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Introduction (The Politics of Cancer - Revisited)

In 1970, when the Environmental Protection Agency was first created, I was among a small group of active members of Congress who understood we were at the precipice of a new era in public health. The disasters of Love Canal and Times Beach Missouri, in which the environmental sins of chemical manufacturing plants left entire communities homeless and stricken with fatal diseases, hit the nation like a tidal wave. For the first time, we were beginning to comprehend the sheer vastness and complexity of environmental dangers of the modern industrial era and the perils -- many of them invisible to the naked eye -- that were lurking in our air, waterways, consumer products, and workplaces.

During that pivotal decade in which the modern environmental movement came to the forefront of the nation's political agenda, Dr. Epstein wrote the epochal Politics of Cancer. It was a bombshell both inside and outside of Washington officialdom, and its vast media coverage sent warning bells throughout the nation.

What made The Politics of Cancer so unique was its fusion of science with politics. For the first time, the intimidatingly complex scientific data and facts of asbestos, vinyl chloride, benzene, and hundreds of other toxic threats were demystified and explained in the context of a political, social, and cultural evolution. Any layperson who knew nothing about which chemicals were dangerous and how Washington reacted to the grave dangers could come away after having read the Politics with an expertise in both. It was an education for the public and a handbook for decision-makers. The book also carefully documented startling evidence of corporate decisions to withhold data from Congress and the public about a vast array of public health dangers, thereby frustrating the institutional wheels of democracy to protect the public _ evidence which spawned a new wave of legislation to criminalize the withholding of vital health and safety data.

This milestone work was not just a wake-up call to the nation, it was also a call to arms for those of us both inside and outside the beltway, Republican and Democrat, young and old, to reclaim our fundamental rights to a safe environment for ourselves and our families. The work served as a treatise for us in the Congress as we fought in the 1980s for the enactment of a half dozen landmark environmental laws, including the Clean Air and Clean Water Acts, the Toxic Substances Control Act, the Resource Conservation and Recovery Act, and much else.

During the intervening two decades since Dr. Epstein first wrote the book, there has been a major shift in the political and cultural landscape. As we enter the year 2000, cancer is well on its way to becoming the nation's number one killer, taking 500,000 lives and bilking our purses of well over $110 billion every year. A sense of crisis _ sometimes even panic _ grips the public when the word "cancer" is spoken, but a sense of paralysis seems to characterize our institutional ability to confront this aggressor.

Inevitably, any public crisis will spawn institutions. During the past two decades, we have seen the birth and maturation of what Dr. Epstein calls the "Cancer Establishment" _ the National Cancer Institute, the American Cancer Society, and the myriad of research centers _ all of whom have been trusted explicitly by the government and implicitly by the American people as the high generals in the war against cancer. What Dr. Epstein charges is that these generals are losing the war, and losing it badly. As we did in 1978 when The Politics of Cancer was first published, we should today hear this clarion call.

Most disturbingly, Dr. Epstein chronicles how the Cancer Establishment has nearly totally ignored cancer prevention, ignored the most common sense proposition that we should simply keep poison out of our communities and immediate surroundings. Every parent tells their child the common-lore adage that a "stitch in time saves nine," but this simple truth seems to have eluded those entrusted with waging one of the most important public policy objectives of the latter part of the century, according to this book.

Simply put, the evidence seems to adduce that our ability to cure and treat cancer has not materially changed in recent decades while the incidence of fatal cancers spins out of control as our communities become increasingly drenched with carcinogens. Given this evidence which fundamentally questions our ability to "cure" our way out of the cancer problem it appears clear that no solution will work without a comprehensive national program to prevent our people from being exposed to poisons in the first place.

With all the data available clearly demonstrating environmental causes of cancer, one might reasonably ask why there has been less focus on cancer prevention both in and out of the Cancer Establishment. THE POLITICS OF CANCER Revisited attempts to answer that question, and in so doing, attempts to show us the way out of our current fix.

In short, this new book argues that the Cancer Establishment has become beset with a range of myopic institutional pressures which prevent it from devoting more research and capital to prevention: the common quest to amass more resources and build bigger empires by the research institutions which promise what may be a mythical pot of gold at the end of the research rainbow; the apparently growing and somewhat disturbing interlocking corporate interests of pharmaceutical industries who benefit from public optimism that an elixir is near, and chemical industries that want as little prevention through environmental regulation as possible. While political scientists commonly theorize that all institutions may be subject to these pressures, no one has attempted to systematically document these problems in the context of the war against cancer until now.

None of this is to say that research into the mechanisms, treatment and potential cures of cancer is not critical or that it should not continue. It should. None of this is to say that there are not noble people struggling to find cures. There are. But, THE POLITICS OF CANCER Revisited argues that as important as the research is, it cannot eclipse prevention. We should not in our emotionally understandable hope for a cure become transfixed with a Nero-like neglect for the simple truth that preventing cancer appears to be well within our grasp. This is the thesis of THE POLITICS OF CANCER Revisited, and Americans in all quarters would be well advised to heed it very carefully.

Congressman John Conyers, Jr. (D-Mich.)
August 1998

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