Prostste Cancer


I was recently awarded a 100% percent benefit for Prostate Cancer (April 2020). I am on a watch and wait and seen every 6 months by my private physician, not the VA. I was just notified I must take an exam with the VA to review my situation. I certainly do not have any issue with that. Just have a few questions regarding possible outcomes of exam. My Doctor says if I do have it removed I could be faced with other issues such as incontinence, etc. Guess you take your chances either way (watch and wait or removal).

My question(s) are, do my benefits get reduced because of my choice to watch and wait? What would cause the VA to do a benefit reduction? If they do reduce, what is the typical percentage reduce to? If they do reduce and I appeal, what documentation would be required from me? Thanks for any information you can provide. 


Jim's Reply:

Watchful waiting in reference to prostate cancer means that you won't treat your low grade, less aggressive cancer but you will monitor it for any change. The Vietnam veteran who is diagnosed with prostate cancer is entitled to a 100% rating while the cancer is active. The rating will drop after the cancer is treated.

Watchful waiting is a very popular option these days since most men will get prostate cancer in their lives but most will die with the cancer, not of it.

VA doesn't grasp this. VA thinks every veteran will aggressively treat every cancer and every cancer will be cured. You will likely encounter many C & P exams where you'll later get a notice that since your cancer is treated now, your benefit will be lowered. You'll need to appeal that if and when it happens to keep the 100% benefit. If you are not treated with surgery, radiation or chemo, your benefit will remain at 100%.

Treatment is a complex discussion. Removal of the prostate leaves most men incontinent to a degree and with erectile dysfunction. 

Personally I'm a fan of watchful waiting. Prostatectomy often leaves the patient worse off than he was before. Quality of life diminishes and statistically speaking, overall life expectancy isn't increased by much. Watchful waiting is a good option if you can deal with the inefficiencies at VA.