When you're rolling against the Big Casino, the odds are with the house."" Whatever you may think of the metaphor, Nobile's essay (it appeared first in Esquire), on the disease which will sooner or later kill one out of four Americans is bad news. Nobile tallies the chances for five- and ten-year survival for cancer of the breast, lungs, colon-rectum, prostate, uterus and other sites--anything from one percent still alive with cancer of the pancreas to an encouraging 90 percent survival rate for Hodgkin's disease. The latter statistic sounds good but Nobile makes it clear that most of the official optimism among researchers is a sham. In fact after collecting the opinions of scores of doctors who disagree acrimoniously on whether surgery or radiation, chemotherapy or immunology, radical or partial mastectomy represents the best hope, Nobile winds up with Nobel Prize winning biologist James D. Watson who terms the National Cancer Program--the new name for the National Cancer Institute's coordination of all cancer-related activities--""a bunch of shit."" The message is that cancer research has been politicized by the competition for government grants and the tumorous egos of the medical profession and that treatment suffers and the patient is often no more than a cipher. Nobile reiterates what has often been said before; there aren't more than a handful of places where the victim will get ""superlative care""; New York's Memorial Sloan-Kettering leads the field--if you can afford $200 a day for a room. Nobile no doubt thought of this as an overdue muckraking report to combat media-inflated claims for new ""cures"" just around the bend. And certainly his chapter on Hollywood's sentimentalizations of this ""monster"" hits home. But on the whole it's a rather crass scare job.