'Last Call at the Oasis': Why Time Is Running Out to Save Our Drinking Water.

 

 

Photo Credit: Shutterstock/Ev Thomas

 

 

 

 

AlterNet / ByTara Lohan

 

 

 

A new film provides a much-needed wake-up call for Americans: Our false sense of water abundance may be our great undoing.

 

The first voice you hear in the new documentary Last Call at the Oasis is Erin Brockovich's -- the famed water justice advocate whom Julia Roberts portrayed on the big screen.

 

"Water is everything. The single most necessary element for any of us to sustain and live and thrive is water," says Brockovich as her voice plays over clips of water abundance -- gushing rivers and streams. "I grew up in the midwest and I have a father who actually worked for industry ... he promised me in my lifetime that we would see water become more valuable than oil because there will be so little of it. I think that time is here."

The film then cuts to images of water-scarce populations in the world: crowds of people at water tankers, stricken children, news reports of drought in the Middle East, Brazil, China, Spain.
The images are heart-wrenching and alarming ... and so are the ones that come next, which are all in the U.S. Water parks, golf courses, car washes, triple shower heads, outside misters -- all point to our folly when it comes to water.

We live with a false sense of water abundance and it may be our great undoing. Even though the film opens with Brockovich's prophecy that water is more valuable than oil, Last Call at the Oasis mostly focuses on how we've yet to grasp this news. The film, which is the latest from Participant Media (Inconvenient Truth, Food Inc., Waiting for Superman), delves into our addiction to limitless growth, our blindness to pressures from global warming, and the free pass that industry and agriculture get to pollute.

The narrative of the film, which is directed by Jessica Yu, is driven by interviews, historical footage and some outstanding cinematography. We're taken to Las Vegas, so often the starting point for discussions of our impending water crisis. We see a receding Lake Mead, learn that Hoover Dam may be close to losing its ability to generate power as water levels drop, and that the intake valve for Las Vegas' water supply may soon be sucking air.

We hear from Pat Mulroy, Las Vegas' infamous water manager, about a plan for the city to pipe water over 250 miles from a small agricultural community. The town of Baker, population 150, looks to be on the sacrificial altar for Sin City. As Mulroy says, it is a "project out of sheer desperation." But that will be little consolation to the folks in Baker. Or to the rest of us. Because what we learn next is that "we're all Vegas."

Phoenix and LA also face water pressures, as the Colorado River strains to meet growing demands. The film shows hotspots like the California’s Central Valley, where 7 million acres of irrigated agriculture have turned near desert into the source of one-quarter of the nation's food -- at a steep environmental price.

California is often warned it will be the next Australia, where a decade of drought has devastated the agricultural sector. At the peak of Australia's drought, the film tell us, one farmer committed suicide every four days. We meet families who are struggling to save their farms, faced with having to slaughter all of their animals. The scenes of heartbreak in Australia are one of the few times in the film the narrative ventures outside the U.S. Mostly the storyline is focused on America's own evolving plight.

We see Midland, Texas where a community is stricken by cancer from hexavalent chromium in its drinking water. A reoccurring voice throughout the film is Brockovich, who works as a legal consultant all over the U.S. for communities that often find themselves powerless in the face of industry pollution. "There are 1,200 Superfund sites the EPA can't deal with," says Brockovich. "The government won't save you."

For all our clean water laws, we aren't very good at enforcement. From 2004 to 2005 an investigation found that the Clean Water Act was violated more than half a million times. It's not just industry, but pesticides like atrazine, which we learn can be detected in the rain water in Minnesota when it's being applied in Kansas. In Michigan we see another awful side to Big Ag, the liquid waste from factory "farming," known as Concentrated Animal Feeding Operations. These CAFOs threaten drinking water with chemicals, antibiotics and growth hormones.

So what do we do in the face of these threats to our drinking water? Apparently we buy bottled water -- which the film details is not only potentially less safe (it has different regulations from tap water) but is environmentally destructive as well.

There are a few bright spots in the film, including strides that have been made in Singapore and other places to recycle water for drinking. (We could at least start in the U.S. by recycling water for re-use in toilet flushing, irrigation and other non potable uses.) And we get to see a hilarious behind-the-scenes look at an advertising company trying to come up with a campaign to pursuade Americans to drink recycled water. Porcelain Springs anyone?

If you don't know much about water issues, the film is an essential wake-up call. And judging from the way Americans use water, this film looks like it should have a large audience. It covers a lot of ground, but how well?

"Last Call offers a few solutions but -- except for a segment on recycled wastewater -- little about how to traverse the tangled political, social and economic pathways to achieve them. In fact, at times its 'stars' show the exasperation and resignation that comes from years spent seeing the tires spin in the same wheel ruts," writes Brett Walton at Circle of Blue. "With so many problems to choose from, some worthy candidates are excluded and some issues are insufficiently explored, but the writers make good use of the material they have selected. They explain technical issues, while never losing sight of the lives that are affected."

Overall the film is beautiful and compelling but misses the mark in one important place -- it fails to address energy in any meaningful way. There are split-second clips of tap water being lit on fire (fracking!) and what looks to be a flyover of a mountaintop removal mining site, but the filmmakers never talk in depth to any of the people who live in our energy sacrifice zones in this country. What about the devastation in Appalachia and the growing threats from fracking and tar sands extraction?

The issues of energy and water are inextricably linked. It takes energy to move and treat water and it takes water to keep our lights on and our cars running. The more we ignore the reality of our fossil-fuel addiction, the more we become tethered to a future of climate chaos -- droughts, floods and more turbulent storms. It'd be nice to see a film about U.S. water issues that starts in West Virginia, Pennsylvania or Nebraska instead of Las Vegas. This is the most significant lost opportunity in a film that will hopefully have a large reach across the country as it imparts its other important messages.


Look for a screening near you and check out the trailer below.

 

 

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Tara Lohan is a senior editor at AlterNet and editor of the new book Water Matters: Why We Need to Act Now to Save Our Most Critical Resource.

Ask Your Doctor if This Big Pharma Scam Is Right for You: The Dangers of a Drugged Up America.

 

 

 

 

Hightower Lowdown / ByJim Hightower

 

 

 

In medicated America, the fix for every problem is just a prescription away. Except that it's not.

 

Butterflies waft across a beautiful field of spring flowers. A delightful young family bicycles joyously down a country lane. A couple on a park bench leans sensually into each other. A 40-something woman's face radiates with both perfect beauty and internal happiness. "All's right with the world," is the message... as long as you've taken your dosages of Lunesta, Celebrex, Cialis, and Botox.

Welcome to medicated America, where the fix for every problem--from incontinence to erectile dysfunction, stiff joints to mood swings, weight gain to wrinkles-- is just a prescription away. Thus the beautiful images, stirring music, attractive actors, and soothing words in the omnipresent, multibillion-dollar kaleidoscope of drug advertising by Pfizer, Merck, Eli Lilly, Johnson & Johnson, and other giants of Big Pharma--all pitching their particular brand-name nostrum directly at us hoi polloi (the industry spends a fourth of its income on ads and other promotions, nearly double its expenditures on research and development). The corporate come-ons typically conclude with a phrase that has achieved cliche status in America's vernacular: "Ask your doctor if 'Suprema Wundercure' is right for you."

The better question, though, is one that cartoonist Dan Piraro expressed in one of his "Bizarro" panels: "Ask your doctor if playing into the hands of the pharmaceutical industry is right for you."

One would assume that in a rich, medically advanced, health-conscious nation like ours, dicey decisions about whether to allow a particular pharmaceutical product into our bodies would be among the most rational we make--as determined by (1) the best science available, (2) the strict moral duty of medical purveyors to "First, do no harm," (3) good government regulation, and (4) the profession's fear of public reproach and legal punishment. One would, however, be wrong on all counts:

• Science has been supplanted by rank hucksterism
• The strictest "moral duty" of corporate executives has been reduced to maximizing profits
• A "good" regulation is one that's good for profit seekers
• Public reproach is just a momentary embarrassment to be covered over by corporate image makers
• Legal "punishment" never includes jail time, but only a fine that's easily absorbed as a necessary cost of doing business by these immensely profitable entities.

In the past three decades, America's healthcare system has radically metamorphosed from a public service network (largely run by independent physicians and nonprofit hospitals) into a corporate profit machine--one that Dr. Arnold Relman, the renowned former editor of the New England Journal of Medicine, calls the Medical-Industrial Complex. Drugmakers have been among the most ambitious, in-your-face pushers of this transmutation of medicine into just another commodity to be sold by hook or crook. In this system, the concept of "care" has been reduced to "caveat emptor," with the shareholders' interest in monetary gain overriding all other interests.

The DTC contagion
A fast-moving, systemic epidemic called DTC has swept across America, endangering public health, jacking up our costs, and weakening the curative connection between health professionals and patients. DTC stands for "Direct-to-Consumer" drug advertising. It's a plague of marketing, empowering profiteering corporations to short-circuit the judgment of doctors by using all of the tricks of Madison Avenue (including lies) to convince viewers and readers that (first) they're suffering from a particular malady, (second) the advertiser's brand-name medicine is the very best cure, and (finally) they must go to their doctors pronto to insist on getting a prescription for that specific drug. The essence of this marketing scheme is to turn consumers into sales representatives for drug peddlers. Brilliant.

Prescribing medicine through the television, radio, print, and internet ads of corporations (whose sole motive is to sell more pills) is so crass, so awash in conflicts of interest, and so inherently dangerous that only two countrieshave ever legalized it: New Zealand in 1981 and the USA in 1997.

In our country, the corporate-friendly government of Ronald Reagan first okayed DTC drug ads in 1985, but his Food and Drug Administration ruled that pages-long consumer warnings about health risks had to be included, so there were few takers. Then came Bill Clinton's corporate-friendly government, which issued a revised FDA rule in 1997 allowing drugmakers to dodge the full disclosure provision--as long as their ads met an "adequate" standard for informing consumers about risks.

Such squishy words (slipped into regulations by industry lobbyists) are a corporate wet dream. Thanks to the adequacy loophole, fluffy-puffy, no-worries prescription drug ads quickly mushroomed. In 1997, spending on DTC ads was only $220 million; by 2002, it was $2.8 billion; and it has kept a steady pace of roughly $3 billion a year ever since.


Corporations don't spend that kind of money to dramatize the severity of their products' nasty side effects. As two ad execs giddily put it in a 1998 report to the industry, "The ultimate goal of DTC advertising is to stimulate consumers to ask their doctors about the advertised drug and then, hopefully, get the prescription." Obviously, to "get the prescription," corporate ads don't stress such unpleasant outcomes as these (taken from the small print of full-page ads for just a half dozen heavily advertised drugs): very high fevers, confusion, uncontrollable bowel movements, trouble swallowing, lower sperm count, prostate cancer, loss of vision, suicidal thoughts... and, of course, death.

Side effects do have to be addressed, but not conspicuously--for example, it's "adequate" for an off-camera announcer to buzz through them with a muted, fast-paced delivery (usually while cartoon butterflies flutter playfully on-screen to distract viewer attention). It's a disgusting, dishonorable way to generate sales--but it works. In 2008, the House Commerce Committee found that every $1,000 spent on drug ads produces 24 new patients, and a2003 research report found that prescription rates for drugs promoted with DTC ads were nearly seven times greater than those without such promos. Ethics aside, these consumer hustles have proven to be profit bonanzas:

• From 2000 through 2004, Merck & Co. poured more than $500 million into adverts promoting Vioxx, turning the pain pill into one of the "Top 100 Megabrands" listed by Advertising Age. The drug was meant for the relatively few people who can't stomach aspirin, but the PR push touted it to all arthritis patients, a much larger marketing pool. The campaign promised "everyday victories" over pain and immobility, featuring former Olympic skating champ Dorothy Hamill spinning effortlessly (and pain-free) on the ice. Merck's ads sold some 20 million Vioxx prescriptions, including to people who paid the ultimate price for buying the hype--a 2005 research report in The Lancet, the prestigious British medical journal, attributed as many as 140,000 sudden cardiac "events" in America to the use of Vioxx. In September of 2004, Merck took the pill off the market over "safety concerns." As an expert pharmacy consultant toldForbes magazine in 2006, "Vioxx wasn't a bad drug for everyone, it was a bad drug for certain patients. Unfortunately, people saw the ads and started demanding the drug from their doctors." That's the deadly power of mass advertising for drugs.
• Some ads are simply frauds, including one that Pfizer ran on TV until 2006, hailing the prowess of the company's cholesterol-lowering drug, Lipitor. The star of the spot was Robert Jarvik, who was described as the well-known "physician" who was the "inventor" of the artificial heart. In a picturesque outdoorsy setting, he was shown vigorously rowing a boat across a lake--visual "proof" that his own heart was in robust condition thanks to his use of Lipitor. His tagline was: "You don't have to be a doctor to appreciate that." Good, because he doesn't practice medicine, and while he worked on the artificial heart, he did not invent it. Oh, he also wasn't rowing the boat--a double played that role. Embarrassed, Pfizer had to yank the ad--but it continues to merchandize Lipitor with some $250 million a year in commercials, generating about $11 billion a year in sales, more than any other pharmaceutical in history.
• Bear in mind that these pitches are being made to consumers who cannot just go purchase the product--only licensed medical professionals can diagnose and prescribe. But, again, the promotions work, as an industry spokesman happily affirmed: "There's a strong correlation between the amount of money pharmaceutical companies spend on DTC advertising and what drug patients are most often requesting from physicians." He also noted that the trumpeting of brand-name pills "is definitely driving patients to the doctor's office." No surprise, then, that prescription drug use has soared in the past decade, during which spending (by consumers, private health plans, and governments) more than doubled. A 2010 survey by the National Center for Health Statistics not only found that about 35 percent of Americans over 60 take five or more prescription medicines a day (more than twice the intake in 1999), but even 22 percent of children under age 12 are on at least one Rx regimen. "People may be taking too many drugs," deadpanned the NCHS leader. And in recent years, a whole new market has opened up for DTC hucksters: Medical devices. In 2007, Johnson & Johnson launched the first mass-audience TV commercials for highly specialized, complex therapeutic devices. This is beyond odd; it is dangerous. Only expert practitioners have the knowledge and experience to judge whether one brand-name medical gizmo is superior to another. Yet, here was J&J doing a pitch to us clueless consumers for "Cypher," a drug-coated coronary stent for opening closed arteries. I'm all for consumers getting more say in health care, but--come on!--how would I know enough about the efficacy of various stents to instruct my doctor to "Make mine Cyphers"?

The DTD contagion
In addition to getting you and me to push particular products on our doctors, the drug and device industry runs a massive, sophisticated, and relentless "Direct-to-Doctor" sales program that skates on the thinnest ethical ice and frequently plunges all the way into illegality. While these efforts, costing more than $6 billion a year, occasionally pretend to be "educational," they are in fact an elaborate exercise in medical flimflammery--nothing but a door-to-door ploy by each of the major makers to hoodwink your doctor into prescribing their brand-name pill, rather than a competitor's brand or a generic.

To do this, the biggest of Big Pharma deploy an astonishingly large force of "sales reps" all across the country--90,000 of them! That's roughly one for every nine physicians, and they swarm non-stop into doctors' offices--one Virginia physician says his office had to set a quota of three visits in the morning and three visits in the afternoon in order to get any doctoring done. They are highly trained in persuasive arts, motivated to make the sale at all costs, and alarmingly successful (a 2003 Blue Cross survey found that more than half of "high-prescribing" doctors relied on the reps as their main source of information about new drugs).

INTRIGUING QUESTION: What occupational sub-group of Americans are, by far, the most heavily recruited to take jobs as drug reps? You might think pharmacists, marketing consultants, or even used car salesmen. All wrong. THE SURPRISING ANSWER: College cheerleaders.

Hey, the point is to "make the sale," to entice this mostly male profession to switch from A to B. Solid scientific evidence is one thing, but winks apparently work, too--and who's twinklier, prettier, more buffed, peppier, or more gregarious than cheerleaders? The University of Kentucky, which boasts champion-level cheerleading squads, has been one of the premier movers of talent from pompoms to Pharma. A UK "cheering advisor" notes that his perky collegians are naturals for sales rep positions: "Exaggerated motions, exaggerated smiles, exaggerated enthusiasm--they learn those things, and they can get people to do what they want." He says he routinely receives calls from drugmakers seeking to hire his graduates. "They don't ask what the major is," he says.

The demand is so high that an executive of a business that runs cheerleading camps set up a specialized employment firm in 2004 called"Spirited Sales Leaders." Based in Memphis, it funnels hundreds of former cheerleaders into drug sales.

"There's a lot of sizzle" in being a sales rep, he explains, and these experienced sizzle-generators can earn six figures a year, counting bonuses, for pep-talking doctors into writing more prescriptions for their companies' medicines.

Not that these upstanding corporate citizens would stoop to hiring salespeople based on their sex appeal. No, no, explained a top executive of Bristol-Myers Squibb: "[It] has nothing to do with looks, it's the personality."

Sex appeal or not, the essence of the job is manipulation, and reps are highly trained and well armed to ingratiate themselves with each individual on their list of doctor-clients. Adriane Fugh-Berman, a doctor and professor at the Georgetown University Medical Center, is a drug company watchdog who has studied the doctor-sales rep relationship. In a 2007 article, she reported that the salespeople play to a doctor's feeling of being overworked and underappreciated: "Cheerful and charming, bearing food and gifts, drug reps provide respite and sympathy; they appreciate how hard doctors' lives are and seem only to want to ease their burdens. But every word, every courtesy, every gift, and every piece of information provided is carefully crafted, not to assist doctors or patients, but to increase market share for targeted drugs." Here are key elements of the DTD operation:

The file. Each doctor is a mark, and drug reps are trained intelligence gatherers who build and constantly update a computerized corporate file on the doc's personality, preferences, interests, and any personal tidbits that might help them change his or her prescribing habits. The strategic goal of good reps is to become each doctor's trusted "friend"--not unlike the relationship that lobbyists try to cultivate with lawmakers.

The data. How can pill peddlers know which ones your doctor is prescribing--isn't that a private matter? Not in today's bluntly intrusive world of commercial data mining. A majority of pharmacies sell their records of every single prescription written by doctors doing business with them. This vast trove of computerized info is bought by such data hawkers as IMS Health, which procures
prescriptions from about 70 percent of US pharmacies. While the names of patients are deleted, the name of the doctor who wrote each prescription is easily discernible, so pharmaceutical giants pay millions a year to buy, slice, and dice the electronic data on exactly which medicines each doctor has ordered and in what quantities. This is regularly fed to the laptops, iPads, and even smartphones of the sales reps on the ground--allowing them to target their daily pitches, and to precisely and carefully track the slightest of changes in a doctor's prescribing habits.

The gift. Reps don't go to a physician's office empty-handed. Gourmet donuts and lunch treats for the entire staff are daily routines, and doctors and key staffers are treated to dinners at fine restaurants, holiday gift baskets, tickets to a game or show, and such nice personal presents as a silk tie or a monogrammed golf bag. A New York Times report in January of this year says that two-thirds of doctors accept such goodies. For the heavy prescribers of a drugmaker's concoctions, the gifts grow ever-larger--a ski trip to Aspen, an invitation to make weekly paid "lunch and learn" presentations in other doctors' offices, an honorarium to make brief comments at a conference in some five-star resort (complete with an "educational grant" to cover the bar tabs and other incidentals), big-buck "consulting" contracts that require practically no work, and outright cash payments for prescribing particular drugs. The Times' January report found "that about a quarter of doctors take cash payments" and "that they are more willing to prescribe drugs in risky and unapproved ways."

The hoax. Few doctors are experts in the chemistry and biological impacts of particular medicines, so they rely on honest studies and tests (as reported in credible medical journals) to give them an un-hyped, non-sales-rep picture of the pluses and minuses of the drugs they choose to prescribe to you and me. Unfortunately, this process, too, has been corrupted--drugmakers have regularly paid doctors and researchers to conduct studies and publish results without revealing their financial ties. Pfizer, however, sank this sales-over-science approach to new lows when it launched its antidepressant, Zoloft, in the 1990s. It hired an advertising firm to fabricate "studies," write them up as salutary reports about the drug, pay some big-name psychiatrists a couple of thousand bucks each to put their names on the reports, and convince major journals (read by thousands of doctors) to publish the ghostwritten "findings." About half of the medical articles about Zoloft at that time were ad agency fakes. Journal editors, embarrassed by being scammed, have since imposed safeguards, but many doctors and observers say that up to 20 percent of major journal articles are still being ghosted.

We can do better
DTC and DTD are just two surging branches of the central stream running through America's healthcare industry--an out-of-control stream that should be labeled DTP--"Direct-to-Profit." The very fact that healthcare, an essential human need, has been twisted into an "industry"--a commercial activity for the purpose of maximizing profits--is a damning measure of its moral bankruptcy.

As avaricious and monopolistic drug corporations have demonstrated again and again, "care" is treated, at best, as an externality to their real work of making money--and at worst as an impediment to that corporate imperative. Thus, top executives and boards of directors constantly seek ever more sophisticated forms of deception and manipulation to, at all costs, make the sale. In this ethos, such loathsome products as blatant price gouging, artificial shortages of vital medicines, deliberate promotion of pills that kill, falsification of medical research, and routine corruption of doctors are not merely tolerated, but expected and accepted as normal.

Is this the best that this great, super-rich country can do? Of course not--we Americans can, must, and will create a system that puts public need over private greed. This month's "Do Something" features some groups leading the way. I'll give the final word to Dr. Relman, the thoughtful, insistent, and unflagging voice for an ethical and sensible system of care built around the concept of "Medicare for all." A decade ago, he wrote that "our health policies have failed to meet national needs because they have been heavily influenced by the delusion that medical care is essentially a business... A different kind of approach could solve our problems, but it would mean major reform of the entire system... Since such a reform would threaten the financial interests of investors... the short-term political prospects for such reform are not very good. But I am convinced that a complete overhaul is inevitable, because in the long run nothing else is likely to work."
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Jim Hightower is a national radio commentator, writer, public speaker, and author of the new book, "Swim Against the Current: Even a Dead Fish Can Go With the Flow." (Wiley, March 2008) He publishes the monthly "Hightower Lowdown," co-edited by Phillip Frazer.

Are Olive Oil and Canola Oil Interchangeable?

 

 

 

Photo Credit: Photo courtesy of the Canola Oil Council of Canada

 

 

 

 

AlterNet / ByAri LeVaux

 

 

To look at many cookbooks, you'd think olive oil and canola oil were identical twins separated at birth. But here are some differences.

 

 

 

To look at many cookbooks, you'd think olive oil and canola oil were identical twins separated at birth. Countless recipes call for "extra-virgin olive oil or canola oil," as if the two were interchangeable.

This implied equivalence is odd. Extra-virgin olive oil is cold-pressed from a fruit that has been cultivated for more than 7,000 years, with no refining beyond filtration. Canola oil is refined with heat, pressure, solvents, and bleach, and comes from the seed of a plant that's younger than the Rolling Stones.

The canola plant was conceived when demand for rapeseed oil plummeted in the late 1940s, and the Canadian rapeseed industry began seeking and creating new markets for its product. Since the Industrial Revolution, rapeseed oil has been an important component of lubricants for ships and steam engines, because unlike most oils it sticks to wet metal. During World War II the U.S. built a lot of ships, and so needed lots of rapeseed oil, but couldn't get it from traditional suppliers in Europe and Asia. The Canadian rapeseed industry, which had been relatively small, exploded to fill the gap, and played an important role in the allied naval effort, becoming rich and powerful in the process.
But rapeseed oil demand waned when the war ended, and thus began an intensive program to breed a rapeseed edible to humans. The Holy Grail was a strain with dramatically lower levels of erucic acid and glucosinolates, which are the main culprits behind rapeseed oil's foul flavor, and according to some research, toxic effects.

In 1978 the new plant was christened canola, for "CANadian Oil Low Acid." The "Low Acid" refers to erucic acid.

Canola is processed with heat, pressure, and often solvents like hexane. Even in cold-pressed "organic" canola, the refining steps include bleaching agents like clay, deodorization, and the removal of various gummy, oozy byproducts. In fact, many of these steps are similar to practices that people are worked up about over pink slime, including heated centrifugation and treatment with noxious chemicals. Care should be taken in sourcing olive oil, as well, as some that aren't extra virgin, cold pressed could also be altered by chemicals and heat.

The refining process for canola oil can be seen in this YouTube video. The food and agriculture industries love canola because it grows well, yields more oil per acre than any other oilseed, and because there are so many ways to eat it. That bottle on your kitchen counter is only the beginning.
Canola oil is used in most processed salad dressings, often after being treated with anti-foaming agents. Canola oil is frequently hydrogenated for use in shortenings, fry oil mixes, and many processed foods. Canola oil hydrogenates much more readily than corn or soy oil -- a process that turns unsaturated fats into saturated fats and creates trans fats along the way. Canola hydrogenates so eagerly, in fact, that it happens inadvertently during the oil's steam-injection deodorization process.

Because of this unintended hydrogenation, any refined canola oil is going to be partially hydrogenated. And if it's partially hydrogenated, it's going to contain trans fats. A study published in the Journal of Food Lipids shows that the trans-fat content of commercial, non-hydrogenated canola oil can be as high as 4.6 percent. Nonetheless, many formulations of canola oil are billed as having no trans or partially hydrogenated fats, because they weren't present prior to the refining process.

Another selling point for canola oil is that it can stand high heat without burning, and is thus well suited for deep-frying. Because of this, canola is often considered a preferred alternative to olive oil for very hot cooking. But the oil's large percentage of polyunsaturated fats will oxidize in high heat, turning them rancid. Meanwhile, the widely followed prohibition against frying with olive oil is misplaced. Extra-virgin olive oil has been deep-frying food in Mediterranean diets for centuries. Interestingly, the Canadian Canola Council lists the smoke point for extra virgin olive oil at 331 degrees, despite the fact that most sources pin the smoke point of good quality extra-virgin olive oil above 400 degrees, which will deep-fry anything.

One thing that's certain is that canola oil is low in saturated fat. And according to the medical community's party line, that's a good thing because saturated fats cause obesity and heart disease.
The Mayo Clinic often invokes the Mediterranean diet on its Web site, recommending "Mediterranean-style cooking" for "heart-healthy eating," and the replacement of butter with "healthy fats such as olive oil and canola oil." And thus, the long-lost fatty twins are reunited again, in your heart-healthy lasagna.

But there's nothing close to a scientific consensus about the supposed superiority of unsaturated fats with regard to obesity and heart disease. Many parts of these arguments are currently being debated.
Is the debate influenced by canola's tremendous profitability? Worldwide production is hitting record highs almost every year. And in just a few short decades of life canola oil has leapfrogged in popularity over other unsaturated oils like safflower -- which is lower in saturated fats than canola oil -- and grapeseed, which, for what it's worth, is from the Mediterranean. To what degree this surging popularity is due to the zealous pursuit of unsaturated omega-3 fats or to the marketing genius of the salesmen is a question for the cookbook authors who began recommending the oil in droves in the 1980s. Although in 2006 one such messenger, Andrew Weil, called canola oil a "distant runner-up to olive oil." Weil writes, "We have a wealth of evidence showing that populations that consume good quality olive oil as a primary dietary fat have significantly lower rates of both heart disease and cancer than those that don't. We have no comparable epidemiological data for canola. Also unlike extra-virgin olive oil, canola oil doesn't contain the antioxidant polyphenols that are protective against heart disease and cancer."


Olive oil has flavor; canola is tasteless. Olive oil is intact, alive with enzymes and other biomolecules, while canola is processed, filtered and separated into a sliver of its former self. Olive oil is the ancient foundation of the Mediterranean diet; canola oil is a recent experiment, a Hail Mary effort to save an industry.


But for all of its wonderful qualities, one thing extra-virgin olive oil isn't is cheap. And canola oil, while perhaps not as mind-boggingly awesome as some would have us believe, probably isn't that bad for you -- except for those trans fats created in the deodorization process. But other than the price difference, there isn't any reason to choose canola oil over olive oil. It's a truly inferior product, despite what so many recipes imply.
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Ari LeVaux writes a syndicated weekly food column, Flash in the Pan.

Is Your Stuff Falling Apart? Thank Wal-Mart.

Photo Credit: Daniel Stone

Grist.org / ByStacy Mitchell

Wal-Mart's cheap stuff is hugely costly - right where it matters most.

 

This article is part of a series on Walmart's greenwashing at Grist.org.


My friend Tony’s closet is as good a place as any to begin an investigation of Walmart’s environmental impact. Tony has a pair of Levi’s that date back to high school more than 20 years ago. They still fit him and they’re still in rotation. The fabric has a smooth patina that hints at its age, but, compared to another pair of Levi’s he bought only a couple of years ago, this pair actually looks far less worn. The denim is sturdier, the seams more substantial, the rivets bigger.

Tony’s old pair of Levi’s may well have been made in the U.S, and they likely cost more than his new pair. The new ones were manufactured abroad — Levi’s closed its last U.S. factory in 2003 — and, though Tony didn’t buy them at Walmart, their shoddy construction can be blamed at least in part on the giant retailer and the way it’s reshaping manufacturing around the world.


Since 1994, the consumer price of apparel, in real terms, has fallen by 39 percent. “It is now possible to buy clothing, long a high-priced and valuable commodity, by the pound, for prices comparable to cheap agricultural products,” notes Juliet Schor. Cheapness — and the decline in durability that has accompanied it – has triggered an astonishing increase in the amount of clothing we buy. In the mid-1990s, the average American bought 28 items of clothing a year. Today, we buy 59 items. We also throw away an average of 83 pounds of textiles per person, mostly discarded apparel, each year. That’s four times as much as we did in 1980, according to an EPA analysis of municipal waste streams [PDF].


Most consumer products have followed a similar trajectory over the last two decades. Walmart has done more than any other company to drive these changes, though other retailers have since followed its model. Where once we measured value when we shopped, Walmart trained us to see only price. Its hard bargaining pushed manufacturers offshore and drove them, year after year, to cut more corners and make shoddier products. As union-wage production jobs and family-owned businesses fell by the wayside, many Americans could no longer afford anything but Walmart’s cheap offerings.
Today Walmart says it wants to reduce the amount of pollution involved in making some of the stuff it sells. That seems like a good thing – except that everything else Walmart does is designed to undermine the durability of consumer goods, accelerate the flow of products from factory to landfill, and get us to buy more stuff. Even if Walmart does succeed in reducing the resources used to make a T-shirt or a television set, those gains will be more than outstripped by growth in the number of T-shirts and TVs we’re consuming.


The six-dollar toaster
On a recent visit to Walmart store No. 2659, just outside of Portland, Maine, I tried to find evidence of a shift to more sustainable products, but I didn’t see much beyond CFL bulbs and reusable shopping bags. There were no Seventh Generation cleaning supplies or organic cotton clothes, for example.


I did, however, spot a toaster that retails for $6.24 — a price that renders its longevity virtually irrelevant. If it breaks, just buy another.

Prices on general household goods have fallen by about one-third since the mid-1990s. Given how awash in stuff we were in those boom years, it’s shocking just how much more we buy now. Since 1995, the number of toasters and other small electro-thermal appliances sold in the U.S. each year increased from 188 million to 279 million. The average household now buys a new TV every 2.5 years, up from every 3.4 years in the early 1990s. We buy more than 2 billion bath towels a year, up from 1.4 billion in 1994. And on and on.


While there are certainly factors beyond Walmart that have contributed to this ever-expanding avalanche of consumption, the company has been a major driver of the trend. Its growth and profitability rest on fueling an ever-faster churn of products, from factory to shelf to house to landfill.
In a paper [PDF] that came out last year, three business professors illustrate how inducing manufacturers to cut product quality enhances Walmart’s competitive position. “Because lower quality products are usually cheaper to produce, it is often argued that discount retailers induce lower quality in order to drive down prices. Our model suggests, however, that the competitive and bargaining position effects provide incentives to induce lower quality regardless of changes in production costs,” the authors write.


In other words, getting manufacturers to make shoddier products doesn’t just mean that Walmart can offer super-cheap wares; it also helps Walmart marginalize its competitors and gain more dominance over its suppliers. By using its market power to drive down the quality of manufacturing, Walmart gains an advantage over department stores and independent retailers because quality (and the knowledgeable service that typically goes with it) is no longer an important factor in a consumer’s choice about where to shop. If you are going to end up with a crappy to mediocre blender anyway, then why bother spending more or availing yourself of the advice and service of a specialty retailer? Reducing the overall quality of products thus destroys a key competitive advantage of Walmart’s smaller rivals.


Even when a manufacturer responds to Walmart’s cost-cutting pressure by producing a separate, cheaper line to sell only in big-box stores — as many name-brand companies now do — the brand’s reputation for quality can suffer, making it hard for specialty retailers to persuade customers that the higher-quality, longer-lasting versions they offer are worth more.


As local stores and other competing retailers are weakened, manufacturers become more dependent on Walmart. Many major consumer products companies now rely on Walmart for one-quarter or more of their business. According to the study, this gives the chain greater bargaining power over its suppliers, who have fewer options for bringing their wares to market and thus little leverage to resist the retailer’s demands.


Walmart is also a master at getting shoppers to buy more than they came for. It employs all of the techniques that have been shown to spur “unplanned buying,” according to a recent study [PDF] in theJournal of Marketing. The study found that large stores that promote the concept of one-stop shopping and can only be reached by car generate the most impulse buys. Marketing messages that evoke abstract shopping goals are also highly effective at inducing people to put more stuff in their carts. The authors cite Walmart’s “Save Money, Live Better” slogan as a leading example.


According to the study, the least amount of unplanned buying occurs when a shopping trip involves multiple stores, each with a specific product focus, and the customer arrives on foot or by mass transit – in other words, when you shop at small neighborhood and downtown retailers.


A low-tar cigarette
Walmart has a powerful incentive to increase the scale of consumption. Sustainability will never be more than a modest sideshow to this larger endeavor. Nowhere in Walmart’s pronouncements about greening its supply chain does the company mention the durability of products or the pace at which households burn through the stuff its stores sell.


As consumers, we’re hardly innocent in all of this, of course. With prices falling below the real human and environmental costs of production, we have been happy to upgrade to a bigger TV or buy four T-shirts when one would suffice. But imagining that Walmart might be part of the cure is like putting tobacco companies in charge of ending smoking. Walmart’s sustainability plan is the low-tar cigarette of the environmental movement: it admits there’s a problem, but offers a kind of pseudo-solution that’s really aimed at keeping us all puffing.


As Walmart takes over an ever-larger share of the global economy, companies that favor a more durable and sustainable model of production are squeezed to the margins. The business press is replete with tales of storied U.S. brands, like Levi’s, which held out against Walmart for years before finally giving in, moving overseas, and figuring out how to make a $10 pair of jeans. Some still resist. Stihl, for example, the world’s leading maker of chain saws, has been vocal about retaining the quality of its products by not selling to the big boxes. But if Walmart and those that follow its model continue to grow, there may soon come a day when no producer can escape its dictates.
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Stacy Mitchell is a senior researcher with the Institute for Local Self-Reliance, where she directs initiatives on independent business and community banking. She is the author of Big-Box Swindle and also produces a monthly newsletter, the Hometown Advantage Bulletin.

 

6 Kinds of Pills Big Pharma Tries to Get You Hooked on for Life.

 

 

 

 

Photo Credit: Shutterstock/Adam Michal Ziaja

 

 

 

 

 

 

AlterNet / ByMartha Rosenberg

Since direct-to-consumer drug advertising debuted in the late 1990s, the number of people on prescription drugs for life has ballooned.

 

Why has Big Pharma failed to produce new antibiotics for deadly infections like MRSA (methicillin-resistant Staphylococcus aureus), VRE (vancomycin-resistant enterococci), C. Difficile and Acinetobacter baumannii even as they leap from hospital to community settings? Because there is no money in it.

Pharma executives "have shown less interest in medicines like antibiotics that actually cure disease than in those that only treat symptoms," writes Melody Petersen, author of Our Daily Meds. "Most blockbusters are pills for conditions such as anxiety, high cholesterol or constipation that must be taken daily, often for months or years. They are designed for rich Americans who can afford to buy them." Nor are medicines for tropical diseases like malaria, which kills a child every 30 seconds, a priority, notes Petersen. They also lack ka-ching.

Since direct-to-consumer drug advertising debuted in the late 1990s, the number of people on prescription drugs -- especially prescription drugs for life -- has ballooned. Between 2001 to 2007 the percentage of adults and children on one or more prescriptions for chronic conditions rose by more than 12 million, reports the Associated Press and 25 percent of US children now take a medication for a chronic condition. Seven percent of kids take two or more daily drugs. Who says advertising doesn't work?

Of the top-selling drugs in 2011, led by Lipitor, Nexium, Plavix, Advair Diskus, Abilify, Seroquel, Singulair and Crestor, none is taken occasionally, or "as needed" and the treatment goal is never to get off the drug, like an antibiotic. Why would Pharma deal itself out of the game?

There are two ways Pharma hooks the US public on prescriptions for life. First, prescriptions that used to be taken as needed for pain, anxiety, GERD (gastroesophageal reflux), asthma, mood problems, migraines and even erectile dysfunction, gout and retroviruses (in some cases) are now full-time medicines. Instead of having a bad day or heartburn, you have a disease like anxiety or GERD which calls for full pharmaceutical artillery. Instead of having body pain to be treated transiently, you are put on an antidepressant like Cymbalta or seizure drug like Lyrica or Neurontin indefinitely.
Secondly, many of the top-selling drugs today are to prevent chronic conditions like high cholesterol, high blood pressure and osteoporosis that people are said to be "at risk" for. Needless to say, in both cases, people never know if the drugs are working or whether they would have had symptoms without them. This creates a loyal customer who is afraid to quit a prescription because it might be working. And why should they quit anyway when a third party is probably paying?

Here are some drugs -- not all -- that are marketed for perpetuity.


1. ADHD and Drugs for Pediatric 'Psychopathologies'
Thanks to Pharma's "diagnose early" and screening campaigns, millions of children are treated with stimulants for ADHD and antipsychotics for bipolar disorder and assorted conduct, oppositional defiant, development disorders and "spectrums" today. No wonder Michael Bandick, brand manager for Eli Lilly's popular antipsychotic Zyprexa, called it "the molecule that keeps on giving" at a national sales meeting.

But giving kids daily drugs creates two problems. First, parents will never know if their kids would have outgrown their conditions, and second, it's unlikely they'll ever get "clean." In fact, Pharma marketers worry about the revenue threat of kids going off their meds when they leave home and even run an ad campaigns in college newspapers to keep them on. One ad shows the lead singer of Maroon 5, declaring, "I remember being the kid with ADHD. Truth is, I still have it." The ad's tag line reads, "It's Your ADHD. Own It."


2. Hormone Replacement Therapy
When the popular HRT pill Prempro was launched by Wyeth, now Pfizer, in the 1980s, then-CEO Bob Essner told sales associates, “We can make real the full promise of HRT to create in the near future a world where the majority of women will start HRT at menopause and continue on it for the rest of their lives,” reports Philadelphia magazine. The scheme of treating estrogen "deficiency" for 30 or 40 years worked until 2002 when HRT was found to cause breast cancer, heart attacks, strokes, blood clots and dementia. They were some of the conditions it was supposed to prevent. Oops. But Pharma has not abandoned the billion-dollar franchise and news about estrogen benefits is creeping back into the news, predicated on the public's short memory. People don't lose hormones because they age; they age because they lose hormones, say Pharma hormone sellers. Even men now "suffer from" testosterone deficiencies or Low T.


3. Happy Pills
Pharma's success in convincing people with anxiety or the "blues" that they need an antidepressant was a Wall Street coup. Instead of taking the occasional Xanax, people agreed to alter their entire body chemistry with a drug they took for months, years or decades.

But as antidepressants fall in popularity, because of their many side effects, including alarming "discontinuation symptoms" when people try to stop, WebMD is conducting damage control to keep people on them. Don’t believe that antidepressants turn “you into a zombie,” make you gain weight, ruin your sex life, make you "forget your problems rather than dealing with them" or cost too much, says the huge pro-pill Web site in one article. Depression is linked to heart disease, obesity, diabetes, Alzheimer’s and cancer says a second WebMD article. Stay on your meds.


4. Proton Pump Inhibitors (PPIs)
Some say gastroesophageal reflux disease (GERD) is just lowly "heartburn" whipped up by Pharma into a profitable disease. But over 110 million prescriptions were written for proton pump inhibitors (PPIs) like Nexium and Prevacid in 2009, making it the third most prescribed class of drugs. Long-term use of PPIs increases the risk of hip, wrist and spine fractures, the FDA warns and the drugs can cause potentially lethal C. difficile-caused diarrhea and community-acquired pneumonia says national health advocacy group, Public Citizen. But Pharma has a different message. GERD can lead to esophageal inflammation, scar tissue and cancer, if untreated, it tells patients and symptoms won't go away on their own. No wonder doctors call PPIs "Purple Crack."


5. Statins
The best-selling statin drugs like Lipitor and Crestor that lower their cholesterol risks are pretty much the definition of "lifer medications," taken in perpetuity. Who would dare to go off of them and risk cardiovascular events?

One patient on a cholesterol drug site writes that despite feeling "miserable" on statins, "What do you do? Go off the statins and let your arteries clog up?" But medical professionals say it is not safe to stay on statins indefinitely. Patients are at risk of liver dysfunction, acute kidney failure, cataracts and muscle damage known as myopathy, reports British Medical Journal. And statins can also cause memory loss and increase the risk of developing of Type 2 diabetes and muscle damage, FDA warns.
Still the appeal of a drug that lowers the risk of cardiovascular events without a change in diet or lifestyle made Lipitor the top-selling drug in the world, until recently, when its patent expired. Statins are now prescribed for kids, for the same reason.


6. Asthma-Control Medicines
Like ADHD and "pediatric psychopathology" drugs, Pharma conducts aggressive early treatment campaigns for asthma drugs, recommending that children as young as one year be treated when "symptoms" first emerge. ("Before they go away,” says one cynical doctor.)

It has also marketed daily asthma "control" medicines like Advair and Symbicort so aggressively (prescription drugs added onto patients' regular asthma medicine -- ka-ching) that nearly two-thirds of the nation's millions of asthma sufferers take them. Despite the expense of adding an additional drug to rescue inhalers or inhaled corticosteroids when asthma is a lifelong disease, there are no clinical benefits to the upsell, says the research institute of Medco, the nation's largest pharmacy benefit manager. Neither trips to the ER or hospitalizations are reduced with control drugs. And there's another mark against the daily drugs that don't work: they may make asthma worse says some published reports.
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Martha Rosenberg frequently writes about the impact of the pharmaceutical, food and gun industries on public health. Her work has appeared in the Boston Globe, San Francisco Chronicle, Chicago Tribune and other outlets.

What You Don't Know About Cancer -- Hope on the Horizon.

Written by Marlo Thomas - Award-winning actress, author, and activist.

Cancer is such a dreaded and scary word, and most of us have experienced its wrath at some point in ours lives -- whether through a family member or friend, or through our own struggle with it.


So this being Cancer Awareness Month, I thought it might make us all sleep a little better to ask some of the top cancer scientists in the country to tell us some things (or even one thing) that makes them optimistic about the ongoing battle with cancer.

The exciting news is: they are all optimistic. And at the center of this optimism is DNA.

We all know by now that when DNA is brought into the courtroom it can help prove whether a person is the culprit or not. That's because every person's DNA is unique to that individual -- like our fingerprints.

Well, DNA works the same way in the lab. The "investigator" looks at the normal DNA of the patient, and then compares it with the DNA of the cancer cell in that patient. Typically, these two samples are going to look more than 99.99 percent the same. But it is that tiny difference that holds the secret to what is causing the cancer. What is needed then is a drug that can correct the problems caused by that DNA damage.

Ten years ago, scientists didn't have the technology even to find the DNA damage in each patient's cancer. They used common microscopes to look deep into the cell -- but they couldn't see deep enough. Now, thanks to giant leaps in the science of DNA sequencing, these same scientists can go millions of times deeper into a cell than with a standard microscope -- and whole new worlds of information have opened up before their eyes.

"Just five years ago, these classifications of cancer were invisible to us," the renowned scientific investigator, Dr. Charles Sawyers of Memorial Sloan Kettering Cancer Center, told me. "Now that they are visible, we can create new drugs to target what we can see. It's why I rush to work every day."

Dr. Sawyers is not alone in his passion. All of the scientists I spoke to expressed excitement about DNA's emerging role in the fight against cancer as well as their hope that the public will ultimately grasp the concept of fighting cancer genetically, in order to appreciate these new possibilities.

Pharmacogenomics expert and CEO of St. Jude Children's Research Hospital, Dr. Bill Evans, explained DNA science this way:

"It's like when you build a house. The architect draws up a blueprint, and if that blueprint is faulty and the house starts to lean -- or even fall down -- then obviously the architect has made a mistake. So you must go back to the blueprint and find out where that mistake was made so you can fix the damage."

"DNA sequencing is the blueprint of a cell," Dr. Evans continues. "It helps the investigator look at every letter to find out what went wrong and what caused the damage. And so our optimism comes from our ability to look deeper into the cell to see the 'blueprint' for the first time, and lead us to the cause."

Beyond DNA science, the doctors and scientists I spoke to also celebrated the bold steps being taken on the many different frontlines of the war against cancer. Dr. Judy Garber of the Dana-Farber Cancer Institute, who specializes in breast cancer, expressed hopefulness about doctors' increased ability to treat cancer effectively without leaving the patient debilitated through invasive surgery.


"Less surgery is being done," Dr. Garber told me, "and when it is, surgeons are taking only one to two lymph nodes where they used to take them all. This lesser amount gives women better movement in their arms and less swelling. And, of course, we have discovered much better treatments."

Dr. Bob Wiltrout, Director of the Center for Cancer Research at the National Cancer Institute, National Institutes of Health, is equally enthusiastic about the great strides being made in the treatment of prostate cancer -- which is currently the second-leading cause of cancer death in American men.

"One of our most exciting breakthroughs is the use of precision approaches to detect even very small tumors with exquisite sensitivity," Dr. Wiltrout told me. "Not all prostate cancers actually require treatment, and many men are treated needlessly, or end up getting the wrong treatment for their tumors. But with these new techniques, in the future it should be possible to predict which tumors actually require treatment, and which patients can be safely monitored without needless surgery or radiation."

All of the doctors I spoke to pointed to the increased survival numbers -- the holy grail of all medical science statistics -- as evidence that we are gaining ground in this fight. "We are saving 350 more people per day in the U.S. than we did in 1991," Dr. John Seffrin, CEO of the American Cancer Society, told me. "And what's even more encouraging is that we could get to 1000 per day, if we all did our part -- with screenings, diet, exercise, quitting smoking and controlling obesity."

As someone who has spent many years marveling at the brilliant and painstaking work of the doctors, scientists and researchers at St. Jude, I can attest firsthand to the bone-deep commitment these men and women have made in their fight against disease. They are at it around the clock -- every hour of the day, every day of the year. And so when I hear them speak with such optimism, it fills me with great hope for all of us and our loved ones.

"I believe we are entering a golden era in cancer therapeutics," said Dr. William G. Kaelin of Dana-Farber and the Harvard Medical School, whose expertise in cancer research runs the gamut from the use of "smart drugs" to the current "renaissance" in cancer immunotherapy. "But maintaining this momentum will require that both the public and private sector efforts to eradicate cancer remain vibrant. Science -- especially science that transforms the way we think -- does not lend itself to predetermined timelines."

I hope that you'll join me in remaining as committed to the battle against cancer as Dr. Kaelin implores us to be. We have come too far to let up now, and are closer than ever to that long-awaited cure.

A deeper look at the comments of the doctors and scientists I spoke to appear below. I hope you'll take the time to read them. In the meantime, happy -- and hopeful -- Cancer Awareness Month.

Bill Evans, Pharmacogenics expert and CEO, St. Jude Children's Research Hospital

What gives us such optimism in this new era of cancer research is genomics. Our ability to interrogate the human genome in normal and cancer cells is providing us with incredible insights into what causes cancer -- what causes a white blood cell to become a leukemia cell, for example, or what causes a brain cell to become a brain tumor. We can now sequence DNA more rapidly and cheaper than ever before, and it improves every day -- cheaper, faster, better. This leads us to believe that some day soon we will be able to sequence every patient's genome, and use that to guide treatment. Back in the 1990s, it cost billions of dollars to sequence the first human genome; soon, it will cost less than $1000 dollars.

Computing technologies are allowing us not only to interpret genome changes, but to also develop sophisticated models of how multiple gene mutations interact to cause cancer. These discoveries are leading us to new targeted therapies -- drugs that target the specific abnormalities that cause cancers or cause them to spread, which are more effective and less toxic than current therapies.

Also, electronic medical records are providing new tools that guide physicians in making treatment decisions, often incorporating genetic information into drug-prescribing decisions. That means that when a doctor writes a drug prescription, he or she will be signaled to consider specific genetic tests that will help determine if that is the right drug or the right dose for that individual patient. No doctor can remember all of the genetic tests associated with a drug, but computers can, and they can remind and guide physicians.

Finally, imaging technologies are allowing us to "see inside" cells, and visualize how specific proteins interact to cause diseases and respond to treatment. We are now able to examine diseases at a much deeper level than ever before.

Judy E. Garber, MD MPH, Dana-Farber Cancer Institute

Here are five things that make me optimistic about breast cancer:

1) The observation that breast cancer is not one disease, but rather at least three specific, molecularly-defined diseases. This makes it possible for us to devise specific treatments for each subtype, allowing for more effective therapies for women, and avoiding the side effects of treatments that would not be effective for her particular breast cancer.

2) Targeted treatment for HER2+ breast cancer. The development of Trastuzumab -- an antibody against the HER2 protein -- has completely changed the outlook for women diagnosed with breast cancers driven by the HER2 gene. This type of breast cancer was among the most aggressive; but using Trastuzumab in early treatment, women with HER2 breast cancer can look forward to beating their disease. And newer therapies currently in development may be even better than Trastuzumab.

3) Sentinel lymph node surgery. Women used to be afraid of breast cancer treatment because they expected to be left with a swollen and painful arm. The swelling occurred because surgeons had removed many lymph nodes from under the arm, disrupting normal drainage of fluid. Today, surgeons have proven that they need only remove a few nodes called "sentinel" nodes -- those to which cancer cells are most likely to go and leave a tumor. Consequently, in most patients, Lymphedema -- the swollen arm -- is now much, much less common.

4) Greater focus on young women with breast cancer. As terrifying as breast cancer can be, it often seems more terrible when a young woman is stricken. But programs are now recognizing the special needs of young women and their families, and working to make sure that those needs are addressed -- from helping to protect the woman's fertility (expecting them to survive and be able to have children); to considering genetic testing to explain why the woman developed breast cancer; to determining whether close relatives share an increased risk; and improving plastic surgical options.

5) Breast cancer risk reduction. Wouldn't it be best to prevent breast cancer altogether? In fact, there has been progress in this area as well. Three medications have been shown to reduce the risk of hormone-related breast cancer -- the most common type of breast cancer -- by at least 50% in women at increased risk: tamoxifen, raloxifene and exemestane. There are also emerging technologies for early detection, like MRI, and new approaches that help women estimate how much risk they have, such as genetic testing. The next decade should see more progress in preventing breast cancer.

There are many more reasons for optimism in breast cancer. We are on the brink of a whole new era in cancer treatment and prevention in general, but in breast cancer, we are building on the research of the last 40 years. We must maintain the momentum, and make breast cancer something women "used to worry about." Research funding is critical to this effort.

Charles L. Sawyers, M.D., Investigator, Howard Hughes Medical Institute, Memorial Sloan Kettering Cancer Center

There is much talk today about personalized medicine, in which treatment is more closely tailored to the specific needs of individual patients. This concept is rapidly changing the face of cancer treatment, with many examples of new drugs that attack tumor cells that have specific "driver" mutations in its DNA. Certain types of leukemia, lung cancer, melanoma and sarcoma that were uniformly fatal just a few years ago are now treated routinely by swallowing a couple of pills each day -- just like blood pressure medication -- without the side effects of chemotherapy.

Admittedly, some cancers can come back many years later, and tumors can develop resistance to these new drugs when they are given alone. So we need to learn how to use them in combinations. The good news about resistance to the new drugs is that we already understand why it happens, so we should be able to find the curative combinations more quickly.

No, we do not yet have cures yet, but we are much closer than we have ever been. There has never been a time of greater optimism about the future of cancer therapy.

William G. Kaelin, Jr., M.D., Professor of Medicine, Dana-Farber Cancer Institute and Harvard Medical School

I trained as a clinical oncologist back in the 1980s. Almost all of the anticancer drugs available at that time were developed based on their ability to kill rapidly dividing cells rather than on a deep understanding of the molecular abnormalities that caused cells to become malignant in the first place.

All of this changed with the publication of the first draft of the human genome DNA sequence 10 years ago. Now, for the first time, cancer scientists had a "parts list" that enabled them to systematically identify which genes are responsible for different cancers. This search has been aided by breathtaking advances in our ability to rapidly sequence the genomes (DNA) of cancer cells. In hindsight, cancer science before these advances was a little like trying to fix a car without being able to look under the hood.

The new technologies -- coupled with good old-fashioned detective work -- have helped us produce a rapidly growing list of potential new "smart drugs" in cancer treatment. This includes cancers that have historically been difficult to treat with standard chemotherapy -- such as melanoma and lung cancer.

Naysayers are quick to point out that the responses to this new generation of "smart" drugs are often quickly followed by relapses--sometimes in a matter of months. That's because the cancer cells begin to develop a resistance to the drugs. (Even a tumor smaller than a golf ball will contain billions and billions of cancer cells; if even one is resistant, it will proliferate despite the treatment.) The lesson learned during the last century was that the best way to minimize drug resistance when treating diseases such as AIDS or TB was to combine several drugs -- or a "cocktail." And there is every reason to believe the same principles will apply to the new generation of anticancer drugs.

One final area that gives me great hope is the renaissance in cancer immunotherapy. For most of my adult life cancer biologists have been curing cancers in mice with increasingly clever manipulations of the immune system- only to have those approaches fail in the clinic. In fact, until recently I was resigned to being an "immunoskeptic." Fortunately, our knowledge of the human immune system has matured to the point where we are finally seeing the first real successes in the clinic. One promising approach involves new drugs that remove the camouflage that cancer cells use to avoid being killed by the immune system.


I believe we are entering a golden era in cancer therapeutics, but maintaining this momentum will require that both the public and private sector efforts to eradicate cancer remain vibrant. Science -- especially science that transforms the way we think -- does not lend itself to predetermined timelines and deliverables; and this era will be imperiled if the basic research needed to fight cancer is under-resourced and overly managed.

Bob Wiltrout, Director, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH)
 
The Nation's long-term financial support for basic cancer research has laid the foundation for many new advances that are changing our outlook on the nature of cancer and raising new hope for more effective treatments. We now know that cancer is actually a collection of diseases that share some traits, but also have traits that are unique to that particular cancer. These unique characteristics are like a fingerprint, allowing us to develop and use specific drugs tailored to attack certain critical functions in each patient's cancer. Within the NIH, several investigators have now begun to demonstrate the effectiveness of such precision attacks on various cancers, including lymphoma, kidney cancer, and prostate cancer, among others.

For many years one of the traditional weapons physicians used against cancer has included various forms of chemotherapy, which often kills cancer cells only somewhat better than normal cells that are vital for human health. Through the work of many scientists, we now know there are specific genes that are required to allow cancer cells to grow and survive. Such genes have been termed the "Achilles heel" of cancer, and drugs developed to neutralize the effects of these genes offer exciting possibilities for developing new and more effective drugs against cancers.

Another exciting breakthrough is our emerging ability to detect even very small tumors with exquisite sensitivity--particularly cancers arising in the prostate gland. Prostate cancer is the second leading cause of cancer death in American men, yet not all prostate cancers actually require treatment, and many men are treated needlessly, or end up getting the wrong treatment for their tumors. Some exciting news here at NCI, NIH is that we are now using magnetic resonance imaging (MRI) to accurately identify the location, size and extent of a prostate cancer -- and combining this information with ultrasound (another detection technology) -- to allow targeted biopsies (tissue sampling) of precise, suspicious abnormalities identified on the MRI. If those biopsies shows that the tumor is not aggressive, it can be safely monitored or locally treated, thus avoiding major surgery or radiation. And if the tumors are aggressive, patients can receive the right treatment early enough to prevent the feared complications of the tumor spreading to other organs.

John R. Seffrin, PhD, CEO, American Cancer Society

A century ago, cancer was the eighth leading cause of death in the U.S. Today, it is the second, after only heart disease. The good news is, the majority of people today survive cancer -- and many thrive. There are nearly 12 million cancer survivors living in the U.S. today. But we also know that about half of cancer deaths are preventable. Obesity, lack of physical activity, and poor nutrition are major risk factors for cancer, second only to tobacco use. Approximately one-third of cancer deaths in the U.S. each year can be attributed to poor diet and physical inactivity, while another one-third are caused by use of tobacco products.

We have seen more than 15 years of decline in the cancer death rates in the U.S. Thanks to the progress we're making against the disease, we have helped prevent more than 1 million cancer deaths since death rates started dropping in the early 1990s.
Overall, we have opportunities today that, at one time, we could only dream of. The stars are aligned for us to have an incredible impact on cancer. A few key tools and platforms have helped us press forward:

• We have mapped the human genome.
• We have established the world's first global public health treaty, the Framework Convention on Tobacco Control. Its provisions, if fully implemented, could save countless lives from tobacco.
• We have platforms like the American Cancer Society Cancer Action NetworkSM and C-Change, which bring people together to fight cancer; and a nationwide grassroots movement of advocates that is committed to ending cancer unlike any we've seen before. ACS CAN has volunteers in every Congressional district in the nation
• We have vaccines that we know can save lives, such as the human papillomavirus (HPV) vaccine to help prevent cervical cancer.
• We have "best buys" -- proven, cost-effective strategies we can implement around the world to help save lives.
• And new and more targeted therapies are emerging every day.
As we work to accelerate progress against cancer, we at the American Cancer Society believe we can move from saving 350 lives per day from this disease in the US to 1,000 every day in this country -- and, one day, thousands per day worldwide. That will truly be a world with more birthdays.

Follow Marlo Thomas on Twitter: www.twitter.com/MarloThomas