Cancer, Inc.
They make the chemicals, they run the
treatment centers, and they're still looking for "the cure" — no
wonder they won't tell you about breast cancer prevention.
by Sharon Batt & Liza Gross
Every October, the sponsors of National Breast Cancer Awareness Month go into
overdrive to spread their message, "Early detection is your best
protection." Organizers stage walks, hikes, races, and other events around
the country "to fill the information void in public communication about
breast cancer"-the sponsors' official goal. For the most part that void is
filled with the mantra: "Get a mammogram." As for reducing risk, the
campaign's elaborate 1998 promotion kit says only that "current research is
investigating the roles of obesity, hormone replacement therapy, diet, and
alcohol use."
In other words, the people who bring you Breast Cancer Awareness Month tell
you to find out if you already have the disease. And they tell you to take
personal responsibility for staving off what's become a scourge throughout the
country. What they go to great lengths to avoid telling you is what the country
can do to help stop the scourge at its source.
It's no mystery why prevention gets the silent treatment. The primary sponsor
of Breast Cancer Awareness Month, AstraZeneca (formerly known as Zeneca), is a
British-based multinational giant that manufactures the cancer drug tamoxifen as
well as fungicides and herbicides, including the carcinogen acetochlor. Its
Perry, Ohio, chemical plant is the third-largest source of potential
cancer-causing pollution in the United States, releasing 53,000 pounds of
recognized carcinogens into the air in 1996.
When Zeneca created Breast Cancer Awareness Month in 1985, it was owned by
Imperial Chemical Industries, a multibillion-dollar producer of pesticides,
paper, and plastics. State and federal agencies sued ICI in 1990, alleging that
it dumped DDT and PCBs-both banned in the United States since the 1970s-in Los
Angeles and Long Beach harbors. Any mention of what role such chemicals may be
playing in rising breast cancer rates is missing from Breast Cancer Awareness
Month promos.
After acquiring the Salick chain of cancer treatment centers in 1997, Zeneca
merged with the Swedish pharmaceutical company Astra this year to form
AstraZeneca, creating the world's third-largest drug concern, valued at $67
billion. "This is a conflict of interest unparalleled in the history of
American medicine," says Dr. Samuel Epstein, a professor of occupational
and environmental medicine at the University of Illinois School of Public
Health. "You've got a company that's a spinoff of one of the world's
biggest manufacturers of carcinogenic chemicals, they've got control of breast
cancer treatment, they've got control of the chemoprevention [studies], and now
they have control of cancer treatment in eleven centers-which are clearly going
to be prescribing the drugs they manufacture."
Even the nation's leading cancer organizations are not immune from corporate
influence. The American Cancer Society has the vice president of a major
herbicide manufacturer sitting on its board of directors. High-ranking officials
in the National Cancer Institute routinely accept lucrative posts in the
cancer-drug industry. Such tangled financial interests explain why the cancer
establishment-the medical institutions, corporations, and agencies that control
cancer research, treatment, and education-continues to ignore mounting evidence
that many cases of cancer are avoidable.
These conflicts may also help explain why, 28 years and billions of dollars
after President Nixon declared war on cancer, the risk of breast cancer is
higher than ever. In 1950, an American woman faced a lifetime risk of 1 in 20;
today that risk has more than doubled to 1 in 8. Breast cancer will strike some
175,000 women in the United States in 1999, and kill 43,000. The cancer business
is booming, but the selective brand of awareness the cancer industry promotes
comes at a price.
Samuel Epstein predicted 30 years ago that cancer rates would increase,
citing an explosion in the use of synthetic chemicals. From 1940 through the
early 1980s, production of synthetic chemicals increased by a factor of 350.
Billions of tons of substances that never existed before were released into the
environment. Yet only some 3 percent of the 75,000 or so chemicals in use have
been tested for safety. Forty of them are recognized human carcinogens.
The widespread presence of carcinogens in our environment is clearly linked
to rising cancer rates, Epstein says. He points to a number of avoidable risk
factors, but pollution, estrogenic medications, toxic ingredients in consumer
products, and carcinogens in the workplace top his list of culprits. One thing
ties all these things together, he says: "Corporate recklessness."
Signs of that recklessness are most evident in the workplace. Of 4 million
women employed in the chemical industry, Epstein says, "about a million are
exposed to chemicals which have been shown to cause breast cancer in
rodents." In cases where scientists conducted epidemiological studies,
women exposed to these chemicals had higher rates of breast cancer. Evidence
that women in the plastics industry face increased risk emerged over 20 years
ago. A study published in the Journal of Occupational Medicine in 1977 noted
higher-than-expected breast cancer deaths in women exposed to vinyl chloride,
which not only produces mammary tumors in animals even at very low doses but
causes breast, liver, brain, and nervous-system cancers in humans.
Living near hazardous-waste sites also appears to increase risk. "A
number of intriguing studies show that breast cancer rates are higher in places
that have toxic-waste dumps," says Sandra Steingraber, who explored the
links between toxic hot spots and cancer incidence in her book Living Downstream
(see "Rachel's
Daughter"). A 1985 study published in the International Journal of
Epidemiology found that in New Jersey-a state with 111 Superfund sites-breast
cancer mortality among white women increased the closer they lived to a dump
site.
Many of these chemicals-and waste dumps-are produced by companies with a
financial interest in cancer products. "General Electric is a major
polluter in PCBs in the Hudson River. GE also manufactures mammogram
machines," says Ross Hume Hall, a biochemist who advised the Canadian
government on environmental issues in the 1980s.
An estimated million pounds of PCBs lie buried at the bottom of a 40-mile
stretch of the Hudson, where GE dumped PCB oil until the mid-1970s,
contaminating the entire 200-mile length of the river below Hudson Falls.
Although PCBs (a family of 209 organochlorine chemicals) were banned in 1977,
the chemicals persist in soil, air, lakes, and oceans. Classified by the EPA as
probable human carcinogens, PCBs are found in the fatty tissue, sperm, blood,
and milk of animals and humans the world over. Although PCBs vary in their
effects, several studies link some PCBs to human breast cancer.
Faced with a government-proposed cleanup plan that would cost hundreds of
millions of dollars, GE launched a local media offensive assailing the measure
as unnecessary because the river is "cleaning itself." These PR
efforts (which happened to be aimed at a community with one of the highest
breast cancer rates in the United States) prompted EPA Administrator Carol
Browner to complain to the New York Assembly in 1998: "GE would have the
people of the Hudson River believe, and I quote, 'living in a PCB-laden area is
not dangerous.' The science tells us the opposite is true."
Responding to mounting evidence of organochlorines' harm, in 1992 a staid
scientific advisory group, the International Joint Commission (IJC), proposed a
global phaseout of whole classes of the roughly 15,000 chlorinated compounds in
use. (The IJC advises the U.S. and Canadian governments on pollution in the
Great Lakes region.) Among the evidence was research from Israel showing that
three organochlorine pesticides detected in milk and other dairy products caused
12 types of cancer in 10 different strains of rats and mice. After public outcry
in 1978 forced the Israeli government to ban the pesticides-benzene hexachloride,
DDT, and lindane-something remarkable happened. Breast cancer mortality rates,
which had increased every year for 25 years, dropped nearly 8 percent for all
age groups and more than a third for women ages 25 to 34 by 1986.
Unimpressed by such findings, the American Cancer Society (ACS) sided with
the Chlorine Institute and issued a joint statement against the phaseout. This
alliance between the world's largest cancer charity and the chemical industry,
says Epstein, amounts to a "frank hostility" to prevention.
The American Cancer Society was founded with the support of the Rockefeller
family in 1913. Members of the chemical and pharmaceutical industry have long
had a place on its board. The society strengthened its industry ties in 1992,
when it created the American Cancer Society Foundation to solicit contributions
over $100,000. The foundation's corporate-heavy board of trustees includes David
Bethune, president of the multinational drug company Lederle Laboratories and
vice president of American Cyanamid, a manufacturer of chemical fertilizers and
herbicides.
The Cancer Society's anti-prevention efforts include opposing the now-defunct
Delaney Clause, passed in 1958 to safeguard food from substances that cause
cancer in animals, because the law "would severely limit the use of
valuable pesticides and food additives and...probably increase food costs."
In 1977 and 1978, it opposed regulations for hair dyes that cause mammary and
liver cancer in rodents. And since 1982, the ACS has insisted on unequivocal
proof that a substance causes cancer in humans before taking a position on
public health hazards.
Ironically, this is the posture of the tobacco industry, which the ACS has
long battled, and explains why decades after the U.S. Surgeon General warned in
1964 that smoking causes lung cancer, tobacco executives were still saying that
smoking isn't dangerous. It was the Surgeon General's courage to act on what
Steingraber calls "good but partial evidence" that would protect
people "while the wheels of science slowly grind on." Thirty-two years
later, scientists finally isolated the carcinogenic agent in smoke and
determined exactly how it causes lung cancer. True to form, the Cancer Society's
latest report on cancer prevention, the 1998 "Cancer Risk Report:
Prevention and Control," makes no mention of environmental factors.
The primary source of support for cancer research in the United States comes
from the federally funded National Cancer Institute (NCI). Senior executives in
both the Cancer Society and the Cancer Institute routinely move through a
revolving door to board and executive posts at companies that make
cancer-treatment drugs.
Such conflicts of interest extend to the petrochemical industry. While
serving as chairman of the National Cancer Advisory Panel (a three-member
committee appointed by the president) in 1990, Armand Hammer announced a drive
to add a billion dollars to the NCI's budget "to find a cure for cancer in
the next ten years." At the time, he was also chairman of Occidental
Petroleum, which would later have to pay the federal government $129 million and
New York State $98 million to clean up its infamous toxic dump, Love Canal.
It's no surprise, then, that reducing exposures to environmental carcinogens
gets short shrift in the NCI's breast cancer prevention efforts, and that the
agency embraced a study in "chemoprevention" in 1992. The Breast
Cancer Prevention Trial, involving over 13,000 women throughout North America,
was designed to see if the chemotherapy drug tamoxifen would reduce the risk of
breast cancer in healthy women. Zeneca supplied the tamoxifen, and the NCI
provided $50 million in funding. With activists demanding prevention, says Cindy
Pearson, executive director of the National Women's Health Network, "the
NCI needed a prevention initiative." It chose what seemed the easiest way
to go-a pill.
Pearson's group opposed the study at a Food and Drug Administration hearing.
"Tamoxifen shouldn't even be mentioned in the same breath as
population-wide prevention," she says. Studies later revealed that the
women on tamoxifen developed 44 percent fewer breast cancers, but twice as many
endometrial cancers, three times as many blood clots in their lungs, and 160
percent more strokes and blood clots in their legs. (Major studies in Italy and
Britain found no reduction of breast cancer risk.) In October 1998, the FDA
approved tamoxifen for healthy women at "high risk," expanding
AstraZeneca's $526 million market for the drug to some 29 million more women.
The National Cancer Institute's latest "prevention initiative" will
compare tamoxifen and Eli Lilly's raloxifene-another drug that appears to reduce
breast cancer risk-in tests on 22,000 women in the United States and Canada.
While these advances in chemoprevention win funding and acclaim, less-toxic
prevention efforts have met fierce resistance. When the International Joint
Commission launched its organochlorine phaseout, the chemical industry first
responded with a media offensive attacking the proposal, then went after
women's-health activists. In a memo prepared for the Chlorine Chemistry Council,
the public-relations firm Mongoven, Biscoe and Duchin outlined a strategy to
"mobilize science against the precautionary principle"-the idea that
when there is evidence of serious risks to public health, we must act to reduce
those risks even in the absence of absolute proof. Singled out was a series of
conferences on organochlorines and women's health in 1994 that featured a
keynote talk by Dr. Devra Lee Davis on synthetic chemicals. Davis, an
epidemiologist, was a health-policy advisor in the Clinton administration at the
time, a post the memo complained gave her "unlimited access to the
media" and helped validate her "junk science."
Industry¹s efforts to stifle evidence of environmental links to breast
cancer has even infiltrated the medical journals. Two incidents that grabbed
national headlines involved The New England Journal of Medicine in 1997. The
first, an editorial by toxicologist Stephen Safe of Texas A&M University,
reviewed studies correlating chemical residues in blood samples with increased
breast cancer risk. Safe judged the evidence unconvincing, dismissing public
concerns as "chemophobia." The Journal did not disclose that Safe had
received research funds from the Chemical Manufacturers Association six months
before his article appeared.
On the heels of Safe's editorial, the Journal ran a book review panning
Sandra Steingraber's Living Downstream. The author, a physician identified only
as Jerry H. Berke, said Steingraber was obsessed with environmental pollution as
the cause of cancer. Berke, it turned out, was a senior official at W. R. Grace,
the chemical giant forced by the EPA to help pay for a $69 million cleanup of
contaminated wells in Woburn, Massachusetts, the setting for the book and movie
A Civil Action.
These events had one positive outcome, says Steingraber: they revived an
important public conversation that Rachel Carson, the anti-toxics pioneer,
initiated toward the end of her life. "She was beginning to document the
interlocking structures of industry and medicine and how the chemical industry
may be using the medical literature as a mouthpiece for its own views."
Carson, herself a victim of industry attacks, saw no contradiction between
preventing cancer and developing better treatments. But a "search for the
cure," she said, misrepresents the slow nature of scientific discovery. As
we single-mindedly chase that elusive cure, we miss opportunities to prevent the
cancers of the next generation. "It is a disservice to humanity to hold out
the hope that the solution will come suddenly, in a single master stroke,"
she warned in Silent Spring.
Carson was dying of breast cancer when she wrote these words. No less tragic,
the pattern of missed opportunities continues more than 35 years later.
PROTECTING OUR HEALTH
What You Can Do to Reduce Toxics
Toxics activists in Sierra Club chapters and groups nationwide are working on
two major campaigns to protect public health. In a global effort, the Club has
joined the International POPs Elimination Network, an alliance of 100
non-governmental organizations advocating a worldwide ban of at least 12
persistent organic pollutants (POPs), the most hazardous chemicals known to
science. All of these "dirty dozen" chemicals are organochlorines that
can travel thousands of miles through the atmosphere, linger in the environment,
and concentrate in the fatty tissues of wildlife and humans. For more
information, contact Michael Gregory of the Environmental Quality Strategy team
at aztoxic@primenet.com
And in the United States, the Club has teamed up with Health Care Without
Harm, a coalition of more than 170 groups dedicated to environmentally
responsible health care. The campaign focuses on reducing the toxic output of
medical incinerators-the leading source of mercury emissions and second-leading
source of dioxin. For more information, contact Doris Cellarius, HCWH
coordinator, at doris.cellarius@sierraclub.org
—Liza Gross
More Resources
on brest cancer research and treatment.
Sharon Batt, a breast cancer survivor, is the author of Patient No More:
The Politics of Breast Cancer. Liza Gross is Sierra's copy editor.
(C) 2000 Sierra Club.
http://www.sierraclub.org/sierra/199909/cancer.asp
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