Archive for September 21st, 2013

An industrialized seascape using 19th century technology: along the Hudson River, upper Manhattan, “Rain on the River” by George Bellowes (1908)

Cancers are essentially preventable diseases. Hidden political and economic factors which have blocked and continue to block attempts to prevent cancer must be recognized

Dear friends and readers,

Many of us are dying of cancer, some terribly. Those surviving live in fear of inexplicable recurrence and are maimed by drastic surgery and/or chemotherapies and radiation. Over the past 7 months I’ve become aware that everyone I know has a relative and sometimes several and friends who have died of cancer, the few where someone lived for a while are the good luck stories where brutal treatments seem to have worked, but who knows for the same brutal treatments were further death sentences for others. Friends’ mothers, fathers, people at churches, in schools, teachers, someone’s 10 year old son, in-laws, nieces, grandchildren. Each time another person commiserates with me I hear more real experiences — and close up. Of course the teller is sometimes the person who had a bout with cancer too — or has it sitting in a office which is but one room in three large buildings all dedicated to “serving” cancer patients. My husband, my daughter’s husband has cancer (not at all related), her husband’s father, my in-laws (my father-in-laws died of lung cancer). This is not atypical. Cancer is everywhere a killing maiming disease.

I bought this book thinking it would be a “read through” and found I had a double-columned 770 odd page book, with thumb marks for sections, charts, appendices. It includes inside or as part of it the first book, The Politics of Cancer. It’s immensely important. It begins,

If one thousand people died every day of cholera, swine flu, or food poisoning, an epidemic of major proportions would be at hand, and the entire country would mobilize against it [would they?]. Yet cancer claims that many lives daily, often in prolonged and agonizing pain, and most people believe they can do nothing about it.

It’s the aim of his book once again to argue that if we had the political will, took organized action, spent money and time and research in the right directions, we could do a lot to control and prevent this epidemic from increasing, indeed begin to diminish it. He opens by making the first necessary argument: it’ll be said the reason so many people die from cancer is they are not dying from degenerative diseases of poverty, hard work, bad diet, infection and so on. Not so. The numbers of people getting cancer have multiplied frighteningly since the beginning of the 20th century; as of the writing of his book 53 million people in the US will develop some form of cancer, 20% of the US population die from it, 5 times higher than the total US military deaths in all the Vietnam and Korean years combined. A subsection on the UK from the original book (1979) showed the same kind of book could not have been written about the UK then as there was so little published and available evidence about all aspects of cancer from the views of scientists to that of industry; at the time it stirred the earliest larger information gathering and prevention and research programs. Still in both countries cancer is the only major killing disease whose incidence is on the increase. Cancer survival rates are near static.

Four axioms: cancer is caused mainly by exposure to chemical or physical agents in the environment; more carcinogens present, the greater exposure, and the greater chance of developing cancer; there is no safe level of exposure; other factors include genetic, endocrine, immunological, viral, biochemical, and possibly psychological. The change from the 19th century which has led to the poisoning of our environment is strongly in the area of petrochemical carcinogens. Organic and exotic chemicals and pesticides flood our environments. They are non- or poorly degradable; synthetic ones, insecticides.

Epidemiology studies are problematical because it is difficult to identify in a precise way statistical requirements across groups of people; an additional problem is the latency factor: decades later one can develop a cancer, but what we find are myriad ways investigating cancer risks so as to avoid regulations of carcinogens and toxic chemicals, ways of evasion: too short a period of time is common.

The opening section of the book identifies and describes a series of cancers grouped around types.

Much of the bulk of the book is taken up with particular case studies showing how industries win battle after battle; inadequate pre-market testing, quick marketing of new products, testing which excludes possible health hazards. Standard ploys blame working conditions, use diversionary tactics. The people in the regulatory agencies come over from the industries they are supposed to regulate, and get their funds from them. I can’t begin to go over the details of each case; they all show the same patterns, from asbestos conditions, to tobacco smoking, to plastics, vinyl chloride, benzenes (a terrible poison producing among other things asplastic anaemia, red dyes #2 and 40 (coal tar dyes which the FDA in effect refused to do anything about for decades), saccharin (which I used to use in coffee, and which the ACS defended as of “safe on the basis of human experience” and wanted by people — you could not get them to ban it), toxic effects of estrogens. Then there’s no full label disclosures (e.g., hair dye, cosmetics of all sorts; lanolin is nowadays laced with carcinogenic pesticides). Widespread contamination with DEA and NDEA (Yvette and I got ourselves shampoos without this stuff for the first time a couple of weeks ago.) And so it goes. He omits the results of wars from Vietnam to Fallujah.

Epstein argues (as in his original book 25 years ago) little fundamental progress has been made in preventing and understanding cancers. The American Cancer society defends itself by arguing that while prevention is important, they are developing practical techniques for dealing with cancer as it presents itself right now. But there are large conflicts of interest here, since the people hired (doctors and teams) to treat cancer now through heroic surgeries, chemotherapies (not well understood) and radiation make a great deal of money from the situation. The FDA is a creature of the industries. These people decide what research projects should be followed and who receives support and for what. All this I’ve now seen in spades.

Chapter 12 in the book is the 1987 report to congress on how the war against cancer is being lost, who’s to blame and what can be done — or ought to be. It’s really alarming to read this chapter which is as germane today as ever. The National Cancer Institute’s behavior has been grossly obtuse, obscurantist, slow, must be re-oriented from diagnosis and immediate treatment to prevention and fundamental understanding. It’s scary to read the attacks on Epstein and the answers the NCI produces to congressional questioning.

You can used the book as an encyclopedia. He gives you addresses to write to and names names. He summarizes in the back of the book risk factors in products.


A chimpanzee and cat comforting one another: from Animal De-liberation — also victims of modern science gone awry

What can one do personally about it? beyond getting publicly involved, you can avoid smoking, alcohol (yes), pay attention to your foods, drugs you use, cosmetics, avoid unnecessary x-rays; there are risks involved in sexual behaviors, too much sunlight, live away from highways if you can, which gets us to things people can’t always do something about: where they work, schools, learn about family predisposition. Shopper beware. Severe warning signs of cancer are change in bowel or bladder habits, sore that does not heal, unusual bleeding, discharge; thickening lump, indigestion or difficulty in swallowing, obvious change in wart or mole, nagging cough or hoarseness. Pain.

The ACS, the NCI and FDA hate alternative treatments to harsh drugs that don’t work, surgeries that maim the body, but the desires of patients to turn to these are not just understandable, they show self-preservation and common sense. Epstein thinks there is real promise in genetic research, and when in Germany was astonished to see combined conventional and non-conventional (in the US and UK) approaches; vitamins, minerals, herbal formulas, using the mind-body connection, hyperthermia, electromagnetic treatments. Again the FDA has done everything in its power to block the development of these alternative or supplementary treatments; it exerts a stranglehold on innovation in research, diagnosis, treatment.

Hardship falls on the poorest and old, on those groups in our society forced to take dangerous jobs, who lack access to good health care at affordable rates.

What I’ve learned to hate particularly is the behavior of many of the people in the medical establishment, the way physicians are treated like gods, their indifference and exertion of false control through shaming you. Right now I’m trying to get more morphine from the hospice people and for over a day have been put off and no one will say why: the doctor didn’t sign the document was one phase of it. I find some of them to be spiteful. A good-hearted nurse came here today who stayed for a while, did a thorough job, and tried to get this medicine for me. She’s rare, an elderly black grandmother. We had a decent-hearted aide this week who helped the Admiral take a bath. She too took the extra time, was thoughtful (neither spent much time making out forms which is what most of them do.)

My dying husband and I did not have a decade of goodbye, only a month and a week thus far — for after his operation, we were deluded into thinking all would be well and made plans for a future, talked and worked together on getting his strength back. But what this woman describes is what my beloved and I have known, our feelings. He does not like strangers in the house, nor does the admiral. He doesn’t like hypocrisy, nor does the admiral. Like her I am left earnestly wishing each night that my beloved goes into remission. I really sit and wish hard, want this so bad, say it aloud to him. Get well! Cannot take it in. After all why not go into remission? Others do with little rationale. (I know from a friend this happens rarely in the 3rd or 4th stage. We are end stage.) And the description of the hospice nurse is common behavior among them. You can meet kind thoughtful individuals, but by and large not only is it a non-prestigious job, the people do what they can to be inured.

On her comment on Didion’s Year of Magical Thinking and Blue Nights, I have thought that Didion had it easier with her husband but not her daughter. She presents a veiled account of that: the girl was an alcoholic and if there was no hospice experience, Didion spent months near ICU units and there were periods of home care. She actually reveals little of her experiences caring for her daughter intimately. The hardest thing is remaining calm. That is what I work at: all the time trying for calm.

AS to the large issues I broach in this blog, it’s too late for my beloved and me, but not too late for other people. Do not say nothing can be done. Do not believe cancer cannot be successfully fought. This is a political and economic issue, a social one which controls what is happening: what medical knowledge can emerge is shaped by these larger forces.


from Dickens’s sinister Bleak House, as scripted by Andrew Davies (the city is done in such shades stills don’t come out well)


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