Whole (42 page)

Notice two fairly astounding things about this paragraph? First, green vegetables are mentioned, but in a throwaway tone. It’s chlorophyllin that is “practical and cost-effective,” not spinach and broccoli and kale. The NIH is coming down in favor of eating more green vegetables to prevent cancer in a way that won’t actually undermine potential pill sales.

Second, this mechanism description relies on the completely unfounded assumption—not even acknowledged as such on the web page—that AF-related DNA adducts in urine correlate with cancer development. While it may be true, it’s by no means a sure thing; you can’t quantify cancer based on an adduct in urine any more than you can measure the amount of chocolate a child ate on Halloween by counting the candy wrappers in their bedroom trashcan.

The article concludes on a predictable note: the discovery of a gene that may explain why some people get liver cancer after AF exposure while others don’t:

In an effort to identify the genetic underpinnings of liver cancer, the Johns Hopkins University team has discovered mutations in a critical cancer gene, known as
p53,
in the serum of individuals who later were diagnosed with the disease. This discovery may eventually lead to new strategies for the detection, prevention, and treatment of liver disease in susceptible individuals.
²¹

To recap: Our medical research establishment, funded by our government, responds to the scourge of liver cancer by recommending we take a pill to reduce gastrointestinal absorption of a carcinogen that has been shown to have nothing to do with the disease, and by promising much more expensive research into gene therapy that may one day save us from our own faulty bodies. No mention of nutrition at all, unless you count it as a vehicle for a nutrient more easily obtained as a dietary supplement!

I worked for a time with the researcher who led the team at Johns Hopkins mentioned in the article’s conclusion. He is a chemist by training and, like most chemists, a reductionist in spirit. His journey into the question of what causes liver cancer began with a strong bias that the carcinogen AF is a major cause of human liver cancer (you’ll recall I also once thought this could be true, early in my career). Thus he was focused on monitoring possible AF contamination in food, which necessitated routine analyses of food. He also was quite excited about a potentially lucrative company that he and his colleagues were launching to do just this. In addition, he and other Johns Hopkins colleagues were setting up an NIH-sponsored clinical trial in China to test the assessment mentioned on this NIH webpage, that chlorophyllin and related drugs might prevent liver cancer.

It was at this point in his career that he collaborated with my research group as part of our project exploring AF’s connection to liver cancer. His laboratory had what I considered to be the best available method for analyzing urinary AF-to-DNA adducts as an estimator of AF exposure, and partnering with him enabled us to better assess its possible relationship with liver cancer mortality rates. Unfortunately for his interests (business and otherwise), there was no relationship—despite documenting AF exposure in three different ways and despite this being a more comprehensive survey on AF and human liver cancer than all other studies combined.
²²
He refused to coauthor the paper of these findings. Also, his intervention project, in which chlorophyllin was administered to people in rural China, was abandoned after about eight years of NIH funding with no results, to my knowledge.

However, none of this appears on the NIH webpage, and this absence opens the door to and even encourages a variety of lucrative business practices, not least of which are chemical assays to analyze for insignificant amounts of AF (as offered by the company the Johns Hopkins researcher was starting).

This is reductionism—and your tax dollars—at work. Rather than preventing cancer, the NIH’s approach actually serves as a psychological inoculation against true health: “There’s no need to change your diet. You can if you want, but it’s much easier and cheaper to take a pill. And don’t worry, we’ve practically solved the problem by identifying the liver cancer
gene. Just give us a few more years and we’ll have a cure.” Comforting words, with serious consequences.

This is the end result of all the political maneuvering and financial pressure we’ve looked at in this chapter, a version of reality shaped more by the profit agendas of Big Pharma, supplement makers, hospitals, surgeons, and suppliers of processed food and industrial meat and dairy than the truth. If these forces can so strongly influence the pronouncements of a powerful government agency supposedly looking out for our best interests, how can we trust our government’s guidance on how to be healthy?

When the search for truth is confused with political advocacy, the pursuit of knowledge is reduced to the quest for power.

—
ALSTON CHASE

W
hen we make a list of “good guys” in the area of health, surely that list is topped by those selfless societies dedicated to defeating disease and spreading the gospel of good health practices. I’m referring, of course, to patient advocacy and fundraising groups such as the American Cancer Society (ACS) and the National Multiple Sclerosis Society (MS Society), which raise money and awareness in service of cures for very serious diseases, as well as professional organizations such as the American Society for Nutrition (ASN) and the Academy of Nutrition and Dietetics (AND, formerly the American Dietetic Association, until January 2012), which provide the education, networking, and leadership opportunities their professional members need to be as effective at their
jobs as possible. But their donations and PR, their awards and fundraisers, just reinforce the system in which they are embedded—a system that lauds reductionist research and ignores nutrition.

The sad fact is that too many of these organizations are more likely to be found shilling for pharmaceutical companies and the food industry than advocating for patients or sharing scientific truths. And because these wolves clothe themselves in a sheepskin of selfless service, they are exceptionally good at pulling the wool over our eyes.

Patient advocacy groups like ACS and the MS Society ostensibly exist to eradicate specific diseases. The MS Society, according to its website, “helps people affected by MS by funding cutting-edge research, driving change through advocacy, facilitating professional education, and providing programs and services that help people with MS and their families move their lives forward.”
¹
Replace “MS” with “cancer” or “diabetes” or “heart” or any number of diseases or parts of the body and you’ll essentially have the mission statement of every such advocacy group. Professional medical societies have a similar goal; the main difference is their focus on a specific medical discipline, rather than on the particular disease or diseases that discipline treats. The AND, for example, “is committed to improving the nation’s health and advancing the profession of dietetics through research, education and advocacy.”
²
Both types of organization are as concerned with power and influence as they are with treatment and cure; the goal of most disease societies is to set themselves up as the “official” body that sets national policy on their disease, and professional societies typically seek the power to set standards and criteria for membership in their profession.

These organizations see their gatekeeper roles as very important for protecting the public from fraud and incompetence, but this gatekeeping can just as easily stifle innovative approaches and fresh paradigms. Viewed cynically, these organizations begin to look like monopolies seeking to maintain their power at the expense of those who would challenge their worldview. At the heart of every disease society and professional organization is an assumption about who is a legitimate practitioner and who is a “quack.” These assumptions are generally unspoken until a challenger arises with a treatment protocol or research agenda that contradicts prevailing wisdom—and the prevailing wisdom in these organizations, as it
is elsewhere in our health-care system, is the reductionist paradigm. As a result, despite the sincere efforts of many well-meaning people, these organizations actually get in the way of the treatment and cure of the very conditions they demonize in their PR and fundraising.

In a healthy system, these organizations, especially the nonprofit ones, would be independent, beholden only to their members and the patients they serve. However, the main source of funding that supports these organizations is, as with the other groups we’ve looked at these last few chapters, the pharmaceutical and medical industries.

These organizations depend on industry in several ways. Most are funded largely by corporate donations, and they inevitably bend their policies and messages to benefit these funders. Many partner with deep-pocketed companies who cosponsor events and initiatives that the nonprofit could not have pulled off without such partnership. And here, as between industry and the government, there is a revolving door that provides an additional incentive for nonprofit executives and researchers to tune their actions to an industry-approved key. Those same industries might hire them as lobbyists or “thought leaders,” also known as “key opinion leaders”—prominent physicians or medical researchers who have proven effective at influencing their peers—after their nonprofit stint ends.

Let’s take a closer look at some of these nonprofits: two disease societies and two professional groups with which I’m quite familiar.

The ACS is dedicated to eradicating cancer worldwide. They fund research, sponsor patient education, galvanize the public into action, and remove the taboos against mentioning “the C word,” all of which make the world a better place for cancer victims and their loved ones. The ACS’s courageous campaign against the tobacco companies has significantly reduced smoking rates in the United States, and has succeeded in stigmatizing tobacco use. So who would be so Scrooge-like as to impugn their work?
Say a word against them and people respond as if you’ve confessed a fondness for cancer. But the ACS is one of the big obstacles to reducing cancer rates in this country. Called “the world’s wealthiest non-profit” by Samuel Epstein, author of the 2011 book
National Cancer Institute and American Cancer Society: Criminal Indifference to Cancer Prevention and Conflicts of Interest,
³
the ACS guides hundreds of millions of dollars per year into cancer screenings and medical research, and almost none into research or advocacy about diet. While Epstein’s book focuses on environmental causes of cancer at the expense of nutritional ones, his exposé of ACS duplicity and conflicts of interest is required reading for anyone still under the ACS’s spell.

If you were in charge of a wealthy and powerful organization dedicated to eradicating cancer, what would you want its positions on cancer research to look like? Mine would begin with a research program designed to understand the natural biological complexity of this disease, and then would try to take advantage of nature’s tools to restore health. I’d encourage a wide diversity of research: reductionist and wholistic, mechanistic and dynamic, palliative and curative, reactive and preventive. (The more varied the research and interventions, the greater the chance of discovering something new—of stumbling upon a true breakthrough.) And I’d spend the vast majority of the funds I was given attempting to inform the public about what we do know regarding the role of nutrition in the prevention and treatment of cancer. By contrast, the ACS looks for simple solutions involving chemicals used to selectively kill cancer cells, a synthetic approach that ignores nature’s means of restoring and maintaining health. In these aims, the ACS is indistinguishable from the PR departments of companies like AstraZeneca, the pharmaceutical company that has funded the ACS’s breast cancer awareness drives, and, not coincidentally, manufactures and markets several breast cancer drugs; and Amgen, the biotech firm whose CEO, Gordon Binder, served as an ACS board member. In addition to AstraZeneca and Amgen, the following companies are on the ACS “Excalibur Donor” roster, signifying annual contributions of $100,000 or more: Big Pharma companies Bristol-Myers Squibb, GlaxoSmithKline, Merck, and Novartis; and biotech company Genentech.
⁴

With one exception—the ACS’s laudable and successful multi-decade crusade against smoking—the research and advocacy ACS funds is all about “preventive screening” (since when is a diagnosis of a late-stage
existing condition considered prevention?) and molecular mechanisms of cancer development that might lend themselves to the latest toxic drug or genetic manipulation.

Mammography, the most common and lucrative form of breast cancer screening, is one of the pillars of ACS practice and philosophy. Epstein points out that five past presidents of ACS have been radiologists, and DuPont, a manufacturer of mammogram film, heavily funds the ACS Breast Health Awareness Program. The ACS’s Breast Cancer Awareness Month culminates with National Mammography Day, an event underwritten by their corporate sponsors. ACS not only heavily promotes mammograms, it also ignores government guidelines on breast cancer screening when those guidelines threaten the pocketbooks of their sponsors. In 2009, the U.S. Preventive Services Task Force found that the risks of annual mammograms outweighed the potential benefits in women under 50 and so recommended routine biannual screening starting at that age.
⁵
The ACS, beholden to the radiation industry, still promotes annual mammograms for women starting at age 40.