Document p24nz6r2ZGjX2pn5B3bZ8519X

& Cancer: Is `Prevention' the Best Medicine? O-s-S'l a handful of scientists spoke or wrote TJy Stephen S. Sternberg, M.D. about the naturally occurring carcinogens, ' this year about 870,000 Americans will fleam that they have cancer and about 450,r000 will die of it Edith Efron's dramatic '-expose of the "cancer establishment" r/'The Apocalyptics: Cancer and the Big ` Lie" (Simon L Schuster, 589 pages, $19.95), 'charges that a group of diverse apocalyp- tics-includlng government regulators, some academic scientists and self-ap pointed consumer advocates--are in effect increasing rather than decreasing the canleerdeath toll by diverting attention from dtnown causes of the disease to purely hy/ -pothetical ernes. : Specifically, Ms. Efron claims that the apocalyptics have succeeded in needlessly especially those in our foods. Certainly the apocalyptics had little to say about them, yet the knowledge of such carcinogenicity came from the same type of animal exper iments that detected the carcinogenicity of the "artificial" chemicals. Somehow a per plexing double standard exists, wherein those carcinogens that came from the Gar den of Eden are acceptable, while those of synthetic origin are dangerous and unac ceptable at any intake level As Ms. Efron rightly notes: "If a something causes can cer, it causes cancer: the identity of Its creator is irrelevant" The book's epilogue dispels the myths that have become the main "axioms" of Cand perhaps maliciously focusing media rand consumer attention on environmental -chemicals, especially those . emanating ^_^_^^ookshelf :from the food and chemical industries (venomously characterized by Ralph Nader as "corporate cancer"). Thus they create the false impression that the prod ucts of technology are the prime enemies "The Apocalyptics: Cancer and the Big Lie" By Edith Efrm In our war against cancer. The targeting of industrial chemicals as a major cause of the apocalyptics: "The post World War II cancer has led to misplaced emphasis on organic chemists rendered the environ "cancer prevention," and the author shows ment carcinogenic"; "Ninety percent of , uS only toe well the fallacy of the concept cancer comes from industrial chemicals"; of '`prevention" as it exists today. "The United States is number one in can - The fact is that over the past decades cer"; and finally. "A great cancer epi cancer in the U.S. (with the exception of demic is arriving/will arrive." Ms. Efron cigarette-related lung cancer) has re refutes all of these claims with a barrage mained stationary or even dropped of epidemiological and toxicological refer slightly, despite our exposure to many new ences. chemicals manufactured after World War Particularly important is her demolition II. Ms. Efron's documentation is sound and of the anonymous but highly publicized Irrefutable. It is based on a review of thou . "study" jointly issued In 1978 by the Na sands of scientific articles and books over tional Cancer Institute and the National a number of years, as well as on public Institute of Environmental Health Sciences hearing documents from Congress and entitled "Estimates ofthe Fraction of Can government agencies. The background the cer Incidence in the United States Attribut author supplies--detailing the concepts of able to Occupational Factors." Among the carcinogenesis, mutagenesis, thresholds, bowlers it contained was the estimate of animal testing and related subjects-is a future deaths due to asbestos ("two million model at clarity. She also Includes what Is premature cancer deaths in the next three probably the most complete listing of decades"). Ms. Efron prints out the as known human carcinogenic agents ever as bestos death rates -previously projected sembled. Only with this knowledge can we had been "disastrous enough-approxi- understand the problems facing regula mately 2.000 cancer deaths were then be tors: how the information can be interpre ing recorded among asbestos insulators, ted in different ways and how it can be most of whom had also been heavy facts concerning occupational cancer?) The "study" was attacked by many sci entists both here and abroad: The Brit ish medical Journal Lancet noted ". . . its framework is insubstantial. ... It is sad to see such a fragile report under distin guished names." And Sir Richard Doll, the prominent British epidemiologist said: "I regard it as scientific nonsense." But it is still part of the arsenal of the apocalyp tics, who maintain that more extensive regulation of the workplace is a high prior ity for cancer prevention. Cancer prevention is a noble idea, but our white knights have unfortunately per petrated a pious hoax. Occupationally in duced cancers are quite real, currently ac counting for about 4% to 6% of cancer mortality in the U.S. But those exposures resulting in today's, occupational cancers occurred 30 or more years ago and these same risks probably do not exist today. Scientific consensus holds that air and wa ter pollution, food additives and pesticide residues-the primary targets of the apocalyptics-contribute only insignificantly, if at all, to overall cancer mortality. Future scientific research may yield ex citing and practical data on the relation ship of diet and nutrition, including further identification of naturally occurring car cinogens in food. But as of now we have little firm knowledge about how to success fully manipulate diet to reduce our cancer risks. The only thing that will make a no ticeable dent in our cancer mortality rate at present is the elimination of cigarette smoking, both alone and in synergism with alcohol abuse. At most this would eliminate 30% of cancer deaths. But the etiology of some 70% of human cancer is unknown, and there is no way to "prevent" with assur ance that portion of it at the present time. The tragedy is that time, effort and consid erable money is spent disproportionately on "cancer prevention," when the em phasis should be on basic cancer research, an area that has a proven and unmatched record of achievement Ms. Efron's book could do much to change our direction, and to encourage the use of more science than politics in our decision making. misused as well as politicized. smokers." (Can you imagine the uproar if Dr. Sternberg is a member of the staff .Of particular note is the question of an anonymous industry group put together of Memorial Sloan-Kettering Cancer Cen `^natural carcinogens." Until recently, only a report that distorted or playkl down the ter. JO co -tx CO --J