Health
A new analysis has found a link between exposure to Agent Orange and lethal forms of prostate cancer among US veterans.
Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings suggest that Agent Orange exposure history should be incorporated into prostate screening decisions for veterans.
The herbicide Agent Orange was heavily used during the Vietnam War era and was often contaminated with dioxin, a dangerous toxin and potential carcinogen.
Prior research suggests that exposure to Agent Orange may increase men’s risk of developing prostate cancer, but it is unclear whether it specifically increases their risk of developing lethal forms of the disease.
“This is an important distinction as the majority of prostate cancer cases are non-lethal and thus do not necessarily require detection or therapy. Having a means of specifically detecting life-threatening cancer would improve the effectiveness of screening and treatment of prostate cancer,” said Mark Garzotto, MD, of the Portland Veterans Administration Medical Center and Oregon Health & Science University.
To look for a link between Agent Orange exposure and life-threatening, or high-grade, prostate cancer, Nathan Ansbaugh, MPH, designed and conducted analyses on a group of 2,720 US veterans who were referred by multiple providers for initial prostate biopsy.
Biopsy results and clinical information were compiled for analysis by principal investigator Dr. Garzotto.
Prostate cancer was diagnosed in 896 (32.9 percent) of the veterans; 459 (16.9 percent) had high-grade disease.
Agent Orange exposure was linked with a 52 percent increase in overall risk of prostate cancer detection by biopsy.
Exposure to the herbicide did not confer an increase in risk of low-grade prostate cancer, but it was linked with a 75 percent increase in risk of high-grade prostate cancer.
In addition, Agent Orange exposure was associated with more than a two-fold increase in the highest-grade, most lethal cancers.
This study indicates that determining men’s Agent Orange exposure status is a readily identifiable means of improving prostate cancer screening for US veterans, allowing for earlier detection and treatment of lethal cases and potentially prolonging survival and improving quality of life.
“It also should raise awareness about potential harms of chemical contaminants in biologic agents used in warfare and the risks associated with waste handling and other chemical processes that generate dioxin or dioxin-related compounds,” said Dr. Garzotto.
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SACRAMENTO – Legislation that would make the Community Based Adult Services (CBAS) program permanent in California is now in the California Senate.
AB 518, authored by Assemblymember Mariko Yamada (D–Davis), Chair of the Assembly Committee on Aging and Long-Term Care, and Bob Blumenfield (D-San Fernando Valley), Chair of the Assembly Budget Committee, earned unanimous support on the Assembly Floor this week.
The CBAS program, which replaced California’s Adult Day Health Care program (ADHC), offers seniors and persons with disabilities a cost-effective alternative to nursing homes by providing medical and support services in community-based day settings.
“With a rapidly aging population, and California's most turbulent budget decisions behind us, it is time to start re-building a network of home and community-based options for the elderly and persons with disabilities,” Yamada said. “CBAS is both cost-effective and compassionate.”
CBAS was established to settle a lawsuit brought against the state on behalf of disabled individuals whose independence was jeopardized by the elimination of California’s long-standing Adult Day Health Care (ADHC) program. The settlement agreement expires in June of 2014, leaving the future of the program uncertain.
“Thousands of patients and their families don’t know what their future holds when the settlement period expires,” said Blumenfield, author of legislation vetoed in 2011 that closely resembles the CBAS program. “Uncertainty is a nightmare that these families have endured over many years about access to vital care for their loved ones. This bill helps end that.”
The legislation, AB 518 , is intended to provide stability for CBAS by removing it from the uncertainties of the courts and establishing it as a permanent program in state law.
The Legislature agreed to eliminate ADHC during the height of the state’s budget crisis in 2011 based on an understanding that a similar, though smaller program would replace it.
Lawmakers were blindsided when that alternate program was vetoed by Governor Brown, leaving seniors and persons with disabilities stranded without an affordable alternative to institutionalization.
“Making CBAS permanent fulfills the intent of those legislators, including me, who voted to eliminate ADHC, with the commitment to fight for community-based programs,” Yamada said. “A community-based alternative to institutionalization saves money and preserves independence."
The bill Assemblymember Yamada represents the 4th Assembly District, which includes all or parts of Colusa, Lake, Napa, Solano, Sonoma and Yolo counties.
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