Kris Thomas (left) and Jim Fontella in the Art beCAUSE breast cancer calendar (David Fox)
Update, 7/31/12: On Tuesday, the House passed a bill backed by Sgt. Jerry Ensminger and other Camp Lejeune cancer advocates that will help former Marines and their family members get treatment for conditions linked to carcinogens present at the base. The bill has already passed the Senate, and is expected to be signed by President Obama.
It all started with Mike Partain, a.k.a. Number One. A barrel-chested father of four with a goatee and a predilection for aviator sunglasses, Partain was born at Camp Lejeune, the North Carolina base where his father, a first lieutenant in the US Marine Corps, was stationed in the late 1960s. Now he lives in Tallahassee, Florida, where he makes his living as an insurance claims adjuster.
Five years ago Partain's wife noticed a grape-size bump next to his right nipple. "I thought it was from an ingrown hair or something. I blew it off," he recalls. But a couple of weeks later he decided to get it checked out. When his doctor ordered a mammogram, he remembers, "a chill went down my spine." Then came a sonogram: Partain watched in amazement as an image emerged on the screen looking like one of the globular star clusters he knew as an astronomy hobbyist. "I never even knew men could get breast cancer!" he says.
Indeed, it's rare. For every 100 women with the disease, just 1 man is diagnosed—and typically around age 70. Partain was only 39. He would undergo a full mastectomy and eight rounds of chemo, leading to gonadal failure—an inability to produce testosterone. "I kept thinking, 'What did I do to win this lottery?'" Partain told me. "I never drank or smoked. I liked backpacking and Boy Scouts. There is no history of breast cancer in my family."
Not long after he got the bad news, his father called and told him to turn on the TV. There was a news report about toxic chemicals in the drinking water at Camp Lejeune—and their possible links to leukemia and birth defects. It was the first time either man had heard about the contamination. "I knew right away I'd been exposed," Partain says. "I figured if this was the cause of my cancer, I wouldn't be the only one."
He decided to go public with his diagnosis—no easy deal for the son of a Marine. After Partain was interviewed for a local newscast, he got a call from an Alabama preacher who was raised in the same neighborhood on the base at around the same time. He also had breast cancer. The preacher became Number Two.
One Lejeune well had 76 times the federal limit for benzene, a carcinogenic gasoline additive.
Hitting the internet, Partain promptly came across a photo of a man in Michigan—Number Three. "His chest was half gone," Partain recalls. "His Marines jacket was draped over his arm. I was like, 'Holy shit!'" Within a year, he'd tracked down 20 men with breast cancer who'd lived or served on the base. CNN aired a story about the group, and another 20 contacted Partain practically overnight. He set up a spreadsheet to keep track of them. Their number slowly grew: 50...60...70. At last count, there were 77.
Partain's recordkeeping may well prove important, not just for the men—who want answers about their pasts and their destinies—but for researchers seeking insights into the murky environmental causes of breast cancer. From this rare group of men afflicted with an all-too-common disease, scientists might finally get some answers. "We stick out like a sore thumb," says Partain.
From top: Mike Partain's dad (middle row, fourth from right) at Camp Lejeune, 1967; Partain's mother, Lisette, with her newborn; Sgt. Peggy Price, who served at Lejeune in the '80s, after removal of a lemon-sized brain tumor; Dewayne Young and his family at Lejeune—"We were always sick," says his son; Young shortly before his death from adenocarcinoma.People don't live at Camp Lejeune, they live "aboard" it, which kind of makes sense. The coastal base is built on a series of linked wetlands and aquifers, with the lazy New River meandering through it all en route to the Atlantic Ocean. It's also massive, covering 244 square miles and hosting some 137,000 Marines, family members, and civilian employees.
At first impression, the place seems like a glorified summer camp. Signs posted along its main drags point to archery and bowling. But farther out are the Fortified Beach Assault Area, the Flame Tank and Flame Thrower Range, the (former) Live Hand Grenade Course. These places, and dozens of others, are sodden with a witches' brew of volatile organic solvents and industrial toxins. In 1989 they were added to the federal National Priorities List—basically Superfund sites.
Beginning in the 1950s, for more than three decades, the worst of Lejeune's contamination intermingled with its water supply. An estimated 750,000 people regularly drank the water, bathed and swam in it, and inhaled its vapors. At Hadnot Point, where the 2nd Maintenance Battalion fixed tanks, jeeps, and other fleet vehicles, storage tanks quietly leaked more than a million gallons of gasoline, forming an underground plume more than 100 feet deep in places, and nearly as big as the National Mall. Through it all pumped Well No. 602, which provided water to thousands of people on any given day. In late 1984, when the military started routinely testing Lejeune's wells, No. 602 clocked in with 76 times the federal limit for benzene, a carcinogenic gasoline additive. Heavy-duty chlorinated solvents also flowed freely at Hadnot Point, notably perchloroethylene (PCE) and trichloroethylene (TCE)—a known human carcinogen that workers used to degrease machinery before dumping or burying the waste at a disposal site up the road.
Dewayne Young, who worked as a mechanic in Lejeune's motor pool, died of adenocarcinoma (glandular cancer) in 2010 at age 58. "He said they had them use that one solvent for everything—cleaning anything they were working on, washing their hands with it," recalls his son, Jeremy Young, who lived with his family on the base during the 1970s. "I can still remember the horrible smell of the water. You couldn't drink it, it tasted so bad. On top of that, Mom wouldn't let us. She mostly boiled it and made tea from it, and the tea still tasted funny."
Two other wells, TT-23 and TT-26, sucked up PCE waste from a nearby dry-cleaning business that catered to the troops. Although the brass knew about some of the contamination as early as 1980, they didn't close any wells until 1984 and 1985. By that point, wells were coming back with TCE readings as high as 1,600 parts per billion—320 times the current federal limit. The tap water at one elementary school on the base contained 1,148 ppb, which was four times the worst readings in Woburn, Massachusetts, the town immortalized as a poster child of toxic drinking water in the bestseller A Civil Action. While the contamination at Lejeune varied by location, water from numerous wells was combined at centralized treatment plants on the way to offices, barracks, hospitals, and the residences where military families raised their children.
In addition to being the "Home of the Marine Expeditionary Forces in Readiness," Camp Lejeune now enjoys the distinction of having hosted what is arguably the most contaminated public drinking water supply ever discovered in the United States. It may also be the common thread uniting what appears to be the biggest cluster of male breast cancer cases ever identified.
In 2006, Boston University epidemiologist Richard Clapp got a phone call asking if he'd like to serve on an advisory committee being set up to help the federal government study the chemical exposures at Lejeune. He was an obvious choice. Back in 1980, Clapp had put together the Massachusetts Cancer Registry in response to a childhood leukemia cluster emerging out of Woburn. "I thought, 'Wow, this is going to be something to watch,'" he says of Lejeune. "That kind of massive exposure, with so many people passing through there, and levels a lot higher than what we saw at Woburn."
Epidemiology is considered a blunt instrument of science. Most suspected cancer clusters are not what they appear to be—or if they are, it's tough to prove. They get dismissed as statistical anomalies or phantoms dreamed up by victims desperate to explain what caused their illnesses. Usually the numbers are too small to work with, the exposures too hard to nail down. "You know you have a catastrophe when even epidemiology can detect it," says Clapp.
"This is up there with the classics: Love Canal, Times Beach," says epidemiologist Richard Clapp. "History will look back on this as significant."
Even when local cancer rates do pop out as statistically significant, it's rarely possible to draw a straight line between environmental exposure and disease the way you can in the lab. (Our proof that radiation causes breast cancer came courtesy of that large-scale public health experiment known as the atomic bomb.) Some 200 different chemicals have been linked to mammary tumors in animals and people, but you can hardly lock human subjects in a lab and feed them TCE or benzene to see what happens.
Yet in a sense, Lejeune is that lab. As Clapp notes, the numbers are huge: hundreds of thousands of men, women, and children exposed to contaminated water. What's more, the military has precise records of who lived where and for how long. In some cases, it may even be possible to pinpoint, down to the trimester, when fetuses were exposed—knowledge useful for tracking developmental defects. Indeed, it was a survey indicating low birth weights that first caught the attention of the Agency for Toxic Substances and Disease Registry (ATSDR), which is now conducting massive health studies at Lejeune.
Partain's group, Clapp cautions, still might not be big enough to make a slam-dunk case, but epidemiologists are excited by its potential to dramatically advance what we know about the causes of a disease that kills some 40,000 American women each year and is on the rise globally. As it stands, we don't know much. Last year's report on breast cancer and environmental factors by the nonprofit Institute of Medicine declared the evidence on chemicals mostly inconclusive. If the Lejeune data is good enough to prove a link between industrial chemicals and breast cancer in the general population, it will be a first. Clapp, 66, stepped down from his teaching position in 2010, but "I can't retire from this," he says. "It's too compelling. This is up there with the classics: Love Canal, Times Beach. History will look back on this as significant."