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The Secret History of
the War on Cancer

A Note from Dr. Davis

The best wars finish fast.  Nearly forty years and more than forty billion dollars since the official launch of the “War on Cancer” in 1971, that effort shows no signs of ending.  Despite spectacular progress on several fronts, many forms of the disease remain devastating.  Half of all men and a third of all women will contract the disease and more than one in four citizens of developed nations will die from it. 

Accounts of breathtaking advances in cancer research provide a steady rumble today, just as they have for decades. Talk of imminent victory has grown muted. In recent years cancer deaths have dropped in many industrial nations chiefly because fewer are smoking, and more are getting screened and treated for survivable cancers, like those of the colon, cervix and breast. 

But lately, cancer is showing up in neighborhoods and at ages where it used to be quite rare. As a world class athlete, Lance Armstrong, is unique. As a survivor of advanced cancer he is not. Of the ten million cancer survivors in the U.S. today, one in ten is under age forty.

For several hundred years, it has been understood that certain trades doomed their practitioners to an early death. By the 20th century, sitting behind a desk, dispensing medical advice or multi-tasking with the help of cell phones, computers and GPS seemed far safer ways to earn a living.

But are they?  In the past decade, cancer claimed more than half the men and women in science and medicine whose New York Times obituary listed any cause of death—that’s twice the rate of the rest of us.  Could the things that doctors do to become physicians lie behind their doubled cancer risk?  That’s certainly what Ruth Spector suspects.  An anesthesiologist who diagnosed her own leukemia, Spector is one of the growing number of lucky ones.  While we can’t say for sure precisely what agents may have caused her cancer, we do know that physicians find themselves working with drugs and radiation at levels that may well contribute to their greater chances of getting cancer.

The hubris of the formal war on cancer is clear today.  President Nixon in 1971 declared war on the disease itself, but left untouched the things known at the time to cause it, including tobacco and synthetic hormones.  From the start, the cancer effort has made astonishing advances in treating and finding the disease, but failed to tackle known carcinogens like radiation, benzene, asbestos and other toxic materials, including tobacco until quite recently.  The enterprise has virtually ignored the incompletely tested 80,000 industrial chemicals found – in infinite combinations– in everything from cosmetics to carpet glue.   

We hear quite a bit lately about the poorer chances of black Americans with cancer.  Even though they tend to get fewer cases of some forms of cancer, when they do develop the disease, they are much more likely to die from it.    But could the environment play a role in explaining some of the disappointing disadvantages that black Americans face with cancer?  While one in eight Americans is black, one out of every two sanitation workers is black, as is one of every three factory workers.  Could their work in dirtier jobs and lives in more polluted neighborhoods, with less access to fresh fruits and vegetables, account for some of the greater health problems of black Americans?

We need to answer such questions, given the growing importance of cancer for modern societies today.  We have to move beyond finding and treating cancer to coming up with ways to prevent it from happening altogether.  One way to jump-start the process of understanding and acting to address the avoidable causes of cancer is surprisingly simple.  Around the world today, medical centers like the one where I work are launching massive efforts to rid buildings and grounds of groups of proven and suspected toxic agents.  We are doing this not because we know it will reduce the incidence of cancer. 

Like Hackensack Medical University, Beth Israel Hospital, University of Texas Nursing School at Houston, Kaiser Permanente and others, the University of Pittsburgh Medical Center is moving our fifty-odd hospitals and clinics to use less toxic materials because we strongly believe, as professionals who have devoted our lives to fighting this disease, that doing so will reduce the chances that anyone’s brother will develop cancer.

We would never take all the drugs in our medicine cabinets at once.  Yet, our regulatory system today treats suspect cancer hazards, whether CT scans, aspartame, or a new adhesive, as trade secrets that can be examined like drugs one at a time, ignoring the simple fact that modern life is the ultimate mixture.  Concerned about the growing use of diagnostic radiation, when less dangerous forms such as MRI and ultrasound can often be used instead, the American College of Radiology recently advised that radiation should be used more sparingly in young children and the rest of us. 

Many of us in America today are living longer and better, in large part because we have benefited from the tremendous advances of modern society.   But, we are also seeing the growth in chronic diseases, like cancer and neurological problems, that can arise from various good and bad things that happen to us over our lifetime.  The question of the combined effects of radiation and small doses of chemicals on our health over the long term is generally not being asked by those in positions to set standards for such materials. 

A further complication in resolving how to advance our health today relates to the fact that information on the potential risks of many modern devices is often protected as confidential business information.   In fact, what are protected as today’s trade secrets may turn out to have cost my father his life.

To break the logjam of single-minded regulation, we need to create an open democratic and truly independent scientific forum--a Truth and Reconciliation Commission where producers of modern products, whether jet engines or computer chips, open their files to unflinching examination of health patterns from past exposures that can provide clues about how to prevent future harm.   If we want the world of the future to be healthier than that of the past, we can start with ending the protection of toxic trade secrets and taking more realistic looks at the combined impacts of modern agents on our lives.

—Dr. Devra Davis, September 2007

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