Cancer war should focus
Wednesday, April 27,
By SAMUEL EPSTEIN
Today, there are generals waging a war that continues to take a massive
toll of Americans' health and life. These generals are asking for billions of
dollars -- on top of the more than $50 billion already spent -- to defeat the
enemy's scourge. But increasingly, independent experts are reporting that the
generals' intelligence and strategies are patently wrong, and that they
consciously misrepresent critical facts in order to paint false, rosy
In all likelihood, you must suspect that I am referring to the Iraq war.
But there is actually another war being handled with startling ham-handedness
and deception. It's a war that claims far more victims than the war against
terror. It is the war against cancer.
In 1971, President Nixon declared the war against cancer and Congress
passed the National Cancer Act. These actions ushered in the new battle,
spurring a 30-fold increase in the budget of the government's National Cancer
Institute -- to a tune of $5 billion this year. The new war also helped the
nation's leading cancer charity, the American Cancer Society, raise tens of
millions in public donations.
With the wind at their backs, and locked at the hip, leaders of the NCI and
ACS became the generals in the new war, and have spent billions of tax and
public dollars in waging it over ensuing years.
But after three decades of highly publicized and misleading promises of
progress, the sad reality has finally dawned: We are in fact losing the cancer
war, in what can only be described as a rout. The incidence of cancers --
notably breast, testes, thyroid, myeloma, lymphomas and childhood -- all
unrelated to smoking -- has escalated to epidemic proportions, now striking
nearly one in every two men, and more than one in every three women.
Meanwhile, overall mortality rates -- the indicator of our ability to survive
cancer once it strikes -- have remained unchanged for decades.
There is strong scientific evidence that this epidemic is due to avoidable
exposures to industrial carcinogens in the totality of the environment -- air,
water, soil, workplaces as well as consumer products, notably, food,
toiletries and cosmetics and household products -- and even some common
But our ongoing defeat in this war is attributable to two important
First, NCI and ACS have focused their abundant resources and institutional
mindsets not on preventing cancer, but on attempting to treat it once it
strikes. NCI, for instance, allocates less than an estimated 3 percent of its
budget to environmental causes of cancer, while the ACS allocates less than
0.1 percent toward this goal. As recently admitted by the president of one of
NCI's leading cancer centers, most NCI resources are spent on "promoting
ineffective drugs" for terminal disease.
By forsaking prevention -- the basic principle that medicine has taught us
over the centuries, and the need for which science again underscores in the
war against cancer -- our cancer generals have embraced a
"damage-control" strategy, akin to treating wounded soldiers, rather
than trying to halt further advance of the enemy.
The simple fact -- the more cancer is prevented, the less there is to treat
-- continues to elude the generals' master plan.
Another reason why our cancer generals are so disserving is that they have
become far too chummy with special interests who either oppose cancer
prevention policies or who trivialize cancer prevention. The ACS heavily
depends on their "Excalibur donors" -- a gallery of chemical
industries opposed to regulating carcinogens, and pharmaceutical companies
seeking approval of their highly touted miracle drugs -- drugs that have shown
limited if any success over decades.
Similarly the NCI has also developed incestuous relationships with cancer
drug companies. Indeed, a former NCI director candidly admitted that the NCI
"has become what amounts to a governmental pharmaceutical company."
In order to change course, drastic reforms are needed in the cancer war
high command and strategies. Both NCI and ACS must be required to devote at
least equal priority and resources to prevent as to treat cancer. The NCI and
ACS must also be required to inform the public, Congress and regulatory
agencies of substantial scientific evidence on industrial, and other avoidable
causes of cancer. Congress should also ensure that companies that pollute our
environment and consumer products with industrial carcinogens are held to the
highest standards of accountability and disclosure.
Nearly every American knows the pain to family and friends caused by
cancer. The crime is that so much of it is avoidable.
Samuel S. Epstein, M.D., is professor emeritus of environmental and
occupational medicine at the School of Public Health at the University of
Illinois-Chicago and author of "Cancer-Gate, How to Win the Losing Cancer
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