Vitamin C and Cancer: Medicine or Politics?

277 Pages·1991·33.516 MB·English

by  Evelleen Richards (auth.)

Evelleen Richards
VITAMIN C AND CANCER:
MEDICINE OR POLITICS?
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The original draft of Linus Pauling's letter to Arnold Reiman, editor of the New
England Journal of Medicine, in the wake of the second Mayo Clinic trial of vitamin C.
(Reproduced by kind permission of Linus Pauling)
Vitatnin C and Cancer:
Medicine or Politics?
Evelleen Richards
Science and Technology Studies Dept
University of Wollongong, Australia
M
MACMILLAN
© Evelleen Richards 1991
Softcover reprint of the hardcover 1st edition 1991
All rights reserved. No reproduction, copy or transmission
of this publication may be made without written permission.
No paragraph of this publication may be reproduced, copied
or transmitted save with written permission or in accordance
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issued by the Copyright Licensing Agency, 33-4 Alfred Place,
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Any person who does any unauthorised act in relation to
this publication may be liable to criminal prosecution and
civil claims for damages.
First published 1991
Published by
MACMILLAN PROFESSIONAL AND ACADEMIC LTD
Houndmills, Basingstoke, Hampshire RG21 2XS
and London
Companies and representatives
throughout the world
British Library Cataloguing in Publication Data
Richards, Evelleen
Vitamin C and cancer: medicine or politics?
1. Man. Cancer. Drug therapy. Drugs. Testing.
I. Title
616.9940610287
ISBN 978-1-349-09608-4 ISBN 978-1-349-09606-0 (eBook)
DOI 10.1007/978-1-349-09606-0
To Warwick,
whose idea this was
Contents
Acknowledgements xi
Introduction 1
Why the Vitamin C and Cancer Controversy? 6
Telling It Like It Is 9
PART I: Interested Parties and the Background
to the Controversy
1 Charting the Terrain 17
1.1 Introducing Vitamin C 17
1.2 The Battlefield: The Treatment of Cancer 20
1.3 National Differences in Medical Organization and
Practice 27
1.4 Cancer Clinical Trials 28
2 The Vitamin C 'Believers' 33
2.1 Linus Pauling 34
2.2 Ewan Cameron 38
2.3 The Linus Pauling Institute 40
2.4 The Robinson Affair 42
2.5 Megavitamin Therapy and Orthomolecular
Medicine 43
2.6 The Holistic Health Movement and the 'Freedom
Fighters' for Alternative Cancer Treatments 45
2.7 The Health Food Industry 49
3 The Vitamin C 'Nonbelievers' 52
3.1 Dr Charles Moertel 53
3.2 The Cancer Establishment 54
3.3 The National Cancer Institute 55
3.4 The Food and Drug Administration 57
3.5 The American Cancer Society 61
vii
viii Vitamin C and Cancer
3.6 Orthodox Nutritionists, 'Quackbusters', and the
Fight Against 'Nutritional Quackery 63
3.7 The New England Journal of Medicine and the
Profession of Medicine 66
PART II: Reconstructing the Vitamin C and
Cancer Controversy
4 The Cameron-Pauling Hypothesis and the Vale
of Leven Trials 75
4.1 The Cameron-Pauling Hypothesis: Vitamin C
and PHI 76
4.2 The Pilot Vale of Leven Trials 87
4.3 The PNAS Affair 90
4.4 Cameron's Pilot Trial Findings and his
Presentation Strategy 92
4.5 Refining the Vale of Leven Trials 101
4.6 Publicity 106
4.7 A Time of Optimism 107
4.8 The Conclusion of the Sloan-Kettering Trial 109
5 The First Mayo Clinic Trial: Pauling's 'Head-On
Collision with the Scientific Method'? 111
5.1 The First Mayo Clinic Trial 112
5.2 The Second Mayo Clinic Trial is Announced 124
5.3 Pauling, Moertel, and the Laetrile Controversy 127
5.4 Of Mice and Men 134
5.5 Cameron's Continuing Research 137
6 The Second Mayo Clinic Trial: 'A Conspiracy to
Suppress the Truth'? 141
6.1 The Second Mayo Clinic Trial 142
6.2 The Pauling-Cameron Criticisms 145
6.3 Ploys and Tactics 149
6.4 The Publication Game 158
6.5 Closing the Controversy 165
PART III: The Politics of Therapeutic Evaluation
7 The Social Shaping of the Vitamin C and Cancer
Controversy 171
Contents ix
7.1 The Social Negotiation of the Efficacy of Vitamin C
as a Cancer Treatment 174
7.2 More Negotiations: The Social Character of the
Publication Process 178
7.3 Fact-making and the Media, with a Law Suit
on the Side 181
7.4 The Importance of Rhetoric 182
7.5 The Rhetorical Deployment and Malleability of
Ethical Claims 184
7.6 The Centrality of Method Talk: Its Rhetoric
and Political Functions 186
8 Comparative Analysis of the Controversy:
Vitamin C, 5-Fluorouracil, and Interferon 192
8.1 5-Fluorouracil: 'The Breakthrough That Never Was'
as Conventional Cancer Treatment 193
8.2 The Adjudicating Community: The Profession
of Medicine 199
8.3 Interferon: From 'Pseudoscience' to Professionally
Accredited Cancer Treatment 206
Conclusion: Making and Creating Choices 216
Options and Pressures for Change 219
Implications of this Study for the Evaluation and
Social Implementation of Therapies 230
m
~~e
Bibliography 241
Index 260
Acknowledgements
I owe debts of gratitude to a great many people who contributed to the
making of this book.
My greatest debts must be to Linus Pauling and Ewan Cameron, who
first welcomed me to the Linus Pauling Institute of Science and Medicine
in 1983. With courage and generosity they gave me unrestricted access
to their personal correspondence, manuscripts and referees' reports. Over
the years, Ewan Cameron in particular, they unstintingly provided me
with supplementary material, and responded patiently and graciously
to my many questions and demands for information. Without them, in
more senses than the obvious one of their centrality to the vitamin C
and cancer dispute, this book could not have been written. Although
they have not always agreed with my interpretation of their material,
they have scrupulously refrained from any intervention in my project.
They have given generously their permission for the many quotations
from their private correspondence that I have used in my reconstruction
of the controversy. I have great pleasure in thanking them both.
Emile Zuckerkandl, Director of the Linus Pauling Institute, was
unfailingly courteous and hospitable, and provided some crucial material
and information. I thank him for these and for our enjoyable debates
on the social construction of science. Other Institute members I would
like to thank include Mrs. Dorothy Monro, for her unflagging assistance
in finding relevant correspondence and material in the vast, and as
yet uncatalogued, Pauling Archives; Richard Hicks, Executive Vice
President, who patiently answered my questions on Institute funding
and resources; and Steve Burbeck, Zelek Herman, Raxit Jariwalla,
Rick Marcuson, Ruth Reynolds, Fred Stitt, Constance Tsao, and Dick
Willoughby, for discussion of their research and Institute matters. I
should also like to thank Dr. Robert Paradowski, Rochester Institute
of Technology, who is working on the official Pauling biography, for
his generous sharing of some valuable material.
For interviews or correspondence by mail, I would like to thank Dr.
Robert E. Wittes and other personnel at the National Cancer Institute;
Dr. Charles Moertel, Dr. Edward Creagan and Robert Horton of the
Mayo Clinic; and Professor Kenneth J. Carpenter of the Department of
Nutritional Sciences at the University of California, Berkeley.
I would also like to thank the investigative journalists, Peter Chowka
and Ralph Moss, for their valuable information on the American alter
native health network; and Ian Anderson, West Coast correspondent for
xi