Cancer-Gate: How to Win the Losing Cancer War

Award-winning author, Samuel S. Epstein, M.D., whose 1978 book The Politics of Cancer shook the political establishment by showing how the federal government had been corrupted by industrial polluters, has written a book that is sure to be of equal consequence. Cancer-Gate: How to Win The Losing Cancer War is a groundbreaking new book. It warns that, contrary to three decades of promises, we are losing the winnable war against cancer, and that the hand-in-glove generals of the federal National Cancer Institute (NCI) and the private “nonprofit” American Cancer Society (ACS) have betrayed us. These institutions, Epstein alleges, have spent tens of billions of taxpayer and charity dollars primarily targeting silver-bullet cures, strategies that have largely failed, while virtually ignoring strategies for preventing cancer in the first place. As a result, cancer rates have escalated to epidemic proportions, now striking nearly one in every two men, and more than one in every three women. This translates into approximately 50 percent more cancer in men, and 20 percent more cancer in women over the course of just one generation.

According to Epstein, these failed strategies are largely due to institutional malaise and outdated mindsets fixated on treatment, to the virtual exclusion of prevention, other than quitting smoking. But, Epstein says, there is much more. In particular, the book shows how the NCI and ACS are corroded with major institutional and personal conflicts of interest with cancer drug companies (“Big Pharma”). As candidly admitted by a recent NCI director, the NCI has become a “government pharmaceutical company.” For the ACS, these conflicts extend to environmental polluters in the chemical industry, and connivance in white collar crime. Not surprisingly, The Chronicle of Philanthropy has charged that “the ACS is more interested in accumulating wealth than saving lives.” These close ties to industry have transformed the NCI and ACS into cheerleaders for special interests rather than stewards of the public interest.

Astoundingly, and for the first time, Epstein chronicles how the NCI and ACS are sitting on mountains of information about avoidable environmental causes of cancer rather than making this available to the public in any systematic and understandable way. This silence has even extended to frank suppression of such information, denial of the public’s right to know, and violation of human rights. Following a detailed indictment of these public betrayals, Epstein explains how we can “take back” the war against cancer with a wide range of strategies. These include “right-to-know” laws, ensuring public dissemination of critical information on environmental carcinogens and avoidable causes of cancer, and legislative reforms and oversight to ensure that the NCI protects the public rather than special interests.

The Losing War

• Since President Nixon launched the 1971 cancer war, cancer incidence rates (adjusted for the aging population) have escalated to epidemic proportions.
  
• Contrary to NCI and ACS claims, the escalating incidence of cancer cannot be explained away by smoking, but is due to avoidable exposures to a multiplicity of environmental carcinogens. And, while lung cancer rates have declined steadily, rates for a wide range of cancers unrelated to smoking have increased sharply.
  
• These alarming statistics do not reflect a lack of resources. Since 1971, NCI’s budget has increased 30-fold, from $150 million to $4.6 billion; annual revenues of ACS have now reached $800 million. Paradoxically, it seems that the more money we spend on cancer, the more cancer we get.
  
• Meanwhile, and in spite of the NCI/ACS’s overwhelming expenditures on an ongoing series of claimed miracle cancer drugs, overall cancer mortality rates have remained essentially unchanged for more than
  three decades. In fact, as recently admitted by a Nobel Laureate director of an NCI Comprehensive Cancer Center, most of NCI’s resources are spent on promoting ineffective drugs for terminal disease.
  
• These statistics are also in striking contrast to three decades of highly publicized and frankly misleading promises by the NCI and ACS of drastic reductions in cancer incidence, “turning the corner in the cancer war,” and dramatic breakthroughs in treatment.

How to Win the War
By calling for an end to the “cancer plutocracy” and a return to public health democracy, Epstein outlines a wide range of reforms that could save hundreds of thousands, if not millions, of lives. These include:

• Reforming the NCI and ACS: Cancer-Gate lays out systematic reforms, including a requirement that NCI’s cancer prevention programs be placed on an equal budgetary footing with all its other programs combined. Cancer-Gate also proposes the creation of a National Cancer Prevention Registry—a clearing-house freely available to the public in print and on-line—for all known chemical and radioactive carcinogens (similar to NCI’s freely available registry of cancer drugs and treatment), as NCI has already pledged the U.S. Congress. Cancer-Gate also argues that the “nonprofit” ACS must end its corrupting dependency on special interest “soft-money” financial contributions, or risk public boycott of its funding.
• The Right-to-Know: Cancer-Gate insists that the public’s right-to-know be validated by requiring the NCI to disseminate information about known carcinogens in the environment and consumer products, as required by the 1971 National Cancer Act. Epstein also argues that consumers have the basic right-to- know, through explicit labeling, of known carcinogens in consumer products—food, cosmetics and personal care products, and household products. Additionally, patients have the basic right to be informed by their health care professionals of the carcinogenic risks of prescription drugs (and the availability of safe alternatives), and of screening and diagnostic medical procedures, particularly high X-ray dose CAT scans. Cancer-Gate also calls on state and local governments to utilize public databases to inform local citizenries about carcinogenic hazards posed by chemical industries in their communities. State and local governments should also be required to develop ordinances to obtain such information, and should develop­ remedial initiatives to prevent hazardous exposures to industrial carcinogens.
• A Wake-up Call for Congress: Cancer-Gate charges that Congress has been asleep at the wheel in the cancer war and has shirked oversight of the cancer establishment. Cancer-Gate proposes that Congress should use the budget process to ensure that cancer prevention, particularly from environmental causes, be given the highest priority, and that NCI is reigned in from its current independent “rogue status” and is made directly accountable to the director of the National Institutes of Health, as are some 25 other National Health Institutes. The book also urges Congress to schedule regular oversight hearings to monitor NCI’s progress in preventing environmental cancers, and its related belated implementation of a comprehensive registry of environmental carcinogens.
• Taking Matters Into Your Own Hands: Finally, Cancer-Gate tells you—the reader—how you can fight back by arming yourself with information that you need to protect yourself from everyday carcinogens, and how to become an activist in the war against cancer.

# posted by Samuel S. Epstein, M.D. @ 11:30 AM