The tiny rural community of Sabine County leads the world in few things. It has been voted time after time as one of the world's best bass fisheries, and also has one of state's highest unemployment rates.
The red dirt roads that snake through the evergreen pine forests and murky bayous are home to people who often revel at living a quiet, unassuming country life. However, another invisible entity lurking in the shadows is literally eating away at the community, giving the county another rather dark claim at being superlative.
Sabine County has the highest rate of cancer of any county in Texas, according to data compiled by the Texas Cancer Registry.
According to the state entity, Sabine County's crude rate of cancer is 859.9 per 100,000. That's based on data compiled from 2011 to 2015, the most recent years for which data is available. That's more than double the statewide rate of 410.5 per 100,000 for the same time period.
However when Daily News contacted the Cancer Registry, they noted another rate might give a more accurate representation of how much cancer there is in the community: the age-adjusted rate of cancer.
"The age adjusted rate allows us to compare the rates of cancer between areas with greater accuracy," Texas Cancer Registry spokesperson Lara Anton said. "The age adjustment enables us to compare an area with mostly younger people to an area with a larger population of older people. In an area with a higher number of older people, we would expect to see a higher number of people diagnosed with cancer."
Sabine County, a certified retirement community, is known for advertising to older populations. However, even factoring for age, the cancer rate is high. Sabine County has the seventh-highest age-adjusted rate of cancer, at 482.1 per 100,000 people.
Both rates are reflected for a grand total of 449 cases from 2011 to 2015.
Despite these high numbers state officials told Daily News that there has not been a cancer cluster investigation of the community for one reason: no one's asked.
Anton told Daily News that most investigations are initiated after a request from the public.
One of the Cancer Registry's more recent investigations stretched up to the Sabine County line in 2016.
The agency's report on the cancer cluster investigation of Shelby County in 2016 indicates that state investigated in three census blocks of Shelby County that stretch from the town of Center, down to the entire shared border with Sabine County, and a great portion of the shared border with San Augustine County.
According to the report, data from 2000 to 2013 was analyzed for the report and 112 cases of breast cancer, 19 cases of leukemia, and 164 cases of lung cancer were noted.
"Observed numbers of two of the cancers analyzed were statistically significantly less than expected, while one was within the range expected, based on cancer rates in Texas," the report noted.
The report went on to explain how investigations of potential cancer clusters are limited.
"The assessment step in a cancer cluster investigation has several inherent limitations, and results should be interpreted with these limitations in mind," the report reads. "Cancer is not a single disease, but rather many different diseases. Different types of cancers vary in etiologies (causes or origins) and may not share the same predisposing factors. Cancers may be associated with a variety of factors such as genetics, lifestyle, and socioeconomic status. Because cancer is common, cases might appear to occur with alarming frequencies within a community even when the number of cases is within the expected rate for the population."
Other factors should also be considered.
"Additionally, cancer incidence data are based on residence at the time of diagnosis," the report notes. "As people move, it becomes more difficult to determine whether living in the area of investigation is associated with an excess of cancers, because residential history is not tracked. Latency (the time period elapsed between exposure and illness onset) adds to the complexity of this step in the investigation. For most adult cancers, a period of 10 to 40 years can elapse between the beginning of an exposure to a cancer-causing agent and the development of a clinically diagnosable case of cancer. It is possible that former residents who developed cancer no longer lived in the area at the time of diagnosis, and these cases would not be included in this assessment. It is also possible that new people have moved into the area and then were diagnosed with cancer; these cases are included in this assessment."
Sharon Yonts is one of the people who falls into the category of someone who once lived in Sabine County, but moved away, before the battle for her life was set to begin. She still lives in a nearby community in East Texas.
Yonts lived in Sabine County for many years into her mid 30s. Over the years, she had watched family members and friends battle cancer of many different types. It was some out-of-place bleeding from the bum that sent her to the Sabine County Hospital one day, more than three years ago.
She went to Nacogdoches Hospital afterward for a colonoscopy. The next day, nearly a foot of her colon was removed.
"'I said you're kidding me right?'" Yonts said of her diagnosis. "You're thinking that you are going to die... When he told me the cancer word I just burst out in tears in my office. It was really, really scary."
But the stage 2 cancer was contained to what doctors removed from her during surgery. Chemotherapy followed.
"The chemo itself with make you feel like you are dying," Yonts said.
After seven rounds Yonts was declared cancer-free. It's been three years since that fateful day.
Yonts said she'd watched family members and friends also go through the disease and lose the fight.
"I watched them wither away to nothing," Yonts said. "He was down to a fifty pound man."
Another individual was rendered so weak they couldn't hold themselves up.
"You get survivor's guilt big time," Yonts said.
A support system is necessary to make it through, she said.
"You've definitely got to have somebody there to help you through that," Yonts said. "Moral support is just wonderful."
Yonts also credits a higher power to helping her through to recovery.
"I was never so grateful that I lived through it," Yonts said. "I don't worry about it. I don't think about it, but it's always in the back of my mind. There's a percent chance it could come back. I've prayed to God the whole time.If I didn't have God on my side I don't know what I would have done."
Yonts encourages others to go to the doctor at any sign something might be off.
"Get checked early. You never know," Yonts said. "No body's not susceptible to cancer."
Recent cases in the community have shown the truth in that statement. Last year the community rallied around Carmen Sanchez, the friendly Family Dollar worker whose insurance would not cover the cost of chemotherapy after she had more than a dozen tumors removed from her breast. The cancer was rather aggressive at a stage 3.
More than $9,000 was raised for Sanchez.
More recently, Hemphill Middle schoolers have started selling t-shirts to help support the cancer treatments of their classmate, Skyler Easterling, 14. Skyler underwent surgery in June and is currently under treatment.
The list of stories are numerous. This summer Daily News received reports of children selling lemonade to help grandmothers pay for treatment and newlywed former college football players being stricken with the disease.
This article was Published by Daily News in late October 2018-re-posted by request of residents of Sabine County. Written by Megan Strickland