“War on Cancer” Book Elicits Warring Reviews

By Dick Clapp

There were two reviews of Devra Davis’s new book, The Secret History of the War on Cancer (Basic Books, 2007), published in Lancet journals last month. One was in the November 24 issue of the Lancet and the other was in the November issue of Lancet Oncology. They are so diametrically opposite that one wonders if the reviewers had read the same book. The Lancet review is by Peter Boyle, the current director of IARC (the International Agency for Research on Cancer) – an agency that is widely respected but whose recent report on attributable causes of cancer has raised some eyebrows among cancer researchers. Boyle’s review is a broadside against the book that starts with “Devotees of conspiracy theories and aficionados of gossip and innuendo will be drawn toward this book like wasps to a juicy piece of meat.” The review by Fred Pearce, a well-known environmental consultant and science writer, starts with “This is a clash of titans.  Not between mankind and cancer so much as between the clinicians and chemical companies on one side, and the environmental and public health people on the other.”

In his dismissive tone, Boyle goes on to say that Davis’s book describes “industry cover-ups, hidden consultancies. . . tittle-tattle, and accusations about the conduct of famous names. He jokes that it “only lacks the steamy sex section, but perhaps this is being held back for a further volume.”  He complains that Davis has not done her research properly, not provided sufficient evidence to support her thesis, and misstated the date of a momentous episode at IARC – this last item being a minor mistake that Davis readily admits she made.

In a contorted defense of Sir Richard Doll and his research on tobacco and cancer, Boyle claims that Davis is asserting that “if you believe that tobacco smoking is a major cause of cancer then ipso facto industrial and environmental exposures are not.”  Nothing could be further from the point of The Secret History, though. Davis goes to great length to point out that both things are true, i.e., that smoking is a major cause of cancer and industrial and environmental exposures are, too. As Barbara Ehrenreich has pointed out, dialectics is the ability to hold two thoughts in your head at the same time; Devra Davis obviously is capable of doing this, but it is not clear that Boyle can manage it.
  
Fred Pearce notes in his review that Davis met with Sir Richard Doll, and was persuaded that smoking was indeed one of the major causes of cancer, but was not persuaded by his assertion that much of the “seeming post-war epidemic of cancer in the west could be explained by better diagnosis.”  In fact, Davis examined this carefully, as she explains in her chapter on “Deconstructing Cancer Statistics,” and proved that Doll’s assertion is not borne out by the data.  Pearce notes that Davis is a “feisty and highly accessible writer” and that she does not shy away from pointing out some inconvenient truths about who knew about environmental causes of cancer and chose to suppress or diminish their importance for dubious and sometimes cowardly reasons.  Pearce then points out that Davis worked up the courage to expose these truths, and “we can be glad that she did.  Others have, of course, hinted at this ‘secret history.’ But nobody before has laid it out in such detail – and from within the research establishment.”

In my view, it is this latter point – the fact that Davis has worked within the research establishment for most of her professional life – that makes her book particularly powerful.  Her first-person account of her explorations of the scientific evidence and the prejudices and limitations of many of the researchers in the mainstream cancer institutions provide rare insight into our dilemma.  We, in the industrialized countries, have privileged the research effort aimed at treating cancer once it has occurred, and undervalued the effort to prevent carcinogenic exposures in the first place.  Devra Davis’s book is a welcome addition to the struggle to correct the imbalance, and, as Fred Pearce says, “is a rattling good read and raises vital issues that remain relevant today.”

Dick Clapp is Professor in the Department of Environmental Health at Boston University School of Public Health, and co-Chair of Greater Boston Physicians for Social Responsibility. Dr. Clapp served as Director of the Massachusetts Cancer Registry from 1980-1989 and worked in two environmental health consulting groups in addition to his teaching and research activities. He was a consultant to the U.S. EPA Science Advisory Board in its 1995 and 2000 reviews of the dioxin reassessment.