• Posted May 10, 2024

His Cancer Journey Shows Health Dangers Firefighters Face

For 14 years, David Perez fought fires in South Florida, thinking he was in peak physical shape. Then a routine physical turned up anomalies in his blood work that turned his life upside down.

"The labs came back irregular. Everything was off," Perez, 44, recalled. "I went to a hematologist and it wasn't until I saw the word cancer on the side of the building that I realized I might have a problem." 

That was in 2020. Since then, he has battled blood cancers twice -- first, multiple myeloma and then, mantle cell lymphoma. Six months ago, Perez had a stem cell transplant, and he's currently cancer-free.

But his risk remains. 

Compared to the general public, firefighters have a 9% higher rate of certain cancers, likely due to their exposure to high levels of carcinogens released into the air as buildings burn. The incidence of multiple myeloma -- the first cancer Perez developed -- is about 50% higher in firefighters than in the general population. 

"The first doctor I saw actually told me that there was no relation between cancer and firefighters, which threw up a lot of red flags for me," he recalled. 

Despite the known risks, Perez said many firefighters remain unaware or skeptical of the links between their work and cancer. Since his diagnosis, he has not returned to active firefighting and instead has adopted the role of educator and advocate. 

He is working to make sure other firefighters understand the risks that go along with their work, sharing his knowledge about cancer prevention and health management at various events and training sessions.

Perez is also helping develop new health monitoring technologies, including biomonitors that can analyze sweat for indicators of exposure to carcinogens.

His efforts dovetail with studies underway at the Sylvester Myeloma Research Institute at the University of Miami. Researchers are working to understand risk factors for multiple myeloma, including age, race and family history. 

Dr. C. Ola Landgren has been researching links between occupational exposures and multiple myeloma for a number of years -- particularly in first responders such as firefighters. At Memorial Sloan Kettering Cancer Center in New York and the National Cancer Institute, Landgren began to recognize patterns. 

In New York, for example, Landgren had three myeloma patients who lived on the same block on Staten Island. Their houses had been covered by dust after the World Trade Center towers fell in 2001. 

"Myeloma has a precursor condition known as MGUS, which is more common in the population, allowing us to identify risks earlier,"Landgren said. "We've actually observed higher rates of MGUS in first responders compared to the general population." 

MGUS -- which stands for monoclonal gammopathy of undetermined significance -- has also been linked to pesticide use among farmers and exposure to Agent Orange among veterans of the Vietnam War. Levels also were higher in firefighters, police officers and construction workers who were on-site immediately after the 9/11 attacks.

Perez applauds the research.

"These are things we need to know and talk about. It took me something like a cancer diagnosis in order to learn and look at the big picture for me and my colleagues," he said. "I don't want that to happen to them and their families."

When he was first diagnosed, Perez kept the news within a tight circle and didn't tell his children, who were 6 and 4 years old at the time. 

"I didn't want them to worry about their dad being sick," Perez explained. 

He adopted a plant-based diet, continued to exercise regularly and thought he would be back on the job in eight or nine months. But, shortly after completing treatment for multiple myeloma, he received another diagnosis: mantle cell lymphoma. 

This second battle with cancer introduced new complexities and another series of treatments, including more chemo and a stem cell transplant. 

"That was when I told my kids about the cancer," Perez said. "There was a 1 in 6 chance I would not survive the transplant, so they needed to know what was happening." 

More than eight months out from his stem cell transplant, he is currently cancer-free and stepping up his efforts to build awareness about job-related cancer risks. 

"I'm almost grateful for going through what I've been going through,"he said. "Honestly, it's given me a perspective that I wouldn't have had otherwise if I wouldn't have had the perspective I do, or the chance to raise awareness and bring change to the culture in the fire service." 

His efforts extend to collaborating on initiatives like Sylvester's Firefighter Cancer Initiative, where he participates in events aimed at raising awareness and promoting research into the links between firefighting and cancer. 

Perez stresses the importance of preventive measures, regular health screenings and ongoing education to respond to the risks firefighters face. 

Perez is also spearheading creation of a Health and Wellness Department at North Collier Fire Control and Rescue in Naples, Fla., where he worked for 14 years. Its aim is to teach firefighters how to maintain their health through lifestyle choices and changes that promote long-term well-being. 

One thing he urges everyone to incorporate into their daily routine is a holistic approach to health he calls the "MEDSS System." The acronym stands for Mindset, Exercise, Diet, Sleep and Stress response -- a formula he shares with fellow firefighters and other high-risk professionals. 

These issues not only affect firefighters, but also their entire families, Perez emphasized.

"My wife handled everything with such toughness, balancing care for our kids and supporting me through my treatments, but I was also always worried about what would happen to my family if anything happened to me,"he said. 

As such, he is establishing a nonprofit to provide financial support to families of firefighters and police officers who lose their lives in the line of duty and mentorship to their children.

"I feel like my experience was a call to action, to ensure that other firefighters understand their risks and know how to protect themselves,"Perez said. "If there's one thing I would want them to know, it's that I want them to take responsibility and to take more control of their own life,"he said.

More information

The National Institute for Occupational Safety and Health has has cancer-prevention tips for firefighters.

SOURCES: David Perez, 44, firefighter and cancer patient, Naples, Fla; C. Ola Landgren, MD, PhD, director, Sylvester Myeloma Research Institute, and professor, University of Miami Miller School of Medicine; Sylvester Comprehensive Cancer Center, news release, April 29, 2024

What This Means for You

First responders have a higher risk for some cancers than the general population. Monitoring health regularly is a must.