Pentagon Study To Help Flight Crew and Aviation Ground Support Veterans' Cancer Claims

So, what’s this all about?

About YOU as a veteran, and perhaps also you as a veteran with cancers the Pentagon has identified as somehow related to aviation. We’re addressing active duty as well as Reserve Component servicemembers.

A 2024 Pentagon study identified several cancers as being significantly higher among aircrews and aviation ground support than in a similar non-flying population: What’s greater? 87% melanoma, thyroid cancer 37%, and breast cancer and prostate cancer both 16% greater. The study is attached for your review.

We’re veterans of the 74th Aeromedical Evacuation Squadron, Westover ARB, MA. Our history includes flying the infamous former Agent Orange spray airplanes, the C-123 Provider. Our planes remained contaminated with dioxin. It took many years of fighting until in 2015 VA finally conceded our exposures. Our veterans (plus many other bases and units- see attached lists)) are now presumed by VA as having been exposed and our claims for the various Agent Orange ailments are finally being honored. So much so, in fact, that over $80 million in medical care, compensation and survivor Agent Orange benefits have been won for C-123 veterans.

However, Agent Orange is now pretty much in the “rear view mirror.” Our concern shifts to you if you were in some way associated with military aviation and now suffer one of these cancers. We want to help you understand the importance of the Pentagon study and its value to a VA claim – and the great value to your physician who we hope will cite the study as persuasive in a nexus opinion supporting your VA claim for what VA terms "direct service connection."

VA has typically denied Reserve Component exposure claims (except ours) insisting Reservists weren’t on active duty when exposed: no active duty = no benefits. They also insisted active duty veterans experiencing these cancers only many years after service weren’t injured with exposures and their claims were also denied.

The Pentagon study is our solution. It established that something associated with aviation is causing significantly greater risk of cancers, with worrisome percentages cited above. Now Reservists can claim an exposure injury and have the study (and their physician’s letter citing the study) as strong supporting proof. An exposure injury makes a Reservist a veteran per VA regulations. The same with active duty – if you flew, the study gives a link between flying/maintaining and the cancers. Being a Department of Defense report, the VA finds it damn hard to dispute, particularly because they contributed to it!

There are four claim packets in our Pentagon report. For each named cancer, we’ve writing a brief introduction, discussed the VA Form 526EZ disability claim form, the VA physical exam form for each specific cancer, and a VA Form 21-10210 statement of support. The 21-10210 explains to the VA claims agent why the Pentagon report constitutes powerful evidence supporting your claim. In fact, other veterans have already won claims and appeals by citing the report – it works! Share it with your VSO!

Here are individual claims packets:

Melanoma

Breast Cancer

Thyroid Cancer

Prostate Cancer

Good luck with your claim and let us know how you did.

Wes Carter, 74AES, C-123 Veterans Association.  

rustysilverwings@gmail.com

c123kcancer.blogspot.com

CLICK TO DOWNLOAD: Claims packets for flight crews and aviation ground support veterans: Melanoma, thyroid cancer, breast cancer and prostate cancer. All four are in one file to simplify distribution. Each has an intro, info about VA Form 526EZ to initiate a claim, a cancer-specific VA veterans benefit questionnaire" for a physical exam, and a VA statement form with an explanation about the Pentagon study's importance to aviation-related disability claims.

Here is information on the Pentagon study.

Here's the Vietnam Veterans of American excellent claims guide, although it focus on Agent Orange issues rather than aviation-related illnesses.

VA Disability Claim Form VA 526EZ now includes Agent Orange C-123 details

 Reference VA Form 526EZ disability claim form.

I hadn't noticed but Veterans Benefit Administration now includes C-123 veterans in their Agent Orange exposure section. BTW: if you haven't checked with VA for their full range of toxic exposure disabilities, do so NOW!

VA 526EZ, Section IV EXPOSURE INFORMAON

Houston VA to Study Prostate Cancer & Agent Orange in African-American Vets, Using New Research Grant

NOTE: Like me, many C-123 vets are concerned about bladder cancer and prostate cancer, and we hope that VA will soon designate bladder cancer as an Agent Orange-related illnesses. Some vets have been successful with claims that prostate cancer increased their odds of bladder cancer, and argued with VA successfully to win disability claims.

Prostate cancer, however, is well-established as an Agent Orange-presumptive illness. VA has honored disability claims for many years, and even the most recent research has only firmed up the science behind the link between Agent Orange and cancer. My own oncologist at VA MedicaL Center Portland, Dr. Mark Garzatto, established that Agent Orange vets have twice the rate of cancers, and that ours are twice as likely to be highly aggressive cancers. Not good, and maybe this recent grant by the Prostate Cancer Foundation will help improve things.

Houston VA to Study Prostate Cancer with New Research Grant
Thanks to a new $1 million grant awarded by the Prostate Cancer Foundation, researchers will be able to study the link between prostate cancer and exposure to Agent Orange in African-American male veterans who served during the Vietnam War.

A PARTIAL VICTORY: Retroactive C-123 benefits for claims AFTER June 19, 2015!

ARE YOU A C-123 VETERAN WHO FILED AN AGENT ORANGE CLAIM AFTER JUNE 2015 BUT YOUR ILLNESS WAS DIAGNOSED BEFORE THEN?

Most likely, the VA started your disability compensation effective on the date you filed, not when you became ill. That may have cost you months or years of lost compensation.

I think I found a solution to recover those lost months and years of compensation, based on language a BVA veterans law judge used in a recent C-123 decision. There is a way to backdate to June 2015 some or all of the compensation due you.

Once it finishes processing an application, the VA provides disability compensation for claims based on the date filed. Many of our C-123 veterans were diagnosed with Agent Orange related illnesses before the VA rules took effect for us on June 18 2015.

Many of our vets submitted claims after that date but have Agent Orange illnesses diagnosed before then. In that situation, there is a way you can argue for compensation not based on whenever you filed after June 2015 but instead, all the way back to the June 2015, for a maximum of twelve months compensation. As an example, twelve months of prostate cancer at 100% is over $30,000, so you'll want to consider this carefully with any claim submitted after June 2015.

Read the following paragraph (taken from a C-123 retroactive compensation decision) very carefully.  1. Note that it specifies Agent Orange illnesses diagnosed prior to the date of the liberalizing law VA used to grant benefits, which for C-123 claims is June 19 2015.
2. Also, that illness must have been evident from the diagnosis to the date whenever you filed. If your prostate cancer was diagnosed in 2011 and cured in 2014, this won't apply to you. If, however, you remained on "watchful waiting" up to June 19 2016 and beyond, this rule could apply. Same thing for any of the other Agent Orange illnesses like diabetes, IHD, peripheral neuropathy, etc.
3. If your claim was submitted after June 19 2016, and your diagnosed illness continued from before June 18 2015 to the date your claim was filed, say June of 2017, could argue retroactivity only to June 19, 2015. That is because VA limits this situation to one year of back pay.

However, retroactive effective dates are allowed, to a certain extent, in cases where an award or increase of compensation is granted pursuant to a liberalizing law. 38 U.S.C.A. § 5110 (g); 38 C.F.R. § 3.114 (a). Under these provisions, the claimant must have met all eligibility criteria for the liberalized benefit on the effective date of the liberalizing law or VA issue, and have been continuously eligible from that date to the date of claim or administrative determination of entitlement. These provisions apply to original and reopened claims, as well as claims for increase. Id.; see also McCay v. Brown, 9 Vet. App. 183, 188 (1996), aff'd, 106 F.3d 1577, 1581 (Fed. Cir. 1997). In such cases, the effective date of the award or increase shall be fixed in accordance with the facts found, but shall not be earlier than the effective date of the liberalizing law or VA issue. 38 C.F.R. § 3.114 (a). For claims received more than one year after the effective date of the liberalizing law or VA issue, benefits may be authorized for a period of one year prior to the date of receipt of the request for review. Id.

I'll summarize:.

1. This is for claims for illnesses diagnosed before June 18 2015 and continuing to the date a claim was submitted to VA.

2.  VA limits this retroactive compensation to one year. If you filed after June 2016 or any later date, you may be eligible for one year of retroactive compensation.

If you think this may apply to you, please discuss with your veterans service organization...you will probably have to bring them a clipping of the paragraph I quoted from the C-123 award.

Agent Orange Vets Face Increased Risk of Aggressive Recurrence of Prostate Cancer Following Treatments

A study of 1,495 veterans who underwent radical prostatectomy to remove their cancerous prostates showed that the 206 exposed to Agent Orange had nearly a 50 percent increased risk of their cancer recurring despite the fact that their cancer seemed relatively nonaggressive at the time of surgery. And, their cancer came back with a vengeance: the time it took the prostate specific antigen, or PSA, level to double – an indicator of aggressiveness – was eight months versus more than 18 months in non-exposed veterans.

"There is something about the biology of these cancers that are associated with prior Agent Orange exposure that is causing them to be more aggressive. We need to get the word out," says Dr. Martha Terris, chief of urology at the Charlie Norwood VA Medical Center in Augusta and professor of urology at the Medical College of Georgia School of Medicine.

Dr. Terris, corresponding author on the study published in the British Journal of Urology International, says she wants her colleagues following prostate cancer patients with Agent Orange exposure to know those patients may need more meticulous scrutiny and so-called salvage therapy quickly if their prostate cancer returns. "Not only are their recurrence rates higher but their cancers are coming back and growing much faster when they do come back," the Georgia Cancer Coalition Distinguished Scholar says.

The PSA of prostate cancer patients is typically measured every three months for two years after surgery then every six months for life. After surgery to remove the diseased prostate, the PSA should be zero, but any prostate cancer cells left behind continue to make PSA, a red flag of recurrence, Dr. Terris says. The PSA often "percolates along" so physicians tend to watch it for a while to determine if additional therapy is needed. However in patients with Agent Orange exposure, radiation or hormone therapy to kill remaining cells may need to be done sooner rather than later, she says.

Increasing evidence is emerging that exposure to Agent Orange, a herbicide and defoliant used during the Vietnam War, increases risk for a variety of health problems, including prostate cancer, although the exact mechanism is unclear. (NOTE: A 2011 investigation for the American Cancer Society, conducted by Dr. Mark Garzotto of Oregon Health Sciences University as well as Chief of Urology Oncology at the VA Medical Center, Portland Oregon, identified Agent Orange exposure as having doubled the rate of highly aggressive cancers in exposed veterans.) Dioxin, its known carcinogen, also is found in herbicides and pesticides used by U.S. farmers, forestry and chemical plant workers who studies have shown to have an increased cancer risk. Scientists suspect dioxin activates regulatory regions of genes to enable the uncontrolled cell division that is a cancer hallmark.

Dr. Terris led a separate study of 1,653 veterans at VA medical centers in five cities between 1990 and 2006 that also showed recurrence rates were higher and recurring cancers were more aggressive with Agent Orange exposure. Dr. Sagar R. Shah, MCG urology resident, presented the findings at the 2007 annual meeting of the American Urological Association.

This new study – which includes the VA Medical Center in Augusta, Veterans Affairs Greater Los Angeles  Healthcare System, Veterans Affairs Palo Alto Healthcare System and six affiliated medical schools –  included new patients as well as longer follow up on many of the original study patients. As with the previous study, prostate cancer seemed to have a similar course in blacks and whites, but Agent Orange exposure was more common in blacks, who were more likely to be ground troops in Vietnam.

Plenty of questions remain, such as what happens to patients whose primary treatment is standard radiation or brachytherapy, where rice-size radiation pellets are implanted in the prostate, rather than surgery, Dr. Terris says.

She also wants to know whether the veterans' degree of exposure is related to the severity of their cancer. Everyone has some dioxin exposure; "Even if you never set foot in Vietnam or outside the United States," she says. So she is now measuring levels in the body fat – which is like a repository for what the body has been exposed to – to determine how levels correlate to their cancer severity.

Prostate cancer is the most common cancer in men and trails lung cancer as the second leading cause of cancer death.

The study was funded by the Department of Veterans Affairs, the National Institutes of Health, the Georgia Cancer Coalition, the Department of Defense Prostate Cancer Research Program and the American Urological Association/Astellas Rising Star in Urology Award.

Story Source: The above post is reprinted from materials provided by Medical College of Georgia. Note: Materials may be edited for content and length.

Cite This Page: Medical College of Georgia. "Agent Orange Exposure Increases Veterans' Risk Of Aggressive Recurrence Of Prostate Cancer." ScienceDaily. ScienceDaily, 23 April 2009. .

VA Awards First C-123 Agent Orange Claim to Ed Kosakoski

Great News!

Retired LtCol Ed Kosakoski, former commander of the 74th Aeromedical Evacuation Squadron, Westover AFB MA, was awarded service connection for his Agent Orange exposure and resultant prostate cancer. The VA's action was taken yesterday, July 17 and retroactive to June 19. 

Staffers for Under Secretary for Benefits Allison Hickey notified his family of the good news. Ed's claim happened to be the first to be processed under the VA's interim final rule ordered by Secretary McDonald for post-Vietnam C-123 veterans, with the St. Paul VARO assigned to process all C-123 claims.

A pharmacist in civilian life, Ed's military service began in the Army, rising to Master Sergeant before earning his Air Force commission and transfer to the Air Force Reserve. As a squadron commander he took special interest in helping his senior airmen earn their commissions, and so many did his unit developed a reputation as "Colonel K's OCS." He is married to retired active duty LtCol Ingrid Kosakoski.

Good job, VA!

VA Refused Fort Collins Veteran Surgery for Prostate Cancer

Talk about Catch-22 upon Catch-22, cancer style! I initially elected "watch and wait" on my cancer,
but it seems I was doing the waiting, and nobody was doing the watching for me even as my PSA numbers went up and alerts from the lab went out.

Watch and wait turned into a spreading cancer addressed far too late.

On my own and through a civilian urologist, I asked for a biopsy after a year or so had passed since the last one at VA Portland, but it was too late to be as helpful as it might.

I asked the 800-number for VA's Choice Program for local surgery for aggressive prostate cancer, but was immediately turned down. Seems I live within the 40 miles from a local VA day clinic so Choice Program determined me "ineligible."

Even though my Fort Collins VA day clinic does no surgery at all, the VA rules are that outside care is only permitted if no VA facility exists within a magic forty mile circle from one's home.

It doesn't matter whether the nearest VA facility provides that, or any other service...if it exists within 40 miles, under its Choice Program a veteran can only get non-existent VA treatment and not outside contracted care...read: "Do without."

So carrying the conversation further, I inquired about prostate cancer surgery at the nearest VA hospital, which is Cheyenne. They explained they don't do that procedure any longer, and that they refer patients to local providers. Probably, the same ones I wanted VA to send me to in the first place!

BUT...I'd have to wait at least a month to see a VA physician in Cheyenne for the necessary referral, then wait whatever time is required for an appointment with the referral surgeon, and then get the operation scheduled someday in the future.

Problem:  Stage Three cancers don't wait. Certainly, not the three months or even more VA requires to begin treatment for cancer already spread past the prostate. I didn't want to wait three months for the cancer surgery, which we now know would have been three months for the cancer to continue spreading. So, like many other 100% service-connected veterans eligible for non-existent (or at least, very hard to get) care at the VA, I was forced to fall back on other options.

I also believe the VA's limit on a vet seeing one's primary care provider but twice a year played a harmful role. As a veteran already rated 'catastrophically disabled" its hard to see how all the issues at hand can be addressed in two face-to-face meetings a year.

When I asked about trying to see my wonderful VA primary care provider earlier as problems arose, I was told instead to go to the Cheyenne, Wyoming VA emergency department, 50 miles away and difficult to get there with a wheelchair.

So instead, I sought out our local hospital's ER where I was treated for eye injuries, shoulder surgery, and probable hip replacement as well as non-urgent medical concerns for which I sought attention between the VA's six month visits.

For me, the system didn't work, neither for caring for me as the cancer started elevated PSAs nor for the surgery to catch it before it metastasized. For VA, it worked perfectly as designed...they saved thousands by building a health care system which avoids providing care. Especially in the case of C-123 veterans.

VA Secretary McDonald's March 17 Memorandum on C-123 Agent Orange Veterans

We haven't seen it but have had references from various sources. We've heard enough to be disappointed.

We'll have faith that the Secretary of Veterans Affairs meant for VA to respond effectively to C-123 veterans, but his Office of General Counsel (OGC) has been very effective in preventing any impact that matters.

Apparently responding to the January 8, 2015 report to the Secretary by the Institute of Medicine C-123 Agent Orange Committee, Secretary McDonald has issued a memorandum summing up the VA reaction and plan going forward, but his plan was created by OGC in defiance of the committee set up by the Secretary to recommend his response. The committee recommended a much more reasonable course, but the OGC felt it best to prevent veterans' care with their own plan.

Our first response to the Secretary's action is that we're grateful that the memorandum acknowledges the IOM report, and concurs with its finding of exposure and harm to the C-123 aircrews and maintainers.

Our next response is one of bewilderment. While the VA now agrees we were exposed and harmed flying the former Agent Orange spray aircraft, the Office of General Counsel developed its extra-legal approach which prevents any medical care or benefits. Widows, widowers and disabled vets whose claims have been in for years are blocked from any VA care.

How? By the OGC decision to limit service connection from March 17 going forward, and just to those Reservists who happened to develop their prostate cancer over the weekend duty. By limiting all benefits to Reservists whose ALS developed during their two-week annual training. By limiting benefits to Reservists whose soft tissue sarcomas, or any of the other recognized Agent Orange illnesses, developed during, and only during, their Reserve duties.

But there likely aren't any aircrew or maintenance personnel affected by the Secretary's memorandum because science and medicine know perfectly well these Agent Orange illnesses take decades to manifest themselves. Thus VA yields nothing, concedes nothing. Cares about nobody. Saves VA money.

We've learned that VA's OGC approach endangers today's Guard and Reserve forces. Reserve Component volunteers who deploy on some hazardous situation in which they are exposed to horrible diseases such as ebola and return to civilian status when the mission has been completed, will be refused care and benefits from the VA when the disease completes its two week incubation period and the Reservist is struck with horrible illness.

VA has responded to the four year C-123 thorn in its side with courtroom adversarial lightning bolts. VA found a clever way to say "We care" while simultaneously preventing care for all C-123 veterans as well establishing a new and magnificent barrier to all future pesky Reserve Component disability claims.

Dengue fever, malaria, ebola, burn bits, insect bites, dirty water, any and all other environmental hazards which present an illness taking time to develop...VA will care only for personnel (read none, except sudden-type situations like snake bites or chemical burns) who develop the illnesses while on duty. If a disease in its natural course takes a few days or weeks to develop and the Reservist has returned to civilian life in the meantime, too bad. VA announced April 16 it save money and keep appointment lines in its hospitals shorter by refusing any and all benefits with firmly-expressed appreciation for their service and regrets that the volunteer dead or dying servicemembers aren't real veterans.

OGC's inventive but certainly extra-legal approach has been challenged by Senate and House leaders, by veterans service organization, legal scholars, and C-123 veterans themselves.  At this point, things seem to have stalled for weeks. The Secretary's actual plan, announced to the Senate Veterans Affairs Committee as ready for implementation by early March, still flounders.

And veterans are still refused care. And OGC has developed a whole new way to prevent care sought by today's veterans exposed to harmful biological or toxin agents. Real Perry Mason stuff, this!

By the way, let's hope the VA informs DOD of their decision, because somebody has to tell the Reserve Component servicemembers still volunteering for such duty placing them in harm's way without VA at their back.

Maybe some firm should market a special health insurance scheme for the US Army Reserve, US Marine Corps Reserve, Navy Reserve, Coast Guard Reserve, Air Force Reserve, Air National Guard and Army National Guard.

As soon as those volunteers learn that once finished with their Reserve duty, VA won't care for them and neither will DOD's health care facilities, they'll either be out of the military or well-advised to insure themselves: DOD and VA won't.

"Leave No Man Behind." Veteran C-123 Pilot Fights VA for Agent Orange Exposure Benefits Due Stateside Crew Mates

Northhampton Gazette, July 19, 2014, reporter: Laurie Loisel

BELCHERTOWN — One lesson retired Air Force Col. Archer Battista says he learned in his six years in Vietnam was never to leave anyone behind.

This explains why Battista, 68, has since 2010 thrown his energy into an effort to get pilots who flew stateside planes contaminated by Agent Orange qualified for disability services and compensation.

Battista knows about Agent Orange, a defoliant the United States dumped on the Vietnamese countryside during the war. In early 2009, when he was 62, he was diagnosed with prostate cancer, for which he is still being treated. Because he served in Vietnam from 1968 to 1973, he qualified for a variety of benefits won for Vietnam veterans after a long and drawn-out fight with the government. This explains why Battista, 68, has since 2010 thrown his energy into an effort to get pilots who flew stateside planes contaminated by Agent Orange qualified for disability services and compensation.

Battista knows about Agent Orange, a defoliant the United States dumped on the Vietnamese countryside during the war. In early 2009, when he was 62, he was diagnosed with prostate cancer, for which he is still being treated. Because he served in Vietnam from 1968 to 1973, he qualified for a variety of benefits won for Vietnam veterans after a long and drawn-out fight with the government.

In 1991, the government acquiesced and began authorizing disability, medical and survivor benefits for “presumed exposure” to Agent Orange. Veterans who served in Vietnam (as well as the Korean demilitarized zone during the Vietnam era) are presumed to have been exposed to Agent Orange. This qualification means these veterans suffering from illnesses.

A Long Reserve Career

After his six years of active duty, Archer Battista logged a 27-year career in the Air Force Reserves, retiring May 1, 2001. He also has had a long career as a civil litigation lawyer as a partner with the Holyoke law firm Lyon & Fitzpatrick. These days, he is listed on the firm’s letterhead as “of counsel,” which is legalese for semi-retired.

And while Battista may have wanted to devote his retirement years to some of his many interests (history) and civic pursuits (YMCA boards), his cancer diagnosis — and then his increasing involvement in the effort to get this new group of veterans covered for Agent Orange benefits — got in the way.

When he was in Vietnam, Battista flew the Cessna 02A observation airplane for missions from Danang to Laos.

When he was back home on duty with the Air Force Reserves, he started flying the C-123 cargo planes on training missions, steadily from 1974 until 1982. Battista estimates he flew hundreds of these training missions, and he recalls that a couple times each winter — most notably when the plane’s heater was cranked up — crews would fall into bouts of uncontrollable vomiting.

He says he’d get a report in the cockpit from the loadmaster in the back of the plane with some variation of, “Art, the smell back here is unbearable. We can’t go on with this mission.” Battista adds: “They'd be saying what we already knew, because we could smell it, too.” Battista says his immediate response would be that he couldn't abort a training mission, until he realized that a training mission in which most of the crew can’t stop throwing up is not much of a training mission. So, he'd wind up canceling the flight. The source of the danger was dried Agent Orange residue left after Vietnam, fouling areas in the wings and below the cargo deck, in nooks and crannies impossible to reach to clean.

In those days much less was known about Agent Orange and its noxious elements — but still, Battista says, he and other crew members started wondering what was wrong with the Spray Birds.

“We knew they were Spray Birds that flew the Ranch Hand Mission, but they told us that there was no risk of any kind,” he said.

One of the men who flew the C-123 Provider cargo planes alongside Battista was Wes Carter, a retired major who now lives in Colorado, but who flew at Westover from 1974 to 1991. Carter, who founded the C-123 Veterans Association in 2011, did not serve in Vietnam, and is fighting to receive Agent Orange-related coverage from his many years at Westover. For him, as for Battista, the fight is deeply personal — but also being waged on behalf of others.

“We have our crew mates dying from recognized Agent Orange illnesses,” he said. Carter has testified before government hearings, filed complaints with the Department of Defense, fought for data through the Freedom of Information Act and worked with other veterans groups to agitate for the government to widen the net to cover more veterans. He is web master for the site C-123 Veterans Agent Orange Exposure 1972-1982.

For his part, Battista said when he was first diagnosed with cancer, he didn't link it to his military service at all.

But when a former Air Force buddy reminded him that prostate cancer is one of the Agent Orange presumptive diseases, he sought out and received care from the U.S. Department of Veterans Affairs Central Western Massachusetts Healthcare System in Leeds. He says he received excellent care, though subsequently, he moved elsewhere for continued care. Battista he has no quibbles with the care he has received. As he puts it, “I don't have any skin in the game.”

But he’s got plenty to say about men he flew with at Westover Air Base in Chicopee, who he, Carter, and others believe have been abandoned by the Veterans Affairs department. “It’s appalling. I'm a pretty mainstream guy. I spent 22 years in the U.S. Air Force. I loved all of it,” he said. “I just shake my head. I’m thinking what in the hell is the matter with these people?”

In an interview at his secluded home at the end of a long driveway off Summit Street — where an American flag was stationed on the mailbox on the day a Gazette reporter and photographer visited this month — Battista was overcome with emotion several times. Neatly dressed in blue jeans, a gray and yellow “Livestrong” T-shirt and yellow Livestrong rubber bracelet, with white hair and wire-rimmed glasses, he apologized each time his eyes welled up, saying this was not like him. It’s a combination of the medicine he takes for his cancer, and his feelings about the issue.

“Here’s the point. The point is there are all these guys and gals who spent just as much time in a C-123 as I did, but they didn't happen to go to Vietnam," he said. "Its abominable. Its inexcusable, and incomprehensible to me."

Battista has written letters to political leaders, met with a representative from U.S. Rep. Richard Neal’s office and been involved in spreading the word about the issue online by supporting Carter’s efforts through the group he founded. The two first met when they flew together at Westover.

The appeals to Neal’s office paid off. In a letter to Ronald Maurer, director of the Congressional Liaison Service dated June 2, Neal wrote:

“According to a Yale Law School study on this matter, a 1994 Air Force commissioned study of a C-123 plane flown both in Operation Ranch Hand and after the Vietnam War found it still contained enough of the carcinogen dioxin to subject a restoration worker repairing the plane to ‘an acceptable level for lifetime exposure.’ The plane as a result was deemed ‘heavily contaminated,’ 12 years after active crews worked on the plane. This surface presence of dioxin coincides with the National Academy of Science statement that ‘exposure of humans to TCDD [dioxin] is thought to occur primarily via the mouth, skin and lungs,’ confirming the exposure of the crewmen of these planes to dioxin."

“Taking into account this information and the high levels of illnesses known to be linked to Agent Orange occurring in these Westover veterans, I believe these men and women are entitled to the same benefits granted to those who served on the ground in Vietnam.”

Battista believes with letters like that and other forms of political pressure, Veterans Affairs will change a policy he says is wrongheaded and unfair. He takes particular issue with comments from a former Air Force officer, now consultant to the VA, saying veterans seeking coverage for exposure while in the United States are "freeloaders." 

“This isn't a fight that should be personalized. We shouldn't be name-calling,” said Battista. “Every time I read that, it makes me very angry.”

Meantime, he is waiting for the government to change its policy and do what he believes is the right thing.

“I just can’t believe this is happening,” he says. “They've gotta flip. They've got to understand they’ve got this wrong.”

New Study Links Agent Orange with Aggressive Prostate Cancer

(Posted: An article by my own VA urologic oncologist here at the Portland VA Medical Center. Note that the VA has earlier dismissed Dr. Garzotto's opinion confirming C-123 Agent Orange exposure as "unacceptable lay evidence", regardless of any qualifications he obviously presents. Any evidence at all which contradicts PostDeployment Health is unacceptable.)

About 3 million Americans served in the armed forces in Vietnam and nearby areas during the 1960s and early 1970s, the time of the Vietnam War. During that time, the military used large amounts of mixtures known as defoliants, which are chemicals that cause the leaves to fall off plants. One of these defoliants was Agent Orange, and some troops were exposed to it. Many years later, questions remain about the lasting health effects of those exposures, including increases in cancer risk, according to the American Cancer Society.

Past studies have linked agent orange exposure to serious health issues including tumors birth defects and cancers such as breast cancer, multiple melanoma and prostate cancer however, some studies found a small excess risk of prostate cancer related to dioxin exposure until now.

A new study reveals U.S. Veterans who were exposed to Agent Orange is linked to a two-fold risk for developing the most deadliest forms of prostate cancer.

Photo credit:  

GettyImages/TIME & LIFE Images 

A new study led by Dr. Mark Garzotto, MD, associate professor of surgery/urology at Oregon Health and Science University, Chief Urologic Oncology, Portland VA Medical Center and colleagues have found that agent orange is not linked to a small excess risk of prostate cancer but is linked to a two-fold significant risk of developing the most deadliest forms of prostate cancer.

In this cohort study researchers looked for a link between Agent Orange exposure and life-threatening, or high-grade, prostate cancer, Nathan Ansbaugh, MPH, designed and conducted analyses on a group of 2,720 US Veterans who were referred by multiple providers for initial prostate biopsy. Biopsy results and clinical information were compiled for analysis by principal investigator Dr. Garzotto.

Risk factors included family history of prostate cancer, digital rectal examination, prostate-specific antigen (PSA) density, body mass index, and service branch history. Agent Orange exposure was collected through entry in electronic health records. Those with missing data were considered unexposed.

Participants were mostly Caucasian, average age 64.7, 39.4% were overweight and 42.9% obese.

Prostate biopsy showed 896 participants had prostate cancer and that the cancer was high-grade in 459 of those cases. Medical records showed 203 participants had been exposed to Agent Orange.

Exposure was significantly tied to prostate cancer (P=0.017), and especially so for high-grade prostate cancer (P=0.01) -- a 52% and 74% increased risk, respectively. Agent Orange exposure was associated with a 2.1-fold increase (95% CI 1.22-3.62, P<0.01) in the risk of detecting prostate cancer with a Gleason score ≥8.

Independent predictors included positive family history, older age, Marine Corps service, and increased PSA density.

According to the researchers the findings from this study shows knowing whether they have been exposed to Agent Orange is a readily identifiable way to improve prostate cancer screening for Veterans. Lethal cases would be spotted earlier, which with prompt treatment could potentially prolong survival and improve quality of life for patients.

Dr. Garzotto stated “It also should raise awareness about potential harms of chemical contaminants in biologic agents used in warfare and the risks associated with waste handling and other chemical processes that generate dioxin or dioxin-related compounds.”

The authors note that their findings should influence prostate cancer screening screening practices for veterans, particularly those who have been exposed to Agent Orange.

This study is expected to be published in the journal Cancer today.

More information on Agent Orange and cancer can be found online at the American Cancer Society website.

Citation "Agent orange as a risk factor for high-grade prostate cancer" Cancer 2013

 Explore further: Agent Orange exposure linked to life-threatening prostate cancer

VA oncologist confirms C-123 dioxin "likely" cause of veteran's prostate cancer

Today I received an official opinion on VA letterhead from my VA urology oncologist confirming in the words the VA itself hoped never to hear..."It is my opinion, based on the facts presented, your prostate cancer condition is likely related to (your) exposure to Agent Orange during your service." Thanks, Doctor! That's what I've been telling the VA myself!

What effect will this have on claims like mine? Probably it will be dismissed initially by the VA for some reason even though this physician is the Portland VA hospital director of urology oncology. But once the BVA has a chance to consider when my widow pursues our service connection claim before their more exact and less reactionary forum, it will yet another proof to be weighed in my favor.

Also received today a letter from my orthopedic surgeon in which my avascular necrosis in both hips is found to be likely caused by my C-123 Agent Orange exposure. That doctor, however, was far more "evasive" and wouldn't phrase the issue any more strongly so the VA might not weigh it too heavily.

I asked...but in both instances the doctors were uncomfortable writing letters addressing us as a body of veterans, and both instead would only comment on my case. However, I'm glad to copy anyone interested in the letters themselves.

General Mike Passes

The world became less wonderful, but Heaven rejoiced, on Saturday as retired Brigadier General Mike Walker lifted off to attend his next and most important Commander's Call. Diagnosed with prostate cancer just before Desert Shield, General Mike fought a long battle with the illness that finally claimed his life.

He was one of the best men ever to wear a blue uniform, and the Air Force was blessed to have his lifetime of dedicated service. We were blessed to know and serve with this good man. He commanded the 439th Airlift Wing during tough times, and was the kind of man we all wanted to be like if we ever grew up.

God bless.

Agent Orange & Cancer

Agent Orange and Cancer

About 3 million Americans served in the armed forces in Vietnam during the 1960s and early 1970s, the time of the Vietnam War. During that time, the military used large amounts of mixtures known as defoliants, which were chemicals that caused the leaves to fall off plants. One of these defoliants was Agent Orange, and some troops were exposed to it. Many years later, questions remain about the lasting health effects of those exposures, including increases in cancer risk.

This article offers a brief overview of the link between Agent Orange and cancer. It does not offer a complete review of all evidence -- it is meant to be a brief summary. It also includes some information on benefits for which Vietnam veterans exposed to Agent Orange may be eligible....and eligibility extends to other veterans able to establish their exposure to Agent Orange.

Some background on Agent Orange

During the Vietnam War, US military forces sprayed millions of gallons of herbicides (plant-killing chemicals) on lands in Vietnam and Laos to remove forest cover, destroy crops, and clear vegetation from the perimeters of US bases. This effort, known as Operation Ranch Hand, lasted from 1962 to 1971.

Different mixes of herbicides were used, but most were mixtures of 2 chemicals that were phenoxy herbicides:

• 2,4-dichlorophenoxyacetic acid (2,4-D)
• 2,4,5-trichlorophenoxyacetic acid (2,4,5-T)

Each mixture was shipped in a chemical drum marked with an identifying colored stripe. The most widely used mixture contained equal parts 2,4-D and 2,4,5-T. Because this herbicide came in drums with orange stripes, it was called Agent Orange. Today, Agent Orange is used to refer generally to all the phenoxy herbicides sprayed at the time. (Other types of herbicides were also used, including cacodylic acid and picloram.)

The 2,4,5-T in Agent Orange was contaminated with small amounts of dioxins, which were created unintentionally during the manufacturing process. Dioxins are a family of about 75 related chemicals. They can be formed during the making of paper and in some other industrial processes. The main dioxin in Agent Orange, 2,3,7,8-tetrachlorodibenzo-p-dioxin, or TCDD, is one of the most toxic.

After a study in 1970 found that 2,4,5-T could cause birth defects in lab animals, the use of 2,4,5-T in Vietnam was stopped. A year later, all military herbicide use in Vietnam ended. During the 1970s, veterans returning from Vietnam began to report skin rashes, cancer, psychological symptoms, birth defects and handicaps in their children, and other health problems. Some veterans were concerned that Agent Orange exposure might have contributed to these problems. These concerns eventually led to a series of scientific studies, health care programs, and compensation programs directed to the exposed veterans.

A large class-action lawsuit was filed in 1979 against the herbicide manufacturers, and was settled out of court in 1984. It resulted in the Agent Orange Settlement Fund, which distributed nearly $200 million to veterans between 1988 and 1996.

Although there is now quite a bit of evidence about the health effects of Agent Orange, many questions have not yet been answered.

How were people exposed to Agent Orange?

About 3 million people served in the US military in Vietnam during the course of the war, about 1.5 million of whom served during the period of heaviest herbicide spraying from 1967 to 1969.

In studies comparing Vietnam veterans with veterans who had served at the same time elsewhere, TCDD (dioxin) levels were found to be higher among those who had served in Vietnam, although these levels went down slowly over time.

Exposure to Agent Orange varied a great deal. Most of the large-scale spraying operations in Operation Ranch Hand were done with airplanes and helicopters. However, some herbicides were sprayed from boats or trucks, and some were applied by soldiers with backpack sprayers. Those who loaded airplanes and helicopters may have been exposed the most. Members of the Army Chemical Corps, who stored and mixed herbicides and defoliated the perimeters of military bases, probably also had some of the heaviest exposures. Others with potentially heavy exposures included members of Special Forces units who defoliated remote campsites, and members of Navy river units who cleared base perimeters.

Exposures could have occurred through breathing the chemicals in, ingesting them in contaminated food or drink, or absorbing them through the skin. Other exposure pathways may have been possible as well, such as through the eyes or through breaks in the skin.

One of the challenges in assessing the health effects of Agent Orange exposure has been determining how much any individual veteran was exposed to (or even what they were exposed to), as there is very little information of this type available.

Does Agent Orange cause cancer?

Researchers use 2 main types of studies to try to determine if a substance or exposure causes cancer. One type of study looks at cancer rates in different groups of people. Such a study might compare the cancer rate in a group exposed to a substance versus the rate in a group not exposed to it, or compare it to what the expected cancer rate would be in the general population. But studies of people can sometimes be hard to interpret, because there may be factors affecting the results that are hard to account for.

In studies in lab animals, other factors are easier to control for, but it's not always clear if the results in animals would be the same in humans.

In most cases neither type of study provides definitive evidence on its own, so researchers usually look at both human and lab-based studies.

Studies in people

Studies of Vietnam veterans potentially provide the most direct evidence of the health effects of Agent Orange exposure.

The Centers for Disease Control and Prevention (CDC), the US Air Force, and the Department of Veterans Affairs (VA) have conducted studies involving thousands of Vietnam veterans. However, most of these studies have been limited by the fairly small number of people who were highly exposed to Agent Orange. About a dozen states have also conducted studies of their veterans, some of which have yielded cancer risk information. A series of studies of Australian Vietnam veterans has also provided some information on cancer risk.

Because of the limits of the Vietnam veteran studies, studies of 3 other groups have provided important information on the potential cancer-causing properties of Agent Orange exposure:

• Vietnamese soldiers and civilians exposed to the same herbicides as United States service personnel, often for more prolonged periods (although there have been few thorough health studies in these populations)
• Workers exposed to herbicides in other settings, such as herbicide manufacturing workers, herbicide applicators, farmers, lumberjacks, and forest and soil conservationists, who often had much higher blood dioxin levels than Vietnam veterans
• People exposed to dioxins after industrial accidents in Germany, Seveso (Italy), and California, and after chronic exposures at work and in the environment

Each of these groups differs from the Vietnam veterans in the characteristics of the people exposed, the nature of the dioxin exposures, and other factors such as diet and other chemical exposures.

Taken together, these studies have looked at possible links between Agent Orange (or dioxin) and a number of cancer types.

Soft tissue sarcoma: Studies of Vietnam veterans have not found an increase in soft tissue sarcomas. However, soft tissue sarcomas have been linked to phenoxy herbicide exposure in a series of studies in Sweden and in some studies of industrially exposed workers. Many studies of farmers and agricultural workers show an increase in soft tissue sarcomas, which may relate to herbicide exposure. Soft tissue sarcomas have also been linked to dioxin exposure in some chemical manufacturing workers and in some other workplace studies.

Non-Hodgkin lymphoma: Most studies of Vietnam veterans have not shown an increase in non-Hodgkin lymphoma (NHL). But several studies have found a link between phenoxy herbicide exposure (usually on the job) and NHL. Some studies of farmers and agricultural workers also suggest this association, although not all studies have found such a link.

Hodgkin disease: Studies of Vietnam veterans have not found an increase in Hodgkin disease. However, Hodgkin disease has been linked to phenoxy herbicide exposure in some other studies. Many studies of farmers and agricultural workers show an increase in Hodgkin disease, which may relate to herbicide exposure.

The link between Hodgkin disease and dioxin exposure specifically is less clear, as studies have given mixed results.

Lung and other respiratory cancers: Most studies of Vietnam veterans have not shown an increase in respiratory cancers, such as those of the lung, trachea (windpipe), and larynx (voice box). Most studies of people exposed to herbicides at work, such as herbicide manufacturing workers, herbicide applicators, and farmers have not found an excess risk of lung cancer.

Most studies of groups of people highly exposed to dioxin after industrial accidents have not found an increase in respiratory cancers. However, chronic workplace exposures to dioxin have been linked with increased risk of respiratory cancers among those with high exposures.

Prostate cancer: Most studies of Vietnam veterans have not found an excess risk of prostate cancer, but results from a few studies have suggested a possible link.

Studies of other groups have also yielded mixed results. Most studies of people exposed to phenoxy herbicides at work do not show an excess of prostate cancer. However, some studies have found a small excess risk of prostate cancer related to dioxin exposure.

Multiple myeloma: Studies of Vietnam veterans have had too few cases of multiple myeloma (a type of immune system cancer that affects the bones) to be helpful in determining if there is a risk.

However, other studies of people exposed to pesticides, herbicides, and/or dioxins have suggested a possible link. Several studies of farmers and agricultural workers have reported a small increase in risk of multiple myeloma, although other studies show no excess risk.

Acute myelogenous leukemia (AML) in the children of veterans: At least 3 studies have pointed to possible link between a father's exposure to Agent Orange or other herbicides and acute myeloid leukemia (AML) in his children.

Gastrointestinal (GI) cancer: Cancers of the GI system -- esophagus, stomach, pancreas, colon, and rectum -- have been extensively studied in Vietnam veterans, groups with herbicide exposure in the workplace, and people exposed to dioxins. These studies have not found a link between these exposures and any GI cancer.

Brain cancer: Studies have not found a link between Vietnam service, workplace herbicide exposure, or dioxin exposure, and brain cancer.

Other cancers: Few studies have looked at a possible link between Agent Orange exposure and other cancers, including cancers of the nose and nasopharynx (upper part of the throat), breast, cervix, endometrium (uterus), ovaries, liver and bile ducts, bone, kidneys, bladder, testicles, or skin, or leukemias other than chronic lymphocytic leukemia (in veterans themselves, as opposed to their children).

Studies done in the lab

Herbicides such as 2,4,5-T and 2,4-D are not considered highly toxic compounds by themselves, and high doses are required to cause effects in lab animals. These compounds have not been linked with cancer in animal studies.

In the lab, TCDD (dioxin) increases the risk of a wide variety of tumors in rats, mice, and hamsters. In lab dish studies, it has been shown to alter which genes are turned on or off and affects how cells divide and die, all of which could affect cancer risk.

What the expert agencies say

Several agencies (national and international) study different substances in the environment to determine if they can cause cancer. (A substance that causes cancer or helps cancer grow is called a carcinogen.) The American Cancer Society looks to these organizations to evaluate the risks based on evidence from laboratory, animal, and human research studies.

A few expert agencies have looked at whether Agent Orange or related compounds can cause cancer.

Institute of Medicine

Since 1994, the federal government has directed the Institute of Medicine (IOM), part of the National Academy of Sciences (NAS), to issue reports every 2 years on the health effects of Agent Orange and similar herbicides. Titled Veterans and Agent Orange, the IOM reports assess the risk of both cancer and non-cancer health effects. Each health effect is categorized as having one of the following:

• sufficient evidence of an association
• limited/suggestive evidence of an association
• inadequate/insufficient evidence to determine whether an association exists
• limited/suggestive evidence of no association

This framework provides a basis for government policy decisions in the face of uncertainty. As of the most recent update, the links between Agent Orange exposure and cancer were designated as shown. (Note that this table shows only cancers. Other health effects are listed in the next section.)