Jeanne Lenzer is a freelance medical investigative journalist based in Kingston, New York, United States of America. E-mail: jeanne.lenzer@gmail.com
A year ago, I received an E-mail from a research scientist at a major pharmaceutical company. The scientist had read my articles on whistleblowers who had raised concerns about the undue influence of the pharmaceutical industry on American medicine My industry source had information for me about drug company practices, but—out of fear of career ruin—would only talk on the condition that I would conceal the scientist's identity.
For the next year or so, I had repeated contacts with the scientist. As I listened to this researcher—and to the other medical whistleblowers that I continued to interview—it occurred to me that each whistleblower was like the proverbial blind man with a hand on the elephant. Each could describe one piece of the puzzle, but the full picture could only emerge by bringing these whistleblowers together.
With an eye to focusing on the systemic problems that have allowed American medicine to be unduly influenced by industry, on May 15, 2005, I brought together five whistleblowers in Washington, D. C. I asked them each to tell their story and to suggest ways to restore objectivity to medicine and medical research.
The Whistleblowers
Four whistleblowers attended in person, and the anonymous industry scientist participated via speakerphone. The whistleblowers came from an extraordinary variety of different professional backgrounds.
David Graham
This Food and Drug Administration (FDA) safety officer raised concerns about the cardiovascular side effects of rofecoxib (Vioxx) and other Cox-2 inhibitors. He testified at a United States Senate Finance Committee hearing on rofexocib, the FDA, and Merck [1,2]. Graham attended the roundtable in his own personal capacity and was not representing the FDA.
Allen Jones
This investigator at the Pennsylvania Office of the Inspector General led an investigation into an off-the-books account, funded in part by drug companies, from which payments were made to state employees to develop a medication treatment algorithm. He filed a civil rights lawsuit against the Pennsylvania Office of the Inspector General to protect his right to publicly discuss his findings, and was later fired from his job for talking to the press [3–6].
Stefan Kruszewski
This Harvard-trained psychiatrist was hired by the Bureau of Program Integrity in the Pennsylvania Department of Public Welfare to oversee the state's mental health and substance misuse programs. He filed a law suit in a federal court in the Middle District of Pennsylvania, charging that he was fired after uncovering widespread abuse and fraud in the bureau [7,8].
Kathleen Slattery-Moschkau
This former drug representative left the pharmaceutical industry after witnessing marketing practices that she found disturbing. She wrote and directed the movie Side Effects, a fictionalized account of her experiences [9,10].
The anonymous research scientist
This is an industry insider who said to me, ahead of the roundtable, that the culture of secrecy at drug companies too often results in claims that are closer to “propaganda” than science.
Lessons Learned from the Roundtable
Ties between drug regulators and industry may influence new drug approval
David Graham described the frustrations he had felt in his almost 20 years of experience as an FDA drug safety officer. Although he was instrumental, he said, in getting ten drugs off the market because of safety concerns, his experience was like a salmon swimming upstream—“a single individual…against the tide.” The tide, he said, “is an entire institution whose mission is to approve drugs and make industry happy.”
The FDA, said Graham, is in a “collaborative relationship” with industry. The FDA gets money from drug companies through the Prescription Drug User Fee Act of 1992 (see http://www.fda.gov/cber/pdufa.htm) “to approve new drugs and approve them more quickly.” The mindset at the FDA, he said, is that “we will find a reason to approve a drug no matter how small the indication for the drug.” Graham explained that a senior official at the FDA had told him: “industry is our client.”
When the FDA knows there is a serious problem with a new drug, he said, the FDA deals with this by saying, “well, we'll handle it in labeling” even though, said Graham, “FDA knows labeling doesn't work.”
“There is no independent voice for drug safety in the United States,” he said. The upper-level managers in the FDA's Office of Drug Safety are appointed from the FDA's Office of New Drugs, which approves new medicines. This makes the Office of Drug Safety “captive,” he said, to the Office of New Drugs.
The anonymous scientist said that in order to speed up drug approval, companies “don't measure things like whether we are really curing the disease, or prolonging life, or preventing hospitalization, or whether a patient is truly more functional. Oftentimes, we're measuring intermediate, lesser things, markers, predictors—we hope—of these clinical endpoints, but they may or may not be accurate.”
And the FDA, said the scientist, requires just two positive studies to grant approval to a new drug, but there is no limitation on how many negative studies can be done before one or two positive studies are produced. This can lead to approval of a drug even when most studies are negative or show no effect.
Both Graham and the anonymous scientist suggested putting an end to the Prescription Drug User Fee Act, and Graham argued that there needs to be independent authority for those in charge of drug safety. They indicated that two bills in Congress, introduced by Senator Grassley and by Congressman Hinchey, at least partly address these concerns.
“The pharma–FDA complex has to be dismantled,” said Graham, “and the American people have to insist on that, otherwise we're going to have disasters like Vioxx that happen in the future.”
The race to approve new drugs without proper safety testing may be compromising the public's health
“Drug companies assiduously avoid acquiring information about side effects,” said the industry scientist. “Drug companies will not conduct safety studies unless they have to—meaning basically that they're required by a regulator—and that rarely happens.” High-risk patients who might have a bad reaction to a drug, said the scientist, “are excluded from studies deliberately, even though, when the drug is approved, these patients will be targeted for sales.” When a safety study is proposed within the industry, said the scientist, “a typical response will be that if we conducted a study to find out if there was a safety problem, people would learn about it and think we had a problem [which] would destroy the image of safety that has been so carefully constructed.”
Studies are too small and are conducted over too brief a period to properly assess safety: “The largest studies—the phase three studies, [which] might be several thousand people—last for a few months. If drugs kill one in several thousand per year, this would be a public health catastrophe. A blockbuster drug with that kind of hazard associated with it could be associated with tens of thousands of deaths a year, and it would never be detected in studies of the kind that we routinely submit and are the basis for approval.” These drugs, said the scientist, and these kinds of risks, are “essentially out there now, unlabeled, unnoticed, all beneath the radar.”
The scientist said that, “to ensure that safety problems will go unnoticed, we compound the problem of conducting small studies by setting a statistical threshold for acknowledging the safety problem that is so high that you know in advance it could never be reached for any serious side effect, like myocardial infarction.” This practice, said the scientist, “virtually ensures that if a bad side effect happens to show up, it's not going to reach the arbitrary level that we call statistically significant, and the company can maintain that it's just bad luck.” And if a bad result does happen, “typically a company is not going to publish the study at all. If they do publish it, the bad result can be omitted as ‘not statistically important.’”
The funding of state officials by industry may be affecting prescribing patterns
Allen Jones described how he believed that drug companies were acting at the state level to influence the prescribing of psychiatric medications.
“I began to investigate an account into which pharmaceutical companies were paying money that was being accessed by state employees,” he said. “Additionally, I found that various pharmaceutical companies were paying state employees directly—also giving them trips, perks, lavish meals, transportation, honorariums up to $2,000 for speaking in their official capacities at drug company events. They were given unrestricted educational grants that were deposited into an off-the-books account—unregistered, unmonitored, literally operated out of a drawer.”
These same state officials, he said, were responsible for dictating clinical policy and writing guidelines for the treatment of patients in the state system. These officials were, he said, receiving money from companies with a stake in the guidelines. “The protocol they [the officials] were developing was called the Texas Medication Algorithm Project, TMAP, which began in Texas in the mid-90s. It outlined detailed medication guidelines for schizophrenia, depression, and bipolar disorder. It recommends almost exclusive usage of newer, patented, very expensive atypical antipsychotics, SSRIs [selective serotonin uptake inhibitors], and mood stabilizers.” The Texas Medication Algorithm Project, said Jones, was based on “expert consensus” from industry-supported meetings.
Jones said that when he wanted to investigate these findings, he was shut down. “I was told point black, ‘Look, drug companies write checks to politicians, they write checks to politicians on both sides of the aisle—back off.’” He was told, he said, to “quit being a salmon, quit swimming against a stream.” He wouldn't back down from his investigation, he said, and was demoted. On November 22, 2002, he filed a civil rights lawsuit “to preserve my job and my right to speak out.” His employer, he said, took him off investigative duties altogether.
Stefan Kruszewski, who has filed a law suit in a federal court in Pennsylvania, raised concerns to his seniors in the Pennsylvania Department of Public Welfare about prescribing practices in the state that he did not feel were evidence based, and said he lost his job for raising his concerns. For example, he alerted his seniors to the off-label prescribing of the anticonvulsant gabapentin (Neurontin) for mood disorders and addictive disorders.
“The pharmaceutical industry is the single most powerful lobbying group on Capitol Hill—outspending even the oil and banking industries,” said Jones. “It should come as no surprise that the ties go far beyond just the mental health officials who wrote the guidelines, but extend to many of the politicians who, in the end, allowed an investigation into pharma corruption to be dropped, and the investigator—me—to be fired.”
Efforts to detect and deter fraud and abuse due to these conflicts, he said, “will be likely to be undermined as long as those charged with detecting fraud and abuse, like the [Pennsylvania] Inspector General, are appointed by politicians who are themselves beholden to the drug industry. Such positions should instead be filled by career civil servants and not political appointees.”
Regulatory agencies are not being held accountable
In comments that echoed his testimony to the US Senate Finance Committee, Graham said that, “FDA was the single greatest obstacle to doing anything effective with Vioxx. As a result, nearly 60,000 people probably died from that drug. That's as many of our soldiers that were killed in the Vietnam war [who] died as a result of Vioxx use. And FDA had the opportunity, the responsibility, to stop that and didn't. In fact, FDA allowed it to continue. In my book, FDA shares in the responsibility for those deaths and yet it's not being held accountable by Congress.” Congress itself, added Graham, is deeply beholden to the drug industry since many politicians receive “often quite a bit of campaign contributions” from the industry.
Kruszewski reflected upon the problems he said he had encountered in Pennsylvania, saying that “there is no accountability in the system for oversight [agencies].” He has become “a stronger advocate than ever for a federal patient bill of rights.”
Marketing departments can influence doctors‘ prescribing habits
The research scientist said that the job was attractive because of the “many excellent drugs” developed, such as drugs to treat HIV, but the scientist “also saw drugs marketed in a way that will exaggerate the benefits and conceal the risks.”
Kathleen Slattery-Moschkau gave an insider's view of drug marketing practices, from her former experiences as a drug rep. She clutched her head in disbelief as she told the roundtable that doctors would come up to her with patients’ charts asking her for advice on treating patients. Slattery-Moschkau, like most of the drug representatives she came to know over the years, had no science background at all.
The various techniques drug representatives were trained in to “educate doctors” eventually proved to be not just “comical” but “also scary,” she said. “Whether it was hiring, training, what we were told to say about drugs and what we were told not to say,” it was marketing, not science, that dominated. One of the techniques used by drug companies was to buy doctors' prescribing records so drug representatives knew “to the dime” what drugs doctors were prescribing and could tailor their marketing to them. Drug representatives developed “personality profiles” on doctors and were taught to pitch their sales to specific personality types. Representatives were compensated, she said, by “how many prescriptions we could encourage.”
Both Slattery-Moschkau and the industry scientist described tensions within drug companies between marketing departments and industry scientists. “The marketing spin on things,” said the scientist, “carries the day.”
The published medical literature contains many biases
“When studies are published,” said the scientist, “they are frequently written not by the trained research scientist, who might have designed and analyzed the study, but by a designated medical writer with little if any background in research, but who is trained instead to craft the findings of the study in the best possible way for the company.”
The body of literature available to the public, said the scientist, “is a biased sample of what companies want people to see.” The research scientist described “a culture of secrecy,” which makes it hard even for industry scientists tasked with ensuring drug safety to obtain the full datasets needed to genuinely understand a drug's risk–benefit profile.
Conclusion
Whistleblowers have been compared to bees—they have just one sting to use and using it may lead to career suicide [11]. Many of the whistleblowers at the roundtable said they had experienced retaliation from their employers for raising concerns, but all had felt obligated to speak out about practices in medicine and medical research that they believe are risking the public's health or safety. Graham said he felt “trapped by the truth” and had to act. “There are bigger issues here,” said Kruszewski. “I felt right from the start [that] if I wallowed in self-pity about being fired and having my belongings piled in the gutter that I would never understand why all these things were happening. The bigger issue is that we've got people in the pharmaceutical industry and the health-care industry all acting in synchrony.”
Each of these whistleblowers, in very different ways—from making a satiric film to speaking out in Congress—has shone light on how this “synchrony” may be compromising the integrity of American medicine. We should not have to rely on medical whistleblowers to alert us to these fault lines. If we are to restore objectivity to drug development, prescribing, and safety monitoring, we must be willing to examine and change all of the institutions that allow this synchrony to occur.
Acknowledgments
The roundtable was co-sponsored by the Public Library of Science and the Government Accountability Project (www.whistleblower.org), a public interest group that helps whistleblowers in order to promote governmental and corporate accountability.
NEW YORK — It is a unique situation in medicine: Unlike other kinds of doctors, cancer doctors are allowed to profit from the sale of chemotherapy drugs.
"The significant amount of our revenue comes from the profit, if you will, that we make from selling the drugs," says Dr. Peter Eisenberg, a private physician who specializes in cancer treatment.
Doctors in other specialties simply write prescriptions. But oncologists make most of their income by buying drugs wholesale and selling them to patients at a marked up prices.
"So the pressure is frankly on to make money by selling medications," says Eisenberg.
Ethicists see a potential for conflict of interest.
"They might have a preference to give you the one that they're going to make the most money from," says Arthur Caplan with the University of Pennsylvania Center of Bioethics. Caplan also writes MSNBC.com's Breaking Bioethics column.
This unique payment system started years ago because Medicare and insurers wanted to save money by moving cancer treatments out of the hospital. But it has come under increasing scrutiny as prices for some cancer drugs skyrocketed to tens of thousands of dollars a year.
That's a lesson patient Cynthia Adams quickly learned.
"I almost had a heart attack when we got the first insurance statement," says Adams. "It was pretty outrageous."
Dr. Eisenberg, like many of his colleagues, does not like the system.
"Patients should feel that their physician has their best interest at heart, always," he says. "And the way the system is set up, because of the incentives, does something to destroy that."
Three years ago the government tried to fix the system by cutting back on the amount doctors got for the drugs and trying to find ways to pay the doctors more for other services, like spending time with the patients. But many experts say the underlying problems remain — with the potential for patients to get expensive drugs for the wrong reasons.
Clip from the documentary The Corporation - Watch the full film here.
Watch Healing Cancer from the Inside Out which exposes the Cancer Profit Industry here. Watch Eating which exposes more about the Disease Industry®™, specifically the American Cancer Society and the American Heart Association here. Remember, the AMA/American Medical Association started out only as a trade organization, a club for medical personnel.
The American Cancer Society is fixated on damage control— diagnosis and treatment— and basic molecular biology, with indifference or even hostility to cancer prevention. This myopic mindset is compounded by interlocking conflicts of interest with the cancer drug, mammography, and other industries. The "nonprofit" status of the Society is in sharp conflict with its high overhead and expenses, excessive reserves of assets and contributions to political parties. All attempts to reform the Society over the past two decades have failed; a national economic boycott of the Society is long overdue.
The American Cancer Society (ACS) is accumulating great wealth in its role as a "charity." According to James Bennett, professor of economics at George Mason University and recognized authority on charitable organizations, in 1988 the ACS held a fund balance of over $400 million with about $69 million of holdings in land, buildings, and equipment (1). Of that money, the ACS spent only $90 million— 26 percent of its budget— on medical research and programs. The rest covered "operating expenses," including about 60 percent for generous salaries, pensions, executive benefits, and overhead. By 1989, the cash reserves of the ACS were worth more than $700 million (2). In 1991, Americans, believing they were contributing to fighting cancer, gave nearly $350 million to the ACS, 6 percent more than the previous year. Most of this money comes from public donations averaging $3,500, and high-profile fund-raising campaigns such as the springtime daffodil sale and the May relay races. However, over the last two decades, an increasing proportion of the ACS budget comes from large corporations, including the pharmaceutical, cancer drug, telecommunications, and entertainment industries.
In 1992, the American Cancer Society Foundation was created to allow the ACS to actively solicit contributions of more than $100,000. However, a close look at the heavy-hitters on the Foundation's board will give an idea of which interests are at play and where the Foundation expects its big contributions to come from. The Foundation's board of trustees included corporate executives from the pharmaceutical, investment, banking, and media industries. Among them:
David R. Bethune, president of Lederle Laboratories, a multinational pharmaceutical company and a division of American Cyanamid Company. Bethune is also vice president of American Cyanamid, which makes chemical fertilizers and herbicides while transforming itself into a full-fledged pharmaceutical company. In 1988, American Cyanamid introduced Novatrone, an anti-cancer drug. And in 1992, it announced that it would buy a majority of shares of Immunex, a cancer drug maker.
Multimillionaire Irwin Beck, whose father, William Henry Beck, founded the nation's largest family-owned retail chain, Beck Stores, which analysts estimate brought in revenues of $1.7 billion in 1993.
Gordon Binder, CEO of Amgen, the world's foremost biotechnology company, with over $1 billion in product sales in 1992. Amgen's success rests almost exclusively on one product, Neupogen, which is administered to chemotherapy patients to stimulate their production of white blood cells. As the cancer epidemic grows, sales for Neupogen continue to skyrocket.
Diane Disney Miller, daughter of the conservative multi-millionaire Walt Disney, who died of lung cancer in 1966, and wife of Ron Miller, former president of the Walt Disney Company from 1980 to 1984.
George Dessert, famous in media circles for his former role as censor on the subject of "family values" during the 1970s and 1980s as CEO of CBS, and now chairman of the ACS board.
Alan Gevertzen, chairman of the board of Boeing, the world's number one commercial aircraft maker with net sales of $30 billion in 1992.
Sumner M. Redstone, chairman of the board, Viacom Inc. and Viacom International Inc., a broadcasting, telecommunications, entertainment, and cable television corporation.
The results of this board's efforts have been very successful. A million here, a million there— much of it coming from the very industries instrumental in shaping ACS policy, or profiting from it. In 1992, The Chronicle of Philanthropy reported that the ACS was "more interested in accumulating wealth than in saving lives." Fund-raising appeals routinely stated that the ACS needed more funds to support its cancer programs, all the while holding more than $750 million in cash and real estate assets (3). A 1992 article in the Wall Street Journal, by Thomas DiLorenzo, professor of economics at Loyola College and veteran investigator of nonprofit organizations, revealed that the Texas affiliate of the ACS owned more than $11 million worth of assets in land and real estate, as well as more than 56 vehicles, including 11 Ford Crown Victorias for senior executives and 45 other cars assigned to staff members. Arizona's ACS chapter spent less than 10 percent of its funds on direct community cancer services. In California, the figure was 11 percent, and under 9 percent in Missouri (4):
Thus for every $1 spent on direct service, approximately $6.40 is spent on compensation and overhead. In all ten states, salaries and fringe benefits are by far the largest single budget items, a surprising fact in light of the characterization of the appeals, which stress an urgent and critical need for donations to provide cancer services.
Nationally, only 16 percent or less of all money raised is spent on direct services to cancer victims, like driving cancer patients from the hospital after chemotherapy and providing pain medication.
Most of the funds raised by the ACS go to pay overhead, salaries, fringe benefits, and travel expenses of its national executives in Atlanta. They also go to pay chief executive officers, who earn six-figure salaries in several states, and the hundreds of other employees who work out of some 3,000 regional offices nationwide. The typical ACS affiliate, which helps raise the money for the national office, spends more than 52 percent of its budget on salaries, pensions, fringe benefits, and overhead for its own employees. Salaries and overhead for most ACS affiliates also exceeded 50 percent, although most direct community services are handled by unpaid volunteers. DiLorenzo summed up his findings by emphasizing the hoarding of funds by the ACS (4):
If current needs are not being met because of insufficient funds, as fund-raising appeals suggest, why is so much cash being hoarded? Most contributors believe their donations are being used to fight cancer, not to accumulate financial reserves. More progress in the war against cancer would be made if they would divest some of their real estate holdings and use the proceeds— as well as a portion of their cash reserves— to provide more cancer services.
Aside from high salaries and overhead, most of what is left of the ACS budget goes to basic research and research into profitable patented cancer drugs. The current budget of the ACS is $380 million and its cash reserves approach $1 billion. Yet its aggressive fund-raising campaign continues to plead poverty and lament the lack of available money for cancer research, while ignoring efforts to prevent cancer by phasing out avoidable exposures to environmental and occupational carcinogens. Meanwhile, the ACS is silent about its intricate relationships with the wealthy cancer drug, chemical, and other industries. A March 30, 1998, Associated Press Release shed unexpected light on questionable ACS expenditures on lobbying (5). National vice president for federal and state governmental relations Linda Hay Crawford admitted that the ACS was spending "less than $1 million a year on direct lobbying." She also admitted that over the last year, the society used ten of its own employees to lobby. "For legal and other help, it hired the lobbying firm of Hogan & Hartson, whose roster includes former House Minority Leader Robert H. Michel (R– IL)." The ACS lobbying also included $30,000 donations to Democratic and Republican governors' associations. "We wanted to look like players and be players," explained Crawford. This practice, however, has been sharply challenged. The Associated Press release quotes the national Charities Information Bureau as stating that it" does not know of any other charity that makes contributions to political parties." Tax experts have warned that these contributions may be illegal, as charities are not allowed to make political donations. Marcus Owens, director of the IRS Exempt Organization Division, also warned that "The bottom line is campaign contributions will jeopardize a charity's exempt status."
TRACK RECORD ON PREVENTION Marching in lockstep with the National Cancer Institute (NCI) in its "war" on cancer is its "ministry of information," the ACS (6, pp. 306– 314). With powerful media control and public relations resources, the ACS is the tail that wags the dog of the policies and priorities of the NCI (7, 8). In addition, the approach of the ACS to cancer prevention reflects a virtually exclusive "blame-the-victim" philosophy. It emphasizes faulty lifestyles rather than unknowing and avoidable exposure to workplace or environmental carcinogens. Giant corporations, which profit handsomely while they pollute the air, water, and food with a wide range of carcinogens, are greatly comforted by the silence of the ACS. This silence reflects a complex of mindsets fixated on diagnosis, treatment, and basic genetic research together with ignorance, indifference, and even hostility to prevention, coupled with conflicts of interest.
Indeed, despite promises to the public to do everything to "wipe out cancer in your lifetime," the ACS fails to make its voice heard in Congress and the regulatory arena. Instead, the ACS repeatedly rejects or ignores opportunities and requests from Congressional committees, regulatory agencies, unions, and environmental organizations to provide scientific testimony critical to efforts to legislate and regulate a wide range of occupational and environmental carcinogens. This history of ACS unresponsiveness is a long and damning one, as shown by the following examples (6):
1. In 1971, when studies unequivocally proved that diethylstilbestrol (DES) caused vaginal cancers in teenaged daughters of women administered the drug during pregnancy, the ACS refused an invitation to testify at Congressional hearings to require the FDA (U. S. Food and Drug Administration) to ban its use as an animal feed additive. It gave no reason for its refusal.
2. In 1977 and 1978, the ACS opposed regulations proposed for hair coloring products that contained dyes known to cause breast and liver cancer in rodents. In so doing, the ACS ignored virtually every tenet of responsible public health as these chemicals were clear-cut liver and breast carcinogens.
3. In 1977, the ACS called for a Congressional moratorium on the FDA's proposed ban on saccharin and even advocated its use by nursing mothers and babies in "moderation" despite clear-cut evidence of its carcinogenicity in rodents. This reflects the consistent rejection by the ACS of the importance of animal evidence as predictive of human cancer risk.
4. In 1978, Tony Mazzocchi, then senior representative of the Oil, Chemical, and Atomic Workers International Union, stated at a Washington, D. C., round-table between public interest groups and high-ranking ACS officials: "Occupational safety standards have received no support from the ACS."
5. In 1978, Congressman Paul Rogers censured the ACS for doing "too little, too late" in failing to support the Clean Air Act.
6. In 1982, the ACS adopted a highly restrictive cancer policy that insisted on unequivocal human evidence of carcinogenicity before taking any position on public health hazards. Accordingly, the ACS still trivializes or rejects evidence of carcinogenicity in experimental animals, and has actively campaigned against laws (the 1958 Delaney Law, for instance) that ban deliberate addition to food of any amount of any additive shown to cause cancer in either animals or humans. The ACS still persists in an anti-Delaney policy, in spite of the overwhelming support for the Delaney Law by the independent scientific community.
7. In 1983, the ACS refused to join a coalition of the March of Dimes, American Heart Association, and the American Lung Association to support the Clean Air Act.
8. In 1992, the ACS issued a joint statement with the Chlorine Institute in support of the continued global use of organochlorine pesticides— despite clear evidence that some were known to cause breast cancer. In this statement, Society vice president Clark Heath, M. D., dismissed evidence of this risk as "preliminary and mostly based on weak and indirect association." Heath then went on to explain away the blame for increasing breast cancer rates as due to better detection: " Speculation that such exposures account for observed geographic differences in breast cancer incidence or for recent rises in breast cancer occurrence should be received with caution; more likely, much of the recent rise in incidence in the United States . . . reflects increased utilization of mammography over the past decade."
9. In 1992, in conjunction with the NCI, the ACS aggressively launched a " chemoprevention" program aimed at recruiting 16,000 healthy women at supposedly " high risk" of breast cancer into a 5-year clinical trial with a highly profitable drug called tamoxifen. This drug is manufactured by one of the world's most powerful cancer drug industries, Zeneca, an offshoot of the Imperial Chemical Industries. The women were told that the drug was essentially harmless, and that it could reduce their risk of breast cancer. What the women were not told was that tamoxifen had already been shown to be a highly potent liver carcinogen in rodent tests, and also that it was well-known to induce human uterine cancer (6, pp. 145– 151).
10. In 1993, just before PBS Frontline aired the special entitled "In Our Children's Food," the ACS came out in support of the pesticide industry. In a damage-control memorandum sent to some 48 regional divisions, the ACS trivialized pesticides as a cause of childhood cancer, and reassured the public that carcinogenic pesticide residues in food are safe, even for babies. When the media and concerned citizens called local ACS chapters, they received reassurances from an ACS memorandum by its vice president for Public Relations (9): “
The primary health hazards of pesticides are from direct contact with the chemicals at potentially high doses, for example, farm workers who apply the chemicals and work in the fields after the pesticides have been applied, and people living near aerially sprayed fields. . . . The American Cancer Society believes that the benefits of a balanced diet rich in fruits and vegetables far outweigh the largely theoretical risks posed by occasional, very low pesticide residue levels in foods.”
11. In September 1996, the ACS together with a diverse group of patient and physician organizations filed a "citizen's petition" to pressure the FDA to ease restrictions on access to silicone gel breast implants. What the ACS did not disclose was that the gel in these implants had clearly been shown to induce cancer in several industry rodent studies, and that these implants were also contaminated with other potent carcinogens such as ethylene oxide and crystalline silica. This abysmal track record on prevention has been the subject of periodic protests by both independent scientists and public interest groups. A well-publicized example was a New York City, January 23, 1994, press conference, sponsored by the author and the Center for Science in the Public Interest. The press release stated: "A group of 24 scientists charged that the ACS was doing little to protect the public from cancer-causing chemicals in the environment and workplace. The scientists urged ACS to revamp its policies and to emphasize prevention in its lobbying and educational campaigns." The scientists— who included Matthew Meselson and Nobel laureate George Wald, both of Harvard University; former OSHA director Eula Bingham; Samuel Epstein, author of The Politics of Cancer; and Anthony Robbins, past president of the American Public Health Association— criticized the ACS for insisting on unequivocal human proof that a substance is carcinogenic before it will recommend its regulation.
This public criticism by a broad representation of highly credible scientists reflects the growing conviction that a substantial proportion of cancer deaths are caused by exposure to chemical carcinogens in the air, water, food supply, and workplace, and thus can be prevented by legislative and regulatory action. Calling the ACS guidelines an "unrealistically high-action threshold," a letter to ACS executive vice president Lane Adams states that "we would like to express our hope that ACS will take strong public positions and become a more active force to protect the public and the work force from exposure to carcinogens." ACS's policy is retrogressive and contrary to authoritative and scientific tenets established by international and national scientific committees, and is in conflict with long-established policies of federal regulatory agencies. Speakers at the conference warned that unless the ACS became more supportive of cancer prevention, it would face the risk of an economic boycott. Reacting promptly, the ACS issued a statement claiming that cancer prevention would become a major priority. However, ACS policies have remained unchanged. More recently, the author has issued this warning again, a warning echoed by activist women's breast cancer groups.
In Cancer Facts & Figures— 1998, the latest annual ACS publication designed to provide the public and medical profession with "Basic Facts" on cancer— other than information on incidence, mortality, signs and symptoms, and treatment— there is little or no mention of prevention (10). Examples include: no mention of dusting the genital area with talc as a known cause of ovarian cancer; no mention of parental exposure to occupational carcinogens as a major cause of childhood cancer; and no mention of prolonged use of oral contraceptives and hormone replacement therapy as major causes of breast cancer. For breast cancer, ACS states: "Since women may not be able to alter their personal risk factors, the best opportunity for reducing morality is through early detection." In other words, breast cancer is not preventable in spite of clear evidence that its incidence has escalated over recent decades, and in spite of an overwhelming literature on avoidable causes of this cancer (6, Chapt. 6). In the section on "Nutrition and Diet," no mention at all is made of the heavy contamination of animal and dairy fats and produce with a wide range of carcinogenic pesticide residues, and on the need to switch to safer organic foods.
CONFLICTS OF INTEREST Of the members of the ACS board, about half are clinicians, oncologists, surgeons, radiologists, and basic molecular scientists— and most are closely tied in with the NCI. Many board members and their institutional colleagues apply for and obtain funding from both the ACS and the NCI. Substantial NCI funds go to ACS directors who sit on key NCI committees. Although the ACS asks board members to leave the room when the rest of the board discusses their funding proposals, this is just a token formality. In this private club, easy access to funding is one of the "perks," and the board routinely rubber-stamps approvals. A significant amount of ACS research funding goes to this extended membership. Such conflicts of interest are evident in many ACS priorities, including their policy on mammography and their National Breast Cancer Awareness campaign (6).
Mammography The ACS has close connections to the mammography industry. Five radiologists have served as ACS presidents, and in its every move, the ACS reflects the interests of the major manufacturers of mammogram machines and films, including Siemens, DuPont, General Electric, Eastman Kodak, and Piker. In fact, if every woman were to follow ACS and NCI mammography guidelines, the annual revenue to health care facilities would be a staggering $5 billion, including at least $2.5 billion for premenopausal women. Promotions of the ACS continue to lure women of all ages into mammography centers, leading them to believe that mammography is their best hope against breast cancer. A leading Massachusetts newspaper featured a photograph of two women in their twenties in an ACS advertisement that promised early detection results in a cure "nearly 100 percent of the time." An ACS communications director, questioned by journalist Kate Dempsey, responded in an article published by the Massachusetts Women's Community's journal Cancer: "The ad isn't based on a study. When you make an advertisement, you just say what you can to get women in the door. You exaggerate a point. . . . Mammography today is a lucrative [and] highly competitive business."
In addition, the mammography industry conducts research for the ACS and its grantees, serves on advisory boards, and donates considerable funds. DuPont also is a substantial backer of the ACS Breast Health Awareness Program; sponsors television shows and other media productions touting mammography; produces advertising, promotional, and information literature for hospitals, clinics, medical organizations, and doctors; produces educational films; and, of course, lobbies Congress for legislation promoting availability of mammography services. In virtually all of its important actions, the ACS has been strongly linked with the mammography industry, ignoring the development of viable alternatives to mammography.
The ACS exposes premenopausal women to radiation hazards from mammography with little or no evidence of benefits. The ACS also fails to tell them that their breasts will change so much over time that the "baseline" images have little or no future relevance. This is truly an American Cancer Society crusade. But against whom, or rather, for whom?
National Breast Cancer Awareness Month The highly publicized National Breast Cancer Awareness Month campaign further illustrates these institutionalized conflicts of interest. Every October, ACS and NCI representatives help sponsor promotional events, hold interviews, and stress the need for mammography. The flagship of this month-long series of events is National Mammography Day, on October 17 in 1997. Conspicuously absent from the public relations campaign of the National Breast Cancer Awareness Month is any information on environmental and other avoidable causes of breast cancer. This is no accident. Zeneca Pharmaceuticals— a spin-off of Imperial Chemical Industries, one of the world's largest manufacturers of chlorinated and other industrial chemicals, including those incriminated as causes of breast cancer— has been the sole multimillion-dollar funder of National Breast Cancer Awareness Month since its inception in 1984. Zeneca is also the sole manufacturer of tamoxifen, the world's top-selling anticancer and breast cancer "prevention" drug, with $400 million in annual sales. Furthermore, Zeneca recently assumed direct management of 11 cancer centers in U. S. hospitals. Zeneca owns a 50 percent stake in these centers known collectively as Salick Health Care.
The link between the ACS and NCI and Zeneca is especially strong when it comes to tamoxifen. The ACS and NCI continue aggressively to promote the tamoxifen trial, which is the cornerstone of its minimal prevention program. On March 7, 1997, the NCI Press Office released a four-page "For Response to Inquiries on Breast Cancer." The brief section on prevention reads:
“ Researchers are looking for a way to prevent breast cancer in women at high risk. ... Alargestudy [is underway] to see if the drug tamoxifen will reduce cancer risk in women age 60 or older and in women 35 to 59 who have a pattern of risk factors for breast cancer. This study is also a model for future studies of cancer prevention. Studies of diet and nutrition could also lead to preventive strategies.”
Since Zeneca influences every leaflet, poster, publication, and commercial produced by National Breast Cancer Awareness Month, it is no wonder these publications make no mention of carcinogenic industrial chemicals and their relation to breast cancer. Imperial Chemical Industries, Zeneca's parent company, profits by manufacturing breast cancer– causing chemicals. Zeneca profits from treatment of breast cancer, and hopes to profit still more from the prospects of large-scale national use of tamoxifen for breast cancer prevention. National Breast Cancer Awareness Month is a masterful public relations coup for Zeneca, providing the company with valuable, if ill-placed, good will from millions of American women.
The Pesticide Industry Just how inbred the relations between the ACS and the chemical industry are became clear in the spring of 1993 to Marty Koughan, a public television producer. Koughan was about to broadcast a documentary on the dangers of pesticides to children for the Public Broadcasting Service's hour-long show, Frontline. Koughan's investigation relied heavily on an embargoed, ground-breaking report issued by the National Academy of Sciences in June of 1993 entitled "Pesticides in the Diet of Children." This report declared the nation's food supply "inadequately protected" from cancer-causing pesticides and a significant threat to the health of children.
An earlier report, issued by the Natural Resources Defense Council in 1989," Intolerable Risk: Pesticides in our Children's Food," had also given pesticide manufacturers failing marks. The report was released in high profile testimony to Congress by movie actress Meryl Streep. A mother of young children, Streep explained to a packed House chamber the report's findings, namely, that children were most at risk from cancer-causing pesticides on our food because they consume a disproportionate amount of fruits, fruit juices, and vegetables relative to their size, and because their bodies are still forming. Shortly before Koughan's program was due to air, a draft of the script was mysteriously leaked to Porter- Novelli, a powerful public relations firm for produce growers and the agrichemical industry. In true Washington fashion, Porter-Novelli plays both sides of the fence, representing both government agencies and the industries they regulate. Its client list in 1993 included Ciba-Geigy, DuPont, Monsanto, Burroughs Wellcome, American Petroleum Institute, Bristol-Meyers-Squibb, Hoffman-LaRoche, Hoechst Celanese, Hoechst Roussel Pharmaceutical, Janssen Pharmaceutical, Johnson & Johnson, the Center for Produce Quality, as well as the U. S. Department of Agriculture, the NCI, plus other National Institutes of Health.
Porter-Novelli first crafted a rebuttal to help the manufacturers quell public fears about pesticide-contaminated food. Next, Porter-Novelli called up another client, the American Cancer Society, for whom Porter-Novelli had done pro bono work for years. The rebuttal that Porter-Novelli had just sent off to its industry clients was faxed to ACS Atlanta headquarters. It was then circulated by e-mail on March 22, 1993, internally— virtually verbatim from the memo Porter-Novelli had crafted for a backgrounder for 3,000 regional ACS offices to have in hand to help field calls from the public after the show aired.
" The program makes unfounded suggestions . . . that pesticide residue in food may be at hazardous levels," the ACS memo read. "Its use of `cancer cluster' leukemia case reports and non-specific community illnesses as alleged evidence of pesticide effects in people is unfortunate. We know of no community cancer clusters which have been shown to be anything other than chance grouping of cases and none in which pesticide use was confirmed as the cause." This bold, unabashed defense of the pesticide industry, crafted by Porter- Novelli, was then rehashed a third time, this time by the right-wing group, Accuracy in Media (AIM). AIM's newsletter gleefully published quotes from the ACS memo in an article with the banner headline: "Junk Science on PBS." The article opened with "Can we afford the Public Broadcasting Service?" and went on to disparage Koughan's documentary on pesticides and children. "In Our Children's Food . . . exemplified what the media have done to produce these `popular panics' and the enormously costly waste [at PBS] cited by the New York Times."
When Koughan saw the AIM article he was initially outraged that the ACS was being used to defend the pesticide industry. "At first, I assumed complete ignorance on the part of the ACS," said Koughan. But after repeatedly trying, without success, to get the national office to rebut the AIM article, Koughan began to see what was really going on. "When I realized Porter-Novelli represented five agrichemical companies, and that the ACS had been a client for years, it became obvious that the ACS had not been fooled at all," said Koughan. "They were willing partners in the deception, and were in fact doing a favor for a friend— by flakking for the agrichemical industry." Charles Benbrook, former director of the National Academy of Sciences Board of Agriculture, worked on the pesticide report by the Academy of Sciences that the PBS special would preview. He charged that the role of the ACS as a source of information for the media representing the pesticide and produce industry was "unconscionable" (11). Investigative reporter Sheila Kaplan, in a 1993 Legal Times article, went further: "What they did was clearly and unequivocally over the line, and constitutes a major conflict of interest" (12).
Cancer Drug Industry The intimate association between the ACS and the cancer drug industry, with cur-rent annual sales of about $12 billion, is further illustrated by the unbridled aggression which the Society has directed at potential competitors of the industry (13). Just as Senator Joseph McCarthy had his "black list" of suspected communists and Richard Nixon his environmental activist "enemies list," so too the ACS maintains a "Committee on Unproven Methods of Cancer Management" which periodically "reviews" unorthodox or alternative therapies. This Committee is comprised of "volunteer health care professionals," carefully selected proponents of orthodox, expensive, and usually toxic drugs patented by major pharmaceutical companies, and opponents of alternative or "unproven" therapies which are generally cheap, nonpatentable, and minimally toxic (13).
Periodically, the Committee updates its statements on "unproven methods," which are then widely disseminated to clinicians, cheerleader science writers, and the public. Once a clinician or oncologist becomes associated with "unproven methods," he or she is blackballed by the cancer establishment. Funding for the accused "quack" becomes inaccessible, followed by systematic harassment. The highly biased ACS witch-hunts against alternative practitioners is in striking contrast to its extravagant and uncritical endorsement of conventional toxic chemotherapy. This in spite of the absence of any objective evidence of improved survival rates or reduced mortality following chemotherapy for all but some relatively rare cancers.
In response to pressure from People Against Cancer, a grassroots group of cancer patients disillusioned with conventional cancer therapy, in 1986 some 40 members of Congress requested the Office of Technology Assessment (OTA), a Congressional think tank, to evaluate available information on alternative innovative therapies. While initially resistant, OTA eventually published a September 1990 report that identified some 200 promising studies on alternative therapies. OTA concluded that the NCI had "a mandated responsibility to pursue this information and facilitate examination of widely used `unconventional cancer treatments' for therapeutic potential" (14).
Yet the ACS and NCI remain resistant, if not frankly hostile, to OTA's recommendations. In the January 1991 issue of its Cancer Journal for Clinicians ACS referred to the Hoxsey therapy, a nontoxic combination of herb extracts developed in the 1940s by populist Harry Hoxsey, as a "worthless tonic for cancer." However, a detailed critique of Hoxsey's treatment by Dr. Patricia Spain Ward, a leading contributor to the OTA report, concluded just the opposite:" More recent literature leaves no doubt that Hoxsey's formula does indeed contain many plant substances of marked therapeutic activity" (13).
Nor is this the first time that the Society's claims of quackery have been called into question or discredited. A growing number of other innovative therapies originally attacked by the ACS have recently found less disfavor and even acceptance. These include hyperthermia, tumor necrosis factor (originally called Coley's toxin), hydrazine sulfate, and Burzynski's antineoplastons. Well over 100 promising alternative nonpatented and nontoxic therapies have already been identified (15). Clearly, such treatments merit clinical testing and evaluation by the NCI using similar statistical techniques and criteria as established for conventional chemotherapy. However, while the FDA has approved approximately 40 patented drugs for cancer treatment, it has still not approved a single nonpatented alternative drug.
Subsequent events have further isolated the ACS in its fixation on orthodox treatments. Bypassing the ACS and NCI, the National Institutes of Health in June 1992 opened a new Office of Alternative Medicine for the investigation of unconventional treatment of cancer and other diseases. Leading proponents of conventional therapy were invited to participate. The ACS refused and still refuses. The NCI grudgingly and nominally participates while actively attacking alternative therapy with its widely circulated Cancer Information Services. Meanwhile, the NCI's police partner, the FDA, uses its enforcement authority against distributors and practitioners of innovative and nontoxic therapies. In an interesting recent development, the Center for Mind-Body Medicine in Washington, D. C., held a two-day conference on Comprehensive Cancer Care: Integrating Complementary and Alternative Medicine. According to Dr. James Gordon, president of the Center and chair of the Program Advisory Council of the NIH Office of Alternative Medicine, the object of the conference was to bring together practitioners of mainstream and alternative medicine, together with cancer patients and high-ranking officials of the ACS and NCI. Dr. Gordon warned alternative practitioners that "they're going to need to get more rigorous with their work— to be accepted by the mainstream community" (16). However, no such warning was directed at the highly questionable claims by the NCI and ACS for the efficacy of conventional cancer chemotherapy. As significantly, criticism of the establishment's minimalistic priority for cancer prevention was effectively discouraged.
THE ROLE OF ACS IN THE WAR AGAINST CANCER The launching of the 1971 War Against Cancer provided the ACS with a well-exploited opportunity to pursue it own myopic and self-interested agenda. Its strategies remain based on two myths— that there has been dramatic progress in the treatment and cure of cancer, and that any increase in the incidence and mortality of cancer is due to aging of the population and smoking, while denying any significant role for involuntary exposures to industrial carcinogens in air, water, consumer products, and the workplace.
As the world's largest nonreligious "charity," with powerful allies in the private and public sectors, ACS policies and priorities remain unchanged. Despite periodic protests, threats of boycotts, and questions on its finances, the Society leadership responds with powerful public relations campaigns reflecting denial and manipulated information and pillorying its opponents with scientific McCarthyism.
The verdict is unassailable. The ACS bears a major responsibility for losing the winnable war against cancer. Reforming the ACS is, in principle, relatively easy and directly achievable. Boycott the ACS. Instead, give your charitable contributions to public interest and environmental groups involved in cancer prevention. Such a boycott is well overdue and will send the only message this "charity" can no longer ignore. The Cancer Prevention Coalition (chaired by the author) in April 1999 formally announced a nationwide campaign for an economic boycott of the ACS (http://www.preventcancer.com).
Published in: International Journal of Health Services Vol. 29, No. 3, 1999.
REFERENCES 1. Bennett, J. T. Health research charities: Doing little in research but emphasizing politics. Union Leader, Manchester, N. H., September 20, 1990.
2. Bennett, J. T., and DiLorenzo, T. J. Unhealthy Charities: Hazardous to Your Health and Wealth. Basic Books, New York, 1994.
3. Hall, H., and Williams, G. Professor vs. Cancer Society. The Chronicle of Philanthropy, January 28, 1992, p. 26.
4. DiLorenzo, T. J. One charity's uneconomic war on cancer. Wall Street Journal, March 15, 1992, p. A10.
5. Salant, J. D. Cancer Society gives to governors. Associated Press Release, March 30, 1998.
6. Epstein, S. S., Steinman, D., and LeVert, S. The Breast Cancer Prevention Program. Macmillan, New York, 1997.
7. Epstein, S. S. Losing the war against cancer: Who's to blame and what to do about it. Int. J. Health Serv. 20: 53– 71, 1990.
8. Epstein, S. S. Evaluation of the National Cancer Program and proposed reforms. Int. J. Health Serv. 23( 1): 15– 44, 1993.
9. American Cancer Society. Upcoming television special on pesticides in food. Memorandum from S. Dickinson, Vice-President, Public Relations and Health, to C. W. Heath, Jr., M. D., Vice-President. Epidemiology and Statistics, March 22, 1993.
10. American Cancer Society. Cancer Facts & Figures— 1998, pp. 1– 32, Atlanta, 1998.
11. Kaplan, S. PR Giant makes hay from client cross-pollination: Porter/ Novelli plays all sides. PR Watch, First quarter, 1994, p. 4.
12. Kaplan, S. Porter-Novelli plays all sides. Legal Times 16( 27) :1, November 23, 1993.
13. Moss, R. W. Questioning Chemotherapy. Equinox Press, Brooklyn, N. Y., 1995.
14. U. S. Congress Office of Technology Assessment. Unconventional Cancer Treatments. U. S. Government Printing Office, Washington, D. C., 1990.
15. Moss. R. W. Cancer Therapy: The Independent Consumer's Guide to Non-toxic Treatment and Prevention. Equinox Press, Brooklyn, N. Y., 1992.
16. Castellucci, L. Practitioners seek common ground in unconventional forum. J. Natl. Cancer Inst. 90: 1036– 1037, 1998.
Contact:
Samuel S. Epstein, M.D. University of Illinois at Chicago
School of Public Health, MC 922 2121 W. Taylor Street Chicago, IL 60612-7260
Ever wonder how mammogram radiation machines really work?
(NaturalNews) A new report released by the National Council on Radiation Protection and Measurement reveals that Americans' exposure to radiation has increased more than 600 percent over the last three decades. Most of that increase has come from patients' exposure to radiation through medical imaging scans such as CT scans and mammograms.
Most patients have no awareness of the dangers of ionizing radiation due to medical imaging scans. Virtually no patients -- and few doctors -- realize that one CT scan exposes the body to the equivalent of several hundred X-rays (http://www.naturalnews.com/023582.html), for example. Most women undergoing mammograms have no idea that the radiation emitted by mammography machines actually causes cancer by exposing heart and breast tissue to dangerous ionizing radiation that directly causes DNA damage.
Even low doses of radiation can add up to significant increases in lifelong cancer risk. A study published in the New England Journal of Medicine (2007) found that survivors of the 1945 atomic bombs unleashed on Japan during World War II still faced significant increases in lifetime cancer risk. And the levels of radiation to which these particular study subjects were exposed is equivalent to receiving only two or three CT scans, explains an ABC News story (http://abcnews.go.com/Health/Cancer...).
Yes, it's true: A couple of CT scans can expose your body to as much radiation as standing a few miles from an atomic bomb explosion. This is a simple scientific fact.
Is modern medicine priming the population for a wave of future cancers?
Exposure to CT scans and mammograms today can lead to cancer much later in life. As ABC News reports, Dr. Len Lichtenfeld, the deputy chief medical officer of the American Cancer Society, says, "Radiation exposure from these scans is not inconsequential and can lead to later cancers."
Thanks to the widespread use of medical imaging scans, hospitals are also becoming a major source of nuclear waste material. See the NaturalNews report on that topic here: http://www.naturalnews.com/025711.html
This material can be seized by terrorists and used to make dirty bombs. Thus, hospitals are now a major source for potential tools for terrorists.
Tuesday, February 24, 2009 by: David Gutierrez, staff writer
(NaturalNews) Hospitals have become a major source of nuclear waste in the United States, producing and storing millions of radioactive materials each year with no long-term disposal plan. Experts increasingly fear that such waste could pose health hazards or be stolen by terrorists and used to build dirty bombs.
"Instead of safely secured in one place, it's stored in thousands of places in urban locations all over the United States," said nuclear waste consultant Rick Jacobi.
Hospitals and other health facilities use radioactive material for a variety of functions, from examination to treatment. For example, radiation from cobalt and powdered cesium is used to sterilize blood and medical equipment, while cobalt is also used to kill diseased brain tissue. Capsules of cesium are implanted next to tumors to kill cancerous cells, and thin tubes of radioactive material are used to operate gauges and other diagnostic devices.
The federal government has long had a policy that individual states should build sites where radioactive waste produced in that state can be stored and disposed of, but failed to create penalties for states that did not comply. As a consequence, only three such radioactive waste facilities exist in the United States.
The first such site, South Carolina's Barnwell Low-Level Radioactive Waste Disposal Facility, used to accept waste from 39 states across the country, seal it in concrete, and bury it. But on July 1, a new state law went into effect, restricting use of the facility to waste generated in South Carolina, New Jersey and Connecticut.
Due to a widespread citizen aversion to having radioactive waste stored anywhere near neighborhoods or wild areas, the odds are not high that many new landfills will be built any time soon -- only one, in Utah, has opened in the last 30 years. Plans are in the works for a new facility in Texas, but that site would accept waste only from Texas and Vermont. A group of four southern states sued North Carolina in 2002 for failing to build a radioactive waste storage site, but the case is still pending.
As a consequence, hospitals - along with pharmacies, research labs and the manufacturers of devices for those facilities - are left with the task of storing and disposing of their own waste. Some hospitals, such as those affiliated with Louisiana State University (LSU), have turned to outside companies for disposal.
"The vendor picks it up a couple of times a year," said Donell Chagnard, safety and risk management director of LSU Health Sciences Center. Chagnard seemed to be uncertain exactly what the vendor does with the radioactive waste, however.
"Some of it is probably burned, some is probably buried," he said.
Other facilities simply store the material on site until its radioactivity drops to levels considered safe for normal disposal. At some institutions, this waste is stored in highly secure, lead-lined safes, clearly marked with warning labels and even protected by alarmed doors. These procedures are in line with a government directive issued after September 11, 2001, that radioactivity sources be secured from possible theft by terrorists, using measures such as 24-hour surveillance and the fingerprinting of employees.
At other institutions, however, radioactive waste may simply be piled up in basements or closets.
While the government officially monitors the disposal of radioactive waste, officials admit that inspections occur only once every five years or so. Furthermore, a 2003 Government Accountability Office report concluded that the government doesn't even know how many facilities around the country are even using or storing radioactive materials, and that tracking of such material remained inadequate.
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