MARCH 1996 · VOLUME 17 · NUMBER 3
B O O K N O T E S
By Robert N. Proctor
New York: Basic Books, 1995
356 pp., $25
Reviewed by Steve Farnsworth
THE POLITICS OF CANCER have many permutations and mutations, ranging from shameless disinformation (cigarette companies denying the tobacco-cancer link) to willful neglect (legislators ignoring worker safety needs or businesses exporting dangerous products and manufacturing processes). Perhaps the most damaging form of political cancer, however, is changing the subject: targeting research on cancer cures rather than prevention measures that target industrial and other carcinogens.
Robert N. Proctor, a science history professor at Pennsylvania State University, argues that cancer is as much a political problem as it is a health problem. Part of Proctor's book examines how the tobacco industry has evaded tougher government regulation while misinforming the public about smoking risks. But he sets his sights on more than just another attack on big tobacco, focusing attention also on other industries that have misled the public about the cancer risks posed by their products and manufacturing processes. Proctor discusses the cancer risks involving the energy, mining, chemical and asbestos industries.
The most important section of the book describes how government and private researchers have been intimidated and sometimes even silenced by government officials who are anxious to curry favor with business executives. The powers that be, Proctor asserts, discourage studies of the industrial origins of cancers while encouraging research into treatments of cancers that have already developed. Such an approach suits toxic industries, protecting their profits. Even when there is a recognition that cancers are not immaculately conceived, toxic corporations prefer to shift the focus to natural causes. This orientation helps promote public resignation toward the cancer slaughter.
Scientists share the blame for the limitations of this approach, Proctor contends. Their professional incentive system is stacked against prevention. Corporate and government research funding is skewed against prevention and the best and brightest scientists know that cancer cures offer a road to a Nobel Prize. In contrast, cancer prevention is more likely to lead to significant but low-profile progress in fighting cancer as measured by statistics, not by survivors.
This well-researched book is the latest effort to draw more attention to the ways in which the modus operandi between corporations and the government is steadily increasing the toxic load on the planet and its inhabitants. Proctor follows in the tradition of Rachel Carson's Silent Spring and Samuel S. Epstein's The Politics of Cancer, two landmark works on the risks of toxic denial. Proctor's book sets a tightly reasoned argument within a broad historical context of how views of cancer have evolved since ancient times.
Proctor provides a report from the front of the cancer war, one that he suggests is unlikely to be won with the current strategy. While the number of people surviving for five years following a cancer diagnosis is increasing, so too is the number of people being diagnosed with cancer. Great progress would be made, he claims, if the government spent more money on cancer prevention or simply replaced tobacco subsidies with a stiffer tax on tobacco. Another largely ignored but potentially fruitful area of research, he says, is behavioral: finding ways to convince people to stop smoking and engaging in other unsafe practices.
Fighting cancer on the cure front alone is not working. Proctor argues that it is time to shift to a two-front war that pursues prevention at least as vigorously.