Cancer: It's a Growth Industry
David Ross interviews Dr.
Z magazine, October 2003
Dr. Samuel Epstein is emeritus professor
of environmental medicine at the University of Illinois School
of Public Health, and chair of the Cancer Prevention Coalition.
He has published some 260 peer reviewed articles, and authored
or co-authored 10 books including the prize-winning The Politics
of Cancer, The Safe Shopper's Bible, The Breast Cancer Prevention
Program, and The Politics of Cancer, Revisited. Epstein has worked
internationally and domestically providing testimony, consulting,
and drafting legislation. For decades he has doggedly exposed
the National Cancer Institute and the American Cancer Society
for losing the winnable war on cancer.
What is the impact of cancer on society and what are the stated
causes of cancer ?
Over recent decades, the incidence of cancer has escalated to
epidemic proportions, now striking nearly one in every two men,
and over one in every three women in their lifetimes. Even more
disturbing is the recent recognition that this very high incidence
of cancer is going to increase further still and, by the year
2050, it will be doubling the current very high incidence rate.
If you look at a cancer called non-Hodgkin's
Iymphoma (the cancer from which Jackie Kennedy died), over the
last few decades, the incidence has gone up by nearly 100 percent.
When you look at brain cancer,
the incidence has gone up about 80 or
90 percent. When you look at breast cancer, it's gone up about
60 or 65 percent. When you look at testicular cancer, particularly
in men between the ages of 28-35, it's gone up, believe it or
not, nearly 300 percent. When you look at childhood cancers, depending
on the particular cancer, the incidence has gone up as high as
40-50 percent. These are all non-smoking cancers.
The public is under the general impression
that the real increase in cancer rates is due to smoking. There's
no question that smoking is the single most important cause of
all cancer, however, when you look at the data, lung cancer and
other smoking-related cancers account for between one-third and
one-quarter of the increased incidence of all cancers. Incidentally,
the incidence of lung cancer in men is being sharply reduced because
men are giving up smoking, while in women it is increasing.
Is it because people are living longer
that they're getting more cancers? The answer to that is no, because
when we talk about cancer incidence rates, we adjust them to reflect
the increasing longevity of the population.
Can genetics be the possible reason for
this major increase in cancer? Not at all. There's no chance whatsoever
that the genetics of human populations has changed in the last
40-50 years. It takes tens of thousands of years for genetic effects
in the general population to change. So one can exclude genetics
and sharply limit the role of smoking.
What about fatty diet? There's really
little evidence that fat is a risk factor for cancer. For instance,
if you look at Mediterranean countries, they have extremely high
fat consumption, particularly olive oil, which can be as high
as 40 percent of the diet. But the rates of cancers, particularly
reproductive cancers, are low. However, you find strong relationships
between the consumption of animal and dairy fats and some cancers.
But that's a reflection of the fact that these are highly contaminated
with a wide range of industrial, chemical, and petrochemical carcinogens.
There has been a massive escalation in
the incidence of cancer that cannot be explained away on the basis
of smoking, longevity, genetics, or a fatty diet.
Is the reason we're seeing this enormous
increase because there isn't money to pay for the research necessary
to investigate all the causes of cancer and to give the public,
Congress, and the regulating industries this information? Not
on your life. In fact, if you look at the finances of the National
Cancer Institute (NCI) and the American Cancer Society (ACS),
you find the following: when President Nixon declared the war
against cancer in 1971, the annual budget of the NCI was about
$180 million. Now, the budget is $4.6 billion dollars a year.
That's a 30-fold increase. Similarly, the budget of the ACS has
been escalating and it's now near $800 million a year while they
have about $1 billion dollars of assets in cash and other reserves.
NCI and ACS compose what we call the "cancer establishment."
NCI is a governmental or federal institution, which taxpayers
pay for, and ACS is the world's largest non-profit, a so-called
What are the rationales of NCI and ACS on the causes and prevention
First of all, they try to explain away cancer by what's called,
"blame the victim." If you get cancer, it's your fault.
You smoke too much. It's a fatty diet." Or they claim it's
because people are spending too much time in the sun. There's
no question that malignant melanoma and skin cancer will result
from spending too much time in the sun, but that has nothing to
do with any of the other major cancers that I mentioned-brain
cancer, non-Hodgkin's lymphoma, breast, testicular, and childhood
cancers. They parallel this emphasis on blame the victim by ignoring,
to all intents and purposes, a vast body of scientific information
on avoidable causes or risk factors of cancer.
What, then, are their policies? First
of all, they confuse the public by using the words "secondary
prevention." By that they mean screening, diagnosis, and
the use of chemicals, vitamins, etc. to help reduce cancer risks
due to past exposures to carcinogens. So when they talk about
how much money they spend on prevention, not only is there gross
exaggeration, but they also, by using the word secondary prevention,
mislead the public. The cancer establishment is fixated on what
I call, "damage control"-the screening, diagnosis, and
treatment of cancer, as opposed to prevention.
For example, occupation is a major cause
of cancer in men and, to a lesser extent, breast cancer in women.
In children, too, because children whose parents work in plants
during the pregnancy of the wife, have major excesses of childhood
cancer. Their parents also carry occupational carcinogens into
the home and they are exposed to carcinogens themselves, which
are absorbed into their bloodstream.
Of the NCI's $4.5 billion dollar yearly
budget, the amount of money the NCI spends on in-house research
on occupational cancer is $15 million dollars, which is less than
one percent. Of the ACS's budget on cancer prevention, the money
spent on occupational, environmental, and other preventable causes
of cancer is less than 0.1 percent.
Many of us have charged the cancer establishment
with major responsibility for losing the winnable war against
cancer. The Chronicle of Philanthropy, the leading American charity
watchdog stated, "The American Cancer Society is more interested
in accumulating wealth than saving lives."
What are the conflicts of interest between NCI, the American Cancer
Society, and industry ?
The conflicts of interest extend particularly to the mammography
industry-the machine and film industry. We have excellent data
showing that pre-menopausal mammography is not only ineffective,
but is also dangerous for a variety of reasons, including the
high doses of radiation. Two films of a breast in a pre-menopausal
woman gives that woman about 500 times the dose of a chest X-ray.
If a pre-menopausal woman gets a mammography every year over a
ten-year period, the dosages of radiation can well amount to about
ten rads-a rad is a "radiation absorbed dose," a measure
of radiation exposure. Radiation from routine pre-menopausal mammography
reaches reasonably close to the kind of dosage that women got
in Hiroshima and Nagasaki outside of the major epicenter where
the atom bomb was exploded. Nevertheless, a radiologist will tell
women, when asked if there's any problem with the radiation, "Well
my dear," and they'll call them by their first name, "not
at all. It's just the same as spending a few days in Denver or
taking a transatlantic flight." This is deception and manipulation.
The conflicts of interest are not only
with the mammography industry. The relationships between NCI,
ACS, and the cancer drug industry are a matter of record. In fact,
the previous director of the National Cancer Institute said we
must recognize that the NCI has become a "governmental pharmaceutical
As taxpayers we pay for a great deal of
research on drugs for cancer treatment. What happens when the
research and development is done? When a drug starts looking hopeful,
that drug and all its backup research is then passed on to industry
that charges massively high prices to consumers. For instance,
citizens paid for the research and development of Taxol and then
it's passed over to Bristol Meyers Squibb who can charge up to
30-50 times more for the same drug. So the taxpayer pays twice.
If we can't explain this major epidemic of cancer on the basis
of smoking, increased longevity, genetics, or a fatty diet, what
are the reasons for it ?
They fall into three general categories. The first relates to
consumer products. By consumer products, I mean things you can
buy in a store which include food, cosmetics and toiletries, and
household products. In all of these areas, the consumer, once
given the information on which of these pose cancer risks, could
boycott them and shop for safer products.
Animal and dairy products are highly contaminated
with a wide range of pesticides and other industrial, chemical
carcinogens. Take meat for instance. Apart from the pesticides
and industrial carcinogens, you have the sex hormones. Cattle
in feedlots, 100 days to slaughter, are implanted with sex hormones,
from which high residues are left in the meat that you eat. These
are very important risk factors for reproductive cancers-testicular
cancers in men, breast cancers in women- and leukemia in children.
Children love hot dogs. Hot dogs are dyed
pink and red with nitrite and the nitrite reacts with certain
amines-chemicals naturally present in food-to produce highly potent
carcinogens known as nitrosamines. We have the chemical data showing
that nitrosamines are found in nitrite-dyed hot dogs. We also
have what's called epidemiological studies showing that children
who eat nitrite in their dyed hot dogs-which are the standard
hot dog-have up to about a three- to four-fold increased incidence
of brain cancer and about a six- to seven-fold increased incidence
Apart from that, most of the milk in this
country is contaminated. It comes from cows that have been injected
with a genetically engineered growth hormone to increase their
production of milk and this hormone increases levels of a natural
growth factor, known as IGF1. The milk becomes supercharged by
this growth factor, which in high levels has been clearly associated
with breast, prostate, and colon cancer.
Aside from food, cosmetics and toiletries
are a witches' brew of undisclosed carcinogens. When you look
at the label on the back of a bottle of shampoo, you see about
20 chemicals listed. This means nothing to anybody because there's
no indication as to which of these chemicals are carcinogens.
These chemicals fall into three categories.
There are ingredients that are carcinogenic themselves like talcum
powder. For example, women, particularly pre-menopausal women
that dust their genital areas with talcum powder after showering
and bathing, have up to a three- to four-fold increased incidence
in ovarian cancer. There are also other ingredients that themselves
are not carcinogenic, but which break down to release carcinogens
like formaldehyde. Lastly, you have ingredients, which interact
with each other to form carcinogens. Are woman informed? Not at
One other area of consumer products, besides
foods, cosmetics, and toiletries, is household products. For instance,
there's a deodorizer a lot of people use in their toilets, bathrooms,
and elsewhere called Para. Para is composed of dichlorobenzene,
which is a highly volatile, highly potent carcinogen. But there's
no warning whatsoever about this.
Pesticides in the home, lawn, or garden
are very risky indeed. If you use pesticides in and around the
home, your dog will have a five-fold increased risk of getting
a not uncommon cancer in dogs called canine lymphoma. More importantly,
there are major excesses of childhood cancers where pesticides
are used in and around the home, lawn, or garden, and where pet
collars containing carcinogenic chemicals are used.
So these are the three areas of consumer
products for which the consumer, given a choice, could reduce
his or her risk, but they are denied this information by the cancer
establishment-a fundamental violation of the democratic right
to know. So that's the first category in which the public could
easily reduce their risk of cancer.
The second is medical drugs given to you
by your doctor. There is the requirement for informed consent.
When your doctor gives you a drug, you are entitled to be given
the basic information as to the dangers of these drugs. But in
general, you're not. The drug companies do not provide doctors
this information or the information is trivialized. They're not
provided this information by the cancer establishment.
Ritalin, for instance, is a drug widely
used for Attention Deficit Disorder (ADD) in children. We use
about 10 times more per capita in the U.S. than any other country
in the world. If a child misbehaves in school, the parent is told
that the child has ADD and the doctor prescribes Ritalin, which
is a highly dangerous carcinogenic drug, which also has been shown
to induce very aggressive liver cancers in rodents.
Then you've got Evista or Raloxifene,
which is the trade name. It is widely prescribed by Ely Lily for
osteoporosis-millions of women the world over get it. There's
clear-cut data, which Ely Lily has admitted in its own internal
confidential information, that Evista induces ovarian cancer.
When estrogen-based drugs are used for
estrogen replacement therapy, particularly the estrogen drug alone
without the testosterone, you get risks of uterine cancer in 1
in every 100 women after 10 years. This is a very high risk. It's
much greater than the 1 in 250 annual incidence of lung cancer
in heavy smokers.
Let's move on to the third category-domestic,
chemical terrorism. The petrochemicals and other industries have
contaminated our environment-air, water, workplaces, and foodstuffs-with
a wide range of petrochemical and other carcinogens. They have
done this knowing full well that these chemicals are carcinogenic.
This relates not only to the petrochemical industries, but also
to the mining and other industries, particularly in medical radiation.
Why are we being subjected to these risks? It is for the profit
of corporations that could relatively easily, by what's called
"toxic use reduction," phase out the use of chemical
carcinogens and substitute them with much safer chemicals.
I really haven't dealt sufficiently with
labor, but occupational exposures to carcinogens are the single
most important cause of cancer in the country not only for men,
but also for women. We know that probably one million women are
exposed in the workplace to chemicals that induce breast cancer,
that also, as I mentioned earlier, lead to cancers in children.
How can toxic use reduction be implemented ?
In 1989, the Commonwealth of Massachusetts passed a Toxic Use
Reduction Act, in which a group of responsible industries got
together with citizen groups, environmental groups, and the University
of Massachusetts. They worked together to show that it's possible
to make products safely and to phase out the use of carcinogenic
chemicals and replace them with safe chemicals. Over the last
decade or so, there's been a phenomenal reduction in the use of
carcinogenic chemicals and hazardous waste in Massachusetts.
In February 2003, the Cancer Prevention
Coalition created a report known as Stop Cancer Before It Starts
campaign. It's basically a formula for winning the losing war
against cancer (www.preventcancer.com). Nearly 100 independent
experts in cancer and cancer prevention have endorsed this campaign.
Environmental, consumer, public interest, and labor groups have
also endorsed it.
The Stop Cancer Before It Starts campaign
has been sponsored by socially responsible businesses, which are
phasing out or have phased out carcinogens from their products.
David Ross hosts a talk show on KMUD radio
in Redway, California.