Environment Committee on June 11th, 2009

[Dr. John O'Connor]

I've had some discussions with some experts outside Alberta as to how this could be tackled, simply because the window of opportunity for a base line is long gone. There are some suggestions that there be a presumption that the community was healthy to begin with. One thing, which may not be a major factor, is that the community never had a word for cancer; it didn't exist in their vocabulary. Now they have. There's a Cree and a Chip name for it.

The presumption of health is one thing. The assumption going into this that there either is a contribution to the ill health of the community from industry, wherever it be, or there is not is a major question that needs to be answered first. It's such a complicated issue that I couldn't do it justice with the time we have here.

[The Chair, Conservative, James Bezan]

Thank you very much.

Thank you, Ms. Duncan.

Mr. Warawa, you have the last of the seven-minute round.

[Mark Warawa, Conservative, Langley, BC]

Thank you, Chair.

Thank you, Dr. O'Connor, and both witnesses, for being here.

I'm going to focus my questions to Dr. O'Connor.

Dr. O'Connor, what are your qualifications?

[Dr. John O'Connor]

My exact qualifications are Bachelor of Medicine, Bachelor of Obstetrics, and Bachelor of Surgery, and I have the LMCC from the federal licensing board.

[Mark Warawa, Conservative, Langley, BC]

Thank you. You described yourself as a family physician, a health advocate, and during the testimony this morning you said you also describe yourself as an activist.

[Dr. John O'Connor]

I've been labelled as that.

[Mark Warawa, Conservative, Langley, BC]

Okay.

You reported that in 2002-03 you were very sure you saw six cases of cholangiocarcinoma in Fort Chipewyan. Is that correct?

[Dr. John O'Connor]

From 2002 to 2005.

[Mark Warawa, Conservative, Langley, BC]

So you saw your first cases between 2002 and 2003?

[Dr. John O'Connor]

That's right.

[Mark Warawa, Conservative, Langley, BC]

Did you do a study?

[Dr. John O'Connor]

No, I didn't do a study.

[Mark Warawa, Conservative, Langley, BC]

Do you still believe you saw six cases of cholangiocarcinoma?

[Dr. John O'Connor]

Since the documentation has been looked at in more depth, what I suspected...I must give you a bit of background.

Cholangiocarcinoma is a difficult diagnosis to make. It comes on very quickly. Frequently, the very first symptom and sign is that the patient presents jaundice, and they usually have a history of feeling tired. At that point, it's very often too late. So we rely on diagnostic imaging by CT, MRI, and ultrasound. Frequently the patients are too ill to be biopsied. So on the basis of the clinical picture, the picture built up by the tests we can do or manage to put together, and with experience—and, in the end, an educated guess, which is part of the art of medicine—my presumption at that point was that we were at least dealing with a biliary tract cancer, possibly into the pancreas. There was not a lot of pain, and painless progressive jaundice is something that can be a very distinct hallmark of this type of cancer. So my presumption at that point was that it was at least biliary tract cancer, if not cholangiocarcinoma.

[Mark Warawa, Conservative, Langley, BC]

Do you agree with the results reported in the study just released this year, indicating that there were in fact only two cases of cholangiocarcinoma?

[Dr. John O'Connor]

There were two males who were biopsied. Along the way—back in 2006, actually—Alberta Health revealed a third case, a female, whom none of us knew, but they were adamant this lady came from Fort Chip. So we accepted there were three cases. She seems to have disappeared. The three other cases were biliary tract cancers, presenting exactly like bile duct cancers.

So at this point, yes, I'm accepting there were three documented cases of cholangiocarcinoma and three cases of biliary tract cancer. Unfortunately, the latter were not well enough to be biopsied. So in the end, there is a question.

[Mark Warawa, Conservative, Langley, BC]

So the report identified two cases and you're saying there were three cases.

[Dr. John O'Connor]

Well, going on the documentation presented to us, there is some difference of opinion between Alberta Health and the Alberta Cancer Board.

[Mark Warawa, Conservative, Langley, BC]

You've just come back from a trip to the Scandinavian countries. You were with Greenpeace. Is that correct?

[Dr. John O'Connor]

I was with Greenpeace, the Lubicon Cree representative from Alberta and, actually, Andrew Nikiforuk.

[Mark Warawa, Conservative, Langley, BC]

What was the purpose of that trip?

[Dr. John O'Connor]

I wanted to continue to advocate for my patients in Fort Chip. I wanted to be part of the process of informing people in Scandinavia of exactly what's happening; I basically told my story.

One of the things that's been a hallmark of this process in northern Alberta is that there's been no action or reaction from government unless media were involved.

Actually, in 2006, the mother of Brian Jean, the Conservative MP, alerted CBC of her concerns for the health of the people at Fort Chip, and CBC were told to approach me.

[Mark Warawa, Conservative, Langley, BC]

Sorry for interrupting you, Doctor, but I want to get back on...because my time is limited.

So you went on a trip to the Scandinavian countries with Greenpeace. I did some research to find out what you've been doing since 2007 when you left Fort Chipewyan, and it's reported by Tar Sands Watch that you just came back on May 26.

[Dr. John O'Connor]

That's right.

[Mark Warawa, Conservative, Langley, BC]

It says that “Greenpeace capped the campaign by using its four shares in StatoilHydro to put forward a motion that the company withdraw its investments in the oilsands”.

You made a comment earlier that you were going to see this through no matter what.