Cancer

In October 1926, the frequently dissident New York journal Cancer published an article from London by Dr. Stanton Hooker, “Eclecticism in Cancer Therapy.” This, in effect, was favorable to the nineteenth-century, or medical-missionary, approach and deplored concentration upon producing cancer in beasts artificially and then watching them sicken and die — all with the hope, of course, of finding out how to stop the trouble the experimenters themselves had started, they talking optimistically meanwhile. Said Dr. Hooker:

“There is, as a matter of fact, a growing group of independent thinkers — both lay and professional — who are anything but impressed with the story of the discovery and isolation of the ‘cancer germ’ ... Mr. Ellis Barker has also written reiterating his views in common with those of Sir Arbuthnot Lane, my own, and many others, that cancer is a disease of civilization, caused by wrong eating, drinking, and other factors ...”

Hooker quotes Sir Arbuthnot Lane: “‘Possibly some cancer research institution may find a cure for cancer, but the chance of their doing so is infinitely small.’” Implying that we already know that cancer is prevented or retarded by certain diets, promoted by others, Hooker says, “The medical slogan of the near future will be: ‘Prevention is better than cure ...’” Hooker paraphrases Dr. Hastings Gilford: “His general statement is that civilization is the cause of cancer.”

In the July 1927 issue of Cancer is an article by Dr. William Howard Hay of Buffalo, N.Y., “Cancer a Disease of Either Election or Ignorance.” The trend is the same as that of Hooker's article, favoring the nineteenth-century approach to the cancer problem and with a strengthened attack upon the twentieth-century version:

“Think back over the years of cancer research, of the millions spent, the time consumed, the pains expended ... and where are we today? Is it not time to take stock of our basic conception, to see if there is not something radically wrong with this to account for the years of utter and complete failure to date? ... Cancer has been consistently on the increase ... since the advent of the Society for the Control of Cancer; with the millions of endowed effort, this increase has been accelerated ...

“A study of the distribution of cancer, among the races of the entire earth, shows a cancer ratio in about the proportion to which civilized living predominates; so evidently something inherent in the habits of civilization is responsible for the difference of cancer incidence as compared with the uncivilized races and tribes. Climate has nothing to do with this difference, as witness the fact that tribes living naturally will show a complete absence of cancer till mixture with more civilized man corrupts the naturalness of habit; and just as these habits conform to those civilizations, even so does cancer begin to show its head ...

“Is it possible the cause of cancer is our departure from natural foods? It would surely look so to any man from Mars; but we have so long lived on processed foods ... that we are in a state of unbalanced nutrition from birth ... we have come to regard these foods as the hallmark of civilization, when it is a fact that these very foods set the stage for every sort of ill, including cancer ...”

 Obviously, from the testimony presented so far, the frontier doctors of Alaska and northern Canada would have expected that statistics, if and when published, would confirm their view that the most civilized parts of northern territories would show the highest cancer incidence.

The chance to test this theory against the facts of statistically adequate population, and for a large and culturally differentiated area, did not come until the U.S. Treasury's Public Health Reports for March 2, 1934, carried “Mortality in the Native Races of the Territory of Alaska, with Special Reference to Tuberculosis," by F. S. Fellows, Passed Assistant Surgeon, United States Public Health Service, and Director, Alaska Medical Service.

The discussion by Dr. Fellows does have “special reference to tuberculosis.” But “malignancy" receives a column in the statistical tables, from which we can readily derive the information we need. The time covered is the five years 1926-30; the population, by the 1930 census, was around 60,000, about evenly divided between natives and whites, thus about 30,000 of each. As to causes of death, Dr. Fellows compares natives with whites and each of the four judicial divisions of Alaska with the other three. For my analysis of his cancer results I shall arrange the divisions in descending order of Europeanization. With an eye on the map (p. 91) and bearing history in mind, we may characterize the judicial divisions as follows:

Most intensively and longest civilized is the First Judicial Division, the Panhandle that stretches southeasterly along British Columbia. Its first European contacts were probably with Spain through Mexico in the 1500's. After Bering's voyage in 1741 the capital of Russian America was established at Sitka, where it remained even for some decades after the over-all name was changed to Alaska through purchase by the United States in 1867. Both before and after 1776 Yankee influence was considerable, as was British. After the purchase the influence of San Francisco was at first dominant, until Seattle and Vancouver took over.

Since the forest Indians of the Panhandle have been civilized the longest and most intensively of native Alaskans, the First Judicial Division ought to show the heaviest cancer incidence, according to the views of the frontier doctors whom we have quoted. That is the theory. Let us turn to statistics and seek the facts.

Table 2 of the Fellows paper is entitled “Actual and relative mortality from important causes among the native Indians and Eskimos and among the white population of Alaska during the five years 1926-30.” In the first third of this table, under “Average annual death rate per 100,000,” we find in the column marked “Malignancy” that in the First Judicial Division the white deaths from cancer are 92, the native 70. In the middle third of the table, under “Percent of all deaths due to indicated cause,” we learn that the white percentage from cancer was 7.8, the native 2.8. In the lowest third of the table, under “Number of deaths,” we learn that the whites who died of cancer were 59, the natives 21.

Map showing judicial divisions of Alaska

Historically the Third Judicial Division of Alaska ranks second among the divisions in Europeanization. It consists of the Aleutian island chain and of the southwestern corner of the mainland. Russian influence in the islands dates as far back as in the Panhandle, but the mainland part of the division was never intensively Europeanized. By the Tanchou-Le Conte principle, the native cancer rate should be fairly high but not as high as that of the Panhandle. According to Fellows' Table 2, the cancer figure per 100,000 is 75 for whites and 22 for natives; in percentages the whites rate 6.0 and the natives 1.4; in actual cancer deaths the whites have 33 and the natives 8.

The Second Judicial Division, from its history, should be in native cancer deaths the next to the lowest of the judicial districts, by the frontier theory. According to the tables of Dr. Fellows the per hundred thousand rate is white 126 to native 14; in percentages it is white 10.8 to native 0.8; in actual deaths the white are 9 to the native 6.

The Fourth Judicial Division should be lowest of the four in native cancer deaths. Here the population consists mainly of Athapaskan forest Indians who, except in becoming Christian, have resisted Europeanization much more successfully than either Eskimos or Aleuts, and far more successfully than the natives of the Panhandle.

According to Dr. Fellows the per hundred thousand rate is white 98, native 3; in percentage it is white 8.4, native 0.1; in actual number of cancer deaths the Fourth Judicial has white 27 and native 1.

The medical missionary theorists, those who favor the Tanchou-Le Conte principle, will think that the percentage table (the middle division of Dr. Fellows' Table 2) confirms their belief in most satisfactory fashion. In percentages of all deaths during the five years 1926-30, the cancer rate drops from the highest to the lowest of the districts on the scale as 7.8 to 2.8; 6.0 to 1.4; 10.8 to 0.8; and 8.4 to 0.1.

BUFFALO, Sept. 3 (P), Sugar is "fuel' for cancer, and its regulation in diet essential for cancer treatment, the American Chemical society was told yesterday. The report came from the cancer research department of the University of Pennsylvania, from work done by Gladys E. Woodward and Edith G. Fry, under direction of Dr. Ellice McDonald. 

"In cancer," said Dr. McDonald, in explaining the technical report, "the essential difference between tumor tissue and normal tissue is the ability of cancer to digest the animal sugar (or glycogen) in a different and more expeditious way than normal. "The greater the amount of sugar there is in the blood of cancer patients, the shorter is the expectation of their lives. There is a greater growth of the cancer when there is a large amount of sugar in the blood. The tumor grows faster, and there are a greater number of dividing cells. Cancer patients with a low blood sugar respond well to treatment and have a better chance of survival, with slow growth of the tumor.

"The amount of the sugar in the blood of cancer patients should be periodically measured, particularly before and after any treatment, for if the blood sugar increases after any treatment of the tumor, this should be corrected before any further treatment is instituted, and any new treatment should be based on the results of the tests. 

"The general conclusion is that cancer patients, particularly those with a high level of blood sugar, should be put on a low carbohydrate diet which should contain little or no sugar."

 

The Mortality from Cancer Throughout the World, a work I have cited frequently, was issued during 1915 by the Prudential; it is an 826-page volume by Dr. Frederick L. Hoffman, head of the company's statistical department as well as chairman of the Committee on Statistics of the American Society for the Control of Cancer. As implied above, it runs through Hoffman's work that uncivilized people seldom if ever have cancer. Throughout it is implied, and now and then stated, that this is a common and orthodox belief.

But in later works it appears that Hoffman, though still himself of the same view, realized that there were many skeptics. This is especially apparent in the second of his huge volumes, Cancer and Diet (1937). Here, page 90, is the passage I shall use to introduce Cope:

“An exceedingly important work on Cancer: Civilization and Degeneration by John Cope, was published in London in 1932. Cope discusses the early eating habits of the English and the rarity of cancer at the time, the disease increasing as the consumption of meat decreased. He deplores certain civilized customs ...”