Monday, October 22, 2007
Cancer clusters
My mother is one of twenty women in her neighborhood who have been diagnosed with breast cancer. And when I mean neighborhood, I'm talking about a two block radius. The women who lived next door, the lady up the street her friend in the corner house were all were affected by the same illness. Some have been fortunate and survived, like my mom. Others have passed away. But the question remains; how is it possible that so many women can come down with the same condition in such a small area? County and state public health officials investigated. Environmentalists came out to their homes... even the National Institutes of Health sent a crew to survey the area. Why breast cancer and why so many? They've never come up with a theory.

The CDC defines a cancer cluster as "a greater than expected number of cancer cases that occurs within a group of people, in a geographic area, or over a period of time. A person may suspect that a cancer cluster exists when several loved ones, neighbors, or coworkers are diagnosed with cancer." But the agency warns that many times what appears to be a "cluster" may actually reflect the normal number of cancer cases expected in a particular area. That's because cancer is a common disease. I would imagine that everyone knows at least one person who has been diagnosed with some form of the illness. Also, the term cancer can refer to a lot of different forms of the disease; a cluster usually refers to one form of cancer. And a cancer cluster may be due to chance alone. The CDC finds most cancer clusters are likely to consist of one type of cancer, a rare type of cancer or a form of cancer that is not usually found in a particular age group.

So in my mom's case, there were twenty women of different ages, different races, and different family backgrounds all with breast cancer in a tiny stretch of land. Sounds like a cluster to me.

A lot of health experts say cancer clusters are caused by the environment. For example, according to the National Cancer Institute, one in seven women living in parts of Long Island have a chance of developing breast cancer in her lifetime. New York State 2000 Cancer Registry data indicates that 500 women living in Nassau and Suffolk counties will be diagnosed this year alone. Geographic variation in breast cancer rates has been well documented, and researchers and the public are increasingly turning to environmental exposures to our air, water, soil and food to look for explanations for these pockets or clusters.

In many cases, if health officials look hard enough they can sometimes find the cause of the cancers. In Tom's River, New Jersey, 103 children were part of the nation's largest cancer cluster. State workers eventually found that 4,500 drums of toxic liquid were dumped at a nearby landfill. Federal investigators discovered in the famous "Love Canal" cancer cluster in Niagara that thousands of toxic chemicals were buried on the site 20 years before homes were built.

As I mentioned, in my mother's case, they never found the source of the problem. Officials did discover her housing development was built on an old turkey farm. Perhaps pesticides and chemicals were used on the birds, eventually permeated into the soil her home is now built on. It's difficult to say. But the problem exists.

If you think you might be a part of a cancer cluster contact your local or state health department or state cancer registry (See links here and here). These agencies provide the first level of response and have the most current local data.

Have you or someone you know been part of a cancer cluster? What did they find? Let us know.
I live in Pittsfield, Mass. My town was the home of GE (General Electric Corp.) headquarters for decades. The company is alleged to have used our river, the Housatonic, to routinely dump chemical waste. As a result, our river has high levels of polychlorinated biphenyls (PCBs), which are suspected carcinogens (cancer-causing chemicals). The company has agreed to pay for cleaning up the river. We also have a high incidence of cancer here. However, it is difficult to attribute this solely to PCBs because Pittsfield is located in the Berkshires, a haven for retirees from Boston and New York, and cancer incidence increases with age. Plus, people smoke here, although perhaps no more than people elsewhere, and we all know that causes cancer.
Hey Val,

Has your mother, before she was diagnosed cancer, experienced any sort of biological conflict shock (e.g. severe argument, death of s.o., difficult isolated situation) related to a friend, partner, child or parents?

I understand that there is a link between our psyche (conflict), brain (location affected) and organ (specific cancer).

Just wondered if you were aware of how Calif. Dept of Ag is now spraying untested compounds over populated areas. The compound has just been identified after being kept secret. It is a very scary scenario.

It is being aerially sprayed to get rid of the Light Brown Apple Moth and supposedly pheremones are being used to confuse this moth. No one knows if this process is even effective.
My daughter Stephanie Suzanne Sands, late of the Fallon, Nevada childhood leukemia cluster, was the 2nd child diagnosed in this cluster. The "official cluster" includes 16 cases of ALL (Acute Lymphocytic Leukemia) and 1 case of AML (Acute Myelocytic Leukemia).

The expected rate of incidence of ALL at the time of the cluster was approximately 3 cases per every 100,000 children per year. According to US Census2000 data Fallon, Nevada is home to 2,383 children. The rate of incidence of ALL in Fallon, Nevada is roughly 50 times what is expected according to SEER data.

In OCT2002 I sponsored and conducted Stephanie's Walk-the Fallon volunteer health survey which revealed concurrent clusters of a number of other cancers including brain cancer, Hodgkin's Disease, NHL, and pediatric rhabdomyosarcoma. These other Fallon cancer clusters are ongoing and contemporary to the Fallon, Nevada childhodd leukemia cluster.

The Fallon, Nevada childhood leukemia cluster is the most aggressive attack of cancer in medical history worldwide, in terms of time/spatial clustering.

The Fallon, Nevada childhood leukemia cluster is no less than the 3rd officially recognized cancer cluster to strike Fallon since 1961; an adult leukemia cluster in 1960-61 which killed 13 adults, and an adult brain cancer cluster in the mid-to-late 1980's which killed 8 people.

CDC and Nevada State Health Division claim to conducted an "exhaustive investigation" in the Fallon, Nevada cancer tragedy. This investigation by it's very design was doomed to failure from the outset. CDC's Fallon, Nevada effort represents it's 108th consecutive failure in identifying causes and contributors of known cancer clusters.

From the official failure in Fallon, Nevada and in Calvine/Florine, CA, and elsewhere, parent and community health activists, scientists and Public Health professionals have joined together and created NDCA-the National Disease Cluster Alliance. NDCA will hold it's first full Board meeting Thursday, 25OCT2007 and will elect it's Board members and Officers.

NDCA is developing a response model similar to that used by The American Red Cross in their disaster relief efforts. NDCA advises and mentors communities finding themselves with emerging disease clusters. NDCA facilitates cooperation and bridges between Academia, Public Health and various governmental agencies which have historically been in adversarial relationships.

Floyd Sands

Fallon, Nevada
Mehoopany, PA
A/C (570)833-2983
I did not realize that the same type of cancer could affect this many people in such a small area. It is strange that the source of cancer can’t even be determined, seeing that so many women were affected with the same breast cancer. Now I realize that cancer can be prevented with cleanliness, if the cause is pesticides or disease passed on from animals. Understanding how cancer clusters are formed will be vital to how we fight the disease. People need to just prevent more of the dangers around where they live and cancer clusters will not be such a large problem.
My family resides in Howard County, Md. My aunt recently died from breast cancer. As a result, all of her sisters including my mother are routinely tested for cancer. So far, all tests have come back negative but are the chances of getting breast cancer greater? And would the occurences of breast cancer within a family be considered a cancer cluster? Does living in separate areas possibly lesson the chances of a cancer cluster, or is there no direct relation?
Please check out Buckingham County Virginia. Everyone is dying of cancer
Public perceptions of a cancer cluster are quite errant... how many investigations of cancer clusters do you think reveal an ACTUAL cancer cluster? There is no reason to cause panic.

Cancer is a slowly progressing disease. Generally, the time from exposure to outcome (ie. toxic chemicals that cause cancer to the cancer being diagnosed) is between 15 to 20 years, even for exposures such as asbestos, well known to cause a very specific cancer, mesothelioma. Just because a group of people in a neighborhood have a cancer doesn't mean it was all a common exposure. Did everyone live in your neighborhood for the last 15 years? If not, the exposure that caused the cancer may have occurred before moving there. Also, the cancer in question should be uniform in all the cases, and it will be specific to the environmental exposure. An environmental exposure will NOT cause 10 different cancers (please see the ridiculous nature of the PGE / Erin Brokovich case... sorry to burst your bubble, but INGESTED Chr6+ has no causal association to the cancers being presented, INHALED Chr6+ is known to cause a very specific lung cancer, nothing else, and was there any inhalation of Chr6+? No.../end rant).

The toughest thing for an environmental toxicologist is telling your patient that their cancer was NOT caused by the local landfill, toxic waste, new powerplant, etc. Its very difficult to pinpoint the cause of any cancer. The public needs to understand the scientific basis of a causal relationship versus speculation. Be prudent about the advice you give and refer to a local public health agency if you have any questions or concerns.
My aunt, uncle and cousin were all diagnosed with a different form of cancer within a two year time. My aunt had breast cancer and has survived, my uncle prostate cancer and has also survived. My 15 year old cousin, though, was not so lucky. She died after a 18 month struggle with brain cancer that eventually spread to other major organs causing her death.

Fortunately for my other cousin, of the whole family in that house (in Homer, NY) he was the only one who, cross your fingers, did not get the disease.

Since my cousin died, my aunt has had an environmental assessment around the house and their neighborhood with no evidence pointing to any environmental factors / causes. My question: is there any literature that documents what exactly these "environmental assessors" do so that we can ensure the integrity of the assessment...and not become victims to more cases of cover-up??
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