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“
Why prevent cancer if we’re making money on it?”
As the American Cancer Society's wealth grows,
its spending on prevention research remains at lowest priority
Responding to
a 1999 article in Sierra, the magazine of the Sierra
Club, which charged the ACS with indifference to prevention,
Dr. Harmon
Eyre,
executive vice president for research and medical affairs for
the Society, released details of its allocations for research
on environmental carcinogenesis. Yet while Eyre claims cancer
cause and prevention are a high priority and receive generous
funding from the ACS, his documentation says the contrary.
Eyre's figures indicate the Society spent $2.6 million in 1998
on nineteen
large research grants on environmental carcinogenesis, but
only three grants could reasonably qualify as environmental cancer
research. And although the Society claims it allocated $100
million
of its $677 million budget to support cancer research in 1998,
analysis reveals that actual expenditures on environmental
carcinogenesis totaled less than $500,000, well under one-hundredth
of one percent
of the Society's total annual budget.
Marching in lockstep with the National Cancer
Institute (NCI) in its "war" on
cancer is its "ministry of information," the ACS
(6). With powerful
media control and public relations resources, the ACS is the
tail that wags the
dog of the policies and priorities of the NCI (7, 8). In addition,
the approach of
the American Cancer Society (ACS) to cancer prevention reflects
a virtually exclusive "blame-the-victim"
philosophy. It emphasizes faulty lifestyles rather than unknowing
and avoidable
exposure to workplace or environmental carcinogens. Giant corporations,
which
profit handsomely while they pollute the air, water, and food
with a wide range of
carcinogens, are greatly comforted by the silence of the ACS.
This silence
reflects a complex of mindsets fixated on diagnosis, treatment,
and basic genetic
research together with ignorance, indifference, and even hostility
to prevention,
coupled with conflicts of interest.
Indeed, despite promises to the public
to do everything to "wipe
out cancer
in your lifetime," the ACS fails to make its voice heard
in Congress and the regulatory
arena. Instead, the ACS repeatedly rejects or ignores opportunities
and requests from Congressional committees, regulatory agencies,
unions, and
environmental organizations to provide scientific testimony
critical to efforts
to legislate and regulate a wide range of occupational and
environmental carcinogens.
This history of ACS unresponsiveness is a long and damning
one, as shown
by the following examples (6):
1. In 1971, when studies unequivocally proved that diethylstilbestrol
(DES)
caused vaginal cancers in teenaged daughters of women administered
the drug
during pregnancy, the ACS refused an invitation to testify
at Congressional
hearings to require the FDA (U. S. Food and Drug Administration)
to ban its
use as an animal feed additive. It gave no reason for its refusal.
2. In 1977 and 1978, the ACS opposed regulations proposed
for hair coloring
products that contained dyes known to cause breast and liver
cancer in
rodents. In so doing, the ACS ignored virtually every tenet
of responsible public
health as these chemicals were clear-cut liver and breast carcinogens.
3. In 1977, the ACS called for a Congressional
moratorium on the FDA's
proposed ban on saccharin and even advocated its use by nursing
mothers
and babies in "moderation" despite clear-cut evidence
of its carcinogenicity in
rodents. This reflects the consistent rejection by the ACS
of the importance of
animal evidence as predictive of human cancer risk.
4. In 1978, Tony Mazzocchi, then senior representative
of the Oil, Chemical,
and Atomic Workers International Union, stated at a Washington,
D. C., round-table
between public interest groups and high-ranking ACS officials: "Occupational
safety standards have received no support from the ACS."
5. In 1978, Congressman Paul Rogers censured
the ACS for doing "too
little,
too late" in failing to support the Clean Air Act.
6. In 1982, the ACS adopted a highly restrictive cancer policy
that insisted
on unequivocal human evidence of carcinogenicity before taking
any position on
public health hazards. Accordingly, the ACS still trivializes
or rejects evidence of
carcinogenicity in experimental animals, and has actively campaigned
against
laws (the 1958 Delaney Law, for instance) that ban deliberate
addition to food of
any amount of any additive shown to cause cancer in either
animals or humans.
The ACS still persists in an anti-Delaney policy, in spite
of the overwhelming
support for the Delaney Law by the independent scientific community.
7. In 1983, the ACS refused to join a coalition of the March
of Dimes, American
Heart Association, and the American Lung Association to support
the Clean
Air Act.
8. In 1992, the ACS issued a joint statement
with the Chlorine Institute in
support of the continued global use of organochlorine pesticides— despite
clear
evidence that some were known to cause breast cancer. In this
statement, Society
vice president Clark Heath, M. D., dismissed evidence of
this risk as "preliminary
and mostly based on weak and indirect association." Heath
then went on to
explain away the blame for increasing breast cancer rates as
due to better detection:
" Speculation that such exposures account for observed geographic
differences
in breast cancer incidence or for recent rises in breast cancer
occurrence
should be received with caution; more likely, much of the recent
rise in incidence
in the United States . . . reflects increased utilization of
mammography over
the past decade."
9. In 1992, in conjunction with the NCI, the
ACS aggressively launched a "
chemoprevention" program aimed at recruiting 16,000
healthy women at supposedly
"
high risk" of breast cancer into a 5-year clinical trial
with a highly profitable
drug called tamoxifen. This drug is manufactured by one of
the
world's most powerful cancer drug industries, Zeneca, an offshoot
of the Imperial
Chemical Industries. The women were told that the drug was
essentially
harmless, and that it could reduce their risk of breast cancer.
What the women
were not told was that tamoxifen had already been shown to
be a highly potent
liver carcinogen in rodent tests, and also that it was well-known
to induce human
uterine cancer (6, pp. 145– 151).
10. In 1993, just before PBS Frontline aired the special entitled "In
Our
Children's Food," the ACS came out in support of the
pesticide industry. In a
damage-control memorandum sent to some 48 regional divisions,
the ACS
trivialized pesticides as a cause of childhood cancer, and
reassured the public that
carcinogenic pesticide residues in food are safe, even for
babies. When the media
and concerned citizens called local ACS chapters, they received
reassurances
from an ACS memorandum by its vice president for Public Relations
(9):
“ The primary health hazards of pesticides are from direct contact
with the
chemicals at potentially high doses, for example, farm workers
who apply
the chemicals and work in the fields after the pesticides have
been applied,
and people living near aerially sprayed fields. . . . The American
Cancer Society
believes that the benefits of a balanced diet rich in fruits
and vegetables
far outweigh the largely theoretical risks posed by occasional,
very low pesticide
residue levels in foods.“
11. In September 1996, the ACS
together with a diverse group of patient and
physician organizations filed a "citizen's petition" to
pressure the FDA to ease
restrictions on access to silicone gel breast implants. What
the ACS did not disclose
was that the gel in these implants had clearly been shown to
induce cancer
in several industry rodent studies, and that these implants
were also contaminated
with other potent carcinogens such as ethylene oxide and crystalline
silica.
This abysmal track record on prevention has been the subject
of periodic
protests by both independent scientists and public interest
groups. A
well-publicized example was a New York City, January 23, 1994,
press
conference, sponsored by the author and the Center for Science
in the Public
Interest. The press release stated: "A group of 24 scientists
charged that the ACS
was doing little to protect the public from cancer-causing
chemicals in the
environment and workplace. The scientists urged ACS to revamp
its policies and
to emphasize prevention in its lobbying and educational campaigns." The
scientists— who included Matthew Meselson and Nobel
laureate George Wald,
both of Harvard University; former OSHA director Eula Bingham;
Samuel
Epstein, author of The Politics of Cancer; and Anthony Robbins,
past president
of the American Public Health Association— criticized
the ACS for insisting on
unequivocal human proof that a substance is carcinogenic before
it will
recommend its regulation.
This public criticism by a broad representation
of highly credible scientists
reflects the growing conviction that a substantial proportion
of cancer deaths
are caused by exposure to chemical carcinogens in the air,
water, food supply,
and workplace, and thus can be prevented by legislative and
regulatory action.
Calling the ACS guidelines an "unrealistically high-action
threshold," a letter to
ACS executive vice president Lane Adams states that "we
would like to express
our hope that ACS will take strong public positions and become
a more active
force to protect the public and the work force from exposure
to carcinogens." ACS's policy is retrogressive and contrary
to authoritative and scientific tenets
established by international and national scientific committees,
and is in conflict
with long-established policies of federal regulatory agencies.
Speakers at the
conference warned that unless the ACS became more supportive
of cancer prevention,
it would face the risk of an economic boycott. Reacting promptly,
the
ACS issued a statement claiming that cancer prevention would
become a major
priority. However, ACS policies have remained unchanged. More
recently, the
author has issued this warning again, a warning echoed by activist
women's
breast cancer groups. In Cancer Facts & Figures— 1998,
the latest annual ACS publication designed
to provide the public and medical profession with "Basic
Facts" on cancer—
other than information on incidence, mortality, signs and symptoms,
and
treatment— there is little or no mention of prevention
(10). Examples include: no
mention of dusting the genital area with talc as a known cause
of ovarian cancer;
no mention of parental exposure to occupational carcinogens
as a major cause of
childhood cancer; and no mention of prolonged use of oral contraceptives
and
hormone replacement therapy as major causes of breast cancer.
For breast cancer,
ACS states: "Since women may not be able to alter their
personal risk factors, the
best opportunity for reducing morality is through early detection." In
other
words, breast cancer is not preventable in spite of clear evidence
that its incidence
has escalated over recent decades, and in spite of an overwhelming
literature
on avoidable causes of this cancer (6, Chapt. 6). In the
section on "Nutrition
and Diet," no mention at all is made of the heavy contamination
of animal and
dairy fats and produce with a wide range of carcinogenic pesticide
residues, and
on the need to switch to safer organic foods.
REFERENCES
1. Bennett, J. T. Health research charities:
Doing little in research but emphasizing politics.
Union Leader, Manchester, N. H., September 20, 1990.
2. Bennett, J. T., and DiLorenzo, T. J.
Unhealthy Charities: Hazardous to Your Health
and Wealth. Basic Books, New York, 1994.
3. Hall, H., and Williams, G. Professor
vs. Cancer Society. The Chronicle of Philanthropy,
January 28, 1992, p. 26.
4. DiLorenzo, T. J. One charity's uneconomic
war on cancer. Wall Street Journal,
March 15, 1992, p. A10.
5. Salant, J. D. Cancer Society gives to
governors. Associated Press Release, March 30,
1998.
6. Epstein, S. S., Steinman, D., and LeVert,
S. The Breast Cancer Prevention Program.
Macmillan, New York, 1997.
7. Epstein, S. S. Losing the war against
cancer: Who's to blame and what to do about it.
Int. J. Health Serv. 20: 53– 71, 1990.
8. Epstein, S. S. Evaluation of the National
Cancer Program and proposed reforms. Int. J.
Health Serv. 23( 1): 15– 44, 1993.
9. American Cancer Society.
Upcoming television special on pesticides in food. Memorandum
from S. Dickinson, Vice-President, Public Relations and Health,
to C. W.
Heath, Jr., M. D., Vice-President. Epidemiology and Statistics,
March 22, 1993.
10. American Cancer Society. Cancer
Facts & Figures - 1998,
pp. 1– 32, Atlanta, 1998.
Excerpted from “The
High Stakes of Cancer Prevention” by Samuel Epstein
and Liza Gross, Tikkun Magazine, Nov/Dec 2000 www.tikkun.org
and “American Cancer Society: The
World’s Wealthiest
Nonprofit Institution”
by Samuel S. Epstein, International Journal of Health Services
Volume 29, Number 3, 1999
CONTACT:
Samuel S. Epstein, M.D.
Cancer Prevention Coalition
University of Illinois at Chicago
School of Public Health
2121 W. Taylor St., MC 922
Chicago, IL 60612
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