In Long Island last week, U.S. Senator Charles Schumer revealed that the Department of Veterans Affairs (VA) is about to launch a major study on ‘toxins.’ But what Schumer pointed out is that Long Island’s own Northport VA already did a 2017 study on a rare, cancer-causing parasitic toxin, liver-fluke that is—more or less—sitting on a shelf, and that cannot simply stay there without the larger VA seeing what might be of use.

Adult Clonorchis sinensis.
Image/Sripa B., Kaewkes S., Sithithaworn P., Mairiang E., Laha T., et al. (2007).

“In the Spring of 2017, our local VA in Northport conducted a study on a rare, toxic cancer-causing parasite—and environmental exposures—known as liver fluke,” said U.S. Senator Charles Schumer. “Now, it was just a pilot study, but Northport examined nearly 100 veterans who may add value to the larger medical questions so many have related to bile duct cancer and Vietnam vets. We have samples, antigen markers, and more; there’s good stuff here from this smaller study, but it is largely sitting on a shelf, and we are here today to say: use what’s useful.”

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Schumer says there must, and should, be some use for even aspects of the Northport data as part of the VA’s newly-announced large-scale research effort on toxins and environmental exposures, and he is urging the agency to act. The Senator demanded that as part of this new study, the VA incorporate Long Island’s data, or some of the information from its participants, in hopes to speed the new effort and give local vets the answers –and the care—they deserve. Schumer made the case that the VA should not advance another big study on toxic or environmental exposures without considering the incorporation of Long Island veterans’ data on Liver-Fluke, and the rare cancer that this exposure might deliver.

Sen Charles Schumer

According to the Department of Veteran Affairs, they will launch a major study in the new year on military environmental exposures and their connection to diseases in vets. VA researches have even been speaking with veterans about the environmental toxins they may have encountered while in combat, similar to what local VA officials have already done on Long Island. According to media reports, the VA is currently determining the focus and scope of this and future studies, which is why Schumer is chiming in now. After the Northport study was finished, Schumer urged the larger VA to move forward with treatment reviews, screening and awareness programming to help Vietnam vets who might be at risk for developing bile duct cancer. Schumer still wants these measures taken, but even more, he wants to ensure that the one hand of the VA knows what the other is doing, especially in the case of exposures and local data already collected.

“Hundreds of veterans have been diagnosed with bile duct cancer over the past decade and many who may have it might not know they are at risk for it.  That’s why I urged the feds to study whether this is more than a coincidence and why I am glad they are doing a larger study, but we want Northport’s data incorporated. An association might exist between bile duct cancer and parasites known to live in the Vietnam region during the Vietnam War, and maybe the Long Island data helps propel the national data.” Schumer added.

Bile duct cancer, also called Cholangiocarcinoma, is a rare disease in which malignant cancer cells form in the bile ducts. There are three types of bile duct cancer: 1) perihilar, which is most common; 2) distal (where the duct passes into the pancreas); and 3) intrahepatic. According to the VA, 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. Individuals can become infected by eating fish or ingesting water that has these parasites. Once eaten, the liver flukes grow to adulthood inside the human biliary duct system. The irritation and scarring caused by liver fluke infection can lead to bile duct cancer. According to the VA, two parasites are commonly involved: Opisthorchis verrini, which is found in Southeast Asian countries like Vietnam, Thailand, Lao People’s Democratic Republic, and Cambodia; and Clonorchis sinensis, which is common in rural areas of Korea and China. The VA says that veterans who ate raw or undercooked freshwater fish during their service in Southeast Asia, such as Vietnam War Veterans, might have been infected.

According to media reports, like the Chicago Tribune, hundreds of Vietnam veterans have been diagnosed with bile duct cancer. According to Dr. Ralph Erickson, Chief Consultant of Post-Deployment Health Services at the VA, approximately 700 patients with bile duct cancer have passed through the agency’s medical system in the past 15 years. According to reports, the number of benefit claims for bile duct cancer has increased six fold since 2003. In 2015, 60 benefit claims for bile duct cancer were submitted to the VA and nearly 80 percent of those were denied.

Liver flukes, Vietnam Vets and cholangiocarcinoma

Schumer pointed to the VA’s process for acknowledging service-related illnesses. For instance, at one time Parkinson’s disease was not considered service-related among Vietnam War veterans, but now it is. In 2009, the National Academy of Sciences, Engineering, and Medicine published a study on veterans and Agent Orange. The study suggested limited evidence that exposure to Agent Orange and other herbicides during the Vietnam War were associated with an increased chance of developing Parkinson’s disease. Subsequently, later that year, the VA announced that Parkinson’s disease would be added to the list of conditions connected to exposure to herbicide agents.

Thailand: Koi pla linked to high incidence of liver cancer in Northeast thanks to liver flukes

Schumer said that this is the point of why the Northport study was commissioned, and should be the point of future studies—to determine answers on service-related health claims, give veterans clear answers, and then, subsequently, the care they have earned and deserve.