Cancer: It's a Growth Industry

David Ross interviews Dr. Samuel Epstein

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.

DAVID ROSS
What is the impact of cancer on society and what are the stated causes of cancer ?

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 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 "charity. "

DR
What are the rationales of NCI and ACS on the causes and prevention of cancer?

SE
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."

DR
What are the conflicts of interest between NCI, the American Cancer Society, and industry ?

SE
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 industry. "

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.

DR
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 ?

SE
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 of leukemia.

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 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. 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.

DR
How can toxic use reduction be implemented ?

SE
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.

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