Tuesday, December 09, 2025

NCCN Summit seeks to improve care for veterans and first responders with cancer from line-of-duty exposure

Speakers explore how we can better protect the heroes who protect us all

National Comprehensive Cancer Network

Intro+Panel — image:
Speakers discuss the unique cancer care needs of veterans and first responders during the 2025 NCCN Patient Advocacy Summit. Learn more at NCCN.org/summits.
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Credit: NCCN

WASHINGTON, D.C. [December 9, 2025] — The National Comprehensive Cancer Network® (NCCN®)—an alliance of leading cancer centers—hosted a Patient Advocacy Summit on the unique cancer needs of veterans and first responders. It featured a fireside chat from Representative Mariannette Miller-Meeks, MD, MS (IA-01), a physician and veteran of the U.S. Army. The program also brought together a diverse group of experts to discuss how veterans, firefighters, and other national heroes face elevated cancer risk on the job, what policies and programs are in place currently to help with long-term care, and how to better meet these needs in the future.

“Our nation’s military, veterans, fire fighters, and other first responders risk their lives every day to keep all of us safe. We convened this cancer patient advocacy summit to make sure we are doing right by them in return,” stated Crystal S. Denlinger, MD, Chief Executive Officer, NCCN. “People with occupational risks should have straightforward access to high-quality cancer prevention, screening, and treatment as defined by leading evidence-based, expert consensus-driven guidelines.”

“Our veterans fought for our freedom; now they deserve hope and life-saving cancer care. No one who served should have to fight for cancer treatment or access to clinical trials,” agreed Mel Mann, MBA, MEd, U.S. Army Major (retired), Survivor, Advocate.

Speakers noted that veterans and firefighters can face elevated risk due to exposures while on the job. For example, protective gear worn while fighting wildfires has not changed much over the past century, while exposures to potentially carcinogenic compounds may arise from participating in fighting fires. These potentially dangerous exposures may be through the air or through the skin.

“There is no doubt that firefighting is dangerous work. However, doing dangerous work doesn’t mean enduring or accepting unsafe working conditions,” said Dan Whu, MD, MPH, FACPM, FAAMA, ABOIM, DNBPAS, CFO, PMD-T, Chief Medical Officer, International Association of Fire Fighters. “The research findings are clear that occupational cancer is an epidemic in the fire service. In recent years, between two-thirds to three-fourths of the fallen fire fighters being honored at the International Association of Fire Fighters’ (IAFF) Annual Fallen Fire Fighter Memorial, have succumbed to occupational cancer. Politicians at the federal, state, and local levels; leaders of regulatory and enforcing agencies; fire service administrators; academics; researchers; clinicians; and fire fighters must all work together to continue to identify, mitigate, and ultimately eliminate as many occupational carcinogenic exposures as possible.”

“Recent studies show that veterans have an increased risk for all types of skin cancer and have a significantly higher likelihood of being diagnosed with late-stage melanoma compared to the civilian population,” pointed out Brett Sloan, MD, FAAD, Professor of Dermatology, Former VA Site Director, UConn School of Medicine. “There are many reasons for this, including occupational risk factors, the inaccessibility of sun protection, and a lack of education around cancer signs and symptoms.”

The panel participants discussed ‘presumptive laws’ which guarantee certain benefits to workers in certain jobs based on a proven likelihood for future illnesses. Unfortunately, these laws vary dramatically state-by-state and can include narrow definitions of exposure or job role. The legislation can often lag far behind the science. The result is that people who are diagnosed with cancer may need to prove line-of-duty causation at a time when they are most in need of support.

“According to the Bureau of Labor Statistics, out of 18 million veterans alive today, roughly 22%—or 3.96 million—have a VA-recognized service-connected disability. But only about half of the 18 million are deemed eligible for care through Veterans Association Health Service,” explained Jim Pantelas, Vietnam-Era War Veteran, Lung Cancer Survivor, and Patient Advocate. “What’s more, exposure to one or more cancer-causing chemicals while on the job is not always considered enough of a causal factor to result in automatic benefits coverage. It still often falls to the veteran to provide proof of prolonged exposure to achieve that service-relatedness claim.”

Pantelas, a member of the steering committee for the National Lung Cancer Round Table, noted that Agent Orange is the only toxic substance that is considered presumptive, though veterans frequently experienced exposures to additional carcinogens, including:

Asbestos (all eras)
Burn Pits (Iraq and Afghanistan)
Depleted Uranium (Iraq and Afghanistan)
Diesel Fumes (all eras)
Plutonium (Cold War era)

Speakers discussed how the PACT Act legislation that expands the list of illnesses connected to military service is a step in the right direction, though more work is needed. The event also highlighted existing support services and called for expanding them.

According to Joanna Doran, Esq., CEO, Triage Cancer: “Veterans and first responders who have been diagnosed with cancer may be eligible for specific programs and benefits that can help them access care, manage the financial impact of a cancer diagnosis, and improve their quality of life. Our community is faced with an opportunity to ensure that veterans and first responders are connected to those programs and benefits.”

Erin Kobetz, PhD, MPH, Director and Principal Investigator for Sylvester Comprehensive Cancer Center’s Firefighter Cancer Initiative, part of the University of Miami Miller School of Medicine concurred: “Firefighters are at increased risk of developing and dying from cancers given occupational exposures. We have an opportunity and obligation to better protect our first responders through translational research that identifies the role of such exposures in disease etiology, and can inform new prevention, screening, and treatment strategies to improve outcomes.”

Many emphasized that the Veterans Administration (VA) has significant strengths, particularly when it comes to cancer screening and mental health. Speakers noted there are opportunities for the VA and community health providers to work together and learn from one another.

“The VA and private community cancer centers should collaborate to deliver the best comprehensive cancer treatment to veterans,” said David Eplin, PharmD, BCOP, Past President, Association of VA Hematology/Oncology. “VA providers offer invaluable expertise in veteran culture and the complex health needs of service members, including psychosocial behavioral support. This specialized knowledge is a vital resource when veterans receive care outside the VA system. Utilizing healthcare associations that include both VA and private sector members could effectively bridge these two systems.”

Clinical trial enrollment and data collection across various occupations were brought up as key pieces for improving care.

The program included a series of best practices presentations from the University of Kansas, the California Firefighter Cancer Research Study, the Firefighter Cancer Support Network, and others. Their blueprints for evidence-based care for those who serve can be found at NCCN.org/patient-advocacy-resources.

The 2026 NCCN Oncology Policy Summit series will have a new format, which will include a mix of webinars and in-person events. The series will explore topics such as Health Literacy in the Digital Age, Innovations in Cancer Care Throughout the Ages, Policy Strategies to Shift the Paradigm in Cancer Screening and Prevention, and Advancing Family-Centered Cancer Care. Learn more at NCCN .org/summits.

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About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®) is marking 30 years as a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to defining and advancing quality, effective, equitable, and accessible cancer care and prevention so all people can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provide transparent, evidence-based, expert consensus-driven recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation®. NCCN also advances continuing education, global initiatives, policy, and research collaboration and publication in oncology. Visit NCCN.org for more information.

The global plastic waste trade contributes to coastal litter in importing countries, study shows

University of Illinois College of Agricultural, Consumer and Environmental Sciences

URBANA, Ill. – The ubiquitous plastic beverage bottle makes up about half of plastic waste collected for recycling in the U.S. Most recycled plastic is processed domestically, but a portion is traded overseas. A new study from the University of Illinois Urbana-Champaign draws on citizen science data to investigate how the global plastic waste trade contributes to litter along coastlines and waterways in importing countries.

“There has been a lot of news coverage about the plastic waste trade. The concern is that exporting waste to another country creates opportunities for that waste to escape into the environment during transportation and storage. We wanted to see if plastic waste imports lead to higher amounts of plastic litter found in coastal areas,” said Becca Taylor, assistant professor in the Department of Agricultural and Consumer Economics, part of the College of Agricultural, Consumer and Environmental Sciences at U. of I.

Plastic waste is an internationally traded commodity, which can be recycled into reusable materials, whereas plastic litter is the pollution that results from untreated waste.

“Overall, we find that a 10% increase in the amount of plastic waste a country imports is associated with a 0.6% increase in the amount of littered plastic bottles collected from coastal areas,” she said.

This may not sound like much but it adds up quickly. While only about 2% of plastic waste is traded globally, it is a substantial amount considering the huge growth in plastic production over the past 30 years. International trade of plastic waste reached its peak in 2014 with 16 million metric tons (about 35 billion pounds). Furthermore, the waste trade moves primarily from the global North to the global South, leading to concerns about “pollution havens,” where countries with low environmental regulations and inefficient waste management systems are more likely to attract polluting industries.

To study their question, the researchers turned to an unconventional source: citizen science — that is, data collected by ordinary people around the world.

The Ocean Conservancy, a non-government environmental advocacy organization, leads an annual global beach clean-up event. Volunteers are trained to collect and document all coastal litter in designated areas. The data are aggregated to the country level and made publicly available.

Taylor and her colleagues obtained data for 90 countries from 2003 to 2022. They focused on plastic bottles because they are a recycled commodity, unlike other common types of waste such as cigarette butts and food wrappers.

The researchers used the United Nations global trade database to measure plastic waste imports per country and year. They also drew on existing academic research to evaluate plastic waste mismanagement rates by country. The authors find that a doubling of the amount of plastic waste a country imports is associated with a 6% increase in the number of littered bottles collected. Furthermore, countries that struggled with poor waste management systems had a proportionally higher increase in litter.

The authors also examine recent changes in the international waste trade, which shifted considerably in 2017, when China banned plastic waste imports. China had been the primary market for plastic waste, and its policy change caused total plastic imports to decrease by 73%.

Some of the waste found its way to other countries, such as Thailand and Malaysia, where plastic imports increased significantly after China’s ban. The researchers looked at what happened to litter in those countries, finding that a 1000-ton increase in plastic waste imports from 2016 to 2017 was associated with a 0.7% increase in littered plastic bottles.

However, countries that initially saw an increase in their plastic imports after China's policy changed later implemented their own waste import bans. Another policy change came in 2019 when plastic was added to the Basel Convention, a global agreement on the trade of hazardous waste. Consequently, countries that have ratified the convention (the U.S. is not among them) agree to follow certain guidelines for trade.

“In summary, we do find that plastic waste imports lead to increased coastal litter, and policies that aim to regulate or ensure importing industries are following best practices will have an impact. But cutting down on trade is not sufficient to eliminate litter along the coastlines. We also need to consider waste management practices more broadly and provide assistance to countries with less advanced waste management systems,” Taylor concluded.

The paper, “Plastic waste imports & coastal litter: Evidence from citizen science data,” is published in Ecological Economics [10.1016/j.ecolecon.2025.108848].

Research in the College of ACES is made possible in part by Hatch funding from USDA’s National Institute of Food and Agriculture.

Journal

Ecological Economics

DOI

10.1016/j.ecolecon.2025.108848

Article Title

Plastic waste imports & coastal litter: Evidence from citizen science data

Research reveals new hybrid state of matter where solids meet liquids

University of Nottingham

video:
Theoretical modelling explores the movement of atoms within a liquid nanodroplet of platinum that is confined inside a defect in a carbon support. The colours represent the mobility of the atoms: platinum atoms at the edges are much less mobile and create an atomic corral around the more mobile atoms located in the centre.
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Credit: University of Nottingham

Researchers have discovered that not all atoms in a liquid are in motion and that some remain stationary regardless of the temperature, significantly impacting the solidification process, including the formation of an unusual state of matter—a corralled supercooled liquid.

The formation of solids is essential in various natural processes, including mineralisation, ice formation, and the folding of protein fibrils. It also plays a significant role in technological applications such as pharmacy and industries that use metals, such as aviation, construction, and electronics.

Scientists from the University of Nottingham and the University of Ulm in Germany have used transmission electron microscopy to image the solidification processes of molten metal nano-droplets. This study has been published today in ACS Nano.

Professor Andrei Khlobystov, who led the team, said, ‘When we consider matter, we typically think of three states: gas, liquid, and solid. While the behaviour of atoms in gases and solids is easier to understand and describe, liquids remain more mysterious.’

Atoms in liquids move in a complex way, resembling a jostling crowd of people. They constantly and rapidly pass by each other while still interacting with one another. Studying the behaviour of atoms in liquids can be challenging, especially during the critical stage when the liquid starts to solidify. This stage is crucial because it determines the structure and many of the material's functional properties.

Dr Christopher Leist, who performed transmission electron microscopy experiments at Ulm using the unique low-voltage SALVE instrument, said, ‘We began by melting metal nanoparticles, such as platinum, gold, and palladium, deposited on an atomically thin support—graphene. We used graphene as a sort of hob for this process to heat the particles, and as they melted, their atoms began to move rapidly, as expected. However, to our surprise, we found that some atoms remained stationary.’

The researchers found that stationary atoms are strongly bonded to the support material at locations of point defects, even at very high temperatures. They were able to increase the number of defects by focusing the electron beam and so control the number of stationary atoms within the liquid.

Professor Ute Kaiser, who estabilished the SALVE centre at Ulm University, said, ‘Our experiments have surprised us as we directly observe the wave-particle duality of electrons in the electron beam. We visualise the material using electrons as waves. At the same time, electrons behave like particles, delivering discrete bursts of momentum that can either move or, surprisingly, even fix atoms at the edge of a liquid metal. This remarkable observation has allowed us to discover a new phase of matter.’

The team previously reported films of chemical reactions involving individual molecules, including the first instance of a chemical bond breaking and forming in real time. Their method enables the observation of chemistry at the atomic level.

In this study, the researchers found that stationary atoms have an influence on the solidification process. When there is a small number of them, a crystal forms directly from the liquid and continues to grow until the entire particle solidifies. However, when the number of stationary atoms is high, the solidification process is significantly disrupted, preventing any crystal from forming.

Professor Andrei Khlobystov from the University of Nottingham said ‘The effect is particularly striking when stationary atoms create a ring that surrounds the liquid. Once the liquid is trapped in this atomic corral, it can remain in a liquid state even at temperatures significantly below its freezing point, which for platinum can be as low as 350 degrees Celsius—that is more than 1,000 degrees below what is typically expected.’

Below a certain temperature, the corralled liquid solidifies, not into a crystalline form but as an amorphous solid. This amorphous form of metal is highly unstable, maintained only by the confinement of stationary atoms. When the confinement is disrupted, the tension is released, allowing the metal to transform into its normal crystalline structure.

Dr Jesum Alves Fernandes, expert in catalysis at the University of Nottingham, said, ‘The discovery of a new hybrid state of metal is significant. Since platinum on carbon is one of the most widely used catalysts globally, finding a confined liquid state with non-classical phase behaviour could change our understanding of how catalysts work. This advancement may lead to the design of self-cleaning catalysts with improved activity and longevity.’

So far, corralling at the nanoscale has been achieved only for photons and electrons; this work is the first time that atoms have been corralled. Professor Andrei Khlobystov said, ‘Our achievement may herald a new form of matter combining characteristics of solids and liquids in the same material.’

The researchers hope that manipulation of the positions of pinned atoms on the surface may create more extended and complex corral shapes. This could pave the way for more efficient use of rare metals in clean technologies, such as energy conversion and storage.

This work is funded by the EPSRC Programme Grant ‘Metal atoms on surfaces and interfaces (MASI) for sustainable future’ www.masi.ac.uk addressing the challenges of sustainable use of rare elements in the future.

Journal

ACS Nano

DOI

10.1021/acsnano.5c08201.

Article Publication Date

9-Dec-2025