It's one of the most dangerous jobs in the world. Every day firefighters risk their own lives to protect the lives of others. Firefighters like Fire Captain Mike Palumbo. During his more than two decades of service, his wife Chrissy and their five kids couldn't help worrying about the job's more obvious dangers.
"He was drawn to service, I think," Chrissy said. "He was very passionate about giving back to the community that gave him the opportunity to have that career."
But a few years ago, far from any smoke or fire, something else caught up with Palumbo while hiking near the family's home in Beachwood, Ohio
"I knew as soon as we got there, something was wrong," Chrissy told correspondent Tony Dokoupil. "And I tried to convince him just to get back in the car. He was, like, 'No, I'm fine, I'm fine.' And we got down the ravine. And he literally walked into a tree. And I just panicked."
She rushed Mike to the hospital, where they learned he had stage 4 brain cancer.
Dokoupil asked, "What do you do when you get that kind of news?"
"I literally crawled into bed with him and prayed into his ear," Chrissy replied, crying. "I had my kids brought in, 'cause I didn't know if they'd ever see him again."
She said prior to the diagnosis, Mike had been "so healthy. It's just so mind-boggling that you have this young, healthy, strong, happy guy. And then in a snap of a finger, your life is turned upside-down."
For Palumbo's family, his diagnosis was a shock, but in fact it's part of an alarming national trend that's caught the attention of researchers like Dr. Jeffrey Burgess at the University of Arizona.
"The cancer risk that firefighters have is unique to being a firefighter," Dr. Burgess said. "They have so many different types of cancers that have been shown to be elevated."
He said the biggest danger to firefighters today has changed, from the fires they fight to the smoke those fires produce.
Since 2002, almost two out of every three firefighters who died in the line of duty died of cancer, according to the International Association of Fire Fighters.
Boston Fire Chief Joseph Finn said, "We have about 13 members right now who are battling various stages of cancers, active members. And we have a number of retirees in that fight."
Finn showed Dokoupil a memorial wall: "All the black-and-whites are members who have passed away from occupational cancer."
Since 1990, Finn said, cancer has killed more than 200 of his colleagues.
Dokoupil asked, "How does that compare to the number of firefighters who die in the fire itself?"
"It certainly outnumbers it at least ten, 20, 30 to one," Finn replied.
That's a change from the past, said Finn. And scientists believe it may be linked to another change, in modern building materials.
"Everything you buy today is laced with plastic," said Finn. "So, once they decompose and they combust they're going to give off all these toxins and carcinogens that are really deadly to firefighters."Mortality and cancer incidence in a pooled cohort of U.S. firefighters from San Francisco, Chicago and Philadelphia (1950-2009), published in Occupational & Environmental Medicine
According to the Centers for Disease Control and Prevention that includes formaldehyde, asbestos and arsenic.
And adding to the risk is an age-old tradition in firefighting: a celebration of soot as a sign of good work.
Long ago, being dirty was a badge of honor to a firefighter: "The dirtier you were, looked like the more you'd done and that you were the guy who got the job done," Finn said.
Now, as if surviving the flames and then fighting cancer weren't enough, some firefighters are facing another, even more stunning challenge from the very cities they're protecting.
Patrick Mahoney, 37, is a firefighter in Baytown, Texas, a city full of refineries and chemical plants, where taking on an inferno is all in a day's work.
In 2017, after 15 years of service in Baytown, Mahoney discovered a bulge on his neck - thyroid cancer.
"And we already had, at that point, one or two guys in my department that had cancer," Mahoney said. "And these were all people who were not smokers, who did not use chewing tobacco. They were healthy people. So, when I was diagnosed, I definitely felt that it was job-related."
It's impossible to ever be sure what causes a particular case of cancer, but Texas is one of 38 states with so-called "presumptive laws" - meaning if an active-duty or recently-retired firefighter is diagnosed with certain types of cancer, it's presumed he or she got it on the job and is entitled to workers compensation benefits (like lost salary and medical coverage).
But for many firefighters, those benefits are still out of reach.
"My city's workers' comp carrier initially flat-out said, 'We don't cover cancer,'" Mahoney said.
He appealed his case and won, twice, but then the city of Baytown sued him to get the decision reversed.
"To be sued like this after they denied it is a betrayal," Mahoney said. "It makes me sometimes want to go work at a coffee shop, because I feel like, they don't care."
At issue, according to Baytown, is whether Mahoney's thyroid cancer should be covered under Texas law. "Baytown has been seeking judicial clarification," the city explained in a statement, adding that paying each claim could cost the city "between $600,000 and $2 million per case."
And Mahoney's case is not unusual. Since 2012 in Texas, more than nine in ten firefighters have had their workers comp claims denied, according to the Texas State Association of Fire Fighters.
And it's the same back in Ohio, where Mike Palumbo worked his entire career.
Chrissy Palumbo said, "Like any other person who gets sick or injured on the job, the benefits should be there to take care of their health and to replace their income. It's that simple. Somebody breaks a leg at work, it's covered."
In 2017 Mike and his family had helped pass the Michael Louis Palumbo, Jr. Act a law that presumes firefighters will receive benefits if they get certain types of cancer on the job. "Firefighters just want to have the help, and now they have the help. It truly means a lot to me," Mike said two years ago.
Yet when Mike himself was too weak from the cancer treatments to work, his claim was denied.
He was only two months shy of official retirement when he had to turn in his badge.
Ten months later, at just 49 years old, he died.
"It's not, like, he died in a fire and you can say on this day at this time," said Chrissy.
"He died from all the fires," Dokoupil said.
"Yeah. You're telling me that because my husband died slowly from his job, that he shouldn't get the same benefits as somebody who died suddenly from their job? And that is the bottom line for me."
Two years after Palumbo's death, half of current firefighter cancer claims in Ohio have either been denied or are caught up in appeal, including his. Chrissy Palumbo says she'll keep fighting.
Fire departments around the country, meanwhile, have begun to focus on prevention.
In Arizona, Dr. Burgess says one of the easiest things that firefighters can do to help reduce cancer risk is wash their gear and themselves immediately after a call.
"When they go to a fire, they get the cancer-causing chemicals over all their gear," he said. "In the past they wouldn't segregate their gear. They may go sit down in their living quarters maybe with their gear on and get it on the couches, et cetera."
Tucson firefighters are also taught that looking "dirty" isn't heroic, but dangerous. Air masks have to stay on, even after the flames are out. And many departments are investing in a second set of gear, so something clean (and hopefully carcinogen-free) is always handy.
But for those who have been on the force for years, like Boston's Fire Chief Joseph Finn, the damage may already be done.
Dokoupil asked, "Do you think today talking about this you're carrying remnants of fires from the '80s?"
"Ugh, there's probably a good chance of that," Finn replied.
And he wonders, if we can't protect this generation of firefighters, who will come forward in the next generation to protect all of us?
Chrissy Palumbo's youngest son, she said, wants to be a firefighter, like his dad. "It frightens me," she said. "He emulates his dad. He misses him greatly."
Dokoupil asked Nicholas Palumbo, "Do you remember when you decided you wanted to be a firefighter?"
"Ever since I went to the fire station for the first time," he replied.
What was that like? "Basically, better than going to Disney, I can say that!"
Dokoupil asked Chrissy, "Bottom line, if you had your say as a parent, would you want Nicholas to become a firefighter?"
No, she said. "It's a good profession. It's a good life. But our family suffered enough."
For more info:Boston Fire Department Ohio Association of Professional Fire Fighters Baytown Fire Department Baytown, Texas Texas State Association of Fire Fighters Dr. Jeffrey Burgess, University of Arizona Firefighter Cancer Support Network
Story produced by Sari Aviv.