Image provided by: University of Oregon Libraries; Eugene, OR
About The Bulletin. (Bend, OR) 1963-current | View Entire Issue (April 13, 2022)
THE BULLETIN • WEDNESDAY, APRIL 13, 2022 A3 LOCAL, STATE & REGION Company promotes tests to detect Energy company undiagnosed cancers in patients admits turbines killed 150 eagles, to pay $35 million Some experts question whether such tests are necessary LINDSEY BEVER The Washington Post BY CARLA K. JOHNSON Associated Press Joyce Ares had just turned 74 and was feeling fine when she agreed to give a blood sample for research. So she was surprised when the screening test came back posi- tive for signs of cancer. After a repeat blood test, a PET scan and a needle biopsy, she was diagnosed with Hod- gkin lymphoma. “I cried,” the retired Oregon real estate broker said. “Just a couple of tears and thought, ‘OK, now what do we do?’” The Canby resident had volunteered to take a blood test that is being billed as a new frontier in cancer screen- ing for healthy people. It looks for cancer by checking for DNA fragments shed by tu- mor cells. Such blood tests, called liq- uid biopsies, are already used in patients with cancer to tai- lor their treatment and check to see if tumors come back. Now, one company is pro- moting its blood test to peo- ple with no signs of cancer as a way to detect tumors in the pancreas, ovaries and other sites that have no recom- mended screening method. It’s an open question whether such cancer blood tests — if added to routine care — could improve Amer- icans’ health or help meet the White House’s goal of cutting the cancer death rate in half over the next 25 years. With advances in DNA se- quencing and data science making the blood tests pos- sible, California-based Grail and other companies are rac- ing to commercialize them. And U.S. government re- searchers are planning a large experiment — possibly lasting seven years and with 200,000 participants — to see if the blood tests can live up to the promise of catching more can- cers earlier and saving lives. “They sound wonderful, but we don’t have enough information,” said Dr. Lori Minasian of the National Can- cer Institute, who is involved in planning the research. “We don’t have definitive data that shows that they will reduce the risk of dying from cancer.” Grail is far ahead of other companies with 2,000 doctors willing to prescribe the $949 test. Most insurance plans don’t cover the cost. The tests are being marketed without endorsements from medical groups or a recommendation from U.S. health authorities. Review by the Food and Drug Administration isn’t required Nathan Howard/AP Joyce Ares sits for a portrait in her home on March 18 in Canby. Although Ares feels lucky, it’s impossible to know whether her cancer blood test added years to her life or made no real difference, said Dr. Barry Kramer , former director of the National Cancer Institute’s Division of Cancer Prevention. for this type of test. “For a drug, the FDA de- mands that there is a substan- tial high likelihood that the benefits not only are proven, but they outweigh the harms. That’s not the case for devices like blood tests,” said Dr. Barry Kramer of the Lisa Schwartz Foundation for Truth in Med- icine. Grail plans to seek approval from the FDA, but is market- ing its test as it submits data to the agency. The history of cancer screening has taught cau- tion. In 2004, Japan halted mass screening of infants for a childhood cancer after stud- ies found it didn’t save lives. Last year, a 16-year study in 200,000 women in the United Kingdom found regular screening for ovarian cancer didn’t make any difference in deaths. Cases like these have uncov- ered some surprises: Screen- ing finds some cancers that don’t need to be cured. The flip side? Many dangerous cancers grow so fast they elude screening and prove deadly anyway. And screening can do more harm than good. Anxiety from false positives. Unnec- essary costs. And serious side effects from cancer care: PSA tests for men can lead to treat- ment complications such as incontinence or impotence, even when some slow-grow- ing prostate cancers would never have caused trouble. The evidence is strongest for screening tests for cancers of the breast, cervix and co- lon. For some smokers, lung cancer screening is recom- mended. The recommended tests — mammography, PAP tests, colonoscopy — look for one cancer at a time. The new blood tests look for many can- cers at once. That’s an advan- tage, according to Grail execu- tive Dr. Joshua Ofman. “We screen for four or five Gillian Flaccus/AP Vials of blood from a participant in a clinical study of the effective- ness of a new liquid biopsy technology are packaged for shipment at Oregon Health & Science University in Portland on March 14. The clinical trial will follow hundreds of participants for three years to see if signals of any cancers that participants later develop were present in their blood. cancers in this country, but (many) cancer deaths are coming from cancers that we’re not looking for at all,” Ofman said. Dr. Tomasz Beer of Oregon Health & Science University in Portland led the compa- ny-sponsored study that Joyce Ares joined in 2020. After a miserable winter of chemo- therapy and radiation, doctors told her the treatment was a success. Her case isn’t an outlier, “but it is the sort of hoped-for ideal outcome, and not every- one is going to have that,” Beer said. While there were other early cancers detected among study participants, some had less clear-cut experiences. For some, blood tests led to scans that never located a cancer, which could mean the result was a false positive, or it could mean there’s a mystery can- cer that will show up later. For others, blood tests detected cancer that turned out to be advanced and aggressive, Beer said. One older participant with a bad case declined treat- ment. Grail continues to update its test as it learns from these studies, and is sponsoring a trial with Britain’s National Health Service in 140,000 peo- WE’RE ALL EARS Take our brief online survey and you could win a $100 Old Mill District gift card! Your answers will help us learn about our community’s concerns so we can better serve your needs. BendBulletin.us/survey ple to see if the blood test can reduce the number of cancers caught in late stages. Although Ares feels lucky, it’s impossible to know whether her test added healthy years to her life or made no real difference, said Kramer, former director of the Na- tional Cancer Institute’s Divi- sion of Cancer Prevention. “I sincerely hope that Joyce benefited from having this test,” Kramer said when told of her experience. “But unfor- tunately, we can’t know, at the individual Joyce level, whether that’s the case.” Cancer treatments can have long-term side effects, he said, “and we don’t know how fast the tumor would have grown.” Treatment for Hodgkin lymphoma is so ef- fective that delaying therapy until she felt symptoms might have achieved the same happy outcome. For now, health experts stress the Grail blood test is not a cancer diagnosis; a pos- itive result triggers further scans and biopsies. “This is a path in diagnos- tic testing that has never been tried before,” Kramer said. “Our ultimate destination is a test that has a clear net benefit. If we don’t do it carefully, we’ll go way off the path.” An American wind energy company has admitted to killing at least 150 bald and golden eagles, most of which were fatally struck by wind turbine blades, federal prose- cutors said. ESI Energy pleaded guilty April 5 to three counts of vi- olating the Migratory Bird Treaty Act after eagles died at three of its facilities in Wy- oming and New Mexico, ac- cording to a statement from the Justice Department. The act prohibits killing, capturing or transporting protected migratory bird species without a permit. “For more than a decade, ESI has violated those laws, taking eagles without ob- taining or even seeking the necessary permit,” Assistant Attorney General Todd Kim of the Justice Department’s Environment and Natural Resources Division said in the statement. As part of a plea agree- ment, ESI was sentenced to more than $8 million in fines and restitution and five years of probation. The company has also agreed to implement up to $27 million in measures to minimize future eagle in- juries and deaths, the prose- cutors said without detailing what that would entail. Prosecutors said ESI will pay $29,623 for each bald or golden eagle killed by its tur- bine blades in the future. The company has three years to apply for permits for any unavoidable killing of eagles, according to the state- ment. Court documents show that in March 2019, shortly after ESI decided to build wind power facilities in Con- verse County, Wyoming, the U.S. Fish and Wildlife Ser- vice warned that there was an “unusually high number” of golden-eagle nests in the area and discouraged the build, noting that up to 44 golden eagles and 23 bald eagles could collide with a turbine blade within the first five years. ESI moved forward with the build, court records said. ESI has since acknowl- edged that at least 150 bald and golden eagles have died at 50 of its 154 wind farms over the past decade and that 136 of the deaths occurred when the birds flew into a turbine blade, prosecutors said. Rebecca Kujawa, presi- dent of ESI parent NextEra, criticized the government’s enforcement policy, saying Dina Cappiello/AP file A golden eagle flies over a wind turbine in Converse County Wyoming in 2013. ESI Energy admitted to killing 150 bald and golden eagles, mostly through wind-turbine blade strikes. some animal deaths are “un- avoidable” with wind tur- bines. “The reality is building any structure, driving any vehicle, or flying any airplane carries with it a possibility that ac- cidental eagle and other bird collisions may occur as a re- sult of that activity,” Kujawa said in a statement. “Unfortunately, the federal government, at odds with many states and a number of federal court decisions, has sought to criminalize un- avoidable accidents related to collisions of birds into wind turbines while at the same time failing to address other activities that result in far greater numbers of acciden- tal eagle and other bird mor- talities.” ESI and NextEra did not immediately respond to a request for comment from The Washington Post on Sat- urday. The bald eagle, which has been the national bird in the United States since the late 1700s, was removed from the endangered species list in 2007. But it still faces a number of threats and re- mains protected under the Migratory Bird Treaty Act and the Bald and Golden Ea- gle Protection Act, according to the U.S. Fish and Wildlife Service. Such threats include collisions with man-made structures and vehicles, poi- soning, electrocution and il- legal shooting, among other things, the agency said. Wind turbines are a known killer of numerous species of birds, includ- ing eagles. At their tips, the blades can spin up to 200 mph. Research shows that between 140,000 and 328,000 birds are killed each year at monopole turbines in the United States, with an increased risk of death the higher the turbines.
