Damn the Doctors--and Washington

Oregon State Senator Ken Jernstedt insists that the contest involves a treasured principle: "We want to maintain our freedom of choice." Florida State Representative Robert McKnight sums up the issue bluntly: "Stay the hell out of my business." With victory, argues California State Senator William Campbell, "our society will be a little bit freer."

These legislators are in the front ranks of a coast-to-coast uprising that has welded together an unusual alliance of right-wing civil libertarians and left-wing civil rightists, nut-nibbling food faddists and humanitarians groping for a way to relieve suffering. The crusade is the dark side of the mounting anti-Washington tide, a movement against Government interference in citizens' lives that involves states' rights, freedom of the individual and the fundamental subject of people's health. The question: Should state legislatures make an end run around federal bureaucrats and legalize the use of drugs that the Food and Drug Administration has banned or not yet approved? They are Laetrile, an unproved anticancer nostrum, dimethyl sulfoxide (DMSO), Gerovital and saccharin.

Federal Disapproval. So far. seven states--Alaska, Arizona, Florida, Indiana, Nevada, Texas and Washington--have legalized Laetrile: Delaware, New Hampshire and Oklahoma will join them as soon as their Governors sign authorizing bills or let them become law without their signatures. Similar legislation is pending in twelve states and will probably be revived in seven others when their legislatures reconvene. In addition, Nevada has approved the manufacture and sale of Gerovital. Oregon has legalized DMSO and soon may approve saccharin, which has already been okayed by Indiana. (Apparently heeding FDA warnings that saccharin may cause cancer, legislators in Arizona and Nevada rejected bills to legalize the sweetener.)

The rush to approve the drugs has overwhelmed objections by the FDA, which, since the 1962 thalidomide scare, has been required by law to license only substances that are scientifically proved to be effective as well as safe. But the FDA can control only drugs that cross state lines; the states are free to license those that are manufactured and used within their boundaries in spite of federal disapproval. In fighting against the drugs, federal health officials have suffered from their loss of some public respect following the false swine-flu scare and the FDA'S proposed restrictions on the sale of saccharin. The agency acted after the laboratory rats which were fed huge quantities of the substance then developed cancer.

The state-by-state movement to legalize drugs of questionable value has chiefly involved Laetrile, which is already being used illicitly by tens of thousands of American cancer sufferers. The substance is smuggled into the U.S., mainly from Mexico. No reputable studies have found evidence to support claims that the drug cures or prevents cancer (TIME, May 23). Its use is opposed by the American Medical Association, and Dr. Frank Rauscher, American Cancer Society senior vice president for research, insists: "We know doggone well that Laetrile doesn't work." But backers put their faith in tales of miracle apricot-pit cures and refuse to be dissuaded. Many are impatient with the pace of cancer research and suspect that doctors and the drug industry are more interested in profits than cures. The median cost of conventional cancer treatment, including surgery, radiation and chemotherapy, is about $19,000 per patient; Laetrile goes for $1 a capsule and about $10 a shot.

Although some urban liberals are working to legalize Laetrile, the campaign is led by the Committee for Freedom of Choice in Cancer Therapy, based in Los Altos, Calif., which is dominated by right-wingers, including members of the John Birch Society. Well-financed and well-organized, the group claims to have 25,000 members, including a few Communists, meeting in 450 local committees across the country.

Bumper Stickers. To whip up enthusiasm for the bills, supporters have packed committee hearings and state house galleries with vocal supporters, many of whom are elderly. In Wichita, Kans., Virginia Wilson held a Laetrile taste-in at her home, featuring fresh fruits, lima beans, beets and carrots, which proponents claim are rich in the substance. She also showed a 45-minute pro-Laetrile film called World Without Cancer. At the Illinois state house, some 300 Laetrile backers passed out blue-and-white bumper stickers that read: LAETRILE WORKS! YOU BET YOUR LIFE. In Massachusetts, supporters delivered to the legislature 40 shopping bags stuffed with more than 12.000 pleas for legalization of the drug.

Many of the bills' sponsors are cancer sufferers or relatives of patients, and fervently believe in Laetrile. New Jersey Assemblyman John Gregorio, whose father has cancer and whose mother and two uncles died from it, takes regular doses of the drug.

The arguments are often strengthened by the testimony of cancer victims who claim they have been helped by the substance. In Texas, explains anti-Laetrile Lobbyist Ace Pickens, "legislators said, 'Oh hell, if it doesn't do them any harm and if it gives them any hope, why not let them have it?' " Otherwise, says Arizona State Representative Herb Everett, "we are making criminals out of those who want to use Laetrile." Most potent of all has been the plea that people who are dying from cancer should be free to try even worthless cures. The New York Times agrees, and California Governor Jerry Brown believes that people should be allowed to ingest anything that has not been proved to be harmful.

Talking Suicide. One of the forces driving the movement is a growing distrust of doctors. The onslaught caught many medical associations by surprise. Convinced that the Massachusetts bill would die quickly, the state chapter of the American Cancer Society did not even bother to testify at a hearing on the proposal. Only a dietitian spoke against the bill at a hearing in Arizona. Medical societies in Oregon and Louisiana ducked the issue.

Most doctors are horrified at the prospect of their patients demanding Laetrile. New York Psychiatrist Samuel Klagsbrun told an FDA hearing: "The sad part about it is that for an individual to leave orthodox treatment is to choose to leave their only real chance for survival. It is suicide we're talking about." The FDA has cases of women with cervical cancer who refused surgery, which has a 65% cure rate, in favor of taking Laetrile, and died. Similar cases are cited by Harvard Neurosurgeon H. Thomas Ballantine, a past president of the Massachusetts Medical Society. He calls Laetrile "pure quackery." Says Illinois State Representative Eugenia Chapman: "Persons victimized by cancer should not be twice victimized."

Making up for lost time, the FDA is busily assembling all of the evidence against Laetrile. To strengthen the case, the National Cancer Institute is considering testing the drug on cancer patients. FDA Commissioner Donald Kennedy has organized a team of four experts to fly off at a moment's notice to testify before state legislatures. In addition, says Richard Merrill, FDA chief counsel: "We are likely to be more aggressive in enlightening the general public." The agency's lawyers are preparing to mount court challenges against the sale or production of Laetrile under the new state laws. They believe that they can win if the bottles, labels or anything else employed in making or selling the drug crosses a state line.

But no one has yet obtained a license to manufacture or distribute Laetrile in any state. For one thing, some state health authorities seem ready to drag their feet on issuing permits. Arizona Health Services Director Suzanne Dandoy predicts a long delay because her staff lacks the expertise and research data needed to set guidelines. Says Thomas Caton, executive director of Oregon's state board of pharmacy: "We have to do some study to define purity and dose levels."

Scarce Apricots. Moreover, backers have not yet figured out how to manufacture the drug legally in some states--even if there were enough demand to make production profitable--without crossing a state line. Indiana, for instance, has few apricot trees. But the state has plenty of peach trees, so proponents are giving some thought to producing the drug from peach pits.

Even if production does begin in the states that have legalized Laetrile, most doctors will probably refuse to prescribe it for their patients. The Texas Medical Association has already urged its members not to use Laetrile, and other state medical groups are expected to follow suit. The drug would be left in the hands of the same quacks and medical mavericks who have been promoting it for years--and who are slowly beginning to win their battle, state by state.

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