Exposure to Agent Orange has caused serious health issues for many veterans. One of the most severe consequences includes different types of cancers. Veterans who served during certain periods or locations may qualify for service-connected compensation if they develop specific cancers.
Presumptive Agent Orange Cancers
The VA recognizes certain cancers as presumptive conditions linked to Agent Orange exposure. This presumption simplifies the process for veterans because it removes the need to individually prove a medical nexus between their cancer and Agent Orange. If a veteran meets the service requirements, such as serving in Vietnam or other recognized locations, the VA automatically connects these cancers to Agent Orange. Presumptive cancers include:
- Respiratory cancers affecting the lungs, bronchus, larynx, and trachea, often developing years after exposure.
- Prostate cancer, one of the most common cancers among veterans exposed to Agent Orange, frequently occurring in older age.
- Bladder cancer, officially recognized recently due to strong evidence linking chemical exposure to its development.
- Soft tissue sarcomas, which are cancers forming in muscles, fat, blood vessels, nerves, tendons, or connective tissues. Notably, the VA excludes osteosarcoma, chondrosarcoma, and Kaposi’s sarcoma from this presumptive list.
- Lymphomas, leukemias, and other blood cancers, specifically categorized and detailed in a separate section below due to their complexity and variety.
Presumptive Agent Orange Blood Cancers
The following blood cancers are presumed service-connected if related to Agent Orange:
- Hodgkin’s disease – lymphoma involving abnormal Reed-Sternberg cells
- Non-Hodgkin’s lymphoma – a group of lymphoid blood cancers arising from B or T cells
- Multiple myeloma – a plasma cell cancer in the bone marrow, causing bone damage and anemia
- Monoclonal gammopathy of undetermined significance (MGUS) – a precursor blood disorder to multiple myeloma with abnormal monoclonal protein
- Chronic lymphocytic leukemia (CLL) – blood and bone marrow cancer
- Hairy cell leukemia – a rare chronic B-cell leukemia marked by cells with hair-like projections
- B-cell prolymphocytic leukemia – an aggressive leukemia of immature B cells (prolymphocytes)
- Acute lymphoblastic leukemia (mature B-cell type) – a fast-growing leukemia of mature B cells
- Precursor B lymphoblastic leukemia – a rapidly progressive leukemia of immature B-cell precursors
Can the VA Deny a Presumptive Agent Orange Cancer Claim?
Even if some cancers are presumed to be caused by Agent Orange exposure, veterans should understand that the VA can still deny these claims under specific circumstances. To grant a presumptive claim, the VA must verify that the veteran served in an approved location or situation linked to Agent Orange exposure. For instance, merely serving during the Vietnam War era is insufficient without documented presence in Vietnam or other recognized exposure sites.
The VA examines military service records closely to confirm eligibility for presumptive conditions. Denials may result if military records explicitly contradict the claimed exposure—for example, if a veteran’s official records indicate their duties occurred in areas far removed from where Agent Orange was used. Additionally, the absence of official documentation or corroborating statements from fellow service members confirming the claimed exposure could lead the VA to conclude that the exposure is unsupported.
This means veterans should make sure their records are complete, consistent and can show exposure to Agent Orange. For more details on the eligibility criteria visit our guide on Agent Orange presumptive conditions.
Has the VA Made a Mistake?
Mistakes by the VA can occur when processing presumptive cancer claims, particularly because the rules for service connection frequently change. Sometimes VA adjudicators, who review claims, might mistakenly rely on outdated information or miss important updates. For example, new conditions or service locations that qualify under the presumption might be overlooked due to recent changes under laws like the PACT Act.
These errors happen if the VA doesn’t keep pace with policy revisions or when adjudicators mistakenly interpret medical records or exposure evidence. Veterans might find their claims denied unfairly simply because the adjudicator didn’t apply updated guidance or recent scientific findings.
Fortunately, many such errors are fixable through the appeals process. But overturning these decisions often requires clear evidence of the VA’s oversight or misinterpretation, something veterans might find challenging without experienced help.
Hill & Ponton specializes in identifying these types of mistakes, guiding veterans through the appeal process, and ensuring the VA properly applies current rules and regulations to their claim. Get your free case evaluation here.
Non-Presumptive Cancers Associated with Agent Orange
The VA doesn’t automatically recognize some cancers as caused by Agent Orange. However, claims can succeed with expert medical opinions and be granted service connection on a direct basis. These cancers include:
- Colon cancer
- Pancreatic cancer
- Kidney cancer
- Skin cancer
- Liver cancer
- Breast cancer
- Brain cancer
Recent scientific research has increasingly shown that veterans exposed to Agent Orange face a higher risk of developing head and neck cancers compared to veterans without such exposure. Specifically, these studies indicate that exposure to Agent Orange’s toxic chemicals significantly increases the likelihood of developing cancers of the oropharynx, nasopharynx, larynx, and thyroid gland.
The chemicals in Agent Orange are known to disrupt normal cellular functions, potentially causing DNA mutations or hormonal imbalances that contribute to the growth of cancer cells. For instance, cancers of the larynx and thyroid are closely linked to hormonal and cellular disruptions; both conditions notably prevalent among veterans who came into direct contact with herbicides containing dioxin, a primary toxic component of Agent Orange.
Veterans with non-presumptive cancers like head and neck cancers should seek detailed medical opinions to support their VA claims, even if their specific cancer type is not automatically recognized as presumptive. Learn more about cancer VA ratings.
Service Connecting Non-Presumptive Agent Orange Cancer
Establishing service connection for cancers not officially recognized by the VA as presumptive conditions involves providing clear, detailed evidence to support the claim. First, veterans need documentation proving they were exposed to Agent Orange during their military service. Acceptable evidence can include official service records, assignment orders, personnel files, deck logs, or credible supporting statements from fellow service members confirming exposure scenarios.
Second, the veteran must obtain a medical nexus opinion. This is a detailed report provided by a qualified medical professional explaining precisely how exposure to Agent Orange led to the development of the veteran’s specific type of cancer. A strong medical nexus typically includes references to scientific studies, medical literature, or case-specific details that clearly demonstrate a causal link between the chemical exposure and the cancer diagnosis.
Given the complexity and high standards of proof required, veterans frequently benefit from seeking guidance from an experienced attorney. Hill & Ponton disability lawyers understand exactly what the VA looks for and can significantly increase veterans’ chances of approval after previous denials.
Secondary Service Connection via an Agent Orange Presumptive
Veterans diagnosed with diabetes mellitus type 2 due to Agent Orange exposure may also claim secondary service connection for cancers linked to diabetes. This means the cancer itself doesn’t need direct proof of Agent Orange exposure but that it’s connected through diabetes, a condition the VA already recognizes. To establish secondary service connection clearly and effectively, veterans must:
- Already have diabetes mellitus type 2 officially service-connected by the VA as related to Agent Orange.
- Obtain a medical nexus opinion from a qualified healthcare provider. This expert opinion must clearly state diabetes is “at least as likely as not” the cause or aggravating factor for the cancer and include references to credible medical research or scientific studies linking diabetes to the cancer type.
- Address and clearly differentiate other potential risk factors like smoking, obesity, or alcohol use, ensuring the medical provider emphasizes why diabetes remains the primary or a significant contributing factor.
Cancers Associated with Agent Orange-related Diabetes
Medical research has consistently highlighted strong links between diabetes and certain types of cancers. When veterans develop these cancers and have diabetes presumed to be related to Agent Orange exposure, they might have a strong basis to file a secondary service connection claim. The connections recognized through medical studies include:
- Liver Cancer: Chronic diabetes has been proven to significantly raise the risk of liver cancer, likely because diabetes-related inflammation and insulin resistance can damage liver cells over time. See more below.
- Pancreatic Cancer: There is a well-established relationship between diabetes and pancreatic cancer, as diabetes can either occur before the onset of pancreatic cancer or develop as a result of it. This complex interplay suggests a strong biological connection between these two conditions.
- Colon Cancer (Colorectal Cancer): Diabetes often leads to chronic inflammation and insulin imbalances, both of which increase colon cancer risk, as seen in numerous studies.
- Breast Cancer: Women with diabetes face an increased risk, especially for types of breast cancer sensitive to hormones. This is likely due to diabetes-related hormone changes, particularly involving insulin and estrogen.
- Endometrial (Uterine) Cancer: Diabetes and insulin resistance have been consistently linked to higher endometrial cancer risk because elevated insulin levels can stimulate excessive cell growth in uterine tissue.
- Kidney Cancer: Medical literature identifies diabetes as a key risk factor for kidney cancer. Chronic high blood sugar can stress the kidneys, leading to damage and potentially cancerous cell mutations.
- Brain Cancer: While less common, diabetes-related complications and treatments can contribute indirectly to brain cancer development. Diabetes can create conditions in the body that support tumor growth or affect the body’s ability to fight abnormal cells effectively.
Agent Orange and Liver Cancer
In past cases, the VA has acknowledged a potential link between liver cancer and Agent Orange exposure when compelling evidence was presented. In a 2014 Board of Veterans’ Appeals decision, the veteran’s claim for liver cancer was granted based on the opinion of a private physician who concluded it was “more likely than not” that the veteran’s in-service exposure to Agent Orange contributed to his liver cancer.
The physician supported this with references to toxicology research, highlighting the carcinogenic nature of dioxin, the active ingredient in Agent Orange. The VA agreed that the medical rationale was strong enough to warrant service connection, even though liver cancer is not on the presumptive list.
However, newer research challenges that connection. A 2023 study published in the journal Cancers analyzed liver cancer rates among nearly 900,000 Vietnam veterans. The researchers found no statistically significant increase in liver cancer diagnoses among those presumed exposed to Agent Orange, compared to those who were not. This large-scale analysis suggests that Agent Orange may not be a direct risk factor for liver cancer on a population level, making individual claims more difficult to prove without specific medical evidence.
Because of this conflicting data, veterans seeking service connection for liver cancer must often rely on detailed medical nexus opinions and personalized evidence to show how Agent Orange likely caused or contributed to their condition. These claims are more complex and may benefit from the assistance of an Agent Orange lawyer.
Agent Orange and Breast Cancer
Although Agent Orange has long been suspected of affecting hormone regulation, particularly due to dioxin’s known role as an endocrine disruptor, recent research has not established a direct link between Agent Orange exposure and breast cancer.
A 2024 study published in Frontiers in Oncology analyzed the health outcomes of women veterans and civilian workers exposed to dioxin-contaminated herbicides. Researchers reviewed both epidemiological data and animal studies to determine whether breast cancer risk increased with exposure. The results showed no statistically significant rise in breast cancer incidence among those exposed to Agent Orange compared to unexposed populations. While hormonal changes were observed in some cases, they did not consistently correlate with breast cancer development.
However, the study did note gaps in available data, particularly for long-term outcomes and for women exposed during specific life stages. Because of these limitations, the researchers called for further investigation, especially in populations with confirmed Agent Orange exposure and coexisting risk factors like diabetes.
For veterans, this means that while a direct Agent Orange-breast cancer link remains unproven, indirect pathways such as diabetes-related hormonal imbalances may still offer a path to service connection. These claims will require a strong medical nexus opinion that can clearly explain how service-connected diabetes may have contributed to or aggravated the cancer.
Agent Orange and Brain Cancer
Glioblastoma Multiforme is an aggressive and deadly form of brain cancer that has been associated with various toxic environmental exposures. While the PACT Act recognizes this brain cancer as a presumptive condition related to burn pit exposure, it has not yet been added to the list of presumptive conditions linked to Agent Orange. This leaves veterans exposed to Agent Orange in a gray area when seeking benefits for gliablastoma or similar brain cancers.
For example, in an appeal from the VA Regional Office in Houston, Texas, the Board of Veterans’ Appeals reviewed a claim of gliablastoma caused by Agent Orange exposure. Although the VA initially denied the claim, the appeal by the veteran’s widow included multiple medical opinions; one of which cited scientific evidence suggesting a possible link between dioxin exposure and central nervous system tumors. The Board ultimately service connected the cause of the veteran’s death which was glioblastoma.
The case demonstrated how a well-structured appeal using medical literature and expert testimony could present a serious challenge to the VA’s position. This case also highlighted a critical issue: brain cancers like glioblastoma are not automatically dismissed but rather evaluated on the strength of medical evidence and the persuasive quality of expert nexus opinions.
Veterans who also have diabetes mellitus type 2, which is presumptively linked to Agent Orange, may have another path. Diabetes can increase the risk of various cancers, and some medical opinions have suggested that prolonged metabolic complications might play a role in the development or progression of brain tumors. Although rare, secondary service connection via diabetes may be a valid route if a medical professional provides a clear, well-reasoned opinion tying the cancer to the service-connected diabetes.
Given the complexity and the current lack of presumptive status for Agent Orange-related brain cancers, veterans pursuing these claims may benefit from legal representation to gather the strongest evidence and navigate the appeals process. Call us today to get a free evaluation of your case.