Veteran’s Day prompted a flurry of stories on bile duct cancer, or chlolangiocarcinoma and Vietnam veterans after the Associated Press discovered hundreds of patients in recent decades and the large number of claims denials by the Department of Veterans Affairs.

Opisthorchiasis Life Cycle Image/CDC
Opisthorchiasis Life Cycle

The cause of the cancers may be linked to eating raw fish while fighting in Southeast Asia and a flatworm found in the fish called broadly, liver flukes.

The Los Angeles Times reports:

Ralph Erickson, who heads post-deployment health services at the Department of Veterans Affairs, says about 700 cholangiocarcinoma patients have passed through the agency’s medical system in the last 15 years. In some instances, the government has acknowledged that the illness is “as likely as not” connected to veterans’ time in service. By VA standards, that’s enough to make them eligible for benefits.

Fewer than half of those 700 submitted claims, however, in part because they were unaware of any possible link to their service. Of the claims submitted, 3 out of 4 have been rejected, according to data obtained by the Associated Press through the Freedom of Information Act.

As a result, some veterans are spending their final days fighting the VA. They say they were never told they could be at risk.

The Facebook page, Vietnam Vets and Cholangiocarcinoma or Bile Duct Cancer, a page that has been in existence since 2010, lists a large number of vets that have succumbed to bile duct cancer.

The page offered the following assistance to vets on Aug. 19 this year:

For the Vietnam Veterans newly diagnosed, Joseph Comerro sent a link regarding filing a claim for compensation. In addition, I would suggest contacting a organization such as the Vietnam Veterans, DAV, VFW, etc. for filing. This in an informational post to give some idea of what to expect. this particular post does not apply to the spouses who are filing a claim, it only pertains to Veterans who are filing a claim- Compensation and Pension Exam

The page states: Cholangiocarcinoma is a rare cancer in the United States. It is prevalent in Asia and Vietnam. One of its causes is from a parasite, called the liver fluke which is ingested through food or water. After ingestion, it may or may not cause symptoms. The parasite gets into the bile duct, changes the cells and is usually excreted. In time the cells may turn into cancer. Not so much research is being done in the U.S. More is being done in Asia because of the wide occurrence.

Want to let all Vietnam Vets and those who served in Asia to be aware of any stomach or gallbladder issues and have the bile ducts checked. It can also metastasize in the liver. I am trying to make Vets aware and also create a data base of those that have this cancer and were in Vietnam.

Infection with liver flukes often involve consuming raw fish dish or other ingestion of undercooked, salted, pickled, or smoked freshwater fish mostly of the cyprinid variety. They infect an estimated 25 million people globally.

According to the CDC, most infections of Opisthorchis and Clonorchis are asymptomatic. In mild cases, manifestations include dyspepsia, abdominal pain, diarrhea or constipation. With infections of longer duration, the symptoms can be more severe, and hepatomegaly and malnutrition may be present.

Opisthorchis viverrini is the major risk factors for the development of hepatocellular carcinoma (HCC). Untreated cases can also lead to cholangitis, cholecystitis, and chlolangiocarcinoma.

One vet described how they would seek out fish to eat in the LA Times story and stated, “I dodged all those bullets, then get killed by a fish.”