While Bile Duct Cancer is not a presumptive Vietnam Vet disability, there are other ways to get VA disability for related side-effects.
Bile duct cancer is not one of the many cancers caused by Agent Orange exposure, but it is still a risk for Vietnam Veterans. Eating raw or undercooked fish or ingesting contaminated water happened more often than anybody liked in Vietnam. That water could have had Liver Flukes – a parasite that lives in your intestines and can cause bile duct cancer and other gastrointestinal problems for as long as 25 years.
If you are a veteran with liver problems or if your are a surviving family member of a veteran that died too soon from conditions that may have been caused by service, give us a call. If this article on Bile Duct Cancer and liver flukes doesn’t answer your questions, we’d be happy to help with a free phone call.
In This Article About VA Ratings for Bile Duct Cancer:
- What is Bile Duct Cancer?
- What Causes Bile Duct Cancer?
- Liver Flukes: Critters That Can Cause Bile Duct Cancer
- Primary Biliary Cirrhosis (PBC) or Primary Sclerosing Cholangitis (PSC)
- Cholangiocarcinoma (Bile Duct Cancer) Symptoms and Risk Factors
- Elements of a Cholangiocarcinoma VA Disability Rating
- Three Types of Cholangiocarcinoma
- Bile Duct Cancer Survival Rate
- Agent Orange Presumptive List Conditions
- Signs of Bile Duct Cancer
- Treatment for Bile Duct Cancer
- When the VA Calls Their Lawyers, Make Woods and Woods Yours
What is Bile Duct Cancer?
Bile Duct Cancer first shows its damaging effects in the thin tubes connecting the liver to the small intestine. The thin tubes are where bile from the liver starts to break down fat and waste products. The epithelium tissue covers most of your internal organs and lines all your hollow organs like your intestines. Bile Duct Cancer starts in the epithelium tissue and can show up as liver problems or digestive pain.
Unfortunately, bile duct cancer isn’t one of the many cancers that are associated with Agent Orange exposure. This mean that disabled veterans have to provide solid medical evidence and a service connection to get benefits.
It helps if the Veteran can establish he or she had a diagnosis of primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). These conditions increase your chances of having Bile Duct Cancer later. You can even establish that diagnosis before you find you have Bile Duct Cancer.
What Causes Bile Duct Cancer?
A Cholangiocarcinoma diagnosis occurs in the epithelial cells of bile ducts. There are some risk factors, and then there are the unknowns that contribute to Bile Duct Cancer. Sometimes the causes are unclear. Other times you may be able to show you have a genetic predisposition to either PBC or PSC. Research is still in progress on the genetic influence of this and other cancers.
Parasites called Liver Flukes can also damage your liver and make you more likely to get Bile Duct Cancer. They can survive in your system for 25 years before you know that they are affecting you. They don’t directly give you cancer, but the damage they do often leads to cancer. Other injuries that weaken your liver can increase your cancer risk too.
Proving a service connection for any of these risk factors will help you get VA disability.
In this video, one of our clients that was in the Navy didn’t realize the ringing in his ears was a VA disability until long after his service.
Liver Flukes: Critters That Can Cause Bile Duct Cancer
Sometimes veterans receive a diagnosis that will sometimes include a diagnosis of liver flukes. Liver flukes are parasites that infect humans and cause bile duct problems. There are two families of liver flukes:
- Opisthorchildae is part of the Clonorchis and Opishorchis species.
- Fasciolidae is part of the Fasciola species.
Live flukes enter your digestive system either by spending time in contaminated water or from food. Veterans who ate raw or uncooked food while deployed can carry a liver fluke for years and not know it. There aren’t any studies proving that bile duct cancer happens more in the Vietnam vet population than in the general population, but exposure to raw contaminated food increases the risk for this rare cancer.
Vietnam war veterans that can prove they were in these environments, even with an old letter written home to mom, can build a much stronger case for service-connected liver problems.
Primary Biliary Cirrhosis (PBC) or Primary Sclerosing Cholangitis (PSC)
Any diagnosis that includes Primary Biliary Cirrhosis (PBC) or Primary Sclerosing Cholangitis (PSC) can be helpful for your case. Both of these conditions can weaken the liver and bile ducts, leading to cancer. The symptoms of these conditions may show up long before you discover you have bile duct cancer. If you are applying for VA disaiblity for any of these conditions, be prepared to apply for a VA rating for liver cancer too. Since it takes a long time to work through the application process, you might have to add on conditions before you get approved.
Primary Biliary Cirrhosis (PBC) Symptoms:
PBC is a liver disease that occurs 95% of the time in women aged 35-70. It may be hereditary and is also classified as an auto-immune disease like rheumatoid arthritis. These causes may make it hard to prove a service-connection, but PBC could amplify the effects of a normally survivable service-connected condition like diabetes.
Symptoms of PBC are:
- Cholestatic jaundice (yellowing) without an identifiable cause
- Itching (pruritus)
- Loss of appetite
- Nausea and vomiting without an identifiable cause
As the disease progresses, it acts like full-on cirrhosis and your liver functions worse and worse.
Primary Sclerosing Cholangitis (PSC) Symptoms
Primary Sclerosing Cholangitis (PSC) is a slightly different condition. It shows up with liver problems in some people, but is asymptomatic in many other people. It commonly pops up in veterans that also have irritable bowel disease or ulcerative colitis. If you have either of those and these symptoms also begin, you want to call your doctor right away.
Symptoms of PSC are:
- Itching (pruritus)
- Abdominal pain
- Gall stones (in advanced stages)
- Cholestatic jaundice (yellowing) without an identifiable cause (also in advanced stages)
Nausea and vomiting impact you with PBC and PSC but most of the time, nausea and vomiting have no identifiable cause.
Cholangiocarcinoma (Bile Duct Cancer) Symptoms and Risk Factors
For a VA Cholangiocarcinoma Symptom Rating claim to be successful, the Veteran must have some of these symptoms or risk factors:
- Primary sclerosing cholangitis
- Chronic ulcerative colitis
- Cysts in the bile ducts
- Cirrhosis of the liver
- Hepatitis B or C virus
If you have any of these and can prove a service-connection, your liver condition may be a secondary condition. That’s ok. It’s better to have a disability rated as secondary than not counted.
Here is a video explaining how the VA combined ratings table works from one of our Veterans Disability Lawyers.
Elements of a Cholangiocarcinoma VA Disability Rating
Proving Bile Duct Cancer as a service-connection and eligible for VA disability requires 3 criteria:
- The Veteran has a qualifying diagnosis of PBC or PSC;
- The Veteran has not received a liver transplant;
- The VA or the treating physician has established a relationship between the Veteran’s qualifying diagnosis and his/her current symptoms.
That might not be your best initial application. When we work with veterans on appeals, we often find that they had other conditions that were easier to service-connect. We also help you figure out what medical conditions you have may be service-connected in other ways. Just because you call us about liver cancer disability doesn’t mean that’s all we’ll do for you. A complete whole-life picture for the VA is what wins the best disability claims.
Talk to Us About Your Claim: (866)232-5777
Three Types of Cholangiocarcinoma
Doctors divide Cholangiocarcinoma or Bile Duct Cancer into different types. The three different types depend on which part of the bile ducts are affected.
- An Intrahepatic Cholangiocarcinoma diagnosis is when parts of the bile ducts in your liver have cancer. Sometimes this type of bile duct cancer is also classified as liver cancer.
- A Hilar Cholangiocarcinoma diagnosis is when the bile ducts have cancer outside of the liver. Sometimes this type can be classified as perihilar Cholangiocarcinoma.
- A Distal Cholangiocarcinoma diagnosis is when a bile duct portion near your small intestine has cancer.
The Bile Duct Cancer survival rate in all three types of Cholangiocarcinoma is very low. As with most cancers, early detection leads to early treatment, which can help prolong your life.
While the VA isn’t going to give you different ratings for these three types, each of them are going to come with a differernt set of side-effects. If your symptoms result in renal failure, digestion problems, or jaundice, you should make sure to add that on your VA disability application. We help you write up a full picture of your disability so that the VA can give you the best ruling for your disabilities.
Here are some tips on your C&P exam from one of our VA disability lawyers.
Bile Duct Cancer Survival Rate
The survival rate for Bile Duct Cancer is concerning. As of 2020, the five-year survival rate for Bile Duct Cancer is about 10%. If you are fortunate, your diagnosis of Bile Duct Cancer will be in an early stage which increases your survival rate to about 15%. Because the VA can take years to decide on your claim, you want to make sure you have it all filled out and set up correctly the first time. You’ll also want to designate beneficiaries or a Power of Attorney to continue your case if you are unable to do it yourself.
When the VA is working on a claim, if there are no next of kin or surviving spouses, they drop the case in the event of the veteran’s death. That means any compensation that you deserve wouldn’t go on to your spouse, grandkids, or anyone. Make sure you have all of that clear on your VA application if you have a terminal illness.
Agent Orange Presumptive List Conditions
While Congress added bladder cancer, hypothyroidism and Parkinson’s-like symptoms to the Agent Orange Presumptives list in 2020, liver cancer and bile duct cancer are still not on the list. If you are a Vietnam veteran, you’re first approach to VA disability should be via the Agent Orange presumptives. If any of your conditions fall on that list, then you may be able to link other illnesses to those as secondary conditions.
If you are the family member of a veteran that died and you don’t know if they were eligible for any Agent Orange presumptives, call our office and our team can help you figure it out for free.
Talk to Us About Your Claim: (866)232-5777.
One of our VA disability lawyers goes over the Agent Orange Presumptive Conditions list in this video:
Opisthorchildae is a parasitic worm that you get from eating raw or undercooked fish, crabs, or crayfish. Usually, the parasite in undercooked fish, crabs, and crayfish is found in Asia and Europe. They are especially prevalent in Thailand, Laos, Cambodia, Vietnam, Germany, Italy, Belarus, Russia, Kazakhstan, and Ukraine.
Liver flukes are easy to miss as most people won’t show symptoms even as the parasite infects the liver, gall bladder, and bile duct. If you start to exhibit symptoms, you will have severe abdominal pain, diarrhea, or constipation that can last years. If you have any of those symptoms in your C-File, that is a good foundation to start proving your service connection.
Here one of our VA disability lawyers goes over the questions Woods and Woods, The Veteran’s Firm, is often asked about veterans’ disability claims and appeals.
Clonorchis is also caused by eating raw or undercooked fish, crabs, or crayfish. The parasite lives inside raw or undercooked fish, crabs, or crayfish, which are from parts of Asia. This family of liver fluke infects the bile duct, gallbladder, and liver.
Clonorchis nickname is called Chinese liver fluke, and if left untreated, you can carry the parasite with you for up to 25-30 years.
Fascioliasis is caused by eating raw watercress or water plants and it resides in over seventy countries. The parasite larvae contaminate the water plants where sheep, cattle, and humans eat. The worms go through your intestinal wall, bile ducts, liver, and abdomen, where they mature and lay eggs.
More often than not, they predominately infect the liver and bile ducts, but no matter where it infects, it is treatable. The VA provides treatments for the liver fluke parasitic worm. But the VA is not required to agree or concede that bile duct cancer is service-connected because of the flukes so your VA disability benefits get denied.
Signs of Bile Duct Cancer
One of the signs of bile duct cancer is jaundice, resulting in the yellowing of your skin and the whites of your eyes. You can also experience dark urine, fevers, nausea, vomiting, and unexpected weight loss. You can also suffer extreme pain in your abdomen.
Bile duct cancer can also cause bile ducts to leak bile fluid. The leaking fluid causes water loss and dehydration. If you notice any of the above or clay-colored stools and itchy skin, it’s time to talk to your doctor.
You also want to consult with legal experts that can help you obtain VA disability benefits. You can call us before your doctor’s appointment and we can help you with the questions you should ask.
The Nexus Letter is like the missing link to a successful VA disability compensation claim. In this video, one of our veteran’s disability lawyers explains the importance of the Nexus Letter.
Treatment for Bile Duct Cancer
As with any cancer, treatment depends on how far the cancer has spread. Treatments include, but aren’t limited to;
- Chemotherapy – This is a treatment in which cancer cells are destroyed by anti-cancer drugs.
- Enzyme therapy – This type of treatment involves the use of enzymes to kill or suppress cancer cells.
- Immunotherapy – This is a treatment that uses your immune system to fight against cancer cells that have grown in your body.
- Radiation Therapy – This treatment uses high-energy X-rays or other forms of radiation to destroy cancer cells.
Finally, you can have a liver transplant. The VA only does organ transplants in about twenty locations across the United States and there is a waiting list for donors. You may have to travel far from home because not all VA medical centers handle such delicate surgery. If you are eligible for a liver transplant and get on the waiting list, your doctor will explain your travel arangements and your responsiblities.
When the VA Calls Their Lawyers, Make Woods and Woods Yours
At Woods and Woods, the Veteran’s Firm, we’ve helped thousands of veterans with their VA disability applications and appeals. We’ve been adding staff and lawyers during the Covid-19 pandemic to serve disabled veterans better in difficult times.
Call us today to discuss your VA disability appeal or your first application. The call is free and we won’t charge you a single fee until we win your case. We even pay for the postage for all of the documentation you send to our office. You can look for a VA disability attorney near you or call us and join the thousands of veterans living off of VA disability thanks to Woods and Woods.
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Frequently Asked Questions
No, if you are a surviving spouse, give us a call and let’s see how we can build your DIC case. Sometimes you can even get benefits for children of veterans via the G.I. Bill or other benefits.
I don’t have bile duct cancer, but I have some of these other conditions that lead to it. Can I apply for VA disability for these other liver problems?
Yes. Most of the time, VA ratings are issued based on your symptoms rather than the actual illness. You can use that to your advantage and apply for VA disability for your conditions rather than your diagnosis of a specific illness. Talk to your nexus doctor to see what is related to your in-service injuries.