KENSINGTON, PEI The countryside surrounding this small community near the centre of Prince Edward Island is picture-postcard perfect. Neatly tended farm fields devoted to the island's famed potatoes are interspersed with clapboard homes, imagery seemingly taken straight from the pages of Anne of Green Gables.
It is perhaps because of the province's appearance as a bucolic rural idyll that Ron Matsusaki had the biggest shock of his professional career when he moved to the island three years ago. The affable 57-year-old doctor was taken aback by all the rare cancers he began noticing. The illnesses seemed more like what might be expected near a hazardous waste site.
"Nowhere, nowhere did I see cancer that in any way resembles the cancers that I saw when I came to PEI," Dr. Matsusaki said. "I was totally dumbfounded."
In short order after his arrival, he came across an osteosarcoma that led to the heart-wrenching death of a young girl, several lymphomas, an Ewing's sarcoma, and a number of myeloid leukemia cases, all among children. Brain cancers weren't sparing young and middle-aged adults either, with three of them last year.
Perhaps because he arrived with the fresh eyes of a newcomer, Dr. Matsusaki was sufficiently alarmed that he started to speak out publicly about this rash of unusual cancers and his suspicion that the blame for them lies with one of the island's economic mainstays, potato farming, and its promiscuous use of pesticides.
This view -- that exposure to pesticides and other everyday environmental pollutants is a big source of the cancer epidemic sweeping Canada -- is one of the most controversial subjects in cancer causation. It stands to reason that poisons used to kill bugs and weeds might pose a risk to people, but the research picture linking pesticides to cancer has been mixed.
Many studies, but not all, on the health of residents of farming areas have found associations between crop sprays and cancer. But this research, known as epidemiology or the tracking of disease incidence, is considered less conclusive than the medical evidence on such well-known carcinogens as cigarette smoke, asbestos fibres and radon gas.
Researchers think that about 80 to 90 per cent of all cancers are due to environmental causes broadly defined to include lifestyle factors such as smoking and diet. It's far harder to tease out just how much is due to polluted air, water or food, or to radiation or workplace exposures to cancer-causing substances. One recent estimate of the impact of pollution placed the total cancers due to this factor at about 8 to 16 per cent.
At the high end of the range, this would suggest that about 25,000 people in Canada getting cancer this year might owe their misfortune to pollution.
Prince Edward Island would be a good place to shed more light on the health effects of agricultural chemicals because areas such as Kensington have some of the highest airborne concentrations of pesticides around farm fields in the world, and a sizable rural population literally living on the doorstep of the spraying.
After Dr. Matsusaki began to voice his concerns, the province decided to launch an investigation to check whether Islanders have recently been more afflicted by cancer than people elsewhere in Canada. The Department of Health is expected to make the new cancer review public late this year, says Dr. Linda Van Til, an epidemiologist with the PEI government.
In an e-mailed statement to The Globe, she said previous monitoring by the Canadian Cancer Society and the federal government has found cancer rates on the island are "slightly higher" than the national average, although she added that this may reflect the broader national trend of having more cancers in the East and lower rates in Western Canada.
It is possible the flurry of cancers observed by Dr. Matsusaki has been just an unlucky coincidence. Even with extremely rare cancers, there is always a small statistical probability that a few people living in close proximity to each other will develop them around the same time by chance.
Dr. Matsusaki, nicknamed "Dr. Ron," worked for two decades in the U.S. before returning in 2003 to his native Canada, where he had received his medical training. After a career at hospitals and clinics in Texas, Alabama and Indiana, he was convinced he'd seen everything a doctor might reasonably be expected to come across -- until he came to PEI.
On the island, he's working as an emergency-room physician and on-call doctor at the Western Hospital, a small 25-bed institution serving a farming community of about 14,000 people at the island's western tip. He says one of his first clues that something might be amiss were the two sarcomas, both bone-related cancers, discovered in children within a year of each other in this small population.