State to meet with parents of leukemia patients

Responding to concerns raised last year about a potential “cancer cluster” involving children diagnosed with leukemia in Grand Forks County, officials from the North Dakota Health Department and the Statewide Cancer Registry plan to meet next month with parents of the children.

The families and child advocates had identified at least nine cases of children diagnosed with some form of leukemia in the previous three years, including seven in the city of Grand Forks. Two of the children had died, while the rest were in treatment or in remission.

After Grand Forks residents raised concerns last year, state health officials analyzed 10 years of county health records to determine whether they could find any worrisome patterns.

“While the rates (of childhood cancer) from 1997 to 2006 were comparable to the rest of the state and the U.S., the numbers for 2007 were higher than expected,” epidemiologist Alice Musumba wrote to the families.

She said that she and the director of the Statewide Cancer Registry “would like to meet with each family” in early to mid-July. As of Monday, she had received “very positive responses” from two of the families.

“Although this apparent increase could be by chance, it could also be due to a number of factors that we would need to investigate,” she wrote. “To help us understand what might have caused the increase, we would like to meet with you and explore (whether) some common factors exist between your children and other children in the county.

“If common risk factors are found, we may need to test them in a formal investigation study.”

Ali’s fighting

One of the children, 13-year-old Ali Borgen, Grand Forks, was diagnosed with leukemia in March 2007. Last year, after struggling through chemotherapy and other treatment, she accompanied her mother, Karen Borgen, to Bismarck to lobby legislators on the need for more research and funding to fight childhood cancer.

Ali also led the Grand Forks City Council in the Pledge of Allegiance in September as Mayor Mike Brown and the council proclaimed childhood leukemia awareness month in the city.

She had celebrated what she believed would be her final chemotherapy in July 2009 and returned to school last fall. But early this year, she began to suffer again from fatigue and pain, prompting new rounds of tests at Altru Hospital and at the Mayo Clinic in Rochester, Minn.

On May 11, Karen Borgen posted disheartening news on Ali’s CarePages website.

“It’s leukemia. Bone marrow biopsy showed 40 percent leukemia cells.

“Goal is to be in remission in two-three months and then have bone marrow transplant. … Immediate goal is to get Ali’s pain under control. Pain specialist is taking her off morphine and switching to something else. Back brace is being sent overnight from Grand Forks, and we hope it will enable Ali to go outside like she so desperately wants.

“To put it mildly, we are devastated. And even though sweet Ali is sad and angry, she still thanked the doctor for telling her.

“We’re going to be in Rochester for quite a while, so please continue to keep us in your prayers.

“Today we cry. Tomorrow we fight.”

Disease clusters

The National Cancer Institute defines a disease cluster as “the occurrence of a greater-than-expected number of cases of a particular disease within a group of people, a geographic area, or a period of time.”

The Centers for Disease Control and Prevention defines a cluster investigation as “a review of an unusual number, real or perceived, of health events (for example, reports of cancer) grouped together in time and location.”

Some causal relationships, such as the link between smoking and lung cancer, have been well-established. But while air, soil and water quality remain sources of great public concern, “few community-level environmental exposures have been well studied,” according to the CDC’s National Environmental Public Health Tracking Network.

It was the discovery of an unusually high number of cases of a rare type of pneumonia among homosexual men in the early 1980s that led eventually to identification of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS).

Cancer, the uncontrolled growth and spread of abnormal cells anywhere in the body, is an umbrella term for many different but related diseases, each with certain risk factors, known or suspected, associated with it.

One of the best known examples of a cancer cluster emerged in the 1960s, when doctors reported many cases of mesothelioma, a rare cancer of the lining of the chest and abdomen. Researchers found exposure to asbestos the likely shared risk factor.

Reach Haga at (701) 780-1102; (800) 477-6572, ext. 102; or send e-mail to chaga@gfherald.com.

Tags: gf and egf, health, north dakota, news, leukemia, cancer