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Agent orange is associated with invasive skin cancer

Harold Mandel's picture
A scene from Vietnam

There has been increasing evidence of carcinogenic effects of Agent Orange. A great deal of controversy has persisted over the years about the use of Agent Orange as part of the U.S. military's herbicidal warfare and jungle defoliant programs during the Vietnam war due to the horrible side effects on people which have been observed from this agent. New research shows there is an association between Agent Orange and invasive skin cancer.

Agent Orange, or 2,3,7,8-tetrachlorodibenzodioxin, has been found to cause indirect DNA damage, therefore producing malignancies, reported Plastic and Reconstructive Surgery. However, the association between Agent Orange and nonmelanotic invasive skin cancer has not been clear. Researchers decided to investigate whether 2,3,7,8-tetrachlorodibenzodioxin exposure increases the incidence of this type of cancer.

The researchers retrospectively reviewed the medical records of 100 male patients with Fitzpatrick skin types I through IV who enrolled in the Agent Orange registry at the Veterans Affairs Hospital of Washington, D.C., from August of 2009 and January of 2010. The results of this study suggested that 2,3,7,8-tetrachlo rodibenzodioxin exposure is associated with the development of chloracne and may be associated with an increased incidence of nonmelanotic invasive skin cancer. It has been noted that patients who were involved directly with spraying the agent and those patients with light eye and skin colors may be the most susceptible to the development of nonmelanotic invasive skin cancer. At this time an understanding of the development of nonmelanotic invasive skin cancer after exposure to Agent Orange is incomplete.

Vietnam War veterans who were exposed to the herbicide Agent Orange appear to be at high risk for the development of certain types of skin cancer, reports the American Society of Plastic Surgeons. This study adds to previous evidence that the risk of non-melanotic invasive skin cancer (NMISC) is higher even four decades after exposure to Agent Orange exposure. Furthermore, at least some of the exposed veterans have unusually aggressive non-melanoma skin cancers. The lead author of this research paper was Dr. Mark W. Clemens of The University of Texas MD Anderson Cancer Center and colleagues.

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About half of Vietnam veterans who were exposed to Agent Orange present with skin cancer. Agent Orange was used extensively as an herbicide and jungle defoliant during the Vietnam War. This agent has been linked to a wide range of cancers and other diseases, which are caused by the extremely toxic dioxin contaminant TCDD. Dr. Clemens and coauthors have said, "TCDD is among the most carcinogenic compounds ever to undergo widespread use in the environment."

In this study exposure to TCDD consisted of living or working in areas which were contaminated with Agent Orange in 56 percent of veterans, actively spraying this agent in 30 percent, and traveling in areas which were contaminated for 14 percent. Men with lighter skin types were focused on in this study.

In the men exposed to TCDD the rate of nonmelanotic invasive skin cancer was 51 percent, or about twice as high as the rate which is expected in men of a similar age group. There was an increased risk of skin cancer up to 73 percent for veterans who actively sprayed Agent Orange. It was also observed that exposed men with the lightest skin types and those men with lighter eyes were at higher risk. Chloracne was observed in forty-three percent of the veterans. Chloracne is a skin condition which is specifically caused by exposure to dioxins. In this group the rate of nonmelanotic invasive skin cancer was greater than 80 percent.

A wide range of health problems, including many different types of cancers, have been found to be associated with exposure to Agent Orange and TCDD. In the mid-1980s cases of "aggressive and diffuse" non-melanoma skin cancers in veterans exposed to TCDD were first reported in plastic surgery journals. The results of the present study have strengthened the previously reported association between TCDD exposure and the development of nonmelanotic invasive skin cancer, even many years after exposure. Dr. Clemens and coauthors have written, "Further studies are warranted to determine the relative risk within this patient population and to determine appropriate management strategies."

The controversy about the use of Agent Orange in the Vietnam war has raged on for decades. This new study adds to the list of concerns about its use. I have observed uneasiness among Vietnam veterans and among the Vietnamese people, while visiting Vietnam, about the use of this toxic agent during the Vietnam war. This research and other research which shows associations between exposure to Agent Orange and cancer, along with other serious illnesses, helps to elucidate the need to be far more careful about the use of such agents in times of war or peace. Work should be continued to help determine the best ways to handle the problem of side effects from Agent Orange exposure and the results of this work should be shared with Vietnam in order to assist survivors of Agent Orange exposure in Vietnam too.