By ALLISON SLOAN
We've heard the gruesome statistics: Approximately 180,000 women are diagnosed with breast cancer every year in the United States -- a number that has been rising since 1940. Breast cancer kills 44,000 American women annually, and more women have died from it in the past two decades than all Americans who died in World Wars I and II, the Korean War, and the Vietnam War combined.
Only 30 percent of women with breast cancer match any standard risk factor other than age, and only 5 to 10 percent have a family history of it. In other words, we have not been able to pinpoint why women develop breast cancer or why it has reached such epidemic proportions, although it is estimated that two-thirds of cases are influenced by estrogen, based on the type of tumor developed. Researchers have found links to radiation and to certain industrial chemicals and pesticides, some of which can affect estrogen levels.
At the same time, we don't know the full health effects of 97 percent of man-made chemicals in existence. Over 75,000 synthetic chemicals have been released since World War II. Only 3 percent of these have been tested for their ability to cause cancer, and it is unknown how many of that total may influence estrogen levels. About 2,000 new and untested chemicals are introduced to the market every year, in effect making us the test animals in an Earth-size laboratory.
For years, cancer research and its numerous public relations races and events have focused primarily on treatment, therapy, and a cure. While the survival rates of women with breast cancer have improved, significantly less attention is paid to finding what causes cancer and how to prevent people from getting sick in the first place.
The reason for this may be written on the bottom line: Cancer Is Profitable. It even has its own monthly newsletter, Cancer Economics. (For a free sample, call 202-362-1809 or see its web site, www.cancerletter.com.) The pharmaceutical industry is a major player in politics, with among the highest lobbying and campaign contribution expenditures of all industries, and it surpassed all others in 1997 lobbying expenses, at $74.4 million, the Center for Responsive Politics reports. This purchased political clout may be why drug companies are allowed to play dual roles in the world of medicine without raising any government eyebrows: specifically, as maker both of cancer treatment drugs and of the pesticides and other chemicals that are suspected to cause cancer.
While Rhone Poulenc Rorer's pharmaceutical division churns out docetaxel (trademarked as Taxotere), a breast cancer treatment drug, material safety data sheets reveal that 56 of the 91 crop protection products on the company's website "contain ingredients that are probable or suspected carcinogens."
Also the world leader in 1998 agrochemical sales, at $4.15 billion, Novartis makes the pamidronate compounds used to treat bone metastases in breast cancer patients. On one web page, this multinational boasts that "Novartis intends to lead the fight against cancer by introducing therapies that battle the disease and alleviate the patients' suffering." Another page boasts, "Novartis Crop Protection is the leader in fungicides."
Eli Lilly and Co. sells millions worth of raloxifene (Evista) to treat breast cancer, but a cash cow for Elanco, Lilly's animal health division, is the cattle hormone Rumentin. Eating hormone-treated meat is suspected to alter estrogen levels, which may contribute to cancer risk.
Elanco is also licensed to sell Monsanto's Posilac, the controversial bovine growth hormone (rBGH) injected into cows to increase milk production, outside of North America. Milk from rBGH-treated cows contains elevated levels of insulin-like Growth Factor-1 (IGF-1), which has been found to promote proliferation of breast cancer cells. And Elanco manufactured pesticides under Eli Lilly until 1997, when DowElanco, the progeny of its marriage to Dow Chemical Co., became a separate entity.
While 49 percent of Zeneca Group PLC's 1997 profits came from pesticides and other industrial chemicals, another 49 percent were from pharmaceutical sales, one third (about $1.4 billion worth) of which were cancer treatment drugs. The remaining 2 percent of Zeneca's profits derived from health care services, including the 11 cancer treatment centers Zeneca operates across the U.S. The herbicide acetochlor, considered a probable human carcinogen by the EPA, accounted for around $300 million of Zeneca's 1997 sales. Tamoxifen citrate (Nolvadex), the most prevalent breast cancer treatment drug, accounted for $500 million. Zeneca's April 6, 1999, merger with Astra will form the world's third-largest pharmaceutical and third-largest agrochemical company, the Wall Street Journal reported.
Other breast cancer profiteers include General Electric and DuPont, who manufacture mammography machines and X-ray film while racing each other for the highest number of SuperFund toxic waste sites in the country.
Two breast cancer prevention options have made the news recently. The first is prophylactic double mastectomy, or the preventive removal of both healthy breasts. A January study by the Mayo Clinic found 90 percent fewer breast cancer cases in women with family histories of breast cancer who had undergone this surgery. One would hope that such a radical procedure would be 100 percent effective, but as it turns out, mastectomy cannot remove all breast cells, and those that remain may still become cancerous.
The second option for breast cancer "risk reduction" is Zeneca's tamoxifen. (Thanks to the efforts of women's health activists, Zeneca is not permitted to use the word "prevention" for this drug.) Formerly available only for breast cancer treatment, tamoxifen was approved by the FDA in October 1998 for reducing the risk of breast cancer in high risk but healthy women. This decision was reached after a four-year trial by the National Cancer Institute of 13,388 "high risk" women found that tamoxifen decreased breast cancer incidence by almost one half.
Unfortunately, women in the tamoxifen group also had twice the incidence of uterine cancer, three times the rate of blood clots in the lungs, and 50 percent more cases of blood clots in major veins. Five women in each group died: all five from breast cancer in the placebo group, and three from breast cancer and two from drug side effects in the tamoxifen group. Ironically, tamoxifen itself is considered a probable human carcinogen by the World Health Organization.
But which women are "high risk" enough to take tamoxifen? Using NCI's criteria, virtually all females possessing breasts are at some level of risk. Women who are over 50 years old, have direct-line relatives with breast cancer, have had atypical breast biopsies, bore their first child after age 30, or who began menstruating at or before age 11 are considered at risk. Other prevention literature lists a high-fat diet as a risk factor, but neglects to mention that organochlorine chemicals such as DDT and PCBs can accumulate in fat tissue, passing animals' body burdens of toxins up the food chain.
Also omitted is the fact that such chemicals exit women's bodies through the placenta and through breast milk, which may partially explain why breast cancer risk decreases with each child borne and breast fed. Disturbing, however, is the fact that only 30 percent of women with breast cancer match any of the NCI's risk factors other than age, as mentioned previously. Nevertheless, a Zeneca spokeswoman claimed in the New York Times that 29 million women are at increased risk for breast cancer and "should ... determine if tamoxifen therapy is appropriate." If only 10 percent took tamoxifen for the recommended 5-year period at its average annual cost of $1,000, tamoxifen sales would amount to $14.5 billion!
Zeneca has done its math: Since October 1998, tamoxifen has been aggressively marketed to women, with no mention of the potentially life-threatening side effects. Television ads for tamoxifen first take care to discredit ideas women may have about why they would not get breast cancer, then say only that there is something women can do to reduce their risk, and to call Zeneca to find out how (800-528-7852). Zeneca's first two print ads for tamoxifen were revoked by the FDA for making claims they called "false or misleading and lacking in fair balance," and the FDA has failed to act against the television ad only because tamoxifen is not mentioned by name.
Zeneca is also the founder, since 1985, of October's National Breast Cancer Awareness Month (NBCAM), with its false message, "Early detection is your best prevention." If cancer is detected, it is obviously too late for prevention. This annual event markets the notion that mammography is our only weapon in fending off breast cancer, omitting any mention of possible environmental causes or of true prevention. "The sole mission of NBCAM is to promote the importance of the three-step application to early detection: mammography, clinical breast exam and breast self-exam," says NBCAM's promotional brochure. Although early detection through mammography does save some lives, the brochure neglects to mention that medical irradiation, including mammography and other X-rays, is a known cause of breast cancer in younger women. As the manufacturer of pesticides and cancer treatment drugs, and as owner of cancer treatment centers, it is clearly detection and not prevention that benefits Zeneca's business plan.
Another deceptive event is Revlon's Run/Walk for Women to raise cancer research funds. Cancer prevention on Revlon's behalf would involve removing all the suspected carcinogens from their hair dyes, shampoos, and cosmetics. (For ingredient safety information, see The Safe Shopper's Bible, by David Steinman and Samuel Epstein, M.D., MacMillan, 1995.)
Fortunately, there are alternatives to these pseudo-philanthropic disinformation campaigns. The Toxic Links Coalition has renamed October "Cancer Industry Awareness Month" and will be hosting its sixth annual Cancer Industry Tour, a march on polluters and cancer profiteers, in San Francisco this October. TLC can also link you to similar happenings in your community or provide the steps for organizing your own educational event. (Toxic Links Coalition, at Communities for a Better Environment, 415-243-8373, Ext. 305, www.igc.org/justice/tlc)
Get educated! Read The Breast Cancer Prevention Program, by Samuel Epstein, M.D. and David Steinman (Macmillan, 1997); Breast Cancer: Poisons, Profits, and Prevention, by Liane Clorfene-Casten (Common Courage Press, 1996); and Living Downstream, by Sandra Steingraber (Addison Wesley, 1997). Contact the National Women's Health Network for comprehensive information on tamoxifen, raloxifene, hormone replacement, and other women's health issues, 202-347-1140.
Get active! Host your own anti-Cancer Industry event! Support campaign finance reform! Avoid exposure to toxins by eating organic foods; reducing meat and dairy consumption; choosing natural pest control measures and cleaning products (for more information, call the Washington Toxics Coalition, 206/632-1545, or read The Safe Shopper's Bible); and avoiding synthetic building materials, such as vinyl and urea-formaldehyde particleboard and plywood (see Environmental Building News, www.ebuild.com, 802-257-7300). Support the organizations fighting to expose the politics and money behind the cancer epidemic: Breast Cancer Action, 877/2STOPBC, www.bcaction.org; the Women's Community Cancer Project, 617/354-9888; Women's Environment and Development Organization (WEDO), 212/973-0325.
Allison Sloan is a member of the Green Party and an environmental educator and activist at Mothers & Others for a Livable Planet, where she is assistant editor of The Green Guide. (888/ECO-INFO). An earlier version of this article was voted the #2 most censored news story of the year by Project Censored, and appears in the book, Censored 1999 - The News That Didn't Make the News: The Year's Top 25 Censored Stories, by Peter Phillips and Project Censored (Seven Stories Press).