"It took 20 years for the military to admit that some of the warfare was dangerous to our soldiers and they were going to have long consequences years later," Bugay said, citing Vietnam War veterans sickened by the defoliant Agent Orange. "I'm afraid that's what's going to happen to our Iraqi veterans and Afghanistan. It'll take them forever to figure out that these (burn pits) are contributing factors to these illnesses."
The government, though, is moving faster. After a congressional hearing in 2008 raised concerns, the Defense Department closed all burn pits in Iraq last year, and spokeswoman Cynthia Smith told the Tribune-Review that by the end of this year, it will close burn pits at Afghan bases with more than 100 Americans who have been there for at least 90 days.
"We continue to be concerned about the possibility that airborne sand, dust and burn pit smoke in Southwest Asia may pose a health risk to our service members," R. Craig Postlewaite, director of Force Readiness and Health Assurance for the Pentagon, wrote in an e-mail.
The Department of Veterans Affairs has commissioned the Institute of Medicine to conduct a study for release this fall to determine whether Bugay's cancer and the illnesses of perhaps thousands of other veterans of Iraq and Afghanistan are linked to exposure to the burn pits.
"There's been a better response than with Agent Orange," said Susan L. Burke, a Washington attorney who is lead counsel in a lawsuit against the contractors who ran many burn pits. "You won't see a knee-jerk denial of the problem."
The VA also is conducting the National Health Study for a New Generation of U.S. Veterans, which includes 30,000 veterans of Iraq and Afghanistan. The study examines an array of health effects, including exposure to smoke from burn pits.
The Defense Department acknowledges that the dry, dusty desert conditions as well as the inhalation of burn pit smoke can cause mild, acute respiratory symptoms, Postlewaite said. But, he continued, the military has not found any increased incidence of neurological conditions, cancer, depression or heart disease that can be linked with sand, dust or smoke exposure.
Bugay's doctor, James M. Rossetti, associate director of the cell transplantation program at the Western Pennsylvania Cancer Institute, said her cancer often results five to 10 years after exposure to environmental toxins like benzene. Usually, he said, the disease befalls people in their 70s or 80s — not age 50.
"The most likely scenario is that she had some kind of toxic exposure, and it seems reasonable that the military service contributed to this," said Rossetti, an oncologist who specializes in blood disorders.