How affordable screening is helping firefighters find cancer early

As firefighters face a greater risk of cancer, some are taking a proactive approach to detect issues early

Cancer can be a scary diagnosis, but for firefighters, it’s not a matter of if they get cancer, it’s when.

That’s the shared sentiment with the firefighters the Solutionaries team talked with. Catching cancer early can mean life or death, and there is one easy, affordable way to find problems early that is saving lives.

My favorite part of the job is helping people. I do get a sense of accomplishment when people call us on the worst day of their lives, and we can come in, and we at least try to make their day better or make them better, take care of them, or save their lives, save their property. My dad, he’s been a volunteer firefighter since the ‘70s as well as my uncle. I grew up visiting my dad at the firehouse a lot, sitting around in the trucks and it’s kind of what I knew that I wanted to do.

Justin Ratcliffe, a lieutenant with Roanoke County Fire and Rescue

Why do firefighters experience higher risks for cancer?

While there are many risks for firefighters, some aren’t as apparent early on.

“It’s inherently dangerous on the job and off the job, too. There’s the obvious as running into burning buildings, sitting on the side of roads for car accidents, and being exposed to a lot of infectious diseases and whatnot. But also outside of the job, just coming back here into the stations, we’re exposed to a lot of things that people aren’t normally exposed to,” Ratcliff explained. “There’s a lot of research out now that suggests that our protective gear that’s been protecting us through these fires and stuff like that are actually causing cancers in firefighters.”

The International Association of Firefighters said forever chemicals are a problem, “PFAS is used in firefighter turnout gear and poses an unnecessary occupational threat. The IAFF is actively working on behalf of members to pursue next-generation, toxin-free protective gear.”

“Cancer is a leading cause of death among firefighters, and research suggests firefighters are at higher risk of certain types of cancers when compared to the general population,” according to the National Institute for Occupational Safety and Health.

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“It seems like now it’s not if, but when you’ll develop cancer of some kind, but you don’t necessarily think about it when you’re in your early 20s,” said Duane Noell, the Roanoke Firefighters Association, President of Local 1132. “We’ve lost what I would say more than our fair share here in the City of Roanoke in the Roanoke Valley to occupational cancer there for a while it seemed like it was becoming a very frequent event. I was like, ‘Oh so and so has cancer. Oh, there’s another one. There’s another one.’ So it’s it’s definitely hit home.”

How can firefighters protect themselves from cancer risks?

That’s why it’s so important to catch problems early. United Diagnostic Services sets up screening events across the country. For one week, they tested people in Roanoke.

The 30-minute appointments examine nine critical areas of the body, including the following:

  • Echocardiogram
  • Carotid Doppler
  • Aortic Aneurysm (AAA)
  • Thyroid
  • Liver
  • Spleen
  • Kidneys
  • Gallbladder
  • Bladder Ultrasound
  • Pelvic (external, women only)
  • Testicular (men only)

“Usually, the scan is to find cancer, but along the way, we do find other stuff such as cysts, stones, any other thing is abnormal we do find it along the way because it is a full body scan,” said Shantelle Barker, a UDS medical assistant who helps with the process.

Noell went through his third scan the day we were there. A previous ultrasound found a heart valve issue that needs to be monitored.

“Had I not known about it, it could have developed into a problem, which ended up in open heart surgery,” he said. “As a young firefighter coming into the service, I knew that there was a possibility that I could get injured, or burned, or something, but cancer was far, far in the back of your mind or even unknown back in the day. It just wasn’t something you thought about, but it’s risen to that to the forefront. We’re starting to find out that they were a lot more susceptible to getting occupational cancer.”

Ratcliff said the first year the scan was available, he didn’t think much about it and skipped it.

“I didn’t think twice about doing it. But then last year they brought the scan back, and I said to myself, ‘I’m over 30 years old. I need to start taking care of my health. I need to start keeping track of these things,’ and I signed up for the scan. It was really, really easy. Then, about a week later is when I got the phone call saying that they had found some abnormalities in my thyroid and that I needed to get some follow-ups,” said Ratcliff.

The 33-year-old said that the call was unexpected, especially as young as he is.

“I knew especially with the dangers of the job and the risks associated with cancers and firefighting, that more or less I made up my mind that at some point in time, I was going to end up with cancer. I just didn’t think it was going to be this early on,” said Ratcliff.

You can see how many issues this finds. UDS is reporting more than 40 cancer detections in firefighters in less than two years.

UDS screens first responders in multiple states. (Courtesy: UDS)

“It seems to be thyroid cancer is becoming fairly prevalent in the fire service. Thyroid cancer is typically one of those that it’s not early-detected unless you go looking for it. It’s not something that’s going to show signs that cue you in until it’s advanced,” said Noell.

They find other problems too. Across 76 screenings, more than 8,000 findings needed action like heart issues. Not all of the issues are life-threatening, but they do need to follow-up with a doctor to do more testing, monitor a condition or create a treatment plan.

UDS screens first responders in multiple states. (Courtesy: UDS)

Compared to other comprehensive scans, the service from UDS is relatively inexpensive and accessible, making it easy for firefighters to sign on for the testing that runs a little more than $300.

“It’s low cost. Obviously, we’d love to see our city council and our city support this endeavor to do this cancer screenings on a yearly or biannual basis or whatever they see fit just to bring this company in to do the cancer screenings. But the majority of our membership see right now that it’s so important that they’re willing to come on their own time and pay their money out of pocket to get this done because they’ve seen the results of how important it actually what,” said Noell.

Ratcliff is inspiring other firefighters to go through screening too.

“My fellow firefighters have come to me and said, ‘Hey, we’ve heard what’s happened. We’ve heard what’s going on and I’ve signed up because of what you’ve done, but you were 100% healthy, you had no sound outward signs of anything, no symptoms, saying that anything was wrong and it did find something.’ Early detection is probably the biggest thing we can do to help ourselves with this is you know, catching it early before it becomes a major problem,” Ratcliff explained.

He has a positive outlook, as he waits for more testing, including a biopsy.

“I’ve taken the attitude that it’s just one of these things that I’m just going to have to deal with. I’m going to take it as every step that it comes and the treatments going to be the treatment.”

What challenges exist when it comes to screenings?

There are limitations to what the screening can find because it only screens certain parts of the body.

“I think the biggest setback, or the biggest hurdle to overcome is for a lot of our younger people. They’re like, ‘Well, I’m young, in my 20s and I’m bulletproof.’ Sometimes it takes several years to learn that you’re not and to get it into their heads how important this is,” said Noell.

Ratcliff said others can learn from his experience by keeping an eye on their health.

“Your health is the most important thing. Just because you’re not experiencing any symptoms or you’re not having any problems doesn’t mean that there isn’t something going on. Get the scan. Honestly, that’s the biggest thing,” said Ratcliff. “Get the scan done, if not for just peace of mind. For me, that’s what it was going to be.”

Ratcliff said this doesn’t change his career outlook. He plans to beat whatever is thrown his way and come back to the job he loves.

Reports are only shared with the person who went through the exam. They recommend firefighters go through these screenings every two to three years.

The Virginia Firefighter Cancer Support Network is a resource for firefighters.

For more information on United Diagnostic Services, visit the website here.

This article is part of “Solutionaries,” our continuing commitment to solutions journalism, highlighting the creative people in communities working to make the world a better place, one solution at a time. Find out what you can do to help at

About the Author

You can see Jenna weekday mornings at the anchor desk on WSLS 10 Today from 5-7 a.m. She also leads our monthly Solutionaries Series, where we highlight the creative thinkers and doers working to make the world a better place.

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