Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

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Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Lawsuit against Madonna dismissed in Russia

ST. PETERSBURG, Russia (AP) — A Russian court has dismissed a lawsuit that sought millions of dollars in damages from Madonna for allegedly traumatizing minors by speaking up for gay rights during a concert in St. Petersburg.

In February, the city made it illegal to promote homosexuality to minors. Six months later, the singer criticized the law on Facebook, then stood up for gay rights at a concert in St. Petersburg that drew fans as young as 12.

On Thursday, a St. Petersburg court threw out the Trade Union of Russian Citizens' lawsuit and the 333 million rubles ($10.7 million) in damages it sought from the performer for allegedly exposing minors to "homosexual propaganda."

Madonna did not attend the trial, and her publicist Liz Rosenberg said Thursday the star wouldn't comment about it.

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Judge to let Hostess liquidation proceed

Hostess Brands Inc. on Wednesday won permission from a U.S. bankruptcy judge to begin shutting down, and expressed optimism it will find new homes for many of its iconic brands, which include Twinkies, Drake's cakes and Wonder Bread.

U.S. Bankruptcy Judge Robert Drain in White Plains, New York authorized management, led by restructuring specialist Gregory Rayburn, to immediately begin efforts to wind down the 82-year-old company, a process expected to take one year.

"It appears clear to me that the debtors have taken the right course in seeking to implement the wind-down plan as promptly as possible," Drain said near the end of a four-hour hearing.

The judge authorized Hostess to begin the liquidation process one day after his last-ditch mediation effort between the Irving, Texas-based company and its striking bakers' union broke down.

Roughly 15,000 workers were expected to lose their jobs immediately, and most of the remaining 3,200 would be let go within four months.

"This is a tragedy, and we're well aware of it," Heather Lennox, a lawyer for Hostess, told the judge. "We are trying to be as sensitive as we can possibly be under the circumstances to the human cost of this."

Lennox said Hostess has received a "flood of inquiries" from potential buyers for several brands that could be sold at auction, and expects initial bidders within a few weeks.

Joshua Scherer, a partner at Perella Weinberg Partners, which is advising Hostess, said the company was in "active dialogue" over its Drake's brand with one "very interested" party that had toured a New Jersey plant on Tuesday.

He said that regional bakeries, national rivals, private equity firms and others have also expressed interest in various brands and that more than 50 nondisclosure agreements have been signed.

"These are iconic brands that people love," Scherer said.

While prospective buyers were not identified at the hearing, bankers have said rivals including Flowers Foods Inc. and Mexico's Grupo Bimbo SAB de CV were likely to be interested in some of the brands.

Representatives of neither company responded on Wednesday to requests for comment.

Scherer said Hostess could be worth $2.3 billion to $2.4 billion in a normal bankruptcy, an amount equal to its annual revenue. It also has about $900 million of secured debt and faces up to about $150 million of administrative claims.

Scherer expects a discount in this case because plants have already been closed and Hostess' value could fall further if the liquidation were dragged out.

"I've had buyers tell me, 'Josh, the longer it takes, the less value I'm going to be able to pay you,' " he said.

Hostess decided to liquidate on Nov. 16, saying it was losing about $1 million per day after the Bakery, Confectionery, Tobacco and Grain Millers Union, representing close to one-third of its workers, went on strike a week earlier.

The bakers union walked out after Drain authorized Hostess to impose pay and benefit cuts, which the International Brotherhood of Teamsters, Hostess' largest union, had accepted.

Hostess has about 33 plants, plus three it decided to close after the strike began, as well as 565 distribution centers and 570 bakery outlet stores.

Many of the 3,200 workers expected to stay on will help shut these properties and prepare them for sale. Hostess expects to need only about 200 employees by late March.

Rayburn, a former chief restructuring officer for the bankrupt phone company WorldCom Inc., said that letting 15,000 workers go now helps preserve their ability to obtain unemployment benefits.

"I need to maximize the value of the estate, but I need to do the best I can for my employees," he said.

Hostess filed for Chapter 11 protection on Jan. 11, its second bankruptcy filing in less than three years.

The case is In re: Hostess Brands Inc. et al, U.S. Bankruptcy Court, Southern District of New York, No. 12-22052.

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4 hurt in extra-alarm fire in senior high-rise

2 hurt in extra-alarm fire in senior high-rise (November 21, 2012)

Staff report

11:09 a.m. CST, November 21, 2012

At least five people have been injured in an extra-alarm fire at a senior citizen high-rise on the West Side this morning, officials said.

The five were taken to the University of Illinois Medical Center, one in serious to critical condition, three in serious to fair condition and the other in fair to good condition, officials said.

The fire broke out around 9:30 a.m. at 1633 W. Madison St., apparently in bedding in an apartment on the 9th floor, officials said.

The fire was under control by 10:10 a.m., according to the Fire Department.

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In HP-Autonomy debacle, many advisers but little good advice

(Reuters) - When Hewlett Packard acquired Autonomy last year for $11.1 billion, some 15 different financial, legal and accounting firms were involved in the transaction -- and none raised a flag about what HP said Tuesday was a major accounting fraud.

HP stunned Wall Street with the allegations about its British software unit and took an $8.8 billion writedown, the latest in a string of reversals for the storied company.

HP Chief Executive Meg Whitman, who was a director at the company at the time of the deal, said the board had relied on accounting firm Deloitte for vetting Autonomy's financials and that KPMG was subsequently hired to audit Deloitte.

HP had many other advisers as well: boutique investment bank Perella Weinberg Partners to serve as its lead adviser, along with Barclays. Banking advisers on both sides of the deal were paid $68.8 million, according to data from Thomson Reuters/Freeman Consulting.

Barclays pocketed the biggest banker fee of the transaction at $18.1 million and Perella was paid $12 million. The company's legal advisers included Gibson, Dunn & Crutcher; Freshfields Bruckhaus Deringer; Drinker Biddle & Reath; and Skadden, Arps, Slate, Meagher & Flom, which advised the board.

On Autonomy's side of the table were Frank Quattrone's Qatalyst Partners, which specializes in tech deals and which picked up $11.6 million.

UBS, Goldman Sachs, Citigroup, JPMorgan Chase and Bank of America were also advising Autonomy and were paid $5.4 million each. Slaughter & May and Morgan Lewis served as the company's legal advisers.

While regulators in the United States and the United Kingdom, as well as the Federal Bureau of Investigation, are likely to spend many months if not years investigating what happened, legal experts said on Tuesday that it wasn't clear if any of the advisers would ultimately be held liable.

"The most logical deep pocket would be the acquired firm's auditors, who should have allegedly caught these defalcations," said James Cox, a professor at Duke University law school who specializes in corporate and securities law. Since both auditors missed the problems and it appeared to have taken HP a while to catch it after it took over Autonomy, the auditors may have a strong defense.

"You can have a perfectly sound audit and still have fraud exist," he said. A Deloitte UK spokesman said the company could not comment and would cooperate with any investigations.

The law firms and the bankers will likely argue that they were not hired to review the bookkeeping and had relied on the opinion of the auditors, securities law experts said.

Multiple sources with knowledge of the HP-Autonomy transaction added that the big-name banks on Autonomy's side were brought in days before the final agreement was struck. These sources said the banks were brought on as favors for their long relationships with the companies, in a little-scrutinized Wall Street practice of crediting -- and paying -- investment banks that actually have little do with the deal.

LAWSUITS, REPUTATIONS AT STAKE

Plaintiffs lawyers said they were taking calls from investors about HP on Tuesday. Darren Robbins, a San Diego-based plaintiff lawyer who represents shareholders, said the tech icon appears to have spent billions on a shoddy company without undertaking the proper due diligence, and thus misrepresented its finances to investors.

"I think they have serious troubles," he said.

But plaintiff lawyers may have difficulty bringing so-called derivative lawsuits against professional services firms, said Brian Quinn, an M&A professor at Boston College Law School. In those cases, plaintiff lawyers can sue third parties, such as auditors, on behalf of HP -- but they must convince a judge that HP's board is unfit to pursue those claims itself. In this situation, though, HP's board disclosed the alleged fraud itself, Quinn said.

Even if the bankers and lawyers escape any legal problems, they could suffer a reputational hit. The scrutiny could be particularly unwelcome for Perella Weinberg: the firm advised Japanese camera maker Olympus' acquisition of British Gyrus -- a transaction that prompted investigations in the United States, United Kingdom and Japan into fees and payments made by Olympus.

Olympus had hired Perella to execute the transaction, which included a fee paid to "advisers" of $687 million - way beyond the usual scale for a transaction valued at only $2 billion. Perella was not implicated in the matter.

Meanwhile, the most controversial banker involved in the HP-Autonomy deal, Frank Quattrone of Qatalyst, represented Autonomy and played a key role in getting HP to pay a high price.

A star investment banker in the 1990s, Quattrone had worked at Morgan Stanley, Deutsche Bank and Credit Suisse, and helped arrange some of the biggest tech initial public offerings of the era, including Amazon.com Inc and Cisco Systems Inc.

But his time at the top of Silicon Valley was curtailed by charges that he blocked an investigation into IPO kickbacks. After two trials failed to resolve his case, he ultimately reached a deal with prosecutors.

His return to the Silicon Valley M&A scene has impressed many in the tech world.

"His reputation is at an all-time high right now," said Dan Scheinman, the former head of mergers and acquisitions at Cisco who has worked with Quattrone on several deals.

Analysts almost uniformly deemed the $11.1 billion he got HP to pay for Autonomy as overly rich -- a compliment to him at the time, but possibly a hollow success if HP's allegations prove true.

(Reporting By Nadia Damouni and Nicola Leske in New York and Andrew Callus in London. Additional reporting by Dan Levine in San Francisco.; Editing by Peter Lauria, Jonathan Weber, Muralikumar Anantharaman, Janet McBride)

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Boxer 'Macho' Camacho critical in Puerto Rico

SAN JUAN, Puerto Rico (AP) — Hector "Macho" Camacho was clinging to life Wednesday after being shot in the face while in a car, with doctors and his family expected to decide whether to remove the former boxing champion from life support.

Doctors had said Camacho was in critical, but stable condition and expected to survive after he was shot Tuesday night in his hometown of Bayamon. But his condition worsened overnight and his heart stopped at one point, said Dr. Ernesto Torres, director of the Centro Medico trauma center in San Juan.

"He's battling minute to minute. This is the most important fight of his life," Torres told The Associated Press outside the hospital in the Puerto Rican capital.

Torres said doctors were trying to determine the boxer's level of brain activity.

The specialists will then consult with other doctors and Camacho's mother, who flew in Wednesday from New York, to discuss whether he should be removed from life support, said Ismael Leandry, a longtime friend and former manager who was also at the hospital.

"We just have to wait to see if 'Macho' gets better. It's a hard battle," Leandry told AP.

Torres said Camacho's mother, Maria, spent about 20 minutes with her son, one of the most dynamic boxing personalities of his era, and was expected to return for a second visit on Wednesday night.

"His mother came and she is devastated," he said. "She knows the prognosis is not at all favorable."

A godson, Widniel Adorno, said the family has discussed the possibility of organ donation but no final decision has been made.

The 50-year-old Camacho was outside a bar in a parked Ford Mustang with a friend when he was shot in the face. The friend, identified as 49-year-old Adrian Mojica Moreno, was killed. Police said two assailants fled in an SUV but no arrests have been made and no motive has been disclosed.

Camacho was rushed to Centro Medico, where doctors initially said he was fortunate in that the bullet passed through his head and lodged in his shoulder. Torres did warn, however, that the boxer, who was trailed by drug and alcohol problems during a career that included some high-profile bouts, could be paralyzed from the shooting.

Steve Tannenbaum, who has also represented Camacho in the past, said he was told by friends at the hospital that the boxer would make it.

"This guy is a cat with nine lives. He's been through so much," he said. "If anybody can pull through it will be him."

Friends and family members waited anxiously at the hospital, fondly recalling Camacho's high-energy personality and his powerful skills in the ring.

"He was like a little brother who was always getting into trouble," said former featherweight champion Juan Laporte, a fellow Puerto Rican who grew up and trained with Camacho in New York.

Camacho has been considered one of the more controversial figures in boxing.

The fighter's last title bout came against then-welterweight champion Oscar De La Hoya in 1997, a loss by unanimous decision. He last fought in May 2010, losing to Saul Duran. Tannenbaum said they were looking at a possible bout in 2013.

"We were talking comeback even though he is 50," he said. "I felt he was capable of it."

Camacho was born in Bayamon, one of the cities that make up the San Juan metropolitan area

He left Puerto Rico as a child and grew up mostly in New York's Harlem neighborhood, one of the reasons he later earned the nickname "the Harlem Heckler."

He went on to win super lightweight, lightweight and junior welterweight world titles in the 1980s.

Camacho has fought other high-profile bouts in his career against Felix Trinidad, Julio Cesar Chavez and Sugar Ray Leonard. Camacho knocked out Leonard in 1997, ending what was that former champ's final comeback attempt.

Camacho has a career record of 79-6-3.

In recent years, he has divided his time between Puerto Rico and Florida, appearing regularly on Spanish-language television.

Drug, alcohol and other problems have trailed Camacho since the prime of his boxing career. He was sentenced in 2007 to seven years in prison for the burglary of a computer store in Mississippi. While arresting him on the burglary charge in January 2005, police also found the drug ecstasy.

A judge eventually suspended all but one year of the sentence and gave Camacho probation. He wound up serving two weeks in jail, though, after violating that probation.

Twice his wife filed domestic abuse complaints against him, and she filed for divorce several years ago.

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Associated Press writer Ben Fox contributed to this report.

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US abortions fall 5 pct, biggest drop in a decade

NEW YORK (AP) — U.S. abortions fell 5 percent during the recession and its aftermath in the biggest one-year decrease in at least a decade, perhaps because women are more careful to use birth control when times are tough, researchers say.

The decline, detailed on Wednesday by the Centers for Disease Control and Prevention, came in 2009, the most recent year for which statistics are available. Both the number of abortions and the abortion rate dropped by the same percentage.

Some experts theorize that some women believed they couldn't afford to get pregnant.

"They stick to straight and narrow ... and they are more careful about birth control," said Elizabeth Ananat, a Duke University assistant professor of public policy and economics who has researched abortions.

While many states have aggressively restricted access to abortion, most of those laws were adopted in the past two years and are not believed to have played a role in the decline.

Abortions have been dropping slightly over much of the past decade. But before this latest report, they seemed to have pretty much leveled off.

Nearly all states report abortion numbers to the federal government, but it's voluntary. A few states — including California, which has the largest population and largest number of abortion providers — don't send in data. While experts estimate there are more than 1 million abortions nationwide each year, the CDC counted about 785,000 in 2009 because of incomplete reporting.

To come up with reliable year-to-year comparisons, the CDC used the numbers from 43 states and two cities — those that have been sending in data consistently for at least 10 years. The researchers found that abortions per 1,000 women of child-bearing age fell from about 16 in 2008 to roughly 15 in 2009. That translates to nearly 38,000 fewer abortions in one year.

Mississippi had the lowest abortion rate, at 4 per 1,000 women of child-bearing age. The state also had only a couple of abortion providers and has the nation's highest teen birth rate. New York, second to California in number of abortion providers, had the highest abortion rate, roughly eight times Mississippi's.

Nationally since 2000, the number of reported abortions has dropped overall by about 6 percent and the abortion rate has fallen 7 percent.

By all accounts, contraception is playing a role in lowering the numbers.

Some experts cite a government study released earlier this year suggesting that about 60 percent of teenage girls who have sex use the most effective kinds of contraception, including the pill and patch. That's up from the mid-1990s, when fewer than half were using the best kinds.

Experts also pointed to the growing use of IUDs, or intrauterine devices, T-shaped plastic sperm-killers that a doctor inserts into the uterus. A study released earlier this year by the Guttmacher Institute, a nonprofit organization that does research on reproductive health, showed that IUD use among sexually active women on birth control rose from less than 3 percent in 2002 to more than 8 percent in 2009.

IUDs essentially prevent "user error," said Rachel Jones, a Guttmacher researcher.

Ananat said another factor may be the growing use of the morning-after pill, a form of emergency contraception that has been increasingly easier to get. It came onto the market in 1999 and in 2006 was approved for non-prescription sale to women 18 and older. In 2009 that was lowered to 17.

Underlying all this may be the economy, which was in recession from December 2007 until June 2009. Even well afterward, polls showed most Americans remained worried about anemic hiring, a depressed housing market and other problems.

You might think a bad economy would lead to more abortions by women who are struggling. However, John Santelli, a Columbia University professor of population and family health, said: "The economy seems to be having a fundamental effect on pregnancies, not abortions."

More findings from the CDC:

— The majority of abortions are performed by the eighth week of pregnancy, when the fetus is about the size of a lima bean.

— White women had the lowest abortion rate, at about 8.5 per 1,000 women of child-bearing age; the rate for black women was about four times that. The rate for Hispanic women was about 19 per 1,000.

— About 85 percent of those who got abortions were unmarried.

— The CDC identified 12 abortion-related deaths in 2009.

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Justin Bieber won't face charge for May scuffle

LOS ANGELES (AP) — Prosecutors say they won't file any charges against Justin Bieber over a May confrontation with a photographer because of a lack of corroborating evidence.

A document obtained Wednesday states that three Los Angeles County sheriff's investigators found no visible injuries, video or photographs to confirm the photographer's story that Bieber kicked and punched him.

Prosecutors had been asked by police to consider filing a misdemeanor battery charge against the pop star.

Bieber was leaving a movie theater in Calabasas with girlfriend Selena Gomez when he got into an altercation with a photographer in the parking lot.

The photographer claimed Bieber kicked him in the abdomen and punched him.

The case was rejected in October and was first reported Wednesday by celebrity website TMZ.

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Hostess, union fail to reach deal

Hostess Brands Inc, the bankrupt maker of Twinkies and Wonder Bread, said on Tuesday that it failed to reach a deal in mediation with the Bakery, Confectionary, Tobacco and Grain Millers Union.

The company, which operates three facilities in Illinois, including in Schiller Park and Hodgkins, said it will have no further comment until a hearing scheduled for Wednesday before the U.S. Bankruptcy Court for the Southern District of New York.

A representative of the Bakery, Confectionery, Tobacco Workers and Grain Millers International Union (BCTGM) did not immediately respond for comment.

The ailing company, which also makes Wonder Bread and Drake's cakes, went to bankruptcy court on Monday to seek permission to liquidate its business, claiming that its operations were crippled by the bakers' strike and that winding down was the best way to preserve its dwindling cash.

But Bankruptcy Judge Robert Drain of the Southern District of New York urged the sides into a private mediation, prompted by a desire to protect the more than 18,000 jobs at stake.

The 82-year-old Hostess runs 33 bakeries, 553 distribution centers, about 5,500 delivery routes and 527 bakery outlet stores throughout the United States. Bakery operations ceased last week, though product deliveries to stores continued in order to sell already-made products.

The company has blamed union wages and pension costs for contributing to its unprofitably. Hostess Chief Executive Gregory Rayburn has also said the company's labor contracts have deterred would-be bidders for the company and its assets.

Aside from its unionized workforce, analysts, bankers and restructuring experts have said that a fleet of inefficient and out-of-date factories has also eaten up costs. They have said the brand names were likely to be more valuable once they were separated from the factories and sold to non-union competitors.

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Deadly Indiana home explosion investigated as homicide

The house explosion that killed two people and destroyed several homes in an Indianapolis neighborhood is now being investigated as a homicide, authorities said, though no suspects have been named.

Indianapolis Homeland Security Director Gary Coons announced the criminal investigation Monday evening, shortly after a funeral was held for the husband and wife who had lived next door to the house where investigators believe the blast occurred.

"We are turning this into a criminal homicide investigation," Coons said after meeting with residents, the first public acknowledgement by investigators of a possible criminal element to the Nov. 10 explosion.

Search warrants have been executed and officials are now looking for a white van that was seen in the subdivision on the day of the blast, Marion County Prosecutor Terry Curry said. Federal authorities are offering a $10,000 reward for information in the case.

Curry said the investigation is aimed at "determining if there are individuals who may be responsible for this explosion and fire," but neither he nor Coons took questions or indicated if investigators had any suspects. No arrests have been made.

A lawyer representing Monserrate Shirley and Mark Leonard, who lived in that home that is believed to have exploded, said Tuesday that the couple was bewildered by the new direction of the investigation.

Randall Cable said in a statement that Shirley and Leonard have "cooperated fully" with investigators and that they want the cause "of this horrific and saddening tragedy to be determined."

Officials say they believe natural gas was involved in the explosion, which destroyed five homes and left dozens damaged. Investigators have focused on appliances in their search for a cause. The explosion caused an estimated $4.4 million in damage.

"We thought something like this was not just an accident," said Doug Aldridge, who heads the neighborhood Crime Watch.

Aldridge said he and other residents frequently saw a white van parked outside the home, though he didn't know who owned it. He said residents are angry and upset but that he expects most of them to stay in the neighborhood.

Hundreds of people attended the funeral Monday for John Dion Longworth, 34, and his 36-year-old wife Jennifer Longworth.

She was a second-grade teacher remembered for knitting gifts for her students, while her husband, an electronics expert, was known as a gardener and nature lover. The school where Jennifer Longworth taught was closed Monday so teachers and students could attend the funeral.

Indianapolis Mayor Greg Ballard told reporters after attending the Longworths' funeral Monday that he had been having a hard time coming to terms with what happened.

"There is a search for truth and there is a search for justice," Ballard said.

John Shirley, who co-owns the house with his ex-wife, Monserrate, has told The Associated Press that he had recently received a text message from his 12-year-old daughter saying the furnace in the home had gone out.

Monserrate Shirley said Leonard had replaced the thermostat and that the furnace was working. Cable has said the daughter told her mother she had smelled an odd odor in recent weeks, but they hadn't reported it.

Shirley and Leonard were away at a casino at the time of the blast, Cable said. The daughter was staying with a friend, and the family's cat was being boarded.

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