'Presumptive occupational risk': Firefighters are getting pancreatic cancer because of their job. So why aren't all provinces offering support?
Before he was diagnosed with cancer, a 33-year veteran firefighter Leslie McBride had developed jaundice and was suffering from heartburn and acid reflux. He was officially diagnosed with stage I of the disease after undergoing multiple tests while admitted in the ER, and just a few weeks later, he learned that the tumour, which was located on an artery, was inoperable.
Chemotherapy and radiation soon followed — a treatment plan that was difficult, but one that promised to provide an additional 18 months. Leslie was in and out of the hospital every couple of weeks, and when the tumour started growing again, it brought constant pain. After developing a serious infection, chemotherapy and radiation were no longer feasible treatment options and Leslie was moved to a hospice where he received end-of-life care. He passed away on Oct. 15, 2020.
“It has changed our life forever, and not a day goes by without some type of challenge,” says Catherine McBride. “My husband was a huge part of my son’s competitive golf program and that was taken away. Jake has to grow up without a father and we never got a chance to live life together after we retired.”
McBride says that while pancreatic cancer has had a devastating impact on her family, one thing they never worried about was covering the high cost of medication that was required to keep Leslie alive. Fortunately, it was covered through both of their work insurance benefit plans.

Pancreatic cancer not recognized as an occupational risk

According to data provided by the Ontario Cancer Registry , the lifetime cost of pancreatic cancer, per patient, can run upwards of $30,000 in the region, but the province has yet to recognize pancreatic cancer as a presumptive occupational risk to firefighters. This leaves patients and their families with a responsibility to bear the financial burden of a disease they acquired through their profession. Those who live in Manitoba, Yukon, Nova Scotia and British Columbia — regions where pancreatic cancer is recognized as a presumptive risk to firefighters — are eligible for financial entitlements and support.

Michelle Capobianco, the chief executive officer of Pancreatic Cancer Canada says that presumptive occupational risk is legislated by each province and too often, it turns into bureaucratic obstinacy. The risk, she says, doesn’t differ from province to province — in fact, the Canadian Cancer Society estimates that 90 per cent of those diagnosed with pancreatic cancer don’t survive the disease, and geographic location is not a risk factor for the disease.

“A firefighter who is covered for pancreatic cancer in Manitoba does not face any greater risk than a firefighter in Ontario where the disease is not acknowledged as presumptive,” explains Capobianco. “Our governments need to stand with the men and women who devote their lives to protecting their communities if they are diagnosed with this devastating disease.”
She says that she has spoken with countless firefighter families, who, in addition to having to deal with the tremendous stress and grief brought on by a terminal cancer diagnosis, are also left to appeal claims and fight for benefits which they should be entitled to. She says that in its final stages, pancreatic cancer is extremely painful, and because of the nature of the disease, governments across Canada have a responsibility to ensure that those who have acquired the cancer over the course of their working life, have the support they need while in treatment, at the end of their life, and beyond.

Cancer is “number one killer” of firefighters

Neil McMillan, director of Science and Research at the International Association of Firefighters (IAFF), says that cancer is the number one killer of firefighters and a growing body of research proves it.

“Legislation has not kept pace with the science that demonstrates the material association between firefighting and a host of cancers,” he says. “As a result, the true number of firefighters diagnosed with work-related cancer far exceeds the number of deaths officially recognized by workers’ compensation.”

According to a study by the University of the Fraser Valley , nearly 90 per cent of all firefighter workplace fatality claims that were submitted over a 12-year period — between 2006 and 2018 — were related to some form of cancer. Age appears to dramatically increase disease risk, with the 65 and older group accounting for nearly half of the claims.

McMillan hopes that in the future, biomarkers — a type of precision medicine used to help prevent, detect and treat cancer — may help trigger an “early warning system” for firefighters, before the disease develops. Currently, there is no screening tool available to detect pancreatic cancer, and often times, the symptoms can be so vague and broad that may mimic other, less serious conditions. Usually, by the time someone is diagnosed with pancreatic cancer, the disease has progressed to an advanced stage .

Recently, IAFF delegates voted unanimously in favour of a resolution to provide $500,000 annually toward occupational cancer research — a move that could open doors to disease breakthroughs in the future. The association, which represents more than 332,000 professional firefighters and paramedics in Canada and the U.S., also provides support and resources to its members and invests in education so that those who choose to work within the profession can make informed decisions about their future.

“The tragedy exists for all those brave firefighters who, due to cancer, have answered their last call,” says McMillan. “Those who, well before their time, did not succumb to injuries at a fire they bravely ran in to, but died  from  the fires they ran in to.”

Before he was diagnosed with pancreatic cancer, Leslie tried unsuccessfully to get an appointment with his family doctor who had previously misdiagnosed him with diabetes. He was feeling tired — a symptom he initially attributed to decades of shift work — and his urine had turned a dark orange colour. He developed jaundice and was going through containers of TUMS to help relieve acid reflux and heartburn symptoms. Before making the trip to the ER that led to the pancreatic cancer diagnosis, Leslie had asked his family doctor for additional tests, but those requests went unanswered.
“We all know that being a firefighter is a dangerous career, but my husband did not die firefighting,” reveals McBride. “We strongly believe that he lost his life as a circumstance of being in this profession.”