Clinical encounter with three cancer patients affected by groundwater contamination at Camp Lejeune: a case series and review of the literature

Abstract

Background: Advanced understanding of tumor biology has recently revealed the complexity of cancer genetics, intra/inter-tumor heterogeneity, and diverse mechanisms of resistance to cancer treatment. In turn, there has been a growing interest in cancer prevention and minimizing exposure to potential environmental carcinogens that surround us. In the 1980s, several chemical carcinogens, including perchloroethylene (PCE), trichloroethylene (TCE), and benzene, were detected in water systems supplying Camp Lejeune, a US Marine Corps Base Camp located in North Carolina.

Case presentation: This article presents three cases of cancer patients who have lived at Camp Lejeune, and, decades later, came to our clinic located 1000 miles from the original exposure site. The first patient is a young Caucasian man who was diagnosed with T cell acute lymphoblastic leukemia at the age of 37, and the second patient is a Caucasian man who had multiple types of cancer in the prostate, lung, and colon as well as chronic lymphocytic leukemia in his 60s and 70s. The third patient is another Caucasian man who had recurrent skin cancers of different histology, namely basal cell carcinomas, squamous cell carcinomas, and melanoma, from his 50s to 70s.

Conclusions: The US Congress passed the Honoring America's Veterans and Caring for Camp Lejeune Families Act in 2012, which covers appropriate medical care for the people affected by the contamination. We hope that this article raises awareness about the history of Camp Lejeune's water contamination among cancer care providers, so the affected patients can receive appropriate medical coverage and cancer screening across the country.

Keywords: Benzene; Chemical carcinogen; Perchloroethylene (PCE); Trichloroethylene (TCE).

Fig. 1

Map of Camp Lejeune and the water distribution areas. Source Maslia ML. Expert Panel Assessing ATSDR’s Methods and Analyses for Historical Reconstruction of Groundwater Resources and Distribution of Drinking Water at Hadnot Point, Holcomb Boulevard, and Vicinity, U.S. Marine Corps Base Camp Lejeune, North Carolina. Prepared by Eastern Research Group, Inc., Atlanta, GA. Prepared for Agency for Toxic Substances and Disease Registry (ATSDR), Atlanta, GA. April 29–30, 2009; p. 149.

Fig. 2

Chemical structures of a PCE and b TCE

Fig. 3

Chemical structure of benzene