DR. SAMUEL EPSTEIN:

In 1983, a report was leaked from the White House characterizing what was called the “Enemy’s List.” These were scientists who had ventured from the narrow corridors of science into the field of public policy and who had adversely impacted on public policy. And I had the distinction of being number one on the list with an appellation next to my name: “perfectly horrible.”

AMY GOODMAN:

Dr. Samuel Epstein, speaking last night at the Project Censored Awards, handed out to journalists and activists and academics for covering stories that have been censored by the mainstream media. Among them, Dr. Samuel Epstein, the Chair of the Cancer Prevention Coalition, he’s also a professor at the Public Health School of the University of Illinois. He exposed the American Cancer Society, one of the wealthiest non-profits, in an article entitled “American Cancer Society: The World’s Wealthiest Non-Profit Institution.” It gets money from surgeons, from drug companies, from corporations, that he says profit from the cancer industry and have little interest in cancer prevention. According to Dr. Epstein, the American Cancer Society spends most of its money on overhead, salaries and fringe benefits, little on cancer prevention and education.

We’re going to spend the rest of the program talking about this. We welcome you to Democracy Now!

DR. SAMUEL EPSTEIN:

A pleasure to be with you.

AMY GOODMAN:

Well, you are a professor of Environmental and Occupational Medicine and Chair of the Cancer Prevention Coalition. Can you talk about the American Cancer Society?

DR. SAMUEL EPSTEIN:

Yes. In the same ways a few minutes ago we were talking about a growing demand for accountability from major international institutions like IMF and World Bank, we’re now seeing the emerging demand for similar accountability from institutions in this country which are responsible for national cancer policies, and paramount among these are the American Cancer Society, which is the world’s largest non-religious “charity” — charity in inverted commas — and also the Federal National Cancer Institute.

Now, both of these institutions, the policies of both of these institutions are largely fixated on what I call damage control: treatment and diagnosis with indifference, and in the case of the American Cancer Society, to frank hostility to cancer prevention. In fact, I should first of all point out that the incidence of cancer has escalated to epidemic proportions over the last few decades, with the result now that one-in-two men are getting cancer in their lifetime, and one-in-three women are getting cancer in their lifetime, and this is a major increase in cancers, cancer incidence, from the 1950s. In fact, we’re seeing, for some cancers, increase in incidence by 200 percent, such as prostrate cancer, non-Hodgkin’s lymphoma, multiple myeloma, childhood brain cancer, nervous system, 40 percent, adult brain cancers by about 80 percent, and about a quarter of the increase since 1950 have been from non-smoking-related cancers.

Now, the American Cancer Society’s position is they try to explain away, first of all, the increasing incidence of cancer and try to say that cancer is largely an expression of faulty lifestyle and genetics. Well, genetics clearly have nothing to do with the major increases in the last few decades and neither can longevity, because we adjust all our incidence data to take this into account. So, basically, and in the meantime, while the incidence rates are on the increase, our ability to treat and cure cancer have remained static.

Now, the American Cancer Society has a budget of about $700 million a year, total revenues of about $700 million a year. Most of this money comes from public, the public, with donations under $100. There are close interlocking interests with the cancer drug demography and agrichemical industries, but I say most of this comes from the naïve public giving $100, thinking what they’re going to do is help fight the winnable — losing war against cancer.

Now, of this $700 million, roughly about a third of it goes on overhead, expenses, bloated salaries and all kinds of benefits. And about $1 million goes on tobacco-related programs. Outside of the $700 million, one million goes into tobacco-related, and less than one million goes on environmental, industrial and occupational causes of cancer. So there is almost a total denial of the importance of avoidable exposures to carcinogens in our air, in our water, in the workplace, in consumer products. By consumer products, I mean food, cosmetics and toiletries and household products.

Now, I have to stress that there is a vast body of information in the scientific literature, which is relatively inaccessible to the general public or buried in government industry files, clearly demonstrating causal relationships between these avoidable and involuntary exposures to carcinogens and these cancers which I’ve just been talking about. None of this information has been imparted to Congress or to regulatory agencies and the public. So there was a fundamental denial of citizens’ right to know.

And at the same time as all this is going on, the American Cancer Society not only has actually been frankly hostile to any — to major attempts to inform the public —- and, for instance, every year the American Cancer Society produces a report called “Facts and Figures,” in which they talk about the great achievements. And when you look at the facts and figures on, say, on ovarian cancer, there’s no reference whatsoever to avoidable causes of ovarian cancer, such as women dusting their genital area with talc after showering and bathing, which increases incidence of ovarian cancer by three— to four-fold, no information whatsoever for avoidable causes of childhood cancer, and no —

AMY GOODMAN:

Wait, wait. Say that again about talc powder.

DR. SAMUEL EPSTEIN:

Women — some 25 million American women every year, in their reproductive years, routinely dust their genital areas with talc after showering and bathing. Now, we have about three or four clear studies demonstrating strong associations between dusting the perineal area with talc and ovarian cancer. No reference to this ever reaches — no mention of this ever reaches the public. The American Cancer Society knows about this.

It knows — it also has information on a wide range of avoidable causes of childhood cancer. No reference whatsoever to it. And not until very recently, the American Cancer Society was saying there’s nothing a woman can do to reduce her risks of breast cancer. All she need do is go and have early mammography, which basically will prevent her — they talk about this as prevention, which in fact it isn’t. In fact, for these cancers, for most of these cancers, there’s information which just has never reached the public.

And the question is, why is this? It’s a reflection of the mindset of the leadership of the American Cancer Society and the National Cancer Institute. They’re dominated by clinicians, radiologists and surgeons. But there’s also close and interlocking conflicts of interest with the various industries I’ve talked about.

And interestingly enough, even for tobacco, which many people think that American Cancer Society has played a major role, as I mentioned before, they only spend $1 million a year on tobacco-related programs. And in addition to that, two of their major PR operations, the firms that handle their PR, also represent a tobacco interest, like Edelman and Shandwick.

So this is the background to this organization, which, as I say, is reckless, has forfeited the public’s trust and, in my view, and in the growing view of some of my colleagues, funds from the American Cancer — which are being given to the American Cancer Society, should be diverted and given to the other institute — other organizations, public interest and activists organizations that are interested in cancer prevention.

Now, there have been some very interesting recent developments, which I’d just like to draw to your attention. About a couple of years ago, there was a march on Washington headed by Schwarzkopf, and the function of this march was to persuade Congress to increase the budget of the National Cancer Institute to about $5 billion a year. The present budget is $3 billion, and the push is to increase the budget to $5 billion by 2003. The main interest behind this is the cancer drug industry, which is the recipient of most of the — our tax dollars funds which go to the NCI. Now, after the — the march, incidentally, was a bust. About 150,000 people turned up, well under than the million they were hoping for. But after that, a curious thing happened. The American Cancer Society created what’s called the National Dialogue for Cancer. They recruited President Bush for this and had behind-the-door —- closed-doors meetings, in which -—

AMY GOODMAN:

Bush or Clinton?

DR. SAMUEL EPSTEIN:

Bush, former President Bush. And they had a series of closed meetings. Basically what American Cancer Society was doing was trying to gain control of the policy —- of national policy in cancer, which in fact is shared at present moment with the National Cancer Institute, and from this National Dialogue on this closed set of meetings, they approached Senator Feinstein, Dianne Feinstein, with a proposal to -—

AMY GOODMAN:

California Democratic senator.

DR. SAMUEL EPSTEIN:

California — to form an independent advisory committee to rewrite the National Cancer Act and to — and the chairman of the two — the chair of this committee, independent advisory committee, was Seffrin, who’s the CEO of the American Cancer Society, and a man called DeVita, who used to be director of the National Cancer Institute about a decade or so ago, whose track record on prevention, hostility to prevention and ignorance, was just literally overwhelming. So these two are really dominating the Feinstein initiative.

It’s questionable whether the Feinstein initiative is going to go anywhere, but the real motivation behind this recent Feinstein initiative is, to quote from the Society for Clinical Oncologists, “to ensure that the American Cancer Society retains its ability in the fundraising level.” So, essentially, what they are doing is the American Cancer Society now feels threatened by patient advocacy groups, like the prostrate cancer groups, and it is attempting now to assert major influence and to take influence away from these groups and to be the controlling power and at the same time control the money, the public money from the public, into its own coffers.

AMY GOODMAN:

I want to talk the — about the American Cancer Society’s foundations, board of trustees, which include corporate execs from pharmaceutical, investment banking and media industries. You wrote about this in your piece, “American Cancer Society: The World’s Wealthiest Non-Profit Institution.” For instance, you say that David Bethune, the President of Lederle Labs, comes from a division of American Cyanamid, which makes chemical fertilizers and herbicides, as well as the anti-cancer drug, Novatrone. Another trustee, Gordon Binder, CEO of Amgen, the world’s foremost biotechnology company, whose product Neupogen, has enjoyed skyrocketing success as the cancer epidemic grows.

DR. SAMUEL EPSTEIN:

Well, I could go on and on. These are simply further illustrations and examples of the close interlocking relationships between the American Cancer Society and the cancer drug industry. You have similar relationships with the mammography industry, with the agrichemical industry. I mean, talking about the agrichemical industry, a few years ago the American Cancer Society joined forces with the Chlorine Institute of America to downplay the importance of chlorinated pesticides, organic chlorine pesticides, and to say you really needn’t worry about them, there’s a lot of hysteria about them, a lot of ignorance about them. And so working with the agrichemical industry, they did their best to damp down public concerns on contamination of food with pesticides.

And there are innumerable more examples. Another very interesting example is, every year, the American Cancer Society runs the National Breast Cancer Awareness Month. Now, this has been funded since 1985, as I published about eight or nine years ago, funded by Zeneca, AstraZeneca, one of the world’s largest cancer drug industries, which — and Zeneca was an offshoot of Imperial Chemical Industry based in England, the world’s largest manufacturer of carcinogenic pesticides and other industrial chemicals.

AMY GOODMAN:

I’m going to hold you there, because we have to break for stations to identify themselves, and then we’ll come back and continue our discussion with Dr. Samuel Epstein. He’s professor of Environmental and Occupational Medicine at the University of Illinois-Chicago and chair of the Cancer Prevention Coalition. You can go to his website at <a href=http://www.preventcancer.com, recipient of last night’s Project Censored Award for a piece he did on the almost billion-dollar American Cancer Society. You’re listening to Pacifica Radio’s Democracy Now! We’ll continue the conversation in a minute.

[break]

AMY GOODMAN:

You are listening to Pacific Radio’s Democracy Now! I’m Amy Goodman. My guest is Dr. Samuel Epstein. He’s at the School of Public Health at the University of Illinois, professor who’s published some 280 peer-reviewed scientific articles, ten books, including the prize-winning 1978 The Politics of Cancer, and twenty years later, in 1998 now, The Politics of Cancer Revisited. This is a person who has been dealing with the interface between science and public policy for many years, including being consultant to the US Senate Committee on Public Works, drafting congressional legislation, frequently invited to Congress for testimony. I guess the question is, what effect is it having.

So, you’re a person who is part of the establishment, yet your work for so many years has been fighting the cancer establishment. Besides the American Cancer Society, who else represents that establishment?

DR. SAMUEL EPSTEIN:

Well, I’m a little taken aback at being called part of the establishment. I’ve been a critic of the cancer establishment since the early ’70s. But I have worked scientifically, extensively, and my publications have been well received and never challenged on the scientific level.

But coming back to your question, who else is in the cancer establishment, it’s the National Cancer Institute and the American Cancer Society. The two of them form the cancer establishment, and until recently, we used to refer to the American Cancer Society as the tail that wags the dog. In fact, this is a little less true now; the American Cancer Society is struggling very hard to maintain its dominant position in terms — as a charitable organization, because it’s fighting single-organ cancer advocacy groups, like prostrate and breast cancer, and it’s feeling that its turf is being taken away from them.

AMY GOODMAN:

In the Project Censored book that has your article in it and has it published in full in the book, it says more than half the funds raised by the American Cancer Society go for overhead, salaries and fringe benefits for its executives and other employees, while most direct community services are handled by unpaid volunteers. By ’98, the cash reserves of the ACS, American Cancer Society, were worth more than a billion dollars. In addition, the American Cancer Society owns many millions of dollars worth of land and real estate. Nationally, only 16 percent of their funds goes into direct services to cancer victims. By the way, we did invite the American Cancer Society to be on the program today, but they declined.

DR. SAMUEL EPSTEIN:

Well, they always do. There’s only once they ever debated with me. That was in 1991, Dr. Laszlo, who was vice president, and he became so excited and emotional during the program that I think that — it was a decision by the American Cancer Society that it wasn’t worthwhile debating me.

Incidentally, there’s one very small correction of those figures. We’ve found, from more recent data, that the actual amount of money that goes on so-called supporting services is closer to a third of its budget.

The other points that I should make is that uniquely amongst all charities in this country, the American Cancer Society also spends money on lobbying political parties. And this is very questionable from an IRS standpoint and — but the spokesman for the American Cancer Society made it clear that, to quote from her, “We want to be players in the field” and something to this extent.

Now, this — the views I’ve been expressing, incidentally, have been pretty well echoed by the Chronicle of Philanthropy, which is the leading cancer charity — the leading watchdog for all charities in this country, and they charge, and I’m quoting precisely, “The American Cancer Society is more interested in accumulating wealth than saving lives.” More interested in accumulating wealth than saving lives. That was the opinion of the Chronicle of Philanthropy.

AMY GOODMAN:

Well, let’s talk about cancer prevention, which you say they devote the least of their resources to — in fact, you say they show a direct antipathy towards. Can you substantiate your claims? And what, to you, is cancer prevention?

DR. SAMUEL EPSTEIN:

Well, cancer prevention is basically reducing avoidable exposures to carcinogens in air and in water and the workplace and in consumer products. As far as the workplace is concerned, the American Cancer Society spends virtually nothing. In the past, it has been supportive of asbestos work, but it doesn’t provide the public — doesn’t provide workers and Congress with information on this. It doesn’t provide the public with information on the fact that their cosmetics and toiletries are really a witch’s brew of a wide range of avoidable carcinogenic ingredients and contaminants.

AMY GOODMAN:

Besides talcum powder, what else?

DR. SAMUEL EPSTEIN:

Well, it’s really difficult to know where to begin, because if you look at the back of a label of any particular cosmetic or toiletry, you see a list of twenty, twenty-five names. And included amongst these names are chemicals like PEG, polyethylene glycol, which is generally contaminated with dioxane, a very potent carcinogen.

There’s other chemicals which are contaminated. For instance, you have a DEA, is a common detergent. Now, DEA and TEA also present in most cosmetics and detergents. DEA itself was shown to be carcinogenic three years ago, but since the mid-’70s, we’ve known that DEA will react with nitrites, which is present either as a contaminant or preservative to form potent carcinogens known as nitrosamines. In fact, in the mid-’70s, National Institute of Occupational Safety and Health took action into — to block the use of DEA and TEA in metal cutting fluids — that’s fluids used by workers in cutting metals — because it was shown by then that these detergents would interact with nitrites, which were used as preservatives, to form these nitrosamines.

So NIOSH, National Institute of Occupational Safety and Health, over — nearly twenty-five years ago took strong action to stop workers being exposed to these, but from conception — from virtually from birth ’til death, over large areas of skin where people are applying cosmetics and toiletries, creams, lotions, and as I said before, well, I published a book on this called The Safe Shopper’s Bible, based on an evaluation of some 4,000 consumer products showing which of them are safe and which are unsafe. And to all intents and purposes, all mainstream cosmetics and toiletries are contaminated by such carcinogens and they’re — these are avoidable exposures.

There’s also avoidable exposures in carcinogens in food, and as far as these are concerned, the American Cancer Society has fought very hard to block information on these reaching the public.

The same also when it comes to drugs. The American Cancer Society has been very busy promoting Tamoxifen for the chemo prevention of breast cancer. It’s not interested at all in providing people — women with information on the causes of breast cancer. What it wants to do and what it has been doing is been putting women on trials — any woman is considered to be at high risk if she’s over sixty —- and also people who have had a family history are being recruited into trials where they’re told there are some risks of uterine cancer, but they’re not informed about the fact that Tamoxifen has been shown to be one of the most important and potent causes of liver cancer. They’re given no information whatsoever on this. So Tamoxifen is an extremely dangerous drug for use to give to healthy women who don’t have breast cancer, quite apart from the treatment aspect, and at the same time they are being denied the information on the serious risks of liver cancer. Now, I should also point out that -—

AMY GOODMAN:

But don’t you have to give informed consent, and then you —

DR. SAMUEL EPSTEIN:

There’s supposed to be informed consent, but liver cancer is not disclosed on the informed consent forms. And even more seriously, there are very, very cogent reasons for the view that there’s no evidence, there’s no serious evidence, that Tamoxifen will prevent breast cancer. All it will do is treat early undiagnosed cancers.

But to top all that off, we have another drug on the market, which, unlike Tamoxifen, is not going to be a multibillion-dollar drug, which has been shown in four-of-five trials to reduce risks of breast cancer by 30 percent. Now, no information on this drug, which whose name I’ll give you in a moment — no information on this is provided to the public by the American Cancer Society. That drug is aspirin. Aspirin. We have four-of-five studies showing that aspirin will reduce the risk of breast cancer by 30 percent. Now, there’s not money to be made out of that. There’s not billions of dollars to be made by Zeneca from aspirin. But there are billions and billions of dollars to be made by selling Tamoxifen and giving women the impression this would help prevent them from cancer, while at the same time giving no information at all on a wide range of avoidable causes of breast cancer.

AMY GOODMAN:

How could aspirin, Dr. Samuel Epstein, prevent breast cancer?

DR. SAMUEL EPSTEIN:

Very interesting, indeed. I’m glad you asked that. The way aspirin is an extremely — well, first of all, aspirin has been shown to reduce the incidence of colorectal cancer, too. But the way aspirin works is very complex, but one of the ways — one of the things that it does is it inhibits — in this complicated metabolism, it inhibits an enzyme called COX-2, cyclooxygenase-2, so by inhibiting cyclooxygenase-2, which has been shown to block angiogenesis, the growth of blood vessels, among other things, by — it basically functions by inhibiting this.

Now, here’s the very interesting thing. While at the same time the public is being given no information at all on aspirin, the drug companies are manufacturing COX-2 inhibitors, which they’re going to — which they’re hoping — in fact, patents, there’s a big major patent dispute out on who the COX-2 inhibitors have been — are owned by. One university claims it; there’s two drug companies. But this is going to be sold to the public, as among other things, not only for arthritis, but to prevent breast cancer. But not a word about aspirin has reached the public.

And this is just a perfect example of how — of the policies of the American Cancer Society, while at the same time in the National Breast Cancer Awareness Month they’ve given no information at all that told that mammography will prevent — will be useful as early detection, but in fact, by the time you get a mammogram, a tumor is about eight or nine years old, and there’s little or no evidence that pre-menopausal mammography is of any use whatsoever. No other country in the world uses — has pre-menopausal — allows pre-menopausal — routine pre-menopausal mammography screening. It’s been stopped in Canada. It isn’t used in Europe.

And pre-menopausal mammography is not only useless, because the breast is very dense, but also it’s dangerous. You actually increase risks of breast cancer by pre-menopausal mammography for three reasons. First of all, the breast is one of the most radiosensitive organs there are. And if a woman has pre-menopausal mammograms for ten years and the average of a rad per breast — a rad is a unit measure exposure, a chest x-ray is about 1,000 for the rad, but one — one set of four films, one set of four films to the breast, is equivalent to one rad. So, over the course of ten years, a woman would have had twenty rads exposures to her breasts, which is close to the kind of radiation women got outside the epicenter in Hiroshima and Nagasaki. And in fact, the National Academy of Sciences, in 1970, said that for every one rad exposure to the breast in the pre-menopausal woman, you increase risks of breast cancer by one percent. So here we have about twenty rads over a ten-year period, which significantly, in my view, significantly increases risks.

There are other reasons why pre-menopausal mammography is dangerous. One of them is due to the fact that one percent of women carry a silent — are silent carriers of a gene known as the AT gene, the ataxia-telangiectasia gene, and they don’t know they have it. But once you have this gene, you become very sensitive to radiation. And we have estimates that something like 20,000 out of the 180,000 breast cancers every year are due to women that have the AT gene that are radiated.

And the final point why — the final reason why pre-menopausal mammography is dangerous is as follows. When you do a mammogram, you have to squeeze the breast tightly to get as flat, small a — flat a film as possible. Now, we’ve known since the 1920s, pathologists — I used to be a pathologist incidentally — we’ve known since the 1920s that when you squeeze or compress a tumor, say, in an animal — if you’re doing studies in animals, even at surgery — you can rupture small blood vessels, and what is a self-contained isolated tumor which can be circumscribed and not life-threatening, you can open up the blood vessels to it, and you can have spread all over the body. So this tight compression of pre-menopausal breast is one of the other reasons why this is dangerous. And, in fact, we do have some studies which show that women that routinely have pre-menopausal mammography have an increased risk of subsequent — of breast cancer subsequently.

And none of this information reaches the public. No information on the fact that estrogen replacement therapy is an important cause of breast cancer. No information on the fact that the pill, especially when started in early adolescence and taken for long periods of time, a vast body of information, which I summarize as the dirty dozen causes, avoidable causes of breast cancer, reaches the public, instead of which, women are told, go and have an early mammogram, when in fact it’s dangerous, it’s a doubtful efficacy. And, in fact, over 90 percent of all breast cancers are detected by women themselves.

AMY GOODMAN:

We’re talking to Dr. Samuel Epstein. He’s author of The Politics of Cancer Revisited, just won a Project Censored Award for his exposé on what he calls the financially bloated American Cancer Society. In these last few minutes that we have left, two quick questions, one about genes, a tremendous emphasis on the gene now — we may get a whole mapping of the gene, which means more and more emphasis on genetic causes of diseases, and that goes for cancer, as well. Do you think that’s the wrong approach in general to cancer?

DR. SAMUEL EPSTEIN:

Well, first of all, I mean, genetics is terribly important, a study of human pathology and human disease. There’s just no question at all about that. But genetics can play no role whatsoever in the increase in the incidence of breast cancer and the startling increase since 1950. The genetics of human populations haven’t changed. In fact, genetics have only been incriminated in some five to six or, at the most, seven percent of breast cancers.

So while this information is interesting and of potential — possibly of potential value to our understanding of the detailed mechanisms, the facts are this: carcinogens operate via genetic mechanisms. They stimulate genes, and they’re what we call — they stimulate genes to unlock the system which controls cell growth and then to become cancer. So, in other words, they are a stage in the progression to cancer. But the importance of avoidable carcinogens is all the greater, because the avoidable carcinogens act in many different ways, but the final common pathway is almost certainly a genetic pathway, but that — as I say, genes have nothing to do with the increase in incidence of cancer for the last hundreds of years.

AMY GOODMAN:

What do you think is the single most important point to leave our listeners with on the issue of cancer prevention?

DR. SAMUEL EPSTEIN:

That, in fact, there’s a vast body of information on a wide range of avoidable causes of cancer which doesn’t reach the public. There’s a vast body of information showing that many cancers, which I’ve talked about, we know causes for them, and people aren’t being informed about this.

AMY GOODMAN:

Would you say the single most significant reason is because of the corporate control of information?

DR. SAMUEL EPSTEIN:

I would say that it’s the massive influence — the rollover of the media to the PR operations of the American Cancer Society and the National Cancer Institute. Not only that, but also the heavy dependence of papers, like the New York Times, on full-page advertisements of the drug companies. So it’s a rollover of the media, for which there’s many, many factors, but that media basically is the messenger boy for the PR operation of the American Cancer Society and the National Cancer Institute.

AMY GOODMAN:

And in ten seconds, the best way for someone to prevent cancer for themselves or their family or community?

DR. SAMUEL EPSTEIN:

I think to educate themselves about avoidable causes, and time doesn’t permit me — perhaps that’s another program.

AMY GOODMAN:

It is another program. And I want to thank you, Dr. Samuel Epstein, for joining us, the author of The Politics of Cancer Revisited. If people want to get in touch with you, I know one web site, www.preventcancer.com. If they want to get The Politics of Cancer Revisited, where can they call? It’s published by East Ridge Press?

DR. SAMUEL EPSTEIN:

(800) 269-2921, and you’ll find a wealth of information on a wide range of avoidable causes of most cancers.

AMY GOODMAN:

Thank you for being with us, and happy birthday.

DR. SAMUEL EPSTEIN:

Happy birthday to you.

AMY GOODMAN:

Dr. Samuel Epstein is the Chair of the Cancer Prevention Coalition. He’s at the School of Public Health, University of Illinois.