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Teaching firefighters to detect occupational cancer

A Massachusetts-based nonprofit is helping save firefighters’ lives with early cancer detection

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Worcester firefighters hear a 15-40 Connection presentation.

Photo/15-40 Connection

Statistics prove that early cancer detection saves lives, but would you be able to recognize a cancer symptom?

This question is one of many that 15-40 Connection – a Massachusetts-based nonprofit organization that provides early cancer detection education programs – strives to help firefighters answer with certainty.

The decade-old organization, which began its initiative focused on first responders over a year ago, has partnered with nearly 40 fire departments and taught early cancer detection education to over 2,000 firefighters.

“We began working with fire departments a year ago when we learned of the significant increased cancer risk firefighters face,” said Tricia Laursen, president and executive director of 15-40 Connection. “Firefighters are strong and tough so they don’t react to subtle health changes even when they persist because, like many, they don’t know it could be an early sign of cancer.”

The organization’s 3 Steps Detect program trains departments free of charge and is a one-time 30-40 minute class. The class teaches through the experiences of cancer survivors, Laursen said.

“We check back in with departments to offer refreshers, classes for new recruits, and we’ll be launching supplemental training to dive deeper into topics like how to share information with your doctor and how important that can be to helping you save your own life,” Laursen said.

Most recently, 15-40 Connection has partnered with the FDNY to have its 11,000-plus uniformed firefighters learn the 3 Steps Detect education over the next 14 months. The organization will be providing support to the FDNY while the department’s instructors deliver the early detection education to its members.

“We hope this can be the final piece of the puzzle in FDNY’s robust cancer education program and that it will lead to more early diagnoses,” said Carl Setterlund, digital communications and media relations manager for 15-40 Connection.


Photos, left to right - 15-40 president/executive director Tricia Laursen teaching 3 Steps Detect to FDNY members. 15-40 VP of Development Alec Elbert teaching 3 Steps Detect to FDNY members.

Photos/15-40 Connection

To those who are curious, the organization’s name reflects the first data set they were shown. “From 1975 to 2000, cancer survival rates for those in the 15 to 40 age range barely improved,” Laursen said. “Fifteen to 40 is a diverse age group – teens to parents – but the impact of delayed diagnosis was clear.”

Unfortunately, delayed diagnosis is a shared connection for people of all ages and occupations – including those in the fire service.

‘It’s not just a big city issue; it’s happening everywhere’

Fitchburg (Massachusetts) Fire Department Fire Captain P.J. Roy has been a firefighter for 15 years. His firefighter father, James Roy, a 39-year fire service veteran, was diagnosed with neck and throat cancer in 2012.

Before he was diagnosed, Capt. Roy said his father knew something was wrong but waited to get checked by a doctor. “He kept thinking it was going to get better, but it didn’t … it just got worse,” he said.

When Capt. Roy was finally able to convince his father to see a doctor, the doctor took one look at him and told him to start treatment immediately. “He had chemotherapy and radiation and that shrunk the tumor, but it didn’t go away,” he said.

His father then underwent a 16-hour surgery, where doctors removed his right jawbone, five teeth, the lymph nodes in his neck, his tonsils and a portion of his tongue and roof of his mouth. “They basically rebuilt his whole face. Doctors said he was on the mend; he was making strides, but at the same time, he was having some difficulty breathing,” he said.

While on shift, Capt. Roy and his firefighter brother rushed to their parents’ home when his mother couldn’t get back inside the house after running errands. After entering the house, they found their father, who had just undergone a successful surgery and was at home recovering, dead. He was 62.

“It was one of the most difficult calls we have ever gone on,” Capt. Roy said. “Since then, I’ve made it a goal of mine to try and get the word out to our firefighters however we can.”

Through the Massachusetts Fire Academy, and with the help of the Firefighter Cancer Support Network (FCSN), Capt. Roy delivers a class to any firefighters or fire departments in the state. Their two-hour presentation has now been delivered over 300 times to roughly 4,000 firefighters. But, while Roy and the FCSN were delivering their classes, they realized a key component was missing – their program was teaching firefighters about cancer prevention, but not about early detection.

To deliver a broader presentation, they teamed up with 15-40 Connection. “We deliver the presentation to firefighters, and then 15-40 Connection delivers their presentation right after, advising firefighters how to check themselves, why early detection is key and what symptoms to look for,” he said.

This dynamic class is unlike any other in the country, Capt. Roy said: “We really put an emphasis on getting yearly checkups. If anything over two weeks is bothering you, get it checked out right away. This is another tool in the toolbox. If departments don’t buy-in, then our firefighters are just going to keep getting sick and dying.”

Outside of Massachusetts, Capt. Roy has delivered his presentation throughout numerous New Hampshire towns and accompanied 15-40 Connection to help educate FDNY officials about their program.

“Firefighters have this mentality that it’s not going to happen to them,” he said. “Now you can go into a department anywhere and find somebody that knows someone who has been affected by cancer in the fire service.”

Capt. Roy makes it a priority to stress 15-40 Connection’s mission – that early detection can save life your life if you know how to identify the warning signs. “Find it and take care of it early … don’t sit on it like my father did – when it’s too late and you’re taking measures to get ahead of it and it doesn’t work out like it should,” he said.

After Capt. Roy’s father died, another firefighter from the same department died from occupational cancer three years later. And almost a dozen other firefighters from his department have received cancer diagnoses and have either battled and beaten it or had to retire.

“Our union president is battling brain cancer right now,” he said. “The hits just keep coming; it doesn’t just happen to our guys – it’s not just a big city issue; it’s happening everywhere.”

So much so that about 40 miles south of Fitchburg, another fire department is dealing with the loss of their fire chief to occupational pancreatic cancer.

‘The training is worth its weight in gold’

In November 2017, Watertown (Massachusetts) Fire Department Chief Mario Orangio died from job-related pancreatic cancer. He was 51.

After Chief Orangio’s death, Robert Quinn became chief of the department. He has held the position for two years now.

“Since we lost our chief to cancer at a young age, we were already in tune with the needs to do what is necessary to protect ourselves,” Chief Quinn said.

However, when 15-40 Connection reached out to the department, Chief Quinn said the organization’s training put another tool in his department’s toolbox to help protect his members.

“That is my number one goal as fire chief – the health, wellness and safety of all our firefighters,” he said.

Before collaborating with 15-40 Connection, the department had already changed many of their procedures, including the addition of responder wipes, laundry procedures for turnout gear and developing post-fire procedures to ensure firefighters clean themselves of toxins. Now, the education taught by 15-40 Connection is also part of their procedures.

“I feel that any information I can give to my department members to educate them about cancer and detecting cancer early is a great thing for their long-term health,” Chief Quinn said, adding that he carries 15-40 Connection’s card in his wallet so he always has it. “The department members appreciated the information, and it was something simple they could do to check themselves or family members if necessary.”

At the end of the day, any education to detect cancer is helpful, Chief Quinn added.

“If the 15-40 training detects one cancer, then the training is worth its weight in gold,” he said.

And, the proof is in the statistics.

Making change in the fire service

The five most common cancers diagnosed in the U.S. are breast, colon and rectal, lung, melanoma (skin) and prostate.

Laursen’s research shows the following survival rates for the these cancer diagnoses, with the first number being the survival rate for early detection and the second number being late detection:

  • Breast: 99% / 27%
  • Colon and rectal: 90% / 14%
  • Lung: 56% / 5%
  • Melanoma (skin): 99% / 20%
  • Prostate: 99% / 30%

Through the power of early cancer detection, 15-40 Connection hopes to save as many firefighters’ lives as possible, Laursen said.

“We want all firefighters in the U.S. to be able to seize the power of 3 Steps Detect,” she said. “They are all such important community members; we want them to stick around.”

And, to the departments that resist such change, Capt. Roy underscored that change is no longer optional – it’s crucial.

“There’s a mentality in the fire service that we’re untouchable and nothing is ever going to happen to us,” he said. “As firefighters, we hold onto tradition quite a bit, but some of the traditions we have aren’t the greatest, including the mentality that you’re not a good firefighter unless you have a blackened helmet and ripped up gear. This needs to change. It has to change.”

Editor’s Note: Did you get an early occupational cancer diagnosis? Share your story at

Sarah Calams, who previously served as associate editor of FireRescue1 and Fire Chief, is the senior editor of and In addition to her regular editing duties, Sarah delves deep into the people and issues that make up the public safety industry to bring insights and lessons learned to first responders everywhere.

Sarah graduated with a bachelor’s degree in news/editorial journalism at the University of North Texas in Denton, Texas. Have a story idea you’d like to discuss? Send Sarah an email or reach out on LinkedIn.