The analysts suggest that the highly touted gains in ''survival rates'' among cancer patients in recent years are partly, or perhaps even largely, a statistical mirage, caused more by changes in the way cancer is detected and defined than by any real gains in the ability of doctors to cure cancer once it is detected.
However, leaders of the nation's cancer research and treatment establishment dismiss the criticism as the undocumented assertions of analysts who do not fully understand the latest advances in the clinical detection, diagnosis and treatment of cancer.
The issue has implications for patients, doctors and planners of national cancer policy. If cancer treatments are less effective than officially portrayed, some doctors and patients might have second thoughts about the wisdom of resorting to treatments with high risk or severe side effects and little prospect of success. Moreover, if treatment results have shown little improvement over time, policy planners might want to emphasize other approaches to curbing cancer, such as more extensive efforts to find and eliminate the causes of cancer so as to prevent the disease before it needs to be treated.
Those skeptical of the degree of progress appear to be a relatively small group of analysts bearing distinguished credentials. Among them are these men:
- Richard Peto, a British epidemiologist who is the author of a major study of cancer mortality for the Congressional Office of Technology Assessment, contends, ''There has been disappointingly little progress in curative treatment since the middle of this century.'' He said in a telephone interview that he saw no reason to expect substantial progress for the rest of this century.
- John Cairns, a cancer analyst at the Harvard School of Public Health, likens the statistical advances reported by official cancer agencies and leading cancer scientists to the inflated and meaningless body counts used to measure progress in the Vietnam War. ''Their body counts are way too high,'' he said in an interview. ''It's like interrogating a general in Saigon. They come up with statistics that don't add up.''
- John C. Bailar 3d, a Harvard biostatistician who is the statistical consultant for The New England Journal of Medicine, one of the nation's most prestigious medical journals, said he ''tends to agree that survival rates for cancer victims are not going up very much'' and that statistical measures of those gains often turn out to be ''rubber numbers'' by which people are ''very seriously misled.''
- Haydn Bush, director of a regional cancer center in London, Ontario, wrote in the September issue of Science 84, a magazine published by the American Association for the Advancement of Science, ''We're not curing much more cancer than we were a generation ago. There has been very little progress on the biggest cancer killers of the last 25 years.''
These views stand in sharp variance to the tone of Dr. DeVita's assertion, in a major speech two years ago, that ''the best kept secret today is that cancers, as a group, are among the most curable of chronic diseases.''
Some scientists on each side of the debate attack the motives of their opponents. Dr. Bush asserted, ''The more cures the press releases claim, the more money cancer organizations raise.'' And Dr. DeVita retorted that some skeptics were so eager to promote more money for prevention of cancer that they deliberately tried to ''knock down'' the effectiveness of treatment programs. He said the skeptics did not realize that the cancer institute was already spending a third of its $1.8 billion annual budget on activities related to prevention.
And the response of the cancer industry:
''I think it's a bunch of nonsense,'' said Vincent T. DeVita Jr., director of the National Cancer Institute. ''We're saving thousands of lives today that weren't saved 20 years ago. To me, that's pretty damn exciting.''
"Two to 4% of cancers respond to chemotherapy….The bottom line is for a few kinds of cancer chemo is a life extending procedure---Hodgkin's disease, Acute Lymphocytic Leukemia (ALL), Testicular cancer, and Choriocarcinoma."---Ralph Moss, Ph.D. 1995 Author of Questioning Chemotherapy.
"NCI now actually anticipates further increases, and not decreases, in cancer mortality rates, from 171/100,000 in 1984 to 175/100,000 by the year 2000!"--Samuel Epstein.
"A study of over 10,000 patients shows clearly that chemo’s supposedly strong track record with Hodgkin’s disease (lymphoma) is actually a lie. Patients who underwent chemo were 14 times more likely to develop leukemia and 6 times more likely to develop cancers of the bones, joints, and soft tissues than those patients who did not undergo chemotherapy (NCI Journal 87:10)."—John Diamond
Children who are successfully treated for Hodgkin's disease are 18 times more likely later to develop secondary malignant tumours. Girls face a 35 per cent chance of developing breast cancer by the time they are 40---which is 75 times greater than the average. The risk of leukemia increased markedly four years after the ending of successful treatment, and reached a plateau after 14 years, but the risk of developing solid tumours remained high and approached 30 per cent at 30 years (New Eng J Med, March 21, 1996)
"Success of most chemotherapy is appalling…There is no scientific evidence for its ability to extend in any appreciable way the lives of patients suffering from the most common organic cancer…chemotherapy for malignancies too advanced for surgery which accounts for 80% of all cancers is a scientific wasteland."---Dr Ulrich Abel. 1990
The New England Journal of Medicine Reports— War on Cancer Is a Failure: Despite $30 billion spent on research and treatments since 1970, cancer remains "undefeated," with a death rate not lower but 6% higher in 1997 than 1970, stated John C. Bailar III, M.D., Ph.D., and Heather L. Gornik, M.H.S., both of the Department of Health Studies at the University of Chicago in Illinois. "The war against cancer is far from over," stated Dr. Bailar. "The effect of new treatments for cancer on mortality has been largely disappointing."
"My studies have proved conclusively that untreated cancer victims live up to four times longer than treated individuals. If one has cancer and opts to do nothing at all, he will live longer and feel better than if he undergoes radiation, chemotherapy or surgery, other than when used in immediate life-threatening situations."---Prof Jones. (1956 Transactions of the N.Y. Academy of Medical Sciences, vol 6. There is a fifty page article by Hardin Jones of National Cancer Institute of Bethesda, Maryland. He surveyed global cancer of all types and compared the untreated and the treated, to conclude that the untreated outlives the treated, both in terms of quality and in terms of quantity. Secondly he said, "Cancer does not cure". Third he said "There is a physiological mechanism which finishes off an individual".)
"With some cancers, notably liver, lung, pancreas, bone and advanced breast, our 5 year survival from traditional therapy alone is virtually the same as it was 30 years ago."---P Quillin, Ph.D.
"….chemotherapy’s success record is dismal. It can achieve remissions in about 7% of all human cancers; for an additional 15% of cases, survival can be "prolonged" beyond the point at which death would be expected without treatment. This type of survival is not the same as a cure or even restored quality of life."—John Diamond, M.D.
"Keep in mind that the 5 year mark is still used as the official guideline for "cure" by mainstream oncologists. Statistically, the 5 year cure makes chemotherapy look good for certain kinds of cancer, but when you follow cancer patients beyond 5 years, the reality often shifts in a dramatic way."—Diamond.
Studies show that women taking tamoxifen after surviving breast cancer then have a high propensity to develop endometrial cancer. The NCI and Zeneca Pharmaceuticals, which makes the drug, aggressively lobbied State of California regulators to keep them from adding tamoxifen to their list of carcinogens. Zeneca is one of the sponsors of Breast Cancer Awareness Month.
"Most cancer patients in this country die of chemotherapy…Chemotherapy does not eliminate breast, colon or lung cancers. This fact has been documented for over a decade. Yet doctors still use chemotherapy for these tumours…Women with breast cancer are likely to die faster with chemo than without it."—Alan Levin, M.D.
According to the Cancer Statistics for 1995, published by the ACS in their small journal (2), the 5-year survival rate has improved from 50%-56% for whites and 39%-40% for blacks from 1974/1976 - 1983/1990. However, the data is taken from FIVE of the states with the lowest death rates AND the smallest populations! NONE of the 10 states with the highest death rates AND comprising 34% of the Total U.S. Cancer Deaths, were included in the data! Also, in prior years, the Composite (Ave.) 5-year survival rate for ALL Cancers Combined was computed and published. This Ave. 5-year survival crept upward to 50%, in the early nineties. It now stands around 51-52%, due primarily to the improvement of 11% survival for Colon and 13% increased survival for Prostate. It gets worse. The ACS boasts of "statistically significant" results when Uterine Ca survival drops from 89%/60%-85%/55% (W/B)?? Also, Pancreas Ca is 3-3 (W) and Laryngeal Ca survival drops from 59%-53% (B) while Cervical Ca drops from 63%-56% (B). Liver Ca improves from 4%-7%. I wonder how many Pancreatic and Hepatic Ca patients cheered these dramatic results? Ovarian Ca = 36%/40% - 42%/38% (W/B) and Breast Ca = 75%/63% - 82%/66% (W/B). In 16 years the Breast Ca rate improved 3-7%, while Uterine Ca decreased 4-5%. Aren't these marvelous results that the Cancer Establishment should boast about??---RD Hodgell, M.D.
"The five year cancer survival statistics of the American Cancer Society are very misleading. They now count things that are not cancer, and, because we are able to diagnose at an earlier stage of the disease, patients falsely appear to live longer. Our whole cancer research in the past 20 years has been a failure. More people over 30 are dying from cancer than ever before…More women with mild or benign diseases are being included in statistics and reported as being "cured". When government officials point to survival figures and say they are winning the war against cancer they are using those survival rates improperly."---Dr J. Bailer, New England Journal of Medicine (Dr Bailer’s answer to questions put by Neal Barnard MD of the Physicians Committee For Responsible Medicine and published in PCRM Update, sept/oct 1990.
"I look upon cancer in the same way that I look upon heart disease, arthritis, high blood pressure, or even obesity, for that matter, in that by dramatically strengthening the body's immune system through diet, nutritional supplements, and exercise, the body can rid itself of the cancer, just as it does in other degenerative diseases. Consequently, I wouldn't have chemotherapy and radiation because I'm not interested in therapies that cripple the immune system, and, in my opinion, virtually ensure failure for the majority of cancer patients."---Dr Julian Whitaker, M.D.
"Finding a cure for cancer is absolutely contraindicated by the profits of the cancer industry’s chemotherapy, radiation, and surgery cash trough."—Dr Diamond, M.D.
"We have a multi-billion dollar industry that is killing people, right and left, just for financial gain. Their idea of research is to see whether two doses of this poison is better than three doses of that poison."—Glen Warner, M.D. oncologist.
- "Percentage of cancer patients whose lives are predictably saved by chemotherapy - 3%
- Conclusive evidence (majority of cancers) that chemotherapy has any positive influcence on survival or quality of life - none.
- Percentage of oncologists who said if they had cancer they would not participate in chemotherapy trials due to its "ineffectiveness and its unacceptable toxicity" - 75%
- Percentage of people with cancer in the U.S. who receive chemotherapy - 75%.
- Company that accounts for nearly half of the chemotherapy sales in the world - Bristol-Meyers Squibb.
- Chairman of the board of Bristol-Meyers - Richard L. Gelb.
- Mr. Gelb's other job: vice chairman, board of overseers, board of managers, Memorial Sloan-Kettering Cancer Center, World's largest private cancer treatment and research center.
- Chairman, Memorial Sloan-Kettering's board of overseers, board of managers - John S. Reed.
- Reed's other job - director, Philip Morris (tobacco company).
- Director, Ivax, Inc., a prominent chemotherapy company - Samuel Broder.
- Broder's other job (until 1995) - executive director, National Cancer Institute."from Reclaiming Our Health: Exploding the Medical Myth and Embracing the Source of True Healing by John Robbins.
"If you can shrink the tumour 50% or more for 28 days you have got the FDA's definition of an active drug. That is called a response rate, so you have a response..(but) when you look to see if there is any life prolongation from taking this treatment what you find is all kinds of hocus pocus and song and dance about the disease free survival, and this and that. In the end there is no proof that chemotherapy in the vast majority of cases actually extends life, and this is the GREAT LIE about chemotherapy, that somehow there is a correlation between shrinking a tumour and extending the life of the patient."---Ralph Moss
"The majority of publications equate the effect of chemotherapy with (tumour) response, irrespective of survival. Many oncologists take it for granted that response to therapy prolongs survival, an opinion which is based on a fallacy and which is not supported by clinical studies. To date there is no clear evidence that the treated patients, as a whole, benefit from chemotherapy as to their quality of life."---Abel.1990.
"For the majority of the cancers we examined, the actual improvements (in survival) have been small or have been overestimated by the published rates...It is difficult to find that there has been much progress...(For breast cancer), there is a slight improvement...(which) is considerably less than reported."---General Accounting Office
"As a chemist trained to interpret data, it is incromprehensible to me that physicians can ignore the clear evidence that chemotherapy does much, much more harm than good."---Alan Nixon, Ph.D., Past President, American Chemical Society.
"He said, "I'm giving cancer patients over here at this major cancer clinic drugs that are killing them, and I can't stop it because they say the protocol's what's important." And I say, "But the patient's not doing well." They say, "The protocol's what's important, not the patient." And he said, "You can't believe what goes on in the name of medicine and science in this country." --Gary Null
The Politics of Cancer---Epstein
That in spite of over $20 billion expenditures since the "War against Cancer" was launched by President Nixon in 1971, there has been little if any significant improvement in treatment and survival rates for most common cancers, in spite of contrary misleading hype by the cancer establishment---the National Cancer Institute (NCI) and American Cancer Society (ACS).
That the cancer establishment remains myopically fixated on damage control _diagnosis and treatment _ and basic genetic research, with, not always benign, indifference to cancer prevention. Meanwhile, the incidence of cancer, including nonsmoking cancers, has escalated to epidemic proportions with lifetime cancer risks now approaching 50%.
That the NCI has a long track record of budgetary shell games in efforts to mislead Congress and the public with its claim that it allocates substantial resources to cancer prevention. Over the last year, the NCI has made a series of widely divergent claims, ranging from $480 million to $1 billion, for its prevention budget while realistic estimates are well under $100 million.
That the NCI allocates less than 1% of its budget to research on occupational cancer _ the most avoidable of all cancers _ which accounts for well over 10% of all adult cancer deaths, besides being a major cause of childhood cancer.
That cancer establishment policies, particularly those of the ACS, are strongly influenced by pervasive conflicts of interest with the cancer drug and other industries. As admitted by former NCI director Samuel Broder, the NCI has become "what amounts to a governmental pharmaceutical company."
That the MD Anderson Comprehensive Cancer Center was sued in August, 1998 for making unsubstantiated claims that it cures "well over 50% of people with cancer."
That the NCI, with enthusiastic support from the ACS _ the tail that wags the NCI dog _ has effectively blocked funding for research and clinical trials on promising non-toxic alternative cancer drugs for decades, in favor of highly toxic and largely ineffective patented drugs developed by the multibillion dollar global cancer drug industry. Additionally, the cancer establishment has systematically harassed the proponents of non-toxic alternative cancer drugs.
That, as reported in The Chronicle of Philanthropy, the ACS is "more interested in accumulating wealth than saving lives." Furthermore, it is the only known "charity" that makes contributions to political parties.
That the NCI and ACS have embarked on unethical trials with two hormonal drugs, tamoxifen and Evista, in ill-conceived attempts to prevent breast cancer in healthy women while suppressing evidence that these drugs are known to cause liver and ovarian cancer, respectively, and in spite of the short-term lethal complications of tamoxifen. The establishment also proposes further chemoprevention trials this fall on tamoxifen, and also Evista, in spite of two published long-term European studies on the ineffectiveness of tamoxifen. This represents medical malpractice verging on the criminal.
That the ACS and NCI have failed to provide Congress and regulatory agencies with available scientific information on a wide range of unwitting exposures to avoidable carcinogens in air, water, the workplace, and consumer products _food, cosmetics and toiletries, and household products. As a result, corrective legislative and regulatory action have not been taken.
That the cancer establishment has also failed to provide the public, particularly African American and underprivileged ethnic groups with their disproportionately higher cancer incidence rates, with information on avoidable carcinogenic exposures, thus depriving them of their right-to-know and effectively preventing them from taking action to protect themselves _ a flagrant denial of environmental justice.