The Killing Cure

THE SECRET HISTORY OF THE WAR ON CANCER

By Devra Davis

Basic. 505 pp. $27.95

In 1900, infectious diseases were the leading cause of death in the United States; in our current age of pasteurized milk and purified water, this is no longer the case. The focus now has shifted to the chronic maladies of aging -- cancer, heart disease and stroke. Tens of billions of dollars are being thrown into crusades against these killers, with the so-called "war on cancer" capturing the lion's share of media space and public concern. Some experts see it as a model of medical progress; others take a dimmer view. Perhaps the most critical voice belongs to Devra Davis, a professor of epidemiology at the University of Pittsburgh and the author of When Smoke Ran Like Water, an acclaimed history of environmental pollution.

Davis's latest work took 20 years to complete. The Secret History of the War on Cancer is a book with few real secrets but plenty of gossip, speculation and preachy advice. Still, there is much in this overlong account that deserves a serious hearing. For Davis, the war on cancer "has been fighting many of the wrong battles with the wrong weapons and the wrong leaders." The result, she contends, has been the needless loss of "at least a million and a half lives."

How she arrives at this figure is never explained. What is clear, however, is that Davis thinks cancer can best be fought by focusing on its root causes, rather than on its treatment or its cure. Our failure to follow this path, she says, is the result of an unholy alliance among greedy corporations, corrupt philanthropies, compromised medical researchers and spineless government agencies -- all helping to obscure the truth about why people get cancer, and who is to blame.

Davis comes by her suspicions naturally. She grew up in Donora, Pa., a gritty steel town that made headlines in 1948 when a smoggy haze killed 20 of its residents. She writes powerfully about the toll that cancer has taken among her friends and family, many of whom, she believes, were victims of the thousands of chemicals that mark our industrial age.

Davis, whose research combines a sprinkling of industry archives with a mass of secondary sources, provides an excellent summary of environmental cancer research in the 20th century, noting that as early as the 1930s scientists understood that working conditions, radiation, nutrition, hormones and even sunlight could trigger the disease, and that chemicals such as benzene, synthetic dyes and asbestos were carcinogens. Ironically, much of the data came from Nazi Germany, where authorities campaigned against tobacco and experimented with organic vegetables in an attempt to further purify the "master race."

With the end of World War II, according to Davis, a dramatic shift occurred. At the very time cancer rates were climbing, scientific investigation into its likely causes reached a dead end. In particular, she writes, information on "the cancer hazards of the workplace and the environment" were disparaged or ignored, while studies about the treatment of cancer were lavishly funded and publicized. How did this happen? The answer, says Davis, can be traced to the deep pockets of corporate America, which spent billions of dollars over the years to stifle honest debate about the dangers of chemicals and tobacco -- and billions more to hype the "cancer-curing" wonders of medical technologies and drugs.

For the corporations, this was money well spent. It allowed them to earn huge profits by producing both the cancer-causing chemicals and the anti-cancer drugs. They became the real directors of the war on cancer, says Davis, by establishing institutes to influence federal policy, infiltrating groups like the American Cancer Society, and funneling grants to supposedly disinterested scientists -- what Davis calls "the revolving door of cancer researchers in and out of cancer-causing industries." While much of this may sound familiar to a moderately informed reader, David puts it together in a way that illuminates the underbelly of medical research.

There is, however, an odd feeling to this book, a sense that Davis has come to view an enormously complicated endeavor in increasingly conspiratorial terms. She writes about being "stunned" and "shocked" about the misdeeds she has uncovered, and claims to "have learned from others, whom I can't name at this point, that the files of many large multinational businesses could easily tell us about many more health risks." Those who question her assessments -- and the ranks are legion -- are portrayed as disingenuous or corrupt. Her book's final pages are so crammed with ominous warnings about modern life -- cellphones, mammograms, Ritalin and 100,000 or so common chemicals yet to be studied -- that one yearns for the simpler days of rodents and plagues. It's hard to separate the vital points Davis is making about environmental pollution from her relentless assault upon a corporate-medical-scientific cabal that she insists is going to poison us all.

Still, the best watchdogs are often the most obsessive, using shock and alarm as a prelude to discussion. And for many readers of The Secret History of the War on Cancer, I suspect, Devra Davis is a natural for this role. *

David Oshinsky, a professor of history at the University of Texas, Austin, won the 2006 Pulitzer Prize in History for "Polio: An American Story."