Dear Watchdog,

I cannot find an answer to my question about va benefits when undergoing hormone therapy for prostate cancer.

I am a Vietnam Veteran who was diagnosed with prostate cancer. I had surgery to remove my prostate and then radiation but was not cured of my cancer as my PSA continued to rise. I have now been receiving hormone therapy which is not a cure. Hormone therapy suppresses the cancer as evidenced by my declining PSA. However, as my cancer becomes more resistant to the drugs my PSA will once again start to rise. I am currently receiving 100% from the VA for my prostate cancer. My question is can the VA decrease my award based on my PSA level going down even though I will not be cured of my cancer?

Reply:

That's an interesting question.

Hormone therapy or androgen deprivation therapy or androgen suppression therapy isn't commonly thought of as a cancer cure. I can't recall any case of hormone therapy being used as a stand alone treatment. It's usually used in conjunction with radiation therapy or surgery to control further growth of cancer that has spread outside the prostate.

PSA levels aren't much of a guide in treating prostate cancer. Unfortunately, VA uses the PSA as if it were a golden rule and any drop will often signal the VA that they should reduce your benefit rating.

If I were you, I'd take no action unless and until VA makes a move to try and lower your 100% benefit. This is important...don't try to get ahead of the VA, they may never do anything even if your PSA falls to 0.4 or similar.

If you do get a notice that VA proposes to reduce your benefit, you have great reasons to appeal. It shouldn't be difficult to fend off any attempt to lower the rating you have.