Florida Today from Cocoa, Florida • Page 4

4A FLORIDA TODAY, Sunday, July 14, 1991 Special Report: Cluster of Cancer Hodgkin's disease strikes 6 times in neighborhood Modern treatment helps wage a winning battle Hodgkin's and the lymphatic system Hodgkin's disease is a type of cancer that affects the lymphatic system; Lymph nodes; and other lymphoid tissues such as the spleen, become enlarged. Most deaths are caused when the enlarged nodes invade or constrict other organs, or by a breakdown of the immune system. The lymph nodes normally act as filters to trap and absorb harmful matter. 1 Lymph nodes are bunched together in neck, armpits, above the groin and large blood vessels and organs Walter Reed Army Medical Center in Washington, D.C. People in their 20s and 30s, and seniors older than 60 are most at risk, statistics show.

In the cancer textbook Principles and Practices of Oncology, Dr. Vincet De Vita Jr. writes the more educated a person is, the more likely he or she is to get Hodgkin's disease. Nobody knows why. Because many Hodgkin's disease patients also contract tuberculosis, De Vita lists mycobacterium tuberculosis, the bacteria that causes tuberculosis, as one suspect.

Viral theories have also been put forward. Some studies have suggested that people who contract infectious mononucleosis also are more at risk of getting Hodgkin's disease. Because the disease spreads relatively slowly, the victims are likely to ignore some of the symptoms. Hodgkin's disease often shows up as a lump on the neck, under the arms or in the groin. Night sweats and fevers are not uncommon.

Other symptoms include itching, fatigue, back or abdominal pain, vomiting or weight loss. 1 The symptoms are evidence the lymphatic system is under attack. A network of tiny vessels and "nodes," or filtering stations, the lymphatic system circulates disease-fighting white blood cells throughout the body to help kill or neutralize bacteria and other foreign particles. The filtration stations are grouped in the neck, underarms and groin. i By Jim Ash FLORIDA TODAY Vulnerable to radiation and powerful cancer drugs, Hodgkin's disease is one opponent physicians know how to beat.

Of the 7,400 new cases of Hodgkin's disease that will be diagnosed this year about 1,600 will be fatal, according to the American Cancer Society. These days, 90 percent of Hodgkin's disease patients live five years after their first brush with the cancer that attacks their lymphatic systems. When patients reach that milestone without a recurrence, doctors start using the word "cure." But even if the good guys win consistently, that doesn't mean they know a whole lot about the enemy. For one thing, Hodgkin's disease doesn't show up that often. It will make up only a small percentage of the 1.1 million new cancer cases in America this year.

Lung cancer, one of the most common, will afflict 161,000 people and kill 143,000. Of the 175,900 people who will be told they have breast cancer, 44,800 are expected to die. Unlike lung cancer, nobody knows what causes Hodgkin's disease or how to prevent it. Health statisticians know that people living in industrialized nations are much more likely to develop Hodgkin's disease than those who live in developing nations with the one exception of Japan. "Basically, Hodgkin's is a young person's disease," said Lt.

Col. Nancy Dawson, an oncologist with Lymph nodes Source: The American Medical Association Encyclopedia of Medicine, The Human 1 i 1 jwrz the near In early treated are organs All body tissues are bathed a transparent straw-colored fluid called lymph. The lymph also flows through the blood stream. A small amount seeps out of the capillaries and through the lymphatic vessels where bacteria is destroyed. The lymph then flows to the heart.

stages, Hodgkin's can be with radiation therapy. Chemotherapy and anticancer drugs usually recommended if other have been affected. New York physician, Barbara Anne was moved to an experimental cancer center at Jackson Memorial Hospital in Miami. She died in May. At first Richard didn't suspect anything unusual, even though Crockett who lived five streets down on South East 1st, had been diagnosed with Hodgkin's disease earlier that year.

Then in 1970, the cancer struck again, this time closer to home. On July 1, Hodgkin's disease killed 49-year-old Ottilie Olson, one of Barbara Anne's friends. The Andres lived at 160 Egret Drive. The Olsons lived at 170 Egret Drive. "We knew about the Crockett boy before Bobbie even came down with it and we just thought how terrible it was," Andre said.

"Then we really started thinking about it when Otie came down with it. It was sort of something we looked at in retrospect" It never occurred to Andre, the rest of the families or the Hodgkin's disease victims to demand answers from public health officials. Nobody voiced a concern until last month, after Craig, a former Army clerk, read a newspaper story about waste dumping at Patrick. Even though Hodgkin's disease never has been linked to hazardous chemicals, Craig blames his suffering on a childhood spent playing on or near toxic landfills at Patrick Air Force Base or growing up on a barrier island he thinks was once used as part of the installation. Craig contracted Hodgkin's disease in 1982, two years after he and a classmate dropped out of Satellite High School to join the Army.

By 1983, Craig had almost died from Hodgkin's disease, his Army career was cut short by cancer, and two of his high school friends also had contracted Hodgkin's disease. As a teen-ager, Craig enjoyed fishing and swimming in a Patrick Air Force Base survival training area canal. Frequently it was with Bill Latshaw, who was diagnosed with Hodgkin's disease in 1979. Another swimming buddy, Mike Reynolds, was diagnosed with the cancer in 1980. Latshaw, a construction worker, died of complications from pneumonia in 1983 after fighting a long, grueling battle with Hodgkin's disease and tuberculosis.

"Bill was a friend of mine. He was big and strong and the cancer just ate him alive," Craig says. Reynolds, 30, is the luckiest of the group. He emerged from his brush with cancer practically unscathed. These days, Reynolds is healthy enough to indulge his passion for racquetball, a devotion that has earned him several trophies.

Reynolds doesn't know what to make of his or the other Hodgkin's disease cases. "You hear about it, but you don't put it together," he said. "Scott Bill, the Crockett boy, we're literally within six streets of each other." Reynolds remembers the fishing and swimming trips to the survival training area. "I know we had to eat fish from there, we were fishing all the time," Craig says. "You know how when you go swimming, you always swallow a little of the water?" Contaminated water Air Force documents show the recreation area is built on a sliver of spoil island that was used as a dump from 1962 to 1972.

Waste oil, pesticide cans and filters for PCBs highly carcinogenic chemicals used as insulators in electrical generators as well as old car parts and commissary garbage were buried at the site. A private environmental consultant the Air Force hired in 1988 found the groundwater beneath the dump to be contaminated with the pesticides chlordane, aldrin, and DDE. The surface waters of the survival area canal were polluted with the heavy metals copper, silver and mercury. In both cases, the chemicals exceeded state or federal limits. The report warns that the heavy metals in the survival area canal have the potential to harm wildlife.

Air Force officials say monitoring wells show the canal is safe. "We have taken numerous samples from the water in and near the survival area and have found no cause for concern. If we had any cause for concern, we would have erred on the side of extreme caution and closed the area long ago," Patrick Air Force Base officials said in a written statement The area continues to be a popular fishing spot for active duty and retired military personnel and their dependents. Besides Hodgkin's disease, Craig also suffered from Non-Hodgkin's lymphoma, a much more common form of cancer. Studies of agricultural workers have linked various pesticides to non-Hodgkin's lymphoma, but not the types of pesticides found in the survival area canal.

Florida Department of Natural Resources biologist Ed Irby says that without knowing what species of fish the three ate or what levels the chemicals had reached when they were fishing, it's impossible to tell whether the boys were contaminated by their catches. "It's doubtful they got anything DISEASE, From 1A small an area. The pattern first emerged in 1967, when 24-year-old Larry Crockett, a civilian radar technician at Patrick Air Force Base, was out hunting deer with his family doctor. "Larry was feeling sick and showed him this lump. The doctor told Larry he better get to the hospital," remembers Larry's father, Randolph Crockett.

By 1982, five of Larry's neighbors had contracted the cancer, according to public records and interviews with victims, their families and physicians. Only two of the Hodgkin's disease victims are still alive. Typical of the neighborhood, the victims have all been white four males and two females. Three of the male victims were friends from Satellite High School who were diagnosed in 1979, 1980 and 1982. The women also were friends, homemakers who died of the disease in 1967 and 1970.

After he was diagnosed in 1967, Larry Crockett went on to beat Hodgkin's disease, only to die last year from a rare form of stomach cancer. With the possible exception of one of the cases where the information is not available, none of the victims had a family history of Hodgkin's disease. Scott Craig, a 28-year-old Hodgkin's disease survivor, is convinced that the cancer cluster in his neighborhood is linked to toxic landfills at Patrick Air Force Base. "Donl tell me this is chance or a coincidence. There's something under our feet or over there on that base that's causing this," Craig says angrily.

The Air Force denies any connection. There is no known link between the incidence of Hodgkin's disease in the local area and any waste disposal sites on base," Air Force officials said in a written statement In search of the cause National cancer experts and physicians who treated some of the victims said they'd like to see further investigation. "These types of reports should not be ignored," said Dr. Clark Heath, chief epidemiologist with the American Cancer Society and a former cancer cluster investigator for the National Centers for Disease Control. "It's impossible to know at a distance whether the increase is due to chance, or whether it might be due to some shared exposure." Finding a smoking gun would be difficult if not impossible, Heath said.

Researchers would have to sift through thousands of genetic and environmental variables. But it might be worth a try, said Dr. Joseph Fraumeni, director of the Epidemiology and Biostatistics Program for the National Cancer Institute. "If these cases are indeed Hodgkin's disease, it is important and it deserves study many of the clues to etiology (causes of disease) come from clinical studies of these clusters," Fraumeni said. Fraumeni's cancer maps have spotted trends that led to studies linking oral cancers in rural Southern communities to the use of chewing tobacco and snuff.

A cluster of lung cancers along the Eastern Seaboard was traced to asbestos exposure among shipyard workers. Too new to spot the South Patrick Shores clusters, the maps so far have proved to be a disappointment in finding meaningful Hodgkin's disease patterns, Fraumeni said. Map readers can see only a slight increase in rates of Hodgkin's disease in the Northeast The disease is too rare to give trend spotters much help. Of the 1.1 million new cancer cases that will be diagnosed this year, only 7,400 will be Hodgkin's disease, according to the American Cancer Society. State figures, compiled between 1981 and 1987, show that 8 cases of Hodgkin's disease will be diagnosed in Brevard County each year.

Neighborhood tragedy The South Patrick Shores outbreak began long before a cancer data system was created, when the government was more focused on beating the Soviets to the moon than on cancer and the environment They were exciting times for Richard Andre, then a young University of Miami mechanical engineering graduate who followed the Apollo moon program to Brevard. Andre's dreams were tarnished in 1967 when his 28-year-old wife, Barbara Anne, discovered the telltale signs of Hodgkin's disease. "One morning she just woke up with a knot in her groin and I said she better get to the doctor," Andre recalls. "Bobbie" to Richard and her friends, Barbara Anne was diagnosed with Hodgkin's disease in February of that year. Her husband remembers visiting her at Cape Canaveral Hospital while the nation was mourning the death of three Sronauts in the Apollo 1 launch fire.

The daughter of a prominent Joseph Garnett FLORIDA TODAY survivor, he thinks the cancer cluster is linked to base landfills. SCOTT CRAIG, 28, stands in a pedestrian tunnel that connects South Patrick Shores to Patrick Air Force Body Tom McKay, FLORIDA TODAY ing over what is now South Patrick Shores. But the boundries are crudely drawn over a former state roads department map. Workers in the Brevard County land records office could not confirm the map without a lengthy title search. Craig remains unmoved.

"Everybody knows this place used to be part of the base," Craig says. "Even if it wasn't, who's to say the military didn't bring its stuff off base and dump it over here when we were just a bunch of palmetto trees?" South Patrick Shores was platted in 1956 by Taylor Manors Inc. and High House according to county records. Ted Hollo, now a prominent South Florida developer, was a partner in Taylor Manors Inc. when the subdivision was being built He denies any knowledge of building on top of military waste.

"No, we never found anything like that" Hollo said. But "everybody knew they were dumping next door at the base." South Patrick Shores is connected to Patrick Air Force Base by an obscure, unguarded pedestrian tunnel leading under the Pineda Causeway. The walkway empties out near a golf course that partially covers a toxic landfill. For years the tunnel has been a favorite hangout for teen-agers looking for a secluded place to party or an easy way to sneak on base. In 1984, Patrick Air Force Base and Cape Canaveral Air Force Station embarked on a massive program to identify and clean up aging waste dumps and chemical spill sites.

By 1988, Environmental Science and Engineering Inc. of Tampa had identified five landfills covering 126 acres of the base that were active between 1940 and 1972. The dumps are leaking heavy metals such as arsenic, silver and chromium, as well as the solvent Base. A cancer in his neighborhood in Tallahassee. The Tallahassee agency is skeptical.

Program specialist Raul Quirn-bo said that while he was struck by how close together the Hodgkin's disease cases occurred, the statistics don't point to any cause for alarm. Verifying the outbreak would be difficult he said. Only two of the casts can be confirmed using the Florida Cancer Data System, Quimbo said. The rest predate the system or were diagnosed in military hospitals, which don't report to the network. Using the cancer data system projections for Hodgkin's disease cases in Brevard County, the South Patrick Shores cases don't tilt the statistical model far enough tq warrant an investigation, he said.

That's because the cancer cases were diagnosed over such a long period of time, he said. "We have to determine high incidence rates in terms of both location and temporal dimensions. Two of the cases occurred in but you can see that the rest are pretty spread out. If you look long and hard enough at any specific' neighborhood, unusual patterns will' emerge," Quimbo said. HRS uses a simple formula when it decides whether to investigate a1 cancer cluster, Quimbo said.

First state health officials decide whether the cases are occurring unusually close together and at the same time. Then they look for a pattern of a particular cancer that is, repeating itself. Finally, they want to know if the answers to the first two questions point to a "cause and, effect relationship" that could be' reasonably established. Based on the formula, HRS has investigated only four cancer clus-ters since 1980, Quimbo said. Those) investigations were conducted in, conjunction with the state environ-' mental regulators and local health' officials, he said.

"We get lots of calls and we take' every call seriously because cancer' is a serious disease. But when we' explain that these could be due to statistical quirks, most people go" away satisfied," Quimbo said. The state's response is typical for: epidemiologists charged with guarding public health, said Dr. Robert1 Seelman, a Melbourne oncologist who treated Larry Crockett "Next thing you know, they'll be telling us all the cancers near Chernobyl (Soviet nuclear disaster), are a statistical quirk," he said. Tom Sinks, chief of the Health.

Studies Branch for Environmental Health and Injury Control for thes CDC, isn't optimistic that an inten- sive study could ever be successful. "It would be very difficult to; establish a causal effect in a situa-1! tion like this," he said. "The firsts thing you have to ask yourself is; there really an exposure here which is potentially effecting these individ-, uals?" If there is, Sinks asks, why aren't more people who share the expo-" sure getting sick? But Sinks says health officials today should stress taking a more practical than an academic approach to such problems. "Almost always the best thing to'" do is look for a potential environ-1 mental problerfr and clean it fcp. Why spend two or three years on a study?" from the fish, but the potential exists," Irby said.

"The canal is open to the Banana River and the fish can circulate. If you had a closed body of water, it might be a different story," he said. However, Irby questions the wisdom of allowing people to continue fishing in an area where such chemicals have been discovered. "You might want to ask the Air Force why they still let people use that area," he said. The Air Force says it has no intention of closing the canal.

Rumors have been circulating for years, Craig says, that South Patrick Shores was once a military dump for the Banana River Naval Air Station which became Patrick Air Force Base in 1948. The Air Force and some long-term residents of the neighborhood deny it. Jim Gaskin, a pharmacist and one of Larry Crockett's closest friends, has lived in South Patrick Shores since 1957. Except for some construction debris that was buried in the north part of the neighborhood, the area was never used as a dump, he said. At least one eyewitness remembers stumbling across what appeared to be military waste.

Mike O'Hara, 29, who lives on South East 1st Street, remembers playing in a trench dug by telephone workers in his next-door-neighbor's yard in 1971. "We were having a dirt clod fight and I reached my hand down and started pulling something metal out of the ground. It had fins on it I remember I put it in a paper bag and I was going to take it to show and tell, but it disappeared. I think my uncle took it My dad told me later it was a mortar," O'Hara said. "Wouldn't that have been a kick if I took a bomb to school?" Files in the Patrick Air Force Base history office contain a 1946 map of the Banana River Naval Air Station that shows the base extend vinyl chloride and various pesticides into the groundwater and the surface waters of drainage ditches and canals at levels exceeding state and federal standards, the report states.

While there is no timetable for a cleanup, the Air Force expects to spend $10 million before the project is completed. Officials with the state Department of Environmental Regulation say the dumps pose no significant threat to public health because the area gets its drinking water from Cocoa and Melbourne utilities. Craig takes little comfort from the assurances. His battle with cancer has left his right leg disfigured and prone to frequent infections; amputation, or a return of the cancer remains a threat The Army considers Craig completely disabled. "If the Air Force did this to me and the other people, then it should fess up and pay us a fair compensation.

I had to end my military career when I was 18 years old, when it was just getting started," Craig said. Patrick Air Force Base officials deny there's any link between their environmental problems and the Hodgkin's disease outbreak. "It's important to keep in mind that the area in question has not been used as a disposal site since 1972," Air Force officials said. "We are continuing to monitor all past waste disposal sites on base, including (the survival area) through an aggressive environmental monitoring program." No probe planned Local health officials, when provided with a list of the victims, said they thought further investigation was warranted but not by them. "We don't have the resources," said Dr.

Manuel Garcia, director of the state Department of Health and Rehabilitative Services Brevard County Public Health Unitf Garcia said the job rests with HRS's Cancer Epidemiology Section.