Monday, July 7, 2014

USA TODAY: VA rejects link between Gulf War service and cancers

Editor's note:

The article below details the latest VA assault on veterans of the 1991 Gulf War, where a letter from House Veterans' Affairs Committee senior members to VA leaders requesting new presumptives for claims by Gulf War veterans was flatly denied.

Sadly, this is yet one more example of it goes when VA is "asked nicely".  The scientific research evidence for brain cancer in Khamisiyah is compelling, as is noted in this article, yet VA still twists an IOM report to their own advantage (VA wrote the contract for that IOM report, by the way) and now VA denies this new presumptive.  

And sadly, the research evidence for the other conditions is not yet compelling on its fact, as the article also notes -- and this fact is another angering example of why VA's research leadership must be held accountable to perform the right research and to report properly on medical research related to Gulf War veterans.  These serious issues of another area where VA is badly broken are not new, they've been the subject of repeated RAC reports and public meetings and Congressional hearings and testimony over many years.

It's now clear that legislation must be introduced and enacted for a Khamisiyah brain cancer presumptive, and it must be made retroactive to ensure benefits for the surviving spouses including where the veteran may not have had a claim on file that could be approved.  To allay Congressional budget hawks' concerns, the bill's cost should be relatively small given the relatively small number of these brain cancer deaths.  However, for the surviving spouses of those affected, the impact would be profound, and provide a small measure of justice for them.  

Additionally, all of this is just one more fuel for why H.R. 4261, the Gulf War Health Research Reform Act of 2014, must be enacted to ensure the kinds of independent research review that is necessary.  However, currently VA staff are winning over Gulf War veterans in the Senate, where the bill is languishing without action and will not be taken up in the current conference committee, contrary to previous assertions that Gulf War veterans' advocates took to be true on their face.


SOURCE:  USA Today, July 7, 2014 - Kelly Kennedy Reporting


VA won’t add to Gulf War ‘presumptive’ conditions for now

WASHINGTON — The Department of Veterans Affairs has rejected a request from members of Congress and veterans advocates to make brain cancer, lung cancer and migraines presumptive conditions for Gulf War veterans. Officials said they cannot prove the high rate of these illnesses among Gulf War vets are related to military service.
VA officials said the number of brain cancer deaths for soldiers exposed to sarin gas was too low to be conclusive, though it was double the rate of soldiers not exposed.
And the rate of lung cancer deaths, though 15% higher than those who did not serve in the 1991 Gulf War, is "inconclusive" because researchers did not know how many of the servicemembers smoke.
"I'm disappointed with their decision, but hold out hope that further studies will convince the VA," Rep. Timothy Walz, D-Minn., told USA TODAY. "We must ensure our brave veterans get the care they need, and this is part of that effort."
If a veteran is diagnosed with a presumptive condition, Veterans Affairs is required to assume that it is military-connected, and that the veteran is then entitled to medical or disability benefits associated with the diagnosis.
Those exposed to smoke after Saddam Hussein set his oil wells on fire, as well as to sarin gas after the U.S. bombed a munitions plant in Khamisayah, Iraq, saw an increased risk of brain cancer, according to a study Rep. Mike Coffman, R-Colo., and Walz cited in letters to former VA Secretary Eric Shinseki in March.
As many as 100,000 troops may have been exposed to sarin, a nerve agent, according to the Defense Department, but a recent study shows more may have been affected.
Gulf War vets also saw a "significant relative excess" of lung cancer, according to a second study. And a third study showed that veterans with chronic fatigue syndrome or Gulf War Illness were likely to also suffer migraines, the lawmakers wrote.
"I am very interested in your opinion of whether the studies enclosed are sufficient to add these three health problems to the list of presumptives related to Gulf War Illness," Coffman wrote in March. "If you believe they are not, please detail the VA's current and planned efforts related to these three problems."
Robert Jesse, VA's acting undersecretary for health, turned down the request, saying that the Institute of Medicine found "inadequate and insufficient evidence" for an association between Gulf War service and the diseases.
"IOM stated that there 'is no consistent evidence of a higher overall incidence of cancer in veterans who were deployed to the Gulf War than in non-deployed veterans,'" Jesse wrote in a letter to Walz.
Ron Brown, president of the National Gulf War Resource Center, said the official response flies in the face of VA's own research.
"What they've done is used the overall population of deployed veterans during Desert Storm," he said. "If you use the whole population, it does not show an increase of cancers, but if you look at Khamisiyah, there are significant increases of cancers."
A 2007 Institute of Medicine study found that, though the number of cases was small, the brain cancer death rate for servicemembers in the sarin-gas exposure zone was twice as high as for servicemembers outside it, according to the American Journal of Public Health. For unexposed soldiers, the brain cancer death rate from 1991 to 2000 was 12 per 100,000. For those near Khamisiyah, the rate was 25 per 100,000.
Jesse said, in his letter, that there had been "little previous evidence" of a connection between sarin and brain cancer.
According to a VA website about the study, "Controlling for oil well fire smoke exposure, Army Gulf War veterans who were potentially exposed to nerve agents at Khamisiyah had a higher mortality rate from brain cancer compared to Army veterans who were not considered exposed."
Victoria Davey, VA's chief officer of public health, wrote in a letter to Brown that there was a 15% "excess risk of lung cancer" associated with Gulf War deployment, but said that study was inconclusive because the researchers didn't know whether the servicemembers were smokers. She wrote that there was a concern because about 5% more Gulf War veterans smoked than did veterans who did not deploy.
According to the American Cancer Society, the average age of someone who smokes who is diagnosed with lung cancer is 70. Fewer than 2% of all cases are found in people younger than 45. According to VA, the average age of a Gulf War veteran is 44.
Gulf War veterans already have presumptive status for chronic fatigue syndrome, fibromyalgia, gastrointestinal disorders, and undiagnosed illnesses that include weight loss, fatigue, cardiovascular disease, muscle and joint pain, headache, menstrual disorders, neurological and psychological problems, skin conditions, respiratory disorders and sleep disturbances, according to VA.
Data recently released by the VA show that 80% of disability claims filed by Gulf War veterans for conditions related to the war were denied.
"This is nothing new," Brown said. "Our veterans have been fighting for 23 years to get the benefits they've earned."

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