Calif. firefighters take part in early detection cancer testing

By Robert Summa
Appeal-Democrat

YUBA CITY, Calif. — This week, Yuba City firefighters have been able to take advantage of a testing program that is intended to help detect early signs of cancer to get ahead of an issue that profoundly affects these local heroes and their families.

Available for most of this week, firefighters with the Yuba City Fire Department are able to voluntarily take part in a “multi-cancer early detection test” known as the Galleri test conducted by the company Grail.

“The Galleri test uses a first-of-its-kind technology that screens for a signal shared by 50-plus types of cancer with a simple blood draw,” documentation about the test states. “Adding a multi-cancer early detection test to your recommended screenings can help in detecting cancer early.”

Yuba City Fire Chief Jesse Alexander said Grail partnered with the International Association of Fire Firefighters to provide various fire personnel with this testing process at a reduced price. Thanks to the Yuba City City Council and its budget process, Yuba City firefighters are able to take advantage of this testing for free, Alexander said.

“We advocated during the budget cycle and explained the importance behind the two main causes of firefighter deaths is cancer and suicide,” Alexander said. “So, we’re trying to get out in front and we advocated and made a good argument that it’s just running rampant in the fire service. ... Our goal is to try to catch it in Stage 1 or Stage 2 before it gets into Stage 3 or Stage 4, where that’s where people die and it’s harder to treat.”

Along with providing free testing for current personnel, Alexander said the testing also is available to retired firefighters and families of firefighters at a reduced cost.

According to the Centers for Disease Control and Prevention (CDC), cancer is the leading cause of death among firefighters. When compared to the general population, research has suggested that firefighters also are at a higher risk for developing certain types of cancers — for example, some statistics have shown that firefighters are two times more likely to get testicular cancer than members of the general public.

Alexander said firefighters are particularly susceptible to cancer not only because of the equipment they use, but also the harsh environments they are consistently exposed to.

“We are exposed to cancer all the time. Just in our regular turnouts, it’s called the forever chemical PFAS that can get in your system and cause cancer,” Alexander said.

Turnouts are the personal protective equipment typically worn by firefighters. According to the International Association of Fire Firefighters, “PFAS are a category of manufactured chemicals linked to cancer and other diseases.”

Alexander said that a little more than a year ago, the department was able to switch to different turnouts with a lower PFAS count in them.

“However, it’s still in there. ... we were all exposed to those,” he said.

Alexander stressed that it’s not only the clothing or protective gear that firefighters wear that can lead to an increased risk of cancer, but also the work of firefighting itself.

“Every single fire we go on, whether it’s a vegetation or structure fire, we’re exposed to carcinogens,” Alexander said. “Think about what your home looked like when you were a kid versus your home today. Everything’s made out of plastic, polyurethane foam, all the bad synthetics that cause cancer versus more of your traditional (home) of just wood. Same thing with vegetation fires. ... There’s stuff in vegetation that’s burning, whether it’s debris or trash. ... You’re breathing it in and absorbing it. Even if you’re wearing a respirator, formaldehyde, it’s getting absorbed in through your skin. So, when you’re coming out of burned buildings, your formaldehyde levels are super high.”

Justin Johnson, also with the Yuba City Fire Department, said because of the constant exposure to things such as diesel fumes and the everyday dangers firefighters face, not only are firefighters more at risk of developing cancer, but they also are more at risk of developing cancer at a young age.

Including efforts such as the Galleri cancer tests taking place this week and early cancer screenings in general, Johnson said there are ways to get ahead of what is now a known danger.

“We can continue to do some of the stuff with changing the type of gear we have to be more conducive to that,” Johnson said. “All of our stations have a diesel exhaust system that we plug into our engines to basically take that away from our living space. ... Just buttoning up with wearing respiratory protection longer into fires.”

Johnson said vegetation fires are particularly tricky, especially when dealing with homeless encampments.

“When we go to the vegetation fires in the river bottoms, it’s the same things that are inside people’s houses that people are dragging down there,” Johnson said. “We don’t wear the contained breathing system down there because it’s not feasible.”

Johnson said prevention methods such as the Galleri testing is important for keeping firefighters healthy.

“This is going to be huge, though,” Johnson said. “Even though we can’t reduce cancer completely, we can at least find it so it’s at a treatable time. Historically, when most of these cancers are found in firefighters, it’s too late. ... Having that early detection is huge.”

Alexander said the dangers firefighters face with regards to cancer is something the general public doesn’t necessarily always consider when thinking about the service they provide. He personally has seen colleagues, often relatively young, who have been affected by cancer.

“For me, it hits home,” Alexander said. “Two individuals that I worked with that were still working both died from cancer. They ended up dying, both, at the age of 52. ... The same gentleman that was my best man at my wedding — he’s my age, 47 — he just had a large tumor removed. ... The tumor’s already grown back, so he’s going to be battling that for a long time.”

Johnson said a 30-year veteran of the Yuba City Fire Department who retired recently died of brain cancer.

While cancer may be thought of as something that affects mostly those who lead unhealthy lifestyles, Alexander said the two firefighters he knew who died of cancer at 52 led very healthy lives.

“They both ran marathons. I would say they were probably the two healthiest guys in the department,” Alexander said. “One got brain cancer and the other got a type of stomach cancer. The doctor said, ‘Are you a firefighter? Because we only get these kinds of cancer from firefighters.’”

Johnson said previously while in Southern California, he worked with a firefighter that was diagnosed with brain cancer at 32 years old.

“He started in the fire service when he was 18,” Johnson said. “Didn’t drink, didn’t smoke. He led a healthy lifestyle. He passed away at 39, I believe, and they caught it relatively early.”

The holy ‘Grail’

Alexander said the Galleri testing taking place this week by Grail is a “screening mechanism” to see if there are cancer cells present in a person’s body.

Katie Sanford, district manager for Grail, said the company was the first in the world to have a multi-cancer early detection blood test that can screen for more than 50 types of cancer “with a single blood drop.”

Sanford said the company works with various fire departments and has been working with the Yuba City Fire Department for a few months.

“What Grail does is we offer the product Galleri,” Sanford said. “Galleri is the cancer screen, where we’re able to draw a patient’s blood to look for cancer. ... What we’re looking for is a common cancer signal. So, it’s DNA that’s been shed or put into the bloodstream by cancer cells in the body, if they’re present. Every cell in the body sheds this DNA when the cells die.”

Sanford said their testing is able to look at a person’s blood and distinguish if there is healthy cell DNA or cancer DNA. Because it is only a screening test, Sanford said it is possible for those who take part to get a false positive result.

“This is a cancer screen. It’s not a perfect diagnostic test,” Sanford said. “Yes, it is possible that a test result will come back positive and the patient doesn’t actually have cancer. But, if we look at other cancer screens on the market and compare them to Galleri, the false positive rate for Galleri is incredibly low — it’s 0.5%.”

Sanford said that while Galleri doesn’t actually replace other traditional and effective cancer screening options that can be done, it does give an option to find cancers that may not have more established screening methods.

“Now we have an option to be able to find them in an earlier stage,” Sanford said.

Sanford said results from the Galleri tests usually come back to patients after about two weeks.

“If they get a negative result, they’ll get an email with their negative result. If they get a positive result, the ordering physician ... will reach out to them and talk about next steps and imaging to confirm the finding,” Sanford said.

The New York Times in June reported that 400 of Grail’s customers were mistakenly told in May that they might have cancer.

In an emailed statement, Grail said that a vendor it works with — PWNHealth — had sent hundreds of letters with incorrect Galleri test results because of a “software configuration issue,” The New York Times reported. The company said that “issue” had since been resolved.

Grail said the problem was not caused by inaccurate Galleri test results and that “more than half of the people who received the letter in error had not yet had their blood drawn for the test,” The New York Times reported.

According to the Times, Grail contacted the affected customers by phone and email and that “no patient health information has been disclosed or breached due to this issue, and no patient harm or adverse events have been reported.”

After launching to the general public in August 2021, Sanford said the biggest benefit to having something like the Galleri test be available is that it’s “filling the gaps” of currently available screenings for certain types of cancer.

“Right now, most cancer deaths, over 75%, are because of cancers we can’t screen for because we’re just finding them too late,” Sanford said. “Our current screens are good for what they do ... but there’s this massive gap of cancers we can’t find. We have no way of screening for them.”

Sanford, who said Grail is proactively reaching out to fire departments and first responders with its Galleri testing, also echoed many of the statistics and realities that Alexander and Johnson said firefighters face on a daily basis.

“Firefighters are at a significantly higher rate of cancer — not only of getting cancer but dying of cancer,” Sanford said. "... They’re at such a high risk of cancer, that we want to make sure that this is reaching the people that really need it. In the general population, it’s recommended for patients over age 50, just like all other cancer screens.”

Alexander said the Galleri testing already has been taking place at fire departments in other areas of the country and was hopeful that the testing would continue to be available to his department in the future.

“My personal goal is to find a way that it’s an ongoing thing in the fire service. ... It would be extremely beneficial going into the future if we can find a mechanism to keep this going on a yearly basis,” Alexander said.

Johnson said in an ideal scenario, the testing would be part of the annual physicals that are done for the department’s firefighters.

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