Farmington firefighter Stephan Bunker is using his recent cancer diagnosis and treatment to educate other firefighters about how to reduce exposures to carcinogens. He is also training to offer peer support to firefighters and their families who have been diagnosed with the same type of cancer. Submitted photo

FARMINGTON — After spending more than half of his life as an emergency responder, firefighter Stephan Bunker is on a mission to try to prevent other first responders from unknowingly being exposed to hazardous materials on the job.

In September, Bunker will attend a national training seminar hosted by the Firefighter Cancer Support Network that will enable him to educate firefighters on how to reduce exposures to carcinogens and provide peer support for firefighters and family members who have been diagnosed with the same form of cancer he has been treated for.

This X-ray shows the lump found in Stephan Bunker’s head two years ago. He is using his experience to inform other firefighters about carcinogens in the workplace. Submitted photo

“Cancer is that thing that happens to the other person, not to you,” Bunker said in a recent interview with The Franklin Journal. “But life changes in the twinkling of an eye. About six months after our propane explosion in town, just as I was trying to get my head cleared from that event I started coming down with prolonged headaches that were getting progressively worse.

“I kind of pooh-poohed them, used off-the-shelf pain relievers. They didn’t really work that well but I toughed through it for a few weeks until my spouse said, ‘You know, this is not normal, you need to get that checked out.’ My personal care physician thought it was just a deep sinus infection, told me to ‘take two of these and call me on Monday.'”

By then Bunker was even worse, was starting to lose his balance and the headaches had become excruciating.

“Luckily my PCP at that time became suspicious and sent me over to Franklin Memorial to have a CT scan done on my head just in case,” Bunker said. “He told me to stay by my phone and he would call me when he got the results. He called about one and a half hours later and said, ‘I have the results, I want you to come back to my office and bring your wife,’ which is an alarming suggestion – you know that it is not good news coming.”

Bunker was shown a picture of the scan which clearly showed he had a spot behind his right ear against his brain that shouldn’t be there. His PCP told Bunker he had good news and bad news. The bad news was it was fast growing and needed to come out immediately.

“I said, “So what is the good news?”” Bunker responded “[My doctor] said, ‘With COVID-19, surgeons are canceling all elective surgeries at Maine Medical Center. The other good news is I am friends with the best neurosurgeon this side of Boston. I’ve already called him. You are on the operating room table tomorrow morning at 6 a.m.’ So away to Portland we went.”

Stephan Bunker is seen at Maine Medical Center in Portland after undergoing surgery to remove a lump found near his right ear. He is training to become a peer support person to help firefighters who have been diagnosed with the same type of cancer. Submitted photo

Bunker said he was lucky from a couple of standpoints: he had an excellent neurosurgeon and the lump was very centralized, had not embedded itself deep in his brain. This made it easier for the lump to be removed cleanly but Bunker was told he would have to wait for the pathology report to know more.

When the report came back Bunker learned he had Central Nervous System lymphoma, a very aggressive cancer. He was told there was no real cure and minute part of the tumor could still be in his system.

Bunker was referred to an oncologist who recommended very aggressive, intense chemotherapy.

Bunker shared her recommendation: “‘Once a month you will get an injection. This is going to be five days inpatient. We are going to put a port in your chest and they are going to pump you with fluids for five days, day and night and then we will send you home for a week to 10 days to make sure your kidneys can handle this process.'”

Bunker said he didn’t think it sounded that bad until he was told it was going to be repeated eight times.

“That was, I would have to say, a real challenge,” he noted. “Time went so slow with that process. I had to have MRIs done on my head to see if it was still clear.”

With an 80% chance of Central Nervous System lymphoma returning within two years, Bunker’s oncologist worked to get him included in a trial program at Dana-Farber Brigham Cancer Center in Boston. The immunotherapy program was so intense that no one under the age of 60 could take part. Bunker was 71 at the time and his oncologist was able to convince the trial doctor he “wasn’t a toddling old 70-year old on his last legs, that he had handled the chemotherapy fine.”

Seen is the suture line on Stephan Bunker’s head following surgery at Maine Medical Center in Portland to remove a lump found near his right ear. Bunker is using his experience to educate other firefighters on how to reduce exposures to carcinogens. Submitted photo

The trial was six months long consisting of monthly infusions accompanied by an MRI and extensive blood tests. Bunker said he was fortunate with both treatments; he had very few side effects with no hair loss. He said the joke with his oncologist was that “he didn’t have to worry about that as he didn’t have much hair to start!”

Bunker is receiving an MRI and blood tests every two months, then it will be every six months. He considers himself lucky compared to other patients he met who weren’t eligible for surgery and are dealing with chemo and radiation treatments. He still swaps notes with some of them.

“I am hopeful that my being part of the trial work at Dana-Farber and having the results of my neurotherapy treatment will help others, help them perfect that process,” Bunker said. “There have been some remarkable immunotherapy breakthroughs. Years ago chemotherapy killed cancer cells and a lot of other stuff. The type of lymphoma I had are having some remarkable turnarounds.”

Bunker’s story was shared on the Dana-Farber blog. “I am seldom at a loss for words!” he quipped when speaking about it. Part of it focused on the relationship between carcinogens and firefighters, he said. Through that, Bunker was contacted by Firefighter Cancer Support Network, an organization he never heard of.

“Their mission is twofold: train and educate firefighters on how to reduce unnecessary exposures to carcinogens; provide peer support for firefighters (and their families) who have been diagnosed,” Bunker said. “That intrigued me.”

He researched, learned how sophisticated and well informed the organization was and the amount of training curriculum and materials that were available for him to use as an educator. Bunker is working to become a peer-support person.

“One of the toughest challenges I had wasn’t the surgery, wasn’t the chemo, but the fear of loneliness,” he said. “It is a tough thing when someone brings up the C-word. It was tough for my spouse too. She was my biggest advocate but I know she felt and continues to feel those concerns because thus far they do not have a complete treatment but they are doing better.”

Bunker is looking forward to the September seminar, the time he will get referrals from fire departments and their members. He said the ideal will be to match him up with firefighters who have the same type of cancer he has.

Bunker has already started on his educational campaign. He noted studies have found firefighters have a 9% higher risk of getting cancer and a 14% higher risk of dying from the disease than the general population.

Through Bunker’s connection to the State Fire Chiefs Association, he has done some presentations, appealed to them to understand there is more involved when firefighters respond to tragic events.

“Cancer in the fire service has become the number one line-of-duty cause of death for us,” Bunker said. “When you look at the toxic substances firefighters are exposed to, it is a chemical soup of the nastiest things you could think of. There is so much plastic in homes, vehicles now.

“When I started in the late 1970s, you always looked for someone that you wanted to emulate,” he said. “Typically that was a gray-haired crusty firefighter whose turnout gear was singed and dirty, soot around the edges and their helmet was black. Today you don’t want to be like that.

“We have got to change our habits on the scene and afterwards,” Bunker stressed. He shared the 11 actions firefighters can take immediately to protect themselves:

• Use self-contained breathing apparatus from initial attack to finish of overhaul

• Do gross field decontamination of personal protective gear to remove as much soot and particulates as possible

• Use cleansing wipes to remove as much soot as possible from exposed body areas immediately and while still on the scene

• Change clothes, wash them immediately after a fire

• Shower thoroughly after a fire

• Clean all turnout gear immediately after a fire

• Do not take contaminated clothes or gear home or store them in vehicles

• Decontaminate the interior of fire apparatus after fires

• Keep bunker gear out of living and sleeping quarters

• Stop using tobacco products

• Use sunscreen or sunblock

Bunker noted the Farmington department has two sets of gear for every firefighter. Heavy-duty washer-dryers allow one set to be rotated out for cleaning, he added.

On hiring, new firefighters should have a complete physical then annual follow-ups, Bunker said. A blood test can determine the likelihood of about 10 of the most common types of cancer and if they are present before becoming a firefighter – making it easier to apply for workers’ compensation if it should ever be needed, he noted.

Bunker was fortunate to learn about that test requirement – part of Maine’s workers’ compensation law – during a conference five years ago. He asked his doctor to schedule the test at his next physical and include the results in his medical records. Many doctors aren’t aware of the test, firefighters need to ask for it, he added.

“You know more about your body than anyone else does,” he said. “If you spend a couple weeks and feel ‘this isn’t right,’ check it out! That is one of the reasons firefighters have a higher rate of fatalities. We pooh pooh these things, put them off. I am a classic example of that.

“My main mission is to tell firefighters, particularly those newly in their careers, ‘Don’t do as I did, do as I say!’ Maintain good practices on scene and afterwards to reduce exposures,” Bunker urges, “and encourage fire chiefs to have policies and practices in place that will enforce steps to reduce exposure.”

Bunker is a selectman, has been a firefighter for 43 years and a state fire instructor with Southern Maine Community College for 33 years. He is working with those people on training curriculum for new firefighters.

“The material is so logical and straightforward,” he said. “We are battling a huge change in attitudes. There has been 200 years of proud tradition unhampered by progress. How firefighters look at themselves, protect themselves is a huge change for a lot of us. The badge of courage now is not how dirty or soot covered you are but how clean you keep yourself. Changing attitudes will be a huge nut to crack.”

Bunker plans to present programs on how to reduce exposure at mandated refresher courses for Franklin County firefighters – even if only in 30-minute segments. He has also offered his assistance to fire chiefs for review of training policies and operating procedures. Now semiretired, Bunker has time to take these things on.

“There is a saying, ‘There is no atheist in the foxhole,'” he said. “I have learned there is no atheist on the operating table. I made a little bargain with the Good Lord: If you can pull me through this in return I will invest myself in making a better change in others. It has given me focus.”

Bunker said he feels great, his energy has returned, and his new focus motivates him.

For him, the frustrating part is, unlike some other topics, this one has common-sense steps that can be taken.

“We can make a difference,” he said. “Prevention is the big emphasis. I have had line-of-duty deaths that I have had to deal with. This one is so, so easy to identify and deal with.”

For more information on trainings or seeking peer support, email Bunker at stephan.bunker@gmail. com or call 207-778-2558.

“My message to the general public is, aside from firefighting issues, we need to keep the faith and be hopeful about how the diagnosis and treatment of cancer has just gone in leaps and bounds,” Bunker stressed. “Cancer IS survivable, have hope. New immunotherapy practices are bringing amazing results.

“Secondly, try every day to make the world a little better for you having been there,” he said. “There are so many organizations that need volunteers like my firefighter cancer support network. Consider volunteering your time at the hospital, schools, service groups like the American Legion, Elks, Rotary Club, Lions Club, Meals on Wheels, or a town citizens committee or board. It will enrich your life as it has mine.”