Citation Nr: 20008522 Decision Date: 01/31/20 Archive Date: 01/31/20 DOCKET NO. 13-10 591 DATE: January 31, 2020 ORDER Entitlement to service connection for prostate cancer is denied. FINDING OF FACT The Veteran's prostate cancer did not have its onset in service and is not otherwise the result of a disease or injury incurred in service. CONCLUSION OF LAW Prostate cancer was not incurred in or aggravated by service and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1966 to September 1970. This matter is on appeal from a November 2011 decision. This matter was previously before the Board in November 2016 and July 2018, when it was remanded for additional development. Entitlement to service connection for prostate cancer The Veteran contends that his prostate cancer is directly related to active service, specifically recurring prostatitis while in service. Service treatment records document recurrent prostatitis including a July 1969 treatment record indicating a diagnosis and an August 1969 record reflecting that the prostatitis had resolved as there were “no symptoms now.” The Veteran was diagnosed with prostate cancer in November 2010. See i.e. January 2017 VA examination. Thus, the first two elements of service connection are satisfied and this matter turns upon whether a nexus between the current condition and service can be established. While there are multiple medical opinions of record, there is no positive conclusion in support of the claim associated with the record. The most recent medical opinion of record from April 2019 succinctly explains why the Veteran's prostate cancer is less likely than not related to the Veteran's active service, to include the recurrent prostatitis. The examiner identified that medical science does not support a relationship between a bacterial infection and a common malignancy in older men. Rather, the primary risk factors for prostate cancer are age, genetics, and race, with African Americans having risk for prostate cancer at twice the common rate. The examiner further explained that the record did not identify any residuals of the prostatitis in over 40 years since the prior diagnosis during active duty. The examiner concluded that medical literature does not provide any support for an etiological relationship between the disorders, as noted by the evaluations of the prior VA urologists and without any dissenting opinion from his civilian radiation oncologist. The Board accepts the April 2019 VA examiner's opinion that the Veteran's prostate cancer is less likely than not related to his service as highly probative medical evidence on this point. The Board notes that the examiner rendered the opinion after thoroughly reviewing the claims file and relevant medical records. The examiner noted the Veteran's pertinent history and provided a reasoned analysis of the case. The Board has again considered the lay statements of record, to include the Veteran's previously referenced assertions. To the degree that the Veteran has reported a continuity of symptoms since service, he is competent to report his observations and relate what he was told by medical professionals. Of note, the Veteran has not indicated that a medical professional provided him with a relevant diagnosis during service or immediately thereafter. The Veteran's lay evidence of onset and continuity is far less probative than the opinion of the VA professionals, as the VA medical opinions associated with the claims file are far more detailed and reasoned; thus warranting a greater probative value. The Board finds that the probative value of the general lay assertions is outweighed by the clinical evidence of record. There is no reliable evidence linking the Veteran's prostate cancer to service. The contemporaneous records establish that there were no documented manifestations of prostate cancer in service, there were no manifestations of prostate cancer within one year of separation, and prostate cancer was first manifest many years after separation. The Board finds the contemporaneous records to be far more probative and credible than the Veteran's report of onset, continuity, and treatment. Here, chronic disease (prostate cancer) was not "noted" during service or within one year of separation within the meaning of section 3.303(b). While the Board notes the Veteran's reported and documented history of in-service prostatitis, it finds that the service treatment records do not show a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. Furthermore, the evidence does not establish that prostate cancer was manifest to a compensable degree within one year of separation. 38 C.F.R. §§ 3.307; 3.309. The evidence of record shows that prostate cancer was manifest many years after service. The Veteran was not shown to have prostate cancer, or any relevant chronic disorder in service, and did not have characteristic manifestations of such a disorder until multiple years after discharge. In summary, the evidence establishes that in-service prostatitis resolved, and the onset of prostate cancer occurred many years after service. The Board finds that the contemporaneous in-service and post-service treatment records are entitled to greater probative weight and credibility than the lay statements of the Veteran. The Board also finds the April 2019 VA examiner’s opinion to be of significant probative value, especially as the rendered conclusion is corroborated by the multiple previous opinions associated with the record. The more probative evidence establishes that he did not have prostate cancer during service or within one year of separation. Furthermore, the evidence establishes that the remote onset of prostate cancer is unrelated to service. The Board finds that the preponderance of the evidence is against the claim and the claim must be denied. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Marcus J. Colicelli 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.