Below is a copy of an email I recently sent to the editor of The VVA Veteran magazine:
Dear Sean Venables, Editor
The PACT Act added MGUS (monoclonal gammopathy of undetermined significance) to the Agent Orange presumptive disease list. Research by doctors at the VA, National Institutes of Health, and Centers for Disease Control found that over twice as many veterans who were exposed to Agent Orange developed MGUS compared to other veterans.
MGUS is the presence of abnormal proteins in the blood. There are three types of MGUS: IgM MGUS, non-IgM MGUS, and light-chain MGUS. About one in six people diagnosed with IgM MGUS progresses during their lifetimes to the Agent Orange presumptive diseases lymphoma or leukemia (blood cancers) or amyloidosis (the accumulation of abnormal proteins in important organs). About one in eleven people diagnosed with non-IgM MGUS progresses during their lifetimes to the Agent Orange diseases multiple myeloma (another blood cancer) or amyloidosis. Light-chain MGUS was discovered relatively recently, so lifetime risk has not been determined. The potential complications of MGUS include viral or bacterial infections, heart damage, nerve damage, kidney damage, blood clots, and vision loss.
MGUS is a pre-malignant condition that has no symptoms. So, you can have MGUS and not know it. The leader of the above research project recommended that veterans who were exposed to Agent Orange be screened for MGUS. Screening involves performing three common and widely-available blood tests: serum protein electrophoresis, serum immunofixation, and a serum light-chain assay. Follow-up tests are performed if any of the above three tests has a positive result. I have had two VA Agent Orange Registry exams and at neither exam were all three tests performed.
The standard health care for those diagnosed with MGUS is regular lifetime monitoring for progression and complications. How often monitoring occurs (annually or more frequently) depends on the health risks associated with your MGUS type. In any case, early detection of progression to an Agent Orange disease has been shown to have survival benefits for the patient.
While finding out that one has a pre-malignant condition is unpleasant, I urge veterans who were exposed to Agent Orange to be screened for the disease. There is no avoiding the fact that we are all at greatly elevated risk for presumptive Agent Orange diseases. Knowing your MGUS status can motivate you to seek the health care you need earlier, improving your health outcomes should progression or complications occur.
If you are diagnosed with MGUS, be sure to file a claim for copayment-exempt VA health care for your MGUS because VA law (38 U.S. Code § 1710) waives copayments for toxic-exposure related diseases. You can learn more about MGUS at AgentOrangeExposedVeterans.org
Robert M. “Bob” Hunter, PhD
410 South Church Ave
Bozeman, MT 59715
(406) 581-2234