategy also works for Interface, one of the major carpeting suppliers in America. Interface installs a carpet for you, making sure no toxic or hazardous glues are used, and when the carpet is worn out, the company picks it up, recycles it, and provides you with a new carpet.

The organic-food and safe-products industries have taken off like a rocket in the last ten years. Because there’s basically no regulation of consumer products, marketplace pressure is beginning to kick in, and consumers are gradually rewarding responsible industries and punishing reckless ones.

Jensen: I like that idea, but I have a reservation about the marketplace taking care of these problems. For example, labeling genetically engineered foods would be better than their not being labeled, but genetically engineered foods would also be cheaper than their nonengineered counterparts. This would imply that it’s OK for poor people to eat less-healthy food.

Epstein: Actually, I recently expressed the same concern when I was debating the biotech industry together with John Hagelin, the presidential candidate for the Natural Law Party, who advocates food labeling coupled with testing. Unfortunately, labeling is a politically feasible option, whereas calling for an outright ban on genetically engineered foods may well be pissing in the wind.

On the other hand, I’ve advised the European Union not to allow hormone-contaminated meats in at all, because the discrimination inherent in labeling would become a problem in poorer countries such as Greece and Portugal. Eventually, the EU opted to maintain sanctions on such meat.

But I believe if we combine marketplace pressures with government-enacted policy, good things can happen. Indeed, if national policies are directed toward phasing out hazardous technologies, companies will follow suit. PVC -- polyvinyl chloride -- is an example of this process. One of PVC’s major problems is that it is manufactured by the polymerization of vinyl chloride, which is highly carcinogenic. Back in 1974, we put pressure on BF Goodrich to try to regulate occupational exposure to vinyl chloride, but Goodrich claimed that doing so would cost something like $100 billion, thousands of jobs, and so on. Eventually, we gave up on persuasion and moved toward regulation, which was successful. And within eighteen months, Goodrich was making more money, not less.

Jensen: How?

Epstein: Easy: they used a vacuum stripper to recover the vinyl chloride that had previously been going into the air, and they recycled it. Then they leased this technology to other companies and made a profit that way, too.

Jensen: On both a social and a personal level, what can people do to reduce their personal risk of cancer, and also to help stem the epidemic?

Epstein: Well, the first thing is to recognize that there is an epidemic. The second thing is to realize that the National Cancer Institute and the American Cancer Society are largely indifferent, if not hostile, to cancer prevention -- particularly the prevention of involuntary exposure to avoidable industrial carcinogens, which are now present throughout the environment. And everyone should know that there is a total failure on the part of these organizations to make information available to the public. Obviously, too, people can try to avoid exposure to carcinogens and to educate themselves further about these matters.

On a social level, I would encourage people to consider refusing to pay their water bill unless the bill is accompanied by a statement of what carcinogenic contaminants are present in the water. This will encourage municipalities to install activated-carbon filtration systems, which are quite expensive. The local governments, in turn, will become keenly interested in which industries are responsible for the carcinogens they are now having to clean up, and will put pressure on those industries to change their ways.

In any community with a hazardous-waste site, or a petrochemical or nuclear plant, I would urge people to find out exactly which chemicals are present at the site, and what materials go into and out of the plant. On an ongoing basis, people should get information on smokestack and other emissions and on reducing pollution of their community air. This may seem like a hassle, but it’s your life we’re talking about.

At the same time, I would recommend boycotting the ACS and getting Congress to hold the NCI’s feet to the fire by blocking any further appropriations for that agency until it establishes at least parity for prevention programs with all other treatment and related research programs. And we need to get the NCI to tell the truth about its prevention programs. Very often the majority of what the NCI calls "prevention programs" are unrelated studies in which the word prevention is used. And most of the rest are based on chemoprevention of the tamoxifen type. What I mean by prevention is providing the public with information on the totality of exposure to avoidable carcinogens in air, water, food, workplace, and the rest of our environment.

Finally, we need to have a registry on the totality of exposure to carcinogens, like the one the NCI has on drug treatments for cancer, complete with a toll-free number for information. There should be another one for food additives, and one for all environmental exposures. The NCI has done no outreach or education whatsoever in this area, nor has it ever provided Congress or regulatory agencies with scientific data that might provide the basis for legislative and regulatory actions.

The only way to break the "iron triangle" of the cancer-industrial complex -- the partnership of bureaucrats, industry, and politicians beholden to industry -- is by fully establishing and exercising our right to know. The public must be aware of the hazards it faces.

We really need to ask ourselves why we continue to accept assurances from industries with dirty hands and institutions that have shown themselves to be recklessly irresponsible. They say they are winning the war against cancer. How long are we going to believe them?

* * *

Derrick Jensen's most recent book is A Language Older Than Words. He is also the author of the books Listening to the Land: Conversations About Nature, Culture, and Eros, and Railroads and Clearcuts. The former was a Critics Choice for one of the best nature books of 1995. He writes for The New York Times Magazine, Audubon, and The Sun among many others.

He now lives in Crescent City, California, near the ocean and among the redwoods. He is working to improve habitat for the coho salmon who swim upstream near his home, and for the California red-legged frogs who sing nightly outside his windows. He teaches creative writing at Pelican Bay State Prison.  

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