Once again our veterans, who served in Vietnam, have been impacted by their exposure to Agent Orange, a defoliant used to clear the vegetation from the jungles. A recent study, which was presented at the annual meeting of the American Urological Association, in Anaheim, Calif., concluded that the exposure to Agent Orange appears to boost both a veteran’s risk for a recurrence of prostate cancer as well as for a more aggressive return of the cancer.

Dr. Sagar Shah, the lead researcher of the study, who is a urology resident physician at the Medical College of Georgia, said that Agent Orange contains dioxin, which “isn’t really a tumor mutagen — it doesn’t cause cancer — but it is a tumor-promoter. So, if the cancer is there, it makes it more prominent.” When prostate cancer did recur among veterans exposed to Agent Orange, “it seemed that they had a much shorter PSA doubling time, a surrogate for aggressiveness,” Shah said.

In the study, Shah’s team sought to determine if there were any differences in the rate or type of prostate cancer recurrences seen among a group of 1,653 black and white Vietnam veterans of which 199 of whom had been exposed to Agent Orange. All of the veterans in the study were treated between 1990 and 2006 by having a radical prostectomy. When biopsy samples were examined under a microscope, there were no pathological differences between the tumors of veterans exposed to Agent Orange and those who were not exposed, Shah said. However, differences did emerge, when the researchers compared rates of PSA velocity of the veterans, post surgery.

“Veterans exposed to Agent Orange “had a higher relative risk of having a biochemical recurrence (rise of PSA)” than unexposed veterans, Shah said. The rate of post-surgical prostate cancer recurrence among white veterans rose by 42 percent if they had been exposed to Agent Orange, compared to non-exposed veterans, the researchers found. Black veterans exposed to the herbicide fared even less well, with a recurrence rate that was 75 percent higher than their non-exposed peers.

If you are a veteran, either black or white, who was exposed to Agent Orange, you must become even more vigilant after surgery. This study only looked at veterans who were treated with surgery, but vets whose primary treatment was not surgery should also consider taking similar precautions. Make sure that your doctor knows about this study and that you have been exposed to Agent Orange. We must take primary responsibility for our own health. In this case we must aggressively monitor our PSA.

Joel T Nowak MA, MSW