1. EMBARGOED FOR RELEASE UNTIL May 14, 2011 AT 11:30 A.M.
Contact: Wendy Waldsachs Isett, AUA
410-977-4770, wisett@AUAnet.org
AGENT ORANGE LINKED TO RENAL CANCER
Severity of renal cancer in patients exposed to Vietnam-era chemical is examined
Washington, DC, May 14, 2010–In recent years, the prevalence of renal cancer has increased, in part
due to the detection of tumors during imaging studies for non-related health concerns. While Agent
Orange, a herbicide used during the Vietnam war, has been previously linked to a variety of types of
cancers in Vietnam veterans, new data from researchers at the Veterans Affairs Medical Center in
Shreveport, LA, indicates that there may be a connection between veterans’ in-country exposure and
subsequent development of renal cancer. The findings were presented to reporters during a special
press conference at the Walter E. Washington Convention Center in Washington, DC on Sunday, May
15 at 11:30 a.m. during the 106th Annual Scientific Meeting of the American Urological Association
(AUA). The session will be moderated by Anthony Y. Smith, MD.
Researchers at the Overton Brooks VAMC in Shreveport examined charts for 297 patients diagnosed
with renal cancer between 1987 and 2009. Of these patients, 13 (4 percent), ranging in age from 39 to
63 years at time of presentation, claimed exposure to Agent Orange. Eleven of these patients
underwent surgical treatment. Authors reviewed age at presentation, tumor size, side of lesion,
pathology and survival in the 10 patients with documented exposure to Agent Orange for which
pathology reports were available.
Of these patients, 90 percent had clear-cell cancers, which typically have a worse prognosis than
papillary tumors, which appeared in one of the patients. One patient had combined clear-cell and
papillary cancers. Node sampling was negative in all. Mean follow up was 54 months. Four patients
developed metastatic disease and one patient died from his cancer.
“We know that the chemicals in Agent Orange were extremely toxic, and are known to cause cancer,”
Dr. Smith said. These data indicate that we may need to better determine whether exposure to these
chemicals should be considered a risk factor for kidney cancer.”
About Agent Orange: Agent Orange is a combination of two synthetic compounds known to be
contaminated with the dioxin tetrachlorodibenzo-para-dioxin (TCDD) during the manufacturing
process. Named for the color of the barrel in which it was stored, Agent Orange was one of many

2. broad-leaf defoliants used in Vietnam to destroy enemy ground cover. It is estimated that more than
20 million gallons of the chemicals, also known as “rainbow herbicides” were used between 1962 and
1971; approximately half the herbicides were Agent Orange. In 1997, the International Agency for
Research on Cancer re-classified TCDD as a Group 1 carcinogen, a classification that includes arsenic,
asbestos and gamma radiation.
NOTE TO REPORTERS: Experts are available to discuss this study outside normal briefing times. To
arrange an interview with an expert, please contact the AUA Communications Office at the number
above or e-mail wisett@AUAnet.org.
About the American Urological Association: Founded in 1902 and headquartered near Baltimore, Maryland, the
American Urological Association is the pre-eminent professional organization for urologists, with more than
17,000 members throughout the world. An educational nonprofit organization, the AUA pursues its mission of
fostering the highest standards of urologic care by carrying out a wide variety of programs for members and their
patients.
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3. 529: OVERTON BROOKS VAMC PRELIMINARY FINDINGS IN PATIENTS EXPOSED TO AGENT ORANGE
WITH RENAL CELL CANCER
Ayme Schmeeckle, Deborah Moore, Robert Moore, Phillip Hadaad, Shreveport, LA
INTRODUCTION AND OBJECTIVES: The effect of Agent Orange (AO) on the human body has remained
a topic of controversy in medical literature over the last forty years. Previous studies have
documented increased risks of several different cancers in those exposed. There have been no studies
to date reviewing renal cell cancer in patients exposed to AO. The purpose of this study was to review
the characteristics of renal cell cancer in patients exposed to Agent Orange.
METHODS: A retrospective chart review was performed from 1987 to 2009 of all patients diagnosed
with renal cell cancer (RCC) at Overton Brooks VAMC in Shreveport, Louisiana. We specifically
reviewed age of presentation, tumor size, side of lesion, pathology and survival in patients with
documented exposure to AO.
RESULTS: 297 patients were diagnosed with renal cell cancer over a period of 22 years. Thirteen
patients (4%) claimed exposure to Agent Orange. The average age of presentation was 56.5 years
(range 39-63). Eleven of the 13 AO patients were treated surgically. Of these 11 patients treated
surgically, nine presented with T1 lesions; one with T2. Six lesions were left sided. Size ranged from
2.5-5.5 cm in the T1 group. The T2 lesion measured 12cm. Pathology was clear cell in eight, combined
clear cell and papillary in one, and pure papillary in one. Pathology was unavailable in one patient.
Three had nodal sampling at the time of surgery including the patient with T2 disease, and all nodes
sampled were negative. Mean follow-up was 54 months (range 4-168). Four patients developed
metastatic disease. Their mean age was 50.3 years (range 39-59). One patient died of his disease. Of
the remaining two patients, one died of concurrent large cell lymphoma and the other of perforated
diverticulitis.

4. Size Follow Up
Age T N Side Surgery Pathology Grade Outcomes
(cm) (months)
Open Lung metastasis at 8 years. Died of
44 5 1b L Clear cell 1 91
nephrectomy large cell lymphoma.
Open partial
54 3.5 1a L Clear cell 2 93 No evidence of disease.
nephrectomy
Laparoscopic Brain metastasis at 3 years. Died of
59 5.3 1b L Clear cell 3 42
nephrectomy perforated diverticulitis.
Laparoscopic
58 2.5 1a R Clear cell 2 64 No evidence of disease
nephrectomy
Laparoscopic
63 4 1a R Clear cell 2 56 No evidence of disease.
nephrectomy
Open Occipital metastasis at 10 months. XRT.
59 12 2 0/15 R Clear cell 3 44
nephrectomy Currently on sunitinib.
Presented with lung and liver
Open
39 R 168 metastasis at 23 years. Failed sunitinib.
nephrectomy
Died of respiratory failure.
Laparoscopic
58 3.8 1a 0/5 L Clear cell 2 32 No evidence of disease.
nephrectomy
Open partial Clear cell, Surveillance of 1cm contralateral
59 3 1a L 2 19
nephrectomy papillary lesion.
Laparoscopic
60 5.5 1b 0/3 L Papillary 3 4 No evidence of disease.
nephrectomy
Laparoscopic
61 6 1b R Clear cell 3 1 No evidence of disease.
nephrectomy
CONCLUSIONS: 40% of the patients exposed to AO progressed to metastatic disease and in a
population with an average age of 50. Further data is being collected from other VA medical centers to
further investigate if there is a link between renal cell cancer and Agent Orange exposure.
Source of Funding: None