Prostate cancer is the most common cancer diagnosis among U.S. Veterans. In fact, one in five U.S. Veterans are at risk for developing prostate cancer in their lifetime.
Historical access to care issues within the VA, exacerbated during the COVID-19 pandemic, have increased the impact of this disease among Veterans, who are often not screened for prostate cancer until it’s too late. In fact, recent research has shown a clear relationship between declining rates of prostate cancer screening and a subsequent increase in rates of diagnosis of advanced forms of the disease. Even when cancer is identified, the Department of Veterans Affairs (VA) lacks an adequate plan to protect Veterans from this deadly disease. It is critical that Congress acts now by increasing access to preventative prostate cancer care and mandating the creation of a standardized clinical treatment pathway within the Department of Veterans Affairs (VA) to help ensure that more veterans do not unnecessarily die from prostate cancer.
A clear plan of attack
Veterans and active duty military servicemembers know the importance of having a clear plan of attack for defeating your enemies. For me, that became even more apparent when I was diagnosed with stage IV prostate cancer in 2012. At the time, I was only 41 years old, and I was serving as a commander in the U.S. Army’s 101st Airborne Division. After the initial shock of a cancer diagnosis, my military training kicked in, helping me figure out my next steps and my plan for fighting cancer. My treatment has included hormone therapy, chemotherapy, surgery, and immunotherapy, and so far, has helped me hold the disease in check.
By establishing a clinical pathway for prostate cancer through the VA, lawmakers can provide a clear plan of attack and support for Veterans fighting prostate cancer. Legislation should address all stages of prostate cancer, from early detection to end-of-life care. Congressional action would also help draw attention to Veterans who are at an elevated risk for the disease due to evidence-based risk factors, like race, ethnicity, socioeconomic status, and family history. A clinical pathway would also lead to the development of a suggested protocol for prostate screening, diagnosis, treatment, or care based on severity and stage of cancer to provide Veterans with all-inclusive support for the disease.
U.S. Veterans are an extremely high-risk patient population for developing prostate cancer. The United States has an aging Veteran population and many Veterans have been exposed to herbicides, such as Agent Orange – two factors that further increase the risk for prostate cancer. Black men are 1.8 times more likely to be diagnosed with prostate cancer and 2.2 times more likely to die from prostate cancer, highlighting the disparate impact of prostate cancer on Black Veterans, who are most at risk for the disease.
There are already nearly 489,000 prostate cancer patients in the VA health care system, and 16,000 of these patients have metastatic prostate cancer, meaning the cancer has spread to other parts of their bodies. With many men catching up on regular prostate check-ups now, the number of prostate cancer patients within the VA is expected to rise. Early detection of prostate cancer is critical for improving treatment and survival rates.
Congress has the power to expand access to prostate cancer care and help protect Veterans – in fact, Senator Jerry Moran and Senator Jon Tester introduced S. 2720, the Veterans Prostate Cancer Treatment and Research Act, last year. Now is the time for Senators Tester and Moran to lead the charge to finish the job and pass S. 2720 before the end of the year. As we appreciate the sacrifices our Veterans make, let’s honor them this Veterans Day by prioritizing health care services for Veterans and passing this crucial legislation to improve prostate cancer care in the VA.
 Montgomery B. Prostate cancer in military veterans. Clin Adv Hematol Oncol. 2019 Oct;17(10):552-554. PMID: 31730580.
 Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022 Jan;72(1):7-33. doi: 10.3322/caac.21708. Epub 2022 Jan 12. PMID: 35020204.
 Bryant AK, Lee KM, Alba PR, Murphy JD, Martinez ME, Natarajan L, Green MD, Dess RT, Anglin-Foote TR, Robison B, DuVall SL, Lynch JA, Rose BS. Association of Prostate-Specific Antigen Screening Rates With Subsequent Metastatic Prostate Cancer Incidence at US Veterans Health Administration Facilities. JAMA Oncol. 2022 Oct 24:e224319. doi: 10.1001/jamaoncol.2022.4319. Epub ahead of print. PMID: 36279204; PMCID: PMC9593319.
Featured image by MIKE STOLL on Unsplash. Used with permission.