Health equality

Ken Schlossberg

April 25, 1991|By Ken Schlossberg

DESPITE all the research and therapies, more and more American women are suffering and dying from breast cancer. It now strikes one of every nine women.

The statistics are bad enough, but if you have a relative who has had the disease, you are aware of the terrible suffering involved. My mother was diagnosed as having a breast tumor in 1983 and, after an initial "cure," died from its spread five years later.

I happen to have had a direct influence on federal research policy on the possible relationship between diet and breast cancer when I was staff director of the Senate Select Committee on Nutrition almost two decades ago. Hearings on the relationship between diet and chronic diseases, including breast cancer, ultimately led to the adoption of federal dietary goals.

The goals were accepted after considerable opposition within the government to changing research priorities to account for the key role that nutrition and diet play in the long development of disease. One of the most recalcitrant agencies was the National Cancer Institute of the National Institutes of Health.

The latest evidence of this recalcitrance was, oddly, the finding published this month in the cancer institute's journal that rats fed high-fiber diets developed a lot fewer breast tumors than rats that ate no fiber. Unfortunately, this study only demonstrates that the institute seems more interested in studying rats than living, breathing women.

But there was cause for optimism last week when the new NIH director, Dr. Bernadine Healy, announced a bold $500 million initiative to study women's health. Research on the link between diet and breast cancer should be a top priority.

Despite efforts by scientists and women's groups over the years to get the National Cancer Institute to do a large study on diet and breast cancer -- comparable to what the National Heart Institute has done on men and coronary artery disease -- the institute has refused to do so. The most egregious refusal occurred a few months ago after the Senate health appropriations subcommittee instructed the institute "to cooperatively and aggressively move forward" with a study conducted on women.

"The committee is disturbed to learn that more emphasis is not being placed on prevention and education programs within the [cancer institute]," the committee wrote.

This winter, the institute's scientists and the head of prevention programs approved the idea for a large study and presented it to the institute's advisory board, which is dominated by laboratory scientists primarily interested in basic, not applied, research. The board rejected the recommendation on the grounds that the study would cost too much, take too long and might not be worth it. (No one raised these objections when the issue was studying heart disease in men.) Instead, the board approved minimal start-up expenses, with no commitment to a large study.

The NIH should direct the cancer institute to go ahead with this study. If it does, maybe a decade from now we will have the answers we need for our mothers, daughters, sisters and wives -- not just for the rats.

Ken Schlossberg is a consultant on nutrition policy. 9

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