July 11, 2018

The Dept. of Veterans Affairs - National Cancer Institute Alliance, a double edged sword

Jack Kemp

Recently the co-founders of the veterans' charity Backpacks for Life sent me information about the Dept. of Veterans Affairs getting involved with "giving veterans access to the latest anti-cancer treatments." The glowing press release states, in part:


 VA Partnership with National Cancer Institute Will Boost Veteran Access to Clinical Trials

WASHINGTON — Today the U.S. Department of Veterans Affairs (VA) announced that it has formed a partnership with the National Cancer Institute (NCI) which will provide more access to the latest treatment options for VA patients with cancer.

"Strategic partnerships, such as this one with the National Cancer Institute, allow VA to leverage the strengths of both organizations to the benefit of all stakeholders, especially our Veterans,” said VA’s Acting Secretary Peter O’Rourke. "By increasing enrollment in these trials, VA and Veterans will contribute to important cancer research — this will not only help our Veterans, but also advance cancer care for all Americans and people around the world.”

The NCI and VA Interagency Group to Accelerate Trials Enrollment, also known as  NAVIGATE, is launching at 12 VA sites: Atlanta, Georgia; Bronx, New York; Charleston, South Carolina; Denver, Colorado; Durham, North Carolina; Hines, Illinois; Long Beach, California; Minneapolis, Minnesota; Palo Alto, California; Portland, Oregon; San Antonio, Texas; and West Haven, Connecticut. Boston, Massachusetts, will also serve as a coordinating center for the effort.


This has an optimistic tone. But, as they say, "the Devil is in the details."

I don't want to be negative but I've had some indirect life experiences and know the problems involved with what they call in the computer business as "beta testing" and in the medical field as "candidates for first versions of experimental drugs." Both of these situations mean the test subject is the first person getting access to the latest devices or treatments. This can be good, bad or a mixture of both outcomes.

Big tech companies big reputations like IBM or Microsoft are famous for selling its customers on the idea that they will be fortunate to get the first version of a new product - before all the bugs have been worked out. These customers are called "beta testers." What often happens is the customer finds some flaws in the design of the software or hardware and the big company gets the customer to be their testing department for free. After receiving improved suggestion designs (also called "complaints") come in, the big company later introduces "Version 2.0" with fixes made to the mistakes in the original one. The Version 2.0 is called the "new, updated version" - and it is. If the first version didn't have too many flaws, this is a win-win for all people at the customers' companies and for the big manufacturer. And often times this is a mixed bag of good and bad.

As for testing new medicines, the situation is more complicated. As a small boy, I, along with many of my classmates, was one of the test subjects in the 1950s for both the early versions of Dr. Salk's and Dr. Sabin's (anti) polio vaccines. The risk of getting that horrible disease caused many parents to grant permission for their children to become test subjects for the first version of both these medicines designed to fight a dreaded childhood disease. You can read more about those 1950s tests at https://amhistory.si.edu/polio/virusvaccine/vacraces2.htm

The U.S. has had a history of using prisoners as test subjects for new medicines, often (but not always) receiving reduced prison time for their participation. Many adults with serious illnesses that have not responded to other treatments - or for which no other treatment exists but that of the experimental medicine offered - have voluntered to try something untried. As Bob Dylan once sang, "When you ain't got nothin', you got nothin' to lose."

And then there is a history of the military using service people as medical test subjects with vaccines. It has been speculated that the vaccines given to U.S. Veterans of the 1991 Gulf War were possibly a contributing factor in a condition known as Gulf War Syndrome. The Department of Veterans Affairs own website states that:


Research on vaccinations and Gulf War Veterans

The Health and Medicine Division (formally known as the Institute of Medicine) of the National Academy of Sciences, Engineering, and Medicine concluded in its report Gulf War and Health: Depleted Uranium, Sarin, Pyridostigmine Bromide, and Vaccines (2000) that there is inadequate or insufficient evidence to determine whether an association does or does not exist between multiple vaccinations and long-term adverse health problems.

Anne Linscott, an attorney with Hill and Ponton (Disability Attorneys) writes at her firm's website that:


The Anthrax Vaccine

Of the vaccines that Gulf War veterans received, one of the most controversial one is the anthrax vaccine. Concerns were raised over the effectiveness of the vaccine against protecting against inhalation of anthrax, quality control in the production of the vaccine, the vaccine’s short and long-term health effects, the components of the vaccine, and policies of the military that required mandatory vaccination.

A major concern, and one of great debate, is the side-effects of giving the anthrax vaccine. There is still a lot of research that needs to be done to determine the long-term side-effects of the anthrax vaccine. Adding to the lack of information is that many of the Department of Defense’s studies on the safety of the vaccine do not include long-term follow up. All vaccines pose risk of adverse side effects. Common side effects of vaccines include soreness and swelling where the vaccine was administered, and fever. However, there is always a risk that a vaccine can produce more serious side-effects. In 2002, a study of approximately 900 veterans found a strong correlation between the anthrax vaccine and subsequent health problems. Known side-effects of the anthrax vaccine can be mild, moderate, or severe. The following are examples of such side-effects:

    Mild/Moderate: reactions on the arm where the vaccine was given such as tenderness, redness, itching, development of a lump or bruise, muscle aches; headaches; joint pain; fever; and fatigue.

    Severe: signs that a reaction to the anthrax vaccine is severe include difficulty breathing, weakness, hoarseness, wheezing, a fast heartbeat, hives, dizziness, paleness, or swelling of the lips and throat. Serious reactions involving the skin and nervous system have been reported, but a direct link to the anthrax vaccine has not been conclusively proven.

Another concern regarding the anthrax vaccine is the components used to make the vaccine. One of these components is squalene. Squalene, a banned chemical additive, was found in blood tests of hundreds of sick Gulf War veterans. Squalene is not approved for internal human use other than in highly controlled experiments, but it has been studied for use as a tool to boost the body’s immune systems against certain diseases.  In a study of Gulf War veterans suffering from Gulf War Syndrome, conducted by Tulane University, 95% of the veterans had high levels of squalene antibodies in their blood. Researchers believe this may suggest a possible link between the anthrax vaccine and Gulf War Syndrome.

In Closing…Although there is a lot of research showing a link between vaccinations and Gulf War Syndrome, the VA does not officially recognize that link. However, many different research organizations continue to evaluate possible causes of Gulf War veteran’s health problems. As part of the effort to learn more about how Gulf War service affected veterans, the VA established the Gulf War Registry.

The Backpacks for Life website recently had an article on how the malaria medicine mefloquine, given to U.S. troops in the most recent middle east wars, mirrored the effects of PTSD. A doctor, writing in the Huffington Post in 2013, claimed mefloquine could lead to much worse. This became part an article at the Aviary. http://tbirdnow.mee.nu/_malaria_medicine_ptsd_suicides_

Former U.S. Navy psychologist Dr. Heidi Squier Kraft was deployed to the more recent middle eastern war in Iraqi. She wrote a powerful book about her experiences called "Rule Number Two: Lessions I Learned in a Combat Hospital," a book endorsed by, among other notables, U.S. Marine General (Ret.) Anthony Zinni, former commander of the U.S. Central Command.

Starting on page 18, in a chapter called "Fever," Dr. Kraft states:

Before the dawn of my third morning in country, I emer seat-soaked from vivid, disturbing dreams. I felt disorientd and nauseated, and a searing pain ripped across my shoulders and left arm....The pain radiated frm my left deltoid muscle, and suddenly I knew: it was the site of my smallpox vaccination, adminsitered in Kuwait five days before our flight to Iraq.


The Dr. Kraft goes on to tell of her having a temperature of 103 and a Marine physicians' assistant writing her a perscription for antibiotics and ibuprofen. Her fever didn't subside for two days, long after her first "request" from her Marine Commanding Officer to minister to the emotional needs of some Marines whose vehicle had hit a land mine.

So in conclusion I have to say my knowledge of medicine and specifically those medicines used in the U.S. military is more general and not that detailed. Even as a non-medical doctor, and a "citizen blogger" with no travel expense account and no medical background, it is difficult for me to gather more detailed information because I do not have both a travel budget and a press pass from a major news outlet, i.e., a paid job there with an expense account. And all the facts in the Dept. of Veterans Affairs press release point to only one partial conclusion: their optimistic version of the situation. The press release is, ironically, inconclusive and needs a lot more investigation to find out how this partnership between the VA and the National Cancer Institute will work on a practical level and what type of impact it will have on veterans. I suspect there will be glowing stories coming out of this partnership - and some not so glowing.

Posted by: Timothy Birdnow at 04:28 AM | No Comments | Add Comment
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