Roffo, Angel Honorio, Dr.
(Argentinian oncoclogist, did early tobacco studies establ)Biographical Information:
Angel Honorio Roffo was born on December 30, 1882, in Buenos Aires, Argentina, where he lived until his death. He devoted his entire life to cancer research, and both his field of inquiry and his approach were far enough outside the mainstream that the importance of many of his findings were not appreciated until much later. In addition, his reputation fell precipitously and undeservedly after his death, thereby surrounding many of his most significant contributions in mystery. Even now, as his accomplishments are beginning to recognized, there remains no reliable biography and there are many unanswered questions about his life and work.
Roffo received his doctorate in 1909 for a study of cancer. At the time, the disease was poorly understood, with many members of the public fearing that it was contagious. The medical community's understanding was not much better, with many now-discredited ideas circulating. So Roffo's dogged fight against cancer involved equal measures of research, advocacy and public education.
During his long career, Roffo published six books and more than four hundred shorter studies, some of them in collaboration with his wife, who was also a scientist. His publications adhered to the scientific and medical conventions of the day, yet showed a willingness to enlarge the boundaries. At a time when many leading authorities were focused on unlocking the genetic key and finding a cure for cancer, Roffo relentlessly pursued the contribution of environmental factors and sought ways of preventing cancer.
Roffo also recognized that his findings about cancer were too important to allow him to restrict his activities to the laboratory. In 1922, he accepted the position of director of the Institute for Experimental Medicine for the Study of Cancer and spent the remainder of his career overseeing the Institute's clinical and research programs and attempting to educate the public. To further these ends, he founded the Argentine Society for the Study of Cancer and the Argentine League for the Fight against Cancer. He established a Bulletin published by the Institute and was a regular participant in international conferences on cancer.
Intriguingly, Roffo's two best-known studies were both published in German. A 1931 article (A. H. Roffo, "Durch Tabak beim Kaninchen entwickeltes Carcinom," Zeitschrift fur Krebsforschung, 33: 321-332, 1931) was one of the first important studies to show a strong correlation between cancer and smoking. Then in a 1935 study (A. H. Roffo, "Krebs and Sarcom durch Ultraviolett- und Sonnenstrahlen," Zeitschrift fur Krebsforschung, 41: 448-467, 1935), he suggested a relationship between skin cancer and overexposure to the sun, specifically its ultraviolet rays. His reasons for publishing both articles in German is not entirely clear, but presumably German dictator Adolf Hitler's support of tobacco control played a large role.
Angel Roffo continued to broaden and expand his research horizons during the 1930s. As Robert Proctor has observed, Roffo's position at the Institute for Experimental Medicine for the Study of Cancer gave him access to a large pool of cancer patients, enabling him to add statistical techniques to his laboratory expertise. Proctor accordingly credits him with "pioneering the field of experimental tobacco carcinogenesis, blending experimental, clinical and statistical reasoning with a strong sense that many of the world's most common cancers could be prevented."
Among Roffo's important specific findings cited by Proctor are his recognition of tobacco as the most significant cause of lung cancer, his realization that the tar in cigarettes ? not the nicotine ? was primarily responsible, and his identification of polycyclic aromatic hydrocarbons, such as benzo(a)pyrene, as the principal carcinogenic agents. All of these are now regarded as bedrocks of tobacco research, yet when Roffo made them they were controversial or revolutionary. In addition, Roffo determined that higher tar levels made blonde tobacco more dangerous than black tobacco and linked cancers all along the "smoking highway" (which included the lips, tongue, throat, cheek, and bronchial passages) to smoking.
As Roffo's research continued to indict cigarettes, he became an increasingly outspoken advocate of government intervention to prevent the pandemic of tobacco-related deaths that he anticipated. The extent to which his warnings were heeded in his native Argentina remains difficult to gauge, but there is more basis for assessing their reception in the United States. In particular, the contrast between the reaction to his findings about exposure to ultra-violet rays and his conclusions about smoking is very stark.
Roffo's skin cancer study was published in 1935 and, with the sun not employing any public relations consultants, the results were soon conveyed to the American public. For example, in 1936, syndicated health columnist Dr. Irwin S. Cutter presented a detailed nine-paragraph summary of the study, concluding with this warning: "while ultraviolet is very helpful in the preservation of health and well-being, like any other powerful agent, it can be used to excess. The fad of acquiring a deep sun tan of the face may prove a two edged sword. Tanning of the whole body, however, if gradual and not accompanied by sunburn, is safe." In addition, the official journal of The American Cancer Society took note of Roffo's study in an editorial.
In contrast to the rapid dissemination of the skin cancer study, Roffo's far more extensive research on smoking remained out of the eye of the American public. The tobacco industry kept careful tabs on his work, with American Tobacco Company Research Director Hiram R. Hanmer wrote in 1939 that, "We have been following Roffo's work
for some time" and he then went on to cite highly technical critiques of Roffo's methodology that had appeared in the German journal Zeitschrift fur Krebsforschung.
Yet coverage of Roffo's findings in the mainstream American media was very rare, and any mention that did occur was liable to be accompanied by a lengthy disclaimer. Most notably, in 1939 Roffo spoke at the third International Cancer Congress in Atlantic City to describe a study in which he had painted tobacco tar on the skins of rabbits and produced cancer. A similar study on mice conducted by Wynder, Graham and Croninger in the 1950s would become an international sensation, but Roffo's address received the most cursory press coverage. The Chicago Tribune, for example, printed a three-sentence summary of the conclusions and then appended a disclaimer that was almost as long as the article itself ? "The ability of tobacco tars to produce animal cancers has been reported before," it stated reassuringly, adding, "but human experiments have indicated that tobacco users are not likely to give themselves such high concentrations of tar as the experimental animals receive." The Tribune buried the AP piece on page 16, beneath a piece headlined "Invents Shovel with Padded Arm Rest to Make Leaning Easier," while other newspapers apparently passed on the news altogether.
Angel Roffo died in Buenos Aires on July 24, 1947, and the ensuing years saw his reputation decline precipitously, especially in the English-speaking world. A number of factors contributed to the oblivion into which Roffo's research fell, some of them understandable. The language barrier was no doubt one of them, as most of Roffo's work remains available only in its original language, which was usually Spanish or German. The association of tobacco control with the vile intentions of Adolf Hitler's science initiatives was another major factor. In addition, the novelty of many of Roffo's techniques prompted legitimate critiques within the scientific community.
But as was the case during his lifetime, the decline in Roffo's reputation after his death exhibits a striking contrast that suggests that the tobacco industry alone recognized what a major figure he was. According to Council for Tobacco Research-sponsored scientist Domingo M. Aviado, an unnamed tobacco magnate made a major donation to the University of Buenos Aires in the 1950s, with the result that a new research institute was established and the legacy of Roffo eclipsed. In the English-speaking world, the consignment of the great Argentinean scientist to obscurity was even more complete. Even when his work was built upon by major scientists like Richard Doll and the Wynder/Graham/Croninger team, they appear to have been unaware of Roffo's prior work, except for a vague sense of the controversy it produced.
Only the tobacco industry remained aware of the work of the man who was described in a 1950 internal American Tobacco Company memo from Hanmer as "the chief protagonist of the theory that there is a causal relation between smoking and cancer of the respiratory organs." As Proctor notes, it was at least in part because of Roffo that the industry began hiring translators, allowing them exclusive access to his studies. They appear to have taken full advantage of this situation, with a 1953 unpublished internal report by R.J. Reynolds scientist Claude E. Teague citing no fewer than nine of Roffo's studies at a time when the rest of the world seemed to have forgotten about his work.
Neglect of Roffo remained the norm for decades, and when he was remembered the industry was quick to cast aspersions on his contributions. For example, in the 1980s when plaintiffs' expert Jeffrey E. Harris cited Roffo's work in depositions and expert reports for the Cipollone trial, defense expert Aviado produced a confidential report that noted that Harris appeared to be unfamiliar with the many Roffo works that had not been translated into English. And when Harris was cross-examined, industry attorneys attempted to dismiss Roffo as a "fanatical tobacco advocate."
Yet by then the long-overdue rehabilitation of Angel Roffo's reputation had begun. When Harris was specifically asked if Roffo's avowed hatred of smoking diminished his credibility, he replied forcefully, "As a doctor who saw a lot of people dying of cancer, I think that would be understandable."
The years since have seen renewed awareness of the contributions of Angel H. Roffo. Robert Proctor, in a 2006 article in the Bulletin of the World Health Organization, described Roffo as "The Forgotten Father of Experimental Tobacco Carcinogenesis." The Instituto de Oncologia Angel H. Roffo in Buenos Aires is named in his honor and remains a leader in the study and treatment of cancer. Yet Roffo remains largely a forgotten figure, and, what is even more tragic, the message about cigarettes that he tried so hard to get out in the 1930s was stifled and ignored for far too long.
Sources
Domingo M. Aviado, "A Critique of Expert's Report on the State of the Art," January 21, 1986, http://tobaccodocuments.org/bliley_pm/26741.html.
Allan M. Brandt, The Cigarette Century: The Rise, Fall and Deadly Persistence of the Product that Defined America (New York: Basic Books, 2007).
Irving S. Cutter, M. D., "Ultra Violet and Skin Cancer" (syndicated column by the N. Y. News Syndicate under general title, "How to Keep Well"), Chicago Tribune, April 8, 1936, 16.
H. R. Hanmer, letter to E. E. Free, May 11, 1939, http://tobaccodocuments.org/atc/60359251.html .
H. R. Hanmer, "Memorandum on Alleged Causative Relation Between Cigarette Smoking and Bronchiogenic Carcinoma," September 15, 1950, http://tobaccodocuments.org/tplp/MNATPRIV00025929-5958.html .
Jeffrey E. Harris, Trial testimony of JEFFREY EARL HARRIS, M.D., Ph.D., February 3, 1988, CIPOLLONE v. LIGGETT GROUP INC., http://tobaccodocuments.org/datta/HARRISJ020388.edit.html .
Jeffrey E. Harris, Trial testimony of JEFFREY EARL HARRIS, M.D., Ph.D., February 9, 1988 [a.m.], CIPOLLONE v. LIGGETT GROUP INC., http://tobaccodocuments.org/datta/HARRISJ020988AM.html.
Richard Kluger, Ashes to Ashes: America's Hundred-Year Cigarette War and the Unabashed Triumph of Philip Morris (New York: Vintage Books, 1996).
Robert N. Proctor, "Angel H Roffo: The Forgotten Father of Experimental Tobacco Carcinogenesis," Bulletin of the World Health Organization, June 1, 2006 .
Claude R. Teague, "Survey of Cancer Research With Emphasis Upon Possible Carcinogens From Tobacco," February 2, 1953, http://tobaccodocuments.org/youth/CnHmRJR19530202.St.html