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Samuel
S. Epstein M. D.
The American Cancer
Society is fixated on damage control— diagnosis
and treatment— and basic molecular biology, with indifference
or even
hostility to cancer prevention. This myopic mindset is compounded
by
interlocking conflicts of interest with the cancer drug, mammography,
and
other industries. The "nonprofit" status of the Society
is in sharp conflict with
its high overhead and expenses, excessive reserves of assets
and contributions to political parties. All attempts to reform
the
Society over the past two decades have failed; a national economic
boycott of the Society is long overdue.
The American Cancer Society (ACS) is accumulating
great wealth in its role
as a "charity." According to James Bennett, professor
of economics at George
Mason University and recognized authority on charitable organizations,
in 1988
the ACS held a fund balance of over $400 million with about
$69 million of
holdings in land, buildings, and equipment (1). Of that money,
the ACS spent
only $90 million— 26 percent of its budget— on
medical research and programs. The rest covered "operating expenses," including
about 60 percent for generous
salaries, pensions, executive benefits, and overhead. By 1989,
the cash reserves
of the ACS were worth more than $700 million (2). In 1991,
Americans, believing
they were contributing to fighting cancer, gave nearly $350
million to the
ACS, 6 percent more than the previous year. Most of this money
comes from
public donations averaging $3,500, and high-profile fund-raising
campaigns such
as the springtime daffodil sale and the May relay races. However,
over the last
two decades, an increasing proportion of the ACS budget comes
from large corporations,
including the pharmaceutical, cancer drug, telecommunications,
and
entertainment industries.
In 1992, the American Cancer Society Foundation
was created to allow the
ACS to actively solicit contributions of more than $100,000.
However, a close
look at the heavy-hitters on the Foundation's board will give
an idea of which interests
are at play and where the Foundation expects its big contributions
to come
from. The Foundation's board of trustees included
corporate executives from the
pharmaceutical, investment, banking, and media industries. Among
them:
- David R. Bethune, president of Lederle Laboratories,
a multinational pharmaceutical
company and a division of American Cyanamid Company. Bethune
is
also vice president of American Cyanamid, which makes chemical
fertilizers
and herbicides while transforming itself into a full-fledged
pharmaceutical
company. In 1988, American Cyanamid introduced Novatrone, an
anti-cancer
drug. And in 1992, it announced that it would buy a majority
of shares of
Immunex, a cancer drug maker.
- Multimillionaire Irwin Beck, whose father, William
Henry Beck, founded the
nation's largest family-owned retail chain, Beck Stores, which
analysts estimate
brought in revenues of $1.7 billion in 1993.
- Gordon Binder, CEO
of Amgen, the world's foremost biotechnology company,
with over $1 billion in product sales in 1992. Amgen's success
rests almost exclusively
on one product, Neupogen, which is administered to chemotherapy
patients to stimulate their production of white blood cells.
As the cancer epidemic
grows, sales for Neupogen continue to skyrocket.
- Diane Disney
Miller, daughter of the conservative multi-millionaire Walt
Disney, who died of lung cancer in 1966, and wife of Ron Miller,
former president
of the Walt Disney Company from 1980 to 1984.
- George Dessert,
famous in media circles for his former role as censor on the
subject of "family values" during the 1970s and
1980s as CEO of CBS, and
now chairman of the ACS board.
- Alan Gevertzen, chairman of the board of Boeing,
the world's number one
commercial aircraft maker with net sales of $30 billion in
1992.
- Sumner M. Redstone, chairman of the board, Viacom
Inc. and Viacom International
Inc., a broadcasting, telecommunications, entertainment, and
cable television
corporation.
The results of this board's efforts have
been very successful. A million here, a
million there— much of it coming from the very industries
instrumental in shaping
ACS policy, or profiting from it.
In 1992, The Chronicle of Philanthropy reported that the
ACS was "more
interested in accumulating wealth than in saving lives." Fund-raising
appeals
routinely stated that the ACS needed more funds to support its cancer programs,
all the while holding more than $750 million in cash and real estate assets
(3).
A 1992 article in the Wall Street Journal, by Thomas DiLorenzo, professor
of
economics at Loyola College and veteran investigator of nonprofit organizations,
revealed that the Texas affiliate of the ACS owned more than $11 million
worth
of assets in land and real estate, as well as more than 56 vehicles, including
11 Ford Crown Victorias for senior executives and 45 other cars assigned
to staff
members. Arizona's ACS chapter spent less than 10 percent of its funds
on direct
community cancer services. In California, the figure was 11 percent, and
under
9 percent in Missouri (4):
Thus for every $1 spent on direct service,
approximately $6.40 is spent on
compensation and overhead. In all ten states, salaries and fringe benefits
are
by far the largest single budget items, a surprising fact in light of
the characterization
of the appeals, which stress an urgent and critical need for donations
to provide cancer services. Nationally,
only 16 percent or less of all money raised is spent on direct services
to cancer victims, like driving cancer patients from the hospital
after
chemotherapy
and providing pain medication.
Most of the funds raised by the ACS go to
pay overhead, salaries, fringe benefits,
and travel expenses of its national executives in Atlanta. They also
go to pay
chief executive officers, who earn six-figure salaries in several states,
and
the hundreds of other employees who work out of some 3,000 regional
offices
nationwide. The typical ACS affiliate, which helps raise the money
for the
national office, spends more than 52 percent of its budget on salaries,
pensions,
fringe benefits, and overhead for its own employees. Salaries and overhead
for
most ACS affiliates also exceeded 50 percent, although most direct
community
services are handled by unpaid volunteers. DiLorenzo summed up his
findings by
emphasizing the hoarding of funds by the ACS (4):
If current needs are not being met because
of insufficient funds, as fund-raising
appeals suggest, why is so much cash being hoarded? Most contributors
believe their donations are being used to fight cancer, not to accumulate
financial reserves. More progress in the war against cancer would
be made if
they would divest some of their real estate holdings and use the
proceeds— as well as a portion of their cash reserves— to
provide more cancer services.
Aside from high salaries and overhead, most
of what is left of the ACS budget
goes to basic research and research into profitable patented cancer
drugs.
The current budget of the ACS is $380 million and its cash reserves
approach
$1 billion. Yet its aggressive fund-raising campaign continues
to plead poverty
and lament the lack of available money for cancer research, while
ignoring
efforts to prevent cancer by phasing out avoidable exposures to
environmental
and occupational carcinogens. Meanwhile, the ACS is silent about
its intricate
relationships with the wealthy cancer drug, chemical, and other
industries.
A March 30, 1998, Associated Press Release shed unexpected light
on questionable
ACS expenditures on lobbying (5). National vice president for federal
and state governmental relations Linda Hay Crawford admitted that
the ACS was
spending "less than $1 million a year on direct lobbying." She
also admitted that
over the last year, the society used ten of its own employees to
lobby. "For
legal
and other help, it hired the lobbying firm of Hogan & Hartson,
whose roster
includes former House Minority Leader Robert H. Michel (R- IL)." The
ACS
lobbying also included $30,000 donations to Democratic and Republican
governors'
associations. "We wanted to look like players and be players," explained
Crawford. This practice, however, has been sharply challenged.
The Associated
Press release quotes the national Charities Information Bureau
as stating that it" does not know of any other charity that makes contributions to political
parties."
Tax experts have warned that these contributions may be illegal,
as charities
are not allowed to make political donations. Marcus Owens, director
of the IRS
Exempt Organization Division, also warned that "The bottom
line is campaign
contributions will jeopardize a charity's exempt status."
TRACK RECORD ON PREVENTION
Marching in lockstep with the National Cancer Institute (NCI)
in its "war" on
cancer is its "ministry of information," the ACS (6, pp. 306- 314).
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 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.
CONFLICTS OF INTEREST
Of the members of the ACS board, about half are clinicians, oncologists,
surgeons,
radiologists, and basic molecular scientists— and most are
closely tied in
with the NCI. Many board members and their institutional colleagues
apply for
and obtain funding from both the ACS and the NCI. Substantial NCI
funds go to
ACS directors who sit on key NCI committees. Although the ACS asks
board
members to leave the room when the rest of the board discusses
their funding
proposals, this is just a token formality. In this private club,
easy access to funding
is one of the "perks," and the board routinely rubber-stamps
approvals. A significant
amount of ACS research funding goes to this extended membership.
Such conflicts of interest are evident in many ACS priorities,
including their policy
on mammography and their National Breast Cancer Awareness campaign
(6).
Mammography
The ACS has close connections to the mammography industry. Five
radiologists have served as ACS presidents, and in its every move,
the ACS reflects the interests of the major manufacturers of mammogram
machines and films, including Siemens, DuPont, General Electric,
Eastman Kodak, and Piker. In fact, if every woman were to follow
ACS and NCI mammography guidelines, the annual revenue to health
care facilities would be a staggering $5 billion, including at least
$2.5 billion for premenopausal women. Promotions of the ACS continue
to
lure women of all ages into mammography centers, leading them to
believe that mammography is their best hope against breast cancer.
A leading Massachusetts newspaper featured a photograph of two women
in their twenties in an ACS advertisement that promised early detection
results in a cure "nearly 100 percent of the time." An
ACS communications director, questioned by journalist Kate Dempsey,
responded in an article published by the Massachusetts Women's
Community's journal Cancer: "The ad isn't based on a study.
When you make an advertisement, you just say what you can to get
women in the door. You exaggerate a point. . . . Mammography today
is a lucrative [and] highly competitive business."
In addition, the mammography industry conducts research for the
ACS and its grantees, serves on advisory boards, and donates considerable
funds. DuPont also is a substantial backer of the ACS Breast Health
Awareness Program; sponsors television shows and other media productions
touting mammography; produces advertising, promotional, and information
literature for hospitals, clinics, medical organizations, and doctors;
produces educational films; and, of course, lobbies Congress for
legislation promoting availability of mammography services. In virtually
all of its important actions, the ACS has been strongly linked with
the mammography industry, ignoring the development of viable alternatives
to mammography.
The ACS exposes premenopausal women to radiation hazards from mammography
with little or no evidence of benefits. The ACS also fails to tell
them that their breasts will change so much over time that the "baseline"
images have little or no future relevance. This is truly an American
Cancer Society crusade. But against whom, or rather, for whom?
National
Breast Cancer Awareness Month
The highly publicized National Breast Cancer Awareness Month campaign
further illustrates these institutionalized conflicts of interest.
Every October, ACS and NCI representatives help sponsor promotional
events, hold interviews, and stress the need for mammography. The
flagship of this month-long series of
events is National Mammography Day, on October 17 in 1997.
Conspicuously absent from the public relations campaign of the National
Breast Cancer Awareness Month is any information on environmental
and other avoidable causes of breast cancer. This is no accident.
Zeneca Pharmaceuticals— a spin-off of Imperial Chemical Industries,
one of the world's largest manufacturers of chlorinated and other
industrial chemicals, including those incriminated as causes of
breast cancer— has been the sole multimillion-dollar funder
of
National Breast Cancer Awareness Month since its inception in 1984.
Zeneca is also the sole manufacturer of tamoxifen, the world's top-selling
anticancer and breast cancer "prevention" drug, with $400
million in annual sales. Furthermore, Zeneca recently assumed direct
management of 11 cancer centers in U. S. hospitals. Zeneca owns
a 50 percent stake in these centers known collectively as Salick
Health Care.
The
link between the ACS and NCI and Zeneca is especially strong when
it comes to tamoxifen. The ACS and NCI continue aggressively to
promote the tamoxifen trial, which is the cornerstone of its minimal
prevention program. On March 7, 1997, the NCI Press Office released
a four-page "For Response to Inquiries on Breast Cancer."
The brief section on prevention reads:
“
Researchers are looking for a way to prevent breast cancer in women
at high risk. ... Alargestudy [is underway] to see if the drug tamoxifen
will reduce cancer risk in women age 60 or older and in women 35
to 59 who have a pattern of risk factors for breast cancer. This
study is also a model for future studies of cancer prevention. Studies
of diet and nutrition could also lead to preventive strategies.”
Since Zeneca influences every leaflet, poster, publication, and
commercial produced by National Breast Cancer Awareness Month, it
is no wonder these publications make no mention of carcinogenic
industrial chemicals and their relation to breast cancer. Imperial
Chemical Industries, Zeneca's parent company, profits by manufacturing
breast cancer- causing chemicals. Zeneca profits from treatment
of breast cancer, and hopes to profit still more from the prospects
of large-scale national use of tamoxifen for breast cancer prevention.
National Breast Cancer Awareness Month is a masterful public relations
coup for Zeneca, providing the company with valuable, if ill-placed,
good will from millions of American women.
The Pesticide Industry
Just how inbred the relations between the ACS and the chemical industry
are became clear in the spring of 1993 to Marty Koughan, a public
television producer. Koughan was about to broadcast a documentary
on the dangers of pesticides to children for the Public Broadcasting
Service's hour-long show, Frontline. Koughan's investigation relied
heavily on an embargoed, ground-breaking report
issued by the National Academy of Sciences in June of 1993 entitled
"Pesticides in the Diet of Children." This report declared
the nation's food supply "inadequately protected" from
cancer-causing pesticides and a significant threat to the health
of children.
An earlier report, issued by the Natural Resources Defense Council
in 1989," Intolerable Risk: Pesticides in our Children's Food,"
had also given pesticide manufacturers failing marks. The report
was released in high profile testimony to Congress by movie actress
Meryl Streep. A mother of young children, Streep explained to a
packed House chamber the report's findings, namely, that children
were most at risk from cancer-causing pesticides on our food because
they consume
a disproportionate amount of fruits, fruit juices, and vegetables
relative to their size, and because their bodies are still forming.
Shortly before Koughan's program was due to air, a draft of the
script was mysteriously leaked to Porter- Novelli, a powerful public
relations firm for produce growers and the agrichemical industry.
In true Washington fashion, Porter-Novelli plays both sides of the
fence, representing both government agencies and the industries
they regulate. Its client list in 1993 included Ciba-Geigy, DuPont,
Monsanto, Burroughs
Wellcome, American Petroleum Institute, Bristol-Meyers-Squibb,
Hoffman-LaRoche, Hoechst Celanese, Hoechst Roussel Pharmaceutical,
Janssen Pharmaceutical, Johnson & Johnson, the Center for Produce
Quality, as well as the U. S. Department of Agriculture, the NCI,
plus other National Institutes of Health.
Porter-Novelli first crafted a rebuttal to help the manufacturers
quell public fears about pesticide-contaminated food. Next, Porter-Novelli
called up another client, the American Cancer Society, for whom
Porter-Novelli had done pro bono work for years. The rebuttal that
Porter-Novelli had just sent off to its industry clients was faxed
to ACS Atlanta headquarters. It was then circulated by e-mail on
March 22, 1993, internally— virtually verbatim from the memo
Porter-Novelli
had crafted for a backgrounder for 3,000 regional ACS offices to
have in hand to help field calls from the public after the show
aired.
"
The program makes unfounded suggestions . . . that pesticide residue
in food may be at hazardous levels," the ACS memo read. "Its
use of `cancer cluster' leukemia case reports and non-specific community
illnesses as alleged evidence of pesticide effects in people is
unfortunate. We know of no community cancer clusters
which have been shown to be anything other than chance grouping
of cases and none in which pesticide use was confirmed as the cause."
This bold, unabashed defense of the pesticide industry, crafted
by Porter- Novelli, was then rehashed a third time, this time by
the right-wing group, Accuracy in Media (AIM). AIM's newsletter
gleefully published quotes from the ACS memo in an article with
the banner headline: "Junk Science on PBS." The article
opened with "Can we afford the Public Broadcasting Service?"
and went on to disparage Koughan's documentary on pesticides and
children. "In Our
Children's Food . . . exemplified what the media have done to produce
these `popular panics' and the enormously costly waste [at PBS]
cited by the New York Times."
When Koughan saw the AIM article he was initially outraged that
the ACS was being used to defend the pesticide industry. "At
first, I assumed complete ignorance on the part of the ACS,"
said Koughan. But after repeatedly trying, without success, to get
the national office to rebut the AIM article, Koughan began to see
what was really going on. "When I realized Porter-Novelli represented
five agrichemical companies, and that the ACS had been a client
for years,
it became obvious that the ACS had not been fooled at all,"
said Koughan. "They were willing partners in the deception,
and were in fact doing a favor for a friend— by flakking for
the agrichemical industry."
Charles Benbrook, former director of the National Academy of Sciences
Board of Agriculture, worked on the pesticide report by the Academy
of Sciences that the PBS special would preview. He charged that
the role of the ACS as a source of information for the media representing
the pesticide and produce industry was "unconscionable"
(11). Investigative reporter Sheila Kaplan, in a 1993
Legal Times article, went further: "What they did was clearly
and unequivocally over the line, and constitutes a major conflict
of interest" (12).
Cancer Drug Industry
The intimate association between the ACS and the cancer drug industry,
with cur-rent annual sales of about $12 billion, is further illustrated
by the unbridled aggression which the Society has directed at potential
competitors of the industry (13). Just as Senator Joseph McCarthy
had his "black list" of suspected communists and Richard
Nixon his environmental activist "enemies list," so too
the ACS
maintains a "Committee on Unproven Methods of Cancer Management"
which periodically "reviews" unorthodox or alternative
therapies. This Committee is comprised of "volunteer health
care professionals," carefully selected proponents of orthodox,
expensive, and usually toxic drugs patented by major pharmaceutical
companies, and opponents of alternative or "unproven"
therapies which are
generally cheap, nonpatentable, and minimally toxic (13).
Periodically,
the Committee updates its statements on "unproven methods,"
which are then widely disseminated to clinicians, cheerleader science
writers, and the public. Once a clinician or oncologist becomes
associated with "unproven methods," he or she is blackballed
by the cancer establishment. Funding for the
accused "quack" becomes inaccessible, followed by systematic
harassment. The highly biased ACS witch-hunts against alternative
practitioners is in striking contrast to its extravagant and uncritical
endorsement of conventional toxic chemotherapy. This in spite of
the absence of any objective evidence of improved survival rates
or reduced mortality following chemotherapy for all but some relatively
rare cancers.
In response to pressure from People Against Cancer, a grassroots
group of cancer patients disillusioned with conventional cancer
therapy, in 1986 some 40 members of Congress requested the Office
of Technology Assessment (OTA), a Congressional think tank, to evaluate
available information on alternative innovative therapies. While
initially resistant, OTA eventually published a September 1990 report
that identified some 200 promising studies on alternative
therapies. OTA concluded that the NCI had "a mandated responsibility
to pursue this information and facilitate examination of widely
used `unconventional cancer treatments' for therapeutic potential"
(14).
Yet the
ACS and NCI remain resistant, if not frankly hostile, to OTA's recommendations.
In the January 1991 issue of its Cancer Journal for Clinicians
ACS referred to the Hoxsey therapy, a nontoxic combination of herb
extracts developed in the 1940s by populist Harry Hoxsey, as a "worthless
tonic for cancer." However, a detailed critique of Hoxsey's
treatment by Dr. Patricia Spain Ward, a leading contributor to the
OTA report, concluded just the opposite:" More recent literature
leaves no doubt that Hoxsey's formula does indeed contain many plant
substances of marked therapeutic activity" (13).
Nor is this the first time that the Society's
claims of quackery have been called
into question or discredited. A growing number of other innovative
therapies
originally attacked by the ACS have recently found less disfavor
and even acceptance.
These include hyperthermia, tumor necrosis factor (originally called
Coley's toxin), hydrazine sulfate, and Burzynski's antineoplastons.
Well over
100 promising alternative nonpatented and nontoxic therapies have
already been
identified (15). Clearly, such treatments merit clinical testing
and evaluation by
the NCI using similar statistical techniques and criteria as established
for conventional
chemotherapy. However, while the FDA has approved approximately
40
patented drugs for cancer treatment, it has still not approved
a single nonpatented
alternative drug.
Subsequent events have further isolated the
ACS in its fixation on orthodox
treatments. Bypassing the ACS and NCI, the National Institutes
of Health in June
1992 opened a new Office of Alternative Medicine for the investigation
of
unconventional treatment of cancer and other diseases. Leading
proponents of
conventional therapy were invited to participate. The ACS refused
and still
refuses. The NCI grudgingly and nominally participates while actively
attacking
alternative therapy with its widely circulated Cancer Information
Services.
Meanwhile, the NCI's police partner, the FDA, uses its enforcement
authority
against distributors and practitioners of innovative and nontoxic
therapies.
In an interesting recent development, the Center for Mind-Body
Medicine in
Washington, D. C., held a two-day conference on Comprehensive Cancer
Care:
Integrating Complementary and Alternative Medicine. According to
Dr. James
Gordon, president of the Center and chair of the Program Advisory
Council of
the NIH Office of Alternative Medicine, the object of the conference
was to bring
together practitioners of mainstream and alternative medicine,
together with
cancer patients and high-ranking officials of the ACS and NCI.
Dr. Gordon
warned alternative practitioners that "they're going to need
to get more rigorous
with their work— to be accepted by the mainstream community" (16).
However,
no such warning was directed at the highly questionable claims
by the NCI and
ACS for the efficacy of conventional cancer chemotherapy. As significantly,
criticism
of the establishment's minimalistic priority for cancer prevention
was
effectively discouraged.
THE ROLE OF ACS IN THE WAR AGAINST CANCER
The launching of the 1971 War Against Cancer provided the ACS
with a
well-exploited opportunity to pursue it own myopic and self-interested
agenda.
Its strategies remain based on two myths— that there has
been dramatic progress
in the treatment and cure of cancer, and that any increase in the
incidence and
mortality of cancer is due to aging of the population and smoking,
while denying
any significant role for involuntary exposures to industrial carcinogens
in air,
water, consumer products, and the workplace.
As the world's largest nonreligious "charity," with
powerful allies in the private
and public sectors, ACS policies and priorities remain unchanged.
Despite
periodic protests, threats of boycotts, and questions on its finances,
the Society
leadership responds with powerful public relations campaigns reflecting
denial
and manipulated information and pillorying its opponents with scientific
McCarthyism.
The verdict is unassailable.
The ACS bears a major responsibility for losing the winnable war
against cancer. Reforming the ACS is, in principle, relatively easy
and directly achievable. Boycott the ACS. Instead, give your charitable
contributions to public interest and environmental groups involved
in cancer prevention. Such a boycott is well overdue and will send
the only message this "charity" can no longer ignore.
The Cancer Prevention Coalition (chaired by the author) in April
1999 formally announced a nationwide campaign for an economic boycott
of the ACS (http://www.preventcancer.com).
Published
in: International Journal of Health Services Vol. 29, No.
3, 1999.
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.
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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
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and what to do about it. Int. J. Health Serv. 20: 53- 71, 1990.
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proposed reforms. Int. J.
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9. American Cancer Society. Upcoming television special on pesticides
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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,
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11. Kaplan, S. PR Giant makes hay from client cross-pollination:
Porter/ Novelli plays
all sides. PR Watch, First quarter, 1994, p. 4.
12. Kaplan, S. Porter-Novelli plays all sides. Legal Times 16(
27) :1, November 23, 1993.
13. Moss, R. W. Questioning Chemotherapy. Equinox Press, Brooklyn,
N. Y., 1995.
14. U. S. Congress Office of Technology Assessment. Unconventional
Cancer Treatments. U. S. Government Printing Office, Washington,
D. C., 1990.
15. Moss. R. W. Cancer Therapy: The Independent Consumer's
Guide to Non-toxic
Treatment and Prevention. Equinox Press, Brooklyn, N. Y., 1992.
16. Castellucci, L. Practitioners seek common ground in unconventional
forum. J. Natl.
Cancer Inst. 90: 1036- 1037, 1998.
Contact:
Samuel
S. Epstein, M.D.
University of Illinois at Chicago
School
of Public Health, MC 922
2121 W. Taylor Street
Chicago, IL 60612-7260
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