Self-examinations

To build trust with increasingly angry women, government agencies must distance themselves from industries that profit from cancer.

The fear of death and a desire to master pain are at the core of all religions and perhaps all politics. Typically, when progressives see pain, they look to society for the cause and the solution. Our cover package follows this bent: We see environmental pollutants as a likely cause of the rise in breast cancer, and we advocate a precautionary ban on the most suspect chemicals--organochlorine pesticides--while the government researches the toxicological clues it has ignored for three decades.

Many on the right will doubtless see our recommendations as a sneaky attempt to make government hobble industry and support environmentalism. But we believe that industry's pervasive influence has discouraged public agencies from investigating important environmental leads.

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Between progressives and conservatives lies the establishment, which claims to be value-free. Its soothing voice could be heard recently in a Cosmopolitan article by New York Times medical reporter Gina Kolata, who quoted the director of media relations at the American Cancer Society as saying that an epidemic means a "'number of cases beyond what you would expect, a serious public health problem. I don't believe you could find a single serious cancer epidemiologist who would describe breast cancer in this way.'"

We found several. The most prominent, Dr. Devra Lee Davis, a senior adviser in the Department of Health and Human Services, is continually in danger of being marginalized because she's outspoken. Health officials sympathetic to industry, on the other hand, keep a low profile, because their bureaucratic inertia serves the status quo. For example, about a year ago industry representatives met with HHS Deputy Assistant Secretary Dr. D.A. Henderson to protest their products' likely appearance on an annual list of "substances reasonably anticipated to cause cancer." As of this writing, the entire list has never been published, the seventh time in 14 years that HHS has failed to issue the legally required carcinogen report.

Last August Nobel laureate Dr. Harold Varmus was appointed director of the $11 billion National Institutes of Health. Varmus' arrival was hailed by scientists, but some breast cancer activists believe that neither he nor NIH is interested in feedback. Varmus' office refused our request for an interview.

As it happens, I know Varmus. His mother and grandmother had breast cancer. Varmus doubtless wants to sponsor the kind of pure research that wins Nobel Prizes (he won his for codiscovering the cancer-causing genes that reside within virtually every animal's natural chromosomal makeup), but he also wants to eradicate this particular disease.

So where does Mother Jones get off telling a Nobel scientist where to look for a cure? Well, to begin with, we're telling him where to look for prevention. Since cures are more profitable than prevention, our medical industries support research leading to high-tech intervention for most illnesses, including breast cancer. But Mother Jones supports research that points out systemic blind spots, particularly those that serve the status quo. We're alarmed that Zeneca, perhaps the corporation that profits the most from current breast cancer treatment (it manufactures the drug tamoxifen), also produces carcinogenic organochlorine chemicals.

Zeneca is also a prime beneficiary of NIH-supported research, including one controversial study in which healthy women are being given tamoxifen as well as two other studies contaminated by research fraud. The falsified data scandal broke this March, but it was initially discovered more than three years ago. Officials moved slowly; even when they finally disciplined the researcher responsible, they didn't inform the public.

Small wonder that the cancer establishment is becoming a target for women's anger. Five female senators recently blasted the National Cancer Institute's decision to cease recommending routine mammograms for women under 50. Although the medical evidence supports NCI's new position, the NCI created the situation by overpromoting mammograms in the first place. Industry had an overcapacity of mammography machines and government supported its campaign for customers.

To build trust, the NCI and its parent NIH have to distance themselves from the industries that profit from cancer treatment. They also need to support potentially adversarial research. A year ago our medical investigator, Michael Castleman, speculated that the dermatological establishment was ignoring evidence linking the use of sunscreens to the rise in melanoma, the deadly skin cancer. Since our article appeared, studies at Brookhaven National Laboratory and the M.D. Anderson Cancer Center have supported our theory. The evidence linking organochlorines to breast cancer is, at this point, also only suggestive, partly because there have been few official studies.

How and why do cancer genes turn on? Could environmental insults be partly to blame? So-called pure scientists looking for genetic silver bullets deserve our public research dollars and respect, but so do epidemiologists and environmental researchers laboring in the public health field. In the past decade the National Institute of Environmental Health Sciences has received the smallest budgetary increase of all the National Institutes. It shouldn't remain a stepchild.

Although progressives are accused (often accurately) of being relentless critics, we are essentially optimists: We believe we can alter our environment for the better. We accept the inevitability of death, but don't believe that human beings should unwittingly dig their own premature graves.

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