The Fall 1994 Conference of the American College for the Advancement of Medicine convened in San Diego. Several hundred doctors were in attendance from all over the U.S. and the world. The keynote address was delivered by Dr. Samuel Epstein, an internationally recognized expert in toxicology and cancer prevention. He is the chairman of the Cancer Prevention Coalition, an activist group working to make the public aware of the presence of easily avoidable carcinogens in our environment. He is the author of the following books: Mutagenicity of Pesticides, The Politics of Cancer, Hazardous Wastes in America, Cancer in Britain, The Politics of Prevention, The Safe Shopper's Bible and Breast Cancer Prevention.
I found Dr. Epstein's address so informative and so useful that I am reproducing my edited notes from his lecture. Dr. Epstein...
A National Epidemic
The increased incidence of cancer in the past forty years represents a true epidemic. Let me explain that. Statistically speaking one-third of our population will get cancer in their lifetimes, more than one-quarter will die from it. Last year more than 500,000 people died of cancer in the U.S. This is a national epidemic!
In high-risk groups, the incidence is markedly higher. From 1950 to 1990, the incidence of cancer, age adjusted, has increased by 44%; breast cancer and male colon cancer has increased over 60%; prostate cancer, about 100%; malignant melanoma, malignant lymphoma, non-Hodgkin's lymphoma, 150%; testicular cancer for males between 28 and 35, 300%; childhood cancer, over 20%.
After one gets cancer, the ability to treat and cure the disease has not improved for the overwhelming majority of cancers. For whites, the five-year survival rate is around 50% and for blacks, 38%. This is unchanged since 1950. For epithelial cancers (a broad class including many types), for which most chemotherapy is given, there has been no improved survival rates demonstrated and no evidence of efficacy of chemotherapy for these cancers. Despite this lack of effectiveness, chemotherapy continues to be routinely given. Although leukemia and other blood and lymph cancers in childhood can have prolonged remissions with chemotherapy, ten or fifteen years later the incidence of second cancers in these children is ten times the average. This points to the fact that these drugs themselves cause cancer — they are carcinogens.
The cost of cancer to our nation is about two percent of our gross national product. The costs of cancer for Medicare exceed that of any other disease. According to the American Hospital Association, by the year 2000 cancer will be the dominant specialty in American medicine.
What has happened to cause this enormous explosion in the incidence of cancer? From the 1890s until the 1940s, organic chemicals were produced by the fractional distillation of coal and tar. No new chemicals were produced, only those already present in coal and tar were isolated. The petrochemical era was born in the 1940s. In 1940, by using new technology, synthetic chemicals were created which had never existed before. With the advent of thermal cracking and catalytic cracking, it became possible to take petroleum, fractionate it, isolate particular chemicals and then, with a process of molecular splicing and recombination, to produce any chemical you wanted to produce.
In 1940, we produced about one billion pounds of new synthetic chemicals. By 1950, the figure had reached fifty billion pounds, and by the late 1980s, it became 500 billion pounds, including a wide range of toxic, carcinogenic, neurotoxic and other chemicals. Most of these chemicals have never been tested for toxic, carcinogenic or environmental effects.
We have been able to identify around 600 of these chemicals which are carcinogenic in animals and, although one can say that is just in animals, and they are not proven to be carcinogenic in humans, the fact is, without exception, all chemicals which are carcinogenic in humans are carcinogenic in animals. The probability of the reverse being true is extremely high. No exception has ever been proven. In cases of chemicals now known to be carcinogenic for humans, the carcinogenicity in animals was known as long as four decades prior to the establishment of proof of human carcinogenicity. We cannot afford the luxury of waiting for proof of human carcinogenicity after animal carcinogenicity has been proven, and yet that is what is happening. We are subjected daily to a host of chemicals of known carcinogenicity in animals.
It took over three decades and thirty million dollars in research to prove the relationship between smoking and lung cancer. This was a huge number of people, as high as fifty percent of the population at one time, exposed to the same source of carcinogens. When you are dealing with smaller numbers of people and large numbers of carcinogens, it becomes practically impossible to prove a human cancer linkage beyond a scientific doubt.
ACS, the American Cancer Society and NCI, the National Cancer Institute, imply in their literature and public statements that tobacco is the only cause of the increase in cancer. This is nonsense.
Since 1950, if you subtract lung cancer, the increase in overall cancer is more than seventy percent, despite the fact that smoking has decreased from around fifty percent of the population, to around twenty-five percent since 1950. The nonsmoking attributable lung cancers are about thirty percent, most due to occupational hazards and urban air pollution. Despite the fact that people are smoking less, the incidence of lung cancer has more than doubled in recent decades. These cancers must be caused by other factors.
Avoidable Causes of Lymphomas and Childhood Cancers
Non-Hodgkin's lymphoma has increased 150% since 1950. Prolonged use of black and dark brown hair dyes causes a major increase in blood-related diseases, particularly non-Hodgkin's lymphoma. Childhood cancers are associated with maternal and paternal occupational exposures, particularly in the petrochemical industry. Also, parental use of pesticides at about the time of pregnancy is strongly associated with childhood cancers.
Avoidable Causes of Breast Cancer
Breast cancer is associated with heredity (although this is disputed) and reproductive history (early menarche, no children, late menopause). The attempted association between breast cancer and a high-fat diet is now totally discredited by the Willits study at Harvard. However, there probably is a relationship with the contaminates concentrated in fats.
Organic chlorine pesticides are associated with breast cancers. These pesticides are specific for the location of the cancer on the breast, and they concentrate in breast fat. They also have an estrogenic effect, which is carcinogenic when in excess. DDT and PCB are present in increased levels in the blood of women with breast cancer. These data are not new; they have simply not been made available to the general public.
Now, to meat hormones. The great majority of cattle are raised in feed lots where they receive high doses of estrogens before slaughter, so that the meat will be tender for market. The levels of estrogenic hormones present in meat are terrifyingly high. There is no effective regulation of feed additives, including antibiotics and hormones in meat. Women who eat meat are exposed from birth to death to high levels of estrogenic hormones because of feed additives. This goes on with the tacit approval of The FDA and the silence of the American Cancer Society and the National Cancer Institute (abbreviated ACS and NCI from here on out).
Polyvinyl chloride is manufactured from vinyl chloride. Women who work in factories where this is done have a greatly increased incidence of breast cancer. These studies have been "replicated." (That means they have been repeated and are considered reliable.) Despite the fact that over three million women are working in the petrochemical industry, there has been no serious attempt to look further into this matter. Electrical industry work also is an important risk factor in cancer.
Where you live also affects the incidence of breast cancer. People living near hazardous waste dumps are at high risk for cancer. Living in proximity to a nuclear plant results in major excesses of breast cancer.
There also are iatrogenic (doctor caused) breast cancers. In 1971, the National Academy of Science published a report revealing that for every rad of x-ray exposure, the risk of breast cancer increased by one percent. Nine months later the ACS and NCI promoted a mammography project in which 300,000 women were enrolled and were told that the dose of radiation would be perfectly safe, and that the procedure might pick up breast cancer and save their lives. The minimum dose women received in this procedure was two rads per mammogram. Some centers administered five rads and some ten rads. Think of that — an increase in cancer risk of two percent, five percent, or ten percent by a single test for cancer — without being informed of the risks!
The premenopausal breast is much more sensitive to radiation than the postmenopausal breast. If a premenopausal women gets an annual mammogram each year for five years, involving two rads each time, she will have an increased risk of breast cancer of ten percent! The NCI and ACS knew this. They chose to do it anyway for publicity and research money reasons. These women have never been followed up. Probably, part of the story in the increased incidence of breast cancer has been these studies back in the 1970s.
Even though in the 1980s the level of radiation given in mammography was lowered to the range of 200 millirads, there has never been a single published study showing the effectiveness of mammography in the premenopausal woman. There have been seven randomized, controlled trials showing no efficacy whatsoever. In contrast, these studies demonstrate increased mortality in premenopausal women for the three to five years after a mammogram. This data was presented to the ACS and NCI years ago, but they were dismissed and trivialized. Last year, however, the NCI reversed itself and stands against premenopausal mammography, but the ACS still persists, and they are supported by radiologists who fear losing their "premenopausal market." That is the language, the "premenopausal market!"
There are two types of breast implants, a straight silicon gel and a silicone gel implant surrounded by an industrial polyurethane. The object of polyurethane was to reduce contractures and prevent scarring and hardening of the breasts. About two million women have been implanted. From 1960 to 1964, Wilhelm Huper at the NCI — the greatest cancer authority of the age — published a series of research papers revealing that injection of polyurethane into animals resulted in a wide range of sarcomas and carcinomas. He warned that polyurethane would degrade in the body and that its degradation would be accompanied by the appearance of these cancers. There was no question in his mind these cancers were caused by polyurethane, and under no circumstances should polyurethane ever be implanted in the human body.
The chemicals from which polyurethane is made were proven to cause cancer, and these chemicals appear in the breast milk and urine of women with breast implants. Their appearance in breast milk obviously puts the nursing baby at risk as well. The chemical industry was well aware of this. The plastic surgery industry was well aware of this. Nevertheless, 400,000 women were implanted with polyurethane — despite the fact that evidence of its carcinogenicity goes back to the 60s.
The evidence of carcinogenicity was just as clear for the silicone gel. The scientists who were aware of this pushed for a medical alert. The FDA responded by firing those scientists and burying the documentation for years. This information was available to plastic surgeons. We have records of a conference of plastic surgeons in 1985 where serious concern was expressed as to what might happen if the data became available to the general public. And yet they went on doing it! This is our profession. What should we do with these people? Do we dissociate ourselves? Do we condemn them?
Who is Responsible?
Now, let's turn to who is responsible. There is no question that the NCI and ACS bear the major responsibility, because they have failed to provide Congress with information about a wide range of avoidable carcinogens in air, water, food, cosmetics, and the workplace. The only voices lifted in protest have been those of independent scientific activists. Never has the cancer establishment gone to Congress and said "Here is the information, and we need to develop the appropriate responses."
The ACS has trivialized this information and worked with industry to suppress this information. The ACS refused to support the Clean Air Act, the Toxic Substances Act and even supported efforts to reverse the ban on saccharin. Every year the ACS comes out with a volume called Facts and Figure
s, which never includes a discussion of preventable causes of ovarian cancer, nothing on avoidable occupational causes of breast cancer, nothing on the risk factors of childhood cancers. The emphasis is, rather, "You drink too much, you smoke too much, you've chosen the wrong parents. These are the real reasons." The rest is glossed over. The cause for this is a mind set, because doctors are trained in diagnosis and treatment and generally are ignorant in matters of prevention.
Also, there are conflicts of interest. Of the 300 members of the Board of Directors of the ACS, there are 150 lay and 150 professional people. If you analyze who they are, it reads like the Fortune 500 Who's Who. The tie-in to banking, petrochemicals, pharmaceuticals and the cancer drug industry is overwhelming.
Every year, in April, there is a fund-raising drive by the ACS, and every year they tell us they can fund only ten percent of the research grants applied for. The budget of the ACS is 350 million dollars. There is a standard in philanthropic organizations that one should keep only 150% of the annual budget in reserve. Yet in cash, assets and real estate, the ACS is worth 1.2 billion dollars — yet every year they come out and say, "We need money for research."
The NCI has a two-billion-dollar annual budget. Less than 2.5% is used for primary prevention — informing the public about avoidable causes of cancer. Even though occupational hazards account for ten percent of cancers, the study of prevention and information distribution in this area account for only one percent of the NCI's budget.
In 1971, when President Nixon declared the "War on Cancer" and the NCI was given autonomy, two things happened: (1) a massive influx of money went into the NCI and (2) Beno Schmidt was appointed as chairman of the President's Cancer Panel and served ten years. He was a New York investment banker with close ties to the pharmaceutical industry, interested only in treatment of cancer with drugs — and for every cancer drug that was sold, he made a handsome profit. For the next ten years, Armand Hammer was chairman. He was the ex-CEO of Occidental Petroleum, one of the nation's major polluters, who gave us Love Canal among other things. So, for over twenty years, the NCI was in the hands of people from the pharmaceutical and petroleum industries.
A detailed analysis of the results of drug therapy for cancer by the GAO (the U.S. General Accounting Office) has shown us that there is not a shred of evidence for the efficacy of drug treatment in epithelial cancers (cancers involving the linings of the body — lung cancer, colon cancer, skin cancer, etc.). Here we have clear-cut data on the lack of efficacy of a multibillion dollar industry, and yet this is the very argument standardized medicine raises against progressive methods of treatment of cancer. Of course, progressive methods should be scrutinized, but so should standard methods. This is a double standard, and it is unjust. The fact is, standard medical treatment does not face that kind of scrutiny — thanks to a lapse in consciousness, to this date, of watchdog groups and to the general lack of integrity of the cancer/pharmaceutical industry. The same goes for Congress, which does nothing other than listen to platitudes from the NCI and ACS about smoking, drinking and fat being the only causes of cancer. Unwillingness to confront and challenge authority and accept activist positions lies behind this deadly sin of omission.
Commonly Used Carcinogens
Flagyl, the most common drug used for trichomonas infections, is a carcinogen. The evidence is unequivocable. The animal data has been replicated. Lindane is a pesticide we use for not only bugs, but also for head lice in a preparation called "Quell." Up to ten percent of children are treated with Lindane. Lindane is a highly potent animal carcinogen, and in the last few years we have seen data incriminating the use of Quell as a cause of brain cancer in children, and also Lindane as a pesticide as a cause of brain cancer in children. Clomathin (which is used as a fertility drug) is related to excess ovarian cancer.
Tamoxifen is touted as something that will reduce the chances of breast cancer. There is no solid evidence for this point of view — you can see claims of such evidence as wildly optimistic or non- existent. However, the evidence of the carcinogenicity of Tamoxifen is overwhelming. It induces uterine cancer in people who are treated with Tamoxifen for breast cancer. When I mentioned this in an article for the L.A. Times a few years ago, the leader of the trial commented "Well, no big deal, you can always do a hysterectomy for uterine cancer." Quote: "No big deal." Tamoxifen also is a potent liver carcinogen. Its molecular structure is similar to DES. And women are not informed about this. The consent form trivializes the risks.
The interface between science and one's responsibility to speak out as an informed doctor demands that we take a stand to inform people of these things.
(The author agrees, emphatically.)
The breast implant situation is even more shocking, because two million women are involved. The best FDA scientists recommended a medical alert to go out to these women in 1987. The recent 4.52 billion dollar settlement relates to autoimmune disease without a word regarding breast cancer.
Let us talk about cosmetics. The cosmetics industry is in a state of regulatory anarchy. Cosmetics are laden with a plethora of unlabeled carcinogens. Let me give you a few examples.
Hair dyes contain phenylenediamines and various coloring agents, which are proven carcinogens, documented to relate to non-Hodgkin's lymphoma, chronic lymphocytic leukemia and multiple myeloma. Lotions and creams contain diethanolamine and triethanolamine. These react with nitrites added as preservatives or as contaminants to produce nitrosamines which are extremely potent carcinogens.
In the average cosmetic or cream, you find highly potent carcinogens. In others, you find agents which release formaldehyde (from polyethylene glycol, bronopal, quaternium 15). Several of them contain dioxane. Others contain artificial colors, including arsenic and lead. The use of talc has been shown to be related to ovarian cancer. However, the ACS "Facts and Figures" mentions nothing about this.
The average farmer uses one and a half to two pounds of pesticides per acre. Home lawns take ten pounds per acre. Golf courses take fifteen pounds per acre. Up to thirty different pesticides are used, ten of which have been shown to be carcinogenic: such as 2-4-D, related to lymphomas; Atrazine related to ovarian cancer; DDT related to pancreatic cancer. Golf course superintendents have excesses of non-Hodgkin's lymphoma, brain cancer, prostate and lung cancer. Dogs living where lawns are repeatedly treated have a five fold excess of non-Hodgkin's lymphoma. Children also get lymphomas and leukemia and these are in excess in children living in houses where lawns are repeatedly doused with pesticides.
Clothing is dry-cleaned with perchlorethylene (or tetrachlorethylene). When you put it in a cedar closet, the levels of perchlorethylene in that closet become greater than that permitted to a trained worker with protective gear.
Many domestic aerosols have as the propellant dichlormethane, a carcinogenic chemical related to breast cancer. Furniture polishes contain formaldehyde. Cat litter contains crystalline silica, another potent carcinogen.
Xeronol is a nonsteroidal estrogenic compound. It is broken down to xerolenone, a carcinogen. The levels are very high in meats, fantastically high. The hormones are implanted in cattle ears, one allowed per cow. However, to save money and get the cow to market faster, many are implanted and the FDA does not enforce the regulations. There is no requirement for a withdrawal period. This is regulatory anarchy.
We use nearly sixty carcinogenic pesticides in the growth and production of food crops, and instead of the NCI and ACS going to Congress and making the problem clear, they are totally silent. In fact, the ACS has performed damage control in one case. When the TV program "Front Line" was to present a program on the dangers of pesticides in foods, ACS put out a media blitz trivializing the risk of pesticides in foods before the Front Line show was aired. It was subsequently canceled.
Industrial contaminants, PCBs, dioxanes, food coloring agents, etc., and now we come to nitrite preservatives. Nitrites react with amines in cosmetics and in meat and fish, producing nitrosamines. We knew in the seventies of the high content of nitrosamines in hot dogs. The FDA tried to bury the data. In the last few years, we have clear proof of increased brain cancers and leukemia in children eating hot dogs, 5-10 per day.
What Can We Do?
First we must inform ourselves. In the area of iatrogenic cancer, we must accept responsibility. For example, DES, diethylstilbesterol, has been shown to cause adenocarcinoma in the daughters of women who were given this drug in the 1950s. These women were told that the drug was totally safe, just a vitamin, no problem. The evidence was clear, and yet these women were subjected to a carcinogen and, not only that, but without being informed of the data regarding DES, which had been available since the 1930s. We are certainly doing similar things today. Let me explain.
As clinicians we must first inform ourselves, so that we can counsel our patients. We must remember an important part of our sacred Hippocratic oath: "First, do no harm." The Cancer Prevention Coalition takes initiatives on labeling at a national level. Every citizen has the right to know if there are carcinogens in his household products and his food. This is unarguable. You can argue about the science or the economics, but it is unassailable to say that people have the right to know the truth. This also provides a powerful incentive to responsible and responsive industry to phase out carcinogens and replace them with safer alternatives.
The German government has taken steps to phase out diethanolamine and triethanolamine from cosmetics, because they produce nitrosamines. There has been no such attempt in this country. Nor has there been any such attempt to label this information on hot dogs. This is outrageous, scientifically and constitutionally. More important is the realization that we are in the middle of an avoidable cancer epidemic. It is untenable to say "I am just a doctor, and I have nothing to do with this."
Who should be telling doctors and citizens about these things? The NCI and ACS, of course. However, the NCI and ACS are part of the cancer/pharmaceutical industrial complex and, as such, are unlikely to change.
I feel that you all have the right to demand documentation and proof of the assertions I have made today. For that purpose, I refer you to the article I wrote for The American Journal of Industrial Medicine, June 1993 which has detailed citations to verify all the information given in this lecture.
For more information, follow these hyperlinks:
Adjunctive Therapies for Cancer
Ayurvedic Medicine Approach to Cancer
Biologic Therapies for Cancer
Energy Medicine in the Treatment of Cancer
Herbal Treatment of Cancer
Homeopathy in the Treatment of Cancer
Immune Therapies for Cancer
Metabolic Therapies for Cancer
Nutritional Therapies for Cancer
Natural Cancer Therapies