Using Darwin's Theory Of Evolution To Design Cancer Treatment

The recent finding that early signs of cancer can appear years or even decades before diagnosis, bears directly on the types of treatment to deal with it.  This revelation  according to the most comprehensive investigation to date of the genetic mutations that cause healthy cells to turn malignant.  (These findings, based on samples from more than 2,500 tumors and 38 cancer types, reveal a longer-than-expected window of opportunity in which patients could potentially be tested and treated at the earliest stages of the disease.) The study revealed that about half of the earliest mutations occurred in just nine genes, meaning there is a relatively small pool of common genes that serve as triggers for cells to diverge from healthy development to a path towards cancer.

In the words of one co-author of the research (Peter Van Loo)  based at the Francis Crick Institute in London:

"Unlocking these patterns means it should now be possible to develop new diagnostic tests that pick up signs of cancer much earlier."

The work was carried out as part of the Pan-Cancer Analysis of Whole Genomes project, the most comprehensive study of cancer genetics to date.  The import and significance of this finding coincides with the push toward a different sort of treatment modality - based on the principles of Darwinian evolution.  This  novel approach to cancer treatment has now come on stream and is using lessons from Darwin’s theory of evolution.  (WSJ, Jan. 9, p. A12)

The unique approach is called adaptive therapy,  and stems from the recognition that cancerous cells, just like other forms of life, mutate and evolve in response to a changing environment. Traditional cancer treatments— such as I've had with high dose radiation for prostate cancer- continuously bombard cancer cells - but can encourage drug-resistant cells to multiply, eventually creating an untreatable tumor.

Well, I didn't develop an "untreatable tumor" but a resistant one, with resistant cells, which then had to be subjected to focal cryotherapy (freezing them to nearly 90 below zero) for a secondary treatment, e.g.

Fighting Prostate Cancer At -90 C: My Cryo-thera...

By contrast, adaptive therapy doesn’t try to eradicate the entire cancer like my brachytherapy treatment did (using Ir 192) . Instead, it seeks to reduce the treatable cells, stop treatment, the wait for those cells to grow back before treating them again.   Well, interestingly, in a way that's what I did, what happened to me. I had the original adenocarcinoma bombarded by high dose radiation in September, 2012.  The tumor then grew back as diagnosed from rising PSA and an MRA scan  e.g.

What I Got Wrong About My MRI Fusion Biopsy

It was then re-treated with the cryotherapy but now five years after the original therapy.

It is possible then that presence of the treatable cells kept the resistant cells at bay, as they competed against each other for resources. The idea, for now (for me) is to keep the size of the tumor in check  (disclosed by PSA and MRI if needed) and manage the cancer as a chronic condition.  In fact, most oncology now is changing to accepting prostate cancer as a chronic condition and not a "one off" anomaly to be cured.   (And if you've read the stories of all those whose cancers have returned after radical prostatectomy you'd see why)

In the larger, more generic sense, adaptive therapy as a concept is still largely experimental, and experts caution that it needs more trials with larger groups of patients. A few doctors are starting to bring the idea into practice—primarily for late-stage, incurable cancers. But a  growing number of researchers are paying attention and looking at cancer through an "evolutionary, survival-of-the-fittest perspective."  (WSJ, ibid.)

Robert Gatenby, the co-founder of Florida-based Moffitt Cancer Center’s new Center of Excellence for Evolutionary Therapy, is a pioneer in the field and driving the bulk of the work in the U.S. on adaptive therapy. He is also a co-author on a small, pilot study, with initial results published in 2017 in Nature Communications, that showed that patients lasted at least 27 months on average without their tumors growing, compared with the usual 16.5 months, while receiving less of the same drug. 

Dr. Gatenby, who had a background in physics before going into medicine, often points to pest control to describe therapy, and others in the field have picked up the analogy as well. In pest management, managers often don’t try to eliminate all of the insects but instead reduce their numbers, keeping the spray-sensitive bugs around to compete against the resistant bugs. Pest management developed the technique after overusing insecticides, which eliminated most of the insects. But some resistant bugs came crawling back.

Quoted in the WSJ piece, one oncologist opined:

“I think pest managers are about 30 years ahead of the oncologists,” 

To be sure, evolutionary oncology, is decades old but it has gained more clinical traction in recent years as mathematical modeling has better enabled researchers and mathematicians to predict how tumors will change in response to specific treatments.  According to Christine Iacobuzio-Donahue, director of the David M. Rubenstein Center for Pancreatic Cancer Research at Memorial Sloan Kettering Cancer Center, who researches cancer genetics:

“The field is small but it’s growing.  Right now, people hear evolution and cancer and it’s intellectually stimulating, but we want to get past intellectually stimulating and save lives.”

Nonetheless,  the idea of not completely destroying a cancer isn’t always easy to sell, especially since cancer research and treatment has focused firmly on a cure for decades.  A misplaced emphasis in my opinion, given how many patients are devastated - especially after having a radical surgery that destroys their sex lives (as in RP) and then learn the prostate cancer has returned.   Certainly, if many cancers are now found to originate earlier than believed it makes sense to keep treatment "powder" dry, until really needed, in line with the Darwinian adaptive solution.

Although the mathematical modeling predicted that the optimal time to halt treatment would be after the tumor had shrunk by 25%, the researchers decided to wait until the tumor had shrunk in half to make the concept more palatable, said Alexander Anderson, the chair of the Integrated Mathematical Oncology department at Moffitt, who works closely with Dr. Gatenby

The Moffitt pilot study originally enlisted 11 patients with late-stage, metastatic prostate cancer that was resistant to earlier treatments. The patients were put on the drug abiraterone, or Zytiga, and researchers tracked the tumors by monitoring the  PSA  (prostate specific antigen) in  their blood.  Once the PSA levels drop by half, the doctors halted all treatment until they rose again.    This is a smart approach that directly reflects the adaptive method. (See top graphic)   As we learn in the piece:

"The treatment length was patient-specific: Some patients cycled through the treatment regimen every few months, while others took longer. At least one patient was able to go without the treatment for over a year. Patients, on average, lasted 27 months without tumor progression by the time the initial results were released. Dr. Gatenby says that the continued treatment has extended that average to 33 months, and the project expanded to 20 patients.

The patients also cumulatively reduced the use of the drug to roughly 40% of standard dosing, Dr. Gatenby says, meaning they spend less time dealing with side effects. One month of the drug can cost upward of $6,000, according to the paper, so a pause in treatment can also save a patient thousands of dollars."

This is also the plan I intend to use if and when the currently contained PSA roars back and I may need hormone treatments, or androgen deprivation therapy. So, as I informed my primary care doc, I plan to postpone beginning ADT  until I become symptomatic and then cut it off after 6- 12 months, by which time the most grievous side effects (such as enlarged breasts, cardiac issues, weight gain, cognitive decline etc.) should subside.

It will also provide an adaptive attack plan, such as described in the graphic shown at top, where the drug (e.g. Casodex) eliminates some of the sensitive cells but not all.   The remnants to be cleared out or contained in subsequent administrations.  Interrupting- limiting  Casodex therapy is a good idea in any case, to spare metastatic prostate cancer victims some of the worst side effects, including being reduced to mental vegetables!

See also:

https://www.cnbc.com/2020/01/17/america-is-about-to-get-a-powerful-tool-in-the-war-against-cancer.html

Never Go On A Prostate Cancer Forum And Suggest PSA Screening Cost Control - You'll Be Seen As an Emissary Of The Grim Reaper

Barbara Ehrenreich is trying to get more oldsters to just accept death instead of getting more and more screening tests in old age which often pave the way for treatments that can have more dire consequences than the disease they're designed to control.

Jeez, I don't know. I did my best some two weeks ago to convince oldsters in a prostate cancer forum (Team Inspire)  to stop getting PSA screening tests, and they greeted me like I had the plague. What the hell gives? All I was trying to do is get the nation's medical costs down and we know geezers use up more expensive medical care than any other demographic, up to $500m / yr. of which $150 million is spent in the final month of  life.  Consider: In the 10 years since the financial crisis that works out to a total of $1.5 billion spent in the final month of life.

Why not just be done with that crap and as Barbara Ehrenreich puts it (The Nation, 'The Great Equalizer', October, p. 32):

"No matter how much effort we expend, not everything is potentially within our control, not even our own bodies and minds. In death we will once again be equals - and so an egalitarian politics also means accepting this outcome.

You can think of death bitterly or with resignation, as a tragic interruption of your life, and take every possible means to postpone it.  Or, more realistically, you can think of life as an interruption of  an eternity of personal nonexistence, and seize it as a brief opportunity to observe and interact with the living, ever surprising world around us."

Of course, most Americans are squeamish in terms of death - even discussing it, tending toward euphemisms- and more likely to buy into the codswallop of the longevity researchers. That would be a clique of life extension quacks and fanatics  (many of whom have M.D. or Ph.D. behind their names) who believe many of us could even live to 142, e.g.

http://brane-space.blogspot.com/2015/03/no-this-baby-wont-be-living-to-142.html

Ehrenreich herself got her wake up call in the course of writing her last book, 'Bright -Sided' in which she used her own breast cancer diagnosis as the basis for a striking critique of the whole "positive thinking" twaddle. In this case, puncturing the trope that people with cancer (like me, prostate cancer) are most likely to survive if they keep thinking optimistically about recovery.

Then in her latest book;  'Natural Causes: An Epidemic Of Wellness, The Certainty Of Dying, And Killing Ourselves to Live Longer' ,  she blows the lid off - revealing the body's macrophages as the ultimate 3rd column enemy.  While in normal conditions they are the body's 'blue collar workers' - disposing of dead and injured cells, acting as a vanguard of defense, they can also quickly deviate into a more sinister role - as when they aid and abet  cancerous growth. In that case,  "they serve as cheerleaders of death accumulating at the site of cancerous tumors and encouraging their growth".

Beyond a certain age, in fact, the battle against mortality becomes essentially futile. In the case of prostate cancer it arrives with what's called "castration resistance".  That is, despite the fact testosterone levels have plummeted from hormone therapy, the PSA continues to rise. No further PSA testing will provide any useful info, say to save your life. (One of the reasons for this resistance is that prostate cancer cells are capable of making their own testosterone, hence driving prostate specific antigens higher. Macrophages in action!)

As the latest AARP Bulletin notes ('Should I Get Tested?', November, p. 21), citing research by Kenneth Lin, M.D.,  based at Georgetown Medical Center:

"No study has shown a decrease in overall mortality with PSA screening for men of any age".

In other words, in terms of the statistical data applied to a vast population of men spanning the age spectrum (of whom 1 of 6 get prostate cancer), the PSA test doesn't make a dime's worth of difference. I take that back, it makes a lot of money for the urologists and testing labs (est. $760m a year, according to one research report on controlling costs for these tests)

Besides which (ibid.):

"The screened groups had much higher rates of complications, including impotence and incontinence.  Indeed, the chief sponsors of PSA testing are diaper manufacturers."

(Aside: Of course the preceding presumes one acts on the screening result. Also, at least one PSA test ought to be taken by every guy 50 or older to at least get a baseline for future reference.  My arguments here mainly apply to 70 or over guys who get screening tests 2 or more times a year - often paving the way for more severe treatments, with more complications  - e.g. urinary stricture, fistula etc.)

With this info in hand from a separate source- an email from the UC Berkeley (n a Cancer Health Alert)  I  posted the following to the 'Team Inspire' Prostate Cancer Forum under the header: "Stopping PSA Tests After Age 70":

"Most experts agree that people with a life expectancy of 10 years or less don't need routine screening for cancer. One problem is that overscreening can lead to overdiagnosis and overtreatment. For instance, a screening might find a slow-growing cancer that wouldn't cause any harm within a person's lifetime if left undetected, a situation that's common with prostate cancer. If that's the case, it's not worth the burden and anxiety caused by testing and the potential for more—possibly invasive—follow-up procedures.

Yet, according to published studies, too many older adults continue to undergo unnecessary cancer screenings despite age- and health-related recommendations from professional groups.

Three groups that have weighed in on prostate cancer screening are the National Comprehensive Cancer Network (NCCN), the United States Preventive Services Task Force (USPSTF), and the American Urological Association (AUA). Following are their current recommendations for when to stop:

•The NCCN recommends ending routine PSA screening at age 75 for all but very healthy men with a significant life expectancy, who are most likely to benefit from detection of aggressive tumors.

•The USPSTF discourages men 70 and older from undergoing prostate cancer screening.

•The AUA recommends against screening men who are 70 and older. However, it notes that men of that age who are in excellent health and have a life expectancy of at least 10 years may benefit from the test.

Other professional organizations have also issued guidance on PSA screening. Clearly, there are no hard-and-fast rules. You and your doctor can use the screening recommendations as a guide, but the decision should be tailored to your overall health, personal preferences, and personal values."

The responses were fairly immediate and included such choice rejoinders as:

"What are you a politician running for office? An insurance company agent? I am sick of you guys coming in here and trying to tell us to try to control costs and not to get these tests! I don't care how much they cost, even if I'm 78 I am gonna get them! Maybe I want to live to 95!"

"I'm in no position to contradict medical science on this, but 70 seems a bit young. Yes, it leaves a "life expectancy" of 10 years (in 2018, living in the U.S., given today's technology), but healthy people with good genes and healthy  lifestyles routinely live well into their 90s. My G4+5 was discovered when I was 59. What if it had been 12 years later? Answer: a horrible death from PCa, diagnosed only after I became symptomatic, and far too late to treat it."

"I'm in favor of knowing what's going on if there's a good chance that making a decision based on that knowledge could make an important, positive difference. "

"Of course, I'm not in favor of overtreatment, especially of PCa because of the horrific effects on patients' QoL. To me, it's bizarre that something like ADT exists in the world; it's almost as if it's from the 16th Century, before reason and science began to enter human discourse (if she drowns, she was innocent; if she survives, she's a witch)." 

This 72-year old  - who cited the savagery of ADT -  is spot on.  (ADT is among the most barbaric of therapies given it basically destroys what makes a man a man, biologically, i.e.  https://www.youtube.com/watch?v=KtIfsvQh2qI )

In a later post he did note a better alternative - with less horror inflicted on the male body: using transdermal (Estradiol) patches.  

The 75-year old who invoked "good genes" is living in fantasy land.  The latest research, with data extracted from some 400 m people, discloses that genes are responsible for less than 7 percent of life expectancy.  This trumps the (up to ) 30 percent from previous studies. (He does have a point in getting tested at age 59).

The character who thought I was a politico ("running for office")  or insurance co. person out to gut his right to get as many screening tests as he wants is just plain paranoid. I suspect he maybe needs some brewskies or MJ candy.

 Re: The Estradiol patch mentioned, this may also be one of the few options left for me if the cancer spreads. The latest PSA - at my primary care doc's orders -  saw a spike from 2.1 last Oct.  to 4.0  last month. So it increased at the rate of 0.1 ng/ml per month for 6 months, since my focal cryotherapy in July last year.  It then increased at nearly 0.2 ng/ml per month since the previous test in April.

So I am back at the watchful waiting stage and will definitely get an MRI once it hits 6.0 - if it does. My PC doc  was gratified to hear that! 

Another option, which I suggested in a later post, was first broached by Dr. Betrand Tombal, Chairman of the Division of Urology at the Cliniques universitaires Saint Luc and Professor of Urology at the Université Catholique de Louvain (UCL) in Brussels, Belgium.  This was based on an interview given in the online journal Prostapedia   Therein, Dr. Tombal indicated he advised patients with soaring PSAs to try the ADT or other hormone therapies, and if side effects (abbreviated SEs) proved too much to just stop them.  A final alternative I also cited - based on recent research (published in the Scientific American text on Prostate  Disorders) is to just wait to commence ADT until there is actual cancer metastasis.

This sounds crazy in a sense, but as I  learned (p. 70):

"Starting hormone therapy before a man has symptoms of cancer metastasis is a mistake. This take is underscored by the fact that hormone treatment doesn't cure prostate cancer and it causes side effects such as erectile dysfunction, hot flashes, type 2 diabetes, weight gain, heart disease and osteoporosis."

IN a related study, it was found that the rate of deaths for  those 70-plus on hormone therapy was twice as  likely to be from myocardial infarction than the cancer.  All of which elicits the question of how do you pick your time (and mode)  of croaking?  Because it is coming, and if you're past 70 with aggressive prostate cancer, probably before you hit  80 or 82.  

Those guys talking about living into their 90s or to at least 95 are also in economic la-la land .  Most Americans today haven't even got sufficient money to live to 75 far less 90 or 95. As a recent article in MONEY  magazine noted (November, p. 44):

"At just 2 percent inflation the gallon of milk that cost you $3.75 today will cost you $6.79 in 30 years."

If you think that's a lot, think of the cost of medical  and dental care, rents,  home prices, or buying a car. Or of anything - any kind of product.   Where are all these guys going to get the money, especially as corporations today want no part of them?

Despite the dismal economics, all the guys over 70  on the survivor group were adamant that giving up PSA tests would be like "driving without a gas mileage indicator".  Which, of course, is bull pockey.  One character  nicknamed "Cycling guy" actually bragged at having four focal cryotherapies, e.g. with estimated cost at $55,000 each mostly paid by Medicare. 

For which the risk of fistula, hemorrhage etc.  increases each time. Then, when those treatments didn't work he bragged about getting an orchiectomy (removal of the testicles)  He swore he prevented turning into a freak (with gynecomastia)  or eunuch by getting testosterone shots later and claimed his significant other regards him like John Holmes reincarnated.  He then had the temerity to post: "Gee, guess I'm one of the lucky ones!" But not so fast there, Bud.

In the end, irrespective of how resolute he is in fighting this cancer, Cycling guy will lose - that is,  once the macrophage "death cheer" creeps in - and it will. By that time, it is likely he (or rather the gov't)  will have spent some half a million bucks - including for hospice care- to grab maybe 3 extra years of life. Is this foolishness?

Yeah, I think so, but that's me. I am still wrestling with what choices I may have to make in the coming year - and also whether living an extra year or two  is worth it - as a mental vegetable with huge "man boobs", 5x higher cardiac risk, diabetes and shrunken genitals ("they are reduced to prepubescent stage" according to one researcher).

In the end, what's missing in the conversation for all these screening tests - including the predictable docs' demands for expensive follow up treatments- is how to deal with death in American culture. That is,  re-educating citizens not to continually run away from it or obsess over absurd longevity ideations. This take was validated most recently in the same MONEY magazine issue, (pp. 41-50) , showing a 100-year old geezer (Orville Rogers) who runs every day and lives the "life of Riley" at a retirement center, e.g.


Folks, do not be deceived by such fanciful longevity B.S. This guy is the exception and not the rule, especially as he "retired at age 60" according to the piece. Which then went on to admit retirement planners are losing sleep over the amount ($195k)  most 65 year  olds currently have socked away. 

 Most important, since nature often operates randomly and isn't guided by individual choices, we need to act in concert to equalize health outcomes for all citizens.  Alas, that may mean - to enable younger people to get the care they need- we oldsters let go of the fantasy of trying to live to 95 or 100.  Besides, just because 5 or 6 percent can do it - like good ol' Orville-  doesn't make it a valid aspiration for us all. 

Contemporary society, as Ehrenreich writes, is "so deeply invested in the idea of an individual conscious self that it becomes both logically and emotionally impossible to think of a world without it."  In Ehrenreich's view there is one time-honored balm for the anxiety of approaching self-dissolution. And it isn't more chemo, more lab tests more cryotherapy or getting your balls cut off to fight prostate cancer at age 79. No, it is "submergence of oneself into something larger than oneself".

For most Americans, like the guys in the prostate cancer forum, a truly alien concept.

Yes, Truth Is A Casualty In The "War On Cancer"

Prostate image yielded as part of 3D staging biopsy with cancerous lesions in mud yellow, urethra in green. This is completed prior to focal cryotherapy treatment  - where a cryo-probe at -90C is inserted into the perineum to freeze cancer cells.  The procedure can last from an hour to an hour and forty five minutes. But no promises are made to rid the cancer entirely.

Steve Salerno, in his WSJ article ('In The War On Cancer Truth Becomes The Casualty',  p. A13, April 21-22) is adamant that cancer patients are being sold a bill of goods via phony TV ads where "the multimillion dollar industry appeals to emotion".  He wrote this after seeing an M.D. Anderson ad proclaiming:  "Come to us and you will beat  cancer "  i.e. rendered in red strike through to reinforce the point.

Salerno emphasized there were "no asterisks" and "no disclaimers" - viewing the ad as exaggeration to prey on false hopes.  After all, those with cancer are often desperate to get rid of it, get the proverbial "cure", so if a promise (by a reputable medical center)  is made to "beat cancer" that's interpreted as getting the job done. And why not, given "Cancer Inc's denizens will compete for an estimated $207 billion in 2020.."  So "it is less a war on cancer than a war on truth - and on vulnerable consumers."

Salerno continues:

"The most comprehensive study of such advertising, published in the Annals of Internal Medicine in 2014, notes that cancer treatment ads as a class rely on emotional appeals evoking hope or fear, while pointedly eliding useful information. Eighty -eight percent tout treatments and only 18 percent mention screening even though early diagnosis is more critical to survival than the interventions romanticized on TV"

Which is absolutely true.   For example, by the time my youngest brother Mike was diagnosed with stage IV liver cancer in early May he'd already run out of time for any useful treatments. The  most discriminating screening test - the liver biopsy -   was just too late.   His oncologist informed him-  soon after the grim  diagnosis -  that he could provide "palliative" treatment and  keep him alive an "extra few months" by use of radiation plus chemo, "but there would be side effects."  Mike wanted nothing of it, and said flatly 'No!'   He could not be moved to struggle for a further month or two,  expending a lot of money for useless treatments,  knowing his time was up anyway.

In my case, with prostate cancer, I also know the clock is ticking but I am not sure how fast. Having had high dose radiation in September, 2012 as a first treatment then focal cryotherapy as a salvage treatment last June, all I know is what the further screening tests have disclosed: that is a PSA of 2.7 at the end of April, and free PSA of 4.1 % - which indicates a more than 70 percent probability the cancer is still there - in other words it hasn't been "beaten" yet.

When I  asked the UCHealth NP, Kristen. : "Why has it seemed to come back?" She replied, "Well, it happens!"  Perhaps, but perhaps you guys never had it as much  under control - or treatable (especially with a focal therapy) -  as you assumed! After all, prostate cancer is a multifocal disease.

Even if we adhere to the most judicious diets and avoid all meats, alcohol, smokes etc. there is absolutely no assurance of continued wellness to the point of escaping all diseases such as cancer. Nor, I will add, is there any assurance that ANY prostate cancer treatment - even the "gold standard" radical prostatectomy - can ultimately beat it.  When one reads the litany of complaints on the Team Inspire prostate forum it is totally disheartening.  Forum members have referred to treatment after treatment:   RP, EBRT, HIFU, HDR brachytherapy, focal cryotherapy, proton beam - but none  working with finality. Well, let's amend that a bit:  maybe there is a 0.5% success rate, i.e. 0.5 % of guys who come away from said treatment and find no recurrence afterward.  That includes no more rising PSA, no more low free % PSA, no more need for invasive biopsies.

In other words, in the "war on cancer' there are very few ultimate victors, at least with prostate cancer and I suspect with many others.  One Team Inspire member actually insisted that "with so many different treatments it's obvious the oncologists and urologists know little or nothing."  An extreme take but it illustrates the level of frustration after getting a professed "excellent treatment" then having it come back.

Thus, all the ads bleating  about "beating it" are mostly fulsome rubbish fed to people desperate to be rid of it.  The ads then are more inundated with false hopes than realistic expectations, and cancer patients - at least those with prostate cancer - are starting to figure that out.

At the center of the hopelessness of fighting the disease is Barbara  Ehrenreich's research on immune cells as a Ph. D. student in the 1960s, specifically on  “macrophages".  Her research led her to drop the  rose tinted glasses of hope and finally grasp these cells originally viewed as friends – frontline defenders against microbial invaders-  had been exposed as traitors. They were "biological double agents" for their role in cancer and autoimmune diseases. Hence, one of her basic "wellness" beliefs was shattered early and with it all the associated hokum and delusionary twaddle. . If one's body can attack itself, then why bother trying to look after it? At least to any assiduous, extreme extent?
 
Much of this was exposed in her new book, Natural Causes: An Epidemic Of Wellness, The Certainty Of Dying, And Killing Ourselves to Live Longer')   Such discoveries led Ehrenreich to conclude once one reaches the mid-70s, then extraordinary life preserving measures as well as screenings ought to be off the table. Let it go already! 
 
As even Salerno puts it (ibid.):

"The war on cancer is not the place for pep talks and poetic license. We could do with more disclosure, less delusion. "


But the other side that needs less delusion has to do with the covert nexus of the "cancer industry" and its components, agenda.  What is the "cancer industry"? According to Breast Cancer Action, quoted by Lauretta Schwarz -Nobel in her book,  Poisoned Nation, St. Martin's Press, 2007:

"The Cancer industry consists of corporations, organizations, and agencies that diminish or mask the extent of the cancer problem, fail to protect our health or divert attention away from finding the causes of breast cancer...this includes drug companies that, in addition to profiting from cancer treatment drugs, also produce toxic chemicals that may be contributing to the high rates of cancer in this country and increasing rates throughout the world. It also includes the polluting industries that continue to release substances we know or suspect are dangerous to our health, and the public relations firms and public agencies who protect these polluters.

The Cancer industry includes organizations like the ACS that downplay the risk of cancer from pesticides and other environmental factors and which have historically refused to take a stand on environmental regulation".

This take on concealing the extent of the cancer problem, especially in terms of chemical toxins and their effects, was first broached by Devra Davis in her 'Secret History of the War on Cancer'.  She courageously exposed the PR underbelly of the American "Cancer wars" and their beneficiaries (see. e.g. Chapters 1-4), while also naming the American Cancer Society as having conflicts of interest and mixed motives (Chapter 5, 'Fear Sells').

Davis notes that people get told over and over (by the likes of the ACS and their physician apologists) that "too much fat" is causing their cancers - whether of lungs, bladders, prostate gland or breasts - and hence they bear greatest responsibility.  Never mind the evidence from more than 80 years of cumulative data which discloses it's chemicals in the environment that contribute more than fifty times as much.  

By contrast,  Ms. Schwarz -Nobel pulls no similar punches. She not only names environmental toxins and the chemical industry as the biggest culprits in the cancer explosion (she notes breast cancers have increased 300% since the 1960s) but shows in her (named) Chapter 6 that one of the biggest cancer drug producers (Astra Zeneca) ALSO produces one of the most toxic herbicides around, acetochlor. See also my earlier blog on Toxic America: http://brane-space.blogspot.com/2011/10/america-toxic-1.html

I point all this out because this is the major delusion in terms of the cancer wars, imho, not the TV ads blabbering false hope and bunkum.  If we don't know the extent of the agents that are connected to cancer then there is little chance of proactively avoiding them, and the necessity of getting so many screening tests (at the cost of tens of billions of dollars a year) in the first place.

Schwarz -Nobel asks, as every thinking American ought to, how it is that a multinational that manufactures one of the worst known carcinogens (p. 107) can also be manufacturing cancer treatment drugs. How can you basically be causing cancers and treating them at the same time?

Referring to AstraZeneca, the author points out:

"According to Sierra Magazine, '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". AstraZeneca is also the world's third largest drug concern, valued at $67 billion."

She then goes on to quote a Dr. Samuel Epstein from the same Sierra piece (ibid.):

"This is a conflict of interest unparalleled in the history of American medicine."
And further:

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

Clearly, the exposure of these hidden connections is the truth that needs to come out in the ongoing cancer battle, including the funding of treatments. At the end, we should not be funding companies if they are causing cancers at the same time as offering treatments. 

See also:

http://brane-space.blogspot.com/2018/07/guarding-against-cancers-in-pruitt.html