Cancer: 'Of course; but maybe'

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Nick Johnson, guest columnist

Louis C.K. has a stand-up bit he calls, “Of Course ...; but maybe ...”

The Cancer Moonshot Summit June 29 brought it to mind.

Vice President Joe Biden has been tasked with accomplishing ten years of cancer progress in the next five years.

Louis C.K. hasn’t used “Of course ...; but maybe ...” regarding health care, but he could. Here’s my example, based on UNICEF’s reporting one billion people “don’t have a safe water supply within fifteen minutes’ walk” and “a lack of clean water and basic sanitation is responsible for 1.6 million preventable child deaths each year.”

“Of course, we should develop more medicines to treat children’s diseases from impure water. Of course. We should provide medicines and personnel to help those children. Of course, we should. But maybe, just maybe, we should also provide those children easy access to pure water and sanitation facilities.”

The Cancer Moonshot program, and Vice President Biden’s speech at the Summit, almost exclusively focus on the detection and treatment of the roughly 200 forms of cancer.

Most of the 20 “activities to support the goals of the Cancer Moonshot” involve drugs — easing and speeding their discovery, clinical trials, patents, and patients’ access. There is genetic research, and the search for effective and less toxic therapies. Some are efforts to improve communication and coordination between agencies, institutions, researchers and doctors, the creation and sharing of big data and the Genomic Data Commons, and speeding up information distribution.

“Of course, we should launch a Cancer Moonshot, find a cancer cure, and alleviate patients’ suffering from cancer and its treatment. Of course, we should support doctors’ research. Of course. But maybe, just maybe, we should devote at least as much in the way of personnel and resources to discovering and eliminating the carcinogens to which we are all exposed.”

When Washington Post reporters Bob Woodward and Carl Bernstein set out to understand and report the story of the 1972 Watergate break-in, one of their most useful sources was FBI Associate Director Mark Felt — known only as Deep Throat until he revealed his identity in 2005.

Never direct or fulsome, Deep Throat’s suggestions sounded more like those in a Zen master’s koan. One of his most useful was, simply, “Follow the money.”

It’s equally useful advice in our search for cancer’s causes.

Who profits from cancer? Not who profits from researching and treating it. Who profits from causing cancer?

Major causes of cancer are carcinogens — substances in our homes, workplaces, air we breathe, water we drink, and food we eat.

The National Institute for Occupational Safety and Health lists 132 known carcinogens — just in the workplace. Physicians for Social Responsibility provides 10 categories of carcinogens and their cancers.

Virtually all carcinogens are the products or byproducts of corporations. In addition to which there are 100,000 additional substances we ingest that haven’t even been tested — thanks to a subservient Congress.

The tobacco industry hooks junior high kids (the “replacement smokers” for the 400,000 it kills annually) on its cancer-causing product with addictive nicotine.

But most of our exposure to corporate cancer results from neither our choice nor a corporate executive’s homicidal tendencies. It’s the result of our unawareness, congressional subservience, and corporate executives’ everyday profit maximization (carcinogens may be cheaper than safe alternatives), apathy, or ignorance.

“Of course, we should support cancer research and treatment. But maybe, just maybe, we should also go after the corporations that are contributing the carcinogens that cause the problem.”

• Nicholas Johnson was the co-director of the former University of Iowa Institute for Health, Behavior and Environmental Policy. Comments: nicholasjohnson.org

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