20 years ago, the 9/11 terrorist attacks changed the world. Thousands of lives were lost. The Twin Towers fell. For a brief moment, the United States was quiet as if in a state of shock. 

And then came the helpers. As Mr. (Fred) Rogers’ mother used to say to him when there was a catastrophe, “Always look for the helpers. There will always be helpers.” Mr. Rogers said that news programs need to show rescue teams going into a place where there was a tragedy because “if you look for the helpers, you’ll know that there is hope.”

On September 11, and the days that followed, firefighters rushed to help for search and rescue and then recovery. Firefighters are referred to as, “the ones that are going in when everyone is coming out.” While police have long been considered “the finest” of the first responders, the firefighters have been considered “the bravest.”

We’ve all heard “heroes don’t always wear capes.” But one thing to consider with firefighter heroes is their increased risk of cancers. The International Association of Fire Fighters (IAFF) recommends cancer screenings different from that of the general population.

“Given the known occupational risk of exposure to carcinogens and the excess number of certain cancers in the fire service, the IAFF Wellness-Fitness Initiatives (WFI) Medical Committee, for some cancers, made recommendations beyond those made for the general population.”

Some of these screenings are recommended to be performed at a younger age than people who are not as high risk due to occupational hazard or to be performed with more frequency. 

For colorectal cancer (CRC) screening, the IAFF WFI says if a fire fighter decides to begin screening at age 40, then fecal occult blood testing (FOBT) is the method recommended. They recommend screening for colorectal cancer at age 50 and continuing until age 75*. (In May, the U.S. Preventive Services Task Force recommended lowering the age for regular colorectal screening from age 50 to age 45.

If an FOBT result is positive or when there is a consistent change in bowel habits, the IAFF WFI recommends a colonoscopy regardless of age. 

Joe Maschke, a career firefighter for 17 years (and volunteer for 11 years prior to that), was 47 years old when he went to his gastrointestinal (GI) doctor with signs and symptoms. Because of his age, he believed his issues, as did his GI, were internal hemorrhoids. Both Joe’s GI and Joe were shocked when his colonoscopy revealed a tumor in his rectum, which was diagnosed a week later as stage IIIb CRC. 

Because of Joe’s screening, a few of his coworkers went for colonoscopies. Although one of his coworkers, Scott Oatman, didn’t have signs or symptoms, he was aware that firefighters are at increased risk. Oatman’s colonoscopy screening came back clear, but he says his doctor didn’t want to screen him originally because he had no signs or symptoms, and he wasn’t age 50. It took Oatman numerous attempts before his doctor agreed to screen him.

Eric Hausmann is a 28-year career firefighter, with four years as a volunteer, and four years in the Navy. Hausmann was screened at age 44 after his wife was diagnosed with CRC. Hausmann has been an advocate for Fight Colorectal Cancer for more than 12 years, and he is not uncomfortable having conversations about CRC. He knows that firefighters are at a higher risk for CRC than the rest of the population, and he has had conversations with his coworkers about the high risk for CRC given their occupation.

According to the Firemen’s Association of the State of New York (FASNY) in the Firefighters and Colorectal Cancer blog posted on January 21, 2021, “Firefighters are at increased risk when it comes to colorectal cancer risk among firefighters, the majority of scientific studies shows an increase in the range of 10% to 45% more compared to the risk in the general population.”

Maschke says that awareness is crucial, and that people often want to “wish away” signs and symptoms rather than go for a colonoscopy. He says, “Two days of prep can save you a lifetime of hell. Life will never be the same. There is no new normal. What works one day, doesn’t work the next day. I’m now 50 years old taking fiber, laxative, and immodium, and trying to balance digestion issues every meal and every day of my life. I’m a fireman, so sitting at a table taking my time and chewing food thoroughly and slowly as my surgeon has recommended doesn’t happen. I never know when the bells are going to go off. Get screened.”

Not all heroes wear capes. But all heroes need to be screened. 

5 Tips for Colonoscopy

Maschke has had colonoscopies four times in three years. Though not something he will ever enjoy, he knows the importance of screening, and he has learned how to manage and “not dread” them.

1. Don’t assume the “quick prep” is the best prep. Find a beverage that you enjoy. While Gatorade^® is recommended, you have choices. His doctor recommended homemade sweet tea mixed with Miralax^®. Miralax dissolves, so you don’t taste it. Broken down into four 8 oz. glasses the night before, and four 8 oz. glasses the morning of the colonoscopy were doable. 
2. Use a straw. His doctor recommended drinking each 8 oz. glass with a straw. It made the drink more manageable and he didn’t swallow as much air. 
3. Pat dry. Once you head to the bathroom, don’t wipe. Use soft toilet paper to blot or pay dry. Wiping makes your already tender area more tender.
4. Chicken Broth. Prep day with no solids is a long day. Chicken broth tastes like lobster when you’re doing a colonoscopy prep.
5. GET. IT. DONE. There are 1,000 reasons not to get a colonoscopy. “I don’t have time” is one of the biggest excuses to delay CRC screening. CRC is the only cancer that can be prevented when polyps are found early and removed before they turn into cancer. Get the colonoscopy. No excuses. Just do it.

https://www.iaff.org/wp-content/uploads/FFCancer_CancerScreenings.pdf

Firefighters and Colorectal Cancer