According to researchers, veterans exposed to Agent Orange are at increased risk of aggressive recurrence of prostate cancer.
Prostate cancer is the most common cancer in men and trails lung cancer as the second leading cause of cancer death.
A study of 1,495 veterans who underwent radical prostatectomy to remove their cancerous prostates showed that the 206 exposed to Agent Orange had nearly a 50 percent increased risk of their prostate cancer recurring despite the fact that their cancer seemed relatively nonaggressive at the time of surgery. And, their cancer came back with a vengeance: the time it took the prostate specific antigen, or PSA, level to double, an indicator of aggressiveness, was eight months versus more than 18 months in non-exposed veterans.
“There is something about the biology of these cancers that are associated with prior Agent Orange exposure that is causing them to be more aggressive. We need to get the word out,” says Dr. Martha Terris, corresponding author on the study.
Dr. Terris says she wants her colleagues following prostate cancer patients with Agent Orange exposure to know those patients may need more meticulous scrutiny and so-called salvage therapy quickly if their prostate cancer returns. “Not only are their recurrence rates higher but their cancers are coming back and growing much faster when they do come back.”
The PSA of prostate cancer patients is typically measured every three months for two years after surgery then every six months for life. After surgery to remove the diseased prostate, the PSA should be zero, but any prostate cancer cells left behind continue to make PSA, a red flag of recurrence. The PSA often “percolates along” so physicians tend to watch it for a while to determine if additional therapy is needed. However in patients with Agent Orange exposure, therapy to kill remaining cells may need to be done sooner rather than later, Dr. Terris says.
Increasing evidence is emerging that exposure to Agent Orange, a herbicide and defoliant used during the Vietnam War, increases risk for a variety of health problems, including prostate cancer, although the exact mechanism is unclear. Dioxin, its known carcinogen, also is found in herbicides and pesticides used by U.S. farmers, forestry and chemical plant workers who studies have shown to have an increased cancer risk. Scientists suspect dioxin activates regulatory regions of genes to enable the uncontrolled cell division that is a cancer hallmark.
Once dioxins have entered the body, they endure a long time because of their chemical stability and their ability to be absorbed by fat tissue, where they are then stored in the body.
More than 90% of human exposure to dioxins is through the food supply, mainly meat and dairy products, fish and shellfish. Trimming fat from meat and consuming low fat dairy products may decrease the exposure to dioxin compounds.
Dr. Terris led a separate study of 1,653 veterans at VA medical centers in five cities between 1990 and 2006 that also showed recurrence rates were higher and recurring cancers were more aggressive with Agent Orange exposure.
This new study included new patients as well as longer follow up on many of the original study patients. As with the previous study, prostate cancer seemed to have a similar course in blacks and whites, but Agent Orange exposure was more common in blacks, who were more likely to be ground troops in Vietnam.
References:
1. Martha Terris, et al. Medical College of Georgia .
2. World Health Organization.
