The American Cancer Society and the fight against cancer
Posted by Jonathan Chamberlain on September 5, 2008
Copied from http://www.preventcancer.com
American Cancer Society: The World’s Wealthiest “Nonprofit” Institution
Samuel S. Epstein M. D.
The American Cancer Society is fixated on damage control— diagnosis and treatment— and basic molecular biology, with indifference or even hostility to cancer prevention. This myopic mindset is compounded by interlocking conflicts of interest with the cancer drug, mammography, and other industries. The “nonprofit” status of the Society is in sharp conflict with its high overhead and expenses, excessive reserves of assets and contributions to political parties. All attempts to reform the Society over the past two decades have failed; a national economic boycott of the Society is long overdue.
The American Cancer Society (ACS) is accumulating great wealth in its role as a “charity.” According to James Bennett, professor of economics at George Mason University and recognized authority on charitable organizations, in 1988 the ACS held a fund balance of over $400 million with about $69 million of holdings in land, buildings, and equipment (1). Of that money, the ACS spent only $90 million— 26 percent of its budget— on medical research and programs. The rest covered “operating expenses,” including about 60 percent for generous salaries, pensions, executive benefits, and overhead. By 1989, the cash reserves of the ACS were worth more than $700 million (2). In 1991, Americans, believing they were contributing to fighting cancer, gave nearly $350 million to the ACS, 6 percent more than the previous year. Most of this money comes from public donations averaging $3,500, and high-profile fund-raising campaigns such
In 1992, the American Cancer Society Foundation was created to allow the ACS to actively solicit contributions of more than $100,000. However, a close look at the heavy-hitters on the Foundation’s board will give an idea of which interests are at play and where the Foundation expects its big contributions to come from. The Foundation’s board of trustees included corporate executives from the pharmaceutical, investment, banking, and media industries. Among them:
The results of this board’s efforts have been very successful. A million here, a million there— much of it coming from the very industries instrumental in shaping ACS policy, or profiting from it. In 1992, The Chronicle of Philanthropy reported that the ACS was “more interested in accumulating wealth than in saving lives.” Fund-raising appeals
Thus for every $1 spent on direct service, approximately $6.40 is spent on compensation and overhead. In all ten states, salaries and fringe benefits are by far the largest single budget items, a surprising fact in light of the characterization of the appeals, which stress an urgent and critical need for donations to provide cancer services.
Nationally, only 16 percent or less of all money raised is spent on direct services to cancer victims, like driving cancer patients from the hospital after chemotherapy and providing pain medication.
Most of the funds raised by the ACS go to pay overhead, salaries, fringe benefits, and travel expenses of its national executives in Atlanta. They also go to pay chief executive officers, who earn six-figure salaries in several states, and the hundreds of other employees who work out of some 3,000 regional offices nationwide. The typical ACS affiliate, which helps raise the money for the national office, spends more than 52 percent of its budget on salaries, pensions, fringe benefits, and overhead for its own employees. Salaries and overhead for most ACS affiliates also exceeded 50 percent, although most direct community services are handled by unpaid volunteers. DiLorenzo summed up his findings by emphasizing the hoarding of funds by the ACS (4):
If current needs are not being met because of insufficient funds, as fund-raising appeals suggest, why is so much cash being hoarded? Most contributors believe their donations are being used to fight cancer, not to accumulate financial reserves. More progress in the war against cancer would be made if they would divest some of their real estate holdings and use the proceeds— as well as a portion of their cash reserves— to provide more cancer services.
Aside from high salaries and overhead, most of what is left of the ACS budget goes to basic research and research into profitable patented cancer drugs. The current budget of the ACS is $380 million and its cash reserves approach $1 billion. Yet its aggressive fund-raising campaign continues to plead poverty and lament the lack of available money for cancer research, while ignoring efforts to prevent cancer by phasing out avoidable exposures to environmental and occupational carcinogens. Meanwhile, the ACS is silent about its intricate
TRACK RECORD ON PREVENTION
Indeed, despite promises to the public to do everything to “wipe out cancer in your lifetime,” the ACS fails to make its voice heard in Congress and the regulatory arena. Instead, the ACS repeatedly rejects or ignores opportunities and requests from Congressional committees, regulatory agencies, unions, and environmental organizations to provide scientific testimony critical to efforts
1. In 1971, when studies unequivocally proved that diethylstilbestrol (DES) caused vaginal cancers in teenaged daughters of women administered the drug during pregnancy, the ACS refused an invitation to testify at Congressional hearings to require the FDA (U. S. Food and Drug Administration) to ban its use as an animal feed additive. It gave no reason for its refusal.
2. In 1977 and 1978, the ACS opposed regulations proposed for hair coloring products that contained dyes known to cause breast and liver cancer in rodents. In so doing, the ACS ignored virtually every tenet of responsible public health as these chemicals were clear-cut liver and breast carcinogens.
3. In 1977, the ACS called for a Congressional moratorium on the FDA’s proposed ban on saccharin and even advocated its use by nursing mothers and babies in “moderation” despite clear-cut evidence of its carcinogenicity in rodents. This reflects the consistent rejection by the ACS of the importance of animal evidence as predictive of human cancer risk.
4. In 1978, Tony Mazzocchi, then senior representative of the Oil, Chemical, and Atomic Workers International Union, stated at a Washington, D. C., round-table between public interest groups and high-ranking ACS officials: “Occupational safety standards have received no support from the ACS.”
5. In 1978, Congressman Paul Rogers censured the ACS for doing “too little, too late” in failing to support the Clean Air Act.
6. In 1982, the ACS adopted a highly restrictive cancer policy that insisted on unequivocal human evidence of carcinogenicity before taking any position on public health hazards. Accordingly, the ACS still trivializes or rejects evidence of carcinogenicity in experimental animals, and has actively campaigned against laws (the 1958 Delaney Law, for instance) that ban deliberate addition to food of
7. In 1983, the ACS refused to join a coalition of the March of Dimes, American Heart Association, and the American Lung Association to support the Clean Air Act.
8. In 1992, the ACS issued a joint statement with the Chlorine Institute in support of the continued global use of organochlorine pesticides— despite clear evidence that some were known to cause breast cancer. In this statement, Society vice president Clark Heath, M. D., dismissed evidence of this risk as “preliminary and mostly based on weak and indirect association.” Heath then went on to explain away the blame for increasing breast cancer rates as due to better detection: ” Speculation that such exposures account for observed geographic differences in breast cancer incidence or for recent rises in breast cancer occurrence should be received with caution; more likely, much of the recent rise in incidence in the United States . . . reflects increased utilization of mammography over the past decade.”
9. In 1992, in conjunction with the NCI, the ACS aggressively launched a ” chemoprevention” program aimed at recruiting 16,000 healthy women at supposedly ” high risk” of breast cancer into a 5-year clinical trial with a highly profitable drug called tamoxifen. This drug is manufactured by one of the world’s most powerful cancer drug industries, Zeneca, an offshoot of the Imperial Chemical Industries. The women were told that the drug was essentially harmless, and that it could reduce their risk of breast cancer. What the women were not told was that tamoxifen had already been shown to be a highly potent liver carcinogen in rodent tests, and also that it was well-known to induce human uterine cancer (6, pp. 145– 151).
10. In 1993, just before PBS Frontline aired the special entitled “In Our
The primary health hazards of pesticides are from direct contact with the chemicals at potentially high doses, for example, farm workers who apply the chemicals and work in the fields after the pesticides have been applied, and people living near aerially sprayed fields. . . . The American Cancer Society believes that the benefits of a balanced diet rich in fruits and vegetables far outweigh the largely theoretical risks posed by occasional, very low pesticide
11. In September 1996, the ACS together with a diverse group of patient and physician organizations filed a “citizen’s petition” to pressure the FDA to ease restrictions on access to silicone gel breast implants. What the ACS did not disclose was that the gel in these implants had clearly been shown to induce cancer in several industry rodent studies, and that these implants were also contaminated
This public criticism by a broad representation of highly credible scientists reflects the growing conviction that a substantial proportion of cancer deaths are caused by exposure to chemical carcinogens in the air, water, food supply, and workplace, and thus can be prevented by legislative and regulatory action. Calling the ACS guidelines an “unrealistically high-action threshold,” a letter to ACS executive vice president Lane Adams states that “we would like to express
In Cancer Facts & Figures— 1998, the latest annual ACS publication designed to provide the public and medical profession with “Basic Facts” on cancer— other than information on incidence, mortality, signs and symptoms, and treatment— there is little or no mention of prevention (10). Examples include: no mention of dusting the genital area with talc as a known cause of ovarian cancer; no mention of parental exposure to occupational carcinogens as a major cause of
CONFLICTS OF INTEREST
In addition, the mammography industry conducts research for the ACS and its grantees, serves on advisory boards, and donates considerable funds. DuPont also is a substantial backer of the ACS Breast Health Awareness Program; sponsors television shows and other media productions touting mammography; produces advertising, promotional, and information literature for hospitals, clinics, medical organizations, and doctors; produces educational films; and, of course, lobbies Congress for legislation promoting availability of mammography services. In virtually all of its important actions, the ACS has been strongly linked with the mammography industry, ignoring the development of viable alternatives to mammography.
The ACS exposes premenopausal women to radiation hazards from mammography with little or no evidence of benefits. The ACS also fails to tell them that their breasts will change so much over time that the “baseline” images have little or no future relevance. This is truly an American Cancer Society crusade. But against whom, or rather, for whom?
National Breast Cancer Awareness Month
The link between the ACS and NCI and Zeneca is especially strong when it comes to tamoxifen. The ACS and NCI continue aggressively to promote the tamoxifen trial, which is the cornerstone of its minimal prevention program. On March 7, 1997, the NCI Press Office released a four-page “For Response to Inquiries on Breast Cancer.” The brief section on prevention reads:
“ Researchers are looking for a way to prevent breast cancer in women at high risk. … Alargestudy [is underway] to see if the drug tamoxifen will reduce cancer risk in women age 60 or older and in women 35 to 59 who have a pattern of risk factors for breast cancer. This study is also a model for future studies of cancer prevention. Studies of diet and nutrition could also lead to preventive strategies.”
Since Zeneca influences every leaflet, poster, publication, and commercial produced by National Breast Cancer Awareness Month, it is no wonder these publications make no mention of carcinogenic industrial chemicals and their relation to breast cancer. Imperial Chemical Industries, Zeneca’s parent company, profits by manufacturing breast cancer– causing chemicals. Zeneca profits from treatment of breast cancer, and hopes to profit still more from the prospects of large-scale national use of tamoxifen for breast cancer prevention. National Breast Cancer Awareness Month is a masterful public relations coup for Zeneca, providing the company with valuable, if ill-placed, good will from millions of American women.
The Pesticide Industry
An earlier report, issued by the Natural Resources Defense Council in 1989,” Intolerable Risk: Pesticides in our Children’s Food,” had also given pesticide manufacturers failing marks. The report was released in high profile testimony to Congress by movie actress Meryl Streep. A mother of young children, Streep explained to a packed House chamber the report’s findings, namely, that children were most at risk from cancer-causing pesticides on our food because they consume
Porter-Novelli first crafted a rebuttal to help the manufacturers quell public fears about pesticide-contaminated food. Next, Porter-Novelli called up another client, the American Cancer Society, for whom Porter-Novelli had done pro bono work for years. The rebuttal that Porter-Novelli had just sent off to its industry clients was faxed to ACS Atlanta headquarters. It was then circulated by e-mail on March 22, 1993, internally— virtually verbatim from the memo Porter-Novelli
” The program makes unfounded suggestions . . . that pesticide residue in food may be at hazardous levels,” the ACS memo read. “Its use of `cancer cluster’ leukemia case reports and non-specific community illnesses as alleged evidence of pesticide effects in people is unfortunate. We know of no community cancer clusters
When Koughan saw the AIM article he was initially outraged that the ACS was being used to defend the pesticide industry. “At first, I assumed complete ignorance on the part of the ACS,” said Koughan. But after repeatedly trying, without success, to get the national office to rebut the AIM article, Koughan began to see what was really going on. “When I realized Porter-Novelli represented five agrichemical companies, and that the ACS had been a client for years,
Cancer Drug Industry
Periodically, the Committee updates its statements on “unproven methods,” which are then widely disseminated to clinicians, cheerleader science writers, and the public. Once a clinician or oncologist becomes associated with “unproven methods,” he or she is blackballed by the cancer establishment. Funding for the
In response to pressure from People Against Cancer, a grassroots group of cancer patients disillusioned with conventional cancer therapy, in 1986 some 40 members of Congress requested the Office of Technology Assessment (OTA), a Congressional think tank, to evaluate available information on alternative innovative therapies. While initially resistant, OTA eventually published a September 1990 report that identified some 200 promising studies on alternative
Yet the ACS and NCI remain resistant, if not frankly hostile, to OTA’s recommendations. In the January 1991 issue of its Cancer Journal for Clinicians ACS referred to the Hoxsey therapy, a nontoxic combination of herb extracts developed in the 1940s by populist Harry Hoxsey, as a “worthless tonic for cancer.” However, a detailed critique of Hoxsey’s treatment by Dr. Patricia Spain Ward, a leading contributor to the OTA report, concluded just the opposite:” More recent literature leaves no doubt that Hoxsey’s formula does indeed contain many plant substances of marked therapeutic activity” (13).
Nor is this the first time that the Society’s claims of quackery have been called into question or discredited. A growing number of other innovative therapies originally attacked by the ACS have recently found less disfavor and even acceptance. These include hyperthermia, tumor necrosis factor (originally called Coley’s toxin), hydrazine sulfate, and Burzynski’s antineoplastons. Well over 100 promising alternative nonpatented and nontoxic therapies have already been identified (15). Clearly, such treatments merit clinical testing and evaluation by
Subsequent events have further isolated the ACS in its fixation on orthodox treatments. Bypassing the ACS and NCI, the National Institutes of Health in June 1992 opened a new Office of Alternative Medicine for the investigation of unconventional treatment of cancer and other diseases. Leading proponents of conventional therapy were invited to participate. The ACS refused and still refuses. The NCI grudgingly and nominally participates while actively attacking
THE ROLE OF ACS IN THE WAR AGAINST CANCER
As the world’s largest nonreligious “charity,” with powerful allies in the private and public sectors, ACS policies and priorities remain unchanged. Despite periodic protests, threats of boycotts, and questions on its finances, the Society leadership responds with powerful public relations campaigns reflecting denial and manipulated information and pillorying its opponents with scientific McCarthyism.
The verdict is unassailable. The ACS bears a major responsibility for losing the winnable war against cancer. Reforming the ACS is, in principle, relatively easy and directly achievable. Boycott the ACS. Instead, give your charitable contributions to public interest and environmental groups involved in cancer prevention. Such a boycott is well overdue and will send the only message this “charity” can no longer ignore. The Cancer Prevention Coalition (chaired by the author) in April 1999 formally announced a nationwide campaign for an economic boycott of the ACS (http://www.preventcancer.com).
Published in: International Journal of Health Services Vol. 29, No. 3, 1999.
2. Bennett, J. T., and DiLorenzo, T. J. Unhealthy Charities: Hazardous to Your Health and Wealth. Basic Books, New York, 1994.
3. Hall, H., and Williams, G. Professor vs. Cancer Society. The Chronicle of Philanthropy, January 28, 1992, p. 26.
4. DiLorenzo, T. J. One charity’s uneconomic war on cancer. Wall Street Journal, March 15, 1992, p. A10.
5. Salant, J. D. Cancer Society gives to governors. Associated Press Release, March 30, 1998.
6. Epstein, S. S., Steinman, D., and LeVert, S. The Breast Cancer Prevention Program. Macmillan, New York, 1997.
7. Epstein, S. S. Losing the war against cancer: Who’s to blame and what to do about it. Int. J. Health Serv. 20: 53– 71, 1990.
8. Epstein, S. S. Evaluation of the National Cancer Program and proposed reforms. Int. J. Health Serv. 23( 1): 15– 44, 1993.
9. American Cancer Society. Upcoming television special on pesticides in food. Memorandum from S. Dickinson, Vice-President, Public Relations and Health, to C. W. Heath, Jr., M. D., Vice-President. Epidemiology and Statistics, March 22, 1993.
10. American Cancer Society. Cancer Facts & Figures— 1998, pp. 1– 32, Atlanta, 1998.
11. Kaplan, S. PR Giant makes hay from client cross-pollination: Porter/ Novelli plays all sides. PR Watch, First quarter, 1994, p. 4.
12. Kaplan, S. Porter-Novelli plays all sides. Legal Times 16( 27) :1, November 23, 1993.
13. Moss, R. W. Questioning Chemotherapy. Equinox Press, Brooklyn, N. Y., 1995.
14. U. S. Congress Office of Technology Assessment. Unconventional Cancer Treatments. U. S. Government Printing Office, Washington, D. C., 1990.
15. Moss. R. W. Cancer Therapy: The Independent Consumer’s Guide to Non-toxic Treatment and Prevention. Equinox Press, Brooklyn, N. Y., 1992.
16. Castellucci, L. Practitioners seek common ground in unconventional forum. J. Natl. Cancer Inst. 90: 1036– 1037, 1998.
Samuel S. Epstein, M.D.
School of Public Health, MC 922
Here is a great video from an ex-drug company rep