Book Review: Cancer-Gate: How to Win the Losing Cancer War by Samuel S. Epstein

CANCER-GATE: How to Win the Losing Cancer War

by Samuel S. Epstein, MD

Baywood Publishing, 2005, 377 pages, $24.95

reviewed by Judy Brady


Once a rare disease mostly affecting the old, cancer is now the leading cause of death in the United States. Unlike AIDS, cancer generally is not a disease we can catch from each other, and while a small percentage of cancers may be linked to individual genetic makeup, “cancer genes” don't account for the enormous increase in cancer rates during the last half of the 20th century.


We don't know what causes cancer, the pundits say. Nonsense, says Dr. Samuel Epstein.


For more than a quarter of a century, Dr. Epstein has been exposing cancer's causes. His ground-breaking and still preeminent book, The Politics of Cancer

, published first in 1979 (updated in 1998), is an exhaustive account of what lies behind the cancer epidemic, and he has continued to publish articles and books about why so many of us, despite our efforts to lead a healthy life, will fall victim to this disease.


In this latest book, Cancer-Gate

, Dr. Epstein has put together under one cover articles he wrote in the last 15 years. It is a book which everyone should read who has ever wondered why cancer strikes and kills more and more of us, despite the billions of dollars spent annually on cancer research and treatment. More importantly the book examines the most crucial question of the cancer debate: Why is the general public so unaware of what is causing the cancer epidemic?


Dr. Epstein—along with many eminent scientists—believes that the industrial and agricultural pollutants to which we are all involuntarily exposed are the primary culprits in the cancer scourge. But why this sort of information is hidden from most Americans is a different question, and here is Epstein's unique contribution.


In Cancer-Gate

, he points to some of the industries that have permeated our water, air, soil, and food with carcinogenic substances because it is cheaper and easier to pollute than to protect public health. He points to regulatory agencies which fail to put the brakes on industrial pollution. He points to elected officials who are wooed away from their duty to protect public health by industry lobbies and industry money. He points to members of the scientific community who appear more interested in lucrative research and policy-making careers than in identifying and exposing the ways in which the carcinogens surrounding us make us sick. And he points to what he calls the “cancer establishment,” public and private organizations charged with fighting the war on cancer —principally the National Cancer Institute (NCI) and the American Cancer Society (ACS), which spend enormous sums of taxpayer and charity money but have failed to stem the epidemic.


Epstein charges that in laying the blame for cancer on bad life-style choices and defining prevention as inventing more pills, these two institutions have avoided confrontation with polluting industries. Instead of investigating the sources of carcinogens, the NCI has become, according to one retired NCI official whom Epstein quotes, a “government pharmaceutical company” by concentrating its money and resources on developing drugs to prevent or treat cancer instead of identifying and addressing the causes of the disease. Yet, as the NCI itself admits, “complete remission and cures continue to elude us.”


The wealthiest “charity” of its kind in the world, the ACS abounds with conflicts of interest, Epstein says. Its board is made up of executives from the pharmaceutical, investment, banking, and media industries. Not surprisingly, the ACS has been the most prominent exponent of what Epstein refers to as the blame-the-victim approach. In its campaign against smoking, for instance, it never went after the tobacco industry nor ancillary industries like advertising agencies or public relations corporations that promoted smoking. Instead, it guilt-tripped the smoker.


Another major avenue of exposure to carcinogenic substances is through the food we eat, but, as Dr. Epstein describes, the ACS has actually protected pesticide manufacturers when public disclosure of the dangers presented by pesticide use was threatened.


The ACS' involvement in National Breast Cancer Awareness Month (NBCAM) every October is, according to Epstein, a major public-relations scam. NBCAM was started originally by a major pesticide manufacturer, Zeneca, and is still financially supported by it and other industries that contribute to everyone's body burden of carcinogenic chemicals. Together they present a one-sided picture of the breast cancer epidemic by limiting the message of NBCAM to supporting mammography and research into treatment. Under the leadership of organizations like the ACS and the Susan G. Komen Foundation, the “pink ribbon” campaign has become a multi-million-dollar business. One can buy hundreds of products and services under its banner. Millions of people, believing they are helping a good cause, shop for pink ribbon products and run for the cure every year.


In fact, Epstein says, the money from these efforts goes not toward steps that actually save lives, but primarily toward a misinformation campaign that consistently ignores the environmental/industrial sources of cancer. Amid the music and food, glorious speeches about cancer survivors and fluttering pink flags, and under the shadow of sponsors that include corporations like Chevron, BMW, and Ford Motor Company, no one even whispers about carcinogens.


Epstein is unremitting in his insistence that we could win this war on cancer if we changed our approach from what he calls damage control to implementing primary prevention at the sources of the carcinogens. This has not made him a popular figure. There are a lot of people in this country who have a vested interest in not changing the current approach to cancer.


Epstein says outright that we do not need another 30 years of spending billions of dollars on research. Instead, he believes that efforts should be directed at informing the public about what is in our food, air, water, and manufactured products, protecting workers from carcinogenic exposures at their jobs, and encouraging the development of nontoxic alternatives.


It is unlikely in today's social climate that Dr. Epstein's suggestions will be taken seriously by policy makers. But if a majority of Americans learned why and how pollution is killing us, they might shift from running for the cure to challenging polluters, leaving the policy makers to follow. That's where Cancer-Gate comes in. Get it.


Reviewer Judy Brady has battled two cancers (the second caused by the treatment for the first) and has spent 25 years studying, speaking, and writing about the politics of cancer.


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