Top Medical Experts: “No Known Lifestyle or Environmental Causes” for Rare Childhood Cancer

***APRIL 24, 2019 UPDATE***

Following an investigation into instances of Ewing Sarcoma in Washington County, the Pennsylvania Department of Health concluded “incidence rates for the Ewing’s family of tumors and childhood cancers in Washington County and Canon-McMillan School District were not consistently and statistically significantly higher than expected.”

Click HERE to access the full DOH report. More from the agency:

Studies of children with Ewing’s tumors have not found links to radiation, chemicals or any other environmental exposures….

Overall, there were no conclusive findings indicating that the incidence rates of Ewing’s family of tumors in Washington County and Canon-McMillan School District for female and male populations were consistently and statistically significantly higher than the rest of the state over the time periods reviewed.

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Recently, several news stories have brought attention to cases of Ewing sarcoma – a very rare cancer form, mostly affecting youth – in Washington and Westmoreland counties. Like everyone across our region, we’re profoundly saddened by the impact on these young lives, and felt it necessary to share important information on this very emotional and complex issue.

To be absolutely clear, our industry is deeply committed to protecting the health, safety and environment of our communities – and we support fact-based and objective scientific research. Rather than sensationalizing tragedy, it’s critical to look at independent medical experts on these matters.

According to the American Cancer Society, “there are no known lifestyle-related or environmental causes of Ewing tumors.” Similarly, the Mayo Clinic writes that “the cause of Ewing sarcoma is unknown” and “can’t be prevented.”

More from the American Cancer Society:

The gene changes that lead to Ewing tumors are now fairly well known, but it’s still not clear what causes these changes. It might just be a random event that sometimes happens inside a cell, without having an outside cause. So it is important to remember that at this time, nothing could have been done to prevent these cancers.”

Speaking to WPXI, Dr. Kelly Bailey, a UPMC Children’s Hospital physician explained that “we have no data right now showing that there’s any environmental exposure, anything like that, that would lead to one developing Ewing sarcoma.

She explained further:

Interviewer: So when you hear there are 5 to 6 cases in the Canon McMillian school district, does that send a red flag?

UPMC Children’s Hospital Dr. Kelly Bailey: “I think it’s always wise to take a step back and to think about statistically how rare tumors look if you look at them on a map. So what I’ll always say, in the United States, roughly, you have 200 cases of Ewing sarcoma that happen. If you took a map of the entire United States and each one of those cases was a penny and you tossed those pennies in the air and saw where they landed on the map – you would see ones that are very far apart, but then, some of those pennies are going to fall in a specific area, just randomly. Nothing that caused that or anything. And so having little clusters that happen, it does happen sometimes and we do see stuff like that happen, even in very rare tumors, because, like I said, it’s just random.

And as the Post-Gazette notes in a recent editorial, similar cancer issues have occurred in North Carolina and Georgia – where there is no shale development.

In 2013, the North Carolina Department of Health and Human Services investigated multiple cases of Ewing sarcoma diagnosed between 2009 and 2012 in the same high school graduating class.

The state’s medical and public health experts concluded that the cancers occurred in the “same Wake Forest ZIP code by chance.”

More from the expert report:

“Investigations of cancer clusters have rarely found an etiologic agent [cause] to explain the cancer cluster. In a review of cancer clusters nationwide during the last 20 years, only 1 of 428 investigations revealed a clear cause. In fact, most clusters appear to be chance events (occurring at random), especially those that involve common cancer types or all cancers combined. Cancer cluster investigations are difficult for many reasons, including the small number of cases often involved (making statistical analyses problematic), failure to account for latency, and issues of in-migration to a community where a person may have a similar cancer but the exposure to an agent associated with that cancer occurred years before the person moved into that community. It is recognized that there is a length of time (usually years to decades) from exposure to a carcinogen to the development of the cancer (known as the latency period). This gives the appearance that there may be a common environmental exposure in the community, when in reality the cases are not related. Additionally, there is often a lack of clinical or molecular tests that can determine the cause of cancer. From the time the oncogenic process begins until the person first shows symptoms, many years have usually passed and there is no evidence of the cancer-causing chemical in the person’s body.”

“[The North Carolina Occupational and Environmental Epidemiology Branch] staff did not identify any environmental exposures of immediate concern in the area. Although this finding will hopefully be reassuring to the Wake Forest community, OEEB acknowledges that the lack of a common environmental exposure or explanation for the cancer diagnoses is frustrating for the cases and their families.

“Unfortunately, the majority of cancer cluster investigations across the United States do not find a common environmental exposure that is likely to be associated with the cases. Although many types of cancer are associated with behavioral or environmental risk factors which can be changed (e.g. smoking), based on our current state of knowledge, the cause of Ewing sarcoma remains unknown so specific behavioral or environmental recommendations to decrease the risk are not available.”

Given the available research on this issue, and the views maintained by independent medical and public health experts and professionals, some individuals with ulterior motives – enabled by media reports intended to sensationalize a tragedy – however continue to make suggestive claims that tightly regulated natural gas development may be a cause.

It’s important, for context, to recall that various air quality studies in Washington County have concluded that natural gas development “did not substantially affect local air concentrations.” According to a 2016 study conducted for the Ft. Cherry School District, “all individual (volatile organic compound) concentrations in the monitored area were well below health-protective levels.”

Additionally, a 2018 Pa. Department of Environmental Protection studyfound limited impacts to the air quality around the sites it examined and little risk of healthy residents getting sick from breathing the air nearby,” as the Post-Gazette reported.

Our hearts break for anyone battling cancer, especially young kids. And while we cannot comprehend the grief of all those personally affected, our industry – made up of countless western Pennsylvanians, including many whose children are in the Canon-McMillan school district – takes an enormous responsibility, on a very personal level, to protect and enhance public health and safety.