Agent Orange Exposure, Vietnam War Veterans and the Risk of Prostate Cancer

Newswise — According to the US Census Bureau there are over 8 million Vietnam era veterans. Many have now reached the sixth decade.

During the war, some 20 million gallons of Agent Orange were released into the jungle of South Vietnam. This herbicidal agent, used by the U.S. military in an effort to deny its opponent the thick jungle cover that they enjoyed, is a mixture of two phenoxy herbicides. During the production of one of the two main components, 2,3,7,8-tetrachlorodibenzodioxin (TTCD), a dioxin, is formed. Proposed carcinogenic properties of Agent Orange are attributed to this TTCD dioxin byproduct.

Thousands of veterans are known to have been exposed to Agent Orange. Previous studies have examined the relationship of Agent Orange with the incidence of prostate cancer. Some believe that studies reported to date have been too small, and that examined patients were too young, or that studies were conducted in the pre-PSA era.

Dr. Karim Chamie and colleagues re-examined the issue in this noteworthy study. Clinical data from 17,000 Vietnam War era veterans who received care in the Northern California VA system were included in the analysis. 6,214 were exposed to Agent Orange, while 6,930 patients had no documented exposure. Exposed veterans were more likely to develop prostate cancer (239 vs 124 men). Moreover, exposed patients presented at a younger age (59.7 vs 62.2 years), were found to have higher grade disease (2-fold increase in Gleason 8-10), and were more likely to present with metastases (13.4% vs 4.0%).

This study's importance cannot be overstated. If these findings are substantiated, patients with history of Agent Orange exposure should be screened earlier for prostate cancer. Furthermore, these results may affect Service Connection policies of VA Medical Centers.

Presented by Karim Chamie, MD, Ralph W deVere White, MD, Lars M Ellison, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Alexander Kutikov, MD