Tony Stefani, Founder and President of the San Francisco Firefighters Cancer Prevention Foundation (SFFCPF) has 28 years’ experience fighting fires, having spent most of his career at Rescue One in San Francisco.
In 2001, after a long career as a firefighter, Tony was diagnosed with a rare form of cancer: transitional cell carcinoma (TCC). Normally found in the bladder, Tony’s cancer was in the right renal pelvis of his kidney.
He officially retired in 2003, two years after his initial diagnosis and after exhausting all his sick and vacation time. Without income, Tony had filed a workers compensation claim under the belief that his cancer was job related.
At the time, San Francisco did not have the Cancer Presumptive Law in place, leaving him to prove that the cancer was linked to his firefighting career – a process that took two years of proceedings.
To supplement Tony’s income in the meanwhile, over 200 officers in San Francisco donated one day of time to him so that he would continue to have a pay check. Knowing there was no way of paying back their generosity monetarily, Tony set out on making a change.
In this interview with FSJA’s Isabelle Crow Tony shares how this, alongside the revelation that several fellow firefighters were receiving the same cancer diagnosis, made him recognize he had a message worth sharing.
Having been diagnosed with TCC five years prior, on the 26 April 2006 I was on a bicycle ride and was hit by a pickup truck head, which left me in critical condition- I could have lost my life.
It took almost eight months of rehabilitation just to get back on my feet again. My doctor from UCSF, Dr Marshall L. Stoller visited me in hospital and he told me I was alive for a reason.
He knew about how three firefighters from Station One had all been diagnosed TCC following my own and my struggle to prove the correlation between a career in firefighting and an increased risk of cancer. He encouraged me to make a change.
This is when I decided to put together a nonprofit foundation dedicated to the early detection and prevention of cancer for both active and retired firefighters.
Tony Stefani
I spoke to the Chief of the Department, Joann Hayes White, as well as the Executive Board of San Francisco Firefighters Local 798 about my idea of starting a foundation- they were in complete support.
Additionally, our union agreed to help by providing an attorney who drew up our 501(c)(3) status and contributing $100,000 to get us off the ground.
My focus was to prove that the cancer diagnoses were job related and the only way we could do this is through science-based evidence. In 2007 our first study with the Department of Urology at UCSF was launched, using a test called NMP22, which is a urine-based test that measures your level of nuclear matrix protein.
During this study we tested over 900 firefighters, both active and retired and we were able to find three more cases of TCC.
But after we did this test, we still didn’t have the ability to convince the city that the cancer was job related for firefighters. So, in 2008 we contacted the Department of Gastroenterology at UCSF and decided to do a colorectal cancer screening with them, using a fecal immunochemical test- we caught a few more cases.
The mayor at that time was Gavin Newsom, who I personally spoke to and he told that our rates of cancer were no higher than the general population. This made me even more determined to find a resolution.
In 2010 we were contacted by NIOSH and they asked if San Francisco would be willing to be part of a major study looking at the rates of cancer in firefighters dating back to 1950. We were contacted alongside a few other major cities.
They sent three epidemiologists to San Francisco and they attended one of our board meetings, providing the feedback that they didn’t think we were going to be able to find elevated rates of cancer in the profession.
It took them four years to come up with the final analysis, with a cohort of 30,000 firefighters and tedious amounts of time spent going through journals dating all the way back to the 1950s when things were not computerized.
NIOSH published the outcome, informing us that not only do we have elevated rates of cancer, but we have elevated forms of multiple cancers; prostate, leukaemia, genitourinary cancers, oesophageal, pancreatic, colorectal cancers lung cancer and lymphomas This was the proof that we needed.
At the time the Mayor of San Francisco was Ed Lee and the union went to the mayor’s office and distributed the study. The Mayor and the Board of Supervisors agreed that they should adopt the Cancer Presumptive Law in San Francisco, which they did in 2014.
Now, firefighters were covered and they didn’t have to prove themselves anymore- or that they had contracted cancer as a result of their job. It was decided by the Department of Human Resources in San Francisco that any firefighter that had a least five years of service on the job and contracted cancer had received the diagnosis because of their profession.
I spoke at UC Berkeley on behalf of an organization called the Green Science Policy Institute, surrounding the topic of flame-retardant chemicals and what was happening to firefighters.
In the audience that day was a film producer named Kirby Walker, who spoke to me following my talk and said how she was doing a documentary on the chemicals and wanted me to be interviewed.
Six months later I heard back from Kirby, who phoned me to say the film was in the process of being made and how Robert Redford’s son James was going to be co-producing the piece.
The documentary came out on HBO in 2013 and it can still be watched, because of this the awareness grew even greater. It was a great way to raise a level of awareness for the flame-retardant chemicals, what they were doing and how the chemical industry blindsided us and got caught.
A current focus for the SFFCPF is our ability to financially help a firefighter when they are diagnosed, especially for retired firefighters because they are no longer covered by workers comp unless they retire within a five-year period.
Another facet of the SFFCPF is our work encouraging firefighters to seek a second opinion after a diagnosis. We will pay for a firefighter to go and have a second opinion, up to $1,000 and for their travel too.
Tony Stefani
Our support for every firefighter is individual, just like every fire that we fight- they are all different and so we adjust accordingly. The foundation will help a family out with up to approximately $10,000 but we can go over and above this.
One of our Board members, Anita Parately who is a retired battalion chief from San Francisco, contracted breast cancer in her late 40s. She spoke to me about how there was a rising problem with female firefighters contracting breast cancer but being too afraid to speak about it in case they were let go because of their diagnosis.
As a result of this, we delved into researching what studies had been done with females on the job- there were none.
Tony Stefani
As women are fairly new to the profession; at that time in San Francisco, they had been on the job for a little over 20 years. In conjunction with UCSF, UC Berkeley, the Silent Spring Institute and the Common Wheel Institute, we started a breast cancer study.
We were able to find that women in the San Francisco Fire Department had six times the rate of cancer than the national average. This was especially notable, as San Francisco has the largest population of firefighters in any metropolitan city in the United States- just over 300 women.
