Off-Campus Cancer Cluster?

Spring break at Susquehanna University got off to a sober start Sunday when a local Pennsylvania newspaper, The Patriot-News, published the results of an eight-month investigation into a possible cluster of cancer cases in young alumni of the institution.

University administrators on Monday defended what they called their proactive and mostly private response to nearly five-year-old concerns about a possible cancer cluster among Susquehanna students. But Linda Kadel -- who first collected information suggesting a possible cluster after her son, a  Susquehanna graduate, died from osteosarcoma in 2002 -- wasn’t impressed. Nor was her son's former roommate: “I think they’re doing a lot of backpedaling right now,” said Eric Maerz, a 1997 graduate who lived alongside Patrick Kadel at the "Warehouse,” an off-campus, independent apartment complex that has become a site of scrutiny.

For their part, Susquehanna leaders say that in an extensive investigation, neither they nor state authorities ever found evidence to suggest that the cancer cases are anything but coincidental. Those concerned about a possible cluster, however, look no further than the experts who express a need for further investigation in The Patriot-News account -- and say any investigation that didn't turn up any cause for concern must have been flawed or, at best, incomplete.

The Patriot-News reported that it had identified 18 people who attended Susquehanna between 1990 and 2001 and developed cancer before age 30. Fewer than 1,600 students were enrolled at the university at any one time during the majority of that time period, the paper reported. Many of those identified as having had cancer had connections to the off-campus Weiser Run area, where underground fuel tanks at a now-closed mill had leaked into the soil toward the Weiser Run stream.

Although the tanks were removed in 1990, the Pennsylvania Department of Environmental Protection only became aware of the leakage in 2004, when concentrations of benzene, a known carcinogen, were recorded at levels 850 times higher than Pennsylvania’s safety standard, according to Sunday’s article. About 1,500 tons of contaminated soil were removed and incinerated in 2005.  

In 1996 and 1999, the stream flooded the nearby "Warehouse,” a 12-unit apartment complex and converted factory that attracts Susquehanna students. The Patriot-News also identified 22 documented cancer cases among permanent residents in the Weiser Run area of Selinsgrove, Pa.

Three experts -- Steven R. Browning, an environmental epidemiologist at the University of Kentucky; Kathy J. Helzlsouer, an adjunct professor of epidemiology and oncology at Johns Hopkins University; and Clifford P. Weisel, a specialist in human exposure to environmental contaminants and professor at New Jersey’s Robert Wood Johnson Medical School – all told The Patriot-News that the data warranted further investigation of a potential cluster, a path that the state so far has declined to pursue.

But Susquehanna University officials said Monday that The Patriot-News story contained “no new significant evidence” and that the institution has been engaged in investigating claims of a possible cancer cluster since Linda Kadel first approached them about five years ago. Their finding so far? That the cancer cases in young alumni aren't evidence of a cluster, but cruel chance.

In the course of its internal investigation, the university contracted a pathologist, Arthur H. McTighe, who wrote in a 2003 letter that the variety of different cancer types found in the Susquehanna alumni (melanoma, breast cancer, lymphoma, osteosarcoma, ovarian carcinoma and testicular cancer) have distinct risk factors. Their occurrence in young alumni is “a result of chance alone," he wrote.

The institution also worked with the borough manager and state agencies to investigate the problem -- and has been consistently assured that there isn't one. Not only have concentrations of benzene and other chemicals identified by The Patriot-News as problematic been at non-detectable levels in the borough's water supply “as far back as we tested,” according to John Bickhart, the Selinsgrove borough manager and an environmental engineer, but, in a 2005 study, the local county government also failed to find any health-related environmental hazards in Selinsgrove.

Most recently, a February letter to a top Susquehanna administrator from the director of the Division of Community Epidemiology at the Pennsylvania Department of Health also said there are no data suggesting that area residents are being exposed to risky levels of carcinogens. The February 20 letter stated that the risk for cancer in the Selinsgrove area from 1996 to 2003 was actually 10 percent lower than the risk across Pennsylvania, and refuted the possibility that three different sources of environmental pollution had contributed to health problems.

Interestingly, the fuel tank leaks were not specifically among those sources mentioned, although public water supply contamination was (a request to speak with the author of the letter, Gene B. Weinberg, was referred to a Pennsylvania Department of Health public relations representative, who did not offer a response Monday).

In the aftermath of Sunday’s article, Sara Kirkland, executive vice president of administration and planning at Susquehanna, said the university has requested a meeting with the Pennsylvania departments of health and environmental protection to seek confirmations of their earlier assurances that the so-called cluster doesn't exist.

“The first thing for us is to confirm that they will confirm those assurances again, given the story, and to find out what they intend to do to address the issues that have been raised in the paper,” said Kirkland, who added that authority to deal with the purported off-campus pollution ultimately rests in the hands of state and local governments, where the resources and experts reside.

The administration began contacting students, alumni, parents, faculty and staff after learning of the upcoming Patriot-News story in January, Kirkland said. Before that, officials had discussed the progress of the internal investigation privately with alumni who, alerted to Linda Kadel's concerns about a cluster, had called them. The university had never pinpointed evidence of a potential cluster to merit a widespread release of information before learning of the pending public release of the newspaper's investigation, Kirkland said.

“We’ve been working on this for nearly five years,” said Kirkland, who added that the university “immediately reached out” to Linda Kadel after she originally approached them with concerns. “Anytime you lose an alum, it’s a loss not only to the family, but also the institution. We’re a small place, we care a lot about community, so we really wanted to know very quickly what was going on," said Kirkland.

Kadel said Monday she doesn’t recall much in the university’s response that could be characterized as "reaching out."

After her son Patrick died, Kadel said she was approached by some of his fraternity brothers who alerted her to other recent graduates who were sick. When she found four deaths within a four-month period, all involving former students who had lived at the Warehouse or nearby, she accessed the Susquehanna alumni database through her daughter-in-law, also an alumnus, and began sending off e-mails inquiring about the health of young graduates.

“I started to get responses that kids were sick and kids had cancer; I was startled with the amount of responses I was getting,” said Kadel, who then put together “a modest database” with information she obtained from direct e-mails and by tracking down obituaries of young alumni listed in the memorial section of Susquehanna’s alumni magazine.

She said that when she approached Susquehanna's leaders, “I went in naively, thinking the school would say, ‘My goodness, we have a problem, we’ll investigate, we’ll keep you posted.’ ”

Instead, she said, officials repeatedly tried to direct her to the public relations department and told her the deaths were a "sign of the toxic times." 

She was even told, she said, that she “had it in my power to harm the university that Patrick loved.”

“That’s a direct quote,” said Kadel. “I’m not even quite sure what that means. I think they expected me to go away.” Kadel said the institution blocked her from using the alumni database, and only alerted her once about the progress officials were making investigating the possibility of a cancer cluster. Nor did they ever ask to see the milk crates crammed with information that she’s collected: “I have never once spoken with [President L.] Jay Lemons, never once. The school called me last week and it again was their public relations department. I think their appalling disregard for the safety of their kids is horrendous.”

Eric Maerz was Patrick’s roommate and also the fraternity brother of another recent alumnus who died of cancer -- and lived in the same room as Patrick. Maerz, now 32, said the university attempted to sweep Kadel's concerns under a rug. He cited in particular a line in President Lemons’s recent letter to alumni on "a possible media story that may speculate on health and wellness issues at Selinsgrove" as indicative: “Yet, all reliable indicators tell us that there has not been and there is not an issue in Selinsgrove," Lemons wrote, "and it would be most unfortunate if misinformation were allowed to taint our town and our university.”

“They don’t want to taint the university,” said Maerz, whose room at the Warehouse was flooded by Weiser Run. Susquehanna’s failure to identify an expert who thought the possibility was worthy of a full-fledged investigation -- despite the newspaper’s ability to find three -- suggests somebody’s hiding something, he said. “They haven’t done extensive research ... They have all the money they can play with and here a reporter and Mrs. Kadel have come across information that they didn’t want to say anything about.”

Douglas Carlson, president of the Susquehanna Alumni Association Executive Board, declined comment, and three other former or current alumni office-holders declined comment or did not return messages. Susquehanna students are on spring break and a number of student leaders did not respond to e-mail requests for interviews. However, Amanda Nagy, a junior and student representative to Susquehanna's Board of Trustees, said she personally feels comfortable on campus.

“If other students would feel more comfortable with a further investigation, then that’s what they should do. If not, I don’t see a reason to worry about it further,” said Nagy, whose older brother, a 2006 graduate, lived in the off-campus area pinpointed as a site for concern. “I’m personally not worried and neither is my family. We’ve been assured that there is nothing to worry about. The way I look at it, if there was something that we should be concerned about, I don’t think that the university administrators would keep their families in the area.”

But at least one student blogger said she’d be breaking the lease she signed to live in the Warehouse this coming school year. Stevie Long, who identifies herself as a graphic arts major at Susquehanna, wrote that forfeiting her $500 security deposit is a small price to pay. Some of her friends living there plan to move out immediately.

“Over all, even if there are no carcinogens in the area (which I highly doubt that there aren’t), anyone with a brain would not choose to take that chance,” wrote Long, who did not respond to an e-mail request for comment. “It is a blessing that the Patriot-News has conducted this investigation because it is obvious that if they had not done so, the entire situation would have been covered up.”