Speakers focus on research, prevention and survivorship strategies
A collaborative approach to cancer research, prevention and survivorship is making a powerful impact on firefighters and their families, according to experts at the National Firefighter Cancer Symposium 2022, hosted by the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine on February 24-25.
“We are working together on collaborative research that can be translated into action and save lives,” said Erin Kobetz, Ph.D., M.P.H., associate director for population science and cancer disparities and director of Sylvester’s Cancer Control Program. “The firefighters teach us what questions to ask and how to translate those questions into actions.”
More than 400 firefighters from throughout South Florida and across the nation took part in the event, hosted by Sylvester’s Firefighter Cancer Initiative (FCI), and held online and in-person at the Braman Miller Center and the Watsco Center on the Coral Gables campus. They were welcomed by Dr. Kobetz, who is also professor of medicine, public health sciences, and obstetrics and gynecology; co-vice provost for research; and the John K. and Judy H. Schulte Senior Endowed Chair in Cancer Research.
“This is our moment to share our experiences, learn the latest research and educate ourselves about making a difference,” said Alberto J. Caban-Martinez, D.O. Ph.D., M.P.H., C.P.H., deputy director of Sylvester’s Firefighter Cancer Initiative and assistant professor of public health sciences.
Noting that early detection of a rare form of leukemia saved his life, Julius Halas, M.S., director of the Division of State Fire Marshal for the State of Florida, said, “We are here to share and promote firefighter cancer prevention and mitigation of exposures to carcinogens, and learn and share best practices with each other. We want more firefighter cancer survivors.”
Halas said the state has approved more than $8.465 million in grants to Sylvester since 2015, as well as additional funds for firefighter cancer decontamination, construction and equipment.
“We achieved this support by working together,” he said. “That’s how we can continue to move forward.”
Reducing Risks and Improving Well-being
Reducing cancer risks and boosting the physical, mental and emotional health of firefighters were key themes of the symposium. For instance, one workshop covered how “Mobile Clinic and Cancer Screening Initiatives” in Florida and Massachusetts have effectively enhanced cancer education and cancer screenings in those states.
On Thursday, Vincent Reynolds, Ph.D., toxicologist and a member of the Aetna Hose, Hook & Ladder Company in Newark, Delaware, led a moment of silent prayer for those who have died of cancer and their families before moving into an afternoon session, “A Risk Assessment Framework to Guide Risk Management Decisions for Cancer in the Fire Service.”
Drawing on the National Research Council’s framework, Reynolds looked at research being done to identify mutagenic and carcinogenic chemicals present in smoke and measure exposures to chemicals that firefighters routinely experience.
“We want to develop epigenetic biomarkers as early markers of risk and preventive strategies that are most helpful to reducing those risks,” he said.
Explaining the changes that cancer causes in cells and tissues, Jesse Salk, M.D., Ph.D., CEO of TwinStrand Biosciences, led a session on “Detection of Mutagenesis and Carcinogenesis Using Duplex Sequencing.”
Gary Krichbaum, M.A., program manager at the First Responder Center for Excellence, and who served on the fire service for Prince George’s County, Maryland, stressed the importance of changing firefighter culture to put a greater emphasis on wellness.
“To effect change, we need to act both as individuals and as a unified force. We need to listen to the science and take better care of ourselves.”
On Friday, Dan Kerrigan, chief of Fire and Emergency Services for Upper Providence Township in Montgomery County, Pennsylvania, gave a presentation on “11 Steps to Creating a Culture of Firefighter Fitness.” He also focused on the importance of personal responsibility in changing the culture of departments across the country.
“We take good care of our equipment, and we need to do the same for our most important assets — our people,” Kerrigan said. “But only about 28% of fire departments place wellness as a priority. So we need to change our department cultures for the better and one step at a time. So, how about mandating annual medical evaluations — and not serving doughnuts during trainings!”
Natasha Schaefer Solle, Ph.D., RN, co-deputy director and research assistant professor at Sylvester, noted that cancer survivorship rates have increased significantly in the past seven years.
“Centralized cancer education, survivor support groups and universal cancer training are positive forces for change,” she said, noting that Sylvester has created an online FCI Cancer Education and Survivorship portal.
Vandana Sookdeo, M.D., M.B.A., director of clinical programs, noted that Sylvester’s survivorship programs — both online and in person are aimed at enhancing the wellbeing of cancer patients and families.
“We use evidence-based research to address everything from physical discomfort to emotional distress,” she said.
Reflecting on the Firefighter Initiative
Over the past seven years, Sylvester’s Firefighter Cancer Initiative has resulted in advancements in research, education, and service to Florida firefighters, Dr. Caban-Martinez said.
“FCI’s innovative and cutting-edge research projects have informed and catalyzed policy change, at the county, state and national levels,” he added.
One example is Florida’s dedicated firefighter cancer registry project, whose research findings have positively impacted workers compensation laws at the state level.
“Our educational efforts have generated new, scalable training and educational modules on protection from carcinogens in the fire service, as well as policies on training new firefighters on the importance of cancer prevention,” he said.
This past year, the FCI team expanded research and outreach services to firefighters in response to the COVID-19 epidemic and the tragic Surfside condominium collapse, Dr. Caban-Martinez said. Studies included COVID-19 screening, testing, and return-to-work strategies, as well as research on how chemicals, like per- and polyfluoroalkyl substances (PFAS) impact immune function and COVID-19 infections in firefighters.
Participating in the DCC
After the symposium, more than 100 firefighters stayed an extra day to participate in the Dolphins Challenge Cancer (DCC) ride, run and walk fundraising event on Saturday, February 26 at Hard Rock Stadium.
“Among the participants were fire investigators who audit the scene after a fire has been extinguished, and who have a particularly high risk for cancer,” Dr. Caban-Martinez said. “Having fire investigators at the DCC brought greater awareness of their plight and the need for research to learn how best to protect them.”
Dr. Caban-Martinez added that DCC participants honor the lives of firefighters lost to cancer, including James “Nate” Leonard, a firefighter-paramedic from Coral Springs-Parkland Fire Department. His wife, Nina Leonard, walked shoulder to shoulder alongside Florida firefighters and the FCI team to celebrate Nate and his service to the community.
Looking ahead, Dr. Caban-Martinez said the Sylvester team will partner with other National Cancer Institute-designated centers to provide connections to their local firefighters on cancer control and prevention research and service strategies.
“Through this effort, we can advance our footprint in protecting firefighters from cancer,” he said. “It is time to drive a national scientific agenda to extinguish cancer in the fire service.”