The Firefighter Cancer Support Network has existed since 2005, which means it had five years of operations under its belt before the landmark NIOSH Study of Firefighters revealed how firefighters develop testicular cancer at twice the rate of men in the general population. FCSN president Bryan Frieders assumed his leadership role only a few years after the results of the study were unveiled, inserting himself on the front lines of the fight to reduce rates of testicular cancer in firefighters. This has placed Frieders in an ideal position to steer the responses of fire service personnel to positive cancer diagnoses within their ranks, and also guide firefighters contending with cancer past the common physical and emotional obstacles that emerge once they’re forced to digest the terrifying new realities of their lives.
So how does an organization steer its members through such figuratively troubled waters while somehow keeping them motivated enough to risk life and limb to spray literal water on very real fires? Frieders supplied no-nonsense answers to a few crucial questions.
Splice Today: What was it that led to you wanting to be so directly involved in the fight firefighters have been forced to wage against cancer?
Bryan Frieders: A good friend of mine in the fire department was diagnosed with cancer and died three months later. It brought to the forefront the issue of cancer in the fire service, and when we dealt with his passing, it was devastating for the entire department. It also opened all of our eyes to the significant threat that exists just by virtue of our occupation. For me, it was wanting to be involved and wanting to advocate. As firefighters we’re tasked with providing safety and well-being to the public. What we often forget is taking care of ourselves. As far as I was concerned, it was important to really get involved and do what I could in terms of service to minimize the risk of cancer amongst firefighters.
ST: Why is it that the rate of testicular cancer in particular is so high amongst firefighters?
BF: There’s no doubt that testicular cancer has a statistical significance far greater for firefighters than in the general population because of what we do, and because of where our gear sits, and because of the toxins we’re exposed to every day. We go into an ordinary house fire, and we’re exposed to more than 265 known carcinogens—and that’s just what we know of. That’s a significant risk that firefighters take every time they walk into a burning building.
ST: How challenging has it been to roll out the education piece in the fire service? Has there been any resistance or have the firefighters generally been open to it?
BF: I think that overall firefighters have been open to it. The challenge has been trying to make firefighters understand that some of the things that we do and some of the ways we operate are harming them. Added to that is some of the equipment we use to protect ourselves from the thermal implication of fire doesn't protect us from the exposure issues from carcinogens.The overall reception has been fantastic. We’ve been supported by all of the major fire service organizations. We’ve been on what essentially has been a crusade since our white paper was published in 2013 to really emphasize the importance of making sure we’re decontaminating after fires—we’re washing our gear, and we’re wearing our gear properly.
ST: How rapidly have the changes been happening within fire departments to reduce cancer risks?
BF: With any large organization, change is difficult. I think some of those cultural barriers have been challenging, but because of the high incidence of cancer in the fire service today, a lot of agencies and fire departments are looking at this as a top priority. As an example, the Boston Fire Department was one of the first organizations to reach out to us to train their members on how to reduce their risk. I think they were getting one new cancer diagnosis in their department every two weeks. We’ve conducted training for their entire department, and it was well received by everyone from the brand new firefighters to the salty 30-year veterans. People sometimes don’t want to hear it, but what they eventually realize is that cancer is without the most significant threat to firefighter safety today.
ST: What are some of the cultural elements of firefighting that have contributed to the high rates of cancer amongst firefighters?
BF: As firefighters, we’re in the business of helping others. We often don’t consider ourselves when it comes to risk management. We develop this “invincible syndrome.” We never think it will happen to us, and when it does, we’re shocked. Getting past that superhero syndrome has to be one of the top priorities. That has been a barrier. People look at cancer and say, “That’s never going to happen to me,” and then it does. The fire service is a very proud organization steeped in tradition, and trying to break through some of those invincibility barriers has been a challenge, but we’re making really good progress. As we continue the education programs and the advocacy programs and the research across the country, we’re going to be able to have a better understanding of what we can do to at least reduce our risk.
ST: What services does your organization provide to help reduce those risks, and also to help firefighters after they’ve been diagnosed with cancer?
BF: The Firefighter Cancer Support Network provides one-on-one mentors to the firefighters diagnosed along with their immediate families. If a firefighter is diagnosed with cancer, we’ll pair them up with one of our mentors—we have 250 mentors across the country—who are survivors of cancer. We’ll connect them with one another, and the mentor will help the newly-diagnosed firefighter. As you can imagine, it’s a very lonely and scary position to be in, and having an advocate by your side helps ease that pain.
We also have a toolbox that we send them that has all sorts of material inside, and it’s also a place to organize their laboratory work and other information so that they can keep organized—lab test, x-ray results, all that stuff. We have the Firefighter’s Guide to Cancer Survivorship. It’s a 265-page book that we worked with the American Cancer Society in publishing that helps firefighters walk through some of what they’re going to be challenged with during their treatment. It also helps them chronicle their challenges. There’s a guide for the caregivers and the family members that are going to undertake significant tasks and duties as a result of the firefighter being incapacitated. It’s a great book that we’re very proud of.
ST: Are there any things that you do aside from helping the afflicted firefighters directly?
BF: We support research across the country. We advocate for research as it relates to firefighters with cancer. We have a lot of information about what the issues are as it relates to cancer diagnoses and why things are happening. The last part is our education and training program. We do an education program that goes throughout the country that helps fire departments understand their risk and trains their folks to become trainers so that we’re using the force-multiplier technique to try to get the information out there to keep firefighters safe.
ST: What’s the tradeoff between keeping firefighters free from thermal injuries and also keeping them cancer free?
BF: When we designed firefighter turnout gear, it was specifically to protect us from heat and flames when we entered a burning structure. We never knew that the turnout gear needed to protect us from more. So what happens is when you wear the turnout gear, a lot of those toxins enter beneath where the coat and the boots meet, or where the coat and the pants interface is, and it gets up into our skin. When we’re sweating during firefighting operations, which is a very arduous task, those harmful materials are getting absorbed into our skin. One of the things we’re advocating for with firefighters is to get that stuff off of their skin immediately following the conclusion of the fire, so we encourage people to shower within the hour, to use wipes to get the stuff off their skin that they can see, to do what we call gross decontamination, which is to hose all of your gear off as you exit the structure, and then to thoroughly wash their turnout gear once they get back to the station to change everything out. There’s no really good solution other than trying to reduce your risk. It’s a significant issue, and a lot of gear manufacturers are looking at ways to improve that, but they've yet to find a reasonable solution that allows firefighters to do their jobs without impeding their ability to remain healthy. That’s one of the most prominent issues we’re dealing with. It’s a multi-factorial issue that doesn’t have an easy solution. Firefighters are going to continue to be firefighters regardless of how safe we can make the outcomes of the job.