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California Governor Gavin Newsom is facing calls to launch a state-led investigation to determine what’s behind several cases of a rare childhood cancer in a community in Orange County, but experts told Newsweek that finding a link may not be possible.
State Assemblymember Kate Sanchez on Monday said she had formally called on the governor to launch a “coordinated, state-led investigation,” citing reports that at least six children have recently been diagnosed with Ewing sarcoma in Ladera Ranch.
The rare bone cancer is diagnosed in about 200 children and teenagers across the U.S. each year.
California health officials have not confirmed a cancer cluster in the community or identified a cause. But members of the community have raised concerns that the use of herbicides in the community could be a factor, according to a July 17 letter sent by Orange County Supervisor Katrina Foley to Dr. Erica Pan, the director of the California Department of Public Health, requesting the department expedite its ongoing review into the cancer cases.
“The number of reported diagnoses in a community of approximately 26,000 residents has raised serious concerns among families and residents,” Foley said in a statement.
In a letter to Newsom on Monday, Sanchez called for Newsom to convene a “comprehensive, state-led, multi-agency investigation.”
She wrote: “While no cause has been established, the number of reported cases involving such a rare cancer, together with reports from residents of other serious illnesses within the community, merits a thorough, transparent and independent investigation into potential contributing factors.”
In a statement, Sanchez added: “This is bigger than any one agency. It requires California to bring together state, local and federal partners under one unified effort to investigate every reasonable environmental factor, follow the evidence where it leads, and keep the public informed every step of the way.”
Newsweek has contacted Newsom’s office and the California Department of Public Health for comment via emails sent outside regular business hours. Foley has also been contacted for further comment via email.
Concerns have also been raised by U.S. Attorney Bill Essayli, who sent a letter last week asking the Environmental Protection Agency to “conduct an appropriate investigation to determine if there are any environmental factors causing this cancer cluster” and to determine if any federal environmental laws are implicated.
Families Demand Answers
Hundreds of Ladera Ranch residents attended a community meeting on Tuesday night, calling for a broader investigation into the cancer cases, according to local news outlets.
Residents repeatedly raised concerns that repeated exposure to herbicides and pesticides used in the community could be linked to the cases, according to Fox 11. Ladera Ranch Maintenance Corporation, the company responsible for maintenance and landscaping in the community, said recently that it has paused the routine use of certain pesticides and herbicides for 60 days while reviewing its practices.
Brian Dalton, whose 23-year-old daughter Lily died in January after battling a rare cancer that doctors said contained an Ewing sarcoma gene fusion, called for an investigation to determine the cause of the cases.
“Why are so many children and young adults developing incredibly rare cancers in the same community?” he said during the meeting.
“If Lily’s story can help prevent even one family from experiencing this pain, then her life continues to make a difference. Tonight, I ask our elected officials, our health agencies, our scientists and our community to work together. Follow the evidence wherever it leads. Conduct the research. Share the data openly. Listen to the families, and don’t stop until we understand why this is happening.”
What Causes Ewing Sarcoma?
The cause of Ewing sarcoma is unknown. According to the American Cancer Society, there are “no known lifestyle-related or environmental causes” of Ewing sarcoma.
“The evidence base that Ewing sarcoma is caused by environmental chemical exposure of any kind is very thin, so it would be surprising if the apparent cluster in Orange County found a definitive link,” Logan Spector, a professor of Pediatrics at the University of Minnesota Medical School and chair of the Childhood Cancer and Leukemia International Consortium whose research focuses on the case of childhood cancers, told Newsweek.
“Unfortunately, the track records of community cluster investigations show that they rarely, if ever, identify a clear cause even when incidence of rare cancers is very elevated.”
Other experts have said cancer cases can appear clustered by chance.
“Clusters like this pop up occasionally,” Matteo Trucco, director of the Children’s Cancer Innovative Therapy program at the Cleveland Clinic, told Newsweek.
“There has, in fact, been a cluster of Ewing sarcoma cases here in Lake County, Ohio and I reported a cluster to the State of Ohio of an even rarer sarcoma called Desmoplastic Small Round Cell Tumor (DSRCT) in Northeast Ohio earlier this year.”
These cancers “are driven by chromosomal translocations, where parts of two chromosomes break apart and reassemble, creating genes and proteins that drive the cancer formation,” he said. “We don’t know how or why this happens, and to date we haven’t been able to link clusters of sarcomas like these to any specific exposure, though people are studying this.”
Edward Kim, an oncologist and physician-in-chief at City of Hope, a cancer specialty hospital in Orange County, told CBS Los Angeles: “Sometimes it is just by chance that a certain location, over a certain amount of time, has a higher number of cases, but it may still fall within the norm of the cases described through the country.”
Contact Newsweek editors on this story: John Fitzpatrick and Gray R. Thomas
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