Lloyd Blair joined the Marine Corps as an 18-year-old itching for a fight after hijacked planes rocketed into the World Trade Center towers and set the world on fire. He pulled two tours in Iraq. The first landed him in the hell of Fallujah where some of the bloodiest fighting took place.

There he was, not long out of high school, fighting in the desert, ducking bullets while carrying 40, 50 pounds of full battle rattle on his back.

The stench of human feces flowing out of Fallujah in shallow creeks suffocated the air. There was smoke everywhere. “I mean, there was stuff burning all the time in Fallujah,” says Blair, who is 35.

He didn't give a second thought to the smoke billowing from the burn pits where the military torched its own trash, not until he was diagnosed with testicular cancer after he came home.

Cancer doesn't run in his family, said Blair, who lives in Lee's Summit. So he was confused about why the cancer that befell Lance Armstrong had found him. Looking for answers online, he came across hundreds of other worried veterans with the same diagnosis.

A McClatchy investigation of cancer among veterans during nearly two decades of war shows a significant increase in cancer cases —like Blair's — treated by the Department of Veterans Affairs health care system.

The review, based on VA health care data obtained through Freedom of Information Act requests, found the rate of treatments for urinary cancers — which include bladder, kidney and ureter cancers — increased 61 percent from fiscal year 2000 to fiscal year 2018.

The rate of treatments for blood cancers — lymphoma, myeloma and leukemia — rose 18 percent in the same period. For liver and pancreatic cancer treatments the increase was 96 percent, and for prostate cancer it was 23 percent.

The VA has disagreed with McClatchy's findings, however data from its own cancer registry provided to McClatchy also shows a significant rise during a similar time frame.

McClatchy chose to look at the rate of veteran cancer treatments beginning in fiscal year 2000 to see what happened in the years following the September 11, 2001, terrorist attacks when U.S. forces were involved in wars in Afghanistan and Iraq.

The rate of cancer treatments for veterans at VA health care centers peaked earlier this decade and has declined over the past several years, but is significantly higher than before 9/11.

The barber vet: 'An eye for an eye'

The word is out that the Corner Barber Shop in Northmoor, Missouri, is friendly to those who serve and have served in uniform, be they police officers or veterans. There's usually a veteran sitting in Blair's chair.

At his work station, Blair's barbering supplies sit on a thick black rubber mat advertising Jack Daniel's Tennessee Honey whiskey with the slogan, “Fly Straight Drink Responsibly.”

The shop is a big open room spare of furnishings except for guest seating, a pool table and two barber chairs — owner Rich Dedrick's is closest to the door.

Jabberjawing about LC's Hamburgers and football — both barbers are Raiders fans, their customers are not — and the beef jerky from the bar next door ping-pongs off the walls over the buzzing of razors. Conversations turn polite when a woman is in the room. “Somehow we got a five-star rating,” Dedrick joked one recent morning. “We're trying not to screw it up.”

Blair was a client here before he joined the Marines as a teenager. When he came home from Iraq, the shop owner made him an offer he didn't refuse.

Dedrick worried about his friend, concerned that working on cars was too solitary a gig for someone who came home from war a different man, one with Post Traumatic Stress Disorder. Dedrick knew Blair to be a “self-motivated” man “who goes for it when he sets his mind for something.”

Blair needed to be around people, Dedrick thought. Drinking wasn't helping. So the long-time barber threw his friend a lifeline.

“He's like 'Man I don't want you sitting at home. Why don't you go get your barber's license and I'll let you cut in that chair right there?' And that's what I did,” said Blair, who displays his barber licenses from Kansas and Missouri at his work station.

The barber shop sits in Blair's neck of the woods north of the river. He was 5 when he and his father moved to the Kansas City area from Los Angeles. Some of the tattoos that cover his arms pay homage to his birthplace — the words “California Life” are inked on his upper right arm along with a buxom Latina woman in a hat.

Blair, a member of the Class of 2003 at Park Hill South, was in classes on Sept. 11, 2001.

“As soon as 9/11 happened, it was kind of the jump for all of the kids of my time,” said Blair. “We watched it happen. We were getting ready to be out of high school, and it kind of just ruffled my feathers.

“My grandfather was in the Navy through Korea and Vietnam. A lot of my other family were in the Marine Corps, Army, Air Corps. … I just kind of felt the need to do that as well, to serve my country.”

His dad, a mechanical engineer, had pushed him toward college, he said. But, “I wasn't as good in school as my dad, you know what I mean? Math and stuff like that,” said Blair. “I was more of a hands-on type of kid.” So he waited until his dad went out of town on business to meet with recruiters.

“I was supposed to go into the Army and I went into the recruiting station to turn in my paperwork and there were a couple of (Marines) who had just got back from the first push through Iraq and they were in their dress blues,” he recalled. “And they were kind of talking crap about the Army.

“They were like, 'only sissies go in the Army.' So they kind of got me hook, line and sinker.”

Days later, in February 2003, he headed to Marine Corps Recruit Depot, MCRD, in San Diego. He went to Iraq with 1st Battalion, 5th Marines, Weapons Company.

“I joined infantry off the cuff,” said Blair. “I knew what I was signing up for. From the get-go, I knew I wanted to be infantry and I wanted to go to Iraq and make right what was wrong to us. An eye for an eye. That's the way it should be.”

'A common way to get rid of waste'

The fighting was close-up.

“Nowadays when you go to the Middle East it's house-to-house fighting,” said Blair. “It's not going out into the field and there's 10 million guys lined up in a line and they just watch each other. That's not what it is. They hide in the houses and they shoot from the windows, the tops of the buildings.”

His mission took him into an industrial part of the city to search buildings for weapons caches. “So on a day-to-day basis that's what we were doing, going through and finding where they were storing all their guns and ammunition and RPGs (rocket-propelled grenades), finding them before they could use them on us.”

In Fallujah he lived on an FOB — Forward Operating Base — and that's where he saw his first burn pit.

The VA's website describes burn pits as “a common way to get rid of waste at military sites in Iraq and Afghanistan.”

“Waste products in burn pits include, but are not limited to: chemicals, paint, medical and human waste, metal/aluminum cans, munitions and other unexploded ordnance, petroleum and lubricant products, plastics, rubber, wood, and discarded food,” the website says.

“Basically, it's just a big trash pile,” said Blair. “So if you've ever been to, like, a city dump, that's all it is. It's where we threw all our trash. Basically everything. Bloody camis. Old batteries. Everything. Old food. And then they would set it on fire with diesel fuel and let it burn.”

The pit that Blair lived near in Fallujah sent smoke pouring into their sleeping quarters and showers, he said. “I didn't even think anything about it. It wasn't one of our priorities. That was for the guys that were in charge of the base. We just went in there and slept,” he said.

“I think the reason a lot of us didn't smell anything weird was because our noses were so dead to smell because of how it smelled everywhere around there. So when they're doing the burn pits it didn't smell any different from the rest of the city.”

At the time, he was more focused on staying alive.

The kind of cancer Lance Armstrong had

Blair came home with medical problems he didn't have before — PTSD and a traumatic brain injury sustained in a Humvee explosion, he said. Two weeks after he was discharged in 2007 he collapsed in pain at his father's house in Kansas City and wound up having emergency gall bladder surgery.

He got sick again in 2013 with pain in his lower abdomen. “So I went to the VA and they said I had an infection and sent me home with some antibiotics,” he said.

Two years later in 2015 he was on his way to the VA hospital in Kansas City. He worked there as a service officer for the VFW, helping other vets secure their veterans' benefits. He was riding his motorcycle when he felt excruciating pain below the belt.

He went straight to the hospital's emergency room and that became the day he learned he had Stage 3, advanced, testicular cancer.

“The doctor came in the room and he didn't really say anything, and then he's like, “Hey, you know who Lance Armstrong is? Well, he beat it, so can you.' And then he walked out of the room,” Blair said.

Doctors that day removed one of his testicles “that was basically coated in cancer,” he said. But things got much worse.

More tests over the next few days showed the cancer had spread. “That's when they told me 'We're sorry, you have lymphatic cancer as well.” He spent the next month getting chemotherapy treatments and today is in remission. He's been told the cancer could come back “three days or 30 years from now.”

Because he knew cancer did not run in his family Blair started researching, typing into Google phrases such as: “How many Iraq veterans are coming down with testicular cancer?”

He quickly found one online forum that alone had nearly 400 “guys who all came back and got testicular cancer,” he said.

The American Cancer Society says on its website that testicular cancer “is largely a disease of young and middle-aged men” and “is not common: about 1 of every 250 males will develop testicular cancer at some point during their lifetime.”

Blair already knew, through his work with the VFW, that some veterans suspected that being exposed to burn pits in Iraq and Afghanistan made them sick, some critically. It became his concern, too.

Veterans groups and members of Congress are working on ways to make it easier for veterans to get their illnesses connected to their service. The Airborne Hazards and Open Burn Pit Registry, run by the VA, has collected health information about more than 170,000 Iraq and Afghanistan veterans, Stars and Stripes reported earlier this year.

The VA denies a direct connection, stating on its website: “At this time, research does not show evidence of long-term health problems from exposure to burn pits. VA continues to study the health of deployed Veterans.”

Like Vietnam and Agent Orange

Blair is not angry that he got cancer. He talks about it like most people would discuss a hangnail. Yeah, I had it. I don't anymore.

“You just keep on going. You can't let it get to you. It is what it is,” he said. “I went in during a time of combat and I volunteered.

“I wasn't 'volun-told' like most of the Vietnam guys. I had a decision and I made that decision, and so that's why I don't bag on any of the government agencies or anything. I love my country, I love my government. Some of it's stupid right now, but I would never cross my government.”

He holds no animosity toward the VA, either, “because they've kept me alive on just about everything I've been through.”

But he still wants to know, more so for his fellow veterans, if his cancer was somehow caused by his service to country.

“Obviously none of us knew the burn pits had bad stuff in them,” he said. “We didn't realize, just like (Vietnam vets) didn't realize that Agent Orange was going to give them diabetes and different cancers and a lot of them were going to pass away before their 50th birthdays. They didn't know any of that.”

Dedrick joked that Blair is so patriotic that “I'm not sure he doesn't p**s red, white and blue.”

Two years ago while he was at Headlines Barber Academy in KCK learning his way around a set of clippers, Blair and a couple of veteran buddies took on a new mission. They founded a nonprofit called Veteran Barbers for Veterans as a hand-up for any vet in a hard place.

They began raising money to fund scholarships for veterans who want to go to barber school. And, they turned a 24-foot trailer into a mobile barber shop to take on the road and give free haircuts and shaves to veterans, active duty military and first responders.

They want to take the shop-on-wheels across the country to veterans' events, VA hospitals, anywhere they can meet a vet. They've been to Columbia, Missouri, and Las Vegas already. But they've been sidelined by red tape, some requirement about needing a bathroom onboard, Blair said.

For now he counsels his fellow brothers in arms from his work station, where the conversations aren't always about barbecue and football.

“There's nobody that knows more about a person than his own barber,” said Dedrick.

When McClatchy presented initial findings to the VA, the agency said it disagreed with McClatchy's approach. The VA said an analysis of billing data would create an overcount, and that its internal cancer registry system did not show a significant rise.

“According to the latest official VA cancer data, the annual total number of cancer cases among enrolled veterans peaked in 2010 and has been declining since,” the VA said in a statement. “Colorectal and prostate cancer have been declining, while hepatocellular and skin (melanoma) cancer have been increasing. These trends largely mirror national cancer trends.”

There are multiple ways to track cancer rates, and each has limitations.

Studies have found that the billing data used in McClatchy's analysis, which covered all treatments provided by the VA coded as cancer according to the International Classification of Diseases (ICD), has a tendency to overcount, while data from cancer registries such as the one used by the VA has a tendency to undercount.

McClatchy asked the VA through a Freedom of Information Act request for the internal data that the VA referenced in the statement above.

FOIA Response

In its response to that FOIA request, the Veterans Health Administration said parts of the cancer registry system were not being maintained.

“[The VA Central Cancer Registry] is not a viable source of VA cancer registry data at this time,” the Veterans Health Administration wrote in a response to our open records request. “There are no staff working on so it is not functioning to any standard.”

The VA then sent McClatchy raw data from its cancer registry that could not be adjusted for population and did not include a breakdown by service.

While the VA in its statement noted a decrease in cancers from 2010, viewing the raw cancer registry data over a longer period, from 2000 to 2017, showed an increase in some cancers. It was a similar trend to McClatchy's analysis of billing data over fiscal years 2000 to 2018.

The VA's cancer registry data shows the number of blood cancers increased 41 percent, while bladder, kidney and ureter cancers increased 70 percent. Skin cancers have increased 48 percent, brain cancers are up 20 percent. Liver and pancreatic cancers are up 151 percent — although they represent only a small number of actual cases. Prostate cancers are up 9 percent.

McClatchy's analysis of billing data showed decreases in treatments for brain, respiratory and testicular cancers. VA's cancer registry system showed increases in brain, respiratory and testicular cancers. The differing results are due to differences in methods of calculation and the makeup of the two datasets.

“Don't let anyone convince you that the information you're pulling is wrong. It's not wrong. It's just different from what VA has used,” said Susan Lukas, a former VA official who now advocates for military reservists and veterans through the Reserve Officers Association. “One of the outcomes of your research comparing ICD codes to identify veterans with cancer is that it may be time for VA to use this international system instead of their internal cancer register.”


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