OCEANSIDE — Connie Smith lives with the horrifying thought that in trying to make a better life for her family, she may have put her son in the remorseless grip of cancer.
Six months after the Smith family moved to this seaside suburb north of San Diego, 1-year-old Kenneth Smith Jr., known simply as Junior, fell mysteriously ill and was diagnosed with acute lymphoblastic leukemia, which kills more children than any other disease in America.
As Junior began treatments, Smith met other parents of cancer-stricken children and together they discovered a startling fact that had gone undetected by doctors: An unusually large number of Oceanside-area children had been discovered to have leukemia about the same time.
Choosing to fight rather than grieve, Smith and the other parents banded together to persuade public health officials that they had discovered a cancer cluster in Oceanside and urge an investigation into the cause.
"There are a lot of babies getting sick and I don't like it," said Connie Smith. "My son is already sick but maybe there are other babies that we can help save if can we find out what's causing this."
Although cancer is common, clusters are not. The Oceanside cluster, now being probed by county and state health investigators, is one of only a handful of cancer clusters discovered in California in the last 30 years.
"We don't want to panic anyone but we want answers," said Charlotte Barry, whose daughter, Laura, is undergoing chemotherapy.
For Connie Smith and her husband, Kenneth, the unlikely road to becoming public health activists began two years ago when they decided to leave the community of Signal Hill near Long Beach. "I didn't want my kids to die in a drive-by shooting," Connie Smith said.
The family moved to a small apartment in a tidy corner of Oceanside. Kenneth was willing to endure the long commute to his job in Los Angeles as an oil company mechanic so that Junior and his sister, Kristian, 6, could grow up safely.
In Oceanside, Junior developed an unshakable cough, began to bruise easily and became chronically tired and cranky. Distraught and frantic for explanations for her son's sudden decline, his mother accused a baby-sitter of mistreating him.
After being found to have leukemia, Junior began rigorous treatment at Childrens Hospital in San Diego, one of the nation's leading hospitals for treating childhood cancer. During the many hours at the hospital's hematology unit, Connie Smith began talking to other mothers of children undergoing leukemia treatment.
None of the women had known one another before their children began undergoing the anti-cancer therapies that are part of a leukemia patient's daily rigors.
But Connie Smith, Charlotte Barry, Maryanne Smith, Linda Cotov and others began to suspect that there were an unusually high number of childhood leukemia cases in the area where they lived. The area, which has an approximate five-mile radius, includes the northeast section of Oceanside and adjoining parts of Vista and Bonsall.
Connie Smith and the others compiled a list of neighborhood children who were sick with leukemia and, after finding the public health agencies unresponsive, they took their list and their plea for help to the local media.
"We know God is protecting Hank, but if we can do something to help protect other children, that would be great," said Maryanne Smith, whose son, Hank, needs a bone marrow transplant.
The public health system has concluded that the mothers were right: Seven children under the age of 3 were found to have leukemia during the middle months of 1993, a rate two to three times higher than the national average for the disease, a rate high enough to be considered a cluster.
In medical circles, there is considerable disagreement about cancer clusters and whether a cluster's existence is anything more than a statistical anomaly, a random event. Some researchers even assert that it is medical folly to look for causes and that cluster investigations only cruelly raise the expectations of cancer patients and their families.
Experts from the San Diego County and California health departments, although committed to an investigation, have nevertheless warned the parents and press that the chances of pinpointing a cause for the Oceanside cluster are extraordinarily small.
The parents know this but are convinced that something is dreadfully wrong in Oceanside.
"I'm boiling mad but it doesn't do any good to stay mad," said Ernie Haro, whose son, Steven, needs a bone marrow transplant. "Somebody out there has to know something about what is in our soil or in our air that's making our kids sick."
The cluster list compiled by the mothers actually included a dozen children dating to 1991 who had contracted the disease. State and county health officials have limited their cluster investigation to the seven cases from 1993, including one child who died.
The cancer cluster has become the talk of Oceanside.