The Secret History of the War on Cancer : Book review (Sujatha)

I came across this article in the NYTimes, just as I was preparing to write a review of Devra Davis' recent book "The Secret History of the War on Cancer" and it seemed remarkably apropos of the subject at hand:

"We have enormous gaps in our understanding of how these chemicals affect health and the environment.” said Michael P. Wilson, a public health scientist at the University of California, Berkeley. “And where we do have information, we see cause for concern.”

The effects of human exposure to chemicals in consumer products are difficult to ascertain and are subject to dispute. As a result, there is a growing gap in the ways governments regulate chemicals. The European Union, Canada and California, for example, are restricting the use of some chemicals before the science on their hazards is absolutely clear; the federal government is not.

That sums up in a nutshell Devra Davis's carefully elucidated contention, backed by exhaustive references to scientific studies, that the human race is the ongoing subject of a vast uncontrolled study on the effect of the numerous chemicals brought into existence as part of the jumps and leaps of technology of the last 2 centuries.

The book chronicles the known and observed effects of working with various materials through human history and the increased incidences of cancers of various kinds depending on the worker's occupation. More frighteningly, she sheds light on Big Industry's efforts to keep this data out of the public realm, turning them into 'trade secrets'. In many cases, the effects of carcinogenic materials were known and documented years before they were phased out/eradicated. Among the several examples which Davis describes in detail are the case of asbestos, benzene, vinyl chloride and tobacco. Part of the problem lies in the fact that the very industry that gave access to researchers to the workers to conduct the surveys and tests, was also the very industry that paid the researchers and had control over the publishing of the results. It is sadly, no surprise to find that results were suppressed for years and came to light only years and many avoidable deaths later.

In another example not directly related to carcinogens, but rather the prevailing mores and resistance to change by surgeons, she lays out the case that the Pap smear test for detecting cervical cancer could have been adopted at least 2 decades ahead of the time it finally became the test of choice to detect, treat and prevent cervical cancer.

As for lawsuits to obtain justice for those wronged, the legal standard for proving the causative effects of chemical exposure resulting in cancer has been so narrowly defined and interpreted by courts  as to make it extremely difficult to prove chemical X was the primary cause of illness Y in the plaintiff. This accounts for the cautious NYT assertion that 'The effects of human exposure to chemicals in consumer products are difficult to ascertain and are subject to dispute.' - a classic example of pablum to lull the public into thinking that the absence of evidence is the same as the evidence of absence (to paraphrase a Rumsfeldian utterance in a very different context, as Davis mentions in her book)

We've come a long way from the days of Camel cigarette ads boasting of their brand being 'smoked by the most number of doctors', but need to inject a good deal of skepticism into our approach to any (especially) out-of-the-blue studies 'proving conclusively' that use of chemical X doesn't have any correlation to the incidence of disease Y - as in finding out who funded the study, was it an independent body or not, what are the numbers translated into real terms, etc.

The book touches briefly on current controversies that are still unproven at the time of publishing- the aspartame-cancer linkage, the cell phone- brain tumor connection, among others. Dr.Davis cautions that the studies performed so far are too short term to predict the long term results which can result from small exposures to agents over periods of decades, rather than 3-5 year intervals for which the studies are valid.

Interspersed with the hefty doses of study-backed epidemiological accounts, Dr.Davis inserts her personal history as a lightening element, though a couple of incidents came off as being curious non sequiturs related to her personal views of life with cancer and death viewed in her near and dear.

Overall, I found this a compelling read that highlights the current chemical soup that has pervaded our lives,perhaps alarmist at times, but backed with reams of reports and numbers to bring home the fact that every choice we make as consumers has a bearing on our lives, illnesses and possibly, ultimate deaths.

Comments

[Ruchira]

More than ten years ago I took a class in cancer biology at the University of Nebraska Medical Center. In an otherwise informative course, the one thing that struck me was how reluctant the text books and the professors were to pinpoint correlations between suspected environmental carcinogens and the occurance of cancer. There were some dietary habits that came under scrutiny but that too with caveats. The only culprit that everyone was comfortable blaming unambiguously was tobacco.

I doubt that the clock can be turned back regarding the use of chemicals in our lives unless we are prepared to go back to pastoral living of growing our own food in our backyard and using time consuming methods of cleaning and washing. But what is bothersome is the reluctance of legislators to clamp down even on the very obviously toxic agents such as emissions and effluence from petrochemical and chemical plants that diffuse into our air and wash into our waters. Industry's bottom line is of much more value than disease and death. The Houston area is very much affected by industrial cost cutting and negligence but no-one would admit it nor let anyone else publicize this uncomfortable truth. I am not particularly a holistic / organic type of consumer myself. I accept the presence of some chemicals in the products we use. But dangerous environmental pollution and careless waste disposal are not something we should overlook.

[Sujatha]

In the book, Dr.Davis minces no words in placing the blame on specific chemicals as the primary cause of the forms of cancer she discusses, plus the required footnotes and scholarly references proving them.
If you looked at the textbooks or the research grants for some of the professors who taught your course, you might have seen big names in the industry listed- which would explain the muted tone in pointing out correlations between suspected carcinogens and cancer occurrence. It would have been a matter of directly attacking some of their sources of livelihood, and is quite understandable from a human standpoint, even if it is out-of-whack ethically.
Pandora's box of ills has been open too long for us to slam it shut and the clock of environmental influences continues to tick from the moment of birth. Very few of us are going to escape the consequences, depending on the luck of genes and statistics. While it might not be possible to do away with the conveniences of 'modern' life entirely, it's still possible to reduce some exposures while waiting for sudden enlightenment to dawn on or be hammered into major polluters.
I tend to look rather skeptically at claims to 'holistic' or 'organic'- too much of it is just marketing mumbo-jumbo rather than any real claim to fame. I tend to follow the remedies my mom and grandma used, rather than fall for the hyper-inflated claims to 'herbal only' shampoo that contains "water, aloe vera gel, ShiKai extract (acacia concinna), olefin sulfonate, cocoamidopropyl hydroxysultanine, cocamide MEA, glycerin (vegetable),salt, panthenol, diazolidinyl urea, natural fragrance." I would rather use the powdered shikakai available in many Indian groceries than the above.
The same goes for the 'organic' tomatoes that I had the misfortune of purchasing from a nearby farmer's market- they tasted like cardboard and may well have been straight out from Cherry Valley Farms of Salinas CA, trucked thousands of miles before being sold at $8 a bushel in the supposedly 'local' market.

[kochuthresiamma P. J.]

Thanx for the review. it is an issue in which i have a spocial interest.want to get hold of the book.

there are some strange statistics regarding this disease.the state of kerala has the highest incidence of cancer in india despite being the least industrialised state in the country.

the state has no metros. it is an overgrown village. hence, the majority of people live close to nature.

But the level of consumerism is very high.a lot of product are first test marketed in kerala.

there are theories and theories and theories about the alarming rise of this disease in this health conscious state.but no substantial light is shed on this grey area.

[Sujatha]

Kochuthresiamma,

Actually, Kerala's incidence of cancer does not appear to be the highest (link), there are other areas in India with higher rates for the most common cancers.
Based on diet ('coconut, coconut everywhere'), I might venture that heart disease might be the number one killer, rather than cancer, though fish in the diets might have a beneficial effect on cholesterol levels.
Now that reminds me, maybe it is the sea fish, reflecting toxins that are being dumped in the seas, that could be passing it up the food chain. Perhaps a PhD thesis in the making for some researcher there, to test whether an increase in cancer rates could be linked to increased carcinogenic loads in the fish consumed in an average diet.

[Nasra]

Good info thanks ...

[kochuthresiamma P. J.]

Sujatha
Fish could be a source.Keralites are fish addicts.

there is a theory about the sand in kerala.Chavara where we have the rare earths is a declared area. the other day a nuclear scientist was telling me that radioactive material is pretty high in the sands of the entire kerala!! scary!

reg cocunut oil, there is an earnest effort now to reinstate cocunut oil in kerala as a cooking medium, after it was dislodged in the sixties, allegedly by the refined oil lobby. docs, cocnut farmers, politicians and the media have jumped into the band wagon.

bits and pieces of information from people from various professions convince me that cancer is the product of absence of commercial morality; and caner cure evades us on account of the devious activities of the pharma corporates.

[Sujatha]

Though the theory that radioactive sands could be a contributing factor is interesting, recent studies show that for people living for generations in areas of high natural radioactivity, their bodies may have adapted to repair any chromosomal damage that could occur (Link 1 and Link 2).
On the other hand, with increased immigration from other areas into the high radioactivity areas, there would be increased incidence of cancers in an immigrant population, rather than in a native group.

In general, it's very likely that the lifestyle changes are major factors, as suggested in this article.