‘An uphill battle’: South County firefighter facing his toughest fight

EVERETT — For Nick Jessen, firefighting was never a question of if, but when. He grew up trailing his grandfather on 911 calls, absorbing the rhythms of service from the station floor.

By 17, he was a volunteer firefighter. By 19, a lieutenant. Now, at 38, after 22 years in the fire service, Jessen is facing a battle far more personal: stage four lung cancer.

The diagnosis came as a shock. Jessen had been experiencing persistent nausea and vomiting, prompting a hospital visit in early February. A CT scan and X-ray revealed a mass in his lungs, as well as metastases to his spine and brain.

His story isn’t unique. Firefighters face a significantly higher risk of cancer due to repeated exposure to toxic chemicals and smoke on the job.

Doctors told Jessen that, without treatment, he would have six to 12 months to live. With treatment, his prognosis is uncertain.

“I don’t fit the mold of a typical lung cancer patient,” he said. “I’m 38. I’m healthy. I’m active. I’ve had a physical job for over 20 years, and that will help me long term.”

Jessen’s career in firefighting began in 2003 when he joined North County Fire in Arlington as a volunteer. Over the years, he worked for multiple departments. He is currrently a firefighter at South County Fire and AMR Lewis County.

A known risk

A 2015 study by the CDC and the National Institute for Occupational Safety and Health found that firefighters have a 9% higher chance of being diagnosed with cancer and a 14% higher chance of dying from it. Between 2002 and 2019, 66% of firefighter deaths were attributed to cancer.

Eric Monroe, director and co-founder of the Washington State Chapter of the Firefighter Cancer Support Network and retired battalion chief with the Shoreline Fire Department, has seen too many colleagues succumb to cancer. He spent 38 years in the fire service, 33 of them full-time, before retiring in 2023. Throughout his career, he was dedicated to firefighter health and wellness, working on prevention efforts such as annual physical screenings and exposure reduction policies.

In 2010, Monroe conducted a survey of full-time fire departments along the I-5 corridor to determine how many required annual physicals. The results were alarming — many departments lacked formal health screenings.

This spurred his effort to advocate for preventative health measures in the fire service.

“Going to one fire and breathing in a bunch of smoke will make you sick acutely, but over the long term of your career, absorbing these things through your skin and inhaling them contributes to higher incidences of cancers at earlier ages.” Monroe said.

He worked closely with co-founder Bill Hoover, a firefighter who survived esophageal cancer and dedicated himself to advocating for firefighter health. Hoover was instrumental in establishing the Firefighter Cancer Support Network in Washington. He was killed in a car accident in 2023, but his legacy lives on through the Washington State Council of Firefighters Cancer Foundation, named in his honor.

“It was a deep honor for the firefighters to recognize him,” Monroe said. “Bill was a mentor, and he used his own experience with cancer to support others in the fire service.”

A culture shift

Jessen remembers when fire stations still smelled like smoke, and a soot-blackened helmet was a badge of honor.

“When I first started, there was a lot less information,” he said. “We didn’t talk about cancer risks.”

Today, fire departments stress decontamination protocols, annual physicals and better protective gear. The bunker gear now includes vapor barriers up to the ears and neck to reduce chemical exposure. Firefighters are encouraged to wipe off their skin immediately after fires, shower as soon as possible and swap out contaminated gear.

Monroe said shifting attitudes has been crucial — but also one of the biggest challenges.

“It was accepted and celebrated to have dirty gear,” Monroe said. “Now, it’s ingrained in the fire service mentality that if you come out of a fire, you’re contaminated.”

Despite the progress, firefighters continue to face heightened risks. Monroe himself has had skin cancer spots removed. Esophageal, testicular and lung cancers also occur at higher rates among firefighters, he said.

Research on firefighter cancer risks is still evolving, with gaps in understanding long-term exposure effects. He and the Firefighter Cancer Support Network are working to close those gaps through advocacy, research and education.

Bob Eastman, fire chief at South County Fire, the largest fire district in Snohomish County, has seen firsthand the impact of cancer on his department. Over the years, he estimates that about 35 members of the department have been diagnosed, with at least seven dying from the disease.

South County Fire does not mandate annual physicals unless a firefighter is a hazmat technician, but they are available to those who want them. This year, the district began offering full-body ultrasounds and an expanded blood panel, fully covered for all staff, with the goal of catching cancer earlier.

“The point is to make sure you’re healthy while you’re here and still healthy when you retire,” Eastman said.

The department has also invested in safety measures like specialized washing machines and gear extractors to remove cancer-causing contaminants from bunker gear — an expense many fire departments cannot afford.

Beyond cancer, Eastman noted that the fire service faces other health crises, including high rates of cardiovascular disease, sleep deprivation from shift work, post traumatic stress disorder, high alcohol use and increased suicide risk, have prompted more focus on firefighter wellness in recent years.

Jessen has already completed five rounds of radiation for his brain tumor and is set to begin chemotherapy later this month.

“It’s an uphill battle,” he said. “It’s not like it got caught early … The prognosis is not good.”

Despite his diagnosis, Jessen remains pragmatic. He said the fire service had already shaped his outlook on life. Years of facing death — pulling people from fires, responding to fatal crashes and performing CPR — taught him how quickly everything can change.

As he prepares for the first stage of chemotherapy, Jessen has been overwhelmed by the outpouring of support. An online fundraiser set up by his sister, Colette Massarelli, aims to ease financial pressures as he and his long-term girlfriend, Katie Clark, navigate treatment.

“You just gotta roll with the punches,” Jessen said. “Now I just have to do this cancer stuff.”

Aspen Anderson: 425-339-3192; aspen.anderson@heraldnet.com; X: @aspenwanderson.