Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, October 12, 1994 TAG: 9411150052
SECTION: EDITORIAL PAGE: A-9 EDITION: METRO
SOURCE: NEAL D. BARNARD
DATELINE: LENGTH: Long
In 1971, President Nixon used the same strategy in the War on Cancer. White-coated generals invested in high-tech research and aimed to cut the cancer death rate in half by the year 2000.
Neither war went the way we had hoped.
After 15 years, the New England Journal of Medicine published dispiriting statistics, showing that the world's sharpest research minds, armed with billions of dollars in research funds, could not even hold their position on the battle lines. Cancer death rates kept climbing, about 1 percent every year. That 1986 report concluded that, instead of continuing to focus on high-tech cancer treatments, it was time to try to prevent cancer.
Preventing cancer does not mean mammograms, Pap smears and prostate exams. As helpful as they are, these methods only find existing cancers so treatment can begin. Preventing cancer means eliminating its causes. And a mountain of research gives us a pretty good idea what they are.
Thirty percent of cancers are caused by tobacco. These include lung cancer, of course, but also cancers of the mouth, esophagus and bladder. An even higher percentage is due to diet, according to National Cancer Institute estimates.
Earlier this year, a report in the British Medical Journal showed that meat-eaters have a 70 percent higher risk of cancer, compared to vegetarians. We have long known that carcinogens form on the surface of meats as they are cooked. Animal fat, including that in poultry, encourages cancer of the intestinal tract. These same fats boost the levels of estrogen in women and testosterone in men, increasing the risk of cancers of the breast, ovary, uterus and prostate.
Breaking the meat habit both reduces cancer risk and increases survival when cancer is diagnosed. But these reports have not translated into significant changes in public policy. They have simply gathered dust in medical libraries.
And that's the problem. Confronting cancer, in many ways, means confronting ourselves. It is only in the last year or so that legislators have dared to talk tough to tobacco executives, and they are nowhere near doing the same with the livestock industry.
As a doctor, I have had to admit that the jar of lard my mother kept in the cupboard for frying eggs, the hamburgers I sold as a teen-ager working at a fast-food restaurant, and the fried chicken served at my hospital cafeteria had the power to easily defeat the cancer-treatment strategies I learned about in medical school.
Stopping cancer means confronting not only our taste buds and family recipes, but our own industries as well. My grandfather had never heard of carcinogens when he passed his cattle ranch on to my uncles and cousins, any more than tobacco farmers knew that on their government-regulated allotments they were sowing the seeds of cancer. Chemical manufacturers had no way of knowing the full impact of their products until researchers found higher cancer rates in the children of men and women exposed to chemical toxins in the workplace.
Of course, we have confronted none of these things in any serious way, and the disease now reaches one in three Americans, with medical costs over $35 billion per year, and personal costs that are incalculable. The prevention message has been lost.
Last month, a panel of researchers from the National Cancer Institute unleashed their ``new'' plan: Push the cancer research budget to nearly $900 million, and hope that persistence will bring that elusive victory. But after decades of failure, it is time to admit that the weapons these generals are searching for are as imaginary as a late-inning save in Saigon.
That is not to say that research has done nothing. Just as heart-disease researchers showed us the factors that increase the risk of heart disease, allowing us to use this knowledge or ignore it at our own peril, cancer researchers already have finished their most important task. Through human population studies they have shown us how tobacco, livestock products and chemical exposures conspire to keep the cancer wards full.
This is war. Winning it means committing ourselves to a strategy that will work. Countries in Asia and elsewhere, with lower cancer rates, do not have big research budgets. They have better diets.
Winning the War on Cancer means getting serious about preventing the disease. That means ending all government programs that encourage or subsidize tobacco and meat use, much stricter limits on toxic exposures, and helping Americans to understand that our best weapons are not test tubes and drugs, but knives and forks.
If the words ``nonsmoker'' or ``vegetarian'' sound alien, let's try the words ``cancer-free.''
Neal D. Barnard is a physician and president of the Physicians Committee for Responsible Medicine, a nonprofit organization in Washington, D.C., that promotes preventive medicine and higher standards in research.
Knight-Ridder/Tribune News Service
by CNB