VA struggles to treat veterans due to shortage of cancer specialists

Veterans Affairs Secretary Robert Wilkie said the agency is struggling with the same shortage of cancer treatment experts that the U.S. medical community at large has faced, which veterans told McClatchy has resulted in missed or late-stage cancer diagnoses.

McClatchy last month reported in an exclusive investigation that the rate of urinary, prostate, liver and blood cancer treatments has sharply risen over the last two decades of war.

Many veterans or their surviving spouses told McClatchy that when they went to VA health care centers for care, the cancers were missed or only caught when they became late-stage cancers.

Wilkie said that the VA, like the U.S. medical community, has struggled to have enough cancer specialists on staff.

“We are not divorced from many of the issues that impact America writ-large,” Wilkie said at a White House media briefing in advance of Veterans Day. “There’s a shortage in this country, not only of cancer providers, but there’s a shortage in this country of mental health providers. We are trying to be as creative as we can to bring more people in those categories to us.”

Patrick Gleason/McClatchy

Veterans who served in Iraq and Afghanistan, and previous conflicts, have become much more vocal about the illnesses that their community is facing.

The primary military surviving spouse support network, the Tragedy Assistance Program for Survivors known as TAPS, has reported that for the first time, the top reason that new members — military widows or widowers — joined the organization over the last fiscal year was no longer suicide, it was due to loss from cancers and other illnesses.

“As of September 30, 2019, 28 percent of all new TAPS survivors are grieving the death of their military loved one who died due to an illness,” said Coleen Bowman, TAPS senior advisor on toxic exposure. Bowman’s husband, Sgt. Maj. Robert Bowman, died of cancer in 2013. “This is now the number one cause of death here at TAPS, before suicide, and [killed in action]. The numbers are alarming, and speak volumes about the gravity of this.”

In its investigation, McClatchy obtained through Freedom of Information Act requests data on every cancer billing to the VA health care system from fiscal year 2000 to fiscal year 2018. In that time frame, the rate of cancer treatments for veterans receiving care from the VA’s health care system rose 61 percent for urinary cancers - bladder, kidney and ureter cancers. The rate of treatments for prostate cancers rose 23 percent; liver and pancreatic cancer treatment rates rose 96 percent and blood cancer treatment rates rose 18 percent.

At a second event Friday, at the National Press Club, Wilkie told McClatchy he had read its “Stricken” investigative series. “I enjoyed it. I learned.”

Wilkie said he was “very” concerned about rising cancer rates, which he said also reflect the cumulative effect of an aging Vietnam veteran population. The decades-long struggle of Vietnam veterans to get the VA to recognize Agent Orange-related illnesses continues to weigh on him, Wilkie said, even as his agency now works with the Pentagon to treat the newest generation of Iraq and Afghanistan-related illnesses.

New illnesses faced by the latest generation of veterans “is what we have to get the answers for,” Wilkie said.

“I know what Agent Orange was. I know how long it was to get that right, and we can’t do that again,” Wilkie said.

“Now, we are treating cancers,” he said. “The question then is, how do you categorize burn pit writ-large the way you categorized agent orange?”

Dozens of veterans who contacted McClatchy after its investigation published said they had been concerned about the number of cancers affecting the men and women they served with, and some also questioned whether the numbers are actually higher because not all veterans get their health care from the VA health care system.

Patrick Gleason/McClatchy

In recent weeks the issue has gained momentum. A number of veterans groups are joining forces to convince Congress, the Defense Department and Department of Veterans Affairs to make it easier for veterans — such as the more than 187,000 now reporting respiratory diseases they think are tied to exposure to burn pits in Iraq and Afghanistan — to get care.

Rep. Jimmy Panetta, a California Democrat, introduced a bill on Friday to help former fighter pilots who are now facing increased rates of prostate cancer they suspect may be tied to cockpit radiation. That bill would require the VA to work with the National Academy of Sciences or National Cancer Institute to determine whether cockpit radiation is tied to the rise in prostate cancers among pilots.

On Thursday, Pentagon spokesman Jonathan Rath Hoffman said Defense Secretary Mark Esper would be traveling with Wilkie on Veterans Day and was expected to raise some of these veterans’ concerns with him.

“The secretary has been committed to expanding access to resources and access to care for military members, and we’ll continue to push through with that,” Hoffman said.

Updates with Wilkie comments at National Press Club.

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Tara Copp is the national military and veterans affairs correspondent for McClatchy. She has reported extensively through the Middle East, Asia and Europe to cover defense policy and its impact on the lives of service members. She was previously the Pentagon bureau chief for Military Times and a senior defense analyst for the U.S. Government Accountability Office. She is the author of the award-winning book “The Warbird: Three Heroes. Two Wars. One Story.”
Michael Wilner joined McClatchy as its White House correspondent in 2019. He previously served as Washington bureau chief for The Jerusalem Post, where he led coverage of the Iran nuclear talks, the Syrian refugee crisis and the 2016 US presidential campaign. Wilner holds degrees from Claremont McKenna College and Columbia University and is a native of New York City.