What They Bought With the Grant:

• Wellness and fitness program

How the Grant Has Helped:

The City of Puyallup Fire and Rescue received a grant in 2004 to implement a wellness and fitness program. The AFG-funded program includes providing physical exams to department members. There were two main purposes of the exams—to provide physical fitness baselines from which individually tailored fitness programs could be developed, and to identify hidden health problems before they worsen. Three Puyallup staff members received training in peer fitness counseling to help members develop their own fitness programs.

One of those to receive an exam, Puyallup firefighter Jon Barkas, hadn't had a thorough physical exam in 20 years. It was a good thing the grant and the physical exam came when it did, because the doctors discovered that Barkas had prostate cancer. Fortunately, because the cancer was in its early stage, physicians were able to treat it successfully. “I'm a believer in physical exams,” says Barkas. “If they are made available to you, don't make excuses, just get them done.” Puyallup Deputy Chief Kelvin Johnson comments that, “this program achieved excellent cost benefit—it saved the life of a valued employee!” Jon Barkas asked to share his story with other firefighters who may be postponing getting physical exams. Here is his story.

December 5, 2005

I recently turned 50 and have served over 26 years as a professional firefighter. At my present department where I have worked for the last 20 years, I hadn't had a full annual physical since I was hired because our medical insurance didn't cover physicals and I am not a member of our special teams that require annual physicals. This year my department received a grant to establish a wellness/fitness program and to pay for physicals for department members who have not been provided physicals.

Though I have not been getting a full physical each year, my doctor had been having blood work done on me the last few years, including a PSA ( editor's note.: a blood test for prostate cancer) and a cursory exam which gave no indication of any problems other than a fair amount of wear and tear on my joints and back. Since I am fairly active physically, have kept my weight down, and have not experienced any unexplained physical problems, I was a bit wary of this department-sponsored physical. After I was satisfied that the results would be confidential, except for a fitness for duty approval for the department, I scheduled a physical exam in early September.

The physical exam was uneventful. The doctor at the clinic decided that I should have a digital rectal exam (DRE) rather than a PSA test since it had been so long since I had a DRE. After the exam, the doctor told me that my prostate felt asymmetrical and that I should follow up with a urologist for a further exam. Other than that, I was given a clean bill of health, and told not to lose sleep over the prostate exam but to have it checked out.

To make a long story short, I was referred to a urologist who examined me, gave me a PSA test (results 1.6), did a biopsy on my prostate, and diagnosed me with early stage prostate cancer (stage II) of a moderately aggressive form (Gleason score 7). Surgery was recommended because of my age and the early, aggressive form of my cancer. After consultation with a radiation oncologist and my regular doctor, and a few days of research on the internet, I elected to have surgery.

It was a good thing the grant and the physical exam came when it did, because the doctors discovered that Barkas had prostate cancer.

It's been almost 5 weeks since a successful surgery that removed my prostate and the cancer, which appears to have been confined to the prostate. It has been a challenging and stressful experience, but I am recovering well and returned to work last week on light duty.

If I had not had that physical, it's likely that my cancer wouldn't have been discovered until it was at an advanced stage and the treatment would likely have been devastating—physically, mentally, and financially—and quite possibly, unsuccessful. Also, the costs to my employer would have been months of disability leave and medical coverage for a disabled employee, rather than the 4 weeks I was off from work.

Let's face it; if you are a firefighter, you are in a high-risk group for a number of cancers and other serious health conditions, especially as you age. In my medium-sized department (50–60 employees), I know of one other member who was diagnosed and successfully treated for prostate cancer. We have had at least two other members of the department who have been diagnosed with other serious forms of cancer, one of whom died a year or two after I joined the department. Most of you know or have heard of similar stories.

I am a believer in annual physical exams. If they are made available to you, don't make excuses, just get them done. If annual physical exams aren't available to you, make the case for them and how they can ultimately save your employer money. Finally, if you don't like the old "finger sweep" (DRE), get over it, because the alternative isn't always reliable and the consequences could be much more unpleasant and life changing.

Here are a few prostate cancer statistics from the National Cancer
Institute ( www.cancer.gov ):

• One in six men will be diagnosed with prostate cancer in their lifetime.
• Prostate cancer is the second leading cause of cancer-related deaths among men (lung cancer is number one).
• In 2005, approximately 232,090 men will be diagnosed
  with prostate cancer (compared with an estimated 211,240 women who will be diagnosed with breast cancer).
• During the same time period, 30,350 men will die of prostate cancer (compared with an estimated 40,410 women who will die of breast cancer).

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