When he talks about why little children might be dying of cancer, Dr. Jonathan Buckley speaks gently, as though he's delivering a speech about petunias to a gardening club. But Buckley's recent speech on the mysterious Maryvale cancer cluster had a not-so-gentle message: To have credibility, a cancer study must be expertly designed and planned.
That might not be so easy these days at the Arizona Department of Health Services (DHS). More than three years after news of the west Phoenix childhood-leukemia tragedy first surfaced, DHS is plagued by high employee turnover and politicians who want to play budget games with money that has long been set aside to fund the last phase of the Maryvale cancer studies.
Buckley is a scientist from the Children's Cancer Study Group (CCSG) in Los Angeles. One of the group's projects is a huge study in several states to seek the causes of childhood leukemia.
He was in Phoenix last week to give a talk on cancer clusters to the handful of community activists and local bureaucrats at DHS interested in the three-part cancer study the state has undertaken to learn why children in Maryvale have for decades contracted leukemia and died of it at abnormally high rates. Now that the TV news crews have left Maryvale, only a few west-side politicians seem to care anymore about the little leukemia victims there. One is Representative Bobby Raymond, who says he recently "had a violent reaction" to Governor Rose Mofford's "budget whiz kids" when they suggested DHS fatten the state's general fund with $600,000 that has been set aside for Maryvale cancer studies. "The bums didn't even bother consulting with us," says Raymond. "I learned about it along with everyone else at a budget briefing."
The idea, Raymond says, was to artificially bolster the general fund with Maryvale money now in DHS bank accounts. Then the $600,000 supposedly would be returned to DHS next year, when a new budget is in place.
The idea of using Maryvale cancer-study money in such a manner was also introduced at a recent Senate caucus, Raymond says, but Senator Lela Alston, long a champion of the Maryvale studies, "threw a big fit."
Because of the violent outbursts, Raymond suspects the governor's "budget bums" will no longer propose tinkering with the Maryvale money. "I think the idea has been done away with," he says.
This budget bickering comes right at the time that DHS is trying to get at the heart of the Maryvale mystery. In Phase One of the three-part cancer studies, state and federal scientists established that from 1970 to 1986 (the last year for which statistics are available), kids in an area bounded by Camelback Road, the Salt River, 27th Avenue, and 83rd Avenue died of leukemia at twice the expected national rate. Phase Two of the study confirmed that Maryvale-area children got leukemia twice as often as kids in other parts of Maricopa County.
Now it's time for Phase Three, the so-called "case-control study," in which leukemia victims' lifestyles are compared with those of neighbors who don't have cancer. The idea is to try to find out what the leukemia victims were exposed to that was different from what the neighbors were exposed to. Such studies sometimes point to possible causes of leukemia.
Although it is too late to include Maryvale children in the multistate leukemia study, Buckley was asked to come to Phoenix to offer expert advice to state scientists saddled with designing Phase Three, which is supposed to be completed by the end of 1991. "The firm answers are as yet alluding us," Buckley told the small audience last week.
But he added that many scientists suspect cancer clusters might be caused by environmental factors. He listed the eight "environmental red flags" that "raise suspicions." Five of the eight red flags are in the Maryvale area: Heavy industry, dump sites, heavy pesticide use, traffic and smog, well-water contamination. The problem, he added, is designing a study that can make a firm link between environmental pollution and childhood leukemia. "We cannot make a leap of logic and say something causes the cancer just because it is there," he warned. He added that when several studies all point to the same environmental factor, such as the fact that childhood-leukemia victims often have parents who used industrial solvents in the workplace, scientists should look hard for that factor in future research.
Problem is, DHS has a critical shortage of manpower. Last year when it finally assembled a three-person team to help design and carry out the Maryvale study, the team almost immediately broke up; some members quit and some were promoted.
At the moment, only one scientist, Dr. George Meaney, is working on the study, which is supposed to be designed by late March. Meaney, who is in charge of the study, has never worked on a childhood-leukemia study, although he's done case-control studies before. Meaney says another scientist is expected to come on board in a few weeks.
The high employee turnover disturbs Dr. Herbert Abrams, who is one of a panel of experts appointed by the federal Centers for Disease Control (CDC) to watch over DHS' shoulder as it conducts the study. "Even in the best of hands a study like this is complicated," says Abrams. "But it's not in the best of hands as you can see. They have high turnover and manpower shortages."
Abrams says neither the state nor the CDC has updated him for months. "I gather since we haven't heard anything, they're still struggling," he says. "With all that's going on in the world, sometimes things like this get the lowest priority."--
The budget bickering comes right at the time that DHS is trying to get at the heart of the Maryvale mystery.