Truth and Reconciliation
An Interview with Devra Davis, Author of The Secret History of the War on Cancer
SOURCE: Basic Books
In her latest book, Davis tackles the convoluted history of cancer research, revealing the extent to which governmental anti-cancer efforts were spearheaded by leaders from the very industries producing cancer-causing materials and products.
Devra Davis’ first book, When Smoke Ran Like Water, a tale of corporate deception and environmental pollution, was a finalist for the National Book Award. Dr. Davis, the Director of the Center for Environmental Oncology at the University of Pittsburgh Cancer Institute, has followed up with a more wide-ranging look at cancer risk and epidemiology, The Secret History of the War on Cancer.
Dr. Davis’ new book is an ambitious story of the search for the causes of cancer, extensively footnoted and supported by a website featuring links to scientific studies and corporate documents.
Her research reveals the extent to which official governmental anti-cancer efforts were spearheaded by leaders from the very industries producing cancer-causing materials and products. Her book is already generating considerable buzz, contributing to a lively debate about the nature of cancer risks, what can be done to avoid them, and who is responsible for keeping us safe from dangerous products.
Jeff Stryker’s interview with Dr. Davis for Science Progress has been edited and condensed for posting.
Science Progress: It has been more than 35 years since President Nixon declared “war” on cancer. How are we doing?
Devra Davis: For much of the enterprise we have been fighting the wrong war with the wrong weapons against the wrong enemies. The good news is we now in the United States have 10 million cancer survivors.
We have not dealt with the main causes of the disease. Think about it. In 1971, President Nixon officially declared war on cancer. But by 1936, the world’s leading cancer scientists understood that benzene caused cancer. It was known that diagnostic radiation, solar radiation, and hormones caused cancer in the 1930s. But the war on cancer started in 1971—leaving off the table tobacco, benzene, radiation, sunlight, hormones, mining, and other things then known to cause cancer.
SP: I suppose most casual observers would point to the 1964 U.S. Surgeon General’s report as the first major acknowledgement of the role of tobacco causing cancer, yet you identify the Nazi research as strong on this point.
Davis: The recognition of the dangers of tobacco goes back a hundred years and more. In the late 19th century, autopsies were reported in the literature showing the black lungs of people who smoked cigarettes. Yet individual clinical case reports such as these were basically ignored as the field of epidemiology grew as a science.
SP: How are we doing on some of the particular cancers? I mean, tobacco’s risks are now well known and we’re getting them under control.
Davis: Cancer deaths in the United States are dropping, because we have finally made some inroads against tobacco. If we had acted on tobacco when we first knew it was a hazard, we would never have addicted generations of GI’s in World War I and II to tobacco by giving them free cigarettes, which we did.
We are, in fact, seeing an increase in certain cancers not related to smoking and not as a result of improvements in screening.
SP: Your book left me a bit afraid to leave the house or stay in the house or eat or drink anything.
Davis: The point of the book is not to frighten, but to let people know what can be done to reduce the risk of cancer and its chance of recurrence. People also deserve to recognize that we have not been dealt fairly with by industries that make cancer-causing products.
We are doing amazing research at our Center for Environmental Oncology on the use of certain natural products that can basically extinguish cancer cells, things taken from broccoli or fish oil or yogurt or even sometimes dark chocolate.
SP: Epidemiologists face huge challenges in studying cancer. One hurdle is that they can’t study risky products without the help of the people and companies making and selling them.
Davis: It is hard to do epidemiology. It is expensive. It takes time. The early epidemiologists had to cooperate with industry or they would not have received any data whatsoever. Under our current system there are no incentives for companies to come forward with information about hazards relating to material that they produce.
I think we need a “truth and reconciliation commission” on toxic hazards. Companies could provide independent information with appropriate confidentiality protections concerning potential hazards. This would absolve them from punitive damages. They would still be responsible for paying medical costs for their own workers and to others that they may have injured.
As it stands now, there’s no reason for anyone to come forward with disclosures.
SP: Injured people can always sue. But you discuss the difficulties of doing this in your book—problems in forcing disclosure of trade secrets and with the Daubert rule (Daubert v. Merrell Pharmaceuticals, Inc., 509 U.S. 579 (1993)) if litigation gets underway.
Davis: One group of scholars called it, “The Most Influential Supreme Court Ruling You’ve Never Heard Of.”
The Daubert decision has had exactly the effect the defense bar intended. Namely, 90 percent of all judgments now are going against plaintiffs in tort cases. Daubert raised a very, very high bar of proof. It basically made the collecting of epidemiologic evidence in many cases a requirement before you could prove harm. But cancer is a disease that in humans can take 10, 20, 30, or 40 years to develop. Under Daubert, we have to wait until enough people have been harmed in order to prevent others from additional harm.
SP: What should be the standards of proof before products are deemed toxic or dangerous? Your book resurfaces some battles I thought had been fought and resolved, say, for example, Aspartame.
A recent Aspartame study should give us all cause for alarm. As you may be aware, the typical animal study takes two years, after which animals in both the experimental and control groups are sacrificed and examined for tumors.
SP: By animals you mean mice?
Davis: Rodents—rats or mice.
SP: How long do they usually live?
Davis: Their natural life is three years. But in most studies we sacrifice them at two years. Soffritti and his colleagues in the Ramazzini Foundation in Bologna, Italy exposed thousands of rodents to Aspartame prenatally and throughout their lifetime. He let them live to three years, which is equivalent to humans getting into our 70s, 80s, and 90s. Twice as many exposed animals developed tumors. Yet none of the tumors started to appear until that third year of animal life, corresponding to the last third of human life today. Two hundred million people in the United States today regularly consume Aspartame.
SP: So that horse is out the barn door and headed down the road a piece. How do you study something that’s so prevalent? Is it too late, for example, to be concerned about cell phone risks, now that everyone has one?
Davis: Cell phones are a great convenience and even save lives. It is also clear that the old cell phones, the clunky analog cell phones, were probably much more hazardous than the current generation of cell phones today. Even so, the British, Swedish, and German governments recommend that children not use cell phones. The cell microwave signal is known by industry to penetrate the skull and children’s heads have thinner skulls and are more vulnerable.
My advice is to use a cell phone with speaker phone whenever possible or with a hollow wired headpiece.
SP: Cell phones are changing rapidly. Isn’t the technology a moving target when it comes to pinning down risk?
Davis: Precisely. There’s also the problem that the epidemiology on cell phones, like the epidemiology on Aspartame, has involved studying limited exposures for short periods of time. In the case of cell phones, most studies absolving the technology of risk looked at people who used cell phones in the early 1990s and checked back five years later to see if they had brain cancer. Now, in both cases, that’s far too short a period of observation.
More troubling data has just emerged from a meta-analysis done by Leonard Hardell and his colleagues in Sweden. They found that people using cell phones for 10 years or more showed a doubled risk of certain brain cancers.
SP: Where are the regulators when it comes to toxic hazards? Lead paint in toys has been the scare du jour. Are regulatory agencies letting us down?
Davis: There has been a long-standing decline in the United States of funding for testing and monitoring and measurement. Enforcement on environmental issues is at an all-time low. We do not even have the in-house capacity of the Food and Drug Administration to evaluate toxicology information. We don’t have inspectors. By the way, the problem is not simply lead paint on wood or metal toys. Lead can be put into plastic, and plastics can also contain other toxic materials that can come out of them when children suck on them or when they are heated.
The government has really stopped doing its job. Our laws allow us to think we might be protected. But President Bush has shown a creative ability to ignore laws with his signing statements. Another way to undermine existing laws is to fail to fund the regulatory agencies established to implement them. In the case of the FDA and the Consumer Products Safety Commission, the problem is also their reach. It is clear that they do not have the authority to monitor, for example, contaminants in personal care products or a wide range of imported foods.
SP: Can you talk a bit about the difference between U.S. and European regulatory attitudes on personal care products? I was taken aback by your examples of the placenta-based beauty products.
Davis: It’s been a shock to a lot of us. Hospitals sold placentas to cosmetic companies. They were used in beauty products and marketed principally to the African-American community. These hormones do a good job of plumping up hair and skin all right, but they also penetrate into the body. One study you can find on our website found that black baby girls whose mothers applied skin creams to their scalps developed breasts between the ages of one and three. Dr. Chandra Tiwary, a pediatric endocrinologist treating these girls, asked the mothers what they were using. Dr. Tiwary found they were all applying these hormone creams. When they stopped, in every single case the baby girl’s breasts disappeared. If something can cause a baby girl to develop breasts, what might it do to older women? Could these products play a role in why young African-American women have more breast cancer than their white counterparts?
SP: Is this harder to find out because we don’t have the same kind of rules about ingredients in cosmetics as we do for drugs?
Davis: Absolutely. There are no requirements for approving the safety of the materials in cosmetics. The European Union, which covers a population larger than the United States, nearly half a billion people, has passed legislation requiring the evaluation and assessment of chemical hazards. So, in Europe, it is illegal to use many ingredients in personal care products that can still be used in the United States. For example, baby bubble bath and shampoo in the United States can contain a product known to cause cancer in male and female rats and mice, which is banned in Europe.
SP: Europe is generally ahead of us in warding off these risks?
Davis: Not only are they ahead of us, American business is losing its competitive edge because of this.
SP: You’re very critical of business and industries from many quarters, but also you point to them as the hope for change with the green movement.
Davis: The greening of business is one of the most positive developments we’ve seen. Our own hospital, the University of Pittsburgh Medical Center, is going green. UPMC covers more than 400 different buildings in five states and four countries. We’re saving water by changing the way we clean and mopping floors with removable micro-fiber mops. These mops help reduce infectious disease rates, use a third as much water and fewer toxic chemicals. Less run-off into our rivers and less damaging exposure to our workers will ultimately lead to less cancer.
SP: Beyond what companies are doing, what can we do as individuals to lessen our cancer risk from potentially hazardous products and chemicals?
Davis: We can look under our sinks and read labels. You can clean most things in your house with baking soda, vinegar, and toothpaste. You can get rid of roaches with boric acid powder. And smart companies are now marketing these things as pesticides. You can buy red pepper in a bottle that says, “repels ants.”
SP: So cleaning products that come with warnings about ventilation and fumes—maybe we shouldn’t be using them at all.
Davis: The world is not without risk. Nor am I advocating a return to the Stone Age. If we have outbreaks of potentially lethal infectious diseases, like dengue and yellow fever, which may come about as a result of the changing climate, we’re going to have to rely on pesticides on occasion. But we have to be smarter about what we use. And that’s the message of the book.
There is a lot of hope out there. As someone who has dealt with cancer in my own family, I know that for cancer patients, hope is the most powerful drug in the world. But meanwhile there’s a lot that you can do to reduce your risk of cancer for your families and yourself.
SP: This might be the place to reassure readers that The Secret History of the War on Cancer is more than an epidemiology textbook, given how the science in the book is interwoven with the stories of your relatives, friends, and colleagues who have battled cancer. Was it a hard book to write?
Davis: Yes. Parts of it were very difficult and even painful to write; other parts felt like they wrote themselves. Like when I was sitting talking to my good friend in Wyoming about discovering that the first organic gardens in the world were at Dachau. I was stunned to learn that the Nazis had an interest in organic farming and that my friend’s grandfather had run these gardens.
SP: There are many such stories in the book, and they help leaven the epidemiology.
Davis: Well, cancer epidemiology turns out to be hard work. There is a story from the Torah that I think is relevant. A group of workers are told they have a job to do and they say, “What are you talking about, this job is way too big. We don’t have the right tools. We’ll never ever be able to finish.” And the Rabbi replies, “It is not up to you to finish the job, but you must begin it.”
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