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-
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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.