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St. Louis doctor pushes for free multi-cancer early detection trial for radioactive waste victims

"This is St. Louis. We are in the Midwest. We make a difference, and we matter."

ST. LOUIS COUNTY, Mo. — For more than 50 years, the Morices' have been by each other's side.

The two are high school sweethearts.

Both Linda and Jim looked at each other and said, "(We met) at McCluer High School in North County. We met our junior in high school and then dated through college."

The two lived and worked near Coldwater Creek.

"No one had any remote idea that there was anything dangerous about that creek that flowed through our neighborhoods," Linda admitted.

The creek she's referencing to is Coldwater Creek, which flows 14.2 miles through north St. Louis County. 

In 1940, the Manhattan Project, an American-led effort during World War II to develop an atomic bomb, was created. The Mallinckrodt Chemical Works plant in St. Louis began processing uranium oxide used by the Manhattan Project.

Waste from the uranium oxide production was taken and stored at a site north of St. Louis Lambert International Airport from 1947 until the late 1960s. The toxic waste was purchased and moved from the airport site to a location half a mile away on Latty Avenue.

However, inappropriate storage of the radioactive from the uranium processing led to leakage. The leakage then contaminated Coldwater Creek.

"There were deaths and illnesses in the neighborhood, it seemed kind of strange," Linda recalled, as she thought about the neighborhood she grew up in.

Linda talked about her dad working near the airport, her mom using vegetables from the possible contaminated grounds, and how children would catch crawdads in the creek.

After her mother died, her uncle called out the strange activity. Linda, a historian, began researching.

It led her to write a book.  

"Interesting information in the book called 'Nuked: Echoes of the Hiroshima Bomb in St. Louis,'" Linda said. 

And her family's ailments didn't end there. 

Her husband Jim is now a two-time cancer survivor. He's still monitoring his health, after years of what he calls 'a roller coaster'.

"I had quite a bit of contact with the affected area," Jim said. 

Jim explained, as a teenager, he was a greenskeeper and there was a creek subsidiary of Coldwater Creek that ran by the golf course.

Then in a later job, he built subdivisions.

"A lot of the dirt came out of the creek and subsidiaries came through," Jim added. 

He was in his 30's when he had severe pain pinching his back. 

Jim went to the doctor. Soon, he realized he had a tumor the size of a baseball close to his kidney.

Jim would go through radiation and later find out, his cancer returned. He did aggressive chemotherapy. 

The cancer survivor said, "While I can’t say with certainty that it was caused by Coldwater Creek, I can certainly have good reason to believe that it was."

His health journey led him to Mercy urologic oncologist Dr. Gautum Agarwal.

Born and raised in St. Louis, Dr. Agarwal came back to the area and began his first job at Mercy. 

Dr. Agarwal started digging, too, after seeing a pattern in his first few years working in 2013.

"A lot of them would say Bridgeton or Florissant or in the area near Coldwater Creek. I started noticing, I’m taking care of a lot of people or neighbors of neighbors," Dr. Agarwal admits.

He believed it was too coincidental and began researching.

"There is enough stuff warranted that there is an exposure there," Dr. Agarwal added. "What I noticed— it was odd that people were young."

He explained that the highest risk for cancer is over 50 or 60 years old. However, some of his patients were in their 30's or 40's.

His curiosity led him to his recent opinion article published in the Journal of American Medical Association. 

This summer, JAMA featured the publication titled 'Advancing Precision Equity With Multicancer Detection Liquid Biopsies'.

The article touched on St. Louis’ history as a critical, but often forgotten, site for uranium processing for the atomic bomb.

The article said, “The emergence of minimally invasive liquid biopsy tests that analyze cell-free DNA (and other emerging biomarkers) to detect cancers early has the potential to help correct decades of injustice in St. Louis and beyond.”

It continued by saying, “The underserved community exposed to this waste may have increased risk of cancers, including lung cancer, bone sarcoma, and leukemia, but public health studies of the community at the time did not recommend cancer screening of residents, likely reflecting limited technologies in a pre-liquid biopsy era.”

Dr. Agarwal said he's even working with his two physician assistants.

"Part of the intake process when we talk to a new patient is 'Are you from the Coldwater Creek area?' because it helps people understand why they got cancer," Dr. Agarwal explained. 

It's also a way to show his passion and latest effort to get a trial to come to St. Louis.

It would offer a free multi-cancer early detection test through a blood test to target high risk and underserved populations.

Usually, this test costs around $900.

"How we can utilize the newest technology in genomics that screen for potential cancers that aren’t normally screened for in high risk populations, and we thought Coldwater Creek area was a great example of a high risk population that doesn’t get normal screening. That will equalize the playing field," the physician added.

The couple that's always been there for each other, also wants to be there for others by sharing a warning and their experience.
   
"Making it a priority and giving people the information to have on their life and health," Linda said. 

For Jim, it's a way to process and cope. 

"It’s a way of managing it in the context of my own life, sharing and talking about it, rather then trying to forget about it or get angry and not talking about it," Jim added. "It shaped my life in a major way."

In order for St. Louis to be selected for the trial, it will rely on funding and location.

Dr. Agarwal said it's important to showcase why St. Louis should be picked.

"This is St. Louis. We are in the Midwest. We make a difference, and we matter," he pointed out.

Dr. Agarwal explained this would be a national trial, enrolling 50,000 people. The goal is to enroll 2,000 people locally, specifically patients who are Medicare eligible.

Dr. Agarwal is hopeful in the next six months, they will have answers to get this trial going.

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