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One Mistake Led to Another (Part VI) – What’s the Cause?

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The American Cancer Society lists 14 risk factors for colon cancer, and it breaks those 14 factors into 3 categories: risk factors you cannot change, lifestyle-related factors, and factors with uncertain, controversial, and unproven effects.

Going through the list, I do not seem to be a prime candidate. And yet I have Colon Cancer anyway, seemingly because of one, or possibly two risk factors.

Risk factors you cannot change

  1. Age
  2. Personal history of colorectal polyps or colorectal cancer
  3. Personal history of inflammatory bowel disease
  4. Family history of colorectal cancer or adenomatous polyps
  5. Inherited syndromes (Familial adenomatous polyposis, Turcot syndrome, Peutz-Jeghers syndrome)
  6. Racial and ethnic background (African Americans, Jews of Eastern European descent)
  7. Type 2 diabetes

Lifestyle-related factors
8. Certain types of diets (diet that is high in red meats)
9. Physical inactivity
10. Obesity
11. Smoking
12. Heavy alcohol use

Factors with uncertain, controversial, or unproven effects
13. Night shift work
14. Previous treatment for certain cancers (testicular cancer, prostate cancer)

The first risk factor for me is Age: 90% of the people diagnosed with colon cancer are at least 50 years old. I am 69, almost 70.

But that doesn’t explain why I developed Colon Cancer, it only means that I’m in the same age bracket at the people who get Colon Cancer.

The second possible risk factor is a bit of a stretch. I am not a heavy drinker. You won’t find me sitting at the bar every day after work, and I don’t spend my weekends socializing at any of the local bars. That’s just not me.

But there have been two times in my life when I drank more than the currently recommended “no more than two drinks a day for men.”

The first time was during the Vietnam War when I was flying combat missions over North Vietnam, South Vietnam, Laos, and Cambodia.

I flew 104 combat missions, and after every combat mission if you weren’t flying the next day, it was common practice for the aircrews to sit in the bar at the Officer’s Club at Takhli RTAFB and drink the night away.

At the time, my preferred drink was Johnnie Walker Black, scotch whiskey, and I would have more than two drinks to deal with the stress.

But that stopped when I came back to the States in June 1969.

The other time I drank “more than two drinks a day” was in the mid to late 1990’s, when I was active in the Irish-American community here in Rochester.

Somewhere during that time, I picked up the idea that the limit for drinking was more than three drinks a day, “One for the Father, one for the Son, and one for the Holy Ghost.”

That is a pretty Catholic way of putting things, and for years I thought I’d gotten the idea from the Irish writer Walter Macken, author of Seek the Fair Land, The Silent People, and The Scorching Wind, historical novels set in the time of the Potato Famine in Ireland when the English used the available grain to feed the cattle and let the Irish people starve.

But when I went looking through my collection of Walter Macken’s books I could never find that quote.

But yesterday I discovered that the quote isn’t from Walter Macken at all. It’s from Graham Greene, the British writer who converted from converted from Anglicanism to Roman Catholicism in 1926 when he was 22 years old.

I’ve always loved the straightforward way Greene wrote in novels such as The Third Man, The Heart of the Matter, and The Quiet American.

In fact, I think that The Third Man might be the best mystery novel ever written.

Yesterday, I stumbled across an article by Graham Lord of the Daily Mail, who wrote about meeting the 83 year old Graham Greene at his home in the South of France, four years before Greene ‘s death.

Lord wrote that while they were having lunch at Greene’s favorite pavement café, where they shared three bottles of wine, Greene to told them “how he had once been travelling around Spain with a Catholic priest, and had one day suggested that they should have a third bottle of wine with their lunch. ‘Why not?’ said the priest. ‘One for the Father, one for the Son, and one for the Holy Ghost.'”

So I had inadvertently picked up the idea from a notoriously heavy drinker. Not a good idea.

In the meantime, I found out that I had come back from Vietnam with a wicked case of PTSD.

I’d wake up in the middle of the night, drenched in sweat, and shaking with fear, after having another nightmare reliving the worst moment of my life, in the sky near Vinh North Vietnam when my unarmed reconnaissance place was jumped by a North Vietnamese MIG who fired an air-to-air missile right up our tail.

How the missile missed or failed to explode, I will never know. He had us dead to rights and I should be a dead man.

But I’m not. Instead, I have PTSD.

My doctor told me my young daughter was afraid of me because of the way I’d explode in rage over the weirdest things. So I went to the Veterans Outreach Center for help and after a while they passed me on to the VA, which classified me as 80% disabled because of my PTSD.

During my treatment at the VA Outpatient Clinic in Westfall Road, Amy Warner, a Nurse Practitioner, asked me how much I drank. When I told her never more than 3 a day, she told me that was too much and that I should limit myself to “no more than two drinks a day.”

So I went home and started an Excel spreadsheet to track my alcohol consumption and make sure that I kept to the rule of “no more than two drinks a day.”

Now that I know the rules, I’ll keep them. But for all I know, the damage had already been done.

The American Cancer Society doesn’t specify any time limits on when the heavy drinking took place.

But as Shakespeare wrote in The Tempest, “The past is prologue.” It’s an event that leads to another event or situation, but we can’t do anything to change it.

There is also a third possible risk factor for why I developed Colon Cancer: Agent Orange.

According to the VA, “The following Veterans may have been exposed to herbicides: "U.S. Air Force Veterans who served on Royal Thai Air Force (RTAF) bases at U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang, near the air base perimeter anytime between February 28, 1961 and May 7, 1975.”

For years, the Pentagon denied that it had used Agent Orange in Thailand, but a declassified Department of Defense report written in 1973, Project CHECO Southeast Asia Report: Base Defense in Thailand 1968-1972, “contains evidence that there was a significant use of herbicides on the fenced-in perimeters of military bases in Thailand to remove foliage that provided cover for enemy forces.”

Whenever I flew back into Takhli during the rainy season and looked down, the entire area around Takhli was covered with lush green tropical vegetation except for a small area, perhaps 100 yards wide, around the perimeter fence.

The around the perimeter fence was totally brown. Nothing grew there at all, not even a blade of grass.

Now the Air Force wasn’t particularly careful about where they sprayed and how they sprayed. For example, they use to spray the entire base with insecticides to keep the mosquitoes down.

To do the spraying, a tank truck would drive through the streets of the base spraying a huge cloud of insecticide into the air, coating everything in sight; the trees, the lawns, the hootches, the squadron buildings, everything.

And it was your job to stay out of the way. The trucks just drove down the street spraying. That’s the way the Air Force was. If it was the day scheduled to spray insecticide, they sprayed insecticide.

As a navigator-bombardier, one of my duties was to take my turn in the rotation and help grade every take-off and landing made by an EB-66 at Takhli.

This meant spending a morning, and afternoon, or an evening in a bunker near the landing end of the runway, so we had a close up view of each approach and landing by an E-66.

There were two bunkers, one at each end of the runway, and if the wind changed, we changed bunkers

As we looked out from the bunker, the perimeter was right in front of us, maybe a hundred yards away, and I can remember watching them spray the perimeter with what I later learned was Agent Orange.

However, in May 2010 the VA issued a Compensation and Pension Bulletin that set down the process that the VA would follow in handling any and all Agent Orange claims for Vietnam Veterans stationed at: U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat or Don Muang in Thailand. In effect, the ruling segregate Veterans who served on those bases into "Those that were on the perimeter" and "those that were not on the perimeter."

According to an article published in the Journal of Preventive Medicine and Public Health.

Colon cancer, was found to have a relationship with Agent Orange in this study, even though it did not show a relationship in previous research.

As recently as May 2010, the Department of Veterans Affairs has ruled that

"Colon cancer is not on the list of disease presumed service connected in Veterans exposed to Agent Orange."

So it seems, that like alcohol use, Agent Orange exposure is not a prime suspect in why I developed Colon Cancer and other people my age have not.

Perhaps I'll never know, why me?

To Be Continued in One Mistake Led to Another (Part VII).

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