A string of rare childhood cancer cases in this California suburb has the community on edge

On January 10, 2026, Lilly Dalton wrote her last Instagram post.

“I can’t believe I’m making this post, but today I entered hospice care.”

The 23-year-old from California who spent her childhood as an overachiever, graduating valedictorian and going on to earn a degree in history, was supposed to be beginning her career.

Instead, she had endured aggressive cancer treatment for a year and a half, and now, her liver was failing.

“Doctors aren’t sure how much longer I have left but I’m finding the little joys in every single one of my days,” she wrote under a picture of herself smiling, brown locks gone, in front of the Hollywood sign.

Lilly had gone to the emergency room with stomach pain just three days after graduating from university in 2024. She was initially sent home with a gastritis diagnosis but returned the next day, and after some scans, doctors found a tumor on her liver, her father said.

It would be at least three months before she would be given a more complete, earth-shattering diagnosis: Desmoplastic small round cell tumor that shares a genetic feature with Ewing sarcoma.

The family was told it was an extremely rare cancer.

Lilly did multiple rounds of what her father, Brian Dalton, described as “Red Devil chemo,” known for its red color and intense side effects, along with two types of radiation and major surgery.

Courtesy Brian Dalton

Despite it all, she always had a smile on her face. “All the nurses loved her there. She was like a celebrity,” Brian said. “She was always the best dressed. Her pajamas game was the best.”

“My biggest regret is that I always thought she was going to make it,” the father said.

Lilly died on January 25, leaving her father to grieve her loss while shouldering a mission to spread awareness about the cancer that took his daughter’s life.

So, months later, when Brian heard that multiple children had been diagnosed with Ewing sarcoma in Ladera Ranch, a neighboring Orange County community where he says Lilly spent much of her childhood and teen years in, it set off alarm bells.

“There’s absolutely no way that this is a coincidence,” Brian thought.

Ewing sarcoma is so rare that only about 200 children and teens are diagnosed with it in the United States each year, accounting for 1% of all childhood cancers, according to the American Cancer Society. It typically starts in the bones or surrounding soft tissue, most commonly among adolescents and young adults.

Though little is known about the cancer, it was becoming more familiar in Ladera Ranch this spring, and anxiety has been building for months.

Families in the suburb had been comparing notes and counting Ewing sarcoma cases connected to their community through Facebook groups and word of mouth. Residents tallied seven cases between 2007 and 2024, including at least one per year starting in 2021, according to resident group Ladera Health Watch. CNN could not independently verify those numbers due to privacy laws.

A troubling question began to take hold in Ladera Ranch: How could so many children connected to the same place develop such a rare cancer?

Ladera Ranch prides itself as an ideal place to raise a family. It was built around a particular vision of childhood: soccer games after school, bicycles left on sidewalks and long afternoons spent in neighborhood parks.

Grace Widyatmadja/CNN

Playing fields and gathering spaces thread through the tidy neighborhoods of the master-planned community, home to around 26,000 people, with pristine roads winding through tree-lined cul-de-sacs.

The same spaces have become the focus of residents’ questions.

Those questions nag at Dustin Matteson, whose 16-year-old son, Brody, was the kind of teenager who seemed to live on playing fields in Ladera Ranch. He spent his childhood cycling through football, rugby, baseball, basketball and soccer, piling up season after season of youth sports.

On the football field, Brody was known as a tough kid. His father, a towering former football player himself, said he discovered just how tough his son was during a brutal 19-month battle with Ewing sarcoma.

Even as cancer spread through his body, Brody kept making plans for the future, worried more about others than himself. “He said, ‘I’m happy it was me and not my brother and sister,’” Dustin recalled, covering his face.

“I always say that football doesn’t build character. It reveals it,” he said. “Brody’s fight with cancer, I really feel the same way. It showed the underlying person that he was.”

Brody died in March at 17. For some residents, his death marked the moment the community’s grief turned into a demand for answers.

Though his family had moved to another state, Brian Dalton flew back in July to join the Mattesons and other parents of children with the rare cancer to call for answers at a Ladera Ranch town hall meeting attended by government representatives, public health authorities and homeowners’ associations.

“I don’t want another father standing where I stand today,” Brian told the room. “Please don’t let Lilly’s story end with her. Let it become the reason we demanded answers.”

As anxiety punctured the tranquility of the suburb, questions bubbled up on everything from the community’s water and pesticide use to abandoned oil wells underneath.

Soon, the questions expanded beyond town halls and Facebook groups, prompting a response from public health agencies, environmental regulators and elected officials.

In July, First Assistant US Attorney Bilal Essayli asked the Environmental Protection Agency to determine whether environmental factors could be contributing to the “unusual cluster of pediatric cancers” in Ladera Ranch and whether any laws had been violated.

It’s not known whether any environmental factors can cause Ewing sarcoma and determining that will take years of sustained research, experts say.

The California Department of Public Health’s cancer registry is now trying to answer a first question: Is there really an unusual number of cancer cases in Ladera Ranch?

Results of the state’s review are expected this fall but the agency cautions that even if it does find the pattern unusual, that review alone cannot determine whether there was an environmental cause for the cancers. For now, the state said it has not identified any “immediate environmental hazards” in the area.

California’s current review of Ladera Ranch follows a 2024 assessment that found no unusual cancer pattern at the county level, though state officials said the available data was limited and did not focus specifically on Ladera Ranch.

“It’s fair for the residents to be concerned that the place that they’re having their kids roll around on and play sports on, and spend most of their life living on, needs to be safe and healthy,” said Orange County Supervisor Katrina Foley, who urged state health officials to expedite their review.

In one of Ladera’s parks this month Brody’s father watched as volunteer researchers fanned out across the grass with shovels and latex gloves. They were collecting soil and water samples into carefully labeled sterile plastic cups, searching for anything unusual lurking there.

Dustin said he hopes the efforts lead to answers.

But even before conclusions can be drawn, Ladera Ranch residents say they had pressured local institutions to begin taking precautionary steps. The community homeowners’ association and the Capistrano Unified School District both paused the use of certain pesticides and herbicides at high-use areas while reviews were underway.

Julia Vargas Jones/CNN

“If there is even a possibility that environmental exposures, including pesticides or any other factor, could be contributing, then those possibilities deserve a thorough, transparent, independent investigation,” Brian said.

The community is part of a national shift toward skepticism of chemicals, pesticides and other environmental exposures. Part of that approach includes not waiting for proof before reducing potential harmful exposures.

The California Department of Public Health makes explicit it is not yet known whether pesticides or other chemicals created an exposure risk in Ladera Ranch.

But because pesticide was a top concern raised by residents, the state officials said their assessment is looking specifically at cancer types linked to pesticide exposure “and asks whether those cancers occur more often in Ladera Ranch than expected.”

The search for answers converged with another local fight already underway.

Months before the cancer diagnoses became a public issue, Creek Team OC, a small grassroots organization, was already campaigning against herbicide spraying in local waterways, arguing chemicals were harming creek ecosystems. After public outcry, Orange County paused herbicide spraying in flood channels countywide while officials evaluate the safest procedures for removing vegetation.

On a sunny August afternoon, the group’s founder, Brent Linas, stood in front of the San Juan Creek, 5 miles from Ladera Ranch, pointing out the lack of plants near the channel.

“There was so much herbicide coming down from this poison creek that nothing could ever grow in here, and no one ever really questioned it,” Linas said. CNN could not independently verify the claims.

It wasn’t until he started calling out local leaders by name on his Instagram account and aggressively demanding answers that real progress was made, Linas said.

When Megan Matteson, whose son Brody had recently died, attended one of the Creek Team’s meetings looking for answers, she brought her notebook of painstaking research on who had what kind of cancer in her community. The group was eager to help.

Pesticides became one of several possible explanations the community felt was worth investigating – and one that quickly gained traction in Ladera Ranch conversations, social media posts, and local meetings.

The community’s homeowner’s association, the Ladera Ranch Maintenance Corporation, told CNN in a statement it became aware of increased resident concern in May and paused certain synthetic landscape maintenance products. At a September 9 meeting, the board approved further reducing synthetic pesticide use across their landscapes and expanded the areas maintained without routine synthetic pesticides.

Before scientists can determine whether pesticides, drinking water or any other environmental factor may have played a role, experts say they first have to answer a more basic question: Is there actually an unusual number of cancer cases compared to Ladera Ranch’s population size?

The California Department of Public Health told CNN “fewer than 11 cases” of Ewing sarcoma were identified in Ladera Ranch between 1999 and 2023 but said it could not release a more specific count because of confidentiality rules.

“The problem is these cancers are so rare that a community that size really wouldn’t expect to see a case every year, or every several years,” said Joseph Leo Wiemels, director of the PhD Program in Epidemiology at the University of Southern California.

Seven or eight cases of Ewings in a 10-year, or slightly longer period, may sound like a small number, but “it’s more than you would expect based on the community of that size,” he added.

Wiemels is hoping to work on an additional analysis across the whole state to ultimately help assess whether there is anything unusual happening in Ladera Ranch.

But even if researchers determine that cancer rates are unusually high, Wiemels cautions there may never be a definitive explanation.

Residents have been contacting him for months hoping for answers, he said, but proving a particular environmental exposure caused a rare cancer can be extraordinarily difficult.

Wiemels is also skeptical about hastily drawing connections to pesticides.

“I wouldn’t put the blame on pesticides just because it hasn’t shown up as a strong risk factor in other studies on Ewings sarcoma” he said. “If it was a strong risk factor, we would probably see it in other communities that have similar… kind of residential use pesticides.”

Evidence connecting environmental chemicals of any kind to Ewing sarcoma is “very thin,” Wiemels said. Coincidence also remains a possible explanation for an apparent cluster. “It is important to understand that even if pesticide exposure doubled or tripled the incidence of Ewing sarcoma, that is not likely to result in a cluster.”

The epidemiologist pointed to a study of a cluster of childhood leukemia cases in Fallon, Nevada , which suggested a possible infectious link but found no definitive cause for what was behind the unusual pattern – despite millions of dollars investigating the event.

“In general, for cancer, my automatic thought is: ‘What’s in the air that they’re breathing, what’s in the water that they’re drinking, and what’s in the food that they’re eating?’” said Megan Latshaw, professor in Environmental Health and Engineering at the Johns Hopkins Bloomberg School of Public Health.

“Who lives within a certain mile radius of where the wind blows from air toxic emissions? What’s in the toys our kids are playing with, what’s in the building materials in our houses?” she continued. The questions can become maddening, she admits.

But cancer rarely has a single cause. Exposure to a carcinogen can act as a “1-2 punch” for someone who already carries a genetic vulnerability, Latshaw said.

“Cancer takes time,” she said. “A single DNA mutation … you might not even notice that there’s anything going on for years.”

That complexity makes it difficult to isolate any one factor.

While the gene changes that lead to Ewing tumors are known, it’s still not clear what causes these changes.

Unlike with many cancers among adults, which are linked to risk factors like obesity or smoking, there aren’t many known risk factors for most childhood cancers in general.

Still, uncertainty does not necessarily mean inaction. Latshaw said public health officials often rely on the precautionary principle, reducing potential exposures when feasible even before definitive evidence of harm exists.

“It can’t hurt, right?” she said. “Pesticides are toxic. That is why they are invented – to break down some sort of cellular function in a living organism. So, reducing our use of pesticides can be a really good thing, whether or not it was causing an unusual pattern of cancer.”

As the community’s questions expanded, a group began pushing for records on anything that may potentially be a cause of cancer in their community, according to Jackie French, one of the organizers of Ladera Health Watch .

They started digging into questions about pesticides and landscaping practices and raised concerns about an abandoned oil well beneath a sidewalk they worried may not have been properly resealed.

The group sent a letter to state officials to evaluate the well’s integrity, and the California Geologic Energy Management Division performed an inspection on August 31, finding no leaks or emissions, a state conservation department spokesperson told CNN.

Residents’ questions about the suburb’s water quality also drew a response from the local utility.

The Santa Margarita Water District, which provides water to Ladera Ranch, said it understands residents’ concerns but noted that more than 30,000 tests are conducted annually and drinking water “meets or surpasses all state and federal regulations.” The utility said it is not aware of any links between drinking water and cancer concerns.

French said residents felt they could not afford to wait indefinitely for official investigations to play out. Parents were already wondering who might be diagnosed next.

“That really hit me,” French said. “We can’t wait. We can’t wait another year for a government agency to come in and try to figure out what’s going on. We have to do it ourselves.”

One of the people who answered that call was Jennifer Piazza, a public health researcher at Cal State Fullerton who also lives in Ladera Ranch.

Concerned for her neighbors and her own family, Piazza assembled a multidisciplinary team of researchers that included chemists, geographers, public health experts, air- and water-pollution specialists and cancer epidemiologists, reflecting the wide range of questions residents were trying to answer.

She was at the park last week as researchers gathered soil and water samples from the suburb to analyze for heavy metals, including lead, arsenic, chromium and pesticide compounds.

The goal, Piazza said, is not to prove a particular theory but to determine whether anything unusual is present.

Two agencies, the Department of Pesticide Regulation and the Orange County Agricultural Commissioner, are also reviewing local pesticide use for any possible violations.

Early in their efforts, the Ladera Health Watch sought records showing what pesticides had been sprayed, where they had been applied and in what quantities, but many of those details were difficult to obtain before the cases made headlines, French said.

And the work still continues to try to obtain information on pesticide usage amounts, she added.

The group discovered early just how much responsibility for the community’s parks, landscaping and common areas rested with private organizations.

Ladera’s parks and playing fields may feel like public spaces but are controlled by a private homeowners’ association. Ladera Ranch Maintenance Corporation is governed by community representatives and a non-voting general manager.

“It’s a black box,” she said of the system residents encountered while trying to gather information.

The association told CNN that in addition to pausing use of certain synthetic herbicides and plant growth regulators after hearing concerns, the association created a resident advisory committee to review alternatives to routine synthetic pesticide use and remains in contact with county and state officials.

A pilot program – which French said she helped set in motion through external grants – is also looking at organic options for pest and weed control.

Orange County Supervisor Foley said, by default, the government doesn’t have access to records related to pesticide purchases, training materials and other internal documents for communities like Ladera Ranch, and that can be an obstacle .

“There’s an accountability issue as it relates to private HOAs and private contractors because, unlike with public agencies, we don’t have access to their contracts,” Foley said.

“The only way to have access to that is through the investigation process,” Foley said.

Foley said county officials cannot simply ban pesticide use in privately managed communities, since much of the authority to regulate pesticides rests with the state, while investigations into possible violations are handled through separate regulatory processes.

That meant there was no single office, agency or organization capable of addressing residents’ concerns, but a patchwork of agencies where responsibility is fragmented.

For the Daltons and Mattesons, who watched optimism slip into grief after their children endured brutal battles against cancer, the fight now is about getting more information.

“When your child has a rare cancer like that, you don’t feel like you’re just fighting the cancer, you feel like you’re fighting a lack of information about the cancer,” Brian said.

Michele Abercrombie/CNN

It’s about more than pesticides, water or any single explanation, Brody’s father said.

“We believe that if we can come to figure out what’s causing it, we can address it and move on,” he said.

This month, Brody’s parents and siblings set out to mark his birthday. They got matching tattoos like he had planned to get if he had survived the cancer.

It was their way of honoring the boy who always thought of others first.

As Brian fights to spread awareness about Ewing sarcoma, he said Lilly left him with the request to let everybody know that she didn’t lose her fight with cancer. “It was a draw, because it died with her,” he said.

2026年1月10日，莉莉·道尔顿发布了她的最后一条Instagram帖子。

“我简直不敢相信自己会发这条帖子，但我今天住进了临终关怀中心。”

这位来自加利福尼亚的 23 岁女孩，从小就是个优等生，以全校第一名的成绩毕业，并获得了历史学学位，原本应该开始自己的职业生涯。

相反，她经历了长达一年半的积极癌症治疗，现在，她的肝脏已经衰竭。

“医生们不确定我还能活多久，但我每天都在寻找生活中的小确幸，”她在自己一张面带微笑、棕色头发不见了、站在好莱坞标志前的照片下写道。

莉莉在2024年大学毕业仅三天后就因胃痛去了急诊室。她的父亲说，她最初被诊断为胃炎后就回家了，但第二天她又回来了，经过一些扫描后，医生发现她的肝脏上有一个肿瘤。

至少三个月后，她才得到一个更完整、更令人震惊的诊断：促纤维增生性小圆细胞肿瘤，与尤文氏肉瘤具有相似的基因特征。

家人被告知这是一种极其罕见的癌症。

莉莉接受了多轮她父亲布莱恩·道尔顿称之为“红色魔鬼化疗”的治疗，这种化疗以其红色和强烈的副作用而闻名，此外她还接受了两种类型的放射治疗和一次大型手术。

承蒙布莱恩·道尔顿惠允

尽管如此，她脸上总是挂着笑容。“那里的护士都喜欢她。她就像个名人，”布莱恩说。“她总是穿得最好看。她的睡衣搭配也最棒。”

“我最大的遗憾是，我一直以为她会挺过来，”父亲说。

莉莉于 1 月 25 日去世，留下她的父亲悲痛欲绝，同时肩负起一项使命：提高人们对夺走女儿生命的癌症的认识。

几个月后，当布莱恩听说拉德拉牧场（Ladera Ranch）——一个邻近的橙县社区，也是他莉莉童年和青少年时期生活的地方——有多名儿童被诊断出患有尤文氏肉瘤时，他感到非常震惊。

“这绝对不可能是巧合，”布莱恩心想。

尤文氏肉瘤非常罕见，据美国癌症协会统计，美国每年仅有约200名儿童和青少年被诊断患有此病，仅占所有儿童癌症的1%。它通常起源于骨骼或周围软组织，最常见于青少年和年轻人。

虽然人们对这种癌症知之甚少，但今年春天，拉德拉牧场的人们却越来越熟悉这种癌症，几个月来，焦虑情绪一直在加剧。

郊区居民通过Facebook群组和口口相传的方式交流信息，统计社区内与尤文氏肉瘤相关的病例。据居民组织“拉德拉健康观察”（Ladera Health Watch）统计，2007年至2024年间，居民共报告了7例尤文氏肉瘤病例，其中自2021年起每年至少新增1例。由于隐私法的限制，CNN无法独立核实这些数据。

拉德拉牧场开始出现一个令人不安的问题：为什么这么多与同一个地方有联系的孩子会患上这种罕见的癌症？

拉德拉牧场以其理想的家庭居住环境而自豪。它的建设围绕着一种特定的童年愿景：放学后踢足球，自行车停放在人行道上，以及在社区公园里度过漫长的下午时光。

格蕾丝·维迪亚特马贾/CNN

在这个规划完善的社区里，整洁的街区中点缀着运动场和聚会场所，这里居住着大约 26,000 人，整洁的道路蜿蜒穿过绿树成荫的死胡同。

这些地方也成为了居民们关注的焦点。

这些问题一直困扰着达斯汀·马特森，他16岁的儿子布罗迪似乎是拉德拉牧场运动场上的常客。他的童年时光在橄榄球、英式橄榄球、棒球、篮球和足球中度过，年复一年地参加各种青少年体育运动。

在足球场上，布罗迪以强悍著称。他的父亲，一位身材高大的前足球运动员，说他在儿子与尤文氏肉瘤长达19个月的残酷斗争中，才真正见识到儿子的坚韧。

即使癌症已经扩散到他全身，布罗迪仍然在为未来做打算，他更关心别人而不是自己。“他说，‘我很高兴是我，而不是我的弟弟妹妹，’”达斯汀回忆道，说着便捂住了脸。

“我常说，足球并不能塑造性格，它只会揭示性格，”他说。“布罗迪与癌症的抗争，让我深有同感。它展现了他内在的为人。”

布罗迪于三月份去世，年仅 17 岁。对于一些居民来说，他的去世标志着社区的悲痛转变为对答案的诉求。

尽管布莱恩·道尔顿一家搬到了另一个州，但他还是在 7 月份飞回拉德拉牧场，与马特森一家和其他患有这种罕见癌症的孩子的家长一起，在拉德拉牧场市政厅会议上呼吁给出答案。政府代表、公共卫生部门和业主协会都出席了会议。

“我不想再看到另一个父亲站在我今天的位置上，”布莱恩对在场的人说。“请不要让莉莉的故事就此结束。让她的故事成为我们要求真相的理由。”

焦虑打破了郊区的宁静，从社区的用水和杀虫剂使用到地下的废弃油井，各种问题都涌现出来。

很快，这些问题就从市政厅会议和 Facebook 群组扩展到了公共卫生机构、环境监管机构和民选官员，促使他们做出回应。

7 月，美国第一助理检察官比拉尔·埃萨利要求环境保护署确定环境因素是否可能导致拉德拉牧场“儿童癌症的异常聚集”，以及是否存在任何违法行为。

专家表示，目前尚不清楚是否存在任何环境因素会导致尤文氏肉瘤，确定这一点需要多年的持续研究。

加州公共卫生部癌症登记处现在正试图回答第一个问题：拉德拉牧场的癌症病例数量是否真的异常多？

州政府的审查结果预计将于今年秋季公布，但该机构提醒，即使审查发现癌症发病模式异常，单凭审查本身也无法确定癌症是否由环境因素引起。目前，州政府表示尚未在该地区发现任何“直接环境危害”。

加州目前对拉德拉牧场的审查是在 2024 年的一次评估之后进行的，该评估发现该县没有出现异常的癌症模式，尽管州政府官员表示，可用的数据有限，而且没有专门针对拉德拉牧场。

“居民们担心他们的孩子玩耍、运动，以及他们一生中大部分时间居住的地方需要安全健康，这是理所当然的，”橙县监事卡特里娜·弗利说道，她敦促州卫生官员加快审查速度。

本月，在拉德拉的一个公园里，布罗迪的父亲看到志愿者研究人员戴着乳胶手套，拿着铲子分散在草地上。他们正在采集土壤和水样，放入贴有标签的无菌塑料杯中，寻找任何潜藏在那里的异常物质。

达斯汀表示，他希望这些努力能够找到答案。

但即便在得出结论之前，拉德拉牧场居民表示，他们已经向当地机构施压，要求其开始采取预防措施。社区业主协会和卡皮斯特拉诺联合学区都在审查期间暂停了在高使用率区域使用某些杀虫剂和除草剂。

朱莉娅·瓦格斯·琼斯/CNN

布莱恩说：“如果环境因素，包括杀虫剂或其他任何因素，有可能造成这种情况，那么这些可能性就值得进行彻底、透明、独立的调查。”

该社区是全国范围内对化学品、杀虫剂和其他环境暴露持怀疑态度的趋势的一部分。这种趋势的一部分就包括不等到有证据证明有害就减少潜在的有害暴露。

加州公共卫生部明确表示，目前尚不清楚拉德拉牧场是否存在农药或其他化学物质造成的暴露风险。

但由于杀虫剂是居民们最关心的问题之一，州政府官员表示，他们的评估将专门研究与接触杀虫剂相关的癌症类型，“并询问这些癌症在拉德拉牧场的发生频率是否高于预期”。

寻找答案的过程与当地另一场正在进行的斗争不谋而合。

早在癌症诊断成为公众关注的几个月前，一个名为“橙县溪流保护队”（Creek Team OC）的小型草根组织就已经开始反对在当地水道喷洒除草剂，他们认为化学物质正在破坏溪流生态系统。在公众的强烈抗议下，橙县暂停了全县范围内的泄洪道除草剂喷洒，同时官员们正在评估清除植被的最安全方法。

在一个阳光明媚的八月下午，该组织的创始人布伦特·利纳斯站在距离拉德拉牧场 5 英里的圣胡安溪前，指出河道附近缺乏植物。

“这条有毒的小溪里流下来的除草剂太多了，这里什么都长不出来，但从来没有人质疑过这一点，”利纳斯说。CNN无法独立核实这些说法。

利纳斯说，直到他在 Instagram 账号上点名批评当地领导人，并积极要求他们给出解释之后，才取得了真正的进展。

梅根·马特森的儿子布罗迪最近去世了。为了寻找答案，她参加了溪流团队的一次会议，并带上了她精心整理的笔记本，上面记录着她所在社区里哪些人患了哪些类型的癌症。团队成员们非常乐意提供帮助。

农药成为社区认为值得调查的几种可能解释之一，并且很快在拉德拉牧场的谈话、社交媒体帖子和当地会议中获得了支持。

该社区的业主协会——拉德拉牧场维护公司（Ladera Ranch Maintenance Corporation）在一份声明中告诉CNN，他们于5月份注意到居民对此日益关注，并暂停使用某些合成园林绿化产品。在9月9日的会议上，董事会批准进一步减少园林绿化中合成杀虫剂的使用，并扩大了不使用常规合成杀虫剂的维护区域。

专家表示，在科学家能够确定杀虫剂、饮用水或任何其他环境因素是否可能发挥了作用之前，他们首先必须回答一个更基本的问题：与拉德拉牧场的人口规模相比，癌症病例的数量是否真的异常多？

加州公共卫生部告诉 CNN，1999 年至 2023 年间，拉德拉牧场确诊的尤文氏肉瘤病例“不足 11 例”，但由于保密规定，无法公布更具体的数字。

“问题在于这些癌症非常罕见，像南加州大学流行病学博士项目主任约瑟夫·利奥·维梅尔斯说，如此规模的社区真的不会期望每年或每隔几年就出现一例病例。”

十年或稍长一段时间内出现七八例尤文氏肉瘤病例，听起来可能数量不多，但他补充说：“这比你根据这个规模的社区所预期的要多。”

维梅尔斯希望对全州进行进一步分析，最终帮助评估拉德拉牧场是否发生了什么异常情况。

但即使研究人员确定癌症发病率异常高，维梅尔斯也警告说，可能永远不会有确切的解释。

他说，几个月来，居民们一直联系他，希望能得到答案，但要证明某种特定的环境暴露导致了罕见的癌症，可能非常困难。

维梅尔斯也对仓促地将此事与杀虫剂联系起来持怀疑态度。

“我不会仅仅因为其他关于尤文氏肉瘤的研究中没有发现杀虫剂是强风险因素就将责任归咎于杀虫剂，”他说。“如果它是强风险因素，我们很可能在其他有类似居民使用杀虫剂的社区也能看到这种情况。”

维梅尔斯表示，将任何类型的环境化学物质与尤文氏肉瘤联系起来的证据“非常薄弱”。巧合也可能是造成病例聚集的一种解释。“重要的是要明白，即使接触杀虫剂使尤文氏肉瘤的发病率增加了一倍或两倍，也不太可能导致病例聚集。”

流行病学家指出，内华达州法伦市的一项针对儿童白血病病例群的研究表明，可能存在传染联系，但尽管花费了数百万美元调查此事，仍未找到导致这种不寻常模式的确切原因。

“一般来说，对于癌症，我首先想到的是：‘他们呼吸的空气里有什么，他们喝的水里有什么，他们吃的食物里有什么？’”约翰·霍普金斯大学彭博公共卫生学院环境健康与工程教授梅根·拉特肖说道。

她继续说道：“谁住在空气中有毒排放物被风吹到一定半径范围内？孩子们玩的玩具里有什么？我们房子里的建筑材料里又有什么？”她承认，这些问题确实令人抓狂。

但癌症很少是由单一原因造成的。拉特肖说，接触致癌物对那些本身就携带致癌基因的人来说，就像是“双重打击”。

“癌症的发生需要时间，”她说。“一次DNA突变……你可能好几年都不会注意到有什么变化。”

这种复杂性使得很难将任何一个单一因素单独分离出来。

虽然导致尤文氏肉瘤的基因变化已经为人所知，但这些变化的原因仍然不清楚。

与许多与肥胖或吸烟等风险因素相关的成人癌症不同，大多数儿童癌症通常没有太多已知的风险因素。

然而，不确定性并不一定意味着不采取行动。拉特肖表示，公共卫生官员通常会遵循预防原则，即使在没有确凿的危害证据之前，也会在可行的情况下减少潜在的暴露风险。

“应该没什么坏处吧？”她说道。“杀虫剂是有毒的。它们被发明出来就是为了破坏生物体内的某些细胞功能。所以，无论杀虫剂是否会导致某种异常的癌症模式，减少杀虫剂的使用都是一件非常好的事情。”

据拉德拉健康观察组织（Ladera Health Watch）的组织者之一杰基·弗伦奇（Jackie French）称，随着社区提出的问题越来越多，一个团体开始推动记录任何可能导致社区患癌的因素。

他们开始深入调查有关杀虫剂和园林绿化做法的问题，并对人行道下废弃的油井表示担忧，他们担心该油井可能没有得到妥善的重新密封。

该组织致函州政府官员，要求评估油井的完整性。加州地质能源管理部门于 8 月 31 日进行了检查，未发现任何泄漏或排放。加州自然资源保护部门的一位发言人告诉 CNN。

居民们对郊区水质的询问也得到了当地公用事业公司的回应。

为拉德拉牧场供水的圣玛格丽塔水务区表示，他们理解居民的担忧，但指出每年进行超过3万次水质检测，饮用水“符合甚至超过所有州和联邦法规”。该水务区表示，他们没有发现饮用水与癌症之间存在任何关联。

弗伦奇表示，居民们觉得他们无法无限期地等待官方调查结果。家长们已经在担心下一个被确诊的人会是谁。

“这真的让我深受触动，”弗伦奇说。“我们不能再等了。我们不能再等一年，让政府机构来调查到底发生了什么。我们必须自己来做。”

接听电话的人之一是詹妮弗·皮亚扎，她是加州州立大学富勒顿分校的公共卫生研究员，也住在拉德拉牧场。

出于对邻居和自己家人的关心，皮亚扎组建了一支多学科研究团队，其中包括化学家、地理学家、公共卫生专家、空气和水污染专家以及癌症流行病学家，这反映了居民们试图解答的各种问题。

上周，她来到公园，当时研究人员正在郊区采集土壤和水样，分析其中的重金属，包括铅、砷、铬和杀虫剂化合物。

皮亚扎表示，目标不是证明某个特定的理论，而是确定是否存在任何不寻常的情况。

农药管理部门和奥兰治县农业专员这两个机构也在审查当地农药使用情况，以查找任何可能的违规行为。

拉德拉健康观察组织在早期就试图获取记录，以显示喷洒了哪些杀虫剂、在哪里喷洒以及喷洒了多少，但弗伦奇说，在这些案件成为头条新闻之前，很多细节都很难获得。

她补充说，目前仍在继续努力获取有关农药使用量的信息。

该组织很快发现，社区的公园、景观和公共区域有多少责任都落在了私人组织身上。

拉德拉的公园和运动场虽然感觉像是公共空间，但实际上由一个私人业主协会管理。拉德拉牧场维护公司由社区代表和一位没有投票权的总经理共同管理。

“这就像一个黑匣子，”她这样形容居民们在试图收集信息时遇到的系统。

该协会告诉 CNN，除了在听取了各方担忧后暂停使用某些合成除草剂和植物生长调节剂外，该协会还成立了一个居民咨询委员会，审查常规使用合成杀虫剂的替代方案，并与县和州官员保持联系。

一项试点计划——弗兰奇表示，她通过外部拨款帮助启动了这项计划——也在研究有机害虫和杂草控制方案。

橙县监事福雷表示，政府默认情况下无法获取与拉德拉牧场等社区的农药购买记录、培训材料和其他内部文件，这可能会成为一个障碍。

“私人业主协会和私人承包商存在问责问题，因为与公共机构不同，我们无法查阅他们的合同，”弗利说。

“获取这些信息的唯一途径是通过调查程序，”弗利说。

福莱表示，县政府官员不能简单地禁止在私人管理的社区中使用杀虫剂，因为监管杀虫剂的大部分权力属于州政府，而对可能违规行为的调查则通过单独的监管程序进行。

这意味着没有一个单一的办公室、机构或组织能够解决居民的担忧，而是由多个机构拼凑而成，责任分散。

对于道尔顿一家和马特森一家来说，他们的孩子经历了与癌症的残酷斗争，乐观情绪逐渐被悲痛所取代，如今的斗争是为了获得更多信息。

“当你的孩子患上这种罕见的癌症时，你不仅感觉自己是在与癌症作斗争，还感觉自己是在与缺乏关于癌症的信息作斗争，”布莱恩说。

米歇尔·阿伯克龙比/CNN

布罗迪的父亲说，这不仅仅是杀虫剂、水或任何单一原因造成的。

他说：“我们相信，如果我们能找出造成这种情况的原因，我们就能解决问题并继续前进。”

这个月，布罗迪的父母和兄弟姐妹们决定为他庆祝生日。他们纹了相同的纹身，就像布罗迪生前计划的那样，如果他能战胜癌症的话。

这是他们纪念这个总是先人后己的男孩的方式。

布莱恩一直致力于提高人们对尤文氏肉瘤的认识。他说，莉莉临终前嘱咐他要告诉所有人，她并没有输给癌症。“这是一场平局，因为癌症随着她的离世而消亡。”他说。