Yes, Campbell is talking about paradigms. "Whole":
THE CANCER MINEFIELD
During the late 1980s, I accepted an invitation to give a Grand Rounds lecture to the McGill Faculty of Medicine in Montreal, the top-ranked medical education program in Canada. Because it was before the publication of the results of our nationwide study in China (the one I discuss in depth in The China Study), I spoke only of the potential relationship between cancer and imbalanced nutrition, based on our own findings on protein, along with a few observations of other research groups. I showed in some detail the remarkable results that we were getting on cancer reversal when dietary protein was decreased. I went on to speculate about someday using a nutritional strategy to treat cancer in humans. I could say no more than that, however, because at that time, I did not know what specific strategy might be used.
Later that evening, I was taken to dinner by the chairs of the Big Three departments involved in cancer treatment: surgery, chemotherapy, and radiotherapy. During our conversation, Surgery Chair asked me what I meant by my remark on the possibility of nutrition affecting cancer development after patients had learned of their cancer. I pointed out that we had enough preliminary evidence to justify the testing of this hypothesis. We had a lot more evidence than is generally available for risky commercial treatments, such as new forms of chemotherapy and radiotherapy. Really, it was no comparison. Potential upside of nutritional therapy: turning off cancer development completely. Likelihood based on experimental data: very high. Potential downside of nutritional therapy from a health perspective: none. We all know about the side effects of chemo and radiation, as well as their far-from-stellar success rates. Surely it made sense to give nutrition a try?
Surgery Chair quickly responded to say that he would never allow any of his patients to try a nutritional approach as a substitute for the surgery that he knew well. He went on to give as an example: the superior ability of surgery to treat breast cancer. But Chemotherapy Chair took issue with Surgery Chair’s opinion, saying that chemotherapy was more effective than surgery. While Surgery Chair on my left was contesting Chemotherapy Chair on my right, Radiotherapy Chair, sitting across the table from me, found fault with the opinions of both of his colleagues. On the case under discussion, he insisted, radiotherapy could offer the best treatment. I was in no position to know who might have the better argument and merely listened. Looking back, it was really quite funny, except when you consider all the death and suffering these attitudes have caused.
At the time, I took note of three interesting things. First, these medical luminaries could not agree on which treatment—surgery, chemotherapy, or radiotherapy—was best for treating breast cancer. Second, they had no tolerance for nutritional therapy, because according to them, and me at that time, it hadn’t yet been shown to be effective for humans. Third and far more important, they clearly had no interest even in discussing ways in which research might be conducted to explore the possibility of using nutrition as a means of treatment. Now, more than twenty years later, the discussion remains the same. It was clear that there was a serious disconnect between these gentlemen and me as to what the emerging evidence of nutrition on cancer was showing. The majority of oncologists still worship one of the three “traditional” treatments and have no patience for or understanding of nutritional treatment options.
I since have presented two recent talks, one to an audience of cancer researchers and specialists in Chicago sponsored by two highly reputable medical schools, and the other to a U.S. National Cancer Institute venue in Sacramento, California, in which I recalled this twenty-year-old story. I did so simply to make that point that while the clock is still ticking, the conversation is barely shifting. If it isn’t a new surgery, chemo cocktail, or radiation protocol, the cancer industry isn’t buying.
HERESIES AND MORE HERESIES
I don’t mean to say that everyone who disagrees with me is some sort of dogmatic, narrow-minded caveman. I’m a scientist, and I expect (and hope) that my findings will be challenged by other researchers. Given the importance of what I believe I and others have discovered, it’s critical that we put it to the test to make sure it’s correct, and that it’s not the result of sloppily and poorly executed studies. I welcome those who critique my statistical methods. I’m thrilled when someone attempts to replicate one of my findings, even if their goal is to prove me wrong. Over the years, many of my critics have been responsible for pointing out the next phase of my research, or helping me tighten up a study design, or helping me imagine new ways to approach a thorny issue. That’s the scientific method at its best: all of us competing not for personal glory and wealth, but to serve the highest truth and the highest good.
The attacks on and dismissals of my findings are more than the normal scientific discovery process, however. The real issue in many cases is that I am asking questions that threaten the reigning research and medical paradigms. The questions I and others have asked over the years have produced answers that are outside the rigid mental boundaries that small-minded science enforces. We’ve discovered that cow’s milk protein at reasonable levels of intake markedly promotes experimental cancer growth, which is outside of the nutrition paradigm. We’ve discovered that experimental cancer growth can be turned on and off by altering practical levels of nutrient intake, and can be treated by nutritional means, which is outside of the cancer treatment paradigm.
We’ve observed that these effects are driven by multiple mechanisms acting in concert, which is outside of the medical paradigm.
We’ve found that cancer growth is controlled far more by nutrition than by genes, which is outside of the scientific paradigm. We’ve shown that the nutrient composition of foods is more a determinant of cancer occurrence than chemical carcinogens, which is outside of the cancer-testing and regulatory agency paradigms.
We’ve found that saturated fat (and, for that matter, total fat and cholesterol) is not the chief cause of heart disease (there’s animal-based proteins as well), which is outside of the cardiology paradigm. I could go on and on. I’m just thankful I don’t live in a past era, when heretics were sentenced to house arrest or burned at the stake for their views!
These findings may not be that striking to readers outside of the world of scientific research, but be assured that they clearly are unexpected, even unbelievable phenomena (heresies?) for virtually anyone inside the medical research community. Most of these findings—and many more that I could cite—arose partly by luck, but after making that first unlikely observation (high casein “causing” cancer growth), I became more and more aware that I had strayed beyond the paradigm of normal science.
Once I had tasted the forbidden fruit, I was hooked. Having accidentally strayed from the straight and narrow, I was becoming more and more curious about what else might be hiding in plain sight outside of the existing paradigms. I then began to see, through my public policy work, why paradigms exist and how they function. I especially became aware that the ideas inside of a paradigm are often strikingly opposed to ideas outside of it, thus making the boundaries clearer.
You may be thinking that all this talk about what’s inside and what’s outside of paradigms seems abstract and even academic. Why does this argument really matter? Actually, deciding whether an observation is or is not heretical has real consequences. In the medical research world, unexpected observations are oftentimes ignored. Researchers dismiss them, saying something like, “That can’t be right.” Such observations therefore may never see the light of day (or come to rest on the page of a professional publication). In reality, they might be gems, either pointing out flaws in what we consider to be normal or suggesting a new dimension to our thinking.
Much philosophy has been written through the ages on the research done to discover elusive truths. We make rules to guide our thinking, but we fail to see that these same rules, although helpful in articulating and sharing our current understanding of the world—within science and elsewhere—also may be constraining. We formulate hypotheses, then create or search for evidence to “prove” them.
Another way to pursue truth, proposed by the famous science philosopher Karl Popper, is to try to falsify our hypotheses—in effect, to seek out the boundaries of our mental paradigms and push against them, to see if they can withstand scrutiny. Can we find evidence to disprove our hypotheses, and are we able to take seriously such evidence? At times, I cannot help but wonder how much and how often our rules and strategies keep us from straying from the status quo.
I have always liked exploring outlier observations in my research. They make me think. During my career, I obtained (or at least noticed) more than my share of observations that were not considered normal. After collecting enough of these heresies, however, I began to see an emerging pattern of them that suggested a substantially different worldview—at which point, it seemed to make sense to call them not heresies but “principles.” Here are a few examples.
In the China Study, we discovered that blood cholesterol for rural Chinese adults averaged 127 mg/dL, with individual village averages ranging 88-165 mg/dL.6 At that time (the mid-1980s), 127 mg/dL was considered dangerously low. The “normal” range for serum cholesterol in the United States at that time was 155-274 mg/dL (with an average of 212 mg/dL), and there was some surprising evidence among Western subjects that incidences of suicides, accidents, and violence,7 as well as colon cancer,8 were higher when total cholesterol levels were below 160 mg/dL. Should I therefore have assumed that virtually all rural Chinese were at high risk range for suicides, accidents, violence, and colon cancer? Of course, we found nothing of the sort. Instead, we discovered that the Chinese villagers averaging 127 mg/dL were actually far healthier than Americans with so-called normal cholesterol levels.
My first thought was that perhaps our cholesterol assay method (how we collected and analyzed the blood samples) might be faulty. Following Popper’s principle of trying to disprove my own hypothesis, I tried to discredit my own finding by using another assay method and repeating these analyses at laboratories in three different locations (Cornell, Beijing, and London). All the analyses showed the same low cholesterol levels. Now we had to make sense of the apparent paradox that the healthiest Chinese people had cholesterol levels that would have been considered dangerously low in the United States.
Further examination revealed that, for this Chinese range of 88-165 mg/dL, like the U.S. range of 155-274 mg/dL, lower levels of cholesterol were associated with increased protection from several cancers and serious related diseases. The Chinese population showed correlations between low cholesterol and health that could not be observed in the United States because almost no Americans had cholesterol that low. The Chinese range showed us that cholesterol of 88 mg/dL could be healthier than cholesterol of 155 mg/dL, a finding that simply could not have been gleaned from a study of a U.S. population.
Another example of an outlier that led me away from “accepted wisdom” was our finding that casein, which for decades had been the most highly rated and respected protein, dramatically and convincingly promoted cancer. Even today, it is so heretical that no one wants to say the obvious—that casein is the most relevant chemical carcinogen ever identified. The implications of this heretical finding, like the implications of the exceedingly low blood cholesterol level in rural China, have been among the many hinges on which new doors of understanding opened on the relationship between nutrition and health.
Interestingly, this effect of casein on cancer proved so heretical that even the researchers in India who first showed this effect in a far more limited study never wanted to acknowledge their finding for what it was.9 They preferred to focus not on casein’s long-term effect on initiating cancer, but on the seemingly opposite effect casein had in quickly reducing the toxic effects of huge single doses of carcinogens.10 (We’ll discuss these two effects in greater depth in Part II.) In other words, they ran away from the immense implications of their discovery by focusing on an insignificant detail.
I’m glad I didn’t run because I have observed that giving some attention to unexpected observations that might otherwise be discounted or discarded can be unusually rewarding, especially if these observations are pursued to an explanation. My career began when I followed some outlier observations into murky territory, risking (and ultimately parting with) the pro-animal-protein beliefs of my childhood and early research career. When enough of these heresies accumulated, interconnected patterns began to emerge. Those patterns morphed into principles and then into full-blown theories, alternate paradigms that changed the way I saw the world. The rewards of living with heresies can be an exhilarating experience, well worth the costs of being considered a heretic.
True, my social and professional collegialities changed when I began to speak of research findings that lay outside the norm. Skepticism and silence, to put it gently, became more common. Yet the rewards have been numerous, and I do not hesitate to encourage young people to follow the same path that I trod. (When they ask me, as many have, how they might be able to do what I do, I tell them very simply to never be afraid to ask questions, even ones everyone tells you are stupid. Just be prepared to use good science and logic when defending your perspective.)
The view from the outside of a paradigm can be especially rewarding, and also meaningful, when it is considered within the context of everyday life. As time has passed, the odd and unexpected research observations collectively began to shape a new worldview for me. They seemed to be more and more connected. If this worldview touched on matters of life and death, that’s when personal passions arose, both pro and con. That’s when the boundaries of these paradigms sharpened and came into view.
