Samuel Eaton isn’t afraid of many things.
A battalion chief for the Palm Beach County Fire Rescue, the 52-year-old has made a career of charging into burning buildings and coming out in one piece.
But thinking toward his upcoming birthday, he’ll tell you he’s deeply concerned.
Eaton lost one of his best friends, a retired fire captain in the department, last year at 53. After two decades on the force, it wasn’t a house fire or a collapsed lung that eventually killed Butch Smith.
It was cancer, an invisible killer that stalks victims for years before revealing itself, often contracted by firefighters through microscopic carcinogens that latch onto fire gear or their skin. It’s the leading cause of death among firefighters, and they’re twice as likely to contract it than civilians, according to some estimates.
“Everybody thinks about heart and lung [diseases],” Eaton said. “Explosions and fires and things of that nature. Those are all dangerous things, but we’re losing our life to cancer. It’s not just in retirement. It’s young people. There’s people in their 20s, their 30s, their 40s, their 50s.”
In 2008, Smith was diagnosed with stage four multiple myeloma, a blood cancer, and was given just two years to live.
He lived seven years past that deadline, emboldened by a desire to figure out why firefighters were contracting cancer at a higher rate than the rest of the population and a hope to find a way to prevent further tragedy. He underwent harsh chemotherapy 21 days a month, but the diagnosis served as a wake-up call for Eaton’s department and set into motion a series of events that would ultimately lead to a one-of-its-kind cancer-fighting initiative in South Florida.
One year after his death, Smith’s memory — and that of other fallen firefighters in South Florida— continues to give life to a unique collaboration between firefighters across the state and the University of Miami’s Sylvester Comprehensive Cancer Center.
“Butch kind of wanted his life to represent more than a statistic,” said Dr. Erin Kobetz, the associate director of the Sylvester Comprehensive Cancer Center and the principal investigator of the Firefighter Cancer Initiative. “His diagnosis catalyzed a really important conversation about what was happening as a function of being a firefighter with regard to increasing the risk of developing and dying of cancer.”
Combining cancer studies with the development of new prevention protocols and monitoring technologies, the Firefighter Cancer Initiative hopes to figure out exactly what about firefighting leads to a higher rate of cancer, and in the process, spread awareness and save lives. Through partnerships with fire departments in nearly every Florida county and with the state fire marshall, Kobetz’s team has worked to change department protocols and distribute thousands of decontamination kits.
And departments across the country are taking notice, she said.
“I think now we're at the forefront of a national conversation about firefighting and risk of cancer, and are really leading efforts to understand what is unique about being a firefighter occupationally that increases the risk of cancer,” Kobetz said.
On Saturday, Eaton and Kobetz rode their bicycles 35 miles as part of the annual Dolphins Cancer Challenge in honor of Butch Smith and all cancer victims, finishing inside Hard Rock Stadium, where Eaton and a team of over 65 firefighters presented the center with a UM-themed fire hydrant as a thanks to its commitment to researching firefighter cancer.
The team raised about $24,500 for the center, and the Miami Dolphins raised $3 million.
“To ride alongside people you know have got your back like they do, it’s surreal,” Eaton said. “It’s amazing.”
Joining in was Dr. Juan Garcia, the father of the late city of Miami Fire Rescue Lt. Rafael “Ralf” Garcia, who died of cancer in 2015 at the age of 28, leaving behind a widow more than seven months into her pregnancy. Garcia participated in a 5K walk.
“It was a lot of mixed emotions,” said Dr. Garcia, a cardiologist in a private practice at South Miami Hospital. “I wish that I did not have to participate in it as a supporting family member of somebody lost to cancer. We came very teary eyed as we crossed the finish line, knowing what it was all about.”
The initiative began in 2014 with a call from Palm Beach County Fire Rescue, which served as the initiative’s pilot department. Around that time, Eaton had formed a team of his own with retired division chief Vicki Sheppard called Firefighters Attacking the Cancer Epidemic, or FACE, with 12 other members from their department. That expanded into the Florida Firefighters Safety and Health Collaborative Statewide FACE Team.
“And they called us because we’re the only university-based cancer center in South Florida, and we obviously have research infrastructure to support collaborative science where we could work hand in hand with firefighters to understand their risk, identify exposures that were driving that risk and more importantly, come up with strategies to keep them safer on the job,” Kobetz said.
The programs’ partnership launched the Firefighters Cancer Initiative, and then in 2015, with the death of Garcia, a “tsunami” of awareness began in Miami-Dade County, Dr. Garcia said.
“Our work has now touched almost every county in the state and has a national footprint,” Kobetz said.
The spouses of Miami firefighters formed Fire Families Against Cancer, and eventually that, too, partnered with Sylvester’s program, linking two of Florida’s biggest counties through a shared mission.
“I don’t know why my son’s death triggered so much, but it did,” Garcia said. “I wish I didn’t have to be a part of this. Unfortunately, he’s not here, so the only way we can say that he is here is through these efforts.”
“I think the movement now has taken a life of its own,” Garcia said.
The Firefighters Cancer Initiative eventually absorbed the mission of both programs, forming a giant force to tackle cancer among firefighters. Over the past four years, it has received $3.5 million in state appropriations. This year, Kobetz, said, she’ll ask for $2 million to further the program’s research.
Kobetz’s team consists of about 25 students, staff and faculty, along with clinical support for those diagnosed with cancer.
“I definitely think in terms of firefighters and cancer, it’s one of the first of its kind. And I think what’s really powerful about this research in particular is that it’s firefighter driven,” Kobetz said. “So I think there's a recognition at Sylvester that, you know, we have the scientific and clinical acumen and firefighters have the occupational expertise. And if you want to ask the right questions and get to appropriate sustainable solutions, they need to appropriately engage in what we’re doing, or otherwise it has no relevance to them.”
Eaton said finding hope in tragedy makes the initiative possible, and brought him and Dr. Garcia closer.
“It’s because of their common tragedy that we’ve bonded together to find a way to make this right,” Eaton said.