The following two articles have been taken from the Fall 1998 Issue (#37) of the National Brain Tumor Foundation’s quarterly newsletter “Search” and submitted to the website by a viewer. Reprinted with permission.
For more information, call the NBTF at 1 800 934 CURE (2873), or write to them at:
NATIONAL BRAIN TUMOR FOUNDATIONFor more information about cancer cluster studies, contact the National Cancer Institute (NCI) at 1 800 4 CANCER.
785 Market St., Suite 1600
San Francisco, CA 94103
Audrey Richter and Rose Clark have spent over 10 years investigating the number of glioblastoma cases in their neighborhood. While it has not been easy, their determination and persistence has paid off.
There was an often repeated rumor in our community "There are a lot of people around here who have cancer.” We had heard this so many times. What could be done?
That question was on our minds when our friend Darlene lost her husband to glioblastoma. She was heartbroken, and we consoled her. Then within two years Darlene also was diagnosed with glioblastoma. A husband and wife! Unthinkable!!
We thought the situation in our community surrounding the SeaTac Airport (in Seattle) was dangerous. Because there was no other industry in the area, we suspected jet exhaust as the culprit. We began to make formal inquiries, but were told by the institutions that deal with cancer that we had no more in our area than anywhere else in King County. So in 1990 we decided to survey the community to establish a history.
After creating our own health survey form, we walked in local parades and staffed booths at festivals as a way of distributing the survey to residents. Needing a picture of what was being reported to us, we created a large map of the area that surrounded the airport.
Patterns began to emerge. To the northeast of the airport was a large concentration of cancer including the largest cluster of glioblastoma. Two other large concentrations of cancer could be seen under the flight tracks and on the west side of the airport.
At several community meetings we talked about our findings. Two community newspapers wrote informative articles. But the dilemma was that no one with authority would listen to us. After eight years of our compiling information, one of our state representatives finally met with the State Health Department and was assured that our community was not impacted by cancer and respiratory problems more than any other community. We even attempted to get an air quality study of King County, but this failed.
Finally, at a public meeting a representative from the State Health Department acknowledged that they were examining increased respiratory risks in our community. We spoke with him and made a case that our community also suffered from too much cancer, especially glioblastoma. He gave us a contact within the State Health Department who was responsible for investigating cancer clusters.
In April 1998, State Senator Julia Patterson made her office available for a meeting with Juliet Van Eenwyk, Ph.D., from the State Health Department. The result of that meeting was an agreement to do a data search of the zip codes in our community using the Washington State Cancer Registry. The results of this search showed a 75% increase in glioblastoma; 40% increase in gliomas; and a 10.5% increase in all cancers during the time period 1992 1995.
In August 1998, Senator Patterson convened a meeting of State Health Department officials, led by Dr. Van Eenwyk, two King County Councilmen, a local neurologist, other interested parties, and the two of us. Two things came out of this meeting: (1) the medical professionals would try to determine how to conduct a survey, and (2) the acknowledgment that this was not a political issue, but a public health one.
We waited anxiously for the next meeting. During that time, thanks to media coverage, we received calls from several former residents to say they had health problems also. Most of them had suffered from glioblastoma.
The increasing information about other cases that had fallen through the cracks helped to determine areas to research. It was decided to survey people who had moved as a result of a recent buyout of 88 homes by the airport to determine if there were any cases of glioblastoma that may have started there but were diagnosed elsewhere. We already knew of three cases of glioblastoma among those homes purchased by the airport.
At the next meeting in August, we came up with a work plan to do the following: (1) medical records of glioblastoma cases would be checked for accuracy with the assistance of our local neurologist. (2) the initial data search would be increased to cover from 1985 present. (3) we would determine components of jet fuel and exhaust. (4) we would investigate prevailing wind patterns. Depending on the results of phase one, which will be concluded in April 1999, we will move into phase two of the survey. (For detailed information about the study, visit the web site of the Seattle King County Department of Public Health at http://www.metrokc.gov/health/phnr/eapd/reports/cancer/index.htm
We continue to work closely with both health departments, and they continue to show a willingness to consider our suggestions. But we are still concerned because SeaTac Airport is planning a major expansion that is supported by the four county region.
Yet there is both relief and fear in our hearts that this study is being conducted relief that responsible agencies are joining forces with citizens to investigate this critical issue, and fear that the health risks of our community are horrendous.
Will we be proven accurate in our early comparisons to Love Canal
and Cherynobl? Does this situation exist at other American airports?
Van Eenwyk asked how we would feel if once the survey was completed, it
was determined that there are no higher risks. Our reply was that we
welcome those type of results because it would be one less concern for
people in our community. So for now we wait.
A REPORTER'S PERSPECTIVE ON BRAIN TUMOR CLUSTERS
By JEANNINE DAIGLE MOORE, PRODUCER HEALTH UNIT KIRO TV, SEATTLE
KIRO News first decided to air the story about Audrey Richter and Rose Clark's search for answers after viewing a letter from I the State Health Department that was sent to a state senator. The letter showed that rates of all cancers within a 3 mile radius of the airport were elevated.
State epidemiologist Dr. Juliet Van Eenwyk said that cancer
were 10% above normal, but characterized that as a slight rise. And she
cautioned, only a brief time period, 1992 1995, was measured using the
Washington State Cancer Registry.
The cancer rate that stood out was glioblastoma. The Health Department expected to find 12 cases, but instead found 2 1. Van Eenwyk said that the increase of 75% over the normal rate could be a statistical blip. She emphasized that extremely few cancer clusters nationwide have been linked to any environmental cause.
Still, if there were an environmental cause, KIRO News learned that no agency is set up to monitor it. The Environmental Protection Agency, The Federal Aviation Administration, The Department of Ecology, even the Puget Sound Air Pollution Control Agency each told us that they don't regulate jet emissions.
According to John Bregar of the Environmental Protection Agency, jet fuel does contain carcinogens, He named Benzene, Butadiene, and Formaldehyde. He told us that no agency knows enough about how those chemical interact as they come out the back of jet engines.
Following our first news reports, we received several calls from viewers. Some knew others from that 3 mile area who had died or are now battling brain tumors.
We were struck by reports from viewers who told us about brain tumors found in airport employees. Those cases would not have shown up on the State's data. The employees didn't live in the 3 mile radius of the airport that was measured.
After meeting with the community, the State has agreed to take a
closer look at this brain tumor cluster Dr. Van Eenwyk says it will be
difficult to establish whether a similar pattern exists near other
Washington State has one of the nation's most detailed cancer
She says other states may not even be able to trace addresses for
in their states who have succumbed to glioblastoma.
About half of all primary brain tumors are gliomas. This means that they grow from glial cells. Glial cells are a specific type of brain cell. Gliomas usually occur in the cerebral hemispheres but may also strike other areas, especially the optic nerve, and the brain stem. I understand that, particularly among children, they can also be found in the cerebellum.
Gliomas are classified into several groups because there are different kinds of glial cells. The most common types of gliomas are called astrocytomas. They develop from star-shaped glial cells called astrocytes. Doctors will often assign grades to an astrocytoma following biopsy. The types of graded astrocytomas include:
Well differentiated: Also known as low-grade astrocytomas or grade I and II astrocytomas, these tumors contain cells that are relatively normal and are less malignant than the other two grades. They grow relatively slowly and may sometimes be completely removed through surgery. However, even well differentiated astrocytomas are life threatening if they are inaccessible.
Anaplastic: Anaplastic astrocytomas, also called mid-grade astrocytomas or Grade III astrocytomas, grow more rapidly than well-differentiated astrocytomas and contain cells with some malignant traits. Surgery followed by radiation, and some chemotherapy, is used to treat anaplastic astrocytomas. This is the type of tumor that my wife had.
Glioblastoma multiforme: These tumors, sometimes called high-grade or grade IV astrocytomas, grow rapidly, invade nearby tissue, and contain cells that are very malignant. Glioblastoma multiforme are among the most common and devastating primary brain tumors that strike adults. Doctors usually treat glioblastomas with surgery followed by radiation therapy. Chemotherapy may be used before, during or after radiation.
- Bill Roush