The Department of Veterans Affairs this year will initiate a mortality study of Vietnam-era veterans to determine whether individuals who were stationed in Southeast Asia are more likely to develop a deadly cancer linked to a specific variety of parasites common there.
VA Secretary David Shulkin described the study in a Feb. 6 letter to Rep. Lee Zeldin (R-Shirley). VA spokesman Curt Cashour characterized the planned survey as a “well-designed large scale epidemiologic study,” and said it is expected to produce results within two years.
The VA’s decision comes weeks after the release of a small pilot study produced by researchers at the agency’s medical center in Northport. It indicated that, of 50 area Vietnam combat veterans tested, one in four once harbored infestations of a liver fluke parasite that has been linked to an aggressive liver cancer.
Release of the pilot study spread alarm among Vietnam veterans, who said that the VA has done little to address their concerns about the implication of the findings.
“No one can give us direct answers in reference to what’s going on and how they are going to treat us,” said Gerald Wiggins, 70, of Port Jefferson, who served in Vietnam’s Central Highlands in 1967 and 1968. “People are dying.”
The 12 men in the pilot study, released in January, carried antibodies indicating that they once harbored a variety of liver fluke that is virtually unknown in America but rampant in Southeast Asia. Humans are infected by eating undercooked freshwater fish in which the parasite lives.
The parasite, which can survive for decades inside the liver of its mammalian host, produces a chronic irritation that can lead to cholangiocarcinoma, a bile-duct cancer that often kills within months of diagnosis.
The VA has offered health screenings to the 12 participants who tested positive. But until now it has not indicated whether the small study would prompt a larger, more comprehensive testing protocol.
The agency has also given out confusing information regarding any fluke-related cancer risk facing the nation’s estimated 800,000 Vietnam veterans.
Cashour said in an email just after the small study was released: “VA is not aware of any studies that show that bile-duct cancer occurs more often in U.S. Vietnam War Veterans than in other groups of people.”
And in another email Friday, he noted the VA currently recommends that veterans who do not show jaundice or other symptoms associated with fluke-related liver disease “do not need screening.”
At the same time, however, the VA’s own website has a post that reads: “One risk factor for bile-duct cancer is past infection with tiny parasitic worms called liver flukes, which are found in the fresh waters of Southeast Asia . . . The irritation and scarring caused by liver fluke infection can lead to bile duct cancer.”
“It’s got me very concerned, I tell you that,” said John Ball, 73, of Merrick.
Ball, who was sent to Vietnam from July 1966 to August 1967, and served north of Da Nang, was among the 12 veterans who tested positive.
Ball said he agreed to participate in the survey after a friend, Jim Delgiorno, two years ago told Ball he had been diagnosed with a rare cancer linked to liver flukes. Delgiorno, who lived in Smithtown, died Oct. 3. Gerald “Jerry” Chiano, of Valley Stream, who also served in Vietnam, died of the cancer in November, his family said.
Pat O’Leary, 69, of East Lyme, Connecticut, served with Delgiorno in the same 30-man platoon. For most of 1968 and 1969, they were stationed near the Demilitarized Zone that then separated the two Vietnams.
O’Leary said he wonders if his current health problems — he has liver cirrhosis and other hepatic maladies even though he says he seldom drinks — may indicate he is at risk for what killed his friend.
“It’s been on my mind for a long, long time,” O’Leary said. “What happened with Jimmy was really, really scary and is setting off alarm bells.
Several area Congress members have sent letters urging Secretary Shulkin to make liver fluke a “top priority.”
“I have so much to live for,” said Ralph Goodwin, 73, of Port Washington Station, who is among the 12 survey participants who tested positive for exposure, and says he lives with a sense of worry. “I wouldn’t want it to shorten my life.”
Wiggins also tested positive in the survey, which ended last spring. Just months later, he was operated on at Memorial Sloan Kettering Cancer Center to remove cancerous cysts from his liver, Wiggins said.
He wants the VA to make a priority of educating veterans on the risks they are facing, and to offer clear guidance on what they should do.
“The VA is still dancing around this whole thing,” Wiggins said. “We have gotten no notification, except that they said they’ll call you back in a year and give you a CAT scan.”