A Few Good Men and Bladder Cancer

Veterans of EPA Superfund sites are at risk for bladder cancer from organic solvent exposure. A simple and non-evasive test is available to detect bladder cancer. This information has not been passed to veterans at risk for disease.

Photos of Robert O'Dowd and El Toro, Summer of 2009 by Bonnie King Salem-News.com

(SOMERDALE, N.J.) - Those that served and were exposed to toxic chemicals have a critical need to know what chemicals they were exposed to and access to medical screening to stay healthy. No reasonable person would disagree with this.

In fact, there’s no government program to screen veterans who worked and lived in highly toxic environments. Bladder cancer is only one of the health effects of exposure to these chemicals. Exposure to organic solvents like trichloroethylene (TCE) can cause bladder cancer, brain cancer, esophageal cancer and other serious diseases.

According to Dr. Robert Schlesinger, retired Army Colonel and urologist, “Organic compounds in general, and benzene containing compounds specifically are recognized as carcinogenic for the lining of the entire urinary tract, kidneys, ureters and bladder. There is no dispute regarding this.”

The good news is that bladder cancer, the fifth leading cause of cancer deaths, can be screened with an inexpensive and non-invasive medical test.

The Journal of the American Medical Association reported in 2006 that an easy in office urine test can detect 99 percent of bladder tumors when used in conjunction with a cystoscopy. The $30 urine test called NMP22 BladderChek was reported to be three times more effective than standard urine testing. The test measures the level of NMP22, a type of protein in the urine. Elevated levels of NMP22 are a sign of bladder cancer.

Chemical exposures of thousands of veterans are an indisputable fact. In 2003, the Air Force reported 1,400 military sites contaminated with TCE alone. The EPA National Priority List (Superfund) lists multiple organic solvent and other contaminants for military bases. The potential health consequences of high exposures are medical facts. But these facts haven't reached most veterans.

I am one of thousands of veterans exposed to chemical solvents while in the military. Unlike many civilian workers, my exposure was around the clock since I worked and lived in the same contaminated environment. Marine Corps Air Station El Toro where I served is now a federal hazardous waste site. The hangar I worked and slept in on duty watch for two years was on land where toxic chemicals were in the soil, air, and water.

The chemical that harmed me, TCE was commonly used by the military and industry as a degreasing agent. I knew nothing about what it could do to my health. Neither did the other Marines at El Toro, including many who are now sick or dead from TCE and other chemicals. El Toro contamination is not unique since it is only one of many military bases on the National Priority List.

Over 130 military bases in the US are hazardous waste sites, with such severe land, water and air contamination that federal action is required to prevent further health damage. This is not about a few empty barrels on an open lot. This is about veterans who worked and lived where chemicals caused mutations and ultimately cancer. And it is veterans who could be warned and preserve their health. Instead, current policies will lead to late diagnosis and death from preventable cancers.

In my case and many others, early warning and the $30 screening test to identify pre-cancerous lesions could have prevented cancer. Instead, tens of thousands of dollars have been spent on surgery, chemotherapy, and other medical care.

Costs of Bladder Cancer

The Anderson Cancer Center at the University of Texas estimated the lifetime cost of bladder cancer based on a review of several hundred bladder cancer patients in 2005. Their conclusion was that bladder cancer and its associated complications represent a major economic burden: “The average cost of bladder cancer was $65,158 among the cohort patients. Sixty percent of this cost ($39,393) was associated with surveillance and treatment of recurrences, and 30% ($19,811) was attributable to complications. The lifetime cost of bladder cancer was lower for the worst-case scenario ($99,270 dollars) than for the best-case scenario ($120,684). However, a greater proportion of the costs were attributable to complications with the worst-case scenario (43%, $42,290) compared with the best (28%, $34,169).”

In 2009, the National Cancer Institute estimated 70,980 news bladder cancers and 14,330 deaths. According to recent world-wide study of bladder cancer in Germany: “Bladder cancer has the highest lifetime treatment costs per patient of all cancers. The high recurrence rate and ongoing invasive monitoring requirement are the key contributors to the economic and human toll of this disease.” It’s obvious that bladder cancer screening and prevention can result in significant health cost savings and thousands of lives saved.

Department of Veterans Affairs

The Department of Veterans Affairs conceded that medical specialists correctly attributed my bladder cancer to TCE exposure at El Toro. But a lack of information and the high cost of independent medical evaluations prevent other veterans with service-related illnesses from obtaining VA benefits.

Veterans who seek information and medical care from the Department of Veterans Affairs for cancer or other diseases are required to complete an annual financial assessment or Means test to determine if they qualify for cost-free services. For non-service connected disabilities, the VA assigns veterans to Priority Group 8, which means that all medical services must be paid by the veteran.

Even if a veteran goes to a VA Medical Center, the VA has no on-going program to screen high risk veterans for bladder cancer. Denials of disability claims may be based on questionable economics, but that is an inhumane and dishonest response to veterans placed in harms way. This is especially hard to understand when there is an easy, non-expensive test to screen for bladder cancer and a large number of veterans at risk who served at EPA Superfund sites.

The lengthy delay in onset of disease from organic solvent exposure means that the VA benefits for chemical harm are denied unless a veteran spends thousands of dollars for a medical nexus opinion. The sad truth is that veterans seriously ill with cancer and often out of work, can not afford independent medical evaluations and nexus opinions. As result, many never obtain the benefits they are entitled to.

Instead of denying what they know to be true, the VA could inform veterans about chemicals found on the EPA Superfund bases and the diseases linked to them. A proactive approach could allow veterans to share the information with their medical care providers. The medical professionals could catch cancer and other diseases early, when the option for a cure is best. The VA could save the country untold millions in medical costs and families a great deal of pain and suffering.

The VA and Veteran Service Organizations

The information on contaminants of concern and their health effects for bases on the National Priority List (NPL) is on an EPA database easily accessed from the internet. What’s missing is the “heads-up” to veterans and their medical care providers.

One solution is for the VA to provide the Veteran Service Organizations (VSOs) the internet URLs for the chemicals (contaminants of concern) and health effects (diseases) found in the EPA Superfund database. The VSOs could post this information on their websites, allowing veterans and their medical care providers easy access.

To help spread the word to other veterans, I have posted this information on my own website. See: militarysuperfunds.blogspot.com/. The list of bases is shown at the end of this news story. Posting this information on any VSO website is not “rocket science.” Lives can be saved from veterans who would otherwise not consider asking for this inexpensive and non-invasive test.

In regard to bladder cancer, a government initiative to inform veterans is both proactive and inexpensive. Cost effective screening tests at VA medical centers or private health care providers exist for bladder cancer and many other diseases. The solution isn't difficult or costly.

This is a proactive approach to preventing serious disease before it’s too late. Normally, the VA is not in the business of health care screening for veterans, but there are compelling costs and humane reasons for doing so for veterans of EPA Superfund sites.

We promised to protect our country. We now need to protect our own health. It is the right thing to do, and passing on a legacy of honesty in our military services is the honorable thing to do.

Top to bottom: El Toro flight gear warehouse, squadron logo on a hangar door, Empty MP shack at main gate, View into base housing, looking through the old base dispensary

EPA Superfund Military Bases:

US Air Force

Air Force Plant #4 (General Dynamics)
Fort Worth
TX

Air Force Plant 85
Columbus
OH

Air Force Plant PJKS
Littleton
CO

American Lake Gardens/McChord AFB
Tacoma
WA

Andersen Air Force Base
Yigo
GU

Andrews Air Force Base
Andrews Air Force Base
MD

Arnold Engineering Development Center (USAF)
Tullahoma/Manchester
TN

Brandywine DRMO
Brandywine
MD

Castle Air Force Base (6 Areas)
Merced
CA

Chanute Air Force Base
Rantoul
IL

Dover Air Force Base
Dover
DE

Edwards Air Force Base
Edwards AFB
CA

Eielson Air Force Base
Fairbanks
AK

Ellsworth Air Force Base
Ellsworth AFB
SD

Elmendorf Air Force Base
Anchorage
AK

F.E. Warren Air Force Base
Cheyenne
WY

Fairchild Air Force Base (4 Waste Areas)
Spokane
WA

George Air Force Base
Victorville
CA

Griffiss Air Force Base (11 Areas)
Rome
NY

Hanscom Field/Hanscom Air Force Base
Bedford
MA

Hill Air Force Base
Hill AFB
UT

Homestead Air Force Base
Homestead Air Force Base
FL

Loring Air Force Base
Limestone
ME

Luke Air Force Base
Glendale
AZ

March Air Force Base
Riverside
CA

Mather Air Force Base (ACandW Disposal Site)
Mather
CA

McChord Air Force Base (Wash Rack/Treatment Area)
Tacoma
WA

McClellan Air Force Base (Ground Water Contamination)
McClellan AFB
CA

McGuire Air Force Base #1
Wrightstown
NJ

Mountain Home Air Force Base
Mountain Home
ID

Norton Air Force Base (Lndfll #2)
San Bernardino
CA

Pease Air Force Base
Portsmouth/Newington
NH

Plattsburgh Air Force Base
Plattsburgh
NY

Rickenbacker Air National Guard (USAF)
Lockbourne
OH

Robins Air Force Base (Landfill #4/Sludge Lagoon)
Houston County
GA

Tinker Air Force Base (Soldier Creek/Building 3001)
Oklahoma City
OK

Travis Air Force Base
Travis AFB
CA

Twin Cities Air Force Reserve Base (Small Arms Range Landfill)
Minneapolis
MN

Tyndall Air Force Base
Panama City
FL

Williams Air Force Base
Chandler
AZ

Wright-Patterson Air Force Base
Dayton
OH

Wurtsmith Air Force Base
Oscoda
MI

US Army

Aberdeen Proving Ground (Edgewood Area)
Edgewood
MD

Aberdeen Proving Ground (Michaelsville Landfill)
Aberdeen
MD

Alabama Army Ammunition Plant
Childersburg
AL

Anniston Army Depot (Southeast Industrial Area)
Anniston
AL

Cornhusker Army Ammunition Plant
Hall County
NE

Fort Devens
Fort Devens
MA

Fort Devens-Sudbury Training Annex
Sudbury
MA

Fort Dix (Landfill Site)
Pemberton Township
NJ

Fort Eustis (US Army)
Newport News
VA

Fort George G. Meade
Odenton
MD

Fort Lewis (Landfill No. 5)
Tacoma
WA

Fort Lewis Logistics Center
Tillicum
WA

Fort Ord
Marina
CA

Fort Richardson (USARMY)
Anchorage
AK

Fort Riley
Junction City
KS

Fort Wainwright
Fort Wainwright
AK

Iowa Army Ammunition Plant
Middletown
IA

Joliet Army Ammunition Plant (Load-Assembly-Packing Area)
Joliet
IL

Joliet Army Ammunition Plant (Manufacturing Area)
Joliet
IL

Lake City Army Ammunition Plant (Northwest Lagoon)
Independence
MO

Letterkenny Army Depot (PDO Area)
Franklin County
PA

Letterkenny Army Depot (SE Area)
Chambersburg
PA

Lone Star Army Ammunition Plant
Texarkana
TX

Longhorn Army Ammunition Plant
Karnack
TX

Louisiana Army Ammunition Plant
Doyline
LA

Materials Technology Laboratory (USARMY)
Watertown
MA

Milan Army Ammunition Plant
Milan
TN

Natick Laboratory Army Research, Development, and Engineering Center
Natick
MA

New Brighton/Arden Hills/TCAAP (USARMY)
New Brighton
MN

Picatinny Arsenal (USARMY)
Rockaway Township
NJ

Riverbank Army Ammunition Plant
Riverbank
CA

Rocky Mountain Arsenal (USARMY)
Adams County
CO

Sacramento Army Depot
Sacramento
CA

Savanna Army Depot Activity
Savanna
IL

Schofield Barracks (USARMY)
Schofield
HI

Seneca Army Depot
Romulus
NY

Sharpe Army Depot
Lathrop
CA

Sunflower Army Ammunition Plant
Desoto
KS

Tobyhanna Army Depot
Tobyhanna
PA

Tooele Army Depot (North Area)
Tooele
UT

Tracy Defense Depot (USARMY)
Tracy
CA

Umatilla Army Depot (Lagoons)
Hermiston
OR

US Army/NASA Redstone Arsenal
Huntsville
AL

Weldon Spring Former Army Ordnance Works
St. Charles County
MO

West Virginia Ordnance (USARMY)
Point Pleasant
WV

US Coast Guard

Curtis Bay Coast Guard Yard
Baltimore
MD

US Navy

Adak Naval Air Station
Adak
AK

Alameda Naval Air Station
Alameda
CA

Allegany Ballistics Laboratory (USNAVY)
Mineral County
WV

Bangor Naval Submarine Base
Silverdale
WA

Bangor Ordnance Disposal (USNAVY)
Bremerton
WA

Barstow Marine Corps Logistics Base
Barstow
CA

Brunswick Naval Air Station
Brunswick
ME

Camp Lejeune Military Res. (USNAVY)
Onslow County
NC

Camp Pendleton Marine Corps Base
Camp Pendleton
CA

Cherry Point Marine Corps Air Station
Havelock
NC

Concord Naval Weapons Station
Concord
CA

Davisville Naval Construction Battalion Center
North Kingstown
RI

El Toro Marine Corps Air Station
El Toro
CA

Indian Head Naval Surface Warfare Center
Indian Head
MD

Jackson Park Housing Complex (USNAVY)
Kitsap County
WA

Jacksonville Naval Air Station
Jacksonville
FL

Marine Corps Combat Development Command
Quantico
VA

Marine Corps Logistics Base
Albany
GA

Moffett Naval Air Station
Moffett Field
CA

Naval Air Development Center (8 Waste Areas)
Warminster Township
PA

Naval Air Engineering Center
Lakehurst
NJ

Naval Air Station, Whidbey Island (Ault Field)
Whidbey Island
WA

Naval Air Station, Whidbey Island (Seaplane Base)
Whidbey Island
WA

Naval Amphibious Base Little Creek
Virginia Beach
VA

Naval Computer and Telecommunications Area Master Station Eastern Pacific
Wahiawa
HI

Naval Industrial Reserve Ordnance Plant
Fridley
MN

Naval Security Group Activity
Sabana Seca
PR

Naval Surface Warfare Center - Dahlgren
Dahlgren
VA

Naval Undersea Warfare Engineering Station (4 Waste Areas)
Keyport
WA

Naval Weapons Industrial Reserve Plant
Bedford
MA

Naval Weapons Station - Yorktown
Yorktown
VA

Naval Weapons Station Earle (Site A)
Colts Neck
NJ

Navy Ships Parts Control Center
Mechanicsburg
PA

New London Submarine Base
New London
CT

Newport Naval Education and Training Center
Newport
RI

Norfolk Naval Base (Sewells Point Naval Complex)
Norfolk
VA

Norfolk Naval Shipyard
Portsmouth
VA

NWS Yorktown - Cheatham Annex
Yorktown
VA

Parris Island Marine Corps Recruit Depot
Parris Island
SC

Patuxent River Naval Air Station
Patuxent River
MD

Pearl Harbor Naval Complex
Pearl Harbor
HI

Pensacola Naval Air Station
Pensacola
FL

Port Hadlock Detachment (USNAVY)
Indian Island
WA

Portsmouth Naval Shipyard
Kittery
ME

Puget Sound Naval Shipyard Complex
Bremerton
WA

South Weymouth Naval Air Station
Weymouth
MA

St. Juliens Creek Annex (U.S. Navy)
Chesapeake
VA

Treasure Island Naval Station-Hunters Point Annex
San Francisco
CA

USN Air Station Cecil Field
Jacksonville
FL

Washington Navy Yard
Washington
DC

Whiting Field Naval Air Station
Milton
FL

Willow Grove Naval Air and Air Reserve Station
Horsham
PA

Yuma Marine Corps Air Station
Yuma
AZ

Bob O’Dowd is a former U.S. Marine with thirty years of experience on the east coast as an auditor, accountant, and financial manager with the Federal government. Half of that time was spent with the Defense Logistics Agency in Philadelphia. Originally from Pennsylvania, he enlisted in the Marine Corps at age 19, served in the 1st, 3rd, and 4th Marine Aircraft Wings in 52 months of active duty in the 1960s. He is a graduate of Temple University.