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Veterans Law

Esophageal Cancer and Agent Orange

Alyse Phillips

June 30, 2023

Updated: June 20, 2024

Esophageal Cancer and Agent Orange

What Is Esophageal Cancer?

The esophagus is a hollow tube that moves food and liquid from the throat to the stomach.  The esophagus wall is comprised of several layers of tissue, such as the mucous membrane, muscle, and connective tissue.

Esophageal cancer occurs when malignant (i.e., cancerous) cells form in the inside lining of the esophagus.  The cancer can then grow and spread to the other layers of esophageal tissue.

The two most common forms of esophageal cancer include:

  • Squamous cell carcinoma: Also known as epidermoid carcinoma, this type of esophageal cancer is most often found in the upper or middle part of the esophagus.
  • Adenocarcinoma: This type of esophageal cancer begins in glandular cells, and usually forms in the lower part of the esophagus, near the stomach.

Research has shown that esophageal cancer is linked to heavy tobacco and alcohol use; older age; and Barrett’s esophagus, a condition in which the lower part of the esophagus has been changed or replaced with abnormal cells.

Symptoms

Symptoms of esophageal cancer include:

  • Difficulty and pain when swallowing
  • Weight loss
  • Indigestion or heart burn
  • Chronic coughing or hoarseness
  • Pressure or burning in the chest
  • Bleeding into the esophagus, which may lead to symptoms of anemia
  • Bone pain, if the cancer has spread to the bone

Treatments

Surgery is the most common treatment for esophageal cancer.  However, the type of treatment depends on the location and stage of the cancer, as well as the person’s age and general health.  When esophageal cancer is found very early, the person has a better chance of recovering fully.

Other treatments for esophageal cancer include radiation therapy, chemotherapy, targeted therapy, and immunotherapy.

Overview of Agent Orange

Agent Orange is one of the several “rainbow” herbicides used by the United States during the Vietnam War era.  The United States military used Agent Orange and other herbicides to deforest large areas of land in Vietnam to disrupt enemy supply lines and prevent ambushes.

Agent Orange is composed of a mixture of two kinds of herbicide agents, 2, 4-D and 2, 4, 5-T.  The highly toxic dioxin contaminant known as 2, 3, 7, 8-TCDD is a byproduct that is produced by Agent Orange.  This dioxin often takes years to break down once it has been released into the environment and can cause a wide array of health effects.  As such, Agent Orange exposure in Vietnam has caused many serious health conditions for veterans.

Agent Orange Presumptive Conditions

The Agent Orange Act of 1991 established presumptive service connection for veterans who served during certain time periods in specific locations and have been diagnosed with one of the above conditions.  In addition, the Honoring Our Promise to Address Comprehensive Toxics Act (PACT Act) of 2021 expanded presumptions related to Agent Orange exposure to include additional locations and time periods.

The following conditions have a strong association with Agent Orange exposure and therefore are considered presumptive by VA:

  • AL Amyloidosis
  • Bladder Cancer
  • Chronic B-cell Leukemias
  • Chloracne
  • Diabetes Mellitus Type 2
  • Hodgkin's disease
  • Hypertension
  • Hypothyroidism
  • Ischemic Heart Disease
  • Monoclonal Gammopathy of Undetermined Significance
  • Multiple Myeloma
  • Non-Hodgkin's Lymphoma
  • Parkinson's Disease
  • Parkinson's-like Symptoms
  • Peripheral Neuropathy
  • Porphyria Cutanea Tarda
  • Prostate Cancer
  • Respiratory Cancer
  • Soft Tissue Sarcomas

Agent Orange Presumptive Locations

In addition, the Department of Veterans Affairs (VA) recognizes that veterans who served certain locations during certain time periods are presumed to have been exposed to herbicides.  VA acknowledges presumptive Agent Orange exposure for veterans with active military, naval, air, or space service in the following time periods and locations:

  • January 9, 1962 to May 7, 1975 in the Republic of Vietnam:This includes boots-on-the-ground, Brown Water veterans, and Blue Water Navy veterans.
  • January 9, 1962 to June 30, 1976 in Thailand: At any U.S. or Thailand base, without regard to the Veteran’s military occupational specialty (MOS) or where on base they were located.
  • December 1, 1965 to September 30, 1969 in Laos
  • April 16, 1969 to April 30, 1969 in Cambodia: Specifically at Mimot or Krek, Kampong Cham Province.
  • January 9, 1962 to July 30, 1980 in Guam or American Samoa: Or in the territorial waters thereof.
  • January 1, 1972 to September 30, 1977 at Johnston Atoll: Or a ship that called at Johnston Atoll.
  • September 1, 1967 to August 31, 1971 in the DMZ:On or near the Korean demilitarized zone (DMZ).
  • 1969 to 1986, C-123 aircraft:Active duty and reservist personnel who had regular contact with C-123 aircraft.

Agent Orange and Esophageal Cancer

Unfortunately, the Department of Veterans Affairs (VA) does not currently acknowledge esophageal cancer as a cancer associated with Agent Orange.  Due to this, veterans cannot, as of now, obtain presumptive service connection for esophageal cancer as related to Agent Orange exposure.  However, veterans can still provide evidence (e.g., through scientific studies) of this relation.

Veterans may also be able to prove that esophageal cancer is related to Agent Orange exposure on a secondary basis.  A secondary service-connected disability is a disability that resulted from a condition that is already service-connected.  For example, studies have linked hypertension to an increased risk of developing esophageal cancer.  As of the PACT Act, hypertension is included on the list of presumptive Agent Orange conditions.  Therefore, veterans may be able to obtain service connection for esophageal cancer as secondary to hypertension.

How to Establish Service Connection for Esophageal Cancer

Although veterans may not be able to establish presumptive service connection for esophageal cancer, they can still secure service connection on a direct basis.  Generally, proving direct service connection requires evidence of these three things:

  • An in-service event, injury, or illness;
  • A current diagnosis by a medical professional;
  • A medical nexus, or link, between the in-service event and current diagnosis.

Importantly, veterans must demonstrate a connection between their military service and their esophageal cancer.  Veterans can support their claim by securing a private nexus opinion from a medical professional and by submitting lay evidence.  Lay evidence, or lay statements, can be written by the veteran or anyone who knows the veteran and can speak to their condition.

VA may also schedule the veteran for a Compensation and Pension (C&P) exam to determine if a connection exists between military service and the esophageal cancer.  C&P exams are also generally used to evaluate the severity of a condition.

VA Ratings for Esophageal Cancer

VA automatically assigns a temporary total 100 percent disability rating to veterans with a service-connected active cancer, including esophageal cancer.  This rating continues for as long as the cancer is active, and then for another six months following the successful completion of a treatment program, such as chemotherapy, radiation, or surgery.

VA will then schedule a C&P examination to reevaluate the status of the cancer.  If the examination shows that the veteran’s cancer is no longer active and is in remission, VA will assign a disability rating based on the severity of its residuals.

Camp Lejeune and Esophageal Cancer

Water contamination at United States Marine Corps Base Camp Lejeune in North Carolina exposed thousands of people to serious health risks for decades.  From 1953 to 1987, service members and their families living on the base were unknowingly drinking toxic water, as well as using it to cook, bathe, and wash their clothes.  Veterans have since developed numerous health problems presumed to be connected to their military service at this camp.

Among the toxic chemicals found at Camp Lejeune were Volatile Organic Compounds (VOC), which included tetrachloroethylene, also known as perchloroethylene (PCE), and trichloroethylene (TCE).  PCEs and TCEs can increase the risk of several cancers and Hodgkin’s disease.

Although esophageal cancer is not considered presumptive by VA, it is one of the 15 conditions eligible for healthcare benefits for those exposed to toxic water at Camp Lejeune.  The Honoring America’s Veterans and Caring for Camp Lejeune Families Act provides healthcare benefits to veterans with qualifying conditions who served on active duty at Camp Lejeune for at least 30 days between 1953 and 1987.  The conditions include:

  • Bladder cancer
  • Breast cancer
  • Esophageal cancer
  • Female infertility
  • Hepatic steatosis
  • Kidney cancer
  • Leukemia
  • Lung cancer
  • Miscarriage
  • Multiple myeloma
  • Myelodysplastic syndromes
  • Neurobehavioral effects
  • Non-Hodgkin’s lymphoma
  • Renal toxicity
  • Scleroderma

Was Your Esophageal Cancer Claim Denied?

Did VA deny your claim for esophageal cancer even though you have evidence of Agent Orange exposure?  Chisholm Chisholm & Kilpatrick LTD may be able to help you receive VA disability benefits for esophageal cancer caused by Agent Orange exposure.  For a free case evaluation, call us today at 800-544-9144.

 

About the Author

Bio photo of Alyse Phillips

Alyse is a Supervising Attorney at Chisholm Chisholm & Kilpatrick. Since joining the firm in August of 2016, she has specialized in representing disabled veterans and their dependents before the United States Department of Veterans Affairs and the United States Court of Appeals for Veterans Claims.

See more about Alyse