Firefighter Wellness Supplement
attention the higher incidence of cancer
among firefighters than in the general population. (1) It cited a 14 percent
increased risk of dying from cancer compared to the general population. Close
to 30,000 firefighters from the Chicago,
Philadelphia, and San Francisco Fire
Departments participated. Researchers
from the National Cancer Institute (NCI)
and the University of California at Davis
Department of Public Health Sciences
observed the firefighters.
Among some of the other findings of the
study were the following:
• The most common cancers among fire-
fighters were digestive, oral, respirato-
ry, and urinary.
• Twice as many firefighters as in previous studies had malignant mesothelioma, caused by exposure to asbestos.
• Younger firefighters had more cases
of bladder and prostate cancers than
• The incidence of lung cancer increased
with the amount of time spent at fires.
• Leukemia deaths increased with the
number of fire runs. (1)
It is not within the scope of this
article to discuss the numerous actions
the fire service has taken to lower the
cancer risks in the fire station and on the
fireground or initiatives fire departments
have implemented in addition to those
mentioned above, such as nutrition
and exercise programs and educational
programs offered by the unions and fire
The Cancer MoonshotSM, later
renamed the “Beau Biden Cancer
Moonshot,” in memory of the late son
of former Vice President Joe Biden who
died of a brain tumor, is a multiyear
comprehensive initiative that has as
its goals the following: to accelerate
cancer research, to make more therapies
available to more patients, and to prevent cancer by detecting it at an early
stage. Joe Biden heads the program. A
blue-ribbon panel of experts was established as a working group of the National Cancer Advisory Board. In December
2016, Congress passed the 21st Century
Cures Act, which authorized $1.8 billion
in funding for the Cancer Moonshot over
$300 million in fiscal year (FY) 2017 to
fund Moonshot initiatives.
The Moonshot blue-ribbon panel
recommended that the network include
• Direct patient involvement. Patients
would contribute their comprehen-
sive tumor profile data, which would
increase knowledge about what
therapies work, in whom, and in which
types of cancer.
• A cancer immunotherapy network
to discover why immunotherapy is
effective in some patients but not in
• Therapeutic targets for detecting
mechanisms that lead cancer cells to
become resistant to previously effective treatment.
• A national ecosystem for sharing and
analyzing cancer data so that researchers, clinicians, and patients can
• Intensified research on the major driv-
ers of childhood cancers.
• Accelerated development of guidelines
for routine monitoring and manage-
ment of patient reported symptoms.
• Expanded use of proven cancer prevention and early detection strategies.
• Studying past patient data to predict
future patient outcomes.
• Predicted response to standard treatments through retrospective analysis
of patient specimens.
• Dynamic 3-D maps of human tumor
evolution to document the genetic lesions and cellular interactions of each
tumor as it evolves from a precancerous lesion to advanced cancer.
• New cancer technologies to characterize tumors and test therapies. ( 2)
A significant provision of the Cures
Act was to create a National Institute of
Health Innovation Account ($4.8 billion)
to support the Precision Medicine Initia-
tive ($1.45 billion over the next 10 years).
The Cures statute states the purpose
of the Cancer Moonshot funding as fol-
lows: “To support cancer research, such
as the development of cancer vaccines,
the development of more sensitive diag-
nostic tests for cancer, immunotherapy
and the development of combination
therapies, and research that has the
potential to transform the scientific
field, that has inherently higher risk, and
that seeks to address major challenges
Precision Medicine is a new model of
patient-powered research. It “promises
to accelerate biomedical discoveries
and provide clinicians with new tools,
knowledge, and therapies to select
which treatments will work best for
which patients.” The rationale is that
most medical treatments have been
designed for the “average patient,” ( 2)
meaning that treatments may be very
successful for some patients but not for
others. Precision Medicine takes into ac-
count individual differences in people’s
genes, environments, and lifestyles.
Advances in Precision Medicine have
already led to powerful new discoveries
and several new treatments tailored to
specific characteristics of individuals,
such as a person’s genetic makeup or
the genetic profile of an individual’s
tumor. Through collaborative public and
private efforts, Precision Medicine will
make it possible to manage and analyze
large data sets while protecting privacy
to accelerate biomedical discoveries. A
million or more Americans will volunteer to contribute their health data to
improve health outcomes, accelerate
the development of new treatments, and
bring about a new era of data-based and
more precise medical treatment. A fact
sheet on the Precision Medicine Initiative is at http://bit.ly/2xf9dxh.
NCI and the Cloud4
The Cancer Moonshot goal of expanding cancer data access and data
sharing led to the sharing of public and
private data between the NCI and Cloud
is leading to a
transformation in the
way we can treat diseases
such as cancer.—Cancer