HOW SMOKING, OBESITY & SLEEP DEPRIVATION IMPACT CANCER RISK FAMILY &
POSSIBLE SIDE
WHAT FIREFIGHTER CANCER RESEARCHERS ARE LEARNING HOW YOUR INFORMATION CAN HELP FIGHT CANCER WEAPONS IN THE WAR ON CANCER
in this issue 58 WORKPLACE SUPPORT AFTER YOUR DIAGNOSIS 24
Battling the silent threat Genetics and epigenetics
A LETTER FROM THE PUBLISHER
This issue hits close to home. Cancer's cruel shadow has likely touched all of us, whether it's a personal battle or a loved one's struggle. In this magazine, we confront a harsh reality: the alarming rise of cancer within the fire service.
CRACKYL is proud to expand our partnership with the Firefighter Cancer Support Network to create a publication that raises vital awareness about this ongoing battle.
This isn’t just about reading words; it's about truly engaging with the information presented. Dive deep into the articles, absorb the facts, and, most importantly, act on the recommendations. Firefighters, it’s time to start investing in your cancer resilience. Your health is too important to ignore.
If you hold the power to shape policies and protect firefighters, now is the time to act. We need courageous leaders to champion change and safeguard the lives of those who risk their own. It's time to elevate today's best practices to tomorrow's standard.
We encourage every firefighter to sign up with the National Firefighter Registry for Cancer - you can find more info on page 50.
It’s a simple action with powerful implications for our community. It is our gift to the future generation of firefighters.
Remember, taking care of each other is our responsibility, and it starts with you. Together, we can address these challenges and strengthen the health and safety of our fire service.
Kory Pearn
PUBLISHER / EDITOR-IN-CHIEF
CRACKYL is proud to stand with the National Firefighter Registry for Cancer in addressing the systemic cancer challenges we face daily.
Joining the NFR isn’t just about you — it’s about the fire service as a whole, our families, and the generations of firefighters to come. This critical initiative collects the data we need to better understand the link between firefighting and cancer. Without this understanding, we cannot find new and more effective ways of preventing cancer in firefighters.
This is the true meaning of brotherhood and sisterhood. Let’s leave the fire service better than we found it. Make your difference now.
DIRECTOR OF ACCOUNTS, SALES & MARKETING MARIA PELLETIER MPELLETIER@CRACKYLBUSINESSMEDIA.COM
CONTRIBUTORS
JEFF BURGESS, JIM BURNEKA, MICHELLE CAPOBIANCO, SANDY DANAULT, DERRICK EDWARDS, KENNY FENT, CARRIE FLEETWOOD, ORION GODFREY, JACKIE GOODRICH, SCOTT HILL, BRITTANY HOLLERBACH, SARA JAHNKE, LINDSAY JUDAH, CHRISTINE KANNLER, MEGAN LAUTZ, RICK MARKLEY, DAVID MCELROY, RUSSELL OSGOOD, JIM O’TOOLE, DAVID PEREZ, ROBERT SAUNDERS, JOE SCHUMACHER, STEVE SHAPIRO, MARNEE SPIERER, JEFFREY STULL
PHOTOGRAPHY
PHOTOGRAPHER STEPHEN BAER
CRACKYL Magazine is published four times a year by CRACKYL Media Inc. with copies delivered to firefighters across North America and beyond. No part of the content, including but not limited to editorial, advertising or photography, may be copied or reprinted without the permission of the publisher. ISSN # 2563-612X PUBLISHED AND PRODUCED BY: CRACKYL MEDIA INC.
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The opinions presented in our magazine are those of the authors of the articles. We enjoy the opportunity to present a variety of viewpoints but do not necessarily endorse them.
CRACKYL EXPERTS
PSYCHOLOGY
DR. KRISTEN WHELDON, DR. BURTON CLARK
DR. ZACK ISOMA, PSYD, STEVE GILLESPIE
DR. JONATHAN MILBURN, DR. ANNE BISEK
DR. BROOKE BARTLETT, KAREN F. DEPPA, MAPP
JEN LEFTWICH, LMSW, CCISM
SHAUGHN MAXWELL, PSY.M
MICHAEL A. DONAHUE, PH.D
NICK HALMASY, MACP, PSY. D.
EMERGENCY MEDICINE
MICHAEL GUIRGUIS, M.D.
BEN TANNER, EMERGENCY MEDICINE PA
EXERCISE SCIENCE
ANTHONY DE BENEDICTIS, CAT(C), CSCS
TODD CAMBIO, BS, BA, CSCS
BRITTANY S. HOLLERBACH, PH.D.
JIM MCDONALD, NSCA, CPT, CSCS, TSAC-F
HUSSIEN JABAI, MS, CSCS, TSAC-F, CPT
JOE KOZIKOWSKI, NSCA-TSAC-F, PN2, PPSC
FINANCE
TRISH VAN SICKLE, LLQP, CSC, TONY DONG, MSC
MATTHEW BROOM, BBA, CFP
INTEGRATIVE HEALTH
NOAH GENTNER, PH.D., NBC-HWC
MENTAL HEALTH
ASHWIN PATEL, PH.D , ANASTASIA MILLER, PH.D.
SIMON MATTHEWS, FASLM DIPLLBLM, MHLTH SC, NBC-HWC, ICF-PCC, SARA A. JAHNKE, PH.D.
NUTRITION
MAUREEN STOECKLEIN, RD
MEGAN LAUTZ, MS, RD, TSAC-F
PATRICK MCCARTHY, MS
KATIE BREAZEALE, MS, RD, LD
SEX & RELATIONSHIPS
CARRIE FLEETWOOD, B.A., M.ED., R.P. O.A.M.H.P.
MYNDA OHS, PHD
DERMATOLOGY
SANOBER PEZAD DOCTOR, PH.D
SLEEP HEALTH
BEVERLY DAVID, REGISTERED PSYCHOLOGIST
PH.D., CLIN.PSY.D, CLIN.PSYCH
STRESS
WENDY LUND, BSCN, MSC
DONNIE HUTCHINSON, MBA, PHD
TINA BONNETT, ED.D, M.ECED., R.E.C.E., CERTIFIED TRAUMA INTEGRATION CLINICIAN
TRAINING
JOHN HOFMAN, CSCS-D, TSAC-F D, MS
JAKE PATTEN, SCCC, TSAC-F, USAW, PN-1
AARON ZAMZOW, BS-HEALTH AND WELLNESS, NSCA-CSCS, NASM-CPT, ACE-PEER FITNESS, PN1
DAVID VAUX, MSC
WELLNESS
DANIELLE COOK KAWASH, MS, RD, NBC-HWC
ALWYN WONG, BSC, DC, ART, MED. AC.
ARJUNA GEORGE, TRE COACH/PROVIDER
DR. DONNIE HUTCHINSON, PH.D, MBA
RUSSELL OSGOOD, FCSN VICE PRESIDENT
WHAT'S YOUR WHY? WHY DO YOU WANT TO LEARN AND SHARE ALL YOU CAN TO REDUCE THE RISKS OF CANCER IN THE BOTHERS AND SISTERS WE KNOW AND LOVE?
It is different for every one of us. My why is Sarah Fox.
Sarah was a friend and fellow firefighter. In 2011, Sarah lost her battle to the firefighter cancer epidemic.
Since discovering my why, I have watched the fire service discover
and develop simple programs to reduce our risk and share steps to discover cancer early to improve our survival. I'm not alone, as many of us have similar stories.
We need to continue listening, working together, to discover the path to improved detection, prevention, support, research, treatment, and wellness programs.
IF WE DO THIS TOGETHER, WE CAN DRASTICALLY REDUCE THE IMPACTS FROM CANCER.
This edition of CRACKYL is a continued legacy to all the brothers and sisters that have fought, won or lost their battle.
I ask that you use this information to keep the conversations moving forward so we can see the number of members impacted by cancer fade and the tools used for prevention become a part of the fire service fabric.
FCSN VICE PRESIDENT
Russell Osgood
Russell Osgood
The Firefighter Cancer Support Network was founded with a single, critical purpose:
TO PROVIDE ASSISTANCE AND GUIDANCE TO FIREFIGHTERS AND THEIR FAMILIES WHO HAVE BEEN AFFECTED BY CANCER.
Firefighters are disproportionately exposed to hazardous environments and carcinogens, making cancer one of the leading causes of line-of-duty deaths in the fire service.
Through peer-to-peer mentorship, FCSN provides invaluable emotional and practical support to firefighters and their loved ones who are navigating the difficult journey of cancer diagnosis, treatment, and recovery. Education is a cornerstone of FCSN’s mission.
THIS MAGAZINE IS MORE THAN JUST A PUBLICATION; IT IS A LIFELINE FOR FIREFIGHTERS, THEIR FAMILIES, AND FIRE SERVICE PROFESSIONALS.
Our goal is to inform, inspire, and unite a community that faces significant risks in the line of duty. Each article, interview, and story we present is carefully crafted to deliver actionable insights, share real-life experiences, and foster a sense of solidarity. By highlighting the latest research, sharing preventive strategies, and offering first-hand accounts, we aim to arm firefighters with the knowledge and support they need to stay healthy, both physically and mentally.
THIS EDITION OF CRACKYL MAGAZINE EXISTS BECAUSE THE FIGHT AGAINST FIREFIGHTER CANCER REQUIRES A COLLECTIVE EFFORT.
It is a platform for sharing the voices of those impacted, celebrating resilience, and advocating for meaningful change. Whether you're a firefighter, a family member, or a supporter, this magazine is a reminder that you are not alone. Together, through education, support, and community, we can take significant strides toward reducing the impact of cancer in the fire service. Please share this edition of CRACKYL with your family both on and off the job.
We know that together, we can address and overcome the challenges the fire service faces, provide comfort, strength, and hope by sharing our own experiences with the devastating effects of cancer and promote an understanding that cancer does not have to be faced alone.
WHATIS CANCER?
SOME NEW WORDS YOU're going to hear
THE NATIONAL CANCER INSTITUTE DEFINES CANCER AS A DISEASE IN WHICH SOME OF THE BODY’S CELLS GROW UNCONTROLLABLY AND SPREAD TO OTHER PARTS OF THE BODY. CANCER ISN’T PICKY.
But it is complicated, so we leave all the treatments, care, and expert opinions to the doctors who have spent decades learning their craft. But knowing what cancer is and understanding how staging works and what some of those new terms mean might help you as you peel back the layers of a diagnosis
Cancer, a disease that can strike almost anywhere in the intricate human body, begins with a disruption in the delicate balance of cellular growth and death. Our bodies are composed of trillions of cells, each with its unique role. Normally, these cells divide and multiply in an orderly fashion, replacing old or damaged cells as needed.
But sometimes this harmonious process falters. Abnormal cells, defying the body's natural controls, begin to multiply unchecked. These renegade cells can cluster together, forming masses known as tumors. Tumors can be either benign or malignant.
TERMINOLOGY
NON-MALIGNANT MALIGNANT
Cancerous.
Non-cancerous.
CHEMOTHERAPY TUMOR
An abnormal mass of tissues where cells divide and grow more rapidly.
METASTASIS
A tumor created from cancer cells that have spread from the original site.
STAGING
A method used to determine and describe the extent of cancer in the body. This includes tumor size, presence of cancer cells in the lymph nodes, and whether the disease has spread from its original site. Stages are specific for each type of cancer.
HYPERPLASIA
Abnormal increase in the number of cells in a tissue or organ.
IMMUNOTHERAPY
A cancer treatment that strengthens the immune system to fight cancer.
Treatment that uses drugs to kill cancer cells.
RADIATION
Treatment that uses high-energy rays or particles, such as x-rays or gamma rays, which produce charged ions or molecules to damage or destroy cancer cells. It can be delivered externally or directly via the bloodstream.
DYSPLASIA
Abnormal cellular growth and organization, deviating from normal size, shape, and tissue arrangement. Dysplasia almost always refers to a precancerous condition.
BIOPSY
A procedure to remove tissue samples to be examined under a microscope.
REMISSION
Complete remission means the disappearance of all signs or symptoms. Partial remission means a decrease in or disappearance of some, but not all, signs and symptoms. Spontaneous remission is an unexpected improvement that occurs with little or no treatment.
STEM CELL TRANSPLANT
A treatment involving stem cells (unspecialized cells), which develop into healthy specialized cells and replace tissue damaged from therapies such as radiation.
WEAPONS IN THE WAR ON
CANCER
CHEMOTHERAPY VS RADIATION: KNOWING THE DIFFERENCES
By Dr. Marnee Spierer, Medical Director of Radiation Oncology and Chief of Staff at City of Hope Phoenix
CHEMOTHERAPY AND RADIATION ARE TWO KEY WEAPONS IN THE BATTLE AGAINST CANCER. BUT WHAT DO THEY DO AND HOW DO THEY DIFFER?
So you’ve had a cancer diagnosis and now that the shock is wearing off, the war is on. What weapons can you deploy and how do they work?
Most cancers are treated with some combination of surgery, chemotherapy and radiation therapy. Some patients need just one of these therapies, while others need two or all three: the kind of cancer and stage determines which combination patients need.
First, some background on what cancer is because understanding this helps with the understanding of how and why treatments work.
CANCER IS THE RESULT OF ABNORMAL CELLS GROWING OUT OF CONTROL.
Our cells are made up of several components - DNA being one of them . When the normal process of DNA replication goes haywire, cancer can result. Abnormal cells grow uncontrollably, and tumors are formed.
BOTH CHEMOTHERAPY AND RADIATION WORK BY TARGETING THE CANCER CELLS’ DNA.
If the DNA is damaged, the cancer cells die.
But here is the rub: standard chemotherapy and radiation cannot tell the difference between healthy cells and cancer cells. This means normal, healthy cells are damaged along with the cancer cells.
This damage to healthy cells is what causes side effects.
THE REASON CANCER TREATMENT WORKS IS BECAUSE NORMAL HEALTHY CELLS CAN REPAIR THEMSELVES (SIDE EFFECTS CAN BE HEALED), BUT CANCER CELLS CANNOT (THEY SUFFER IRREVERSIBLE DAMAGE AND DIE).
Both chemotherapy and radiation are conventional weapons in the fight against cancer. How and to what extent these weapons are deployed will depend on the nature and strength of the adversary.
Your medical team will have more insights for you.
Chemotherapy falls under the bigger category of systemic therapy. This means that the treatment works by going into the bloodstream, or system. It can be given through the veins (either through an IV or through a device called a port) or by mouth. Either way, the medicine enters the bloodstream and works on killing cancer cells in its path.
Picture that old Pac-Man video game. The Pac-Man goes through the maze gobbling up the balls in its path. That’s what chemotherapy does.
By targeting the cells’ DNA, it is in essence gobbling up the cancer cells in its path.
There are many kinds of systemic therapy with chemotherapy being the most common. Other forms include immunotherapy, targeted therapy, and hormone therapy.
They too work by going into the bloodstream. They work differently from standard chemotherapy, but are mentioned here to give
CHEMO NUKE
you a complete overview of systemic therapy.
When patients are prescribed chemotherapy, they often get appointments for weekly infusions, or once every two, three or four weeks. Chemotherapy can come as a treatment on its own before or after surgery, or in conjunction with radiation (more on that later). Again, the regimen is based on cancer type and stage.
Because chemotherapy is a systemic therapy, so are its side effects. Blood goes to all our organs, so side effects can affect several organs.
The most common side effects (e.g. hair loss, nausea and diarrhea) happen because chemotherapy affects the organs in charge of hair growth and the gastrointestinal tract.
The good news? These organs should recover after chemotherapy is complete and their damaged cells repair themselves.
Radiation is local therapy and there are two main kinds: external and internal. With external radiation, a beam of energy is aimed directly at an area. It does not need the bloodstream to work but goes directly to the area where cancer cells are.
For some patients, the beam is aimed at an actual tumor. The goal here is to kill the DNA of the cells that make up the tumor. For other patients, the beam is aimed at an area that used to have a tumor before it was removed in surgery. The concern is that microscopic cancer cells can hide in the surgical area where the tumor used to be.
In either case, the beam is directed at tumor cells with the goal of killing them. Sometimes, chemotherapy is given at the same time as radiation. This is called sensitizing, meaning that chemotherapy helps make radiation work better. It is sensitizing the cancer cells to die more quickly and completely at the hands of the radiation.
Unlike chemotherapy, which is given on some kind of weekly regimen, radiation is given daily. Some patients
need one week while others may need six weeks: the regimen is dependent on the kind and stage of cancer.
External radiation is just like an X-ray but stronger - and, like an X-ray, patients don’t feel it while they are getting it.
Side effects happen because of the cumulative effect. Each day a little radiation is given. These little amounts add up, and eventually, the normal healthy cells in the path of the beam feel the effect.
Side effects are local; only the organs in the path of the beam are affected. So if a beam is aimed at the head; hair loss will result. If the beam is aimed at the pelvis, diarrhea is a likely result. And as with chemotherapy, side effects should disappear as the normal healthy cells repair themselves.
With internal radiation, a radioactive seed is used to radiate cancer cells from within. This is called brachytherapy and is commonly used in prostate cancer and in cancers of the gynecologic tract. This type of radiation often can involve a one-time procedure or several procedures.
I SURVIVED
Cancer
HOW I’VE ADDED MORE MEANING TO MY LIFE AFTER THE DIAGNOSIS AND REMISSION
By Jim O'Toole
Firefighters are a unique breed, and asking for help is not easy.
“Jim, you have cancer.”
At the age of 38, these were not the words I ever imagined I would hear. Husband to Crystal and father to two young boys, 9-year-old Ryan and Gavin (6), my life instantly became uncertain.
In 2001, I had the privilege of being hired by the St. John’s Regional Fire Department in St. John’s, Newfoundland and Labrador. During the earlier years of my career, I did what all the older guys did: dirty and wet bunker pants next to my bed in the dorm, taking off my SCBA during overhaul, and no showering between calls.
You get the point; I did it all wrong.
As a 21-year-old kid, I was influenced by those who came before me and simply followed their lead, unknowingly SUBJECTING MYSELF AND MY FAMILY TO THE DEVASTATING EFFECTS OF THE CARCINOGENS THAT FIREFIGHTERS ARE EXPOSED TO EACH DAY.
In 2006, my journey into learning about firefighter safety and the world of exposure began when I joined a steering committee to enact presumptive law in our province. For over 10 years,
we studied the science and presented at various levels of government.
Finally, in 2015, our efforts paid off and our provincial government enacted LEGISLATION TO COVER FIREFIGHTERS DIAGNOSED WITH CANCER.
In May of 2018, I sustained a back injury (a bulged disk) from martial arts. I requested a CT scan of my lower back to ensure no further injury. Within a few days, I received a phone call to see a urologist. I went to the appointment, where the doctor said he could see a shadow around my right kidney. I went to my follow-up scan, where a golf ball-sized mass was found on my kidney. After five anxious weeks, I was officially diagnosed with stage 2 Renal Cell Carcinoma
Fast forward to October of 2018, when I learned that I had stage 2 Melanoma. The next six years would include five surgeries on the right side of my head, face, and neck, an upgrade to stage 3A Melanoma, 23 radiation treatments, and three rounds of different immunotherapies, one of which continues until May 2025. The physical issues healed. However, I needed a behavioral health intervention, which was not an easy ask for me.
FIREFIGHTERS ARE A UNIQUE BREED, AND ASKING FOR HELP IS NOT EASY. However, living day to day with my mind going down the fear rabbit hole of the disease becoming metastatic and me not being there for my family was not an option. I reluctantly made the call to a cancer center clinician.
Some may ask, why not speak to your family? Well, when going through a diagnosis, your thoughts are not really your own. I didn’t want to burden them with my thoughts because they had taken such great care of me for the last six years as I healed from the physical trauma of my diagnosis.
At the clinician sessions, I learned it was OK to talk to others about it, and it was OK to put my family and me first. Today, as I write this as a firefighter/ lieutenant, I am cancer-free and still undergoing treatment. But I am living and loving life with my wife Crystal and boys Ryan, now 15, and Gavin, now 12.
Many people ask if I had to do it all over knowing the risks, would I still become a firefighter?
My answer is simple: absolutely, IT’S STILL THE BEST JOB IN THE WORLD.
BATTLING THE
CANCER AWARENESS AND PREVENTION IN THE FIRE SERVICE silent THREAT
RESPONSE TIME MATTERS: FIREFIGHTERS ARE BEATING BACK
CANCER WITH EARLY DETECTION
By Sandy Danault, Senior Director of Programs & Partnerships at DetecTogether
CANCER IS AN ALARM THAT RINGS FAR TOO OFTEN IN THE FIREFIGHTER COMMUNITY, WITH OVER
45%
OF FIREFIGHTERS EXPECTED TO FACE A CANCER DIAGNOSIS DURING THEIR LIFETIME.
But just like in the line of duty, being prepared and proactive can save your life. When it comes to cancer, time is of the essence and early detection is the gold key to a better outcome.
CANCER SURVIVAL RATES
BASED ON EARLY VS. LATE DETECTION
STAGE 0/1 (LOCAL) STAGE 4 (DISTANT)
THERE ARE OVER
TYPES OF CANCER, YET ACCORDING TO THE CDC ONLY
SCREENINGS HAVE BEEN PROVEN EFFECTIVE.
This means that the responsibility to recognize early warning signs of cancer falls largely on you. DetecTogether's 3 Steps Detect program helps firefighters recognize subtle health changes that could signal cancer.
Unfortunately, 50% of cancers are detected at late stages, when there are fewer treatment options. But it doesn’t have to be that way. 3 Steps Detect teaches you how to recognize cancer's most common early signs – those subtle, persistent changes in your health that last two weeks or more. And once you suspect something, 3 Steps Detect guides you in
3 steps detect PROGRAM
KNOW YOUR GREAT
Know how you feel when you are at your best. Tune into your energy level, sleep patterns, weight, skin and bathroom habits. Get to know what is normal for you.
USE THE 2-WEEK RULE
If any changes in your health last longer than 2 weeks, it's time to call the doctor.
SHARE WITH YOUR DOCTOR
You know your body best. Share information about any health changes with your doctor. It may be difficult or embarassing, but it could be lifesaving.
Tracking subtle symptoms is crucial. Persistent pain, unexplained weight loss, unusual lumps, or any other changes that last two weeks or more deserve your attention. By writing these symptoms down and staying vigilant, you become your own best advocate. Don’t dismiss small changes: they could be your early warning sign.
Captain Julio Delucchi
REAL STORIES Real impact
SREENINGS ONLY CATCH
14% OF CANCERS
Cancer screenings, while vital, catch only about 14% of cancers. For the rest, you need to be your own advocate. By following 3 Steps Detect and being proactive, you give yourself the best chance
Multi-cancer early detection tests show promise, but due to current limitations they are not yet approved by the FDA or widely recommended by experts.
Traditional screenings, such as colonoscopies and cervical cancer tests, can detect precancerous cells and prevent cancer from developing. Mammograms and lung screenings can find cancer at its earliest stage, and men should also discuss prostate cancer screening (a PSA blood test) with their doctor.
While multi-cancer tests may play a significant role in the future of early detection, they are not a substitute
When it comes to cancer, timing can mean the difference between life and death. That’s why DetecTogether works with fire departments to provide training that meets the unique needs of the firefighting community. With both in-person and online training options, it’s easy to learn how to protect your health. One in four people who learn 3 Steps Detect find a health issue earlier. That means
TELLING YOUR
Family & Friends YOU HAVE CANCER
THIS
CAN SEEM A DAUNTING TASK ON TOP OF ALREADY DEVASTATING NEWS, BUT YOU CAN NAVIGATE IT
By Derrick L. Edwards, Ph.D., LPC-MHSP, NCC
Learning that you have been diagnosed with cancer is sure to initiate a roller coaster ride of emotions. It’s important to recognize that this is new territory. You likely don’t have a pre-incident plan prepared for this moment, so don’t be surprised if your emotions take as many twists and turns as the most fiendishly designed coaster.
First, let me encourage you to stop and breathe. Good. Now, more than ever, it is important that you take steps toward daily mindfulness practices
Second, take some time to allow yourself to process. Now is not the time to take on that extra overtime shift or to plan your dream vacation. While there is no way you will ever feel like you have it all figured out, getting yourself squared away is an essential first step before you can begin to let others in on your news.
HOW WILL I TELL HOW WILL I TELL
YOU HAVE CONTROL.
You can choose when and where to share your news. Ultimately, you know the personality of your crew the best. So, whether on shift or off, individually or in a group, it is up to you. Only answer questions you feel comfortable with, and be prepared to say, “I don’t know.” However, be mindful that once shared, the news of your diagnosis is likely to spread faster than brush fire on a windy August day.
my kids? my shift?
AGE MATTERS.
Not all kids are the same, so you must be mindful of your child’s age. Older children (adolescents) can think abstractly and consider hypothetical situations more easily. Younger children (5-12) will benefit from more concrete information. If you have multiple children of varying ages, consider having separate conversations based on age.
OUR COLLEAGUES AT THE STATION ARE OFTEN MORE THAN FRIENDS: THEY ARE FAMILY. HAVING A CONVERSATION ABOUT YOUR DIAGNOSIS MAY, IN SOME CASES, BE UNAVOIDABLE. BUT IT ALSO ALLOWS YOU TO ACTIVATE YOUR MOST POWERFUL TOOL: A POSITIVE SOCIAL SUPPORT SYSTEM. HERE ARE THREE THINGS TO EXPECT FROM THAT CONVERSATION.
REACTIONS WILL VARY. WHAT’S NEXT?
There is no singular way to expect others to react. You are important in their lives, and news of your diagnosis will have a personal impact. Some may express sadness or fear , while others may become overly optimistic or angry Just like you need time to stop and breathe, they will almost certainly need the same advice.
Will others be weird? Short answer: probably. We often struggle with knowing the “right” thing to do or say when someone we care about is going through a difficult time. Consequently, we put far too much pressure on what was previously a natural relationship. Be willing to acknowledge (internally and out loud) when it gets weird. In time, the relationship should return to a level of normalcy
FEW MOMENTS IN PARENTING WILL EVER RISE TO THIS LEVEL OF DIFFICULTY. YOU ARE LIKELY WORRIED ABOUT DOING THIS PART WRONG; IT HAS PROBABLY COST YOU A FEW PRECIOUS HOURS OF SLEEP. HERE ARE THREE THINGS TO BEAR IN MIND.
IT’S PERSONAL. BE OPEN.
Your children, while worried about you, may also be old enough to realize the impact on their lives. Do your best to reassure them that they will be OK Avoid common euphemisms, such as “I’m sick,” which may be confusing to children who also experience everyday sickness.
Navigating this difficult time will be challenging, but remember, you do not have to go through it alone. Seeking high-quality resources from trusted organizations, such as the Firefighter Cancer Support Network, is a helpful step on this journey.
While no two people have the same cancer journey, you may find speaking with those who have been there helpful Surrounding yourself with a strong support system will be key as you progress. Finally, to cope with all the cancer diagnosis ride’s plunges, upside-down loops, and deathdefying speed, you need to stop and breathe
Now is not the time to pretend you have everything figured out. Your children will benefit from your honesty when you say, “I don’t know.” After all, there will be plenty of times when they will not have all the answers. Frequently acknowledge that it is OK to ask questions. This is when it is a priority to keep the lines of communication open.
MADE TO MOVE
BREAKING IT TO THE
Kids
HERE’S ONE FIREFIGHTER’S STRUGGLE WITH HOW AND WHEN TO TELL HIS CHILDREN ABOUT HIS CANCER DIAGNOSIS
By David Perez, Founder of Tiny Hero Foundation and Florida Firefighters Safety and Health Collaborative
At the age of 40, I was diagnosed with multiple myeloma in early 2020. Myeloma is a rare and incurable blood cancer affecting many firefighters. This completely changed my perception of who could and couldn’t get cancer.
After diagnosis, I needed to dig deep and find something to give me hope, a light at the end of the tunnel. That shining light was my two children, my daughter, then 6, and my son, then 4. Little did they know they were the ones who saved my life.
Upon my initial diagnosis, I decided not to tell my kids. I didn’t want to ruin their innocence and I didn’t want to find an excuse for not playing with them. I refused to be a victim of my circumstances. The last thing I wanted my kids to think or feel was, “Dad didn’t play with me because he didn’t love me.”
THIS APPROACH PUSHED ME TO GET OUT OF BED AND MAKE AN EFFORT TO PLAY AND CONNECT WITH THEM MORE OFTEN.
Then, in 2022, I had a swollen tonsil, which eventually led to my second diagnosis: mantle cell lymphoma. MCL is an even more rare and incurable blood cancer than myeloma. At this point, I had a conversation with my wife and decided to tell the kids that I had a compromised immune system, still not telling them I had cancer. (In my head, the name of the diagnosis didn’t matter.)
A few months later, I decided to do an allogeneic stem cell transplant (transplant using donor bone marrow). Since this procedure carries a considerable mortality rate, I decided then to tell the kids what I had been going through. It was the toughest conversation I have ever had.
We all sat around the dining room table, and as I began to speak, the lump in my throat got so big that I couldn’t utter another word without losing it. I nodded to my wife, and she told them. Once she began to speak, I was able to regain my composure and continue the conversation.
We kept it simple and to the point. I knew it went well when my daughter asked if she could continue watching TV, and my son asked if we could go play soccer. So, of course, the conversation I had been dreading and had been worrying a hole in my stomach for years didn’t have the same impact I was afraid it would. I was expecting a somber “Coming to Jesus moment” for the family.
A few months later, I went through the stem cell transplant and after a few speed bumps and issues, I am currently back to work and in remission from both cancers.
EXPLAINING SUCH A DIFFICULT TOPIC TO YOUR CHILDREN OR FAMILY REQUIRES AN EXTRAORDINARY AMOUNT OF COURAGE.
Your health, your ability to push through physically and mentally, and the age and relationship of your children should aid in dictating when and how to tell your kids. A therapist is another great resource. Mine has been a massive help to my mental recovery and is helping me deal with my newfound life.
GENETICS EPIGENETICS AND
CAN THEY HELP US UNDERSTAND CANCER RISKS?
By
In 2022, the International Agency of Research on Cancer, part of the World Health Organization, designated the firefighting occupation as a Group 1 carcinogen. This means firefighters have a heightened risk of developing cancer compared to the general population.
This elevated risk stems from exposure to cancer-causing substances found in smoke, chemicals released during fires, and other hazardous materials encountered on the job. The fire
service and researchers are working together to identify the types of exposures that are most toxic and ways these exposures can be reduced.
For example, personal protective equipment and decontamination procedures have improved over the years, reducing the amount of toxic chemicals that get into firefighter’s bodies. While this line of research continues to improve, there are also biological factors that can help us understand cancer
FIREFIGHTERS HAVE GREATER CANCER RISKS, YET, PREDICTING IF OR WHEN AN INDIVIDUAL FIREFIGHTER WILL GET CANCER IS CHALLENGING.
risk and even screen for cancer before it has fully developed.
At a population level, we know that firefighters are more likely to develop cancer. However, predicting if or when an individual firefighter will get cancer remains challenging. Each individual has unique genetic and environmental factors influencing their risk, making it complex to pin down exact probabilities for cancer development. This is where genetics and epigenetics – two key biological factors – can help us.
Jackie Goodrich, Ph.D., Department of Environmental Health Sciences, University of Michigan Co-Leader, Firefighter Cancer Cohort Study
GENETICS AND CANCER
Genetics is the study of genes and how they influence the traits and health conditions passed down from one generation to another. Our DNA consists of genes that act as instructions for building and maintaining our bodies.
We are born with this genetic code, or set of instructions, which varies slightly from person to person.
Some genetic variations can make an individual more prone to develop cancer. Families with a history of cancer likely carry these types of genetic variations, and individuals in these families should monitor for cancers more frequently.
While genes that we are born with can confer some increased cancer risk, exposures throughout your life – including at work – are behind the development of many cancers. Some toxic exposures, including those that firefighters face, can mutate the genetic code.
WHEN MUTATIONS OCCUR IN GENES THAT PROTECT AGAINST CANCER FORMATION IN THE BODY, CANCERS CAN START TO DEVELOP IN THE TISSUE WHERE THE MUTATION OCCURRED.
The body is able to repair most mutations, but mutations that
escape repair can lead to health issues including cancer.
Blood genetic screening tests have emerged as a powerful tool in the early diagnosis and detection of various cancers. These tests work by analyzing DNA in the blood to identify genetic mutations that commonly occur in tumors.
By detecting these changes early, often before any symptoms appear, blood genetic screening can facilitate prompt and more effective treatment. These tests are new, and their accuracy is still improving. As these tests improve, we can expect to see them used more often in health evaluations for the fire service.
IMAGINE YOUR DNA AS THE KEYS ON A PIANO. EPIGENETICS IS THE WAY THESE KEYS ARE PLAYED TO EXPRESS DIFFERENT SONGS.
EPIGENETICS, TOXICITY, AND CANCER
Epigenetics goes beyond the genetic code to explore how genes are turned on or off by various environmental and lifestyle factors.
Imagine your DNA as the keys on a piano. Epigenetics is the way these keys are played to express different songs. Likewise, the genes within your cells are expressed differently depending on what tissue they are in, what stage of life you are in, and whether a cell is healthy or diseased.
Differences in gene expression are controlled by the epigenetic code which can be modified by diet, stress, exposure to toxic chemicals, and aging.
In the context of cancer, certain epigenetic changes can:
• ACTIVATE ONCOGENES (genes that promote cancer) or
• DEACTIVATE TUMOR SUPPRESSOR GENES (genes that protect against cancer).
In our research with the Fire fighter Cancer Cohort Study, we identified epigenetic changes linked to years working in the fire service or to certain exposures. We do not yet know whether these changes directly contribute to cancer development. But this research is the first step in understanding the biological pathways that underlie risks, and we have ongoing research in this area.
Genetics and epigenetics underlie normal biological function in all tissues of the body. Genetic mutations and epigenetic alterations can occur from toxic exposures , including those faced by fire service professionals.
These changes can contribute to the development of cancer, and partially explain why cancer risk differs from person to person. By studying these changes, researchers can develop screening tools to assess cancer risk more accurately. This area of science is also being used to inform policy and intervention efforts to protect firefighter health.
EXTINGUISH CANCER RISK
WITH FOOD
YOU ARE WHAT YOU EAT, SO FUEL YOUR BODY WITH CANCER-FIGHTING CHAMPIONS
By Megan Lautz, MS, RD, CSCS, TSAC-F
It's no secret that eating well is not only good for you but can actually reduce your cancer risk
The challenge? A quick Google search on nutrition for cancer prevention can get crazy, fast. The good news: alkaline diets (avoiding acidic foods) emphasizing fruits and vegetables and eliminating your favorite foods are not required to reduce cancer risk. These activities can lead to diet burnout and a lack of consistency
Consistently eating well is key to long-term wellness, meaning finding balance is the goal. To help strike a balance and reduce cancer risk, check out these foods to add and what you should cut back on.
ADD MORE +
"Nutrition by addition" is a popular dietitian hack for encouraging better food choices while edging out lower-quality choices. Diets rich in plant foods have strong evidence for lowering the risk of mouth, esophagus, stomach, and lung cancer, as well as some evidence for lowering the risk of colon, pancreas, and prostate cancer.
FRUITS & VEGETABLES
The pigments that provide color to fruit and veggies play an important role as antioxidants. Antioxidants prevent cancer by neutralizing free radicals that cause cell damage. Including dark green, red, orange, and even white produce can provide an array of cancerpreventing antioxidants. This includes frozen and canned produce. Add frozen berries to a smoothie, or try a frozen stir-fry veggie mix.
GOAL: 1 to 2 ½ cups of fruit and 1 to 4 cups of veggies per day.
HIGH FIBER FOODS VITAMIN D
Fiber is found in fruits, vegetables, whole grains, and beans and is linked to a lower risk of colorectal cancer. Fiber is also filling and may reduce your risk of weight gain, which is associated with a higher risk of cancer. Plus, it impacts gut bacteria, which may play a role in cancer prevention. Worth noting: the main benefits of fiber are found in actual food, not supplements. Consider adding fruit as a snack or overnight oats for breakfast.
GOAL: 20 to 25 g per day for women and 30 to 38 g per day for men.
Vitamin D is often associated with bone health, but it may also reduce cancer risk, specifically colon cancer. Dietary sources include fatty fish, mushrooms, fortified juice and cereals. Unfortunately, studies do not suggest that vitamin D supplementation reduces cancer risk. If supplements were recommended at your physical due to low vitamin D, continue taking them while adding foods high in vitamin D.
GOAL: Incorporate foods high in vitamin D into your diet.
CUT BACK ON —
ALCOHOL INTAKE
Alcohol use accounts for 6% of all cancers, and the recommended amount is likely less than you think. Moderate alcohol use is considered one drink per day for women and two drinks per day for men. More than 14 drinks per week is considered heavy drinking. Serving size is classified as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor. Some research has shown that consuming any amount of alcohol increases the risk of some types of cancer (such as mouth and throat).
Drinking more than 14 drinks per week may not mean that you have a clinical dependence on alcohol; however, you may want to evaluate your intake within the context of your health goals. Reducing alcohol intake can provide some relatively instant gratification in sleep quality and weight loss goals. Take note of how many measured drinks you consume per week, and consider switching out for a non-alcoholic option.
GOAL: Keep alcohol to an absolute minimum, or at least under 7 (for women) and 14 (for men) drinks per week.
PROCESSED MEAT
Processed meats have been cured, smoked, salted, or fermented to enhance flavor. They include bacon, sausage, bologna, hot dogs, and deli meat. The International Agency for Research on Cancer has grouped processed meat into Group 1, or sufficient evidence that it is "cancer-causing to humans," based on an increased risk for colorectal cancer. And IARC recently classified the occupation of a firefighter as a Group 1 carcinogen. Just being a firefighter increases your risk.
Unfortunately, no suggested servings per week are considered safe. The recommendation is to eat sparingly or not at all if cancer risk reduction is your goal. Note that IARC classifies turkey- and chicken-based sausage or bacon as processed meat. The nitrates and nitrite preservatives produce N-nitroso chemicals that can lead to bowel cancer. And both "natural" and manufactured nitrates are of concern. Save a reasonable serving (think two slices) of bacon or sausage for Sunday brunch at the station, then choose another side for your daily breakfast.
GOAL: Keep processed meat to an absolute minimum.
WHAT SHOULD I DO IF I AM DIAGNOSED?
As mentioned before, an internet search can ramp up your anxiety fast Consider working with a dietitian to help navigate any nutrition-related changes associated with treatment. Dietitians are trained in medical nutrition therapy, or nutrition that helps manage a medical condition.
For example, radioactive iodine therapy is a common treatment for thyroid cancer. To maximize treatment, a low-iodine diet is required for 2 to 3 weeks, but this diet requires the elimination of iodized salt (i.e., all salt). A dietitian can help you navigate and reduce the stress of behavior change.
Ask your doctor if a dietitian is available at the treatment center. Insurance often covers dietitians; if one is unavailable at the center, your insurance company can connect you with one. Look for a dietitian with the Certified Specialist in Oncology credential.
THE BOTTOM LINE
A combination of factors causes cancer and existing nutrition information can be overwhelming . It is OK to make one small change at a time. You would be surprised what cutting out a serving or two of alcohol, eating an extra vegetable, or fitting in a 20-minute workout can do over time. You can improve your overall health and firefighting abilities with a few targeted lifestyle changes.
ALL IT TOOK WAS AN ACCIDENT TO UNVEIL A BIGGER PROBLEM
By Joe Schumacher, Firefighter Cancer Support Network; Chief Operations Officer
Early DetectionSaved my life
One day, while I was playing with my 2-year-old daughter, she accidentally hit me where no man wants to be hit. It hurt more than it should have. I had a doctor’s appointment the following week for another issue, so I mentioned my daughter running into me and the pain it caused.
The doctor did an exam. Two hours later, I was having an ultrasound of my testicles. I was 29 years old, eight years into my career, and married with two children; I was living a great life.
The ultrasound showed a mass in one testicle. Two weeks later, that testicle was surgically removed since removal was the only way the suspected cancer could be confirmed. Pathology confirmed STAGE ONE SEMINOMA TESTICULAR CANCER and I received 15 radiation treatments as a precaution.
Seventeen years later, by then 46, I was a station captain and looking forward to retiring in five years. My son was graduating college and my daughter was graduating high school. One morning in the shower, I noticed a small bump on the left side of my groin. I went to my primary care doctor and had it checked out.
My doctor said it was probably just an infected ingrown hair follicle. He put me on antibiotics and said to come back in 10 days if it wasn’t better. Ten days later, I was back in his office. An ultrasound was performed; it was inconclusive. Off I went to a general surgeon for a biopsy.
I FEARED THE UNKNOWN. HAD MY CANCER RETURNED?
After a torturous 10-day wait, the biopsy came back: NonHodgkin’s lymphoma (NHL) I was devastated and scared. I cried a lot those first few days after getting the news. I beat cancer once; could I do it again? It was then that I began volunteering for the FIREFIGHTER CANCER SUPPORT NETWORK.
I had surgery to remove one lymph node and again, we waited for the pathology report. Seven long days later, that report indicated stage one follicular NHL. My oncologist told me he was surprised because most of his patients with NHL were over 65. I reminded him that most of his patients weren’t firefighters. After 17 radiation treatments, my treatment was completed.
EARLY DETECTION, RECOGNIZING WHEN SOMETHING WASN’T NORMAL AND HAVING IT CHECKED BY MY DOCTOR
SAVED MY LIFE AGAIN.
I retired in 2018 at 52 after 35 years in the fire service. I had a great career and was looking forward to a long retirement with my beautiful wife.
I was extremely fortunate that my department offered retirees annual physicals at our occupational health center for five years after retirement. Considering my medical history, I made sure to get that annual physical. I always had my physical results sent to all my doctors. My physicals never showed anything abnormal except my prostate-specific antigen (PSA) level, which had been rising as I continued to get older, which is not out of the ordinary.
Four years after retiring and after my annual physical, my urologist called and said he was concerned with how much my PSA number had risen since my last physical. He wanted to do a biopsy. ALL I COULD THINK WAS HERE WE GO AGAIN, AND I CRIED. In the hospital after the biopsy procedure, my urologist told me I could see the results on the MyChart app before he did and not to worry if it was cancer since I had already been through cancer before.
I did see the results before the urologist did and the biopsy showed five of the 12 samples
were cancerous. Even though I knew from discussions with my urologist that prostate cancer was unlikely to kill me, I was still devastated. I cried some more. I was tired of the whole cancer thing by now and didn’t look forward to another battle.
I just wanted the cancer out of me and chose the surgical option for treatment. I was fortunate that I had some great mentors from the Firefighter Cancer Support Network who were able to prepare me for what I could expect after surgery. I never thought that at 55 I would have to learn how to control peeing again.
EARLY DETECTION THROUGH MY ANNUAL PHYSICALS HAS SAVED MY LIFE.
Cancer doesn’t discriminate and as firefighters, we have a 9% greater chance of being diagnosed than does the general public. We owe it to ourselves and those who love us to do everything in our power to reduce our chances of getting cancer. There are very few words scarier to hear than: “You have cancer.” However, if you get annual physicals and cancer screenings when recommended, you are much more likely to catch it early and be able to say the even more important words: “I AM A CANCER SURVIVOR.”
WHAT FIREFIGHTER CANCER RESEARCHERS ARE LEARNING
By Jeff Burgess, MD, MS, MPH, University of Arizona
CANCER RESEARCH IS MAKING GREAT STRIDES IN MALE AND FEMALE FIREFIGHTER REPRODUCTIVE HEALTH
We know that occupational exposure causes cancer in firefighters, as conclusively determined in June 2022 by the World Health Organization's International Agency for Research on Cancer, or IARC.
We also know that firefighters face adverse reproductive effects.
MALE FIREFIGHTERS
have been found to have increased rates of infertility, abnormal sperm, and birth defects in their children.
FEMALE FIREFIGHTERS
have been found to have increased rates of miscarriage, preterm birth, and decreased reproductive reserve.
THE FIRE FIGHTER CANCER COHORT STUDY (FFCCS)
However, while we know some of the risks, our challenge is identifying effective interventions to reduce these health risks.
The framework for our collaborative research with firefighters is the Fire Fighter Cancer Cohort Study or FFCCS. The FFCCS conducts community-engaged research with firefighters.
THE FIREFIGHTERS ARE INVOLVED IN ALL PHASES OF THE RESEARCH.
They help determine the research questions, collect
biological samples, co-publish the results and disseminate them to the fire service.
Our purpose is to research how to best reduce the risk of cancer and other priority health conditions, such as adverse reproductive effects, encountered by firefighters.
Our goal is to enroll 10,000 firefighters and follow them over the 30-year duration of the study, collecting blood and urine every two years and after specific exposures chosen by the fire service. We currently have more than 6,400 firefighters enrolled in FFCCS from
over 275 departments across 31 states and 12 academic and government research partners.
We want to prevent disease. One way we do that is by measuring and evaluating the effectiveness of exposure reduction interventions. Some important exposures that we have evaluated include smoke, per- and polyfluoroalkyl substances (also known as PFAS or forever chemicals, which we have shown are present at higher concentrations in the blood of firefighters than the general population),
and mental health conditions, including stress.
These exposures lead to cellular changes in pathways, leading to disease development. Some of these cellular changes, which we can measure with biomarkers of effect, include five key characteristics of carcinogens identified by IARC to have strong evidence for increases with firefighter exposures.
OUR LONG-TERM GOALS INCLUDE EARLY DETECTION OF CANCER AND REPRODUCTIVE HARM.
10,000
AND FOLLOW THEM
+6,400
30 +257
Every two years and after specific exposures chosen by the fire service
12 31
EPIGENETIC ALTERATIONS: MICRO RNA & DNA METHYLATION
Let’s look at epigenetic alterations, some of the biomarkers of effect that we measure, and which are associated with the development of many diseases, including but not limited to cancer.
EPIGENETIC ALTERATIONS CONTROL GENE EXPRESSION WITHOUT CHANGING THE UNDERLYING DNA STRUCTURE.
We are evaluating both microRNA expression and DNA methylation, both measured in the blood.
THEY ARE LIKE LIGHT SWITCHES, TURNING ON AND OFF GENE EXPRESSION.
Under normal conditions, they help keep healthy cells functioning.
HOWEVER, THEY CAN CHANGE FOLLOWING TOXIC EXPOSURES, CAUSING ALTERED FUNCTION AND
POTENTIALLY ABNORMAL CELL GROWTH, LEADING TO CANCER OR OTHER DISEASES.
MicroRNA expression changes with firefighter exposures. We have found differences in microRNA expression comparing veteran firefighters and recruits, adjusted for age, showing an increase in oncogenic microRNAs and a decrease in tumor suppressor microRNAs, consistent with increased cancer risk. We see similar changes in recruit firefighters after the first 2 to 3 years on the job.
We have measured differences in microRNA expression by comparing municipal firefighters responding to a wildlandurban interface to those who just fought structural fires. We have also found that PFAS levels in the body of firefighters change their microRNA expression. These last two studies will soon be submitted for peer-reviewed publication.
Is the name of a family of molecules that help cells control the kinds and amounts of proteins they make, playing important roles in regulating gene expression.
A study led by Dr. Jackie Goodrich looked at volunteer firefighters responding to the East Palestine, Ohio, train derailment and fire and compared them to firefighters from the same areas who did not respond to the incident. We found differences in microRNA expression in blood collected 2-4 months after the fire. We have reported these changes to the study participants.
We will follow up with them in several months to see if these changes are persistent and to enroll additional firefighters from the region to participate in the study. These findings will also be submitted soon for peerreviewed publication.
DNA methylation, the other epigenetic marker that we are evaluating, changes with both exposure and age. Methylation at certain parts of the DNA has been found to be highly correlated with age. These sites can be
analyzed to calculate epigenetic or cellular age using epigenetic clocks.
IF THESE CLOCKS SHOW AN EPIGENETIC AGE GREATER THAN YEARS SINCE BIRTH, THAT IS CALLED ACCELERATED EPIGENETIC AGE.
This has been shown to be predictive of death from all causes: cancer, adverse reproductive health, cardiovascular disease, and neurodegenerative disease.
WE HAVE SHOWN THAT, ADJUSTING FOR AGE, VETERAN FIREFIGHTERS HAVE GREATER EPIGENETIC AGE ACCELERATION THAN RECRUITS.
We have also shown that increased serum levels of some PFAS chemicals in firefighters are associated with epigenetic age acceleration.
Is a chemical reaction in the body in which a small molecule called a methyl group gets added to DNA, proteins, or other molecules. The addition of methyl groups can affect how some molecules act in the body.
FIREFIGHTERS
LOWER AMH LEVEL ON AVERAGE THAN NON-FIREFIGHTERS.
STUDIES IN PROGRESS
IN THE GENERAL POPULATION, INCREASED STRESS HAS BEEN ASSOCIATED WITH ACCELERATED EPIGENETIC AGE.
In studies linked to the FFCCS, we are evaluating whether improved exercise or intermittent fasting can improve epigenetic age and whether plasma or blood donation can both reduce serum PFAS concentrations and improve epigenetic age.
In a separate study with a partner fire department, we are evaluating whether a broccoli seed or sprout extract supplement containing sulforaphane as the active ingredient can reduce epigenetic age. Sulforaphane has been shown to shift
the metabolism of some smoke products to less toxic forms.
IN THE GENERAL POPULATION, SOCIAL SUPPORT HAS BEEN SHOWN TO IMPROVE EPIGENETIC AGE, AND THIS COULD BE EVALUATED IN FUTURE FIREFIGHTER STUDIES.
To evaluate reproductive health in female firefighters, we are measuring and reporting back to the study participants their blood levels of anti-mullerian hormone, or AMH. AMH is used as a measure of reproductive or ovarian reserve in infertility clinics. Reduced AMH levels are strongly associated with
reduced fertility, earlier age at menopause, and in some studies, miscarriage and preterm birth.
We previously showed that firefighters have a 33% lower AMH level on average than non-firefighters. This is similar to the reduction seen in cigarette smokers.
In our women firefighter studies, now with over 900 participants, we found that a self-reported clinical diagnosis of anxiety was associated with a statistically significant 33% reduction in AMH and a diagnosis of posttraumatic stress disorder was associated with a statistically significant 66% reduction in AMH. We are currently looking at biological mechanisms, including epigenetic clocks, that could explain this
relationship and identify potentially protective interventions to test.
We know that firefighters suffer from increased rates of cancer and adverse reproductive outcomes. That makes it critical that fire departments continue to focus on reducing fireground and PFAS exposures.
In addition, fire departments should take a broader approach, putting in place policies and programs to support cancer prevention, reproductive health, and mental health. And, continued fire service participation in research is needed to help identify, prevent, and hopefully reverse hazardous exposures and their adverse health effects.
W E R E Y O U E X P O S E D
T O 9 / 1 1 T O X I N S ?
$10 Billion Victim Compensation Fund and free lifetime health care
Attention: 9/11 Responders and Volunteers
9 / 1 1 D I D N ' T E N D O N 9 / 1 1 .
69 cancers and many respiratory illnesses have been linked to 9/11 toxins. Anyone who participated in the rescue and recovery operations in Lower Manhattan on 9/11, or during any part of the 8 months that followed, may be eligible for compensation
Illnesses linked to 9/11 toxins:
69 cancers, including:
Skin cancer (basal cell, squamous cell, and melanoma)
Thyroid cancer
Breast cancer
Prostate cancer
Uterine cancer
Blood cancers (multiple myeloma, lymphoma, and leukemia)
Lung cancer
Kidney cancer
Colon cancer
Bladder cancer
Many respiratory illnesses, including:
Asthma
Sinusitis
Emphysema
COPD
It's not too late to apply.
My fight against an cancer
“Insurvivable”
WITH GREAT MEDICAL TREATMENT, FINANCIAL SECURITY AND THE SUPPORT OF LOVED ONES, MY LIFE WAS EXTENDED MORE THAN A DECADE
By Scott Hill
Back in 2009, my life was great. My family and I were all healthy and spent lots of time together doing the things we loved. At that point, I was a 25year career firefighter with Peterborough, Ont., Fire Services, IAFF Local 169, and had just been promoted to captain.
But in late October, I experienced symptoms for the first time, the most obvious being some very dark urine. I thought I must be dehydrated or even have a bladder infection. I went the obvious route and consumed more beer, but this didn’t seem to clear up the symptoms.
A week later, I was on the annual deer hunt. A few days into the week, I experienced back pain so severe that it sent me to the ER. The bloodwork, scans, and ERCP (endoscopic retrograde cholangiopancreatography) scopes began. I knew it was bad news.
After some time waiting, my wife and I received the devastating results: I had a tumor on my pancreas. AT 44, THE HARDEST JOURNEY OF MY LIFE HAD JUST BEGUN.
I can’t help but think that being a firefighter assisted me in getting the best treatment time after time. Yet new obstacles and solutions kept presenting themselves. The first was when the doctor who performed the ERCP put me in touch with a surgeon at Toronto General Hospital – Dr. Bryce Taylor, who just happened to be the chief of surgery. Taylor performed a surgery called “the Whipple,” where part of the pancreas, small intestine, gall bladder and bile duct are removed. This started a trusting relationship with the University Health Network and their exemplary staff serving as my medical treatment team.
Things went well for a period, but in August 2010, CAT scan results showed the cancer had spread to my liver. These new spots were removed, and I RETURNED TO FULL FIREFIGHTING DUTIES BY THE END OF THE YEAR.
Over the next four years, I had a series of ablations and other interventions to eradicate tumors that were popping up. In October 2014, I had laparoscopic surgery to resect the liver and repair a hernia. I also had a few lesions on my
bones and liver that have been treated with radiation. In 2015, I started oral chemotherapy, and because of the loss of energy I experienced, I decided to retire.
Recounting the story of my health sounds terrible, but despite the results and challenges, I’ve actually mostly felt fine. I remember when a doctor on rounds I hadn’t seen before came into my room to see me. He read my chart and looked at me then read the chart again. He then checked my wristband twice. HE THEN SAID I WAS THE HEALTHIESTLOOKING SICK PERSON HE HAD SEEN, a sentiment I heard from numerous doctors over the years.
When I was first diagnosed, I assumed that I would be dead in a relatively short period of time. But here I am, having just celebrated 15 years since my diagnosis, something which is nearly unheard of for those with pancreatic cancer.
I will be fighting this disease for the rest of my life, but I will not be fighting it alone. I will be doing so with an incredible team of doctors and specialists in my corner. I have had amazing support
from my wife, girls, mom, and the rest of my family as well as friends and coworkers.
Furthermore, science is on my side. As I write this, I am awaiting word on traveling to Michigan for a new treatment called histotripsy just developed at The University of Michigan, and not yet available in Canada.
When I started this journey, my cancer was not recognized by the Ontario government in their presumptive legislation as related to my work as a firefighter.
But through the efforts of OPFFA (the Ontario Professional Fire Fighters Association), it was added to the list in 2023 and now I have financial support to cover the costs and hardships caused by this work-related disease.
So, my message in closing, to my brothers and sisters: ALWAYS USE YOUR PPE PROPERLY. If the unfortunate does happen and you end up with an occupational disease, just keep moving ahead day by day. Accept the support of those around you and don’t ever give up! AS I WRITE THIS, IN NOVEMBER 2024, LIFE IS STILL GREAT.
WHEN CANCER YOUR CAREER + CONFIDENCE HIJACKS
By Steve Shapiro, Founder & Executive Director, Minneapolis Fire Foundation
A shocking but now all-toocommon diagnosis: you have firefighter occupational cancer.
It hits you like a punch to the gut. Your mind races — will I survive? How will my family cope? Will my finances be destroyed? Can I return to my career? Will I lose my spouse/ life partner? These are common themes for anyone who has faced this fire service plague: cancer.
FINDING PURPOSE THROUGH MENTORSHIP TURNED MY DIAGNOSIS INTO SOMETHING POSITIVE
My firefighter occupational cancer journey started in the spring of 2013 at the age of 30. I began experiencing stomach pain — not your typical medic call of nausea and vomiting, but pain when I ate. Like most of us in the fire service, my immediate plan of action was to wait and see if this would go away. After three months of losing both weight and sleep, I finally decided to see my family medicine doctor in June.
Over the next six months, I underwent X-rays, ultrasounds, CT scans, an MRI, and blood tests too many to count. All this testing culminated in November 2013 with an upper GI endoscopy. The results were still the same: no cancer. I was declared healthy and cancer-free and sent on my way.
The problem was that I was actually feeling worse. My symptoms had not gone away, and my energy levels were at an all-time low. With my three daughters all in their early teens, I decided to take a break over the holidays and try to get back to normal.
That failed, of course, and in early 2014, I changed providers to the University of Minnesota. I met my new internal medicine doctor on a Tuesday morning. He immediately pulled up my CT scan from the previous summer, and with three clicks of the mouse, he looked at me and said those dreaded words:
“YOU
HAVE CANCER.”
With the mouse, he circled it on the computer screen. He apologized for being so blunt, and through tears, I thanked him for at least figuring out my health issue .
My new oncology team recommended a biopsy procedure, which was soon scheduled for three weeks later to confirm the CT findings. My diagnosis of non-Hodgkin’s lymphoma came back in March 2014, a full year after my initial feelings of not being well.
I realized life would be irrevocably changed. I was facing eight rounds
of aggressive chemotherapy. If successful, that would be followed by 12 rounds of maintenance chemo over the next two years.
While the treatments proved successful, my career as a fire captain on Minne sota’s St. Paul Fire Department ended. Unable to return due to continued chemotherapy treatments. I abruptly retired on July 30, 2015.
TO SAY THIS WAS A DARK TIME FOR ME WOULD BE AN UNDERSTATEMENT.
I had career aspirations — those were gone. I had retirement goals — those were taken away. I repeatedly asked, "Why me?" It took a very long time to come to grips with being out of control of my own destiny and not leaving the fire service on my own terms. Hell, I didn’t even get the opportunity to formally retire and have a party to say thank you and goodbye to my friends and colleagues.
With my early retirement, my whole world was thrown for a loop. My career, identity, income, and retirement plan felt directionless at best. I didn’t have a plan for a shortened career ended by illness (who does?).
During my two-plus years of treatment, I was fortunate to discover the Firefighter Cancer Support Network. Mark Dickinson, a co-worker at SPFD and a cancer survivor himself got me involved. I started by scouring the FCSN website for facts and information to become better informed. I then transitioned into something I had never envisioned: becoming an educator. Using grant funding through Century College and the FCSN curriculum, Chief Dickinson and I brought the first cancer awareness training to Minnesota and the St. Paul Fire Department.
During this time, I taught many departments in Hennepin County and the greater Minneapolis area. Many of their chiefs recognized the need for better health and wellness for firefighters.
OUT OF THIS GROUP, THE MINNESOTA FIREFIGHTER INITIATIVE (MNFIRE) WAS BORN IN 2016.
MnFIRE’s goal is simple: to provide Minnesota’s firefighters the tools they need to prioritize and protect their health.
Recognizing my passion for advocating and educating Minnesota firefighters, Chief Dickinson graciously relinquished the title of FCSN state director, and I was brought in as his replacement. As FCSN Minnesota state director, I also became a mentor for other affected firefighters.
Mentoring fellow firefighters has been a rewarding experience that allows me to guide and support them on their personal and professional journeys.
Ultimately, mentoring for me is about creating a positive impact for sick firefighters, supporting their loved ones, and providing any measure of comfort during the challenge of their lifetime, all while knowing the outcome is not always positive.
I CANNOT STRESS ENOUGH THE IMPORTANCE OF FIREFIGHTERS HAVING SOMEONE TO TALK TO WHO HAS SHARED THIS EXPERIENCE.
As I reach the twilight of my career, my last goal is to leave the fire service in a better position than I found it: safer, healthier, and more educated about the scourge of firefighter occupational cancer, fully aware that not all dangers can be eliminated.
I speak for the voices that are no longer here—my friends and colleagues: Captain Mike Paidar, Firefighter Brett Boss, and Captain Larry Goodman, to name just a few. I walked with them on their journeys, and it is my duty and honor to carry on their legacies and memories.
THREE KEY, CONTROLLABLE PILLARS OF FIREFIGHTER HEALTH PLAY AN OUTSIZED ROLE IN WHETHER FIREFIGHTERS WILL GET CANCER
DEPRIVATION IMPACT CANCER RISK SMOKING , OBESITY & SLEEP
By Brittany S. Hollerbach, Ph.D, Sara A. Jahnke, Ph.D, NDRI-USA, Inc.
In addition to the various risks firefighters face on the fireground, there is something looming way off in the distance, catching many off guard: cancer.
Firefighters face increased risks of cancer due to a combination of occupational hazards and lifestyle factors. In fact, in 2022, the International Agency for Research on Cancer
officially designated firefighting as a Group 1 carcinogen on the basis of sufficient evidence for cancer in humans.
IARC also concluded that there is strong mechanistic evidence that occupational exposure as a firefighter shows the following key characteristics of carcinogens in exposed
humans: is genotoxic, induces epigenetic alterations, induces oxidative stress, induces chronic inflammation, and modulates receptormediated effects. The Group 1 evaluation for occupational exposure as a firefighter should be presumed to apply to all firefighters (including volunteers) and to both men and women.
Firefighters face complex occupational exposures due to the wide variety of emergencies they respond to. In addition to hazards faced on the job, firefighters’ personal behavior also impacts their cancer risk. There are several behavioral factors known to increase cancer risk common among firefighters – take smoking, obesity, and sleep deprivation, for example.
Although smoking is a general risk factor for cancer, firefighters are exposed to additional carcinogens from burning materials such as asbestos, polycyclic aromatic hydrocarbons, and volatile organic compounds.
When combined with smoking, the risk is amplified due to synergistic effects.
REPEATED EXPOSURE TO TOXINS FROM SMOKING
PREVENTS THE LUNGS FROM EFFECTIVELY REPAIRING THEMSELVES, COMPOUNDING
DAMAGE OVER TIME.
Smoking can also impact a firefighter’s ability to receive presumptive cancer coverage.
If there is any good news in all of this, it’s that cigarette smoking among firefighters has decreased. That’s likely due to non-smoking policies and cultural shifts
within the fire service and the general public.
HOWEVER, SMOKELESS TOBACCO USE IS ON THE RISE.
According to research by Dr. Sara Jahnke, the Director of the Center for Fire Rescue & EMS Health Research, and colleagues, tobacco use among male firefighters is still high. In a study published in 2015, Jahnke and colleagues examined a large
national cohort of career firefighters. Among 947 male firefighters, 21% were tobacco users, of which, 34.5% used cigarettes, 53.2% used SLT, and 12.2% indicated they used both cigarettes and smokeless tobacco. Tobacco use among women firefighters was markedly lower than their male counterparts but was similar to adult American women.
Unadjusted smoking and SLT rates among 1,712 women firefighters were 5.1% and 1.2%, respectively.
Obesity (defined as a body mass index, or BMI, of greater than or equal to 30) is linked to several cancers including colorectal, breast, liver, and kidney cancers, through chronic inflammation and hormonal imbalances. Firefighters often develop obesity due to the combination of irregular eating habits (as shift work disrupts routine meals), reduced physical activity after injuries or from sedentary tasks during downtime, and stress eating as a coping mechanism after traumatic incidents or over the course of a career in the fire service.
Chronic inflammation occurs when fat tissue
releases inflammatory molecules like cytokines, creating an environment conducive to cancer growth. Adipose (fat) tissue increases the levels of hormones such as estrogen and insulin, both of which are linked to cancer development.
Obesity can also lead to insulin resistance and elevated insulin-like growth factors, which promote tumor growth. With obesity, firefighters are more likely to develop metabolic disorders, which impair recovery and further increase cancer susceptibility. Our research by Jahnke and others has found that anywhere from 73% to 88% of firefighters are
classified as overweight or obese – a rate which surpasses that of the U.S. adult population.
Firefighters tend to gain weight steadily throughout their careers due to occupational stress, shift work, and disrupted sleep patterns. Research shows that younger firefighters, especially those under 45, experience more significant annual weight gain— around 1.5 to 3.3 pounds per year – compared with older firefighters, who gain weight at a slower rate, typically 0.7 to 1.1 pounds per year.
Over a typical 25-year career, this gradual
increase can accumulate, with estimates suggesting that firefighters may gain between 30 and 85 pounds without intervention. This trend has significant implications for health, as weight gain is associated with a higher risk of cardiovascular diseases, diabetes, cancer and jobrelated injuries, further impacting performance and well-being in later career stages.
DISRUPTIONS IN CIRCADIAN RHYTHMS INCREASE THE RISK FOR CANCERS
BREAST, PROSTATE, AND COLORECTAL CANCERS
How many times have you heard firefighters say some variation of “ I’LL SLEEP WHEN I’M DEAD”?
Well, sleep deprivation increases the risk of cancer through several biological mechanisms, particularly by disrupting the body’s immune function, circadian rhythms, and hormonal balance.
IN FACT, IN 2020, IARC CLASSIFIED NIGHT SHIFT WORK AS “PROBABLY CARCINOGENIC TO HUMANS”
(Group 2A) on the basis of limited evidence of cancer in humans (for cancers of the breast, prostate, colon, and rectum), sufficient evidence of cancer in
experimental animals, and strong mechanistic evidence in experimental animals. Firefighters frequently endure poor sleep quality, disrupted sleep and insufficient sleep duration due to irregular shift patterns, long shifts, nighttime calls, and the high mental acuity required on shift.
PERSISTENT INFLAMMATION CAN CONTRIBUTE TO DNA DAMAGE AND PROMOTE TUMOR GROWTH OVER TIME.
CHRONIC SLEEP DEPRIVATION IMPAIRS THE BODY’S ABILITY TO DETECT AND DESTROY EMERGING CANCER CELLS.
Natural killer cells, which are responsible for targeting tumor cells, become less effective with insufficient sleep. Sleep loss triggers systemic inflammation, which creates an environment conducive to the development and progression of tumors.
Circadian rhythms regulate essential biological processes, including cell division and DNA repair, which occur more efficiently during specific phases of the sleep-wake cycle. Shift work or fragmented sleep can disrupt these rhythms, impairing the body’s ability to repair cellular damage and increasing mutation rates.
Studies show that disruptions in circadian rhythms increase the risk for cancers like breast, prostate, and colorectal cancers.
For instance, melatonin, a hormone that regulates sleep, has antioxidant properties and helps suppress tumor development. Reduced melatonin levels due to poor sleep increase cancer susceptibility.
Lack of sleep combined with regular exposure to carcinogens lowers the body’s ability to eliminate precancerous cells, compounding cancer risks over time.
The toxic exposures faced by firefighters, along with lifestyle risks such as smoking, obesity, and sleep deprivation, interact in ways that magnify cancer risks.
Addressing these factors through targeted health programs—such as smoking cessation, physical fitness plans, and sleep recovery strategies— could help reduce cancer incidence in this vital and high-risk population.
How I Saved My
SUPPORTING OTHER FIREFIGHTERS WITH CANCER AND BEING SUPPORTED CARRIED ME THROUGH ROUGH TIMES
By David McElroy, FCSN State Director for
New
Hampshire, FCSN Mentor
Support is so important to a cancer fight.
Forty-one years into my career, and suddenly, I WAS FIGHTING FOR MY LIFE. It was not how I imagined leaving the fire service.
In November 2017, I was diagnosed with colon cancer, which was discovered following a colonoscopy secondary to GI concerns. I had a surgical resection and revision of my colon; at that time, my cancer was considered stage one.
This is your desired news; no further treatment is needed, but a follow-up colonoscopy in three years is suggested.
Fast forward to April Fools' Day 2020 (no joke), where a CT scan of my abdomen showed a 6-cm tumor in my colon. A colonoscopy and a biopsy discovered adenocarcinoma (which is a type of cancer that starts in the glands that line the insides of organs) in the tumor and in five of the 15 lymph nodes sampled. Several nodules in my lungs were too small to biopsy, so we would watch them.
Twelve rounds of chemo followed by 32 rounds of radiation later, I received the news the treatments had placed me into remission. AGAIN, I BEAT CANCER; WHAT A GREAT REASON TO CELEBRATE.
Life
But the celebration would end in April 2022 when a routine CT scan of my chest, abdomen and pelvis revealed a new tumor on the distal end of my liver. Another surgery and the tumor was removed, as well as a small portion of my liver. Again, no further treatment was indicated, another win.
Sadly, in March 2023, my lung nodules had grown, and a biopsy revealed adenocarcinoma plus black lung disease. Strange, but not shocking, to this old firefighter.
Back to high-dose chemotherapy. Unfortunately, the chemotherapy destroyed my hip, which resulted in a new hip, but THE TREATMENTS WERE KEEPING ME ALIVE.
Today, there is good news and bad news. The progression of the disease has stopped, but I will be on chemotherapy for life and maybe more radiation
SUPPORT IS SO IMPORTANT TO A CANCER FIGHT. My department and Chief Mark Tetreault have been amazing in supporting me. Although I can’t respond to emergency calls, I’m not ready to hang up my helmet. They allow me to remain in a support role by helping with training and assisting with projects I can handle.
My initial cancer battle brought me to the FIREFIGHTER CANCER SUPPORT NETWORK. Today, I am the state director in New Hampshire and assist other firefighters with cancer as an FCSN mentor. This work has been incredibly rewarding. It allows me to assist and support other firefighters and EMS personnel as they navigate their cancer journey.
When I began my fire service career in Maine – first as a 15-yearold apprentice EMS provider for York Volunteer Ambulance, then as a firefighter for the York Fire Department – I never thought battling cancer would be part of my career path.
Today, I have been fortunate to have served. It has been extraordinarily uplifting and gives me a sense of purpose. I want every firefighter to understand the environment is much worse today than in my early days in the fire service. LEARN YOUR RISKS, EDUCATE YOURSELF ON THE TOOLS TO PROTECT YOURSELF, AND IMPLEMENT CHANGE IN YOUR DEPARTMENT.
Cancer sucks ; make every effort to change the culture and do the right thing. It could save your life.
Sex, intimacy YOUR DIAGNOSIS AND YOUR
By Carrie Fleetwood, M.Ed., R.P. Registered Psychotherapist
AS WITH ALL OTHER ASPECTS OF HEALTHY INTIMACY, OPEN, HONEST AND EMPATHETIC COMMUNICATION ARE CRITICAL FOR NAVIGATING A CANCER DIAGNOSIS
Your first response, if the cancer was discovered as part of routine blood work or screening, was likely to sense that awful sinking feeling in the pit of your stomach. And depending on the seriousness (what stage the cancer is at), you might well have felt shaken to the core.
YOU DIDN’T SEE THIS COMING.
If you were feeling unwell for some time, your cancer diagnosis came with some relief (an explanation for the symptoms), but also a huge sense of loss of control, uncertainty for the future and possible regret if you’ve been unkind to your body (drugs, alcohol, smoking, overeating, sedentary lifestyle, etc).
The emotional upheaval that comes with diagnosis is multiplied if you have an unsupportive spouse or highly reactive or dysfunctional family and you don’t just carry your own distress but you worry about everyone else’s response
to your dreaded news. Diagnosis can take anywhere from hours and days to months.
WHEN CANCER DOMINATES THE MENTAL AND EMOTIONAL SPACE OF YOUR MARRIAGE, WHAT DOES IT DO TO YOUR SEX LIFE? WHAT SHOULD YOU EXPECT?
Having had two different cancer diagnoses in the past four years, I can add my personal two cents to these questions.
In this first phase, as in future phases of your cancer journey, you will feel vulnerable and in need of empathy, closeness and support. You will want more hugs and touch from your spouse. Ideally, some of these touches will lead to sexual connection and intimacy.
When your mind can be gently persuaded away from the allencompassing cancer diagnosis,
SEXUAL INTIMACY CAN HELP WITH THE SENSE OF STILL BEING LOVED AND DESIRED DESPITE NOT FEELING WELL OR NOT HAVING CONTROL OVER WHAT IS COMING NEXT
The key to all sexual success during the many months or even years of the cancer roller coaster is communication and flexibility. Keep your spouse informed about how your body feels and whether or not your mental state can make room for love-making.
You can use a 10-scale with zero being “no interest or energy” for it, four being “the spirit is willing, but the body is weak,” six being “worth a try,” and 10 being “ready to go.”
Expressing desire is always important, no matter how you are feeling. “I wish I were feeling better or healed up because I miss being with you” is one way to express it.
SURGERY AND TREATMENT
Once you have an established treatment plan, which may involve surgery, radiation, chemotherapy, medication, or just “watch and wait,” you will need to be prepared for soreness as the surgery heals,
feeling unwell or downright horrible on some days from chemo or medications. In this next phase, hopefully you will begin to feel less rattled as at least something is being done to treat the cancer
OR TERMINAL PROGNOSIS
Recovery may mean that you are not 100% yet but you’re feeling stronger and more interested in sexual intimacy. If you get the go-ahead from your doctor (if in doubt, don’t be shy to ask), you can enjoy your sex life again. But for a time, you’ll want to be careful about incisions that may still be sensitive. Be sure to check with your oncologist regarding the side effects of your medications.
Sadly, you may be one of those cancer patients who eventually will hear the words: “There is nothing more we can do.” In the palliative stages
of cancer, you will likely want lots of closeness from your spouse. You will crave touch and skin-to-skin contact or just lying close and often. You may want some sexual contact just to prove you’re “not in the ground yet.” You may feel too sick and be in too much pain to have any sexual interest at all.
Here again, communicate love and desire even if there is no capacity for sex. Since this period of intense decline can be short or long, communication and flexibility are key. Palliative can mean days, weeks or even months, so don’t
in your body. Depending on how intrusive the treatment is and where any incisions are located, you may or may not be interested in sex. Or having sex may not be advisable.
make assumptions. Ask, talk, test the waters, and have fun when there’s a bit of energy. Laugh when you can, even though the end of your life is in sight. Reflect on the good times and the fun sexual experiences you had together.
For my husband and me, cancer has been a reminder of the shortness and uncertainty of life. We might live to 95, but that’s not likely. In the meantime, we’re busy serving others, helping out with the grandchildren, having fun being active and, yes, enjoying sexual intimacy in our aging bodies.
PPE
Cleaning and Decontamination
By Jeffrey O. Stull, International Personnel Protection, Inc.
We all know the importance of cleaning and decontaminating gear. But when is That procedure recommended?
• After any exposure to smoke, whether your clothing appears soiled or not is an exposure that requires cleaning
• If you wore an SCBA and went on air, then you are likely contaminated
When exiting the fire scene, go through preliminary exposure reduction
• While still on air, have another firefighter wash the external surfaces of your clothing with water, a mild detergent, and a sturdy brush, followed by rinsing
• Preliminary exposure reduction will minimize the contamination on the gear and your potential for continued exposure
Correctly doff your clothing
• Avoid touching the contaminated surfaces with your bare hands or allowing clothing to come in contact with bare skin
• Take off your gloves similarly to how you remove medical examination gloves (use each glove to first partially remove the other glove)
• Do not push your contaminated hood back down on your neck. Instead, after you have opened your coat, pull your hood forward off your face along with your SCBA facepiece
Practice proper personal hygiene following any exposurE
• While still on scene, use non-alcohol wet wipes to clean your hands and face
• Isolate all exposed gear into a clear, thick plastic bag for later cleaning
• Keep contaminated clothing out of the apparatus cab or passenger compartment. If gear must be transported in a personal vehicle, place it in the trunk in a bin or other air-tight container
• Ensure that wet clothing is removed at its destination and not kept in the bag for more than 24 hours
• Back at the station, take a warm shower, thoroughly clean your body with soap, and change your uniform (it was exposed too)
• Transport isolated clothing to either the station or the cleaning facility
Select the correct cleaning approach
• For most routine fires, give your gear advanced cleaning using at least a washer/ extractor for the garments, hoods, and textile components of helmets
• Follow the manufacturer instructions or NFPA 1851 requirements for cleaning different clothing items
• If your gear has been heavily contaminated or exposed to unusual contaminants (e.g., a large lithium-ion battery fire), seek advice for specialized cleaning procedures
Give your clothing the appropriate form of cleaning
• Follow your department procedures for cleaning gear, if charged with conducting turnout gear cleaning
• If your department has a centralized cleaning facility, send your gear to that location following your department’s instructions
• If your department uses an independent service provider, ensure that your gear is picked up for cleaning
• Communicate any specific contamination concerns to others who may be performing the cleaning
Ensure that your clothing is inspected before it goes back into service
• Always look at your gear after it has been cleaned to ensure that there is no obvious damage, regardless of who cleaned it
Wendell’s Mint is proud to manufacture high quality American Made challenge coins for the Fire Service community. We are honored to be your partner
Ask yourself...
Does the company charge for artwork?
Does the company charge a premium for multiple painted colors?
Does the company charge a premium for dies based on design complexity?
Does your artwork ever leave the company’s building?
Does the company create the custom design and mint the products in house, or do they outsource to a 3rd party supplier?
Does the company mint the product in the USA, using US workers and US materials?
Does the company competitively price its coins and dies against foreign imported product?
Does the company engrave coining dies in house using CNC technology?
Has the company been in business long enough to count on?
Wendell’s
SARAH'S
SOMETIMES THE SURVIVORS ARE THE ONES LEFT BEHIND; WHAT THEY DO CAN MAKE ALL THE DIFFERENCE TO THE STRICKEN FIREFIGHTER AND THEIR FAMILY
By Russell Osgood, Fire Chief, Vice President Firefighter Cancer Support Network
In memory of Sarah Jean Fox (Cripps)
OCTOBER 9, 1971 - DECEMBER 9, 2011
THE SAD TRUTH IS THAT NOT EVERYONE SURVIVES CANCER. That was the case when firefighter Sarah Fox died, surrounded by family, just before Christmas. She was only 40.
Sarah’s story created a wave not only in our neighborhood but across the nation. To be diagnosed with breast cancer only days before she gave birth to twins is a tale no one wants to tell.
Her fight brought our department together in a way that I had never experienced before. The members banded together to help around the house, watch the babies, help in their small business, and showed up for the family whenever there was a need. WE BECAME SUPPORTERS. NOT OUT OF NECESSITY, BUT OUT OF LOVE. Caring for someone in need is nothing new for firefighters, but Sarah had a great impact on our small department.
We had been so excited when Sarah returned to work in 2009. Having her back on shift, sharing her life and her many hopes and dreams for the future, was an exciting time.
Story
Then soon after she came back, she experienced a pain in her hip. The cancer was back with a vengeance.
THIS TIME THE MEDICAL PROFESSION DEEMED IT TERMINAL.
Sarah, Matt (her husband) and her brothers and sister in the firehouse had other ideas. Not only were we looking for ways to help her, we were looking for a cure. Again, the firefighters and community came together to help and make her life special.
We assisted her with finding a new treatment that extended her time with us. We built a playset for her children because it was her dream to watch her kids play on the structure she was designing when she returned to work. We made a helmet decal to show support.
THE MEMBERS AND COMMUNITY CAME TOGETHER AGAIN. Dozens of events raised thousands of dollars for Sarah and her family. The money was helpful, but it was the help around the house, connecting her with specialists, and
creating special times for her and the family that made the most impact on both the brothers and sisters struggling to see her fight, and to Sarah and her family.
SARAH’S STORY IS NOT UNIQUE IN THE FIRE SERVICE. But it is one that demonstrates that even when we are losing a brother or sister, we can choose to make their time with us special and meaningful.
The brothers and sisters who die from this disease provide us with a story to share. There are some hard truths with cancer. THE SURVIVOR STORIES ARE MEANINGFUL AND PROVIDE HOPE. BUT SO DO THE STORIES LIKE SARAH’S.
Hers is a story of a loss that will never heal for many but has made great impacts across the nation. She was a wonderful firefighter, mother, wife and sister who left us too soon. The people we lose provide an important message. Not everyone is a survivor, but even in death there is hope, like Sarah gave when the pain associated with her cancer stopped that cold Friday afternoon.
SKIN CANCER - WHAT IS IT?
People are most likely to develop one of the following types of skin cancer, melanoma being the most dangerous.
TYPES OF SKIN CANCER
BASAL CELL CARCINOMAS
BCCs are the “best” and most common. They grow slowly and tend not to spread, but they can be locally destructive if neglected. Typically, a BCC looks and acts like a non-healing wound, a pimple, or flaky skin that comes and goes. BCCs typically occur on the head and neck, arms, torso, and limbs.
Many are surprised to learn they have skin cancer, as these lesions do not look scary. Some signs that you
may have a basal cell are frequent cuts during shaving, small head wounds that don’t heal and seeing blood on the pillow when you wake.
CELL CARCINOMA
SCC is the second most common type of skin cancer; the majority of patients have surgery and are cured. SCC looks and feels like dry skin. Should you develop dry skin, apply a moisturizer and keep it bandaged. If no resolution occurs, call your medical provider as you
could have eczema, dermatitis, psoriasis, an infection, or an SCC.
SCC on the lip and the ear is peculiar in that these cancers have a higher rate of spreading to internal organs and can make you very ill or even cause death.
Rough skin on the ear that doesn't go away with moisturizing or lesions that look like a cold sore on your lip but do not resolve after three weeks should prompt you to call your medical provider immediately.
By Dr. Christine Kannler, Dermatologist at PhyNet Dermatology
The most worrisome skin cancer, melanomas, are usually brown spots, freckles or moles that change over time or look different from your other brown spots. The signs and symptoms to look for are:
A. ASYMMETRY
B. BORDERS
C. COLORS
D. DIAMETER
E. EVOLVING
Brown lesions should be symmetrical. If you draw an imaginary line down the middle of the brown spot, each side should be a mirror image in size, shape, and color. The borders should form a distinct line between the edge of the mole and the border of your normal skin. Each brown spot should be one color. When examining
WHAT ABOUT SUNBLOCK?
There are physical and chemical sunblocks. Chemical sunblocks absorb sun rays like a sponge. It's best to apply it in the morning and reapply during the day. These tend to last approximately 3 to 4 hours.
your skin, look for freckles that look different from all the others.
So, if one freckle is much darker than the others or is larger than the tip of a pencil eraser, that is the one you want to note, photograph, and monitor for changes over three to six months. If changes occur, call your doctor and show them your original photo. The bigger the diameter of a brown spot, the greater the risk of it converting to cancer.
Finally, anyone can develop melanoma, even folks with darker skin tones. Bob Marley died from a melanoma on his toe. Those with darker skin tones tend to have a higher risk of developing melanoma on palms, soles, and nails.
DO NOT USE TANNING BEDS
EVEN ONE TRIP TO THE TANNING BED WILL INCREASE YOUR RISK OF DEVELOPING SKIN CANCER.
More SPF is better than less, and you’ll need to reapply often. Physical sunblocks, like long sleeves, are better than chemical blocks. They form a barrier and reflect the sun's rays away from your skin.
SO, WHAT ABOUT FIREFIGHTERS AND SKIN CANCER?
According to the 2014 Nordic study by Pukala et al., firefighters have an elevated risk of melanoma and even death from skin cancer. The study showed that melanomas were found in firefighters aged between 30 and 49, while the average age of melanoma in the U.S. begins to increase in males only at age 50, peaking at 65.
FIREFIGHTERS HAVE A 21% INCREASED RISK OF DEVELOPING MELANOMA COMPARED TO NON-FIREFIGHTERS.
It is worth noting that skin cancers can occur within tattoos and facial hair.
We don't know why firefighters are at greater risk; perhaps it is the carcinogens found at the fire scene and/or the gear. What we do know is firefighters from the World Trade Center cohort who were present in New York on 9/11 and survived had a statistically significant higher rate of melanoma, notably on their backs, compared with other firefighters not present.
The good news is that when melanomas are found early and are excised, 95% to 99% of those individuals live 5 to 10 years after diagnosis.
• Use sunblock.
• Wear rash guards (long-sleeved shirts with sun protection).
• Eat berries with antioxidants every day.
• Eat broccoli several times a week.
• Minimize time spent outdoors between 10 a.m. and 2 p.m.
• Look for moles that are changing size, shape or color.
• Get dermatological exams starting at age 30 or younger.
• Use wipes at the fire scene.
• Shower asap after attending a fire.
HOW YOUR
INFORMATION INFORMATION INFORMATION
CAN HELP FIGHT CANCER
Firefighters with or without cancer, your information is critical for understanding and reducing cancer in the fire service
By
THE ALARM
It’s dinner time at the firehouse. Your engine and rescue crew are sitting down to a well-deserved meal after a day of training and a handful of medical calls and false alarms. The tones sound, and a familiar voice (often electronic these days) begins to methodically dole out an important list of information.
From the first sound of that tone everything stops. Your ears key into that voice, and you begin to hear and process those first bits of information: location, incident type, responding trucks, engines,
etc. – the most important things a crew needs to know at the start.
Firefighters will also consider a variety of things while en route, such as time of day, weather conditions, traffic congestion, water supply and access. Officers will review all notes on the mobile data terminal and/ or audible information provided by dispatch. While the crew approaches the scene, they may look for signs to help with decision making, such as the smell of something burning in the area or a column of thick black smoke. In most cases, the
incident commander will conduct a 360-degree size-up of the incident to gather even more information.
Just as paramedics, firefighters, and company as well as chief officers want as much information as possible for the incident they’re dispatched to, researchers need adequate information to help identify areas of concern and determine effective prevention strategies. Without this data, researchers are ill-equipped to help the fire service fight back against its most pressing issues, including occupational cancer.
NATIONAL FIREFIGHTER REGISTRY FOR CANCER
Fortunately, firefighters can provide much of this data by voluntarily enrolling in the National Firefighter Registry for Cancer. The NFR, which is mandated by law and managed by the National Institute for Occupational Safety and Health, is the largest effort in the United States to better understand and reduce cancer in firefighters.
Enrolling is relatively easy. Firefighters can visit NFR.cdc.gov and create their account, sign the consent form, and complete their user profile in as little as five to 10 minutes. The questionnaire, which collects critical information about their time in the fire service, takes a bit longer, but firefighters can complete it at their leisure by logging in and out of the web portal.
Robert Saunders, NIOSH, Dr. Lindsay Judah, Rick Markley, CRACKYL’s executive editor, Kenny Fent, Manager, Firefighter Health Program, NIOSH
Importantly, firefighters do not need to report a cancer diagnosis to NIOSH. Cancer is a reportable illness in all 50 states. However, most states do not collect detailed information related to an individual’s occupation. By enrolling in the NFR, if you are ever diagnosed with cancer, even 20 years down the road, NIOSH is able to pull in your cancer diagnosis and match it to your profile, hence, combining your work history and other information with your cancer diagnosis.
YOU MAY BE THINKING, I don’t have cancer now and don’t intend to get cancer in the future, so the NFR doesn’t apply to me?
Firstly, we sincerely hope that no one gets cancer, but unfortunately, cancer is relatively common. In the United States, 40.5% of men and women will be diagnosed with cancer at some point in their lives (Cancer Statistics - NCI). Secondly, even if you are never diagnosed with cancer, your information is still extremely useful. Having firefighters with and without cancer enrolled in the NFR allows researchers to examine what factors are most associated with increasing cancer
risk. Your participation helps the entire fire service and especially those who have an unfortunate cancer diagnosis.
Firefighters of all different backgrounds are critical to the success of the NFR. The NFR is especially interested in studying cancer risk among groups who have been historically under-represented in research. This includes firefighters in rural areas, volunteer firefighters, women firefighters, racial and ethnic minority groups of
firefighters, and various sub-specialties of the fire service (wildland, military, airport, and industrial firefighters, as well as investigators, instructors, and inspectors).
NIOSH’s goal is for 200,000 firefighters to enroll in the NFR. That sounds like a lot, but it’s only around 10% of the total eligible population (there are about 1 million active firefighters and another million who have left the fire service).
YOUR FIRE SERVICE STORY MATTERS
If you knew your story could help prevent cancer in the fire service, would you share it?
The National Firefighter Registry (NFR) for Cancer needs firefighters to share information about their work history and exposures to better understand the link between firefighting and cancer. Your story can help pave the way for new health and safety measures to keep future firefighters safe.
Learn more at CDC.gov/NFR
KNOWLEDGE GAPS POTENTIAL IMPACT
In 2022, the International Agency for Research on Cancer classified the profession of firefighting as a Group 1 known carcinogen to humans. This was based on sufficient evidence of increased risk of mesothelioma and bladder cancer in firefighters. IARC also found limited evidence for colon cancer, prostate cancer, testicular cancer, melanoma of the skin, and non-Hodgkin lymphoma.
Many knowledge gaps have been identified through the research that fed into the IARC evaluation. The truth is there’s a lot we don’t know.
There may be other cancers that occur at higher rates and/or at younger ages in firefighters than the general population, but we currently have incomplete data to examine this. Cancer risk may also vary between men and women, among different racial and ethnic groups, across the different specialties of the fire service, and even regionally across the U.S., but we haven’t been able to evaluate this yet.
We don’t fully understand how occupational exposures contribute to the cancer risk – in part because there is no national database that contains information on firefighters’ incidents and exposures. This knowledge gap is exacerbated by the increasing incidence of natural disasters and other major events. We don’t know the extent that responding to these events impacts one’s cancer risk.
Much of the information needed to fill these knowledge gaps is being collected through the NFR. When this data is collected for hundreds of thousands of firefighters, and further matched to cancer diagnoses over time, researchers can begin to answer the difficult questions that remain and provide findings that support new policies or procedures. Over time, the NFR may be able to:
Identify cancers that have not previously been associated with firefighting. This could lead to increased medical surveillance for these cancers.
Find that firefighters are diagnosed at younger ages for some types of cancer. This could lead to revised cancer screening guidelines.
Identify specific work factors that increase firefighters’ risk of cancer. This could lead to revised policies, procedures, or even equipment.
Identify protective practices associated with reduced cancer risk. This could provide evidence to support the funding and adoption of these practices more broadly.
PRIVACY AND DATA SECURITY
Privacy and data security are top priorities for the NFR. Firefighters register for the NFR through a secure website using multi-factor authentication. They then create an account through Login.gov, which is a single sign-on solution for U.S. government websites. When completing the registration process, firefighters are automatically logged-off if there is no online activity for five minutes. When they
save or submit the questionnaire, their information is recorded on a secure encrypted database
Only authorized NIOSH researchers will have access to identifiable information collected as part of the NFR. Data collected through the NFR are protected by an Assurance of Confidentiality, which is the highest level of protection available for public health data.
The AoC states that no identifiable
information may be disclosed without the consent of the individual and is even protected from subpoena.
Just like the critical data required to effectively respond to structure fires and other emergency incidents, your data is critical for our collective evaluation of cancer in the fire service. Your individual information, including details about your career, is vital.
THE WELCOMING SUPPORT OF PALLIATIVE CARE
WHEN BEGUN EARLY, THIS FORM OF CARE CAN TREAT THE ENTIRE PERSON THROUGH THE ENTIRE PROCESS
By Michelle Capobianco, CEO of Pancreatic Cancer North America
Those affected by cancer often experience emotional distress, an increased need for mental health support services, and a diminished quality of life. Which is where palliative care comes in. It offers compassion and support for firefighters facing cancer.
Palliative care also provides symptom relief and comfort for those living with serious illnesses. It also provides support to caregivers and those impacted
by a loved one’s condition. The focus is on helping people live well for however long that may be
HOWEVER, PALLIATIVE CARE IS TOO OFTEN OVERLOOKED AS AN OPTION FOR PATIENTS UNTIL THE END STAGES OF CANCER.
The healthcare system often prioritizes medical treatment over a patient’s quality of life. Palliative care
is a holistic approach that focuses on the physical, emotional, and spiritual needs of the patient and their family
It helps patients maintain their dignity and quality of life.
For a patient with cancer, the palliative care team collaborates with the cancer care team to manage the pain, the side effects of treatment, and the anxiety and mental suffering of a cancer diagnosis.
WHAT IS THE DIFFERENCE BETWEEN HOSPICE CARE AND PALLIATIVE CARE?
HOSPICE CARE
While both services aim to facilitate symptom management and provide relief from suffering, hospice care is provided to patients near the end of life, with a high risk of dying within six months, and who will no longer benefit from or have chosen to forego further disease-related treatment.
PALLIATIVE CARE
Palliative care, on the other hand, is often misunderstood. Many studies suggest that palliative care is most effective when started early, closer to diagnosis. Palliative care is far more expansive than end-of-life health care. It aims to ease a multitude of distressing symptoms like:
And it can provide advanced care planning and a support system to help you live a life that is as active, fulfilling, and pain-free as possible.
Assessing and managing poorly controlled physical, psychological, social, and spiritual stressors.
THE FOUR KEY BENEFITS TO PALLIATIVE CARE
Better understanding of the illness, its expected trajectory, and treatment options.
SAYS DR. JUSTIN SANDERS, DIRECTOR OF
Exploring the hopes, worries, goals, and values; cultural or religious beliefs that impact patient care or treatment decisions; treatments the patient may or may not want; and what quality of life means to them.
Discussing and documenting the patient’s health care proxy and end of life preferences, including medical interventions which are or are not wanted.
PHYSICAL
6 Steps
to Survive the Emotional Toll of a Cancer Diagnosis
BEATING CANCER PHYSICALLY IS ONLY HALF THE BATTLE: THE MENTAL TOLL CAN BE JUST AS DEMANDING AND INTERFERE WITH YOUR ABILITY TO PHYSICALLY HEAL
By Jim Burneka Jr., Retired Firefighter and Author of Overcoming Tuesday
A cancer diagnosis can be overwhelming, so it’s natural to worry about how it might affect you physically. You will soon learn about the treatment options available, including surgery, chemotherapy, and radiation, all of which can range from short-term to long-term.
While these physical treatments are important, it’s also crucial to acknowledge that the emotional challenges associated with cancer can last far longer.
As firefighters, we frequently take on extraordinary challenges and feel an illusion of invulnerability. Yet, everything shifts when you hear the words, “I’m sorry, but you have [fill in the blank] cancer.” In that moment, you confront your own mortality. As you grapple with this diagnosis, an array of previously unimagined questions are sure to flood your mind.:
HOW IS THIS GOING TO AFFECT MY FAMILY?
IS MY LIFESTYLE GOING TO CHANGE?
IS IT GOING TO SPREAD?
IS THERE ANY OTHER TYPE OF CANCER IN MY BODY?
IS THIS GOING TO BE COVERED BY WORKERS' COMPENSATION?
AM I GOING TO BE ABLE TO RETURN TO WORK?
Not surprisingly, many of us become depressed when diagnosed with cancer. Cancer is scary, and you are gearing up to fight the unknown. It is easy to succumb to depression and hide out in your bed, disassociate from your friends and loved ones, or get lost in a bottle. You must try your best to stay positive and focus on healing and recovery. We do not have control when it comes to cancer, but we do have control over our attitudes and actions following a diagnosis.
The founder of the Firefighter Cancer Support Network Michael Dubron, used to say, “Once you get diagnosed with cancer, you live the rest of your life with the check engine light on.”
In other words, you’re always going to be waiting for the other shoe to drop. But interventions are available to help combat these head games.
2 1
TALKING TO A CLINICIAN
The safest way to be able to vent and process your cancer diagnosis is through a licensed clinician who is also trauma-trained. Your cancer diagnosis is traumatic, meaning you may benefit from a treatment called Eye Movement Desensitization and Reprocessing. Most trauma-trained clinicians are well versed in using EMDR and can use the treatment to help you process your diagnosis to reduce the emotional toll you are experiencing. Clinicians can also be seen through telehealth, eliminating any transport issues.
FCSN Mentor
An FCSN mentor is a fellow firefighter who is a cancer survivor. You become paired with a mentor when you reach out to the FCSN (866994-FCSN or FirefighterCancerSupport.org). The mentor’s role is to share their experience with the newly diagnosed firefighter. A mentor who has lived through being diagnosed and treated is well-equipped to walk with you throughout your cancer battle. This will be a safe person to vent to, and they can assist in answering your questions regarding treatment, effects on the family, returning to work, and so on.
3 4 5 6
FOLLOW-UP APPOINTMENTS
It’s human nature to feel anxious about your follow-up exams. The closer they get, the more anxious you may become. In the song Crawling Back to You, the late, great Tom Petty wrote, “Most things I worry about never happen anyway.” Try not to spend all your time worrying about something that probably isn’t going to happen.
ASKING FOR HELP
Firefighters can be notoriously stubborn and unwilling to ask for assistance. Being diagnosed with cancer is a valid reason to seek help. You must set aside your pride and let others assist you with tasks such as errands, yard work, meals, and driving to appointments. Having help will reduce your stress and burdens, allowing you to focus on getting better.
DISTRACTIONS
Keeping busy is a great way to escape reality, even for a moment. Idle moments may allow you to think of the “what ifs” and other unhealthy thoughts. Focus on your family, games, hobbies — anything to keep you distracted and prevent you from spiraling into negative thoughts.
THE COMEBACK
Nothing can refocus you quicker than receiving a cancer diagnosis. The immediate goal is to beat your cancer and get back to your way of life. Upon receiving a diagnosis, you can’t help but prioritize what really matters to you. Being diagnosed with cancer is an extreme wake-up call. If you are lucky enough to persevere, you may begin to adopt the mindset of a healthier lifestyle, aiming to make the best out of your remaining years on this planet. The cancer may have knocked you down, but don’t let it knock you out. Fight the good fight and make your comeback all the more epic.
Being diagnosed with occupational cancer is no longer a death sentence. Treatments have vastly improved over the years, and may even allow you to have a lifestyle quite similar to how you were pre-diagnosed. You must be your own advocate to ensure that you are doing everything in your power to beat cancer.
Physically, cancer can take a hard toll on you. Please don’t ignore how the mental aspect of your diagnosis can affect you as well. The mental impact of cancer can be a tough hurdle to overcome, and unlike physical cancer, no medicine will shrink or eliminate it. You need to take action to remain healthy in all facets of your life.
WORKPLACE SUPPORT AFTER YOUR DIAGNOSIS
By Orion Godfrey, Secretary/Treasurer of the
FEELING SUPPORTED IN THE FIREHOUSE CAN MAKE ALL THE DIFFERENCE
Just after midnight aboard the USS Peleliu, the lights came on. We were anchored in Darwin, Australia, and most of my fellow marines and sailors were ashore, enjoying some R and R. As I lay there in my rack, half asleep, I assumed the lights and commotion just signaled a drunk marine coming back to sleep off another fun night.
I was wrong. Those lights introduced us to the chaos that the rest of the world had already
been experiencing for the past several hours and a moment that would forever change our lives. Thanks to the time difference between Australia and North America, it was September 12 in Oz. But in New York City, it was September 11. As information continued to come in, a single image captured my attention: the now-iconic picture of three FDNY firefighters raising the flag on top of the pile. These were three people in the fight — exactly where I wanted to be. When duty
called, they were there. And I was experiencing my first dose of what my kids would now call FOMO (That’s fear of missing out, for you old fogies.)
Several weeks later, my fellow 15th Marine Expeditionary Unit Marines started fighting 1,000 miles away. My job was to support the aircraft that brought them and their equipment deep into Afghanistan. But I wanted to do more. That feeling stayed with me for many
years and eventually pulled me towards the fire service.
I finally started my fire service career in 2008. Goodyear is a small city on the west side of the Phoenix metro area. Our fire department had never had to fight cancer. Then, in May of 2015, my very close friend was diagnosed with leukemia, which was, and still is, a presumptive cancer in Arizona.
I had all the usual feelings after hearing that someone
United Goodyear Fire Fighters
I love is sick. And then I remembered the adrenaline I experienced in Darwin all those years ago. I remembered the desire to do something, to do more, to fight back. At first, as the feeling built, I didn’t know what to do since I felt like I had been punched in the nose. I thought that if this is what it’s like to be a friend, what must it be like to be the one with cancer?
SO WE GOT TO WORK. WE ALL GOT TESTED TO SEE IF WE WERE POTENTIAL BONE MARROW DONORS.
We scheduled a charity event to raise money for him because we knew between the medical bills and lost time at work, he would struggle financially. While at the fundraiser, I encountered another close friend. As I was talking with him, I noticed that his nose was swollen. A few other firefighters and I busted his chops, saying that his smart mouth must have finally caught up to him.
Little did we know. It turned out that day had been his last of regular duty as a firefighter. In a few days, he would be diagnosed with cancer. A few weeks later, he would have his first surgery, and in less than four years, he would be gone from us forever.
During those years, we were afforded the opportunity of a lifetime. We got to watch two of the strongest men on this earth fight cancer in their personal ways.
THEY DID EVERYTHING ON THEIR TERMS, WHENEVER POSSIBLE. THEY SHOWED US HOW REAL FIREFIGHTERS ACT WHEN THE CHIPS ARE DOWN.
They talked with the membership about their experience. They got active in politics. They were and remained amazing fathers, husbands, friends, and firefighters. They were exemplary. One even got to play a role in updating Arizona’s presumptive legislation, moving it from a guilty-until-proveninnocent law to one of the country’s premier presumptive laws.
THE GOODYEAR FIRE DEPARTMENT WAS WITH THEM EVERY STEP OF THE WAY, UNITED IN THEIR ACTIONS.
With the efforts of our labor-management team and complete buy-in from the membership, we turned our department’s cancer culture around virtually overnight. When building new fire stations came into the conversation, we knew second-best would be unacceptable. We worked
We didn’t allow their losses to go unnoticed. “If you won’t do it for yourself, do it for them” became our rallying phrase. We learned about the carcinogens that cause cancer. We discovered particularly hazardous areas around our city. We dug in and let the problem guide us no matter its direction. We created work groups within our labor-management process for PPE, station and apparatus designs, cancerrelated training, and many other things that would help keep us safe and allow us to serve the public.
Whenever I open my phone now, I see a picture of my friend who was taken from this world too early. Next to his face are my four ongoing goals:
• IDENTIFY THE RISKS
• REDUCE EXPOSURES
• EARLY DETECTION
• CHANGE LEGISLATION
These four goals have helped drive me to be the best version of myself.
We all have examples like this that can and should drive us toward improvement. I’ve used these experiences to help create and sit in the position of Cancer Claims Coordinator for the
“IF YOU WON’T DO IT FOR YOURSELF, DO IT FOR THEM” BECAME OUR RALLYING PHRASE
through the politics and have fought to ensure that, going forward, every Goodyear Fire station built will be the absolute best station available.
Professional Fire Fighters of Arizona. In addition, I currently occupy one of the five governor-appointed positions on the Arizona Industrial Commission.
We can’t extinguish cancer from the fire service. When going into a burning building, saving lives is part of the job.
FIREFIGHTERS WILL GET SICK. BUT THERE IS SO MUCH WE CAN CONTROL.
A second set of gear, clean-cab apparatus, and modern fire stations provide major protective measures to help us prevent cancer within our organizations . These are expensive and longterm goals, but through effort, they can be reached. We've proven as much. Other measures such as post-fire decon, wearing your SCBA throughout firefighting activities, and an early shower can all be done with no added cost.
REGARDLESS OF EXPENSE, EVERY PREVENTATIVE MEASURE TAKES A CULTURE CHANGE.
We, as a profession, must recognize our situation. We must remind ourselves that there is no number after 911. Firefighters don’t leave when emergencies happen until we have fixed the problem.
We can engage the enemy or choose to watch, but make no mistake, we are in the fight, and our foundation is each other. We can ensure that when the proverbial Mrs. Smith calls for help, we are ready to do what must be done.
Beginning with taking care of ourselves.
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o r a f i n e u p t o $ 5 0 , 0 0 0 o r d o u b l e t h e v a l u e o f t h e f r a u d , w h i c h e v e r i s g r e a t e r , o r b o t h i m p r i s o n m e n t a n d f i n e
Tony Young
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Founded by Firefighters and made in the USA. We take pride in designing the most advanced next-to-skin PFAS-free merino wool clothing and station wear for professionals in high-risk environments and everyday adventurers.
The law firm of Barasch & McGarry represents 9/11 victims, including responders, survivors, and their families. With over 30,000 clients, they help secure compensation and medical care through the Victim Compensation Fund and World Trade Center Health Program.
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Healthy Response is dedicated to supporting the health and well-being of firefighters. Our holistic approach combines clean, trusted supplements formulated by a registered dietitian with an understanding of the unique challenges faced by first responders.
The Inova Saville Cancer Screening and Prevention Center is your medical home for cancer prevention and early detection. It's a place that can not only assess your risk of developing cancer, but one that can also provide you with a proactive plan to reduce that risk. www.inova.org/saville
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MSK Direct connects you and your family to world-class cancer experts at Memorial Sloan Kettering Cancer Center. From finding the right treatment to understanding your risks, we support you every step of the way.
The National Firefighter Registry for Cancer is the largest effort undertaken to understand and reduce cancer among U.S. firefighters. All firefighters - with or without cancer - are invited to join at NFR. CDC.GOV.
The National Volunteer Fire Council is the leading nonprofit membership association representing the interests of the volunteer fire, EMS, and rescue services and provides resources, programs, education, and advocacy for first responders across the nation. www.nvfc.org
We specialize in cleaning and repairing firefighter turnouts, ensuring they meet NFPA safety standards to reduce cancer risks. We use advanced techniques to remove harmful contaminants, extending gear lifespan while prioritizing firefighter health and safety.
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