Cancer

Mrs. Greist, who herself had ceased northern nursing in 1936, advised me to get in touch with a nurse whom the government had sent to help take over the Farthest North Hospital's work when it was transferred by the Presbyterian Church to the Department of the Interior. Mrs. Greist had been deeply impressed with Miss Mildred H. Keaton, both as to her professional training and as to her long and varied experience as a dog team and airplane nurse who was thoroughly familiar with the native situation at the western end of northern Alaska (at the Kotzebue Government hospital, just east of Bering Strait and just north of the Arctic Circle). From there eastward, Miss Keaton had again and again traversed a thousand miles of coast beyond Barrow to the Canadian border.

Miss Keaton replied to my letter on April 15, 1957, from her new post at the White Pass and Yukon Route Hospital, Skagway, Alaska:

“Regarding the absence of cancer from the pre-white Eskimos of arctic Alaska, it has ever been a source of wonder to me that during the fifteen years when I was a field nurse in the Kotzebue and Barrow districts, going east of Barrow to Demarcation Point [on the Canadian boundary], among the more primitive Eskimos, only once did I come in contact with a diagnosed case of cancer ...” (In later correspondence Miss Keaton said this lone case seen by herself was in the middle 1930's, thus two or three years after the above Greist autopsy and cancer identification at Barrow.)

“We field nurses have often wondered why the women did not have breast cancer, due to the way they carried their babies on their backs with a strong leather or reindeer skin belt fastened tightly around their chest ... the pressure on the mammary glands of the breasts must have been severe.

“The late Dr. Ray Edward Smith was hospital physician in Kotzebue for some 16 years ... [serving] a population of native people totaling about three thousand coming to Kotzebue Hospital. He once told me he had always been most pleasantly surprised at the absence of cancer of any kind among these people.”

Since this statement is restricted to one localized form of malignancy, breast cancer, I arranged through mutual friends to meet, on my next visit to Montreal, Dr. Ray N. Lawson of 4459 Sherbrooke Street West, Montreal 6. He said in conversation, and has more recently said in writing, that he believes most or all other types of malignancy to be as rare as breast cancer, among those Eskimos of the Canadian Arctic who still depend for the main part of their food on fat and lean seal's meat, cooked moderately or eaten raw. Those whom he investigated, up to the end of 1957, were typically seal hunters, not much dependent on fur trapping, very little dependent on European foods or on European-style cooking.

At first Dr. Lawson's inability to find cancer led him to think that there might be some special immunizing agent in seal's fat, particularly if rancid. However, my understanding later (as of middle 1958) was that while he remains a believer in the general merit of high-fat, low-carbohydrate, little-cooked diets, he is no longer so strongly inclined to believe that seal's fat, fresh or rancid, has any marked anticarcinogenic effect, beyond whatever merit there is in the Stone Age Eskimo way of life as a whole. He feels that “there is something in primitive [Eskimo] diet that protects from malignant disease.”

Benjamin D. Stewart, of Sitka, Alaska, is a retired territorial commissioner of mines, now past eighty, who knew Romig in his middle years. I sent him for comment the Price interview of 1933, including the statement that Romig was a surgeon of great skill and that he was “the best loved man in all Alaska.” Mr. Stewart replied February 6, 1958:

“As to my first-hand knowledge of Dr. Romig, I can confirm all of the good things said of him in the extracts you sent ... I knew him well during the time he was in charge of the Railway Hospital in Anchorage and later when he was for a time practicing privately in Seward. In fact I called on him to help me recover [from a heart attack] ... I have always believed [that he] actually saved my life. Naturally I have always looked upon him as a highly skilled doctor ... There is no doubt he was widely beloved and that he was regarded as the outstanding doctor in Southwestern Alaska.”

The second letter on Romig is from the Reverend Henry H. Chapman, rector of St. Peter’s-by-the-Sea, Sitka, who wrote September 8, 1958:

“My father was a missionary of the Episcopal Church at Anvik, Alaska. I was born in Anvik, in 1895. The native people of that area are [Athapaska] Indians. My acquaintance with Dr. Romig dates from the years 1923-27 when I was in charge of the Episcopal Church at Fairbanks. Dr. Romig was my physician, surgeon and friend during those years. At that time the Episcopal Church maintained a boarding school for Indian boys and girls at Nenana, 65 miles south of Fairbanks. Dr. Romig used to visit the mission periodically examining the children in the school ... always without charge.”

This is the sort of man and physician it was who told Dr. Price in 1933 that “he had never seen a case of malignant disease among the truly primitive Eskimos and Indians, although it frequently occurs when they become modernized.” Confirming this to me in 1940, Dr. Romig further indicated, both then and later, that he looked upon cancer as nonracial in its selection of victims. He thought it certainly environmental in its cause, and probably nutritional.

Romig thought it interesting to compare malignancies with other troubles that were extremely rare, if found at all, among the primitive Athapaskans and Eskimos of southwestern Alaska around 1900. What some of these rare or missing diseases and troubles were we here set down alphabetically from two sources, the extended text of the Price interview [from which we earlier extracted the quoted remarks on cancer], and then the 1948 paper which Romig submitted in first draft as a contribution to our Encyclopedia Arctica. According to Romig, the very rare or missing nutrition-linked difficulties of the pre-Europeanization time were these, among others: appendicitis, arthritis, beri-beri, cancer, caries (dental), constipation, corpulence, diabetes, epilepsy, gall stones, gastric ulcer, hypertension, night blindness, pellagra, rheumatism, rickets, and scurvy.

Thirty years later Dr Dennis Burkitt, while working as a doctor in Africa, discovered that there was a much lower incidence of cancer of the colon among rural black Africans than among Europeans and Americans. He attributed this low incidence to their relatively crude diet. The theory was that fibre hastened the passage of the bowel contents thus allowing less time for cancer-inducing agents to form. This, of course, presupposed that food became carcinogenic in the gut and there was no evidence that it did. Neither was there any evidence that moving food through the intestine at a faster rate decreased the risk of cancer.

Paper published 1989:

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Abstract

The authors collected and analyzed cancer incidence data for Alaska Natives (Indians, Eskimos, and Aleuts) for the 15-year period 1969-83 by ethnic and linguistic groups. Compared with U.S. whites, observed-to-expected ratios are high in more than one ethnic group for cancer of the nasopharynx, salivary gland, liver, gallbladder, and cervix. Low ratios were found for cancer of the breast, uterus, bladder, and melanoma. In Alaska, Eskimos have the highest risk for cancer of the esophagus and liver and the lowest risk for breast and prostate cancer. Risk for multiple myeloma in Indian men in Alaska exceeds not only those of other Native groups in Alaska but that in U.S. whites as well. Despite the short period studied, increases in cancer incidence over time can be documented for lung cancer in Eskimo men and women combined, and for cervical cancer, especially in Indian women.