Cause of cancer cluster may never be discovered

TALLAHASSEE - A cause of Palm Beach County's Acreage cancer cluster may never be found, representatives from the CDC cautioned as they met with state health experts in Tallahassee on Friday, but obvious environmental hazards can and should be addressed.

"Cancer clusters are fraught with difficulty," said Dr. Michael McGeehin, director of the Division of Environmental Hazards and Health Effects at the Centers for Disease Control and Prevention in Atlanta.

With most clusters, the numbers of people sickened are often too small, from a statistical perspective, to make scientifically meaningful conclusions, McGeehin said during a break in the daylong meeting with about a dozen state health and environmental staff assigned to the Acreage problem. Palm Beach County health officials dialed in by phone.

Cancer can take a decade or more to appear in someone after a chemical or other environmental exposure, making it exceptionally difficult to pinpoint what caused the cancer, he said.

"Plus, the United States is a mobile society," said McGeehin, an environmental epidemiologist. "Many people are constantly moving in and out. All of this leads to a great deal of difficulty."

Recent studies of population and cancer data from the Acreage has found brain and central nervous system cancers at more than quadruple expected rates among children under 19, even after adjusting the Acreage's population estimates upward to around 35,000 to reflect the area's rapid growth.

Brain cancer in particular has no obvious smoking guns, he said.

"We don't have a strong association with any environmental exposures and brain cancer," McGeehin said.

McGeehin's remarks echoed those made Feb. 3 by Palm Beach County Health Director Dr. Alina Alonso.

"From what we have now, it does not seem practical or reasonable to start searching blindly," Alonso said at the time. "It's very frustrating, but I can't make up science."

She said the one thing she felt she could do was raise awareness about rising rates of childhood cancer in general, and bring focus to symptoms.

Alonso's remarks enraged many Acreage residents. More than 1,000 of them turned out for a public meeting Feb. 9 -- so many that hundreds had to stand outside in the rain.

Inside the auditorium at Seminole Ridge High School, the meeting turned volatile and angry when a state radiation expert began to show slides about how radiation is everywhere, and medical exposure is rising quickly.

"You're not answering our questions!" screamed Stefanie Burandt, a mother of four, waving an umbrella like a club. "Is our water safe to drink? Can we shower? Can we brush our teeth?"

In the wake of that meeting, state officials are attempting to give better answers. Last week they took water samples from inside and outside homes where children have had brain and nervous system cancers. This week, they are sending radiation specialists to analyze the homes and their properties.

"This testing is rather extensive, so we will have a really good view of what's going on," said Irv "Doc" Kokol, communications director for the Florida Department of Health.

Major efforts to find cluster causes are both costly and time-consuming, and unfortunately, usually inconclusive, McGeehin said.

"There won't be tremendous bang for the buck," spending on an exhaustive effort to find a cause, he cautioned.

"On the other hand, we have a community that is seeing an increase of cancer in their children. It's very difficult for the community. It is deleterious to things that are very important to them -- their home value. And it is incredibly devastating to the families and individuals affected."

McGeehin has worked closely with Florida health officials on another recent high-profile health concern, the Chinese drywall debacle.

"I'm a big proponent of trying to deal with environmental insults prior to them becoming clusters," McGeehin said.