From the Sierra Club magazine "Sierra Magazine":

THEY MAKE THE CHEMICALS, THEY RUN THE TREATMENT CENTERS, AND THEY'RE STILL
LOOKING FOR "THE CURE"-NO WONDER THEY WON'T TELL YOU ABOUT BREAST CANCER
PREVENTION

Every October, the sponsors of National Breast Cancer Awareness Month go
into overdrive to spread their message, "Early detection is your best
protection." Organizers stage walks, hikes, races, and other events
around the country "to fill the information void in public communication
about breast cancer"-the sponsors' official goal. For the most part that
void is filled with the mantra: "Get a mammogram." As for reducing risk,
the campaign's elaborate 1998 promotion kit says only that "current
research is investigating the roles of obesity, hormone replacement
therapy, diet, and alcohol use."

In other words, the people who bring you Breast Cancer Awareness Month
tell you to find out if you already have the disease. And they tell you
to take personal responsibility for staving off what's become a scourge
throughout the country. What they go to great lengths to avoid telling
you is what the country can do to help stop the scourge at its source.

It's no mystery why prevention gets the silent treatment. The primary
sponsor of Breast Cancer Awareness Month, AstraZeneca (formerly known as
Zeneca), is a British-based multinational giant that manufactures the
cancer drug tamoxifen as well as fungicides and herbicides, including
the carcinogen acetochlor. Its Perry, Ohio, chemical plant is the
third-largest source of potential cancer-causing pollution in the United

States, releasing 53,000 pounds of recognized carcinogens into the air
in 1996. When Zeneca created Breast Cancer Awareness Month in 1985, it
was owned by Imperial Chemical Industries, a multibillion-dollar
producer of pesticides, paper, and plastics. State and federal agencies
sued ICI in 1990, alleging that it dumped DDT and PCBs-both banned in
the United States since the 1970s-in Los Angeles and Long Beach harbors.

Any mention of what role such chemicals may be playing in rising breast
cancer rates is missing from Breast Cancer Awareness Month promos.

After acquiring the Salick chain of cancer treatment centers in 1997,
Zeneca merged with the Swedish pharmaceutical company Astra this year to

form AstraZeneca, creating the world's third-largest drug concern,
valued at $67 billion. "This is a conflict of interest unparalleled in
the history of American medicine," says Dr. Samuel Epstein, a professor
of occupational and environmental medicine at the University of Illinois

School of Public Health. "You've got a company that's a spinoff of one
of the world's biggest manufacturers of carcinogenic chemicals, they've
got control of breast cancer treatment, they've got control of the
chemoprevention [studies], and now they have control of cancer treatment
in eleven centers-which are clearly going to be prescribing the drugs
they manufacture."

Even the nation's leading cancer organizations are not immune from
corporate influence. The American Cancer Society has the vice president
of a major herbicide manufacturer sitting on its board of directors.
High-ranking officials in the National Cancer Institute routinely accept
lucrative posts in the cancer-drug industry. Such tangled financial
interests explain why the cancer establishment-the medical institutions,
corporations, and agencies that control cancer research, treatment, and
education-continues to ignore mounting evidence that many cases of
cancer are avoidable.

These conflicts may also help explain why, 28 years and billions of
dollars after President Nixon declared war on cancer, the risk of breast
cancer is higher than ever. In 1950, an American woman faced a lifetime
risk of 1 in 20; today that risk has more than doubled to 1 in 8. Breast
cancer will strike some 175,000 women in the United States in 1999, and
kill 43,000. The cancer business is booming, but the selective brand of
awareness the cancer industry promotes comes at a price.

Samuel Epstein predicted 30 years ago that cancer rates would increase,
citing an explosion in the use of synthetic chemicals. From 1940 through
the early 1980s, production of synthetic chemicals increased by a factor
of 350. Billions of tons of substances that never existed before were
released into the environment. Yet only some 3 percent of the 75,000 or
so chemicals in use have been tested for safety. Forty of them are
recognized human carcinogens.

The widespread presence of carcinogens in our environment is clearly
linked to rising cancer rates, Epstein says. He points to a number of
avoidable risk factors, but pollution, estrogenic medications, toxic
ingredients in consumer products, and carcinogens in the workplace top
his list of culprits. One thing ties all these things together, he says:

"Corporate recklessness."

Signs of that recklessness are most evident in the workplace. Of 4
million women employed in the chemical industry, Epstein says, "about a
million are exposed to chemicals which have been shown to cause breast
cancer in rodents." In cases where scientists conducted epidemiological
studies, women exposed to these chemicals had higher rates of breast
cancer. Evidence that women in the plastics industry face increased risk
emerged over 20 years ago. A study published in the Journal of
Occupational Medicine in 1977 noted higher-than-expected breast cancer
deaths in women exposed to vinyl chloride, which not only produces
mammary tumors in animals even at very low doses but causes breast,
liver, brain, and nervous-system cancers in humans.

Living near hazardous-waste sites also appears to increase risk. "A
number of intriguing studies show that breast cancer rates are higher in
places that have toxic-waste dumps," says Sandra Steingraber, who
explored the links between toxic hot spots and cancer incidence in her
book Living Downstream (see "Rachel's Daughter"). A 1985 study published
in the International Journal of Epidemiology found that in New Jersey-a
state with 111 Superfund sites-breast cancer mortality among white women
increased the closer they lived to a dump site.

Many of these chemicals-and waste dumps-are produced by companies with a
financial interest in cancer products. "General Electric is a major
polluter in PCBs in the Hudson River. GE also manufactures mammogram
machines," says Ross Hume Hall, a biochemist who advised the Canadian
government on environmental issues in the 1980s.

An estimated million pounds of PCBs lie buried at the bottom of a
40-mile stretch of the Hudson, where GE dumped PCB oil until the
mid-1970s, contaminating the entire 200-mile length of the river below
Hudson Falls. Although PCBs (a family of 209 organochlorine chemicals)
were banned in 1977, the chemicals persist in soil, air, lakes, and
oceans. Classified by the EPA as probable human carcinogens, PCBs are
found in the fatty tissue, sperm, blood, and milk of animals and humans
the world over. Although PCBs vary in their effects, several studies
link some PCBs to human breast cancer.

Faced with a government-proposed cleanup plan that would cost hundreds
of millions of dollars, GE launched a local media offensive assailing
the measure as unnecessary because the river is "cleaning itself." These

PR efforts (which happened to be aimed at a community with one of the
highest breast cancer rates in the United States) prompted EPA
Administrator Carol Browner to complain to the New York Assembly in
1998: "GE would have the people of the Hudson River believe, and I
quote, 'living in a PCB-laden area is not dangerous.' The science tells
us the opposite is true."

Responding to mounting evidence of organochlorines' harm, in 1992 a
staid scientific advisory group, the International Joint Commission
(IJC), proposed a global phaseout of whole classes of the roughly 15,000
chlorinated compounds in use. (The IJC advises the U.S. and Canadian
governments on pollution in the Great Lakes region.) Among the evidence
was research from Israel showing that three organochlorine pesticides
detected in milk and other dairy products caused 12 types of cancer in
10 different strains of rats and mice. After public outcry in 1978
forced the Israeli government to ban the pesticides-benzene
hexachloride, DDT, and lindane-something remarkable happened. Breast
cancer mortality rates, which had increased every year for 25 years,
dropped nearly 8 percent for all age groups and more than a third for
women ages 25 to 34 by 1986.

Unimpressed by such findings, the American Cancer Society (ACS) sided
with the Chlorine Institute and issued a joint statement against the
phaseout. This alliance between the world's largest cancer charity and
the chemical industry, says Epstein, amounts to a "frank hostility" to
prevention.

The American Cancer Society was founded with the support of the
Rockefeller family in 1913. Members of the chemical and pharmaceutical
industry have long had a place on its board. The society strengthened
its industry ties in 1992, when it created the American Cancer Society
Foundation to solicit contributions over $100,000. The foundation's
corporate-heavy board of trustees includes David Bethune, president of
the multinational drug company Lederle Laboratories and vice president
of American Cyanamid, a manufacturer of chemical fertilizers and
herbicides.

The Cancer Society's anti-prevention efforts include opposing the
now-defunct Delaney Clause, passed in 1958 to safeguard food from
substances that cause cancer in animals, because the law "would severely
limit the use of valuable pesticides and food additives and...probably
increase food costs." In 1977 and 1978, it opposed regulations for hair
dyes that cause mammary and liver cancer in rodents. And since 1982, the

ACS has insisted on unequivocal proof that a substance causes cancer in
humans before taking a position on public health hazards. Ironically,
this is the posture of the tobacco industry, which the ACS has long
battled, and explains why decades after the U.S. Surgeon General warned
in 1964 that smoking causes lung cancer, tobacco executives were still
saying that smoking isn't dangerous. It was the Surgeon General's
courage to act on what Steingraber calls "good but partial evidence"
that would protect people "while the wheels of science slowly grind on."

Thirty-two years later, scientists finally isolated the carcinogenic
agent in smoke and determined exactly how it causes lung cancer. True to
form, the Cancer Society's latest report on cancer prevention, the 1998
"Cancer Risk Report: Prevention and Control," makes no mention of
environmental factors.

The primary source of support for cancer research in the United States
comes from the federally funded National Cancer Institute (NCI). Senior
executives in both the Cancer Society and the Cancer Institute routinely
move through a revolving door to board and executive posts at companies
that make cancer-treatment drugs.

Such conflicts of interest extend to the petrochemical industry. While
serving as chairman of the National Cancer Advisory Panel (a
three-member committee appointed by the president) in 1990, Armand
Hammer announced a drive to add a billion dollars to the NCI's budget
"to find a cure for cancer in the next ten years." At the time, he was
also chairman of Occidental Petroleum, which would later have to pay the
federal government $129 million and New York State $98 million to clean
up its infamous toxic dump, Love Canal.

It's no surprise, then, that reducing exposures to environmental
carcinogens gets short shrift in the NCI's breast cancer prevention
efforts, and that the agency embraced a study in "chemoprevention" in
1992. The Breast Cancer Prevention Trial, involving over 13,000 women
throughout North America, was designed to see if the chemotherapy drug
tamoxifen would reduce the risk of breast cancer in healthy women.
Zeneca supplied the tamoxifen, and the NCI provided $50 million in
funding. With activists demanding prevention, says Cindy Pearson,
executive director of the National Women's Health Network, "the NCI
needed a prevention initiative." It chose what seemed the easiest way to
go-a pill.

Pearson's group opposed the study at a Food and Drug Administration
hearing. "Tamoxifen shouldn't even be mentioned in the same breath as
population-wide prevention," she says. Studies later revealed that the
women on tamoxifen developed 44 percent fewer breast cancers, but twice
as many endometrial cancers, three times as many blood clots in their
lungs, and 160 percent more strokes and blood clots in their legs.
(Major studies in Italy and Britain found no reduction of breast cancer
risk.) In October 1998, the FDA approved tamoxifen for healthy women at
"high risk," expanding AstraZeneca's $526 million market for the drug to
some 29 million more women.

The National Cancer Institute's latest "prevention initiative" will
compare tamoxifen and Eli Lilly's raloxifene-another drug that appears
to reduce breast cancer risk-in tests on 22,000 women in the United
States and Canada.

While these advances in chemoprevention win funding and acclaim,
less-toxic prevention efforts have met fierce resistance. When the
International Joint Commission launched its organochlorine phaseout, the
chemical industry first responded with a media offensive attacking the
proposal, then went after women's-health activists. In a memo prepared
for the Chlorine Chemistry Council, the public-relations firm Mongoven,
Biscoe and Duchin outlined a strategy to "mobilize science against the
precautionary principle"-the idea that when there is evidence of serious
risks to public health, we must act to reduce those risks even in the
absence of absolute proof. Singled out was a series of conferences on
organochlorines and women's health in 1994 that featured a keynote talk
by Dr. Devra Lee Davis on synthetic chemicals. Davis, an epidemiologist,
was a health-policy advisor in the Clinton administration at the time, a
post the memo complained gave her "unlimited access to the media" and
helped validate her "junk science."

Industryıs efforts to stifle evidence of environmental links to breast
cancer has even infiltrated the medical journals. Two incidents that
grabbed national headlines involved The New England Journal of Medicine
in 1997. The first, an editorial by toxicologist Stephen Safe of Texas
A&M University, reviewed studies correlating chemical residues in blood
samples with increased breast cancer risk. Safe judged the evidence
unconvincing, dismissing public concerns as "chemophobia." The Journal
did not disclose that Safe had received research funds from the Chemical

Manufacturers Association six months before his article appeared.

On the heels of Safe's editorial, the Journal ran a book review panning
Sandra Steingraber's Living Downstream. The author, a physician
identified only as Jerry H. Berke, said Steingraber was obsessed with
environmental pollution as the cause of cancer. Berke, it turned out,
was a senior official at W. R. Grace, the chemical giant forced by the
EPA to help pay for a $69 million cleanup of contaminated wells in
Woburn, Massachusetts, the setting for the book and movie A Civil
Action.

These events had one positive outcome, says Steingraber: they revived an
important public conversation that Rachel Carson, the anti-toxics
pioneer, initiated toward the end of her life. "She was beginning to
document the interlocking structures of industry and medicine and how
the chemical industry may be using the medical literature as a
mouthpiece for its own views."

Carson, herself a victim of industry attacks, saw no contradiction
between preventing cancer and developing better treatments. But a
"search for the cure," she said, misrepresents the slow nature of
scientific discovery. As we single-mindedly chase that elusive cure, we
miss opportunities to prevent the cancers of the next generation. "It is
a disservice to humanity to hold out the hope that the solution will
come suddenly, in a single master stroke," she warned in Silent Spring.

Carson was dying of breast cancer when she wrote these words. No less
tragic, the pattern of missed opportunities continues more than 35 years
later.

Sharon Batt, a breast cancer survivor, is the author of Patient No More:

The Politics of Breast Cancer. Liza Gross is Sierra's copy editor.