Cancer: It’s a Growth Industry
An interview with Dr. Samuel Epstein
By David Ross
Dr. Samuel Epstein is professor emeritus of environmental medicine at the University of Illinois School of Public Health, and Chairman of the Cancer Prevention Coalition (www.preventcancer.com). He has published some 260 peer reviewed articles, and authored or co-authored 10 books including the prize-winning The Politics of Cancer in, The Safe Shopper's Bible, The Breast Cancer Prevention Program in, and The Politics of Cancer, Revisited. Dr. Epstein has worked at the congressional level providing testimony, consulting, and drafting of legislation. For decades he has doggedly exposed the National Cancer Institute and the American Cancer Society for losing the winnable war on cancer.
David Ross: What is the impact of cancer on society? And secondly, what are the stated causes of cancer?
Dr. Samuel Epstein: 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 the 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.
You may say, “Well, what’s going on here, is it perhaps 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.
The public is under the general impression that the real increase in cancer rates are due to smoking, and there’s no question that smoking is the single most important cause of all cancer. However, when you look at the data, over the last few decades, lung cancer and other smoking related cancers account for between only a third and a quarter of the increased incidence of all cancers. Incidentally, the incidence of lung cancer in men is sharply being reduced because men are giving up smoking, while in women it is increasing, unfortunately.
Let me give you a few figures to give you an idea of some of the other cancers whose rates are shooting up. If you look at a cancer called non-Hodgkin’s lymphoma (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 something like 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 what particular kind of childhood cancer you look at, the incidence has gone up as high as 40-50 percent. These are all non-smoking cancers. So you can’t really, in any way, explain them away on the basis of smoking.
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 have 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. So what are you left with?
What about fatty diet? There’s really little evidence that fat, itself, is a risk factor for cancer. For instance, if you look at Mediterranean countries, they have extremely high fat consumption, particularly olive oil. Olive oil can be as high as 40 percent of the diet. But the rates of cancers, particularly reproductive cancers are low. However, when you look at animal fats and dairy fats, that’s very different. You find strong relationships between 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.
So, the first point I would make is that there has been a massive escalation in the incidence of cancer, and this cannot be explained away on the basis of longevity, smoking, or genetics.
Is the reason why we’re seeing this enormous increase because there isn’t the 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 thirty-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. The NCI and the ACS compose what we call the “cancer establishment:” The NCI is a governmental or federal institution, which you as taxpayers pay for with your tax dollars, and the ACS is the world’s largest non-profit so-called “charity.”
DR: What are the policies of the National Cancer Institute and the American Cancer Society on the causes and prevention of cancer?
Dr. Samuel Epstein: First of all, they try to explain away cancer by what’s called, “blame the victim.” If you get cancer, it’s your own fault. You smoke too much. They’re absolutely right that smoking is an important cause of cancer, but it doesn’t explain the massive, current epidemic. So, it’s not smoking. Apart from smoking, they say, “Well, it’s a fatty diet.” I’ve already indicated that fat, itself is not a risk factor for cancer. Or they claim it’s because people are spending too much time in the sun. There’s no question at all 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 these carcinogens. So when they talk about how much money they spent on prevention, not only is there gross exaggeration, but they also, by using the word secondary prevention, grossly mislead the public. So the cancer establishment is fixated on what I call, “damage control.” Damage control is 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 from carrying occupational carcinogens into the home and from being exposed to carcinogens themselves which are absorbed into their bloodstream.
As far as occupational cancer is concerned, of the $4.5 billion dollars a year, 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 budget on cancer prevention, the money spent on occupational, environmental, and other preventable causes of cancer is less than 0.1 percent. So what we have, then, is a situation in which the cancer establishment misleads the public: first of all, by using the word secondary prevention; secondly, by spending peanuts on research of the causes of cancer; and lastly, by failing to provide the public, congress and regulatory agencies with a substantial body of well-documented scientific information on avoidable causes of cancer.
Therefore, others and I charge the cancer establishment of major responsibility for losing the winnable war against cancer. In examining the track record of the ACS, which not only reflects indifference to cancer prevention, but actual hostility to cancer prevention, The Chronicle of Philanthropy, the leading American charity watchdog stated, “The American Cancer Society is more interested in accumulating wealth than saving lives.”
DR: What are the conflicts of interest between the National Cancer Institute and the American Cancer Society and industry?
Dr Epstein: The conflicts of interest extend particularly to the mammography industry—the machine and film industry. Incidentally, 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 one about 500 times the dose of a chest x-ray. If a pre-menopausal woman gets 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. So, radiation from routine premenopausal 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. So these are massive doses. Nevertheless, when 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 transatlantic flight.” This is frank deception and manipulation. It’s not only with the mammography industry; the relationships between the NCI, the 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 industry."
You and I as taxpayers 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 a drug like 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.
D.R: If we can’t explain this major epidemic of cancer on the basis of smoking, genetics or lifestyle, what are the real reasons for it?
Dr. Epstein: Well, they fall into three general categories. The first is relatively easily avoidable if the public was given information and this relates in particular to consumer products. By consumer products, I mean things you can buy in a store which include number one: food; secondly, cosmetics and toiletries; and lastly, 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. Then the manufacturers of these unsafe products would be punished by a virtual boycott of their products. This would be a powerful incentive for them to clean up their act. However, the American cancer establishment denies the consumer this information.
How do you define democracy? One of the basic ways you define democracy is the consumers right to know, the right to have information which impact adversely on the health and welfare of their lives. Yet the cancer establishment, funded so handsomely to the tune of over $4.5 billion dollars annually has this information, fails to provide this information, and trivializes this information when it comes out.
I’ll give you a few examples as far a food is concerned. First of all, 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. Because cattle in feedlots, 100 days to slaughter, are implanted with sex hormones such as estradiol in their ear, and 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 hotdogs. Hotdogs 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, and we also have what’s called epidemiological studies on children showing that children who eat nitrite in their dyed hotdogs—which are the standard hotdog—have up to about a three- to four-fold increased incidence of brain cancer, and about a six to seven-fold increase incidence of leukemia.
Apart from that, most of the milk in the 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. So the milk becomes supercharged by this growth factor, which in high levels has been clearly associated with breast cancer, prostate cancer, and colon cancer.
Aside from food, you’ve got cosmetics and toiletries. Cosmetics and toiletries are literally 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 which are carcinogenic themselves like talcum powder. Women, particularly pre-menopausal women that dust their genitals areas with talc after showering and bathing, have up to a three to four-fold increased incidence in ovarian cancer. In addition to ingredients, which are carcinogenic themselves, you have other ingredients which themselves are not carcinogenic, but which break down to release carcinogens like formaldehyde. Or you have other ingredients, which themselves are not carcinogenic, but interact with each other to form carcinogens. Are woman informed? Not at all. In fact, our coalition put out a citizen’s petition to the Food and Drug Administration demanding labeling. What did they do? Nothing at all.
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. This is dichlorobenzene. This 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. Far more importantly, there are major excesses of childhood cancers where pesticides are used in and around the home, lawn or garden, or if you use pet collars containing chemicals, which are carcinogens.
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, the category in which the public could easily reduce their own risk of cancer.
The second is medical drugs—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. First of all, the drug companies do not provide doctors this information or the information is trivialized. And secondly, they’re not provided this information by the cancer establishment.
Let me give you some examples of this. Ritalin, for instance, is a drug widely used for Attention Deficit Disorder in children. We use about ten times more per capita in American than any other country in the world. If a child misbehaves in school, the parent is told that the child has Attention Deficit Disorder and the doctor prescribes Ritalin, which is a highly dangerous carcinogenic drug, and which also has been shown to induce very aggressive liver cancers in rodents. Are parents informed of this? No.
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. Yet the public is not informed about this, and the NCI doesn’t provide the public with any information. If the public were to get the full information about the drugs before they accepted them, then they would exercise their options. So again, it’s a denial of the right to know and the lack of informed consent.
Let me give you another example of this, which will make it clearer still. 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. What I want to talk about now is domestic, chemical terrorism. The petrochemical and other industries have contaminated the totality of our environment—our air, our water, the workplace, and our foodstuff, with a wide range of petrochemical and other carcinogens. They have done this knowing full well that these chemicals are carcinogenic. They have failed to inform the public. They have done this to increase their profits. This relates to not only the petrochemical industries, but also the mining industries and other industries particularly in medical radiation. So we have, essentially, domestic terrorism in which, whether you like it or not, in the air you breathe, in the water you drink—quite apart from consumer products—you are being subjected to chemical—I use the word loosely and with a certain hesitancy—but this is the equivalent to chemical warfare, because, are you told about these risks? No. Why are you 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, but also, as I mentioned earlier, to childhood cancers. So here we have a situation in which the total population is exposed to these carcinogens.
DR: How can “toxic use reduction” be implemented?
Dr. Epstein: In 1989, the commonwealth of Massachusetts passed a Toxic Use Reduction Act, in which a group of responsible industries got together with citizen and 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. If the rest of the country were to follow the example of Massachusetts and phase out the use of carcinogenic chemicals, you would find a massive reduction in cancer rates.
But you won’t find this until governors of states take action. Governors of states depend on the cancer establishment for their information, but the cancer establishment remains silent. So I charge the cancer establishment with tacit allowance of a campaign by the chemical industry to increase profits at the risk of public health. They play a major role in the responsibility for losing a winnable war against cancer.
In this connection, I would like to let your readers know that the Cancer Prevention Coalition created a report known as "The Stop Cancer Before It Starts Campaign" (February 2003). It’s basically a formula for winning the losing war against cancer. You’ll find one version of this on our website, www.preventcancer.com. Nearly 100 top-notch 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 business, which are phasing out or have phased out carcinogens from their products. If there are any representatives of citizens groups or public interest groups who want to join us, please email me at email@example.com.
Let me emphasize once again: What we hear day after day is talk of war, and one reason for the talk of war is because of terrorism—chemical terrorism, nuclear terrorism or biological terrorism, when we tolerate domestic chemical terrorism, which is largely responsible for this massive epidemic of cancer. Yet we, the greatest democracy in the world, allow this. We really need to charge the executives, the managers, and the chemists of these corporations with criminal conspiracy for chemical terrorism in the nation.
I assure you, I’m not using these words loosely. I’ve spent a lifetime in this field. I started off my career as a pathologist. I’ve done God knows how many autopsies of people who’ve died of cancer, and I’ve watched this whole field of cancer policy, the NCI and the ACS. I’ve seen the money that we throw at them. I’ve seen their escalating budgets, their indifference, and their hostility.
Frankly, if I was a member of the general public, and read this for the first time, I would be a little skeptical, and you have a right to be. But you will find the detailed documentation, not only in my 1998 book, The Politics of Cancer, Revisited, but also in our newest press releases and in the latest campaign which can be found on our website, www.preventcancer.com. So for those of you who are representatives of labor, citizen groups, environmental groups and public interest groups, we welcome you to join us.
David Ross does a talk show on KMUD radio in Redway, CA. He has worked on the Ralph Nader presidential campaign, corporate malfeasance, U.S. foreign policy and environmental issues. He can be reached at firstname.lastname@example.org.