New Navy guidance to medical providers treating those who've lived in the Laurel Bay housing area in South Carolina expands the concern over potential exposure to cancer-causing agents, now addressing adult cancer risks as well as pediatric ones.
And Melany Stawnyczyj, a Marine wife who once lived in the area near Marine Corps Air Station Beaufort and whose child has undergone cancer treatments, said the guidance doesn't go far enough to allay families' concerns.
She strongly disagreed with a portion of the guidance that discourages testing solely to allay patient (or parent) concerns, calling such a recommendation "unethical and wrong."
A YouTube video posted by former Laurel Bay resident Marine wife Amanda Whatley, whose daughter was diagnosed with cancer, has been viewed more than 49,000 times. She urged other families who have lived there to be aware of early symptoms of leukemia, and to seek medical attention quickly.
Since the video was posted Jan. 7, Whatley and fellow Marine wife Stawnyczyj have been contacted by other previous Laurel Bay families with cancer diagnoses, and are now aware of 13 children, 14 teachers and 20 other adults,Stawnyczyj said .
After the video was posted, NMCPHC officials sent guidance for medical providers worldwide to help them address the concerns of parents who live at – or previously lived at – Laurel Bay. A few days later, they sent guidance related to adult patients, noting that "concern has now spread to include adult cancers as potentially being caused by alleged environment exposures" at Laurel Bay. "Medical providers are being asked for advice by concerned patients and their families."
An investigation into potential environmental exposures has been underway with the Navy and Marine Corps Public Health Center since June 2015, months after the Whatley and Stawnyczyj families first contacted officials at Beaufort MCAS regarding the possible contamination related to aging underground oil storage tanks, and the possible link to childhood cancer.
Base officials have said no reliable information to date establishes that any conditions at Laurel Bay cause health problems, and note that the NMCPHC study is expected to be finished this spring. They've held town hall meetings and established a website to provide information.
The center "routinely" develops and distributes guidance to providers who may encounter patients that have specific environmental-exposure-related health concerns," according to Navy Capt. Alan Philippi, head of the occupational and environmental medicine department at NMCPHC. Physicians in that department at the NMCPHC "are key liaison between the local [medical] providers and public health scientists who are conducting the health risk assessments at those sites of concern."
"Patients with suspected low-dose exposures to chemicals of concern should be evaluated as any other patient," states the guidance for both adult and child patients, from the NMCPHC.
The guidance doesn't recommend blood, urine, imaging or invasive testing for patients who are otherwise healthy and have normal comprehensive examinations, stating that any testing performed "solely to allay patient (or parent) concerns is generally unhelpful and therefore not typically recommended."
Stawnyczyj disagrees with that line of thought.
"If we are being taken seriously, then military officials would not stand in the way of getting medical screenings and blood work done for families possibly affected," she said.
"It has been our mission from the start to reach out to military families worldwide and inform them of the past and current oil tank investigations, as well as spread vigilant awareness on symptoms or varied warning signs of cancer. ... It is unethical and wrong to thwart a family's efforts in seeking reassurance through medical testing. These medical screening and tests can potentially save lives because it can detect the slightest [imbalance.]
"Too often, parents don't recognize the symptoms and it can be mistaken for common illnesses and discomfort," she said, adding that the later the child is diagnosed, the less the chances are of survival.
"I believe most parents would rather find out their child is completely healthy than to find out later that they had the resource to detect cancer sooner," she added.
As the NMCPHC guidance states, "There is no test that can definitively determine if a patient will develop cancer. ... In addition, testing without evidence of disease is likely to result in false positives, leading to further unnecessary and potentially harmful tests and procedures."
Medical providers are advised that the physical examination of patients concerned about possible exposure should focus on establishing a baseline health assessment for, at minimum, the thyroid, lymph nodes, heart, lung and abdomen. If the findings indicate that further testing is needed, the medical provider should consult with a toxicologist, hematologist-oncologist or other expert for specific guidance for further evaluation, the guidance states.
Medical providers should get an accurate patient history, including current symptoms and review of symptoms, according to the guidance. A thorough occupational, social and medical history "should carefully explore possible sources of exposure."
Karen Jowers covers military families, quality of life and consumer issues for Military Times. She can be reached at firstname.lastname@example.org .