The Cancer Industry:
The Classic Expose on the Cancer Establishment
New Updated [1996] Edition

© 1996 by Ralph W. Moss, Ph.D.
Published by Equinox Press

(All rights reserved. Please see Copyright notice.)


Note: This section concerns The Office of Technology Assessment (OTA) 1990 Report on "Unconventional Cancer Treatments." Because of its length we have broken it into two files. This is the second of the two files.

Happily, the OTA Report itself is now available on-line at http://www.ota.nap.edu/pubs.html. You will need about 15-20 minutes of spare time and Adobe Acrobat or Netscape 2.x with the Acrobat Acrobat Plug-in in order to download it, however.


1. The OTA Report, pt. 2

The destructive onslaught against cancerous (as well as normal) cells is chemotherapy's game. For decades, in fact, new chemotherapeutic agents had been screened for merit by seeing whether or not they shrank tumors. By suddenly insisting that IAT shrink tumors in any prospective trial, OTA was dooming the test to almost certain failure. (And this from the people who "wrote the book" on the problems of clinical trials in cancer!) The OTA staff also seemed to be preparing a fallback position for themselves, just in case the treatment actually showed some benefit in a clinical trial. For then, if the patients lived longer, or reported higher performance scores, OTA could always say, "But their tumors didn¹t disappear. So the treatment was a failure.")

OTA added that "smaller and still worthwhile effects on survival would probably require the study of a much larger number of patients." But in that case, how was it ever going to be possible to evaluate the claims of a treatment that helped patients live longer?

Also, Congress had set no limit on the size or cost of the IAT trial. (And in fact OTA spent $500,000 to prepare its written report.)

Here, too, it seemed that OTA was preparing a fallback position: "Sure, the treatment seemed to work, but only for a negligible group. Our conclusion is...that more tests are needed."

OTA's third claim was that "in the proposed clinical trial, it is important that patients with a relatively common cancer, and one for which treatment options are limited, be the focus of attention." This was so that "an important public health problem will be addressed."

Again, one could hardly argue with this. But because of the extension of chemotherapy's use to just about every type of cancer (Dukes' C colon cancer was just then joining the ranks), it was considered "unethical" to give unconventional treatments to most patients.

Also, the great success stories of chemotherapy were always in relatively obscure types of cancer. Childhood leukemia constitutes less than two percent of all cancer cancers and many of chemotherapy's other successes were in diseases so rare that many clinicians had never even seen a single case (Burkitt's lymphoma, choriocarcinoma, etc.)

Why should IAT be held to more demanding standards than chemotherapy? Was there to be a level playing field, or not?

It did not escape Dr. Burton's attention that this particular precondition precluded a study of mesothelioma, his most obvious success.

But by now it was widely believed that OTA had no intention of actually doing a trial of IAT. OTA had, the staff wrote, "completed its formal part in the process...." The "trial's realization" depended on Burton and "members of the U.S. cancer research community," principally NCI, many of whose members were hostile to Burton for his vociferous attacks on the cancer establishment. But, Dr. Herdman warned, NCI "will have its own procedures and criteria for deciding on the priority to be given funding of this study."

In other words, OTA handed the Burton problem over to the tender mercies of NCI. Not surprisingly, no such clinical trial ever took place and the world still awaits hard data on the efficacy of this treatment. NCI simply had other priorities.

By 1990, the report inched towards closure. In late February, interested members of the public received copies of the 560-page final draft. (After nearly four years of work, the OTA gave critics, such as myself, little more than a week to prepare their remarks.) "In its present form," I wrote in an emergency issue of The Cancer Chronicles, this report "will wreak tremendous damage on the movement, with the public, the media and especially on Capitol Hill."

The report digressed into all sorts of arcane directions, but found no room for Sloan-Kettering's studies on laetrile between 1972 and 1975 (see chapter 9). Similarly, it devoted two whole pages to the comments of a pair of doctors hostile to Burzynski, but then merely reported as a fact that "Burzynski wrote a rebuttal of their report, contesting their reading of the clinical data.² None of his rebuttal points were even hinted at. (See chapter 14 for a detailed discussion.)

The final report was due out on May 30, 1990. But the OTA Advisory Panel, to its credit, convinced the staff to open the morning session of its third and final meeting to public comment. Fifteen people, most of them critics, were given five minutes each to speak.

"The cancer alternative movement is facing one of the greatest challenges in its history," I wrote in the Chronicles. The purpose of the report is "to bury this growing movement under a mountain of falsehoods. It is unworthy of the agency from which it comes or of the Congress, which commissioned it. If released in anything like this form, the report would set back the cause of non-toxic therapies and freedom of choice for years." That was because "every time you complain to your Congressmen about suppression and coverup, s/he may throw the OTA¹s 'proof' in your face."

Alarmed, I called for an "effective and militant campaign against this report," including an intensive day of lobbying on Capitol Hill on March 8, 1990. I ended with this emotional appeal to cancer patients:

"To you we say: if you are aroused and well-organized you can do anything. You can stop vicious reports; you can foil the medical-industrial complex; you can change the face of American medicine. Don't doubt your strength....Don't be discouraged by this report but unleash your tremendous anger and direct it at all those who would deny you your freedom of choice...."

Gar Hildenbrand, who was both an Advisory Panel member and an outspoken activist, called on supporters of the Gerson diet and cancer patients in general to practice civil disobedience outside the meeting.

"On March 9th," he wrote, "hundreds of people with cancer, people recovering from cancer, and worried well people will walk into the streets. In the early morning, at the Office of Technology Assessment, cancer patients will lie down in front of the doors to tell Congress: 'You allow this system to go unchallenged OVER MY DEAD BODY.' "

As planned, on the day before the meeting, March 8 [1990], scores of people gathered for a day of lobbying. I was among them. In general, Congressmen and their aides were sympathetic to their complaints. But there were ominous signs, as well. A bomb threat was phoned in to the hotel where most of the report critics had gathered. The caller ranted about quacks and con men. Michael Evers, who was coordinating the lobbying efforts, asked the F.B.I. to investigate, but they never caught the perpetrator. Happily, no bomb went off and the F.B.I. concluded that the caller was a crank.

On the following morning we arrived at OTA headquarters to find a squad of tactical police with night sticks, Plexiglas shields, and several waiting paddy wagons. This seemed provocative, since it was understood that any protest would be entirely non-violent. The staff later complained about the "hostile atmosphere" at this final meeting with "shouted personal attacks on the integrity of the project staff." It omitted all mention of the police presence outside.

With the exception of a representative from NCI, each of the 15 speeches that day was highly critical of OTA. Each was bracketed and occasionally interrupted by resounding applause from the assembled cancer patients, who had come in response to a call to attend from various alternative organizations, including The Cancer Chronicles.

Seymour M. Brenner, M.D., a radiologist from Brooklyn, New York, spoke first. He told how he saw between 100 and 150 patients per day. "After 39 years, he said, "I have seen no significant progress" in the treatment of cancer. In 1988, he had offered, he said, "to do a research program into the investigation of alternative methods," using standard safeguards. But the FDA commissioner told him he would first have to do five year¹s worth of laboratory and animal work.

"I see millions of people dying in five years," he told the commissioner. "I see hundreds of billions of dollars being spent in five years." Brenner wanted his medical colleagues to be told, "If you have a patient who is considered hopeless, with an established diagnosis of cancer, refer them to [an impartial] panel." This panel would then decide if the patient was indeed advanced enough to be given last-ditch alternative treatments.

It is noteworthy that Brenner does not practice any unconventional treatments himself. In fact, his peers regard him as one of the top four radiologists in Brooklyn, according to the independent Castle Connolly guide to the best doctors in New York City. But he was honest enough to admit that he knew of at least ten cancer survivors who had been treated with alternative methods (principally that of Dr. Emannuel Revici) and who "would have died under my supervision."

"I am tired of watching people come to my office and plead for their lives and I have nothing to offer them," an impassioned Brenner told the OTA. "I'm frustrated and I¹m angry and I¹m depressed when I see a 27-year-old woman who says, 'Don¹t let me die,' and I have to let her die." The OTA panel seemed stunned by his words.

The next speaker was journalist Peter Barry Chowka. "The only victory now in sight," Chowka said, "is one of public relations over the reality that has become a medical Vietnam." People by the millions were discontented with conventional medicine and turning towards alternatives, he reminded them. "The OTA report does not adequately address the urgency of this context." He compared it unfavorably to the 1953 report from attorney Benedict Fitzgerald. By contrast, Fitzgerald had concluded that there was indeed a coverup of promising alternative cancer treatments.

Attorney Michael Evers told the panel that the draft report was "a travesty. Its authors have violated every known rule of fairness and impartiality." He also showed how subtly OTA could twist the facts.

Richard Jaffe, Dr. Burzynski's attorney, pointed out the various biases against his client in the report. For instance, OTA had relied on an old NCI report on the failure of antineoplastons to cure a certain type of mouse leukemia. But OTA failed to note that Burzynski himself had warned NCI that his treatment does not work against leukemia.

Virginia Livingston-Wheeler, M.D, the only major alternative practitioner to speak that day, called the report "quite extensive, but not always accurate. Seldom accurate....My work was not covered...." (Dr. Livingston herself died of a heart attack on a trip to Europe that summer. She was 84 years old. On Livingston, see chapter 13.)

In my own remarks to the panel, I said, "This report...was supposed to investigate a coverup. Instead, it has become part of that coverup. In its present form it will set back the study of non-toxic cancer treatments for years to come."

I recounted my own experiences at Sloan-Kettering with Dr. Kanematsu Sugiura and his work of laetrile (see chapter 9). "Now, where are the Sugiura studies in your report? Where are they?" I demanded, angrily. "The OTA report was supposed to contain all the information that could be found, rather than a selective culling. But it¹s gone! It¹s as covered up today as it was in 1975.

"I'm not afraid of you," I concluded, "and I'm not afraid of what you're doing. You'll continue with this? Fine. We'll continue to fight you. If you're smart, you¹ll save the reputation of OTA and radically revise this report."

This meeting strengthened the hand of those on the OTA advisory board who wanted a more balanced presentation. In September, 1990--four years after its start--OTA finally released Unconventional Cancer Treatments (GPO #052-003-01203-3). And, indeed, to almost everyone¹s surprise, the final report did contain some major revisions, all of them giving it greater balance. As I wrote in the Chronicles, "although the report still contains many examples of bias, double standard, error and innuendo, it is an improvement over earlier versions. About half the misrepresentations are now corrected." My conclusion was that "the final OTA report is something we can live with."

The staff had finally discovered about 200 scientific papers supporting the use of alternative cancer treatments. The Summary, Options, and Recommendations had been completely rewritten by the panel chair. In essence, the final report underlined the potential importance of these treatments and called for their fair and adequate testing.

In his foreword, Dr. Gibbons added that "while mainstream medicine can improve the prospects for long-term survival for about half of the approximately one million Americans diagnosed with cancer each year, the rest will die of their disease within a few years."

For thousands, he said, "mainstream medicine's role in cancer treatment is not sufficient." Gibbons remarked that "the debate concerning unconventional treatments is passionate, often bitter and vituperative, and highly polarized." Echoing Rep. Dingell's original letter to him, he wrote that "if history in this area is predictive, some few unconventional treatments may be adopted into mainstream practice in the years ahead, others will fade from the scene, and new ones will arise." That someone in authority thought that conventional treatments were deficient and that at least a few alternative treatments might eventually be "adopted into mainstream practice" was new.

Specifically, OTA made a series of recommendations to NCI. The main ones were: obtain good information about unconventional cancer treatments; use up-to-date screening methods; facilitate "best case" reviews of unconventionally treated patients; establish a reporting system for remissions with such treatments; and provide funding "large enough to provide for a fair test" of innovative methods.

Out of all these, however, NCI only accepted the idea of "best case review," and drew up some guidelines to help those intending to prepare such summaries. But it rejected out of hand all other OTA recommendations. For example, OTA recommended that information on alternative treatments disseminated by NCI be evaluated for adequacy and quality. NCI replied that it already had a program of telephone monitoring in place. Regarding OTA¹s proposal for a registry of remarkable remissions, NCI responded that ³maintaining a population-based registry would be difficult, if not impossible.² But OTA never suggested a "population-based registry," just a simple database of those who seemed to be helped by such methods.

OTA also reminded NCI officials that it was their "mandated responsibility to pursue information and facilitate examination of widely used 'unconventional cancer treatments' for therapeutic potential."

NCI's arrogant response was that it "has funded a grant to develop a comprehensive database on 'unconventional' cancer treatments." This was an apparent reference to the Emprise, Inc. grant, which had been given to a group of self-proclaimed enemies of "health fraud," headed by Grace Monaco, a lawyer who had helped Aetna develop its RICO racketeering suit against Dr. Burzynski. (Emprise, Inc. went out of business soon after NCI, under public pressure, decided not to extend its grants.)

NCI likewise rejected OTA's proposal for a balanced panel to fund evaluations of alternative therapies. NCI said that "the preferred solution is to encourage the proponents of 'unconventional treatments' to interact directly with {NCI's] staff." For those who had tried that route in the past, this was a bitter joke indeed.

One should understand that by 1990 NCI was being attacked on many sides for its bureaucratic policies and its refusal to consider new directions in the war on cancer. As the 20th anniversary of the war on cancer loomed (December 23, 1991), there was a drumbeat of criticism. At the behest of the late Congressman Ted Weiss (D-NY), the General Accounting Office (GAO) had conducted a study, which concluded that "there has been no progress" in preventing breast cancer. Science magazine, usually a strong supporter of mainstream research, also concluded that the war on cancer was a "saga of substantial investments--but little success."

University of Illinois medical school professor Samuel S. Epstein, M.D. and I co-authored a series of guest editorials in the Chicago Tribune, Los Angeles Times and USA Today, pointing out, for example, that "Last year, the congressional Office of Technology Assessment reported on some 200 papers supporting such innovative therapies and recommended that the cancer institute actively investigate them. It refused" (Chicago Tribuine, December 12, 1991).

But NCI had circled the wagons. Science analyst Robert G. Houston's prescient comment at the time was that "Congress may have to force the NCI legislatively to expend a portion of its budget on novel therapies reported to work."

In fact, what was about to happen was even more amazing than any of us could have fantasized. An old Chinese adage suggests that when a rock blocks the path, the most prudent course is to walk around it. In the following year, a path was found around the NCI boulder.


The Cancer Industry Introduction:
1. Intro | 2. OTA Study Pt. 1 | 2a. OTA Study Pt. 2 | 3. Office of Alternative Medicine | 4. Underlying Problems | 5. Role of FDA


Ralph W. Moss, Ph.D. is director of the The Moss Reports for cancer patients. Dr. Moss is the author of eleven books and three documentaries on cancer-related topics. He is or has been an advisor on alternative cancer treatments to the National Institutes of Health, the National Cancer Institute, the American Urological Association, Columbia University, the University of Texas, the Susan G. Komen Foundation and the German Society of Oncology. He wrote the first article on alternative medicine for the Encyclopedia Britannica yearbook. He is listed in Marquis Who's Who in America, Who's Who in the World, Who's Who in the East, and Who's Who in Entertainment (as a film documentarian). This Web site does not advocate any particular treatment for cancer. We urge you to always seek competent medical advice for all health problems, especially cancer. Before consulting our site please read our full Disclaimer statement.



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