Pentagon Cancer Study Aids Aircrew & Maintainers' VA Claims

So...What's This All About?
About YOU as a veteran, and perhaps also you as a veteran with cancers a Pentagon study identified as somehow related to aviation. We’re addressing active duty as well as Reserve Component servicemembers, and veterans of all services.

A 2024 Pentagon study identified several cancers as being significantly greater among aircrews and aviation ground support than in a similar non-flying population: What’s greater? 87% melanoma, thyroid cancer 39%, 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 over a decade flying that 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 dozens of other bases and units) 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” for most veterans. Our concern shifts to you and other exposure injuries if you were in some way associated with military aviation and now suffer one of these cancers. We want to emphasize 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."

The study can help support claims from aircrews or aviation ground support for cancers not already associated with VA-recognized exposure situations. It can also support claims from veterans regardless of whether or not they deployed to VA-recognized exposure situations.

VA has typically denied Reserve Component exposure claims (except ours) insisting Reservists weren’t on full time 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 military exposures and their claims were also denied.

The Pentagon study is often 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, attached a 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, smaller and easier to download:

Breast Cancer

Thyroid Cancer

Melanoma

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 combined in one file to simplify distribution. Each has an intro, the VA Form 526EZ to initiate a claim, the cancer-specific VA veterans benefit questionnaire" for a physical exam, and a VA statement explaining about the Pentagon study's importance to aviation-related disability claims.

Here is information on the Pentagon study.

VA Cites VA Researcher's 2013 Agent Orange-Prostate Cancer Study But Not Acceptable for Claims

When I was first diagnosed with prostate cancer, my oncologist was Dr. Mark Garzotto of the Portland VA Medical Center's Urology Oncology service. With his co-authors, Dr. Garzotto's article in the prestigious Cancer journal from the American Cancer Society revealed the disturbing conclusion that Agent Orange-exposed veterans are twice as likely to suffer highly aggressive forms of prostate cancer than vets without such exposures.

Dr. Garzotto provided his medical opinion that my own prostate cancer is, more likely than not, associated with Agent Orange exposure aboard the C-123s.

Dr. Garzotto's opinion in support of my claim for service connection has been dismissed by Portland VA Compensation & Pension as unqualified input because VAROs are directed by VBA to deny all C-123 claims.

VA respects Dr. Garzotto's findings about Agent Orange and prostate cancer, but disregards his medical finding about me as a patient under his care. Surpisingly, VA recently cited Dr. Garzotto's article on their web site and wrote:

 Research on prostate cancer and herbicides  

"The Institute of Medicine (IOM) of the National Academy of Sciences concluded in its 1996 report Veterans and Agent Orange: Update 1996 and in future updates that there is limited/suggestive evidence of a positive association between prostate cancer and exposure to herbicides used in Vietnam. 

A 2013 study conducted at the Portland VA Medical Center and Oregon Health and Science University found that Veterans exposed to Agent Orange are not only at higher risk for prostate cancer, but they are more likely to have aggressive forms of the disease. Read the abstract for the publication, Agent Orange as a risk factor for high-grade prostate cancer. View more research on health effects of Agent Orange."

- See more at: http://www.publichealth.va.gov/exposures/agentorange/conditions/prostate_cancer.asp#sthash.RM5zHRwG.dpuf

Agent Orange May Double Invasive Skin Cancer Risk

(note: last year, Portland VAMC cancer researcher Dr. Mark Garzotto published in Cancer his dramatic findings which also used the word, "double." In that case, published in the journal Cancer, Agent Orange exposure doubled risks for highly aggressive prostate cancer. This is a remarkable piece of research.)

Agent Orange Exposure Appears to Double Risk of Invasive Skin Cancer

April 2014 | Department of Defense (DoD) | Department of Veterans Affairs (VA) | News | Oncology

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By Annette M. Boyle

Mark Clemens, MD

HOUSTON — Even four decades later, veterans exposed to Agent Orange during the Vietnam War have twice the risk of developing unusually invasive nonmelanotic skin cancers compared with the general population, according to a recent study.

“We noticed a lot of veterans coming into our clinic had very aggressive squamous and basal cell carcinomas, and it seemed like there was a connection to Agent Orange exposure, but a literature search failed to find any studies that showed an association in humans,” said Mark Clemens, MD, assistant professor of plastic surgery, University of Texas M.D. Anderson Cancer Center. Previous studies have demonstrated a positive correlation between 2-, 3-, 7-, 8-tetrachlorodibenzodioxin (TCDD), the highly toxic contaminant in Agent Orange and nonmelanotic invasive skin in animals.

As of 2009, more than 485,000 veterans with Agent Orange exposure had registered with the VA. DoD and the VA recognize and provide benefits for many TCDD exposure-associated diseases, including peripheral neuropathy, amyloidosis, B-cell leukemia, birth defects, chronic lymphocytic leukemia, type 2 diabetes mellitus, Hodgkin and non-Hodgkin lymphoma, ischemic heart disease, multiple myeloma, Parkinson’s disease, porphyria cutanea tarda, prostate cancer, respiratory cancers, soft-tissue sarcomas and chloracne.

Currently, however, skin cancer is not presumptively associated with Agent Orange exposure. The latest Institute of Medicine update to the Veterans and Agent Orange report concluded that there is “inadequate and insufficient information to determine whether there is an association between exposure to Agent Orange and basal cell or squamous cell cancer.”¹

That didn’t dissuade the M.D. Anderson researchers from further investigation.

“In our clinic, we talked about an association on a daily basis. We wanted to systematically take the first step toward conclusively making that case,” Clemens said. “We did a pilot study with 100 consecutive patients and found a surprisingly high rate of 51% of veterans had nonmelanotic skin cancer, which is about twice what you would see in an age-matched cohort in the general population,” Clemens told U.S. Medicine.

The researchers evaluated the medical records of patients who enrolled in the Agent Orange registry at the Washington, DC, VAMC from August 2009 to January 2010. The patients ranged in age from 56 to 80 years old, with a mean age of 65.7 years. Only patients with Fitzpatrick skin types I-IV (fair to medium complexions) were included in the study. The results of the study appeared in the February issue of Plastic and Reconstructive Surgery.²

“We compared whether they sprayed fields every day, lived and worked in the area or traversed a field once as part of work and then looked at the incidence by group,” Clemens said. Among the 30% of patients who actively sprayed Agent Orange, the risk of skin cancer was even higher — 73%. Of those who lived or worked in areas sprayed with the chemical, 46% had nonmelanotic invasive skin cancer (NMISC). For veterans who reported only traveling through areas exposed to Agent Orange, the rate dropped to 21%.

About 43% of patients had chloracne, known to be caused by dioxin exposure. The presence of chloracne increased the rate of NMISC substantially, to 80%. Cutaneous melanoma occurred in 9% of the patients, similar to the 8.8% rate seen in individuals over the age of 65 in the general population. More than one-fourth of the patients (26%) had other malignancies.

Men with lighter skin and light eye color also had increased risk. Of the 14 men with Fitzpatrick skin type I, the lightest, 10 (71%) had NMISC. Just under 60% of those with Fitzpatrick skin type II and 45% of those with type III had NMISC, while none of those with skin type IV did. Of the 38 veterans with blue eyes, 66% (25) had NMISC, as did 60% (9) of those with green or hazel eyes. The incidence rate was much lower in veterans with brown eyes, at 36%.

“The takeaway from the study is that there may be an association between Agent Orange and development of nonmelanotic skin cancer, but it needs to be studied on a larger scale with thousands of patients. What we’ve observed is very, very suspicious and supports what’s been reported anecdotally,” Clemens noted.

Clemens said he and his colleagues are hoping to enroll patients in a larger, prospective study. The researchers pointed out that their study had some significant limitations, such as reliance on recalled TCDD exposure and the absence of a control group of nonexposed Vietnam-era veterans.