Those paying attention to HCV infections know that the virus is a leading cause of  hepatocellular carcinoma (HCC).  Less well known, is that HCV can cause another cancer:  B-cell Non-Hodgkin lymphoma (NHL) (Pubmed -Link) (Pubmed-vet study 2007).

My old Marine has three risk factors for NHL.  He has a history of HCV infection (SVR with interferon treatments in 2004). He lived at Camp Lejeune (NC) (Link: Non-Hodgkin’s Lymphoma is presumptive condition); he was exposed to Agent Orange (AO) as a combat Marine in Vietnam, a presumptive SC condition (Link).  Yet, we don’t think he has ever been screened for NHL. If so, why not?

According to the American Cancer Society, there is no routine screening for lymphoma.

“Screening tests or exams are used to look for a disease in people who have no symptoms. At this time, there are no widely recommended screening tests for non-Hodgkin lymphoma (NHL). This is because no screening test has been shown to lower the risk of dying from this cancer. Still, in some cases lymphoma can be found early.”

This “…in some cases” policy is completely wrong.  By the time lumps can be felt the disease has progressed. Hardly an early or timely diagnosis of a blood cancer.  Prognosis? Cedars-Sinai (Los Angeles) states:

Non-Hodgkin Lymphoma

In the past 10 years, this disease has become easier to treat as more procedures are found to be effective. Overall, 50 to 60 percent of patients with non-Hodgkin lymphoma now live five years or longer without a recurrence.

If a veteran has one, two, three and even more risk factors for lymphoma, screening should be mandatory and frequent.

Veterans know that standard medical history questionnaires do not ask about their military service histories (VA and private).  And yet, even if a veteran has not been deployed to a war zone, he may have served on one of the Superfund military sites, or Formerly Used Defense Sites (FUDS).

The Leukemia and Lymphoma Society has published an excellent booklet (revised 2020) on NHL that offers many specifics we need to be aware of (Link).

NHL_Booklet_2020FINAL

The Lymphoma Research Foundation (LRF) is aware of the Agent Orange risk but does not mention Camp Lejeune in their 158-page booklet, Understanding  Non-Hodkins Lymphoma, a guide for patients, loved ones and survivors.  (Link)

NHL-Booklet_July-2018 

I emailed them with links about the Camp Lejeune exposures and have an received an acknowledgement.  LRF is a very well connected non-profit in the private care medical world but not with VA-based expert advisors.

So veterans, families and friends, we need to talk about pro-active NHL screenings as a war-related and military environmental hazards illness, as well as an extrahepatic HCV-cancer, with medical and veteran influencers and practitioners.  The current screening policies for at-risk patients must change.

Laura (Guest author)