From The Times Literary Supplement, January 30, 2008

Theories of cancer

How paradigms shift and culprits change in the fight against the 
disease, and what concerned citizens can do about it
Sandra Steingraber

(Sandra Steingraber is the author of Living Downstream: An ecologist 
looks at cancer and the environment, 1997, and Having Faith: An 
ecologist's journey to motherhood, 2001.)

Devra Davis
SECRET HISTORY OF THE WAR ON CANCER
505pp. Basic Books. £16.99.
978 0 465 01566 5

Phil Brown
TOXIC EXPOSURES
Contested illnesses and the environmental health movement
356pp. New York: Columbia University Press. £19 (US $29.50).
978 0 231 12948 0

One advantage of being a long-time cancer survivor – besides the obvious 
– is that it provides a front-row seat in the auditorium of ideas about 
the disease’s causation. Theories go in and out of fashion over the 
years, paradigms shift this way and that, and the patient is viewed 
differently by the medical community depending on which idea is 
currently on top.

I was diagnosed with bladder cancer in 1979, when I was twenty years old 
and just at the beginning of my career as a biologist. At that time, US 
newspaper headlines featured Love Canal, the upstate New York community 
whose residents had been evacuated a year earlier when 20,000 tons of 
industrial chemicals were discovered buried under their basements. 
Toxic-waste activism in the United States was in the ascendant, the 
newly formed US Environmental Protection Agency was committed and 
passionate, and major environmental legislation had been recently 
enacted by Congress to defend clean air and clean water in the name of 
human health.

After breaking the bad news from the pathology lab, my urologist asked 
me about tyres: automobile tyres. Had I ever vulcanized tyres? His 
second question was about textile dyes. Any exposure to the colour 
yellow? And had I ever worked in the aluminium industry?

Back at the university, I began to research the causes of bladder 
cancer. Indeed, there were data on dyes and bladder cancer going back to 
the nineteenth century. In fact, there was absolute proof that certain 
textile dyes caused bladder cancer in humans. And yet, mysteriously, 
this evidence had not resulted in the abolition of these chemicals from 
the economy. Other suspected bladder carcinogens, for which the evidence 
was highly troubling, if not outright damning, were produced and used by 
the industries in my home town. The National Cancer Institute was 
generating maps of cancer mortality in an attempt to unveil other 
possible environmental carcinogens that could explain rising rates of 
cancer.

And then Ronald Reagan was elected President, and everything changed. No 
one asked me any more about my possible environmental exposures. In 
fact, by the mid-1980s, I was hard-pressed to find the word “carcinogen” 
in any pamphlet on cancer that I collected from my doctors’ various 
offices. Meanwhile, in the medical literature, the search for cancer 
clusters that might point towards environmental contributors became a 
disparaged practice. The new focus of the National Cancer Institute was 
on “lifestyle” explanations for cancer.

full: 
http://entertainment.timesonline.co.uk/tol/arts_and_entertainment/the_tls/article3277880.ece