National Cancer Institute and American Cancer Society skewered in new book by leading cancer expert
Neeve M. Arnell
In the book, "National Cancer Institute and American Cancer Society: Criminal Indifference to Cancer Prevention and Conflicts of Interest," Epstein argues that the NCI and ACS have spent tens of billions of taxpayer and charity dollars focusing on treatment to the exclusion of prevention, which has allowed cancer rates to skyrocket, with the disease now affecting nearly one in two men and more than one in three women. Furthermore, the author claims that not only do numerous conflicts of interest exist within the NCI and ACS, but the NCI and ACS are also withholding a mass of information on avoidable causes of cancer.
Epstein, who has served as a consultant for the U.S. Senate Committee on Public Works, is an internationally recognized authority on avoidable causes of cancer, particularly carcinogen exposure through conduits such as food, air, water, household products, cosmetics, prescription drugs or industrial carcinogens in the workplace.
Epstein is professor emeritus of Environmental and Occupational Medicine at the University of Illinois School of Public Health and chairman of the Cancer Prevention Coalition. He has published more than 270-peer reviewed articles and 20 books, including the prize-winning 1978 The Politics of Cancer, and has appeared on national media, including NPR, 60 Minutes, Face the Nation, Meet the Press, The McNeil/Lehrer News Hour, Good Morning America and The Today Show. He was a key expert in the banning of hazardous products including DDT, chlordane and aldrin. In his new book, he is now the leading critic of the cancer establishment for its indifference to prevention of the disease, which, for the ACS, he claims, borders on hostility.
Cancer funding skyrockets along with cancer rates, followed by exaggerated claims of progress
The cancer industry has made a series of misleading claims about the advances in the war against cancer over the past three decades, wrote Epstein.
Some of the false claims, according to Epstein, include the industry's 1984 announcement by the NCI that cancer mortality would be halved by 2000, the 1998 NCI and ACS Report Card announcement of a reversal in the almost twenty-year trend of increasing cancer incidence and death, and the 2003 pledge by NCI Director and former ACS president-elect Andrew von Eschenbach to "eliminate suffering and death from cancer by 2015."
The NCI, ACS and the Centers for Disease Control and Prevention also claimed that "considerable progress has been made in reducing the [number of people with cancer] in the U.S. population" in its 2003 "Annual Report to the Nation on the Status of Cancer, 1975-2000."
The claim, however, is not consistent with NCI's own data, Epstein said, which shows the overall number of people with cancer and incidence rates actually increased by 18 percent. The data also shows a dramatic increase in nonsmoking-related cancers, according to Epstein, including a 104 percent increase in liver cancer, an 88 percent increase in prostate cancer, a 54 percent increase in thyroid and testicular cancer, a 29 percent increase in breast cancer and a 14 percent increase in brain cancer. Epstein also notes the overall cancer mortality rates have remained unchanged and have increase by 6 percent for blacks.
It seems that the more we spend on cancer, the more cancer we get, Epstein said, because while the number of people with cancer goes up, so does the NCI budget paid for by tax payers and charity. The NCI budget has increased 25-fold, from $220 million to $4.6 billion, between 1971 and 2000.
Prevention is the key
The fixation on "damage control" instead of prevention is the root cause of the booming cancer rates in the face of billions of dollars aimed at elimination of the disease, according to Epstein.
He claims the NCI priorities are all wrong. The opening statement of the NCI's 2001 Cancer Facts report says that "cancer prevention is a major component and current priority -- to reduce suffering and death from cancer." Meanwhile the report claimed that only 12 percent of the NCI's then $3.75 billion budget was allocated to prevention.
Epstein shows that the actual attention to prevention is probably even less, by citing an analysis of a 1992 NCI budget showing that less than 2.5 percent of its then $2 billion budget was spent on prevention.
Epstein further crucifies NCI stating that prevention tactics defined by NCI only covered the value of avoiding smoking and a bad diet, while wholly ignoring the myriad of environmental and occupational carcinogens.
NCI & ACS withholding a mass of cancer prevention information
The NCI has failed to inform the public of published scientific information on a wide range of avoidable causes of multiple cancers, Epstein said.
According to Epstein, there are three major categories of avoidable causes including:
1. Environmental contaminants in air, water, soil, the workplace, and food;
2. Carcinogenic ingredients in consumer products, particularly pesticides;
Epstein wrote, "NCI's silence on cancer prevention is in flagrant violation of the 1971 National Cancer Act's specific charge to disseminate cancer information to the public. This silence is in further violation of the 1988 Amendments to the National Cancer Program, which called for an expanded and intensified research program for the prevention of cancer caused by occupational or environmental exposure to carcinogens."
Epstein blamed this NCI failure to inform Congress and regulatory agencies of avoidable carcinogens for encouraging petrochemical and other industries to continue manufacturing products containing carcinogens and encouraging corporate polluters to continue polluting.
NCI's aversion to publicizing avoidable carcinogens has even gone as far as suppression and denial, Epstein said, quoting the following examples:
"In 1983, the Department of Health and Human Services directed NCI to investigate the risks of thyroid cancer from I-131 radioactive fallout following atom bomb tests in Nevada in the late 1950s and early 1960s."
"NCI released its report in 1997, based on data which had been available for over fourteen years, predicting up to 210,000 thyroid cancers from radioactive fallout. These cancers, whose incidence has almost doubled since 1973, could have been readily prevented had the NCI warned the public in time and advised them to take thyroid medication."
"At a September 1999 hearing by the Senate Subcommittee of the Committee on Government Affairs, former Senator John Glenn (D-OH) charged that the NCI investigation was plagued by lack of public participation and openness. Senator Tom Harkin (D-IA) charged that NCI's conduct was a travesty."
[Just] as serious is NCI's frank suppression of information. At a 1996 San Francisco Town Hall Meeting on breast cancer, chaired by Congresswoman Nancy Pelosi (D-CA), former NCI director Richard Klausner insisted that "low level diagnostic radiation does not demonstrate an increased risk." However, this was contrary to long-term studies on patients with spinal curvature (scoliosis), which showed that such radiation was responsible for 70% excess breast cancer mortality.
ACS has just as abysmal a track record on prevention as NCI, according to Epstein, and it has been and remains the target of periodic attacks by leading scientists and public interest groups.
One attack in a 1994 press release by the Center for Science in the Public Interest stated, "A group of 24 scientists charged that the ACS was doing little to protect the public from cancer-causing chemicals in the environment and workplace. The scientists urged ACS to revamp its policies and to emphasize prevention in its lobbying and educational campaigns."
The scientists criticized ACS for requiring human evidence of carcinogenic effects before implementing regulation, saying that they had an unrealistically high action threshold. The scientists included: Harvard University Nobel Laureates Matthew Meselson and George Wald; former Occupational Safety and Health Director Eula Bingham; and past president of the Public Health Association, Anthony Robbins.
One major instance of ACS ignoring the science, according to Epstein, was in 1993 when they came out in support of the pesticide industry just before the airing of the PBS Frontline special, "In Our Children's Food." ACS released a memorandum in which it trivialized pesticides as a cause of childhood cancers, and reassured the public that pesticide residues were safe, even for infants.
Possibly most shocking is the failure of the NCI and ACS to inform the public of the increasing incidence of childhood cancers, which has escalated to alarming rates, according to Epstein. The Cancer Prevention Coalition's 2003 report said that childhood cancers have increased by 32 percent between 1975 and 2000 and that cancer is one of the leading causes of death in children, second only to accidents.
Even more shocking, the NCI claims that "the causes of childhood cancer are largely unknown." This is diametrically opposed to substantial scientific evidence, according to Epstein, which shows that children are exposed to numerous avoidable carcinogens, including everything from X-rays, prescription drugs, pesticides and contaminants in beauty products to petrochemical and industrial pollutants, radioactive pollutants in the air and drinking water, and pollutants from hazardous waste sites.
In 2000, the industry publication Cancer Letter had a commentary on ACS' behind-the-scenes creation of a legislative committee to gain major control of national cancer policy, according to Epstein. In the commentary, former executive president of the American Society of Clinical Oncologists Dr. John Durant shared his assessment of ACS behavior.
"It has always seemed to me that was an issue of control by the ACS over the cancer agenda," Durant said. "They are protecting their own fundraising capacity [from competition by survivor groups.]"
Conflicts of Interest
But emphasis on treatment looks likely to remain if, as Epstein shows, the ACS and NCI are in bed with those who profit from a treatment focus.
Approximately half of the members of the ACS board are doctors and scientists with close ties to the NCI, Epstein said. Many of the board members and their colleagues obtain funding from both the ACS and NCI, he said. Frank conflicts of interest are evident in many ACS priorities, according to Epstein, including the two major examples of mammography and cancer drugs.
"The ACS has close connections to the mammography industry," Epstein writes. "Five radiologists have served as ACS presidents, and in its every move, the ACS reflects the interests of the major manufacturers of mammogram machines and films ... In fact, if every woman followed the ACS and NCI mammography guidelines, the annual revenue to health care facilities would be a staggering $5 billion.
ACS promotion continues to lure women of all ages into mammography centers, leading them to believe that mammography is their best hope against breast cancer. A leading Massachusetts newspaper featured a photograph of two women in their twenties in an ACS advertisement that promised early detection results in a cure "nearly 100 percent of the time."
An ACS communications director responded .... "The ad isn't based on a study. When you make an advertisement, you just say what you can to get women in the door. You exaggerate a point. Mammography today is a lucrative [and] highly competitive business."
"The ACS exposes premenopausal women to radiation hazards from mammography with little or no evidence of benefits," Epstein said. "The ACS also fails to tell them that their breasts will change so much over time that the 'baseline' images have little or no future relevance."
The cancer drug industry is even more lucrative than mammography with annual sales over $12 billion. The intimate association between ACS and the pharmaceutical industry is illustrated, Epstein said, by the unbridled aggression which ACS directs at its critics.
"ACS maintains a Committee on Unproven Methods of Cancer Management, which periodically reviews unorthodox or alternative therapies," Epstein wrote. "This committee is comprised of volunteer health care professionals, carefully selected proponents of orthodox, expensive, and usually toxic drugs patented by major pharmaceutical companies, and opponents of alternative or unproven therapies that are generally cheap, and minimally toxic."
Periodically, the committee updates its statements on unproven methods, which are then widely disseminated to clinicians, cheerleader science writers, and the public. Once a clinician or oncologist becomes associated with unproven methods, he or she is blackmailed by the cancer establishment. Funding for the accused quack becomes inaccessible, followed by systematic harassment.
"The highly biased ACS witch-hunts against alternative practitioners are in striking contrast to its extravagant and uncritical endorsement of conventional toxic chemotherapy. This despite the absence of any objective evidence of improved survival rates or reduced mortality following chemotherapy for all but some relatively rare cancers."
The cancer industry's favor of pharmaceutical products is evidenced, Epstein said, "by the fact that the U.S. Food and Drug Administration has approved approximately 40 patented drugs for cancer treatment, while it has yet to approve a single nonpatented alternative drug."
According to Epstein, "Dr. Samuel Broder, NCI director from 1989 to 1995, frankly admitted, in a 1998 Washington Post interview, that 'the NCI has become what amounts to a government pharmaceutical company.' Taxpayers have funded R & D and expensive clinical trials for over two-thirds of cancer drugs on the market. These drugs are given, with exclusive rights, to the industry, which sells them at inflated prices."
Epstein calls for change
NCI reform is two decades overdue, Epstein wrote, based in part on "The Stop Cancer Before it Starts Campaign: How to win the Losing War against Cancer," which is a 2003 report sponsored by eight leading cancer prevention experts and endorsed by over one hundred activists and citizen groups.
Numerous NCI reforms were proposed in 1992 at a Cancer Prevention Coalition press conference, a group of 68 leading cancer prevention and public health experts, past directors of federal agencies, and citizen activists across the nation. But prophetically, the press release concluded, "There is no likelihood that such reforms will be implemented without legislative action."
And the ACS has done no better, according to Epstein.
"The verdict is unassailable," Epstein said. "The ACS bears a major decades-long responsibility for losing the winnable war against cancer. Reforming the ACS is, in principle, relatively easy and directly achievable. Boycott the ACS. Instead, give your charitable contributions to public interest and environmental groups involved in cancer prevention. Such a boycott is well overdue and will send the only message this charity can no longer ignore."
June 14, 2011