Table 3 Thyroid Tumor Diagnoses at Surgery (through 1987)* 19 (28.4) 4 (22.1) 15 (9.0) Unexposed (227)°°"* 5 (2.4) 5.(7.5) 4. (2.4) 2.0.8) - *Modafied from Adamset al. 1989 (A-19) **"Noes not include occult cancers, which are not considered clirucally significant ***'ncjudes in utero exposed persona ****!nejudes all unexposed persons in the regular comparison group since 1957 emphasized for the lifetime of the Rongelap peooie. It is encouraging that the development ofthyroid tumors appearsto be declining, that none of the thyroid cancers spread beyond the neck area. and none recurred or resulted in death ‘A-19). However, although the radiation-induced tumors, have not been lethal, the people In a recent report, Adamslists additional cases of cancer of various organs in both the exposed and unexposed populations (A-19). However, he observed no increase in cancer mortality in the exposed compared with the unexposed Marshallese population. Concern has been voiced about the present-day radiological safety of habitation on Rongelap Island. have suffered considerable adverse conse- one of the nerves‘in the neckin orte case: also. the widespréad developmiént bfhypoftinct! nof Adamsreported that prolonged habitation of _ ¢ationfor their.. 'requires tHedi the thyroid glund Be pei ad +t. ’ lifetinonre. o 1s shin fe In 1972, a 19-year-old ongelap inan”’ the unexposed Marshallese on Rongelap Island from 1957 to 1985 has not resulted in any shortening of life expectancy related to cancer nor in any increasein thyroid tumors (A-19, 56). yp Over the years the medicaj.teams haveidiag- ' nosed and treated many diseasesnet.related to: radiation exposure, particularly themiddle-age: a ao quences of the tumors, such as surgical procedures under general anesthesia with its attendant risks, inadvertent injury to the parathyroid gland ii n two cases, and effect on tee =xposea*** Rongeiap (67) Aulingnae (19) Utarik (167) Cancers (%)** hee Non-Malignant (%) —_— Group (No.) onset type of diabates, which is common in the . Marshallese peopleand.a,Jeading causeof : exposed at one year df'age, developed acute _ __, death. Asa result, advice about the disaase and : myelogenous leukemia and,inspit®‘ofextensive its treatment has been passed on to the extensive irradiation of the skin and prevalence of skin burns shortly after exposure in the Rongelap people, only one case of low-grade can- cer of the skin has developed in an area of previous beta burn (A-19). Three exposed women developed brain tumors. Two (pituitary tumors), which were successfully treated, could have been due to radiation injury to the thyroid gland. The third woman had a meningioma which proved fatal (A-19). It is uncertain if this tumor was reiated to radiation exposure. 24 Soguy 15 About one-third of the people in the originai © examination groups are still living. It is important that continued examinations be carried out for their lifetime since further late effects of radiation exposure might develop. &, Human Interest Relations 1. In the Islands On ourvisits to the islands, the medical teams enjoyed pleasant associations with the Marshallese peopie and learned to appreciate their lifestyle and culture. Lifelong friendships were established. When we arrived on the island, the people gathered on the beach and greeted us warmly, placing fragrant leis around our necks. Membersof themedical team some- times joined the Marshallese in softball and B aeCe | Follow-up examinations of the beta burns of the skin showed only minimal scarring and pigment changes in a few cases. In spite of the Marshailese medical personnei. Bs treatmentat the Clinical Center at the National] Institutes of Health, he died several months later (A- 14). It is likely thathisleukemia was related to radiation exposure.