Citation Nr: 21011087 Decision Date: 02/26/21 Archive Date: 02/26/21 DOCKET NO. 18-03 269 DATE: February 26, 2021 ORDER Service connection for prostate cancer is granted. FINDING OF FACT Prostate cancer is due to the Veteran’s presumed exposure to contaminated water at Camp Lejeune. CONCLUSION OF LAW The criteria for service connection for prostate cancer have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from November 1983 to November 1987. The Veteran asserts that his prostate cancer is due to exposure to contaminated water at Camp Lejeune. 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. See Diseases Associated with Exposure to Contaminants in the Water Supply at Camp Lejeune, 82 Fed. Reg. 4,173 (Jan. 13, 2017); 38 C.F.R. §§ 3.307, 3.309. This presumption may be rebutted by affirmative evidence to the contrary. 38 C.F.R. §§ 3.307 (a)(7), 3.309(f). The Veteran’s service personnel records reflect that he was stationed at Camp Lejeune during the requisite period. 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. Id. As such, prostate cancer is not a disease for which presumptive service connection based on exposure to contaminated water at Camp Lejeune may be granted. Id. Notwithstanding the foregoing presumption provisions for exposure to contaminated water at Camp Lejeune, a claimant is not precluded from establishing service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994); see also Ramey v. Gober, 120 F.3d 1239, 1247-48 (Fed. Cir. 1997), aff’d Ramey v. Brown, 9 Vet. App. 40 (1996); Brock v. Brown, 10 Vet. App. 155, 160-61 (1997). In March 2019, a pharmacologist/toxicologist opined that the Veteran’s prostate cancer is due to exposure to TCE, PCE and vinyl chloride, and that his exposure to contaminants in the water at Camp Lejeune were the precipitating factor in his development of adenocarcinoma. The examiner explained that these agents are mutagenic, form toxic metabolites and elicit oxidative stress causing cellular transformation leading to the development of cancer. Oxidative stress also enhances inflammatory reactions which promote development of cancer. See 04/07/2019 Medical Treatment Record-Non-Government Facility. While prostate cancer is not a presumptive disability, based on the Veteran’s presumed exposure and the March 2019 opinion, the Board finds that service connection is warranted for prostate cancer. The opinion provided sufficient rationale, considered the Veteran’s specific history and was offered by a doctor with a specialty in pharmacology. Thus, it is deemed highly probative. Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.W. Kreindler, 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.