medical examiner The New Cigarette A new book argues that chemical waste is
as much to blame for cancer as smoking.By Barron H. Lerner
Posted Monday, Sept. 24, 2007, at 7:20 AM ET
------------------------------

Devra Davis wants chemical waste to become the new cigarette, an object that
generates reflexive loathing from most Americans. And the pieces of the
puzzle seem to be there: exposure-related cancers, decades of incriminating
research, and cover-ups by the chemical industry. In her new book, *The
Secret History of the War on
Cancer<http://www.amazon.com/Secret-History-War-Cancer/dp/0465015662/ref=pd_bbs_1/102-8015706-5744943?ie=UTF8&s=books&sr=1-1>
*, Davis diligently and persuasively argues that we are ignoring dozens of
cancer-causing chemicals. She also sounds a familiar call for
toxic-producing industries to clean up their waste and figure out how to get
rid of it without creating future hazards.

But along with the problems, Davis' book reveals the barriers to changing
the status quo. A strong indication of the hurdles that confront her hopes
for reform is that her "secret history" is really not very secret at all--at
least to anyone interested in the relationship of cancer to the environment.
For almost as long as there has been a "war on cancer," there has been what
might be called a "war on the war on cancer": a series of efforts to move
beyond a sole focus on the detection and treatment of cancer (the standard
war on cancer) to actual *prevention* of the disease. Although Davis
promises to share "stories I'd never heard before and documents I could
never find in libraries or government documents," her book by and large
tells well-known horror stories about supposedly cancer-inducing products
long vilified by environmental activists, such as asbestos, benzene, vinyl
chloride, and dioxin. Thus, it is far from clear that the public, largely
quiet to this point, will now respond with outrage and alacrity to her
polemic. After all, it took decades to begin to topple the cigarette. And it
has a much more straightforward relationship to cancer.

Davis is truly well-situated to have written this book. She grew up in
infamous Donora, Pa., a steel town where 20 people died in 1948 after a
smoggy haze caused by factory emissions enveloped the city for five days.
Davis' parents both died of cancers that she believes may have been related
to toxic exposures. And she has spent the last three decades at the
forefront of epidemiological research exploring the environmental causes of
the disease.

*The Secret History* starts with an almost wistful look back at the heyday
of investigation into cancer causation. As Davis documents, in several
countries (including Nazi Germany) in the 1930s, scientists conducted
pioneering studies seemingly demonstrating that cancer could be caused by
excessive exposures to, among other things, cigarettes, radiation, arsenic,
benzene, and synthetic dyes. But events intervened, most notably World War
II. When the war ended, the Nazi taint to this research, plus a newfound
confidence that scientists could develop technologies to ferret out and
destroy cancers, deflected attention from potential environmental causes.
After President Richard M. Nixon formally declared war on cancer in 1971,
the resulting programs contained neither funding of research into prevention
of the disease nor environmental cleanup strategies.

That was in large part due to the role of the tobacco and chemical
industries, according to Davis. As has now been extensively documented, most
recently by historian Allan M. Brandt in *The Cigarette Century*, American
tobacco companies spent millions of dollars over decades to deliberately
deceive the public about the carcinogenic potential of cigarettes.
Essentially the same process, Davis says, has occurred in the world of
chemicals. There is now a substantial body of evidence, obtained through
research funded outside the war on cancer, suggesting that industry has
managed to obfuscate the carcinogenic dangers of chemical and other toxic
waste. *The Secret History* provides a thorough, systematic account of these
misdeeds.

For example, data have shown that residents of certain Louisiana Delta towns
have three times the amount of cancer-causing dioxin in their blood than
average Americans and that local children have 10 times the rate of
neuoroblastoma, a rare brain tumor. Yet, Davis writes, chemical companies in
the region have consistently "undermine[d] reports on the dangers of vinyl
chloride, benzene, asbestos and other petrochemical residues for workers,
their families and communities." Similarly, those who worked at or lived
near the Clairton Coke Works of Western Pennsylvania after World War II had
alarmingly high rates of lung cancer. Once again, industry--in this case the
coke manufacturers-- made sure that the news wouldn't get out. Davis
describes her own secret meetings with a former monitor of the coke plants,
who documented toxic levels of chemicals in the local drinking water and
air--findings that were later squelched by the state's Department of
Environmental Protection.

Davis ultimately argues that in their doubt-sowing public-relations efforts,
the chemical industry and others have cleverly manipulated the science of
epidemiology, the study of health and disease among populations.
Epidemiologists would be the first to admit that it is truly difficult to
establish definitive proof that a given hazard causes a given cancer. But
scientists and spokespeople for the chemical industries have gone further,
using epidemiology's penchant for caveat to attempt to nullify a lot of very
convincing data. Those who have accepted money from industry to weigh in
have even included the heroes of epidemiology, such as Richard Doll, who had
earlier been one of the first investigators to prove the connection between
cigarette smoking and lung cancer. Doll, Davis writes, was a "highly paid
consultant" for Monsanto and Dow Chemical and the Chemical Manufacturers
Association. She believes he wrote reports that, among other things,
minimized the connection of vinyl chloride to certain brain and liver
cancers.

But the subterfuge of industry isn't the only barrier to shifting the war on
cancer from simply treatment to prevention and treatment. Also powerful is
the way in which most Americans respond to a diagnosis of cancer. As Davis
remarks about cancer patients, "Nothing can match the singular devotion that
comes to those who are fighting for their own lives or those of family
members." My experience as a clinician caring for cancer patients
corroborates this point as well as its corollary: Most cancer patients are
not especially concerned about *why* they developed cancer. While many of
them become activists, participating in walkathons and races to raise money,
relatively few see their cancer as a reason to man the barricades against
toxic waste. They look forward, to a cure, not backward, to what might have
prevented them from getting sick in the first place. If only a small
percentage of Americans are environmental activists, why should cancer
patients be any different?

There is one additional barrier to consider. Once the perfidy of the
cigarette industry was revealed, the danger of smoking became indisputable:
Cigarettes cause lung cancer. But in the case of chemical hazards, there are
many hazards, many different industries, and many different cancers that can
result. In one of her chapters, aptly titled "No Safe Place," Davis lists a
variety of hazards and related health complications, including contaminated
water, poisoned fish, toxic fumes, miscarriages, and congenital
malformations. The litany is frankly overwhelming. And when one adds in
routine X-rays, cell phones, aspartame, and hot dogs as conceivable causes
of cancer, just where does one begin? Is *everything* toxic?

And yet Davis may be catching the right wave at the right time. Despite all
the obstacles, growing numbers of cancer activists and interested citizens
seem to be grasping her main point: By creating doubt about cancer
causation, industry perpetually prevents reform and thus allows
*more*cancer to emerge. Scientists and funding agencies are finally
beginning to
focus on preventing cancer--not just blasting it away with better and better
medications. For example, according to its Web
site<http://www.cancer.gov/newscenter/benchmarks-vol4-issue3/page2>,
the National Cancer Institute now "supports a large research portfolio which
identifies environmental risk factors for breast cancer."

Davis herself imagines some version of South Africa's Truth and
Reconciliation Commission, where activists, scientists, and industry can
come together, admit past mistakes, and then launch a mass cleanup. This is
a nice thought. But again, the cigarette example is instructive. True change
did not occur until incriminating documents surfaced, which the plaintiffs'
lawyers used to make the tobacco industry admit past wrongdoings and pay
substantial penalties. Davis' book is a good start, but it does not provide
nearly enough of a punch to bring the chemical industry to its knees.
*Barron H. Lerner, a physician and historian at Columbia University Medical
Center, is the author, most recently, of *When Illness Goes Public:
Celebrity Patients and How We Look at
Medicine<http://www.amazon.com/When-Illness-Goes-Public-Celebrity/dp/0801884624/ref=pd_bbs_sr_1/102-3575223-9630567?ie=UTF8&s=books&qid=1190125808&sr=8-1>
.

*Article URL: http://www.slate.com/id/2174376/*

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