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Can You Figure Out If SDSU Has a Coincidence or Cancer Cluster?

Tuesday, March 10, 2009 | Two San Diego State professors and a graduate student died of a rare strain of brain cancer, two in 2008 and one in 1993. They all worked in the same room in the same building.

What are the odds? That’s the question facing students, professors and university officials as they consider what to do about NH 131, a shabby, filthy office on the first floor of SDSU’s Nasatir Hall.

At first glance, the numbers seem to add up to a “cancer cluster,” indicating that something in the room or nearby may be killing people.

But San Diego State isn’t investigating, unlike officials at UC San Diego who are facing a similar rash of cancer cases [1] related to a building. Nor are graduate students staying far away from the room they use as a lounge and office.

Those who study cancer clusters say there’s a good chance that nothing is wrong. Suspicious statistics, they say, are sometimes just a random fluke. And even if there are signs that something is causing cancer at Nasatir Hall, scientists may not be able to figure out the cause.

With the exception of workplaces like factories and mines, “our batting average as epidemiologists in explaining cancer clusters. … has been very poor,” said Dr. Raymond Neutra, former chief of the state Division of Environmental & Occupational Disease Control.

Still, faculty members want more action. “I’m certainly not panicked about it, but we think questions should be asked,” said Brian Adams, an associate professor of political science. “With that high of a number (of cancer cases), dismissing it as being a likely coincidence probably isn’t the wisest path.”

The two professors in question, aged 69 and 49, and the graduate student, 26, all spent time in the room and developed cases of glioblastoma multiforme brain cancer, The Daily Aztec student newspaper reported [2] Monday. Another professor who worked in the room is said to be suffering from another kind of brain cancer.

Glioblastoma multiforme tumors are the most common form of brain cancer, although they’re rare and occur in an estimated two to three out of every 100,000 people each year. At that rate, about 60 to 90 people would be expected to develop the condition in San Diego County annually.

The tumors are very difficult to treat and the prognosis is usually grim. U.S. Sen. Edward Kennedy is suffering from brain cancer and some specialists think he has this kind of tumor.

Despite its newfound reputation as a possible deathtrap, NH 131 continues to be used by students, as well as an adjoining room for office hours with students and as a place to hang out. NH 131 is ratty and dirty, like college lounges everywhere, home to a severely stained carpet and couch along with a pair of computers.

But the news is still a bit disconcerting. “I don’t think I’m going to spend as much time here as I have been,” said graduate student Bonnie Chiurazzi, who spends dozens of hours in the room, known as “Club Grad,” each month.

She heard about the possible cancer link after the campus newspaper’s story. Professors had discussed the problem at a meeting in late February, several months after the graduate student died.

The 1957-era Nasatir Hall is home to asbestos, like many other campus buildings, although asbestos isn’t thought to cause brain cancer. The building, named after a late professor, is also next to a cellular tower that was erected in 2005 and a building that compacts trash from a nearby food court; both the tower and the trash compactor have raised eyebrows in the political science department as people have considered possible cancer causes.

In an e-mail, San Diego state spokesman Greg Block said the university hired a firm in 2007 to assess hazardous materials like asbestos, PCBs and lead paint in Nasatir Hall and neighboring Storm Hall as part of a routine check.

Block said the 2007 assessment and “surveillance” of asbestos-containing materials in 2008 convinced officials that “it was not necessary to conduct further inquiries.” The university found out about the cancer concerns last month.

“Nasatir Hall is safe for students, faculty and staff,” he said.

But isn’t the number of brain-cancer cases too high to be a mere coincidence? Perhaps not.

“Human nature is to perceive order among disorder,” said Alan Bender, an epidemiologist who studies disease clusters at the Minnesota Department of Health. In fact, he said, research has suggested that many seeming cancer clusters are purely random.

“Let’s say the lifetime risk (of cancer) is one in two,” Bender said. “That doesn’t mean every second house or second person.”

It’s also possible that the people who developed brain cancer shared something else in common that caused them to develop the disease. An epidemiologist might investigate whether the victims could have lived near each other, ate the same food each day for lunch or worked out at the same gym.

Even if epidemiologists were to decide the cancer cases related to Nasatir Hall are suspicious, the next step isn’t any easier.

“Our chance of being able to attribute a particular cluster to a single cause is pretty slim,” said Neutra, the former state official.

For one thing, he said, people often need to be exposed to a cancer-causing agent for decades before tumors develop. And while there are exceptions, substances that cause cancer typically don’t leave evidence in the body, he said.

To make matters even more complicated, doctors don’t know what causes brain cancer, although it’s possible that exposure to chemicals could be a factor.

What to do next? In his job for the state, Neutra said he often advised people to “look to see if there’s any possible cause that can be easily removed and don’t argue about whether the cancer cluster is really due to that cause. If it can be done inexpensively, remove it.”

If the state budget permits, San Diego State plans to renovate Nasatir Hall this fall and temporarily move out the people who work there, Block said. Workers will replace everything in the building except its shell, he said.

But the $28 million renovation won’t be enough for associate professor Farid Abdel-Nour because it may not get rid of whatever might be causing the cancer cases. Without an investigation, he said, “how would we know?”

Please contact Randy Dotinga directly at rdotinga@aol.com [3] with your thoughts, ideas, personal stories or tips. Or set the tone of the debate with a letter to the editor. [4]