Samuel Epstein: The Good Doctor

Samuel Epstein has been fighting the establishment for most of his life. As an 18-year-old student in England, he led a militant youth movement opposing the British presence in Palestine. As a rising young pathologist, he revealed that his boss’s “cure” for a childhood disease was based on fraudulent data. Most prominently, Epstein has for several decades challenged the unwillingness of the “cancer establishment”–the major cancer research institutions as well as both government and private funders–to seriously address the environmental causes of cancer.

“We’re talking about high crimes and misdemeanors,” he says. “From the public health standpoint, the cancer establishment’s refusal to act on freely available information is tantamount to criminal offenses.”

While the incidence of cancer has risen dramatically and new treatments have progressed modestly over the past four decades, Epstein argues, the cancer establishment has failed to recognize that most cancers can be prevented. Cancer, he insists, is caused primarily by chemical and physical agents in the environment. While people knowingly expose themselves to some carcinogens, like tobacco smoke, in most cases they unwittingly encounter carcinogens in their workplaces; in air, water, and food; and even in medical treatments such as estrogen replacement therapy and early mammographies.

Now professor of environmental and occupational medicine in the School of Public Health at the University of Illinois, Chicago, the 72-year-old Epstein has a distinguished record as a researcher, but he has had equal impact as an agitator and policy advocate. His blunt, uncompromising criticisms have won him admiration from citizen groups and, last December, a Right Livelihood Award, often called the “alternative Nobel prize.”

Epstein, the son of a prominent rabbinical scholar, became interested in the causes and prevention of cancer in medical school. But it wasn’t until he went up against the Food and Drug Administration in 1965 that he realized fully how entangled the cancer establishment was with corporate interests. Then a 39-year-old researcher at Harvard Medical School, Epstein confronted the FDA with data indicating that a common treatment for athlete’s foot, griseofulvin, was carcinogenic. When he asked how the FDA would respond, the agency’s director replied, “Are you serious? This is on the market. We can’t do anything about it.”

“That started me on another track,” Epstein recalls. “If you’re going to stay in this field, you’ve got to shift some attention to politics.”

Later, the war in Vietnam pushed Epstein further into politics. He joined with other doctors to form the Committee of Responsibility and led the group’s first mission to rescue injured children from the war zone, providing needed treatment while highlighting the war’s brutality.

His new book, The Politics of Cancer Revisited (East Ridge Press)–a revision of his 1978 classic, The Politics of Cancer–denounces what he considers many cancer experts’ overemphasis on “lifestyle” factors–high-fat diets, for example–while they minimize such phenomena as the rise of lung cancer among nonsmokers. He also attacks the influence of major corporations on the American Cancer Society, the National Cancer Institute, and other research institutions. There’s no money to be made in prevention–and for some companies, much to be lost–Epstein argues, but there are fortunes to be made from cancer treatments, including risky chemical prevention strategies, such as giving the potent drug tamoxifen to millions of women deemed to be at risk of breast cancer.

The new book covers the controversy that was unleashed when Epstein organized a petition signed by 65 prominent scientists in 1992 to declare the “war on cancer” a failure on its 20th anniversary, noting that the overall incidence of cancer had increased by 44 percent since 1950. Epstein since then has launched the Cancer Prevention Coalition and published The Breast Cancer Prevention Program and The Safe Shoppers’ Bible. He has campaigned against hormone treatment of cattle (helping the European Union defend its ban on beef hormones at the World Trade Organization) and against bioengineering in general. Increasingly convinced that knowledgeable consumers can accomplish much through market pressures, Epstein believes that the medical profession is too fragmented, too oriented toward treating disease, and too compromised by the politics of research funding to reform itself without pressure from citizen movements.

Indeed, Epstein says cancer prevention is part of a larger issue: “Cancer is a paradigm of runaway industrial technology.” And with key public health decisions now made by businesspeople, who can deflect research from the risks their products create, cancer is also a “paradigm of the failure of democratic decision-making.”

Not surprisingly, the good doctor’s prescription for ending the cancer epidemic has little to do with the latest “miracle cure.” His recommendation? Lots of sunshine and a strong dose of democracy.

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