7343 - Malignant neoplasms of the digestive system, exclusive of skin growths

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Acronym: PMNS

Definition

Malignant new growths may occur at any site in the digestive tract. The digestive system consists of the mouth, tongue, esophagus, stomach, intestine, liver, gallbladder, pancreas, rectum and anus.

Etiology

The exact cause of cancer is generally unknown. Theories describe the impact of factors that may play a role in cancer development including: environment; chemicals; genetics; and viral or immunologic agents.

Signs & Symptoms

Metastatic signs and symptoms will depend on the site and extent of new growths and factors related to the original cancer site.

Tests

Diagnostic measures are dependent on factors related to the new growth, and those related to the original cancer site. Measures may include: biopsies; x-rays; endoscopy; blood work; arteriography; computed tomography (CT) scan; magnetic resonance imaging (MRI); stool tests; and barium studies.

Treatment

Surgical resection of the cancer is one of the main treatments. Radiation, or laser therapy or chemotherapy or both often follow surgery. Malignant new growths will most likely be treated with the same protocol.

Residuals

Treatment for extensive metastatic disease may best be handled by relieving pain and providing support for the family and patient. Vigorous therapy treatment may be futile.

Special Considerations

  • May be entitled to special monthly compensation where the Veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC).

  • Malignant neoplasms of the salivary glands, stomach, bile ducts, gall bladder, small intestine, colon and primary liver cancer (except if cirrhosis of hepatitis B is indicated) shall be service connected if the veteran was in a radiation risk activity as defined by 38 CFR 3.309 [Disease subject to presumptive service connection,38 CFR 3.309(d) Diseases specific to radiation-exposed veterans] provided the rebuttable presumption provisions of 38 CFR 3.307 of the part are also satisfied; or for any malignant neoplasm of the digestive system under 38 CFR 3.311 [Claims based on exposure to ionizing radiation], and 38 CFR 3.311(b) [Initial review of claims] provided the provisions of 38 CFR 3.311(b)(5)(iv) have been met. A claim under 38 CFR 3.311 that involves radiation exposure requires an opinion by the C&P Service before any decision may be made by a Regional Office to grant or deny benefits.

  • This condition shall be granted service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within the applicable time limits under 38 CFR 3.307 following service in a period of war or following peacetime service on or after January 1, 1947, provided the rebuttable presumption provisions of 38 CFR 3.307 are also satisfied.”  [38 CFR 3.309(a)

Notes

  • A rating of 100 percent shall continue beyond the cessation of any surgical, X-ray, antineoplastic chemotherapy or other therapeutic procedure. Six months after discontinuance of such treatment, the appropriate disability rating shall be determined by mandatory VA examination. Any change in evaluation based upon that or any subsequent examination shall be subject to the provisions of 38 CFR 3.105(e) of this chapter. If there has been no local recurrence or metastasis, rate on residuals.”

  • Evaluate under an appropriate diagnostic code, depending on the predominant disability or the specific residuals after treatment.