Rare cancer strikes
Small community near Alberta oilsands has disproportionate number of bile duct disease
By VIVIAN SONG
A mutated, two-mouthed fish caught downstream from the Alberta oilsands caught the attention of the Canadian public last week. Beneath its first mouth is a confusing aberration, a second, baby, jagged-toothed lower jaw that seems to grow timidly out of the fish-face.
Two boys fishing in Lake Athabasca caught the 2.5-kilo goldeye two weeks ago and handed it over to the Mikisew First Nation.
The image is a repellent one, simultaneously drawing in the viewer for a closer inspection and pushing them back in a foggy state of double vision. But there's another story developing in the same region that hasn't captured the attention of mainstream Canadians as would a two-mouthed fish.
Perhaps it's because it's not nearly as visual a story. There are no tangible images of genetic mutations or abnormalities except for the erection of a few more gravestones.
Natives in the small community of Fort Chipewyan, 300 km north of Fort McMurray and downstream from the oilsands, have been dying of a rare bile-duct disease in disproportionate numbers.
When Dr. John O'Connor started treating residents in Fort Chip in 2001, he noted the unusual recurrence of cholangiocarcinoma, a rare cancer of the bile duct which normally strikes one in 100,000 people.
The doctor knows the disease well, for the illness killed his father. Three cases were confirmed in the community through biopsies.
"It was a town with a population of 1,200, a pristine location, an idyllic spot," O'Connor said in a June phone interview from Nova Scotia. "It was the pathology, that's what struck me. The community was far from small cities and towns and pollution, so it really struck me as peculiar."
Elders had been complaining the community was being plagued by diseases in numbers unseen after major oil refineries moved in nearby.
O'Connor raised the alarms, pushing for a public inquiry and garnering media attention. Alberta Health and the Alberta Cancer Board dismissed the concerns, concluding the cancer scares were exaggerated -- a report slammed for being hastily prepared and incomplete.
While the report found a "provocative" six cases of bile-duct cancers, officials concluded the overall cancer rates were comparable with provincial averages. Residents complained officials didn't speak to community members, while some charged the report was deliberately dismissive to coincide with an application before the province's energy board by Suncor Energy Inc. to expand its operations and double the amount of oil produced.
Meanwhile, in an environmental assessment commissioned by Suncor, the levels of arsenic found in local moose meat were found to be 453 times the acceptable levels.
In a subsequent study by Alberta Health, scientists lowered those arsenic figures drastically to between 17 and 33 times the acceptable levels.
"There is a function of mistrust," said George Poitras, the former chief of the Mikisew Cree and chairman of this month's Keepers of the Water conference in Fort Chip. "We feel the government's not respectful of the community.
"The government's usual position is to suggest the claims are far-reaching and absurd. But our fisherman see this time and time again," he said of the mutated fish. "It's happening more frequently than the government would like to acknowledge."
When O'Connor challenged the accuracy of the cancer reports, Alberta Health officials filed complaints against O'Connor for professional misconduct, billing irregularities and raising "undue alarm" in what critics say were attempts to muzzle a whistleblower.
He has since been cleared, but the charge of "undue alarm" remains outstanding. O'Connor now practises in Nova Scotia, driven out because of intolerable working conditions and stress. He continues, however, to treat patients via Telehealth and receives a hero's welcome from the community.
"I try to keep a low profile now," he said.
After mounting public pressure, the Alberta government announced in an embarrassing about-face in May it will be conducting a second investigation.
"It's a continuation of the investigation because of lingering concerns," said Lee Elliott, spokesman for the Alberta Cancer Board.
So far, in 2008, there have been six cancer deaths in Fort Chip. The final report is due out in the fall.
"Fifteen to 20 years ago, elders say you could scoop water from the boats (and drink it) and not be concerned," Poitras said. "Today, nobody would do that. Everything tastes differently. We see fish not only with two mouths, but with blisters and tumours ... Moose meat tastes differently and elders are noticing a change of migration patterns in birds. These are the concerns we're having."
BILE DUCT CANCER
Cancers of the bile duct (cholangiocarcinoma) are rare in the Western world, with less than 400 cases a year (one in 100,000) occurring in Canada. The cause of most bile duct cancers is unknown.
The biliary system is composed of:
- Bile ducts: The tubes connecting the liver and gall bladder to the small intestine (small bowel).
- Gall bladder: Stores bile which breaks down fats during their digestion in the small bowel. In people who have had their gall bladder removed, bile flows directly into the small intestine.
SIGNS AND SYMPTOMS
If cancer develops in the bile ducts, it may block the flow of bile from the liver to the intestine. This causes the bile to flow back into the blood and body tissues. Ultrasound and CT (computerized tomography) scans are commonly used to diagnose bile duct cancer.
SOURCE: www.cancerbackup.org; Graphic News