Fighting the wrong war

The government could cut cancer deaths by a third by educating Americans to eat right. But dollars for diet education are scarce, while the cancer research budget fattens up.

Published October 14, 1998 7:00PM (EDT)

Last month, 150,000 people converged on the U.S. Capitol demanding greater government funding for cancer research. Vice President Al Gore addressed the gathering, boasting of the administration's drive to increase cancer spending. "This marks high noon for cancer," Gore intoned. "We are determined."

Whenever a politician starts talking about high noon, we'd do well to hold onto our wallets. Such rhetoric is usually followed by the sound of lots of money pouring down a rat hole. The U.S. government now spends $2.4 billion annually on cancer research. The day of the march, President Clinton said he wants to boost cancer research spending by 65 percent over the next five years. During his weekly radio address, Clinton told the nation: "We must never stop searching for the best means of prevention, the most accurate diagnostic tools, the most effective and humane treatments -- and someday soon, a cure."

The emotional appeal is undeniable. We've all lost friends or family to cancer. You can understand the anger of the 150,000 people in Washington, wanting the government to do whatever it takes to overcome the disease. But is pouring billions more dollars into research really our best course of action for preventing cancer deaths?

Our nation's anti-cancer strategy -- devoting almost all federal funding to finding a cure -- is fundamentally flawed. While spending billions to seek out a cure for cancer may be politically popular, most of this money would be much better spent on prevention. We could eliminate one-third of all cancer fatalities without spending another dollar on research. Most experts, including the leadership at the National Cancer Institute, believe that one-third of cancer fatalities arise from poor diet -- principally a lack of fruits and vegetables combined with too many foods of animal origin. The trouble, then, is that most Americans don't know how to follow a good-tasting and nutritious diet that will lower their cancer risk. And the government devotes practically no money to teaching people about diet and food.

The government's main nutrition program is called "5 a Day for Better Health," which is sponsored by the National Cancer Institute. The program has a catchy logo, but it receives pathetically little federal funding -- just $1 million per year for outreach and advertising. That means that for every dollar spent teaching Americans how to reduce cancer risk through diet, the National Cancer Institute spends $2,400 on research. The 5 a Day program isn't even mentioned in the institute's 1999 budget proposal -- in which it asks for $3.1 billion, most all of it for research. Yet according to the institute's own publications: "In the vast majority of studies ... those with lower consumption [of fruits and vegetables] experience a cancer risk generally at least twice as high as those with higher consumption levels."

The 5 a Day program isn't perfect. It's a bit like recommending people brush their teeth once a day for best dental health. Cancer risk has been shown to drop even further when people eat closer to 10 servings of fruit and vegetables a day. To the institute's credit, it points out in its literature: "Remember that five is a minimum -- the more the better."

Education is our nation's best hope for dramatically reducing cancer deaths in the near future. If funded adequately, the 5 a Day program would prevent tens of thousands of deaths year. The tragedy is that the program is all but ignored in an agency dominated by researchers.

The vast majority of the money we spend on cancer, of course, goes to neither research nor education, but to treatment. The National Cancer Institute reports that last year $107 billion was spent on cancer treatment, which is 44 times what we're now spending on research and education efforts. If we moved a significant share of our $2.4 billion cancer research budget into educational efforts, anti-cancer nutrition advertisements could run on shows ranging from Ally McBeal to the Super Bowl, and in publications from Newsweek to Ebony.

With that kind of exposure, it's reasonable to assume that we could get Americans eating many more servings of fruit and vegetables a day. As many as a third of cancer deaths could be prevented, saving tens of thousands of lives annually and reducing costs of cancer treatment by more than $30 billion each year.

Realistically, a move to favor education over research will not happen any time soon. The cancer research establishment is too entrenched to give up that money without a fight. But if we want certain progress in the war on cancer, a shift of priorities is in order. We shouldn't devote most of our resources to searching for a magic pill that will eliminate cancer. Federal money should adequately publicize the overwhelming impact of eating right, so that people can take responsibility for their own health.

By Erik Marcus

Erik Marcus publishes the Web site.

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