The Secret History of the War on Cancer

  • Devra Davis
Basic Books: 2007. 304 pp. $27.950465015662 9780465015665 | ISBN: 0-465-01566-2
Smoking risks were suspected when this ad came out in 1946. Credit: ADVERTISING ARCHIVES

Scorn and bitterness steam from the pages of The Secret History of the War on Cancer. This amalgam of history, speculation and memoir argues that “the wrong battles with the wrong weapons and the wrong leaders” have consigned millions to preventable death from cancer.

Dangerous carcinogens — mainly tobacco, radiation, asbestos and benzene — continue to pollute the environment decades after their lethality was clearly identified, writes Devra Davis, an epidemiologist and director of the Center for Environmental Oncology at the University of Pittsburgh Cancer Institute in Pennsylvania. Their prevalence, she asserts, is the product of corporate greed and guile, warped political priorities, supine regulatory practices and dirty dealing by notable scientific generals. Today, new hazards may lurk in innumerable chemical compounds in convenience items, electromagnetic propagation and industrial waste, all shielded from scrutiny by malign cover-ups and evasions.

The well-known reality of this 'war' is that environmental clean-up, which means friction with corporate powers, has been neglected relative to curative strategies, which raise hope, enrich the scientific enterprise and offend no one. But the imbalance has been diminishing. In Davis's telling, however, little has changed in decades, leaving industrial polluters unrestrained, while devious characters profit by spreading cancer. For a nuanced understanding of the confrontation with cancer, look elsewhere.

Davis notes that Richard Doll, the epidemiologist credited with establishing the relationship between tobacco and lung cancer, held lucrative consulting deals with major chemical companies and industrial associations, including a firm that he “defended … against lawsuits from some of its asbestos-exposed workforce”. By way of contrast, Davis chronicles the fate of several scientists who sounded alarms about environmental carcinogens, risking and sometimes losing their careers, while their findings were flushed down the memory hole.

Turning to her own experience, the author reports a conversation that she says occurred in 1986 — 22 years after the US Surgeon General's historic report on smoking and health, and 15 years after President Richard Nixon and the Congress declared war on cancer. While she was an environmental staffer at the National Academy of Sciences (NAS), Davis alleges that the then NAS president Frank Press doused her plan to write a book about “the fundamental misdirection of the war on cancer”. He warned her, she writes: “You can't write a book critical of the cancer enterprise and hold a senior position at this institution.” Davis remained at the academy for a decade. “I watched … the concerted and well-funded effort to identify, magnify, and exaggerate doubts about what we could say that we know [about carcinogens] as a way of delaying actions.”

Asked to comment, Press, now an official at a consulting firm in Washington, wrote to me: “I don't recall the incident. It could have happened.” Press added, “If as a staff member she wrote a book on issues before the academy, the NAS would be viewed as biased and predictable. Davis should have known this.”

Davis details what was long-ago recognized about major environmental cancer risks, and how the polluting miscreants eluded control. The tales she tells, and retells, are generally well known, as evidenced by the predominance of published sources in 22 pages of citations. From insider whistle-blowers and corporate documents unearthed in legal proceedings, the monumental deceits of the tobacco industry, reiterated at length here, have been described and dissected in several distinguished books and innumerable articles. In this respect and others, the 'secret' in the title is questionable.

Nonetheless, for a well-documented, prosecutorial account of the dark side of cancer-control politics, Davis's work — lopsided and verbose as it is — merits attention. Younger readers, particularly, may be unaware of the corporate and political machinations that kept carcinogenic pollutants uncontrolled long after their dangers were understood.

Presented in fascinating detail is the long and troubled career of Wilhelm Hueper. Between the First and Second World Wars, this German émigré pathologist pioneered some of the earliest identifications of industrial carcinogens. Hueper was threatened and eventually fired over his investigations of worker exposure at the chemical company DuPont. At the US National Cancer Institute (NCI), Hueper pursued the connection between environment and cancer, before meeting industrial resistance. Drawing on Hueper's unpublished autobiography, Davis relates that industrial firms were “given extraordinary access to his papers prior to their being submitted for publication when he worked at NCI”. Permission to publish was denied, and Hueper was directed to confine himself to animal studies.

Pessimistic about industry voluntarily mending its carcinogenic abuses or government forcing a cleanup, Davis proposes an intriguing remedy. The creation of a Truth and Reconciliation Commission (TRC), à la post-apartheid South Africa, would, she reckons, encourage industrial executives to confess to their environmental delinquencies: “The files of many large multinational businesses could easily tell us about many more health risks associated with workplace exposures of the past.” Under a TRC regime, she suggests, “grace and forgiveness become the grounds for renewal and restoration”.

Davis's inventory of long-standing corporate and government tolerance of known carcinogenic exposures is faultless. Her failure to acknowledge that in important respects the tide is turning detracts from the credibility of her work. Her call for a TRC is a strikingly imaginative gambit. Given the power and mood of corporate America, file it under 'fantasy'.