Tackling Cancer Straight On

ONE IN FOUR Americans now living will eventually contract cancer, which ranks a close second behind cardiovascular disease as the leading cause of death today. In 1978 alone, he estimated number of deaths due the cancer was five times higher than all American military deaths from the Vietnam and Korean wars combined. The government and the private sector pour billions of dollars yearly into a nationwide attempt to conquer this 20th century plague. Unfortunately: much of this well-intentioned money has been mishandled.

An alarming lack of attention to environmental causes of cancer has been exacerbated by recent actions of the Reagan Administration. As part of its deregulation craze, the current Administration lately took steps to ease the control of cancer-causing substances. The Environmental Protection Agency (EPA), ostensibly the watchdog of the environment, markedly loosened its regulations in dealing with the recent dioxin contamination crisis at Times Beach, Mo. The FPA established much higher acceptable exposure levels after the crisis than those dictated by previous risk assessments. This recent backslide in the regulation of carcinogens reflects the same problem manifested in the misdirection of cancer research--a dangerous lack of attention to the environmental causes of the disease.

Harvard's recently renamed Dana-Farber Institute typifies he tubular vision of most cancer research centers, where emphasis is on the clinical, no the environmental causes of cancer. The foundation devotes little to none of its $20 million in annual funds to the investigation of physical or chemical carcinogens. Rather, it divides its research into four broad categories: virology, genetics, immunology, and treatment.

Interest in possible viral causes of cancer peaked in the 1960s, when various animal studies suggested that viruses could cause turnors. But apart from rare correlations (such as that between the Herpes simplex II virus and cervical cancer in women), researchers could not establish a general cause and effect relationship between viruses and cancer. Recent advances in the field of genetic engineering have paralleled a surge of interest in the possibility of a genetic cause of cancer. But apart from circumstancial evidence for genetic causes of such rare cancers as Burkitt's lymphoma (as Harvard recently announced), the possibility of finding such a genetic cause for all cancers seems remote.

Both viral and genetic approaches to cancer research share one flaw--they attack not the cause of cancer but its mechanism. Even proponents of genetic and viral theories concede that something external must trigger malignant cell growth. These researchers accept the existence of cancer-causing substances in the environment as a given, and devote their efforts to reversing the cancer cycle once it has started--not preventing it from starting. Rather than investigating whether cigarettes, saccharin, asbestos or other hazards should in fact be banned--or going further and lobbying to ban them--such researchers seem to feel helpless to challenge the cancer-causing lifestyle.

THE DANA-FARBER INSTITUTE is not alone in its failure to investigate potentially hazardous chemicals in our midst. The government conducts a little over half the research done in this country into the causes of cancer via the National Cancer Institute (NCI). And the NCI, which spent over $1 billion researching he causes of cancer in 1981, devotes a miniscule amount to investigation of potential carcinogens. Both the EPA and Food and Drug Administration refer suspected carcinogens to the NCI but the NCI tests only 26 suspected chemical carcinogens per year, according to a spokesman for the National Institute of Environmental Health Services.

Scientists justify their lack of attention to chemical carcinogenesis by emphasizing the drawbacks of such inquiries. As a substitute for studies with human subjects, researchers test suspected substances on animals, mostly rodents. Critics point out that such animal tests are costly and time-consuming. (NCI estimates that a typical 600-rat study costs $30,000-$60,000 and takes about three years.) Many manufacturers whose products are under attack have propagated the notion that such animal studies involve exorbitant dosages of the chemical in question, and cannot be compared to the low-dosages exposure that man would receive. But many scientists support the correlation, and animal testing is a widely accepted practice. In the absence of a better tool for testing substances, animal experimentation must not be ignored.

Many manufacturers have also flooded the scientific literature with 'scientific' reports which exculpate their products and focus on the physiological mechanism of cancer. In 1981, industrially supported cancer research totaled $300 million; this amount exceeds the expenditure of non-profit organizations by a factor of four to one, according to a factbook published by the NCI.

Such so-called 'scientific' research groups include the Calorie Control Council, a coalition of dietary product manufacturers who prevented the proposed ban on saccharin in 1977 with a massive ad campaign aimed a diet-drink fanatics, and the Council on Tobacco Research, a group to which five of the six principal cigarette manufacturers belong, which still denies the well-established causal lationship between cigarette smoking and lung cancer. These coalitions attempt toe refute self-incriminating data about their products under he guise of "unbiased" health councils. Countless other similar "scientific" cancer research centers are supported solely by industrial funds, and churn out reports which seem intended only to clear their own names.

Industry wields its financial might on political and scientific levels to divert attention from possible environmental causes of cancer--through overt lobby groups, which battle environmental regulation, and through the less apparent but more insidious basic research by the industrial councils. But no spokesman defends public health as vociferously as industry protects its products. This one-sided debate has led to an increasingly polluted environment which harbors an ever-increasing number of probable carcinogens. The national death rate due to cancer has risen steadily since 1930, according to a 1982 American Cancer Society report. Although this rise in the incidence of lethal cancer could be attributable to medical advances which have conquered other previously fatal diseases, epidemiological studies point to another explanation, showing a clear correlation between the degree of urbanization and mortality for some of the major types of cancer in each area.

AS LONG AS the government continues its current deregulation bonanza, the incidence of cancer could continue to rise. The more lax attitude of the EPA underscores a more general insouciance towards carcinogens in our midst. For example, Chapter 11 of the Bankruptcy Code allowes prospering companies--like the asbestos producer Manville Corporation--to use government funds to help pay the enormous liabilities incurred by worker suits. (Asbestos, an insulator, has been shown to cause lung cancer in humans.)

The Manville Corporation has until this week to present a plan which would shift its burden of payment of health claims to the government. The corporation could declare bankruptcy without ever shutting its doors, and continue to shirk all responsibility for the health of its workers.

Such permissive governmental attitudes towards regulating manmade carcinogens reflects the fundamental misdirection of the fight against cancer. An emphasis on clinical research reflects the hope that research will uncover a cure for cancer--a "magic bullet" which will home in on the cancerous tissue. Cancer, though, is not one disease but many. The wide variety of types of cancer suggests a whole gamut of causes. The philosophical reductionist approach which has characterized medical research--he effort to pinpoint a specific mechanism rather than to look at the whole body--has led to the unrealistic but seductive hope that the cure for cancer is "just around the corner."

Such metaphysical biases not only misguide research; they also jive perfectly with the political motives of the Reagan Administration and the economic motives of the industrial complex. As long as even the most basic research into the causes of cancer remains based on political and economic rather than scientific motives, cancer will continue to plague modern man.