by Ellen Leopold (Rutgers U. Press, 2009) $25.95
Reviewed by Elayne Clift
Among my earliest memories are whispered grieving over a young mother in my town dying of breast cancer, green X-rayed pictures of the bones in my feet when I needed new shoes, and ducking under my school desk during nuclear attack practice drills. These events and others, from my youth to my work in the women’s health movement 30 years later, filled my mind as I read Ellen Leopold’s well-documented, informative exposé of the relationship between Cold War politics and cancer research and treatment.
Leopold humanizes the story by introducing Irma Natanson, a young mother in Kansas diagnosed with breast cancer in 1955. Natanson, one of the first women treated with cobalt radiation, suffered tragic results. We follow her story, including the lawsuit she brought against her radiologist, setting a precedent for informed consent. A version of this account appeared in an earlier edition of the Source.
Cobalt radiation in the 1950s was “inextricably tied to the history of the United States in the decade following the end of World War II.” Leopold carefully fleshes out this premise, revealing how even language fueled a post-war mentality in which communism, along with cancer, had to be defeated. Terms like “the cancer of communism” were commonly used in Cold War propaganda, each word having the power to terrorize, each being framed as a malignant parasite.
We learn how a civilian economy more concerned with profit than people came to rely on nuclear by-products, even in light of Hiroshima, even as nuclear testing in Nevada and the Pacific began to yield worrisome outcomes, even as whistleblowers in the medical and scientific communities were branded “poor scientists” or “communists.” Leopold clearly illuminates the relationship among the military, medicine, and the nuclear industry.
“Subjects were neither informed of the serious risks involved nor told of the likely side effects of radiation exposure.”
We learn that secret experiments involving the Atomic Energy Commission, as well as the military and medical communities, were conducted largely on people of color as well as terminally ill patients to determine the effects of radiation on humans and to assess toxicity in cancer treatment. (Women were especially vulnerable to such treatment.) Often compared to the Tuskegee studies of black men with syphilis, experiments involving whole body radiation took place at such venerable institutions as M.D. Anderson cancer hospital, the Naval Hospital in Bethesda, Maryland, and Sloan Kettering in New York, supported by the Defense Department. “Subjects were neither informed of the serious risks involved nor told of the likely side effects of radiation exposure.”
Risks and ethical questions involved were minimized or denied by those invested in radiation therapy. Even in 1994, the head of radiology at M.D. Anderson told one reporter, “There’s really nothing I can find that would question the ethics of the study at all. I think in the context of the 1950s, the experiments were fully justified as a therapeutic endeavor for people with hopeless cancer.”
Wittingly or unwittingly, the media played a role in suppressing information or in misleading readers by ignoring compelling facts or because of a prevailing ignorance about science. To some degree this has continued. But as stories of radioactive fallout, nuclear energy disasters, and increasing incidents of cancer began to emerge, the public demanded more reliable information. Thanks in large part to the women’s health and consumer movements of the 1970s, more data became available, creating an atmosphere in which educated, assertive patients demanded more of their physicians. Activists like chemist Linus Pauling revealed the truth about fallout and the frenzied fraternity of pro-nuclear bureaucrats and the doctors with whom they colluded. “Mythology in the service of ideology” began to wane.
Leopold’s final chapters deal with prevention, mammography, and continuing questions about cancer treatment. “Today’s concerns may not involve safety, but the need to maintain the position…of mammography within the cancer hierarchy,” she writes. “The technique remains controversial…but the promotion of screening brooks no doubts. It continues to rely on the same mantra of early detection without adding caveats about the technique’s fallibility.”
In 1950, 200,000 Americans died of cancer. In 2000, that number exceeded 500,000 despite all the breakthroughs in diagnosis, “prevention,” and treatment. That statistic alone should clearly be reason to read this important book.
Elayne Clift, a writer and adjunct professor at Granite State College (New Hampshire) and Community College of Vermont, served as program director for the National Women’s Health Network from 1979 to 1981. She lives in Saxtons River, Vermont.