When is breast cancer not "cancer," not malignant and not a tumor? When you're a plastic surgeon trade group funded by implant makers Allergan (AGN) and Johnson & Johnson (JNJ), according to an exchange of letters between watchdog group Public Citizen and the FDA.
In January, the FDA warned of an unusual type of breast cancer associated with implants. Allergan, which makes the Natrelle brand of implants, responded by denying that implants were linked to cancer and by denying that anaplastic large cell lymphoma (ALCL) is "cancer" per se.
On Feb. 3, the presidents of two cosmetic surgery trade groups -- The American Society of Plastic Surgeons and The American Society for Aesthetic Plastic Surgery held a members-only webinar where they advised doctors on what to say to worried women. Dr. Phil Haeck, president of ASPS, said ALCL wasn't a "cancer" but a "condition":
[Y]es it's classically a malignant tumor, but it has such a benign course that when we were discussing ways to talk to the media we decided that we would call this a condition when we talked to the media, not a tumor, not a disease and certainly not a malignancy.
Um, because, and I would recommend that you use the same terms with your patients rather than disturb them by saying this is a cancer, this is a malignancy. The best word is this is a condition. If you develop this condition here's how we are going to treat it, the way we are going to diagnose this condition is this, and that's very reassuring when you are using that word and not using the word cancer or malignancy.
And I think you are certainly justified, with what we know now, in downplaying the malignant potential of these.The FDA responded by having a little chat with the two groups and the video of the webinar has magically disappeared from the groups' web sites.
Following the money
It is probably not a coincidence that ASPSS and ASAPS repeated the cancer-denial line first promulgated by Allergan: Both organizations have received funding from the company. ASPSS has also received funding from Allergan's main competitor, J&J, which makes the Mentor implant line. (Mentor's reaction to the FDA warning was more muted than Allergan's but its statement also avoided mentioning the C-word.)
Both Allergan and J&J fund provide funds for ASPSS, as noted on its web site.
At ASAPS, Allergan's funding is more indirect. It has supplied research grants through ASAPS' research arm, the Aesthetic Surgery Education and Research Foundation. You can see those grant award announcements by searching for "Allergan" here.
The two groups ought to be ashamed of themselves. It is one thing to take funding from drug and device companies -- the money has to come from somewhere, after all. But the groups ought to represent the medical expertise of the healthcare providers who are their members, not the PR agendas of two companies who are afraid they may lose money from too much blunt but accurate talk about breast cancer.