Citation Nr: 21062067 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 15-28 262 DATE: October 6, 2021 REMANDED Entitlement to service connection to prostate cancer is remanded. Entitlement to service connection to papillary thyroid carcinoma is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1970 to April 1974. In July 2018, the Board issued a decision which denied the claims on appeal. The Veteran filed a timely appeal to the Court of Appeals for Veterans' Claims (Court). In a March 2020 memorandum decision, the Court vacated the Board decision and remanded the appeal to the Board for further development. In November 2020, the Board again issued a decision denying the issues on appeal. In July 2021, the Court issued an Order granting a Joint Motion for Remand (Joint Motion), vacating the Board's decision and remanding the issue to the Board for further consideration. 1. Entitlement to service connection to prostate cancer is remanded. 2. Entitlement to service connection to papillary thyroid carcinoma is remanded. The Veteran asserts that he is entitled to service connection for prostate cancer and thyroid cancer as due to in-service exposures during his period of active service. In August 2020, the Veteran submitted part of a National Priorities List (NPL) site narrative provided by the Environmental Protection Agency that stated that the Anderson Air Force Base (AFB) was known to operate with hazardous substances including solvents such as trichloroethene (TCE) and paint thinners; dry cleaning fluids and laundry products; fuels such as JP-4 and gasoline; pesticides; antifreeze; aircraft cleaning compounds; and polychlorinated biphenyls (PCBs). The Veteran also submitted a narrative completed by a private physician, J.D.B., M.D., who opined that it is more likely than not that the Veteran's developing cancers of the thyroid and prostate resulted from his earlier exposure to herbicidal agents, lead, benzene, and PCB's while stationed on Guam. The Board notes that the Veteran's exposures to herbicide agents has not been conceded by VA; however, this medical opinion indicates a potential link between the Veteran's exposure to lead and benzene via his duties as a fuel specialist and his diagnosed prostate and thyroid cancers. The physician notes that lead is a component of jet fuel and that benzene is a component of gasoline and widely used solvents. While the medical opinion provided does not specifically address whether the Veteran's exposure to lead, benzene, and PCB's while stationed on Guam on their own (or separate from exposure to herbicide agents) at least as likely as not resulted in the Veteran's cancers of the thyroid and prostate, the Board finds that a medical opinion addressing this issue should be obtained. The Veteran is invited to submit an updated medical opinion that addresses whether the Veteran's exposures to lead, benzene, and PCBs, either individually or collectively, at least as likely as not have resulted in the Veteran's cancers of the thyroid and prostate. The matters are REMANDED for the following action: 1. Undertake appropriate efforts to obtain a medical opinion regarding the etiology of the Veteran's prostate and thyroid cancers from an oncologist, or a similarly trained physician. The entire claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated. An examination of the Veteran is not required, unless deemed necessary by the examiner. The examiner is asked to address the following: Whether the Veteran's prostate cancer and thyroid cancer (or any residuals) at least as likely as not (50 percent or greater probability) were caused by, or are the result of, any event of the Veteran's period of active service, to include: exposures to lead, benzene, and polychlorinated biphenyls, either collectively, or individually. In providing the requested opinion, the examiner must address the lay assertions of record. Lay statements cannot be disregarded solely due to lack of contemporaneous medical evidence. The examiner is asked to consider the documents submitted by the Veteran in August 2020, including the NPL site report and the medical opinion provided by J.D.B., M.D. (Continued on the next page) A complete rationale should be provided for any opinions rendered. If an opinion cannot be provided without resort to pure speculation, it must be so stated, and the examiner must provide the reasons for doing so. K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P.M. Johnson, Counsel 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.