Monday, November 28, 2016

Vietnam War veterans attacked by rare cancer linked to liver flukes

DANVILLE  — Mike Baughman considered himself one of the lucky ones, returning from Vietnam without any major injuries or psychological scars. But after falling ill nearly a half-century later, he found out he did not escape the war after all.
The 64-year-old is among hundreds of veterans who have been diagnosed with a rare bile duct cancer that may be linked to their time in the service and an unexpected source: parasites in raw or poorly cooked river fish.
The worms infect an estimated 25 million people, mostly in Asia, but are less known in America. They can easily be wiped out with a few pills early on. Left untreated, a cancer known as cholangiocarcinoma can develop, often killing patients just a few months after symptoms appear.
The U.S. government acknowledges that liver flukes, endemic in the steamy jungles of Vietnam, are likely killing some former soldiers. Ralph Erickson, who heads post-deployment health services at the Department of Veterans Affairs, said about 700 cholangiocarcinoma patients have passed through the agency’s medical system in the past 15 years.
Less than half of those submitted claims for benefits, in part because they were unaware of a potential link to time in service. Of the claims submitted, 3 out of 4 have been rejected, according to data obtained by The Associated Press through the Freedom of Information Act.
The VA requires veterans to show medical conditions are at least “as likely as not” related to their time in service to receive financial help, but doctors note that often isn’t easy with bile duct cancer caused by liver flukes.
The parasites typically go undetected, sometimes living for more than 25 years without making their hosts sick. The body reacts by trying to wall off the organisms. This causes inflammation and scarring and, over time, can lead to cancer. The first symptoms are often jaundice, itchy skin and rapid weight loss. By then, the disease is usually advanced.
If American doctors better understood bile duct cancer and the potential risks to those who served in Vietnam, they could use ultrasounds to check veterans for inflammation, and then surgery might be possible for some of them, said Jeff Bethony, a liver fluke expert at George Washington University.
“Early is key,” he said, adding he regularly receives desperate letters from veterans’ family members. “The VA should be testing for this.”

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