PROSTATE MALIGNANT NEOPLASM

S. HENEKS · 2026 · Case ID: A26039490

GRANTED

Summary

The Veteran, a Veteran who served from October 1968 to August 1971, including service at Camp Lejeune, appeals the denial of service connection for prostate cancer. The Veteran claims his cancer is due to exposure to contaminated water at Camp Lejeune, citing his 30-month tenure there and his participation in water activities. He also noted a lack of family history or other risk factors for prostate cancer. The Veteran submitted studies linking Camp Lejeune water contaminants to elevated prostate cancer risk and prior Board decisions granting similar claims. The VA examination initially opined a positive nexus, citing high exposure levels and studies linking contaminants to cancer, but a subsequent addendum opinion from the same examiner found the link less likely due to perceived lack of medical literature. A private urology nurse practitioner, who had treated the Veteran since 2017, provided a favorable opinion, stating it was at least as likely as not that the cancer was a direct result of his documented exposure, citing studies and the absence of other risk factors. The Board found the evidence in relative equipoise and resolved the doubt in the Veteran's favor, granting service connection for prostate cancer.

Rationale

Conflicting medical opinions presented; Evidence in relative equipoise; Benefit of the doubt resolved in Veteran's favor

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250723-569245

Full Decision Text

Citation Nr: A26039490
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 250723-569245
DATE: April 28, 2026

ORDER

Entitlement to service connection for prostate cancer, to include as due to exposure to contaminated water at Camp Lejeune, is granted.

FINDINGS OF FACT

1. The Veteran is shown to have served at Camp Lejeune from January 1969 to August 1971, and exposure to contaminants in the water supply at Camp Lejeune is conceded.

2. Resolving reasonable doubt in the Veteran's favor, his diagnosed prostate cancer has been shown to be etiologically related to his in-service exposure to contaminated water at Camp Lejeune.

CONCLUSION OF LAW

The criteria for service connection for prostate cancer, to include as due to exposure to contaminated water at Camp Lejeune, have been met. 38 U.S.C. §§ 1110, 1112, 1113, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran served on active duty from October 1968 to August 1971, with additional service in the Navy Reserve.

This matter is before the Board of Veterans' Appeals (Board) on appeal from a March 2025 rating decision adjudicated under the Appeals Modernization Act (AMA) by a Department of Veterans Affairs (VA) Regional Office (RO).

Within the framework of the AMA, the Veteran submitted a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) and elected the Hearing Docket in July 2025. See July 2025 VA Form 10182 Notice of Disagreement.

In December 2025, the Veteran and his wife testified at a Board hearing before a Veterans Law Judge (VLJ). A copy of the transcript of that hearing has been associated with the claims file. The Board notes that, under the AMA, the VLJ who held the hearing is not required to adjudicate the appeal. In addition, under the Hearing docket, the Board only may consider the evidence of record at the time of the appealed rating decision as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days thereafter. 38 C.F.R. § 20.302(a).

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); 38 C.F.R. § 3.303.

Entitlement to service connection for prostate cancer, to include as due to exposure to contaminated water at Camp Lejeune, is granted.

The Veteran states that his diagnosed prostate cancer may have been caused by exposure to contaminated water while he was stationed at Camp Lejeune. In this regard, he reported that he was stationed at Camp Lejeune for more than 30 months and lived in a house adjacent to a lagoon, and indicated that he spent time swimming, fishing, and boating in the water throughout his tenure at the base. He further explained that he did not have a family history of prostate cancer, never smoked, rarely consumed alcohol, had never been obese or overweight, and exercised regularly, to include running half marathons. See December 2025 Hearing Transcript, pages 2-10; see also January 2025 VA Form 21-526 Veterans Application for Compensation or Pension.

During the 90 day evidence submission period following his December 2025 Board hearing, the Veteran submitted an article titled Trichloroethylene Cancer Epidemiology: A Consideration of Select Issues, which notes that a 2001 draft trichloroethylene (TCE) health risk assessment prepared by the Environmental Protection Agency concluded that epidemiologic studies, on the whole, supported associations between TCE exposure and excess risk of certain cancers, including prostate cancer. He also submitted a study titled Mortality Study of Civilian Employees Exposed to Contaminated Drinking Water at USMC Base Camp Lejeune: A Retrospective Cohort Study, which found that civilian workers at Camp Lejeune were at an elevated risk for several causes of death, to include prostate cancer. The study also notes that a mortality study published by the Agency for Toxic Substances and Disease Registry found that Marines and Navy personnel who served at Camp Lejeune between 1973 and 1985 had an elevated risk of developing certain cancers, to include prostate cancer. See December 2025 Correspondence.

In addition, the Veteran submitted an article titled Prostate Cancer Causes, Risk Factors, and Prevention, which notes that risk factors for prostate cancer include older age, race and ethnicity, family history, and inherited gene changes, as well as an article titled What Causes Prostate Cancer?, which indicates that prostate cancer can be caused by inherited and acquired gene mutations. See February 2026 Correspondence. The Veteran also submitted multiple prior Board decisions that granted service connection for prostate cancer based on exposure to contaminated water at Camp Lejeune. See November 2025 BVA Decision; February 2026 BVA Decisions.

A review of the Veteran's service personnel records (SPRs) shows an abstract of service and medical history, which confirms that the Veteran was stationed at Camp Lejeune from January 1968 to August 1971. See January 2025 STR - Medical; February 2025 Military Personnel Record. The Board further notes that a February 2025 Toxic Exposure Risk Activity memorandum confirms that the Veteran qualified for a presumption of exposure to Camp Lejeune water contamination, to include exposure to perchloroethylene (PCE), TCE, vinyl chloride, and benzene. See February 2025 Other.

The Veteran's service treatment records are silent for any findings or diagnoses related to prostate cancer. See January 2025 STR - Medical.

A review of the post-service treatment records shows that the Veteran was diagnosed with prostate cancer in January 2025. See February 2025 Medical Treatment Record - Non-Government Facility.

The Veteran underwent a VA examination for male reproductive conditions in February 2025. The examiner noted that the Veteran had been diagnosed with benign prostatic hyperplasia and neoplasms of the male reproductive system including prostate cancer. After performing an examination, reviewing the evidence of record, and considering the Veteran's total potential exposure through all of his applicable military deployments and the synergistic, combined effect of his toxic exposure risk activities, the examiner opined that it was at least as likely as not that the Veteran's prostate cancer was caused by his indicated in-service toxic exposure risk activities. In support of her opinion, the examiner noted that the Veteran and his family lived at a waterfront property while he was stationed at Camp Lejeune and noted that he would bathe and play in the water and drank water daily while he was stationed at the Base. As such, she found that the length, volume, and consistency of the Veteran's in-service exposure to Camp Lejune toxins was alarmingly high.

The examiner further explained that several studies had investigated the association between Camp Lejeune water contamination and prostate cancer. In this regard, she referenced a 2014 study by the Agency for Toxic Substances and Disease Registry, which found that individuals who lived or worked at Camp Lejeune during the period of contamination had a higher risk of developing prostate cancer compared to those who did not. She also referenced another study, published in 2022, which confirmed the above findings and showed that the increased risk was related to the duration and level of exposure to the contaminated water. In this regard, the examiner acknowledged that the exact mechanism by which contaminants from Camp Lejeune water may lead to an increased risk of developing prostate cancer risk were not fully understood but emphasized that studies analyzing the relationship suggested that the chemicals found in the water may damage DNA, promote cell growth, and suppress the immune system. See March 2025 C&P examination.

VA obtained two substantively identical addendum medical opinions in March 2025. After reviewing the evidence of record, and considering the Veteran's total potential exposure through all of his applicable military deployments and the synergistic, combined effect of his toxic exposure risk activities, the examiner opined that it was less likely than not that the Veteran's prostate cancer was caused by his indicated in-service toxic exposure risk activities. In support of her opinion, the examiner stated that the medical research did not offer enough evidence to support finding that the Veteran's diagnosed prostate cancer was a result of his in-service toxin exposures at Camp Lejune. In this regard, she explained that multiple studies indicated that there was a lack of medical literature showing any connection between prostate cancer and exposure to contaminated water at Camp Lejeune. She further emphasized that the Veteran had other risk factors for prostate cancer, to include his age, and emphasized that a 2021 study published by the Centers for Disease Control showed that 42 percent of prostate cancer cases were diagnosed in men aged 70 or older. See March 2025 C&P examinations.

Following his December 2025 Board hearing, the Veteran submitted a private medical opinion from S. P. Chumbley, an advanced practice urology nurse practitioner, dated in February 2026. Chumbley noted that the Veteran had been under his care for urology issues since 2017 or 2018 and stated that he reviewed the Veteran's service and medical records in connection with his opinion. In this regard, he opined that it was at least as likely as not that the Veteran's diagnosed metastatic prostate cancer was a direct result of, or related to, his documented 30-month exposure to contaminated water while he was stationed at Camp Lejeune.

In support of his opinion, Chumbley noted that a Camp Lejeune Agency for Toxic Substances and Disease Registry Incident Study found an elevated risk of cancer, to include prostate cancer, among Marines, Naval personnel, and civilian workers exposed to contaminated water at Camp Lejeune compared to unexposed groups at Camp Pendleton Marine Corps Station in California. He further stated that a statistically significant increase in prostate cancer incidence was found among exposed individuals especially with longer and more intense exposures and emphasized that the Veteran was stationed at Camp Lejeune for approximately 30 months. He also noted that the contaminants identified in the water included TCE, PCE, benzene, and vinyl chloride, all of which have been classified as probable or known human carcinogens.

In addition, Chumbley emphasized that the Veteran did not have any significant or known risk factors for prostate cancer beyond his age and exposure to toxins at Camp Lejeune. In this regard, he explained that the Veteran did not have a family history of prostate cancer or belong to the highest prostate cancer risk ethnic group. He further noted that the Veteran had never been obese and did not smoke, use alcohol, have a poor diet, lack exercise, or experience any other known toxic exposures. Thus, in light of the Veteran's unique exposure history, lack of alternative risk factors other than age, and the robust scientific data linking Camp Lejeune water contaminants to elevated prostate cancer risk, Chumbley found that it was at least as likely as not that the Veteran's diagnosed metastatic prostate cancer was caused by or related to exposure to contaminated water at Camp Lejeune. See February 2026 Medical Treatment Record - Non-Government Facility.

After a review of the evidence of record, the Board finds that entitlement to service connection for prostate cancer is warranted.

In this regard, the Board notes that service connection may be granted on a presumptive basis for certain diseases associated with exposure to contaminants (defined as the volatile organic compounds trichloroethylene (TCE), perchloroethylene (PCE or PERC), benzene, and vinyl chloride) in the on-base water supply located at Camp Lejeune, even though there is no record of such disease during service, if they manifest to a compensable degree at any time after service, in a veteran, former reservist, or a member of the National Guard, who had no less than 30 days (consecutive or nonconsecutive) of service at the United States Marine Corps Base Camp Lejeune and or Marine Corps Air Station New River in North Carolina, during the
service connection may be granted on a presumptive basis for certain diseases associated with exposure to contaminants (defined as the volatile organic compounds trichloroethylene (TCE), perchloroethylene (PCE or PERC), benzene, and vinyl chloride) in the on-base water supply located at Camp Lejeune, even though there is no record of such disease during service, if they manifest to a compensable degree at any time after service, in a veteran, former reservist, or a member of the National Guard, who had no less than 30 days (consecutive or nonconsecutive) of service at the United States Marine Corps Base Camp Lejeune and or Marine Corps Air Station New River in North Carolina, during the period beginning on August 1, 1953, and ending on December 31, 1987. 38 C.F.R. § 3.307(a)(7).

The following diseases are deemed associated with exposure to contaminated water at Camp Lejeune: kidney cancer, liver cancer, Non-Hodgkin's lymphoma, adult leukemia, multiple myeloma, Parkinson's disease, aplastic anemia and other myelodysplastic syndromes, and bladder cancer. 38 C.F.R. § 3.309(f). The Veteran's diagnosed prostate cancer is not listed in 38 C.F.R. § 3.309(f) as a disease recognized by exposure to contaminated drinking water at Camp Lejeune.

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However, the Veteran is not precluded from establishing service connection with proof of actual causation. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994).

Here, the Board notes that there are conflicting medical opinions as to whether the Veteran's diagnosed prostate cancer is related to his active service. In this regard, and after a review of the evidence of record, to include the February 2025 and March 2025 VA medical opinions and the February 2026 private medical opinion from Chumbley, the Board finds that the evidence for and against the Veteran's claim is in relative equipoise. See Lynch v. McDonough, 999 F.3d 1391, 1394 (Fed. Cir. 2021). Accordingly, the Board will resolve reasonable doubt in the Veteran's favor. The claim is granted. Id.

S. HENEKS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Justis, Kathleen

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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