Patrick: Despite mothers' efforts, state can't ignore resource limitations or broad scope of cancer study by David Lias Dr. Sarah Patrick, South Dakota�s new state epidemiologist, has no doubt that the coalition of volunteers collecting petition signatures in Vermillion are sincerely concerned about children diagnosed with cancer here.
But her expertise and the experiences of other scientists who study cancer trends contributed to her decision to not begin a study here, despite the efforts of Vermillion�s mom squad.
�There are limitations to what we can do,� Patrick said. �It is such a huge issue, and there are so many factors, and there are so many different types of cancer to consider.�
Patrick said Vermillion�s mom squad may be drawing some faulty conclusions from some of the data it is collecting. For example, Patrick said relying on a list of maladies suffered by children granted wishes by the Make-A-Wish Foundation probably isn�t scientifically accurate. The list only indicates those children granted wishes, she said. There may be children with cancer that Make-A-Wish doesn�t know about. And the list provides no information on mortality.
Robin Richardson, who spearheaded the mom squad�s petition drive, said the volunteers hope to accomplish a heightened awareness of cancer in the community.
Patrick said that may be the most positive outcome of the women�s efforts. Patrick said one of the most important things that local volunteers can do is �to work with partners on prevention. I think there is a lot of work we can do together on prevention.�
The energies that the women have devoted to gathering petitions will hopefully be directed to such agencies as the American Cancer Society, she said.
�Let�s work together with those volunteers to do a public information campaign so people know what they can do to help themselves and other families,� Patrick said.
Although the mom squad believes Vermillion has too much cancer, the National Childhood Cancer Foundation reports that one in 330 children in the U.S. develops cancer before age 20. Patrick said Vermillion�s childhood cancer rate isn�t that alarming when those statistics are considered.
Patrick cited a quote by Dr. Daniel Miller, chief of cancer surveillance at the Center for Disease Control. In a recent media report, Miller said shortcomings in scientific knowledge about cancer make it difficult to prove cancer clusters exist, let alone find their causes.
Miller described a cancer investigation as similar to trying to do microscopic brain surgery with a tree trunk.
In other words, Patrick said, cancer cases may need public attention. But not much can happen if the wrong tool is used.
�Our concern is to try to protect the public�s health as much as possible,� she said. �But blunt tools don�t work. It would be a misuse of public spending.�
The CDC doesn�t discount concerns like those being expressed by the mom squad in its guidelines for investigating clusters. The CDC�s guidelines state: From a public health perspective, the perception of a cluster in a community may be as important as, or more important than, an actual cluster. In dealing with cluster reports, the general public is not likely to be satisfied with complex epidemiologic or statistical arguments that deny the existence or importance of a cluster.�
The main problem the mom squad faces is that the seven children identified with cancer in Vermillion recently have seven different types of cancer.
A public awareness campaign would remind people that cancer is many, many diseases, Patrick said.
If there was a more obvious pattern to Vermillion�s cancer cases, perhaps it would be easier to justify a study. Patrick noted there is more heightened suspicion if everyone has one type of cancer. That�s not happening in Vermillion.
�If we thought we could find something, believe me, I�d be there,� Patrick said. �But you have to ask ?is there something specific you think is happening?� And some answers to that question never come up the same twice. So what am I supposed to test for?�
She hopes that the coalition behind Vermillion�s petition drive will realize that a continuous gathering of signatures can�t change some of the roadblocks that make a cancer study prohibitive in Vermillion.
�I don�t want to create a situation where it is believed that if only more signatures are gathered, we can change the guidelines,� Patrick said. �I don�t want to create a situation of false hope.�
In the meantime, Patrick�s office is developing a protocol for investigating health events in South Dakota.
Patrick said she and Richardson �have talked on the phone several times. We are having very collegial discussions. We are still missing some spots. We are encouraging a greater definition of the geographical area of concern. And they have been doing an excellent job of trying to identify people who have had cancer.�
Patrick said she has been working closely with the CDC ever since Richardson brought the Vermillion women�s concerns to her attention.
�The consensus is that the most important thing we can work on at this time is more public education on cancer prevention,� Patrick said. �That�s not tied to signatures. The signatures don�t change the facts.�