Gout - Undergoing chemotherapy for a malignant tumour Factor
Definition
The RMA has defined chemotherapy in this SOP as "systemic treatment of a malignant disease with a chemical agent which can lead to a breakdown of cells, examples of which include vincristine, busulphan, thiotepa, cytarabine, 6-mercaptopurine and chlorambucil."
Establishing whether or not there has been treatment with chemotherapy
Chemotherapy is now widely used to treat malignant disease. However, such treatment only became commonplace in the 1970's. Thus it is highly unlikely that a veteran would have received chemotherapy before that time.
Although chemotherapy is also used to treat proliferative diseases such as polycythaemia vera, only chemotherapy that was used to treat a malignant tumour is covered by the chemotherapy factor in the Gout SOP.
Chemotherapy would not usually have been carried out in a doctor's surgery. Treatments are usually given in institutions such as hospitals. Treatment is usually given by intravenous drip or injection, in varying cycles eg one injection a week for 4 weeks, with a break of a month in between, or every day for a week with a break of 2 weeks in between. Such medical treatment would normally be recorded in doctors' notes and/or hospital records. However, these records may have been destroyed or can no longer be obtained. Therefore, if there is a reliable history of chemotherapy at a particular time, this generally will be accepted, unless there is contradictory evidence. Seek medical advice if it is unclear whether the claimed history of chemotherapy is feasible.
LAST REVIEWED FOR CCPS 01 JUNE 2000.
PRELIMINARY QUESTIONS [24676]
24675 there is some evidence that undergoing chemotherapy for a malignant tumour may be a factor in the development or worsening of the condition under consideration.
24677 the veteran has undergone chemotherapy for a malignant tumour at some time.
24689 the veteran underwent chemotherapy for an identifiable malignant tumour at some time. [Default true]
24678 the veteran has established the causal connection between undergoing chemotherapy for a malignant tumour and VEA service for gout.
24680 the veteran underwent chemotherapy for the identified illness or injury, a malignant tumour, within the seven days immediately before the clinical onset of the condition under consideration.
24679 the veteran has established the causal connection between undergoing chemotherapy for a malignant tumour and VEA service for the clinical onset of gout.
24682 the veteran has established the causal connection between undergoing chemotherapy for a malignant tumour and operational service for the clinical onset of gout.
or
24683 the veteran has established the causal connection between undergoing chemotherapy for a malignant tumour and eligible service for the clinical onset of gout.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
24681 the veteran underwent chemotherapy for the identified illness or injury, a malignant tumour, within the seven days immediately before the clinical worsening of the condition under consideration.
24684 the veteran has established the causal connection between the course of chemotherapy and VEA service for the clinical worsening of gout.
24685 the veteran has established the causal connection between undergoing chemotherapy for a malignant tumour and operational service for the clinical worsening of gout.
or
24686 the veteran has established the causal connection between undergoing chemotherapy for a malignant tumour and eligible service for the clinical worsening of gout.
CLINICAL ONSET AND OPERATIONAL SERVICE [24682]
24690 the identified illness or injury, a malignant tumour for which chemotherapy was undergone, is causally related to operational service.
CLINICAL ONSET AND ELIGIBLE SERVICE [24683]
24691 the identified illness or injury, a malignant tumour for which chemotherapy was undergone, is causally related to eligible service.
CLINICAL WORSENING AND OPERATIONAL SERVICE [24685]
24690 the identified illness or injury, a malignant tumour for which chemotherapy was undergone, is causally related to operational service.
24692 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the identified illness or injury, a malignant tumour necessitating chemotherapy, is causally related.
CLINICAL WORSENING AND ELIGIBLE SERVICE [24686]
24691 the identified illness or injury, a malignant tumour for which chemotherapy was undergone, is causally related to eligible service.
24693 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the identified illness or injury, a malignant tumour necessitating chemotherapy, is causally related.