This essay is reproduced here as it appeared in the print edition of the original Science for the People magazine. These web-formatted archives are preserved complete with typographical errors and available for reference and educational and activist use. Scanned PDFs of the back issues can be browsed by headline at the website for the 2014 SftP conference held at UMass-Amherst. For more information or to support the project, email firstname.lastname@example.org
A Ton of Cure: Why There Is No Cancer Prevention
by Carol Horowitz
Carol Horowitz is a public health consultant living in New Mexico. Her specialties are environmental health and occupational cancers.
The prevention of many cancers is a simple matter that seems to be completely ignored by the medical community. Medical science now knows the causes of many cancers. Prevention only requires removing these causes from the environment. What is not simple is the impact that this would have on the powerful forces in the U.S. economy.
The most obvious example of this analysis is the prevention of lung cancer. The American Cancer Society has issued a statement on cancer prevention which claims that “an estimated 118,000 deaths a year could have been prevented if people hadn’t smoked.” Lung cancer is the number one cause of cancer deaths in men and is rapidly increasing in women. There are more than 100,000 new lung cancer cases every year. Lung cancer has one of the lowest survival rates of any cancer; present ten-year survival rates are 5 percent with conventional therapies.
Some lung cancer is caused by occupational exposure, but smoking combined with occupational exposure is a truly deadly duo. Fifty percent of all uranium miners die of lung cancer, and workers exposed to chromate get lung cancer 40 times more often than the average person.
Why do people smoke even though its dangers are so well known? A paper published by the Public Citizens’ Health Research Group1 puts the answer to this question in an interesting economic perspective. Millions of dollars are spent by the tobacco companies every year to convince people that smoking is sexy, liberating, and something that very healthy “outdoors” people do. Every year the industry spends more than $2,857 per lung cancer death to encourage people to smoke. The federal government gives price supports to tobacco farmers that amount to nearly $1,000 per person dying of lung cancer. These price supports to the tobacco industry are presently more than $60 million every year. In contrast to this spending which promotes cigarette smoking, the federal government spends only $14.30 per lung cancer death on education about the hazards of smoking.
After the 1964 Surgeon General’s report on the hazards of smoking, many people quit smoking or reduced the number of cigarettes they smoked. The number of men who smoke is on the decrease. Yet, the number of women smokers is rapidly increasing. In the past ten years many “feminine” cigarettes and advertising campaigns have been designed to encourage women to smoke. The success of this expenditure is mirrored in the increase of lung cancer and lung cancer deaths among women.
It is important to remember that even though the tobacco farmers get government agricultural subsidies, it is the multinational tobacco corporations who reap the real economic benefit from smoking. George Weissman, chairman of Philip Morris, shows how corporate profit is more important than health. He says, “We never let the Surgeon General panic us into losing faith in cigarettes.”2 Phillip Morris “found that cigarette making could be far more profitable in new factories with computerized quality control.”3
Example: Occupational Cancers
Another example of preventable cancers is the category of occupational cancers. It is not fair that the worker is forced to choose between having a job and having health. The National Institute for Occupational Health and Safety released a report in October 1976 which documents occupational hazards as a cause of cancer. The report states that 390,000 American workers suffer new cases of occupational disease every year, and that 100,000 eventually die.4 Dr. Irving Selikoff, one of the most respected authorities on the environmental cancers, described why so many cancers first show up in the workplace:
Since workers are first exposed and most heavily exposed, the workers give us the first indication. Most things that cause cancer in society are discovered in the workplace. We would still have vinyl chloride in cans of aerosol hair spray if it hadn’t been for cases of angiosarcoma (a rare liver cancer) in chemical workers. There would still be asbestos in do-it-yourself wallboard taping compounds, such as Spackle, if it were not for cancer in asbestos factories. We would still use benzene in many cleaning compounds if it were not for leukemia in rubber and other workers.5
Workers are the guinea pigs of America. Chemicals are used without adequate testing until deaths of workers prove the dangers. Many times job hazards would be greatly reduced by installing adequate ventilation systems, adequately clean working conditions, and disposable workclothes.6 These seem very simple to implement, but to a management only concerned with profit, they are too expensive. The government and industry endlessly debate what level of exposure to a carcinogen is safe, while workers continue to die.
Cancer Research and Prevention
There is a computerized cancer literature file called CANLIT. This file lists more than 65,000 articles and abstracts about the various aspects of cancer. There are 500 computer terminals in the U.S. where it is possible to plug into this data bank. I went to one of the terminals looking for information on cancer prevention. I programmed the computer to retrieve articles with prevention appearing in the title. Of the 65,000 articles, 1369 has the work prevention in the title. However, when the titles began to print out it was obvious that “prevention” was not enough of a key word; many of the titles were about the prevention of side effects of various cancer treatments and did not fit into my definition of cancer prevention. The librarian and I then decided to ask specifically for titles with the words “cancer prevention” in the title. This reduced the number of titles to only 171. We then printed out the first 93 of these to see what types of information were represented. These 93 titles are the primary research on cancer prevention for the years 1976-1979, the other 78 were prior to 1976 so I didn’t print them. Of these 93, only 20 fit into the definition of cancer prevention that I was searching. Out of 65,000 articles in the CANLIT, I was able to locate 20 that were about prevention of cancer through the identification of carcinogens in our lives. Interestingly, of these 20 article, half were from foreign journals, the results of studies done in other countries.
To learn what exactly was going on in the labs of America, I went to the three-volume Research Awards Index 1978 published by the Department of Health Education and Welfare (DHEW).7 I took a survey of where cancer grants are going. I found close to 25,500 grants under the main heading “Neoplasms” (tumors). Of the 25,500 grants, only 150 were under the heading “Neoplasms — Prevention and Control.” Relatively few studies are being done on the known causes of cancer. Of these none are discussing how to prevent them. Examples of research into known causes are neoplasms, radiation-induced, 60 studies; nutrition-induced or dependent, 110; hormone-induced or dependent, 400; environment-induced, 210; drug-induced, 33. This shows, more than any other information I found, the total lack of interest in cancer prevention by the medical and scientific establishment. If DHEW states in its own publications that 70-90 percent of all cancers are environmentally caused, how can they justify 210 grants out of 25,500 to study the area of environmentally induced cancers!8
Cut, Burn, and Poison — Cancer Therapies Causing Cancer
Radiation and chemicals, two of the main causes of cancer, have emerged as two of the main treatments of cancer. This has come about as the result of a large-scale publicity campaign by the medical industrial complex. At a conference on breast cancer on April 8, 1978, I learned a great deal about the disease and the standard treatment of it. One workshop was entitled “Treatment Alternatives,” which turned out to be very different from what I had expected. The alternatives referred to were radiation and chemotherapy, presented as alternatives to radical breast surgery!
I asked the doctors leading the workshop, a radiologist and a chemotherapy specialist, how these two causes of cancer had ended up as treatment. Much to my surprise I was told that they are not considered cures of cancer. They said that the patient makes a trade-off — killing cancer in one site now for potential of whole body cancer ten years later. Chemotherapy is known to cause lymphoma (cancer of the lymphatic system) and radiation is a cause of leukemia. Five year survival from cancer is considered a cure. Because of this short-range view, when another cancer is contracted more than five years later, it is considered a separate case.
At this same conference I asked a surgeon what types of prevention were being considered for breast cancer. The surgeon answered my question by saying that the way to prevent breast cancer was the surgical removal of both breasts before cancer develops, primarily for high-risk women. He then continued to describe the three operations which complete this “preventive” technique. First both breasts are removed. A second operation implants silicone to make “new” breasts, and a third operation stitches nipples on the breasts. This is definitely a profitable method of cancer prevention. The methods of breast reconstruction were developed for women who had to have their breasts removed to treat their cancers. It is a sick irony to adapt this into a type of prevention. It is similar to the many gynecologists who encourage women to have hysterectomies to prevent uterine cancer. There is a proven correlation between fat in the diet and cancers of the sexual organs.9 It seems far better to educate people to change their diets to prevent cancer than to have surgery as a preventive technique.
In addition it has recently been learned that the cancer patient who has been treated with radionuclides remains highly radioactive after treatment. This means that the hospital staff is dangerously exposed, as is the family on the patient’s arrival home. Two articles in the March 1978 Journal of the American Public Health Association, “Population Exposures from Radionuclides in Medicine — As Low as Reasonably Achievable?” and “Contamination of the Home Environment by Patients Treated with Iodine 131: Initial Results,” document the ways this cancer cure may cause more cancer than it cures.
All in all, of the $20,000 every cancer case generates, most of the money goes to the three “therapies” of cut, burn, and poison — and the hospitalization expenses that accompany them.
Political Action — The Only Real Cancer Prevention
Some leftist political analysts looking at the 1980s believe that the movement to stop nuclear power will be the most important mass movement of the new decade. There is no doubt that the anti-nuke movement will become an ever increasing movement, but in reality, it is inseparable from the movement to stop cancer.
Periodicals as different as Mother Jones and Fortune have stated recently that the real political issue is cancer. In a Fortune article on carcinogens in diesel exhaust,10 Charles Burck said, “Cancer from man-made (sic) chemicals — so-called environmental cancer — has come in recent years to rival, if not replace, nuclear holocaust as the major specter of technology gone amok.”
Joe Klein states this same opinion in Mother Jones in his article “Are They Just Full of Granola?”11 He says of Three Mile Island that “of course, there are now thousands of people in Pennsylvania who live with the awful fear that they, or, especially, their children will get cancer courtesy of the ineptitude of Metropolitan Edison and who knows what other industrial felons. I suspect, as In These Times suggested last year, that cancer may be the real issue.”
I have always believed that the issue for the 1980’s is cancer. My professional experience in public health has been work in a National Cancer Institute-funded state Cancer Control Program Prevention Unit and work in an occupational health program. I have been part of the blossoming cancer bureaucracy assigned to tasks that do nothing to lessen the epidemic. This has helped me understand that preventing cancer is a political task, not a medical one.
There is much more profit in finding a cure for cancer than in preventing the disease. Industry tries to manipulate cancer prevention into a case of the environmentalists against the workers; just as nuclear power, uranium mining, automobile emissions standards, and too many others have been previously manipulated. But this time, with cancer, there is a new factor that the governmental medical industrial complex has not figured — the cancer victims themselves.
One group of cancer victims has already begun to fight in an organized way. These are the DES daughters. These young women are now getting cancer because their mothers were prescribed the hormone diethylstilbestrol (DES) when they were pregnant. These women have organized a national movement to inform other women exposed to DES in the womb to help guarantee that they have regular examinations and receive the earliest possible treatment if they contract cancer.
DES daughters are involved in several law suits against the drug companies that produced DES and sold it to pregnant women even after it had been proven ineffective for the medical conditions for which it was prescribed. Young women today are still being prescribed DES as a morning-after pill with disregard for its dangers. And only this year has DES finally been banned for use as a growth stimulant in cattle and poultry production, so most meat-eaters have unknowingly been eating this dangerous hormone for many years.
Women are angry about being given cancer for industrial profit and are fighting back.
In the nation’s finest verdict ever in favor of a DES victim, a six-member jury of three women and three men awarded $500,000 to Joyce Bichler, a 25-year-old Network member who developed vaginal cancer 18 years after her mother took DES to prevent miscarriage. The verdict went against Eli Lilly Company, the country’s major producer and promoter of DES.
During the six-week trial, Joyce Bichler told the jurors how she had to have an extensive cancer operation at Albert Einstein Hospital leaving her with no uterus, no lymph glands, one ovary, and only one-third of her vagina.
“I never went to court just for myself,” said Bichler. “I wanted to show that the drug companies just can’t do this to us. They can’t use us as guinea pigs.”
. . . Early in the trial, representatives from the National Women’s Health Network, New York N.O.W., HealthRight, and DESAction-New York demonstrated outside the courthouse in solidarity with Ms. Bichler.
—Quoted from National Women’s Health Network News, September/October 1979.
Women and the Crisis in Sex Hormones by Barbara and Gilbert Seaman12 gives excellent documentation of the cancer epidemic for both men and women. The chapter “Promise her anything . . . . but give her cancer” sums up the authors’ well-researched conclusion about the economic benefits of the cancer epidemic. It says, “Cancer is good for the economy too. There is a grim joke that ‘more people live off of cancer than die from it’. The total care of a terminal cancer patient averages $20,000. Cancer provides lots of jobs for medical workers and morticians.” At this rate, the low estimate of 70,000 new lung cancer cases every year introduces a billion and a half dollars into the medical economy. The total national cancer expense becomes overwhelming when looked at in these terms.
It is up to us to see that cancer becomes a national political issue. This does not mean allowing the government to continue pouring tremendous amounts of money into the search for a vaccine or a genetic cause of cancer or into dangerous and short-term treatments in the name of conquering cancer. This fooled people before. We must demand that cancer prevention take its place as one of the most important issues facing us as a nation. No doubt our lifestyles will be simplified as we learn to do without elements that now seem an integral part of our lives.
Most of the dangerous carcinogens proliferated in the short span of years since World War II. Preventing cancer does not mean a return to the dark ages. If the miracles of technology that occurred in the past 35 years were directed to the development of a non-environmentally-destructive civilization powered by the sun, wind and tides, cancer would retreat to its prior position as an obscure and rare disease.
- Martin Friedman, “Federal Support Against the Public Health: The 60 Million Dollar Tobacco Subsidy,” Public Citizen’s Health Research Group, 2000 P Street, NW, Washington, DC 20036.
- Roy Rowan, “Business Triumphs of the Seventies,” Fortune. December 31, 1979.
- David Zinman, Bob Wyrick, and Dennis Hevesi, Newsday, “Job-related Diseases Kill 300 a Day,” Norman Oklahoma Transcript. February 9, 1977.
- S.S. Epstein, “Cancer and the Environment: A Scientific Perspective,” IUD Facts Anal. No.25 (AFL-CIO), February 1976, p.164.
- National Cancer Program, 1976 Annual Plan for FY 1978-1982, December 1976, DHEW, National Institutes of Health.
- Newell and Golumbic, “What you can do to protect yourself against cancer,” AORN Journal. Vol.25 No.5, April 1977, DHEW reprint.
- Personal communication from Larry Callan, ex-director of New Mexico Cancer Control.
- Charles G. Burck, “The Soot that Clouds the Diesel’s Future: Cancer and the Diesel Car,” Fortune, December 17, 1979.
- Joe Klein, “Are They Just Full of Granola?” Mother Jones. November 1979.
- Barbara and Gilbert Seaman, Women and the Crisis in Sex Hormones, Bantam Books, 1977.