War on Cancer: A Long Day’s Dying
By BOB HOUSTON and GARY NULL -
Great, swift strides of progress have been made in finding funds for cancer research. Between 1972 and 1978, spending by the National Cancer Institute, the Defense Dept. for the U.S. “War on Cancer,” approached $5 billion—twice as much as its total funding in the previous 35 years since its founding. Declared by the National Cancer Act of 1971, the “War” swelled the NCI budget from $233 million that year to $867 million for 1978—a nearly fourfold increase.
In the same period, the American Cancer Society doubled its “warchest”—from $75 million in 1971 to nearly $150 million at last check. But with all the taking, has any progress occurred in reducing the disease? If not, why not, and what are the alternatives for the living—and suffering—to a research effort whose worldly payoff may only be known by a future, mutant generation?
Expressive of the national insight that the answer to a problem consists in throwing gold bricks, Congress drummed for war with an exuberant resolution passed unanimously in 1970, which proclaimed:
“The conquest of cancer is a national crusade to be accomplished by 1976,” and prescribed as cure, “the funds necessary for massive programs.”
If we could get to the moon...? Spurred by a column from Ann Landers, 60,000 of her faithful letter-whipped legislators into passing the bucks in December 1971, and on that tender-green horizon, a new battle star was born. With President Richard Nixon, philanthropist Mary Lasker, scribe Ann Landers, and the American Cancer Society behind it, how could it fail to triumph? The goal of the Act as stated in the schedule of the National Cancer Program, was “to reduce the incidence, morbidity, and mortality of cancer in humans.” How smashing was its success?
On the torpid time-scale of immense developments, the proportion of American mortality due to cancer grew from one in six in 1971 to one in five in 1978. Since comprehensive standardized total cancer incidence data is not available for this period, it is unknown if the increase in mortality reflects ineffective treatment, increased incidence or both. However, the age-adjusted overall cancer incidence declined about 5 percent between 1947 and 1971 while cancer mortality increased from one in seven in 1950 to one in six in 1960-1970. At best, the overall cancer incidence and mortality have remained unchanged or changed concomitantly.
Reflected in the yearly figures—though not utterances—of the American Cancer Society, and the Vital Statistics of the U.S., the glacial advance of the cancer mortality ratio has gone unnoticed by the event-oriented newsmedia. Progress has indeed been steady: in 1968, cancer accounted for 16.8 percent of American deaths, in 1970 the figure was 17.2 percent, in 1975 it reached 19.3 percent, and in 1978 passed 20 percent.
A century of cancer research had been useless in checking the population growth of the disease: its toll was one death in 27 total deaths in 1900, one in 16 in 1920, one in 12 in 1930, one in nine in 1940, one in seven in 1950, one in six 1960-1970, to reach the current, intoxicating fifth. While average life expectancies increased 22 percent during the period due to a decline in child mortality and the control of infectious diseases, thereby possibly increasing the relative contribution of cancer mortalities to total mortality, the National Center for Health Statistics reported an increase in the age-adjusted cancer mortality of 1.2 percent in the period 1968 to 1974, an average of 0.2 percent per year, and an additional 0.7 percent for the following year. If the growth rate of the 1970’s continues, cancer will cause one in four deaths in 1988, one in three by 2008, and reach one in two by the year 2050, to greet those born today.
A cover-up of the new development is evident in the 1978 “Cancer Facts and Figures” of the ACS. The text continues to state the one in six ratio, but its figures show one in five (171.7 out of 888.9 per 100,000 population).
In 1971, about 635,000 cases of cancer were newly diagnosed. Based on the National Cancer Institute’s Third National Cancer Survey for the period 1969-1971, the ACS estimates 700,000 people will be diagnosed as having cancer in 1978, an increase of 10 percent in the first seven years of the “War on Cancer.” In this period, the annual mortality rate of the disease per 100,000 Americans grew 11 percent, from 161 in 1971 to 179 estimated for 1978 by ACS.
The increase in cancer mortality, standardized, averaged 0.2 percent per year during the six year period 1968 to 1974 and accelerated to 0.7 percent in 1974-1975. This latter increase received public attention in 1975, when it appeared, based on partial, crude data, unadjusted for age and sex, that the cancer toll had increased at a 5.2 percent annual rate in the first seven months of the year, as reported by the NCHS. The data for the full 12-month period of 1975 yielded a 2.3 percent increase in crude mortality and a 0.7 percent increase in age-adjusted mortality, still a sharp increase compared to the 0.2 percent average annual mortality increase for 1968-1974. According to Dr. Robert Armstrong, chief of the Center, cancer is the only leading cause of death for which the mortality rate has steadily increased in the last two decades.
At a time when mortality from other major diseases was declining, the growth in cancer at all sites, which had received the lion’s share of biomedical funding and effort, was striking and ominous. The meaning is as inescapable as the increase was inexorable: organized cancer research has been fruitless; overall there has been no progress against the disease at all, but rather, chronic, accelerating defeat. The light at the end of the tunnel was an incinerator.
Wait a second, Mac. What about those ads for checks? Don’t you know that cancer is “the most curable disease” and that the “cure-rate” is just shooting through the ceiling? Just read this from the American Cancer Society, Dept. of Rainbows:
“Has there been any progress against cancer? Yes. In the early 1900’s few cancer patients had any hope of long-term survival. In the 1930’s less than one-in-five were alive at least five years after treatment. In the 1950’s it was one-in-four. Now the ratio is one-in-three.”
This statement, plus congratulations for survival in rare cancers, such as childhood acute lymphatic leukemia, advanced malignant melanoma, Burkitt’s lymphoma, Hodgkin’s disease, and Wilm’s tumor, constitutes the basic optimistic pitch of the cancer establishment. Were it valid, it would still be irrelevant to the last quarter century, for the apparent improvement in cancer survival to the one-in-three level was reached by 1950, according to the End Results Evaluation Report of the NCI.
Only a two percent addition in total five-year survival is shown between 1950 and 1973, the last year surveyed, in the latest report on “Cancer Patient Survival” issued in late 1977 by the NCI. The overall white rate was 39 percent in 1950-59, 40 percent in 1960-66, 41 percent in 1967-73. At this breakneck pace of progress, cancer will be “conquered” in terms of 90 percent three-year survival, in 400 years.
Five-year survival does not invariably mean “cure;” nor does it necessarily mean “disease-free.” Moreover, the changes in diagnostic criteria, in the inclusion of benign growth and in the proportion of early detected localized cases may each shift total survival rates without any improvement in treatment or outcomes.
It is pertinent to note, however, that the incidence rate of cancer, age-adjusted to the 1950 population, declined 5 percent between 1947 and 1971, from 290 to 275 per 100,000. but between 1950 and 1970, the age-adjusted cancer mortality rate increased 4 percent, from 135 to 140 per 100,000. The rise in the age-adjusted mortality rate cannot be attributed to increased incidence, or population growth, or shift in population age. Logically, increased total cancer mortality associated with stable or decreased incidence would imply decreased total survival from cancer.
Dr. James Enstrom, a cancer researcher at UCLA, and Dr. Donald Austin, Chief of the California Tumor Registry on which the NCI End Results estimates are mainly based, have pointed out this basic contradiction to the claim of constant progress:
“So long as incidence and mortality remain unchanged or change proportionately, no genuine change in survival can occur... Both the age-adjusted total cancer mortality rate changed by only a few percent between 1950 and 1970... The fact that neither has changed significantly since 1950 implies that the total cancer survival rate has also remained essentially constant. This is an independent confirmation of the direct data on total survival rates.” (Science, March 4, 1977.)
The Untreated Live Longer
Dr. Hardin Jones, Professor of Medical Physics and Physiology at Berkeley, made a similar objection to roseate survival claims to the California Board of Medical Examiners in 1975:
“Most clinicians claim up to a 50 percent cure rate for various malignancies. If this were sure we would see a shift downward by up to 50 percent in mortality. However, we do not see this; mortality figures show an over-all trend of increase which is unaffected by any attempts to treat the disease. Statistically speaking, patients are as well or better off untreated as those who have treatment in the sense that the death rate remains the same, or slightly better, for those who are not treated at all.”
Dr. Jones was involved for over 25 years in research concerning the life span of humans particularly as affected by cancer.
“I discovered that there have been errors in cancer reporting for many years because of the necessity of gathering cases into statistical groupings during which they are not reported. Those who publish results wait until treatment is over before publishing, and so there is a gap in the statistics brought about by their failure to report anything from the time treatment begins until it ceases, which is usually several years.”
As an example, those who die during surgery are commonly excluded from survival results.
“In the treated group, deaths which occur before completion of treatment are rejected from the data... With this effect stripped out, the common malignancies show a remarkably similar rate of demise, whether treated or untreated.”
In a report to the American Cancer Society’s Science...
Writers Seminar in 1969, he elaborated this view: “No cures as a result of treatment were claimed prior to 1900. Most clinics began to report claims of cures by 1950, typically about 50 percent cure for the common malignancies such as cancer of the breast. Yet, the specific death rates for common malignancies have remained essentially the same for persons of the same age over this entire century.” He pointed out that this situation could only occur if increased incidence precisely offset the clinical advances—an improbable phenomenon. The fact that incidence has slightly declined would mean that the claimed advances are fraudulent. Dr. Jones surmised: “The evidence for the falsity of claims about cancer therapy is overriding... Postulated benefits must be very rare indeed to have been incapable of proof.”
Regarding the claimed improvement in survival since the 1930s, Dr. Jones explained: “Beginning in 1940, through redefinition of terms, various questionable grades of malignancy were classed as cancer. After that date, the proportion of ‘cancer’ cases having ‘normal’ life expectancy increased rapidly, corresponding to the fraction of questionable diagnosis included.”
His prime conclusion: “Evidence for benefit from cancer therapy has depended on systematic biometric errors.”
One would expect such findings, which put in doubt the entire $30 billion a year cancer treatment industry, would have received intense national attention. After the report, Dr. Jones received many letters from physicians commending his study, but only one newspaper and a health newsletter took note of it. A search of Science Citation Index reveals three later reports by other researchers supporting Jones’ classic paper on the subject published in Transactions of the New York Academy of Sciences in February 1956. There he reviewed the entire literature on treated and untreated cancer, and concluded “The chance of survival is not better with than without treatment, and there is the possibility that treatment may make the survival time of cancer cases less.”
However, we feel Dr. Jones’ conclusion should be qualified. Even though it is perhaps accurate, the difficulty with untreated cases is that it is impossible to randomize and match patients, thereby eliminating differences in diagnosis, criteria for malignancy and patient selection, for example. It becomes virtually impossible to make reliable comparisons between treated and untreated cases.
A conservative evaluation by the Connecticut Cancer Registry data indicates that although breast cancer mortality (as a fraction of total cancer mortality) has remained constant for the last 40 years at least, the incidence of breast cancer increased 18 percent from 1935-1965 and by about 50 percent between 1965 and 1975. Therefore there is some utility to treatment since breast cancer mortality/total breast cancer cases declined, e.g., cases are being included, perhaps due to early diagnosis, that really aren’t malignant.
No refutations have appeared, nor have survival rates subsequently improved. Despite his passing in February 1978, Dr. Jones’ findings remain a profoundly relevant challenge to conventional cancer treatment. He found, for example, that even in 1911-1913 the death rate for untreated breast cancer was as low as 88 deaths per 1,000 cases a year. This corresponds to a 5-year survival rate of 63 percent—the same rate as for all treated cases in 1960-1969. Analyzing the data further, Dr. Jones was able to conclude in 1975 that survival in breast cancer is 4 times longer without treatment. “People who refused treatment lived for an average of 12½ years. Those who accepted surgery and other kinds of treatment lived an average of only 3 years. Beyond a shadow of a doubt, radical surgery on cancer patients does more harm than good.”
Conventional therapies for cancer vie with the worst the Dark Ages could devise in Gothic torture made all the more excruciating through gleaming, sophisticated technology. Hippocrates’ counsel to first do not harm has been violated as standard practice by most cancer specialists, and much of the dread of the disease consists in the horror at their therapies, which defile the integrity of the body and subject the sick to severe stress and pain with psychological, as well as physical, ravage. For all the militaristic, glory-boy attack on the enemy, strategic rationale is missing. Cancer radiation suppresses the immune system, the body’s key defense against the disease, and are themselves well recognized to be cancer-causing. Surgery can spread a cancer and spur the growth of deadly metastases, which are actually inhibited by the primary tumor, according to the studies of Dr. Michael Feldman and his colleagues at the Weizmann Institute in Israel in 1978. The standard treatment for breast cancer in the U.S. remains in 90 percent of cases the 1890’s Halsted radical mastectomy, still backed by the American Cancer Society, despite its having been discredited by a special NIC review panel chaired by Dr. Bernard Fisher, Professor of Surgery at the University of Pittsburgh, as butcherizing women on the basis of the 19th century misconceptions of physiology. The NCI study showed that radicals were not better than simple mastectomy in terms of survival when the patients have Stage I or Stage II (localized or regional response) disease. Is such treatment worth its average $20,000 dollar price tag, or is the public being victimized by a massive system of sanctimonious, institutionalized charlatanry? With such a disastrous record on all levels of the “war on cancer,” it becomes imperative that individuals learn the facts for themselves.
Weighing all the studies, Prof. Jones recommended to the public in 1975 the “radical” defiance of modern medicine. “Medical treatment,” he told the press, “seems to interfere with natural resistance. It is not the cancer that kills the victim. It’s the breakdown of the defense mechanism that eventually brings death. “With every cancer patient who keeps in excellent physical shape and boosts his health to build up his natural resistance, there’s a high chance the body will find its own defence against the cancer. He may have many good years left in good health. He shouldn’t squander them by being made into a hopeless invalid through radical medical intervention which has zero chance of extending his life.”
Topless Cover-Up
At least 1,000 women a week are undergoing radical mastectomy in the U.S., often believing they are only going in for a biopsy. The operation entails removal of the underlying muscles and nearby lymph nodes, as well as the breast, often leaving the patient in considerable pain as compared with other procedures. The removal of the lymph nodes is a ritual sacrifice, for in the 1890s when the operation was devised it was not known that cancer could spread through the blood as well as the lymph system, and that the lymph nodes help destroy cancer cells through the action of lymphocytes. It has been suggested that the high fee for a radical has maintained it as the standard treatment in the U.S., though not abroad. In 1976, Dr. Bernard Fisher reported the results of the NCI’s nationwide study involving 34 medical centers and 1,700 patients: it found there was no difference in survival or recurrence of cancer between the radical or simple mastectomies, with or without radiation, in women diagnosed with Stage I or Stage II disease.
In 1978, Dr. Alfred Meyer and associates at Rockford School of Medicine in Illinois released their conclusions that radical mastectomy for breast cancer should be abandoned. Their study of 1686 patients “found no significant differences in 5 and 10 year survival for simple, modified radical, or radical mastectomy.” Dr. M. Vera Peters conducted a study on 162 cases at Princess Margaret Rose Hospital in Toronto comparing radical mastectomy with lumpectomy—removal of the tumor alone—and reported in 1972 that the 5-year survival rate was virtually the same for each group—70 percent for the radical and 72 percent for lumpectomy. But two years later Dr. George Rosemond, then President of the American Cancer Society, reiterated the Society’s policy that the Halsted radical is “preferred.” Custom must be obeyed.
The naked Empress in these issues was pointed out by Hardin Jones in his ACS report: “If a treatment is effective, there is an optimal degree of treatment.” This was the case, for example, in regard to cure of skin cancer. But in regard to cancer “of the breast or cervix, no relationship between dose and cure has been demonstrated, even though widely varying levels of treatment have been investigated. In regard to surgery, no relationship between intensity of surgical treatment and duration of survival has been found in verified malignancies. On the contrary, simple excision of cancers has produced essentially the same survival as radical excision and dissection of the lymphatic drainage.”
Rushing to Surgery
Evangelical faith in the value and urgency of medical therapy as the way to be “saved” has led to zealous emphasis on early diagnosis, even to the point of imperiling health. As the primary thrust of preventive medicine such an approach becomes its denial, for it deals with disease after inception, not before. The rush to “get it out before it spreads” may have the opposite effect of stimulating the spread through surgical incision and trauma. As Prof. Jones instructed the ACS: “No studies have established the much talked about relationship between early detection and favorable survival after treatment... In some types of cancer, the opposite of the expected association of short duration of symptoms with a high chance of being ‘cured’ has been observed. A long duration of symptoms before treatment in a few cancers of the breast and cervix is associated with longer than usual survival.”
In a 1965 study of 2600 cases of cervical cancer, G.C. Lewis found that delay was not inimical to prognosis: the 5-year survival rate was actually higher for patients with delays of over 12 months than for those with shorter delays. Explicitly supporting Jones, Dr. G.H. Green, Prof. of Obstetrics and Gynaecology of the University of Auckland, New Zealand, reported in 1970 a study of 640 patients with invasive cervical cancer, which found that “Except for an indication that Stage I patients with symptoms for more than 12 months may have a better prognosis than others in Stage I, the duration of symptoms made no difference to survival rates.” However, there is the possibility that symptomology may or may not be indicative of disease stage and no symptoms may likewise exist. The existence of time delays in verified invasive cervical cancer patients following the diagnosis must be taken into account. For if there are no time delays, Green’s report on 640 patients may be irrelevant.
In a subsequent study, Dr. Green concluded that “invasive cervical cancer mortality has not been influenced by cytology screening” (Pap tests), and that “hysterectomy is an unnecessarily radical operation for dealing with cervical carcinoma in situ” (localized), for such patients were found to have “only a normal chance of developing invasive cancer in the future”—one in a follow-up of 576 cases.
are contrary to Green’s study. First, the Connecticut Registry Data for invasive cancer correlates a decrease in invasive cancer with widespread Pap smears, although it is not clear why invasive cancer has not yet disappeared totally. The latter is possibly a consequence of a “second” type of cervical cancer, where in situ stages don’t exist or are extremely short timewise or have simply been missed for technical reasons.
Also, among untreated patients with in situ cervical carcinoma the literature indicates a progression to invasive cancer in from 20 up to and approaching 100 percent of cases. Confusion in diagnostic criteria, cautery, biopsy, etc. will all minimize this frequency. Among women with invasive cancer, in situ carcinoma can often be observed at the periphery of the invasive cancer, and evidence of in situ carcinoma exists from earlier biopsies.
In addition, randomized trials in Sweden (or Denmark) indicate the rate of recurrence is no greater following simple excision of an in situ carcinoma than following hysterectomy. This does not argue against any treatment but against hysterectomy. Untreated and treated cervical cancer data do not seem to allow the same (possible) conclusion as the breast cancer data do. The data indicate that one can argue for early detection benefits for the cervical cancer data where the rate of a decrease in incidence and mortality for invasive cancer agrees with the widespread introduction of Pap tests.
Regarding cancer of the breast, a renowned surgeon, Dr. Ian MacDonald, reported extensive data in the American Journal of Surgery in March 1966, concluding that:
“The massive educational, diagnostic, and therapeutic attack on mammary carcinoma of the past two decades has failed to alter rates of incidence and mortality... Reports on the therapy of mammary cancer in the surgical literature often lack significance through selected samples of small size and the lack of statistical validation.” When statistically corrected, the data “lend little if any support to the case for early diagnosis.”
Nevertheless, the ACS and the NCI, as a showcase project of the “War on Cancer,” co-sponsored a massive X-ray screening program for breast cancer—on 280,000 women—the notorious mammography follies. With kind smiles and polyanna counsel, women were encouraged to affirm their virtue on the altar of technology by exposing themselves to periodic radiation known to increase the risk for disease.
When Dr. John Bailor, editor of the Journal of the NCI, pointed out in 1976 that repeated mammography was likely to cause the loss of as many from cancer as it retrieves, the ACS drew up more stringent criteria for screening—so selective as to include 80 percent of all women over 35. Emphasis was placed however on radiating women over 50—the very group that would be most vulnerable to induction of cancer by radiation.
The program continues at full beam, despite the statistical likelihood that it will produce “the worst iatrogenic epidemic of breast cancer in history,” according to Dr. Irwin Bross, Director of Biostatistics at Roswell Park Memorial Institute.
In testimony to the Committee on Health of the New York State Assembly, Aug. 10, 1978, Dr. Bross raised the sensitive issue of the financial motivation of the cancer industry in stressing such diagnostic measures and neglecting primary prevention, such as through diet improvement and control of environmental carcinogens. He asserted:
“Primary prevention of cancer is a threat because it offers an alternative to therapeutic control of cancer. Since if offers a choice it raises a question: Which approach is most effective? This in turn, raises a question that oncologists don’t want raised: How effective is orthodox cancer therapy? For instance, most of the $30 billion is spent on cancer patients with generalized disease. However, none of the orthodox treatments, singly or in combination, can cure a patient with generalized disease. So the awkward question arises: Is it worth $30 billion a year just to prolong the agony for a few months?”
Tunnel to Blight
Dr. Bross’ funds were cut off by NCI when he released the results of his study linking low-dose radiation with leukemia. In hearings before the Fountain Subcommittee of the Congress, he charged that federal cancer research funding goes mainly to “laboratory scientists who have no real interest in human cancer and who couldn’t care less about prevention of human disease.” NCI’s cancer vaccine effort he termed “a fiasco—a waste of time, effort and hundreds of millions of taxpayer’s dollars. If even half of these resources had been put into an effective primary prevention program, we would at this moment be well on our way to the actual conquest of cancer,” he suggested that much of the cancer research appropriations had been “wasted on scientific boondoggles such as the worthless cancer vaccine program.”
Some $100 million a year in the NCI budget is going down the tubes of virus research to prove the hypotheses of certain Institute officials, despite the lack of proof, after decades and billions spent in such research, that viruses cause human cancer. Virologist Dr. Howard Temin, winner of the Nobel Prize, testified:
“We can now say that infectious viruses like those that cause many human diseases do not cause most human cancer. Therefore, we cannot hope to develop a vaccine against a virus to prevent most human cancer.”
Bross asserted that even the NCI’s programs on environmental carcinogens are “little more than public relations gimmicks—paper tigers to reassure the concerned public that something is being done when it isn’t.”
Despite the general recognition that at least 80 percent of human cancer is caused by environmental influences, less than 10 percent of the NCI budget is given to environmental causes.
Despite the recognition that the majority of environmental causes of cancer are linked to diet (as acknowledged in the Congressional testimony of Dr. Donald Frederickson, Director of the N.I.H.), less than 1 percent of the NCI budget is devoted to nutrition studies, and that amount had to be forced on the Institute by a special amendment to the National Cancer Act in 1974. In 1976, Dr. Gio Gori, Deputy Director of the Division of Cause and Prevention at NCI, testified that 60 percent of cancer in American women and 40 percent in American men appeared to be diet-related. For his outspokenness, Dr. Gori was compelled to leave NCI in 1978.
After grilling NCI Director Arthur Upton in hearings of the Senate Subcommittee on Nutrition in June 1978, Sen. George McGovern surmised that “we’re losing the war on cancer because of mistaken priorities and misallocation of funds. There has been no lack of funds—it’s almost $1 billion a year.”
Mismanagement and unscrupulous practices on the part of NCI officials have also been charged, as when it was brought to public attention that they had been awarding huge research contracts to themselves and their friends with little or no independent review.
Dr. Donald Kennedy, Director of the FDA, has characterized the cancer war effort as a “medical Vietnam.” Dr. Sidney Wolfe, of the Center for Science in the Public Interest, termed it “a sham battle,” and called for a preventive strategy.
Dr. Wolfe told the Fountain Committee in 1977:
“Prevention cuts into the profit margin of existing industries which have thus far been able to escape the costs of the cancer they cause. NCI, under new leadership, must choose to become the leader in the war to prevent cancer, rather than the banking operation for the largely unsuccessful war to treat it after it happens.”
Among the severest critics of the “war” was Nobel laureate Dr. James Watson, Director of Cold Spring Harbor Laboratory, who told a 1975 symposium at MIT:
“The American public is being sold a nasty bill of goods about cancer. While they’re being told about cancer cures, the cure rate has improved only about 1 percent.”
In his precise, scientific manner, Dr. Watson drew an analogy between the National Cancer Program and a pile of excrement.
Science writer Daniel Greenberg, editor of Science and Government Report, brought the “bad news” home to his often innocent, credulous colleagues in a celebrated article in Columbia Journalism Review the same year. He contends that “the public is getting a snow job about progress in cancer research and treatment.” Examining the NCI’s own data, he found that “after 25 years and several billion dollars expended on research for cures, survival rates for the most common types of cancer... are virtually unchanged and in some instances may even have worsened.”
The NCI, in a response by then director Dr. Frank Rauscher, acknowledged that Greenberg’s statistics were accurate, but sought to emphasize gains in the control of ten cancers accounting for 8 percent of cancer mortality, emphasizing leukemia and Hodgkin’s disease. Dr. Rauscher noted however that the improvement had occurred in selected cases at special centers before 1972, when the “War” began.
Enstrom and Austin point out that the “doubling” of 3 year survival in acute leukemia nationwide between 1955 and 1969 was from 3 percent to 7 percent—hardly a dramatic control of the disease. Chronic leukemia improved in 3-year survival from 39 percent in 1955-64 to 41 percent in 1965-69. For chronic lymphocytic leukemia, the corresponding rates are 51 percent and 53 percent. They write:
“Although significant increases in leukemia survival are often cited as evidence of great progress in cancer control... the survival rate for leukemia with all forms combined has remained constant (20 percent). This is due to the increasing proportions of the highly fatal forms of leukemia” (Science, March 4, 1977).
Dr. Matthew Block, Prof. of Medicine at the University of Colorado Medical Center, notes that:
“In the case of chronic lymphocytic leukemia as we see it in adults, if the survival time is no better than it was 30 years ago, then we must conclude that there is something we are doing to these people that is making their survival shorter. The use of transfusions as well as other aspects of better ancillary care should have increased longevity in this disease and if it is not any better we must then conclude that... indeed longevity has been decreased by treatment.” (Med. World News, 7/5/74).
In Hodgkin’s disease, a study in the Archives of Internal Medicine (Dec. 1974) found that “after one year from diagnosis, the survival of untreated patients is better than that of those who received subsequent therapy.”
Possible improvement in survival in some cancers has been counterbalanced by decreased survival in others (such as cancer of the esophagus, salivary gland, tongue, lip and connective tissue, nose and ear, which have fallen in 3-year survival). Another grim influence is the increase in incidence of fatal cancers whose survival has not worsened, such as lung. The effective total result is increased yearly mortality. Happily, the mortality rate of cancer in women decreased 8 percent between 1953 and 1975, but the disease remains the main nemesis of women 30-54, and its mortality rate in men increased 18 percent in that period, resulting in an overall lack of progress, 1,070 cancer deaths a day, 390,000 a year.
Improvements in cancer survival rates that occurred in the 1940s and early 1950s have been attributed to better survival of operations, due to post-war antibiotics and transfusions. Such improvement represents a reduction in doctor-caused demise rather than in cancer mortality. Today, as ever before, loss of life due to complications of treatment are described as “from cancer.”
As Enstrom and Austin have pointed out, earlier diagnosis and treatment seem only to extend the period of awareness of early disease, without affecting the outcome. As Jones suggests, a preferred therapy should be mild and not add to the health problems of the patient, inasmuch as genuine survival is statistically better without standard surgery and radiation. The major advance against cancer may be the assumption of self-responsibility by the individual for the maintenance and recovery of health, and the refusal to submit to physical and spiritual destruction at the hands of a benignly dutiful, elite.