Cancer Cases in Southwestern Pennsylvania Raising Important Questions With Few Answers

by admin on March 29, 2019

CDC, state officials investigating multiple cases of rare cancer in southwestern Pa.

From an Article by David Templeton & Don Hopey, Pittsburgh Post-Gazette, March 28, 2019

Many in the Canon-McMillan School District first learned about Ewing sarcoma, a rare childhood bone cancer, when Luke Blanock of the village of Cecil was diagnosed on Dec. 5, 2014.

The media did stories about the community rallying around the smart, handsome teenager and his family, then returned on Feb. 19, 2016, to cover Mr. Blanock — pale, thin and having just been told he had only two weeks to live — when he married his high school girlfriend, Natalie Britvich.

He rebounded a bit and even played a round of golf before succumbing nearly six months later on Aug. 7, from multiple tumors of the brain, spine, skull, jaw and pelvis. He was only 19.

But, as it turns out, the Ewing sarcoma scare within Canon-McMillan’s boundaries in eastern Washington County neither began nor ended with Luke Blanock.

In fact, six cases of Ewing sarcoma have been diagnosed within the school district since 2008, including two cases in the past nine months.

And only now is it being disclosed that twice that number of Ewing cases have occurred in southeastern Westmoreland County since 2011.

Only 200 to 250 cases of Ewing sarcoma — a rare cancer of the bone or nearby soft tissue — occur each year in the United States. The National Cancer Institute said the incidence for all ages is one case per million but up to 10 cases per million among those in the 10-to-19 age group.

Based on a report by a concerned resident and St. Vincent College researchers about the Ewing cases in Westmoreland County, the Pennsylvania Department of Health and the U.S. Centers for Disease Control and Prevention launched a study to determine whether these cases constitute a cluster. The state now has expanded the investigation to include the Canon-McMillan School District and Washington County.

Nate Wardle, health department spokesman, said it received more than a dozen phone calls within the last month from residents of Washington and Westmoreland counties about the Ewing sarcoma cases, and several more called this week.

Ewing Sarcoma Canon Cases mount up

The string of Ewing cases in Canon-McMillan began with the mid-2008 diagnosis of Curtis Valent, a Cecil Township resident who graduated from Bishop Canevin High School. He died on Jan. 2, 2011, at age 23, according to his obituary. His parents could not be reached for comment.

Late in 2008, Alyssa Chambers, then an 18-year-old Canon-McMillan senior living in northern Cecil Township, was diagnosed with Ewing sarcoma and survived. She later became an oncology nurse at UPMC Shadyside.

Kyle Deliere, who lived about a mile from Mr. Blanock in the village of Cecil, was diagnosed with Ewing next, on Oct. 30, 2011. He lost weight, had night sweats and fevers, and developed large tumors on his hip, femur and lungs. The 11-letter high school athlete who wrestled for the University of Pittsburgh died on Nov. 15, 2013, at age 27.

Then in June 2018, David Cobb, 37 at the time, and also living in Cecil Township, was diagnosed with Ewing sarcoma and now is undergoing rounds of chemotherapy.

Compounding this cancer conundrum and fueling concern, Mitchell Barton, a 21-year-old Canon-McMillan graduate now working as a technician in a local box factory, posted news on Facebook of his Dec. 27, 2018, Ewing diagnosis.

He and Mr. Blanock played baseball together in high school. Mr. Barton, now undergoing chemotherapy, still lives at home in North Strabane, where fracked natural gas wells surround him. For that reason, environmental issues crossed his mind from the moment of diagnosis.

“I worked at a golf course for four years and was exposed to a lot of chemicals, weed killers and things like that,” he said. “Our house also is in a valley surrounded by four gas wells. I heard about natural gas and my mom is concerned about methane [natural gas].”

In addition to the Ewing cases, a 14-year-old girl from Cecil Township died of astrocytoma, a brain and spinal cord cancer, in February, and as many as seven current students and two preschoolers in the Canon-McMillan School District have other types of cancer.

Those nine consist of two cases of osteosarcoma (bone); one liposarcoma (joint); one rhabdomyosarcoma (also joint); a Wilms (kidney) tumor in a child whose family has moved from the district; one liver cancer; two cases of leukemia (blood); and a 2-year-old with cancer that the parent declined to identify.

In another case, a 21-year-old Canon-McMillan graduate of North Strabane was diagnosed in early January with leukemia.

Another concentration of cases: The worries about Ewing and other forms of childhood cancer go well beyond the Canon-McMillan School District. In Westmoreland County, 12 cases of Ewing sarcoma were found to be diagnosed from 2011 through early 2018.

Maureen Grace, a Westmoreland County lawyer and teacher, began compiling a list upon hearing of one case after another in areas southeast of Greensburg. “All that I can say is that I saw beautiful children and families suffering. I asked myself, ‘What if this happened to a child in my family?’ Every child, every parent and anyone who cares about children has the right to clean, healthy, safe air, water and surroundings for their babies, little ones and teenagers to grow and become adults. I don’t know if we have this environment right now,” Ms. Grace said.

“Our children are our most precious resource. If we don’t investigate this to the very best of our abilities, who are we as a culture or community?” she added. “We need to do better for our little ones who look to us for the answers. We need to protect them above all else.”

So determined, she sought help from two St. Vincent College researchers — Elaine Bennett, professor of anthropology and public health, and Cynthia Walter, a now-retired professor of ecology and toxicology — who recruited students to help verify cases, analyze results and write a report. Ms. Grace also received help through the Healthy Child/Healthy World Organization. The research team, known as the Westmoreland County Pa. Ewing Sarcoma Project, submitted its report to the state health department and CDC in December 2017.

Working quietly, Ms. Grace finally responded to longstanding inquiries from the Pittsburgh Post-Gazette and stepped forward with Ms. Walter, who holds a doctorate in biology, to publicize their results. Ms. Grace said she initially documented eight pediatric Ewing cases and the health department now has expanded that total to 12, when cases involving young adults were included.

Confirming a cluster requires meeting a high statistical and analytical bar, including identifying a pollution or chemical exposure linked to that cancer, according to a Pitt biostatistician. That presents a problem because Ewing sarcoma has no known cause. What could be the cause?

The Westmoreland project presented the state with a long list of possible pollution sources, including countywide shale gas drilling and fracking operations and a Penn Township landfill that has accepted thousands of tons of radioactive drill cuttings from gas well sites. The project’s report also makes a case for how pollution exposure could lead to Ewing.

But Ms. Grace said she and the team don’t yet know if fracking, water or air pollution, or pollution from old industry, among other sources of pollution and contamination, are responsible. “We don’t want our aim to stray from seeking a scientific cause and solution,” she said.

The health department said it is reviewing cancer statistics for Washington County and for the Canon-McMillan School District, where it is only aware of four cases but has yet to incorporate 2018 cancer data into its review. In the past decade, two additional Ewing sarcoma cases have occurred in Washington County — one in Charleroi and another in or near Bentleyville — with at least two cases each in Greene and Fayette counties.

The health department also said it has been working with researchers to separately evaluate and monitor Westmoreland County statistics. Even with 12 Ewing cases, the department does not see a statistically significant excessive number in Westmoreland County, Mr. Wardle said, adding that that finding has been shared with concerned residents of the county. “But we will continue to monitor the number of cases in the area.”

He said the department is doing the statistical evaluation of the Ewing cases in Washington County and now has included all childhood cancers in the study, including those identified by the Post-Gazette.

The Ewing family of sarcoma is not one of the common cancers the department reports on annually, he said. Most cases occur in teens when they experience growth spurts, and science is limited as to what causes it.

The concerned citizens who recently called the health department wanted to know if the cancer cases are related to environmental factors, including radiation, Mr. Wardle said. Washington County has historic radiation issues related to a uranium mill tailings disposal site in North Strabane, near Canonsburg, where the U.S. Department of Energy continues to report background or below background levels of radiation.

Another concern is the widespread drilling and fracking of more than 1,000 shale gas wells, which produce waste water with radioactive components, among other pollutants. The first experimental well in southwestern Pennsylvania was fracked in 2005 in Cecil Township. The township now sits downwind from a phalanx of compressor stations and a hilltop cryogenics plant, a major source of pollution.

Academic studies done in Pennsylvania and Colorado have found higher rates of childhood cancers in areas where fracking is occurring but with no links to Ewing sarcoma.

The Marcellus Shale Coalition, the trade organization representing the shale gas industry in Pennsylvania, issued a statement citing a review of medical data by the American Cancer Society that found “no known lifestyle-related or environmental causes of Ewing tumors ….”

In a statement, David Spigelmyer, coalition president, said attempts to link the incidence of Ewing sarcoma and other childhood cancers to the shale gas drilling industry were without scientific or medical support.


See also: Study Finds Higher Risk of Brain Tumors in Appalachia, January 17, 2019

{ 3 comments… read them below or add one }

Wikipedia April 7, 2019 at 10:29 pm

From “Ewing Sarcoma” in Wikipedia …..

A grouping of three unrelated teenagers in Wake Forest, NC, have been diagnosed with Ewing’s sarcoma. All three children were diagnosed in 2011 and all attended the same temporary classroom together while the school underwent renovation. A fourth teenager living nearby was diagnosed in 2009. The odds of this grouping are considered significant.[38]

Reference 38. “Three Wake students battle rare cancer: Cluster or coincidence?”. 29 April 2013. Archived from the original on 2013-05-01. Retrieved 2013-04-30.


StateImpact Penna. April 24, 2019 at 5:48 pm

PA State Reports: No cancer cluster in Washington County school district

By Reid Frazier, StateImpact Penna., April 24, 2019

The Pennsylvania department of health has determined that there is no cancer cluster in a Washington County school district. The agency conducted the study after several cases of Ewing sarcoma, a rare bone cancer, were reported there.

The department looked at statistics from the Pennsylvania Cancer Registry dating to 1985. In addition to Ewing sarcoma, the agency looked at other types of cancer rates: liver, brain, bone, lung, and breast cancers. It compared cancer rates in Washington County and Canon-McMillan School District against statewide rates.

In a report released Tuesday, the state concluded that rates of Ewing sarcoma weren’t “consistently or statistically significantly higher than expected” in either Washington County or the school district.

The study did find that between 2005 and 2017, rates of Ewing sarcoma were three times higher than expected in the school district. The rare tumor mainly affects young people and can be fatal.

The authors said the number of cases was so small — just three instances of Ewing sarcoma in the district over those years — that the higher-than-expected rates weren’t “statistically significant.”

Only about 200 cases of the tumor are reported in the U.S. each year.

Jian-Min Yuan, a professor of epidemiology at Pitt’s Graduate School of Public Health, said the state used appropriate methods in analyzing whether the Washington County cases represented a cancer cluster or were a statistical anomaly.

He said the sample size of cases in the district was too small to determine whether there was a cancer cluster.

“It is unusual for this small area to have three Ewing cancers occur in a very short time period, but the scientific evidence does not support it yet,” Yuan said.

When the department announced it was performing the study, it said it would be looking into “possible environmental risk factors” for cancer in the area. The district includes a former radium and uranium plant in Canonsburg. It’s also in one of the busiest natural gas areas in the state, near more than a thousand shale gas wells and several compressor stations and other natural gas processing facilities.

The agency said it will continue to monitor the rate of pediatric cancers in the district as new data become available.

About StateImpact Pennsylvania

StateImpact Pennsylvania is a collaboration among WITF, WHYY, WESA, and The Allegheny Front. Reporters Marie Cusick, Reid Frazier, Susan Phillips, and Amy Sisk cover the commonwealth’s energy economy. Read their reports on this site, and hear them on public radio stations across Pennsylvania.


EHN Report April 24, 2019 at 8:14 pm

More than 80 percent of waste from Pennsylvania’s oil and gas drilling stays in the state

From Kristina Marusic, Environmental Health News, April 22, 2019

Exposure to oil and gas drilling waste has been linked to numerous health impacts, including cancer.

More than 80 percent of all waste from Pennsylvania’s oil and gas drilling operations stays inside the state, according to a new study that tracked the disposal locations of liquid and solid waste from these operations over 26 years.

The study, published in the journal Science of the Total Environment, looked at waste from both conventional oil and gas drilling and fracking, or hydraulic fracturing, a process of extracting oil and gas from the Earth by drilling deep wells and injecting liquid at high pressure. This is the first comprehensive assessment of Pennsylvania’s waste-disposal practices since the state began tracking waste disposal data in 1991, and it suggests that Pennsylvanian’s aren’t being adequately protected from potential health impacts associated with the industry’s waste disposal practices.

“Tracking waste across space—the distance and direction it travels and where it ends up—and across time helps us determine who is absorbing the potential health burdens associated with these waste products, both from recent operations and from legacy pollution across the lifetime of the state’s oil and gas operations,” said Lee Ann Hill, a researcher at Physicians, Scientists and Engineers for Healthy Energy (PSE) and lead author of the study, in a statement.

The study concluded that Pennsylvania residents are bearing more than 80 percent of that potential health burden. Living near fracking operations has been linked to preterm births, high-risk pregnancies, asthma, migraine headaches, fatigue, nasal and sinus symptoms, and skin disorders over the last 10 years.

Pennsylvania also has the third highest cancer incidence rate of all U.S. states. Approximately half of all Pennsylvanians will be diagnosed with cancer at some point in their lifetime, and about one in five Pennsylvanians will die of cancer.

Waste from both fracking and conventional oil and gas operations includes high-salinity water that can contain strontium and radium—both of which are classified as carcinogens—and solid waste like cuttings from drilling that bring naturally occurring radioactive materials like uranium, radium and thorium, up to the surface of the Earth from deep below.

In Southwestern Pennsylvania, most solid waste from oil and gas goes to landfills in the county where it was produced, while in northern counties along state borders solid waste is generally moved to neighboring states of Ohio and New York, according to the study.

The study found that solid waste mainly goes into landfills. Some of the state’s liquid waste—7.6 percent, or 30 million barrels over 26 years—was sent to municipal or other water treatment plants, which discharged into surface waters like rivers after treatment.

Studies have shown that despite treatment, pollution remains in sediment downstream from release sites. For example, radium persists in sediment for many years and strontium, which accumulates in bones of living things, has been found in the shells of Allegheny River mussels downstream of treatment facilities.

More than half of the liquid waste from oil and gas operations that stays in Pennsylvania was reused in extraction operations, the study found. While recycling wastewater sounds good, the practice can result in more concentrated levels of salinity and chemical residues with each use.

The researchers noted this practice raises questions about how to treat or dispose of these more concentrated waste streams in the future.

The final location is unknown for more than a third of liquid waste from all oil and gas operations — 35 percent — often because reporting only lists intermediary locations for transfer or storage.

“This finding illuminates what we don’t know,” Hill said.

The study also found that conventional oil and gas accounts for nearly a third of all waste generated by the industry in Pennsylvania. The researchers noted that legislation passed in 2016 strengthened disposal location tracking for fracking operations, but similar reporting practices weren’t required for conventional operations.

“We know that many of the hazards and risks associated with waste from oil and gas extraction exist for both conventional and unconventional operations,” Hill said. “From a public health perspective, it doesn’t really make sense that conventional operators are held to a different standard.”

The study concludes that a consistent, cradle-to-grave reporting system should be put in place so researchers can properly assess the risks posed to human health and the environment posed by waste from all types of oil and gas production.


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