Pancreatic cancer is a devastating diagnosis, with a high mortality rate and few effective treatment options. For many veterans, the risk of developing pancreatic cancer may be linked to exposure to Agent Orange, a chemical herbicide widely used during the Vietnam War.
Agent Orange was a powerful herbicide used by the military during the Vietnam War to remove dense foliage that provided cover for enemy forces. The herbicide was later found to contain dioxin, a toxic compound that has been linked to a variety of serious health conditions, including several types of cancer.
Exposure to dioxin in Agent Orange has been associated with an increased risk of several cancers, including prostate cancer, respiratory cancers, and some lymphomas, according to data posted on the American Cancer Society’s (ACS) website.1
While pancreatic cancer is not currently on the Veterans Affairs (VA) official list of presumptive conditions related to Agent Orange, there is growing evidence that exposure to this toxic herbicide could increase the risk of developing pancreatic cancer. Scientific studies and anecdotal evidence from veterans have prompted calls for the VA to recognize pancreatic cancer as a presumptive condition linked to Agent Orange exposure.
The National Academies of Sciences, Engineering, and Medicine conducted a comprehensive review of the health effects of Agent Orange and noted that while the evidence is still limited, there is suggestive evidence of an association between exposure to herbicides and pancreatic cancer.2
VA Disability Ratings for Pancreatic Cancer
Veterans diagnosed with pancreatic cancer that they believe is linked to Agent Orange exposure may be eligible for VA disability benefits. The VA rates pancreatic cancer under Diagnostic Code 7343, which covers malignant neoplasms of the digestive system.
- Initial 100% Rating: When pancreatic cancer is diagnosed, the VA typically assigns a 100% disability rating while the cancer is active or undergoing treatment. This rating remains in place until 6 months after the treatment ends.
- Residuals and Re-evaluation: After the initial treatment period, the VA will re-evaluate the condition based on any residuals, such as ongoing symptoms or complications like digestive issues, weight loss, or diabetes. Depending on the severity of these residuals, the VA may assign a lower disability rating.
Service Connection and Pancreatic Cancer
Veterans must provide medical evidence that links their pancreatic cancer to their exposure to Agent Orange during their military service, and members of the patient-aligned care team are in a position to advise on ways to gather this evidence, using the following steps:
- Gather Medical Evidence: Obtain all medical records related to the pancreatic cancer diagnosis and treatment. This includes pathology reports, oncologist statements, and any documentation that suggests a connection between your cancer and Agent Orange exposure.
- Seek Expert Opinions: A medical nexus letter from a qualified healthcare provider can be invaluable.
- Reference Scientific Studies: Including relevant scientific research that supports the link between Agent Orange and pancreatic cancer. For example, studies conducted by the National Academies and the ACS provide crucial support.
- Consider Legal Assistance: Given the complexity of these cases, working with a VA-accredited attorney can help ensure a claim is thoroughly prepared and that all necessary evidence is presented.
Winning Service Connection for Cause of Death Due to Pancreatic Cancer: A Case Example
In this case, the surviving spouse of a Vietnam War veteran sought Dependency and Indemnity Compensation (DIC) benefits based on the service connection for the cause of the veteran’s death. The veteran, who had honorable active-duty service from September 1963 to July 1967, including service in Vietnam where he was exposed to Agent Orange, passed away in February 2012 from pancreatic cancer.
The Board granted service connection for the cause of the veteran’s death, recognizing that his service-connected type 2 diabetes, which was presumptively linked to Agent Orange exposure, materially contributed to his fatal pancreatic cancer. Despite pancreatic cancer not being on the list of diseases presumptively associated with herbicide exposure, compelling medical evidence was presented showing a direct link between the veteran’s herbicide exposure and the development of pancreatic cancer. The claim proceeded using:
- Medical Expert Opinion: A pivotal factor in the case was a well-supported medical opinion from Dr. B, a board-certified endocrinologist, who provided a detailed analysis linking the veteran’s pancreatic cancer to his service-connected diabetes and herbicide exposure. Dr. B’s analysis was supported by medical literature that highlighted the connection between metabolic syndrome, which includes diabetes, and an increased risk of developing pancreatic cancer.
- Consideration of Herbicide Exposure: The Board acknowledged that while pancreatic cancer is not presumptively linked to herbicide exposure, the evidence suggested that the veteran’s exposure to Agent Orange contributed to his development of diabetes, which in turn, was a contributing factor to his pancreatic cancer.
- Benefit of the Doubt Doctrine: Given the conflicting medical evidence, the Board applied the “benefit of the doubt” doctrine, which mandates that when there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the doubt is resolved in favor of the claimant.
The successful outcome demonstrates that veterans can establish a service connection for the cause of death by providing compelling evidence of a direct link between the veteran’s service-related conditions and their cause of death.
While pancreatic cancer is not yet recognized as a presumptive condition related to Agent Orange by the VA, the growing body of evidence suggests that veterans exposed to this herbicide may be at an increased risk.
Disclaimer: The statistics and references mentioned in this article do not imply any formal conclusions on behalf of the author or affiliated organizations. The information provided is intended to foster conversation and encourage further research into this subject. The research here is reprinted with permission.
References
- American Cancer Society. Agent Orange and cancer risk. Accessed September 25, 20024. https://www.cancer.org/cancer/risk-prevention/chemicals/agent-orange-and-cancer.html
- National Academies Press. Veterans and Agent Orange Update 2010 (2012). Chapter 7. Accessed September 25, 2024. https://nap.nationalacademies.org/read/13166/chapter/9
Written by
Claire Szewczyk is a Digital Content Coordinator for Hill & Ponton, PA, in Florida. She was a former US Air Force civilian employee, who worked at Hill Air Force Base, in Layton, UT, as a flight testing administrator. She has also spent several years working with the Department of Veterans Affairs audiology programs in Salt Lake City, UT, and Pocatello, ID. She enjoys working with the Veteran population and keeping them up to date with information they need the most.
