BOOK REVIEW : Still Treating the Debate on Cancer : THE CANCER INDUSTRY: UNRAVELLING THE POLITICS <i> by Ralph W. Moss</i> Paragon House $21.95, 461 pages

In the end, nearly all disputes are theological. The reasons we give for what we believe are rationalizations we make up after we’ve decided. Reason and logic make our beliefs look respectable.

Ralph W. Moss is a science writer who has spent 15 years studying cancer research and treatment. He believes that the conventional treatments--surgery, radiation and chemotherapy--largely do not work and that unconventional treatments--Laetrile, diet and vitamins, for example--are promising approaches that have been dismissed by the medical establishment.

The fact that this debate never ends is yet further proof of people’s willingness to believe nonsense (not that there is any shortage of such evidence). Laetrile has been tested. And tested. And tested. And tested. The National Cancer Institute did a major nationwide study in the early 1980s and concluded that Laetrile is “ineffective as a treatment for cancer.”

Yet the true believers, Moss among them, will not give up. The National Cancer Institute did not use real Laetrile, they say. The study was just a way to discredit Laetrile.

“More laetrile is being used in the late ‘80s than it was a decade before,” Moss writes. He seems to think that this demonstrates that Laetrile works rather than recognizing what it does demonstrate: that desperate people will try anything.

To be sure, the war on cancer (like the war on drugs and the war on poverty) has gotten essentially nowhere. The incidence of cancer continues to increase, and mortality rates remain high. More than a million Americans are diagnosed with cancer yearly, and more than 500,000 die of the disease every year. So far, cancer treatment is not one of orthodox medicine’s success stories.

But I do not understand why otherwise sensible people conclude that the answer lies with unorthodox medicine--particularly when the data show otherwise.

Moss argues that the medical establishment suppresses data that does not agree with its view and harasses or jails health-care providers who try to do things differently. “Scientific theories are suppressed, medical records seized, clinics shut down, and innovative clinicians thrown in prison,” he writes.

But he never adequately explains why this great conspiracy exists or how it is maintained. His book is chockablock with alleged skulduggery by the medical establishment. Does he really believe that doctors don’t want to cure cancer? That they want to see their patients suffer and die? That they blindly turn their backs on promising treatments in order to preserve their erroneous view of disease?

Why is it that only a tiny number of doctors (I’m sure I’ll hear from them and their adherents) continue to believe in the claptrap that Moss is spewing? The great weight of evidence and informed scientific opinion rejects this book out of hand.

The Laetrilists, dietitians, vitamin advocates and believers in the power of positive thinking will respond by pointing to Galileo, a single individual who stood up to and defeated the weight of scientific opinion. The majority of scientists can be--and are--wrong, they will say.

Until effective cures for cancer are found, this dispute cannot be resolved. The orthodox view will continue to dismiss alternate treatments as quackery. The unorthodox view will continue to dismiss the medical establishment as narrow-minded dogmatists. As in most disputes, neither side can persuade the other.

Moss’ personal history exemplifies the problem. He used to be assistant director of public relations for the Memorial Sloan-Kettering Cancer Center in New York, a very orthodox institution. But he was fired because of his views about Laetrile.

He says he was dismissed because he refused to participate in falsifying evidence. Sloan-Kettering undoubtedly says that his judgment is faulty and that he ceased to be an effective spokesman for cancer research. Take your pick.

In this century, medicine has scored tremendous successes in treating and curing communicable diseases--the first time in history that doctors have actually been able to intervene and help their patients, not just hold their hands.

Cancer has proved much more intractable. There is no cancer equivalent to antibiotics. But the approach of orthodox medicine is sound, and it should not be abandoned in the desperate search to find a cure for cancer.

Next: Jonathan Kirsch reviews “The Escape Factory: The Story of MIS-X” by Lloyd R. Shoemaker (St. Martin’s Press).