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The brain cancer that keeps killing baseball players

 
A moment of silence to honor former Florida Marlins catcher Darren Daulton before the start of a game against the Colorado Rockies at Marlins Park in Miami on Friday, Aug. 11, 2017. (David Santiago/El Nuevo Herald/TNS) 1208664
A moment of silence to honor former Florida Marlins catcher Darren Daulton before the start of a game against the Colorado Rockies at Marlins Park in Miami on Friday, Aug. 11, 2017. (David Santiago/El Nuevo Herald/TNS) 1208664
Published Aug. 14, 2017

PHILADELPHIA — Since Darren Daulton succumbed to brain cancer on Aug. 6, heartfelt tributes have honored the way he led a raucous Philadelphia Phillies team to the World Series in 1993.

And unanswered questions have surfaced about the way he died.

Daulton, a longtime Clearwater resident, and several prominent contemporaries in baseball — including at least three other Phillies who played at Veterans Stadium, the team's home from 1971 to 2003 — have died of glioblastoma, according to news media accounts. It is considered the most aggressive and frequently diagnosed form of malignant brain tumor.

Researchers who have examined the baseball cases for years say there is insufficient evidence to determine whether they represent anything more than coincidence. Possible cancer clusters are notoriously hard to prove. Most of the time, upon rigorous examination, no cause can be identified and the cases are considered random.

"There is almost never an explanation for them," said Timothy R. Rebbeck, a cancer epidemiologist at Harvard and the Dana-Farber Cancer Institute who has studied the Phillies cases.

Still, Phillies from that era are curious, some even unnerved, about whether there is any connection between brain cancer and baseball. In particular, they wonder if there is any association with Veterans Stadium, which was built on marshland and was demolished in 2004.

"I'm concerned about it," said Larry Bowa, the Phillies' bench coach, who joined the team as a player in 1970 and has spent much of his professional career here as a shortstop, manager and coach. "It raises your eyebrows, no question. It's sort of scary."

Larry Andersen, who pitched for Philadelphia in the 1983 and 1993 World Series and is now a radio commentator for the team, said: "You can't help but think about it. It would be nice if there were some answers, if nothing else for going forward. But nobody knows anything. It's frustrating."

They spoke Thursday as the Phillies played their first home game since Daulton died. His No. 10 jersey hung in the dugout at Citizens Bank Park. Before a moment of silence, the public address announcer told the crowd that Daulton, a three-time All-Star catcher, had "battled valiantly against the illness that took him far too young" at age 55.

It was impossible not to think about what had caused Daulton's death and whether there was some unexplained correlation with baseball. But John Kruk, a Phillies television commentator who was Daulton's teammate from 1989 to 1994, said he tried not to let his mind wander in that direction.

"If I thought about it, I'd go crazy," he said.

Other former Phillies who also reportedly died of glioblastoma since 2003 were reliever Tug McGraw at age 59, infielder John Vukovich at 59 and catcher Johnny Oates at 58. Ken Brett, a pitcher who played in Veterans Stadium for one season, died at 55 of a brain cancer that has been identified in some news accounts as glioblastoma.

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That same type of cancer is reported to have claimed the lives of other notable major league players, as well as a manager, from the same era: the Hall of Fame catcher Gary Carter at 57, outfielder Bobby Murcer at 62, reliever Dan Quisenberry at 45 and manager Dick Howser at 51.

Brett, Quisenberry and Howser spent part of their careers in Kansas City, where the baseball park at that time, like Veterans Stadium, had artificial turf. Some former Phillies wonder whether chemicals in those early versions of synthetic turf could have increased the risk of brain cancer, but scientists say they know of no research that supports that theory.

Dr. Cory M. Franklin, a Chicago internist who has written about the cancer cases in baseball, said Major League Baseball and the players' union should enlist epidemiologists and statisticians to examine whether the malignancies were workplace related. He also said that they should create an extensive registry of players and their causes of death.

"I think they should be a little more sensitive to this problem," Franklin said. "There may be more problems like it."

Major League Baseball declined to make Dr. Gary A. Green, its medical director, available for an interview. The players' union also declined to comment.

In 2013, when Daulton learned he had glioblastoma, the Philadelphia Inquirer did an analysis of 533 players who wore a Phillies uniform during the 33 seasons the team played at Veterans Stadium. The brain cancers of Daulton, McGraw, Vukovich and Oates appeared to represent an occurrence that was about three times the rate of the general male population, the analysis concluded. But the study had limitations related to adjusting for age and yearly cancer rates.

Rebbeck, the Harvard epidemiologist, was then at the University of Pennsylvania, and he assisted in the study. He told the Inquirer that the seemingly elevated risk to baseball players could have resulted from chance.

In an interview after Daulton's death, Rebbeck said scientists still did not know much more. "It's either just random chance bad luck or there is something there, but we just don't have the science to pick it out yet," he said.

The baseball deaths fit within established patterns in the general population: Glioblastoma is more common among men than women, and the risk increases with age. The scrutinized baseball deaths have occurred within the highest-risk age range of 45-70, according to the American Association of Neurological Surgeons. An estimated 12,390 new cases of the cancer were expected this year, according to the American Brain Tumor Association.

Researchers also note that while the players' cancers have been identified as glioblastomas in news media accounts, all may not, in fact, have been identical tumors. Many other variables make it difficult to make a connection between baseball and brain cancer.

Among the former Phillies who died, not all played together at Veterans Stadium or remained with the team for the same length of time. The Philadelphia Eagles played and often practiced in the stadium, on the same artificial surface, but the NFL team has reported no unusual occurrence of brain cancer.

"Can I tell you definitely there is no relationship between baseball and brain tumor formation? No, nobody can do that," said Dr. Henry S. Friedman, a neuro-oncologist at Duke University who treated McGraw and Carter.

"But," he added, "can I tell you definitively that there is a relationship, that there is something about baseball and the formation in their players of brain tumors? No."

There is simply not enough data "by a long shot," Friedman said, to make any observation other than that "there is seemingly a large number of brain tumors in patients who have played professional baseball. Beyond that, nobody really knows if there is a connection. And nobody would have an easy means of proving a connection."

Melissa L. Bondy, a brain tumor epidemiologist at the Baylor College of Medicine in Houston, said that the deaths of the former Phillies players seemed "to be beyond a coincidence," but that until more research was done, "we don't know for sure."

Still, Daulton's death from glioblastoma has renewed speculation about the possibility of baseball-related causes like concussions, chewing tobacco and pesticides. But no definitive link has been made between these things and brain cancer, scientists said.

In 2009, Daulton told a radio interviewer, "There's probably no one in any sport that has taken more drugs than I have."

But he did not name the drugs. And there has been no authoritative connection, for instance, between muscle-building anabolic steroids and brain cancer.

"I think Darren's passing has created a conversation," said Jennifer Brusstar, the president and chief executive of the Tug McGraw Foundation. Her husband, Warren, pitched for the Phillies from 1977 to 1982.

"Let's look into this and see if there is anything" connecting baseball and cancer, she said. "If there's not, let's move on."

Mickey Morandini, the Phillies' first-base coach, who played in the 1993 World Series with the team, said that, like others, he wondered about any possible correlation. But, if the cancers ever proved to be anything more than coincidence, he said, "I don't know if I'd rather know or not."