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Losing the Cancer War

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The U. S. National Cancer Institute

On February 27, 2002, Senator Dianne Feinstein (D-CA) introduced The National Cancer Act of 2002 (S.1976). Co-sponsored by 30 bipartisan Senators, including Majority Leader Tom Daschle (D-SD) and Hilary Clinton (D-NY), the Bill is a radically different version of the 1971 Act that launched the National Cancer Program. The Bill adds $1.4 billion to the $4.6 billion 2003 budget authorized by President Bush, extra funds coming from the new Federal cigarette tax increase, and a further 50% annual increase to 2007, reaching a grand total of $14 billion. Feinstein said her goal is to "form our new battle plan to fight cancer." The legislation was referred to the Committee on Health, Education, Labor, and Pensions, then chaired by Senator Judd Gregg (R-NH). In April 2002, a similar bill, with 11 co-sponsors, was submitted to the House of Representatives.

These Bills establish a national network of 20 "translation" centers to combine basic and clinical research, and to commercialize promising findings. They also mandate insurance coverage for cancer screening, smoking cessation, genetic testing, and quality care standards, while making no reference to prevention.

Regrettably, this well-intentioned Bill unwittingly surrenders the National Cancer Program to special interests. The legislation has been strongly criticized by survivor coalitions, headed by the Cancer Leadership Council, and also the American Society for Clinical Oncology (ASCO). Of major concern, the Bill displaces control of cancer policy from the public to the private sector, the federal NCI to the "nonprofit" ACS, and thus creates confusing duplication and overlapping responsibility.

American Cancer Society Seeks Control of U. S. Cancer Policy

As disturbing as the Bill is its background. Meeting behind closed doors in September 1998, the ACS created, funded and promoted the National Dialogue on Cancer (NDC). This was co-chaired by former President George Bush and Barbara Bush, with Senator Feinstein as vice-chairman, and former Governors Tom Ridge of Pennsylvania and Tommy Thompson of Wisconsin as "Collaborating Partners" (37). Included also were some 100 representatives of survivor groups and the cancer drug industry. The NDC leadership, including ACS President-Elect Dr. Andrew Von Eschenbach, without informing its NDC participants, then unilaterally spun off its own Legislative Committee, co-chaired by Dr. John Seffrin, CEO of the ACS, and Dr. Vincent DeVita, NCI director from 1980 to 1988, to advise Congress on the proposed new Act. DeVita’s track record as NCI Director was characterized by hostility to cancer prevention, and attempts to mislead Congress to the contrary (12).

The ACS track record raises concerns on conflicts of interest and special interests, in sharp contrast to the public interest (Appendix VI). Dr. John Durant, Executive President of the American Society of Clinical Oncology (ASCO), awarded the Society’s 2002 Presidential U.S. Cancer Fighter of the Year, charged: "It has always seemed to me that this was an issue of control by the ACS over the cancer agenda. They are protecting their own fundraising capacity . . ." from competition by survivor groups (37). Not surprisingly, the authoritative U.S. charity watchdog, The Chronicle of Philanthropy, warned against the transfer of money from the public purse to private hands. “The ACS is more interested in accumulating wealth than saving lives” (38).

These conflicts of interest extend to the personal. The Legislative Committee co-chair, DeVita, is Board Chairman of, a website promoting the ACS Consumers' Guide to Cancer Drugs; other Committee members also serve on the Board. These members have thus developed their own special interests in a publicly-funded forum. As disturbing, DeVita, and Dr. John Mendelsohn, Director of the NCI's M.D. Anderson Comprehensive Cancer Center, were consultants and board members of the publicly traded cancer drug company, ImClone Systems, Inc. (39). Mendelsohn was also a board member of Enron, besides serving on its Audit Committee; Enron was a generous and long-term supporter of the M.D. Anderson. In May and June 2001, DeVita expressed enthusiastic views on cancer drugs that target “EGF” receptors in television and radio interviews (40, 41). However, he failed to disclose his annual $100,000 consulting fees from ImClone which was then actively seeking FDA approval of its targeted cancer drug Erbitux. DeVita also insisted, contrary to NCI’s own data, that the overall incidence of cancer had been decreasing at a steep rate every year since 1990. In May 2002, Dr. Samuel Waksal resigned as president and CEO of ImClone. One month later, he was arrested on charges of criminal conspiracy, securities fraud and perjury, and civil damages for insider trading, and was subsequently indicted on charges of insider trading, bank fraud, forging a signature and obstructing a federal investigation.

In the September/October 2002 issue of The Cancer Journal, an article by its co-editor DeVita, “A Perspective on the War on Cancer” was prefaced by the following disclaimer: “No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this article.” However, as pointed out in a November 15, 2002 letter (by the author) to the Journal’s other co-editors, Drs. Samuel Hellman and Steven Rosenberg, this disclaimer is inconsistent with DeVita’s conflicts of interest relating to the web site, and his ImClone consulting fees. The editors of the Journal responded that it “takes matters of conflict of interest and disclosure very seriously,” but nevertheless declined to publish the letter.

ACS has interlocking interests with the pharmaceutical, cancer drug, mammography film and machine, and biotechnology industries (38). This is reflected by generous ACS allocations for research on highly profitable patented cancer drugs, and aggressive promotion of premenopausal mammography. In striking contrast, less than 0.1% of revenues in 1998 were allocated to environmental, occupational and other avoidable causes of cancer. More seriously, ACS policies on primary cancer prevention extend from a decades-long track record of indifference, or even hostility, compounded by pro-industry bias (Appendix VI), even to the tobacco industry. Shandwick International, representing R.J. Reynolds, and Edelman Worldwide, representing Brown & Williamson Tobacco Company, have been major PR firms for the ACS; Shandwick assisted the NDC in drafting the new National Cancer Act (42), while Edelman conducted the ACS voter education campaign for the 2000 Presidential elections. ACS promptly discontinued these relations, protesting “front end due diligence,” once the damaging information became public (42).

The highly politicized and non-transparent agenda of the ACS is troubling. This is further exemplified by expenditures on lobbying, including donations to Democratic and Republican Governors' associations: "We wanted to look like players and be players," an ACS representative admitted (38). Tax experts have warned that these contributions may be illegal as charities are not allowed to make political donations. Marcus Owen, Director of the IRS Exempt Organization Division, also warned, "The bottom line is campaign contributions will jeopardize a charity's exempt status."

It should be emphasized that the ACS has long exercised dominant influence over NCI policy, and remains “the tail that wags the NCI dog.” This influence has been further consolidated by the February 2002 appointment of Dr. Andrew Von Eschenbach as NCI Director; prior to his appointment, Eschenbach was Vice-President of the M.D. Anderson Cancer Center and President-elect of the ACS. Furthermore, as a condition of his appointment, Eschenbach obtained agreement that he continue as NDC’s leader. Thus, irrespective of the fate of the Feinstein initiative, for all intents and purposes, the National Cancer Program has become privatized.

Excerpted from Stop Cancer Before it Starts: How to Win the War on Cancer, 2003 by Samuel S. Epstein M. D.


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