Cancer changed her life, but a year and a half after being diagnosed with bilateral breast cancer, Lieutenant Nicole Stanley has returned to her job as a firefighter paramedic at the Mashpee Fire and Rescue Department.

“Now I feel like I have purpose again,” Lt. Stanley said.

The lieutenant, who has worked at the department since she became its first female EMT and firefighter in 1991, said she has been “back on my regular shift with my guys on Group Two,” since December 19.

“We’re very glad to have her back,” Mashpee Fire Chief Thomas C. Rullo said. “I think it’s very good for anybody who has cancer or the threat of cancer to know that your life doesn’t have to be over. You can fight it and come back to work.”

Lt. Stanley finished her chemotherapy treatment on December 21, 2018, less than a year before returning to work.

In addition to the 16 weeks of chemotherapy, she underwent two surgeries and myriad medical appointments before being told “no residual carcinoma detected.”

“I was lucky that I got back to work in a year and a half,” Lt. Stanley said. “I responded very well to chemo and chemo is not easy. It’s hard, it’s terrible and I got pretty sick.”

Her original treatment, she said, included radiation therapy and an additional round of chemotherapy, which did not become necessary.

From the moment her doctors prescribed her treatment, Lt. Stanley said she was calculating how long it would be before she could return to work.

“We’re Type A personalities,” Lt. Stanley said of firefighters. “We go in, we fix, we get out and go on to the next problem.”

“I accepted my cancer pretty quickly, what I didn’t accept was the timeframe of the treatment,” she said. “I was like ‘fix it, give it to me, I’ll be back to work in a month.’”

Instead, overcoming cancer and returning to work took “475 days,” Lt. Stanley said. “Not that I was counting, but I was counting.”

Despite being back at work, after fighting cancer, “you never go back to normal,” Lt. Stanley said.

Since returning, “the biggest thing is just watching out for myself,” she said.

“The guys at the station would joke that I was a nighthawk,” the lieutenant said. Now, she makes sure to get enough rest and wears a mask more often to protect her recovering immune system.

“If I get sick, I can’t work and I can’t help the community,” she said. “I can’t be there to do what I love and I love my job and I love this town, I love this community, I love my family of firefighters. I mean, I wouldn’t have gotten through this if it wasn’t for them.”

Presumption

For firefighters, whose job includes entering buildings where burning materials often release dangerous cancer-causing chemicals known as carcinogens, cancer is an occupational hazard.

Compared to the general US population, firefighters face a 9 percent increase in cancer diagnoses and a 14 percent increase in cancer-related deaths, according to the National Institute for Occupational Safety and Health.

With no family history of cancer and a healthy lifestyle, Lt. Stanley said her oncologist told her that years of exposure to carcinogens while on the job as a firefighter was a definite contributing factor in her diagnosis.

“Firefighters have the highest risk of all forms of cancer,” Lt. Stanley said.

“Unfortunately, over the years you hear about firefighters, they lose their jobs, they go bankrupt, they lose their homes because when they got cancer on the job it wasn’t covered. It wasn’t a work related injury unless it was heart or lung related,” the lieutenant said.

She counted herself lucky. Just weeks before her diagnosis in August 2018, a bill was signed into law on July 24, 2018, that designated cancer as a work-related injury for firefighters.

For firefighters diagnosed with cancer, the Cancer Presumption Law covers the cost of medical treatments as well as the time missed because of the illness.

But, Lt. Stanley said, with her diagnosis coming less than a month after the law was adopted, she fell in a gray area: towns did not have to accept the law for 90 days.

“I was lucky because I heard throughout the state there were other female firefighters, that they were in that gray area where they weren’t getting the coverage and they weren’t getting the protection,” Lt. Stanley said.

Town Manager Rodney C. Collins waived the 90-day grace period.

Lt. Stanley said she learned later that although Mr. Collins waived the grace period, the insurance company tried to deny her coverage.

The town took on the bills and fought for Lt. Stanley to receive coverage. Mr. Collins said, “The presumption law was crystal clear in my eyes and I believe its spirit and intent was to resolve these types of situations.”

“I had a few tiffs with the insurance company,” he said. “I acknowledge that maybe I got a little tart with them.”

After learning what the town manager did for her, Lt. Stanley said that when she ran into Mr. Collins at the Mashpee Commons Starbucks she went up to him to “thank him for having my back.”

“He hugged me like a dad,” she said. “He just took me and he goes, ‘We’ve got your back. We’ll take care of you.’”

The town manager described Lt. Stanley as “the personification of toughness.”

“She has a lot of passion for the job and I think it’s a true reflection of her character and courage as well as her commitment not to give in or to give up,” Mr. Collins said. “She was gone and determined to return to full duty status and she made it.”

Covered by the presumption law as she underwent and recovered from her chemotherapy treatments and surgeries, the lieutenant did not have to use vacation days, personal time, or the 2,100 hours of sick leave she accrued during a firefighting career.

“The only thing I had to do was fight cancer,” she said.

The Hardest Part

Lt. Stanley described having “cancer brain” when she learned of her diagnosis and “chemo brain” as she went through treatment.

“The ping pong balls just start bouncing and they don’t stop,” she said. “They just don’t stop because life is just—all of a sudden you’re just numb.”

Although her oncologist told her early on that she was not going to die from breast cancer, during chemo, she said, “there were days that I didn’t think I was going to make it.”

“There were times I woke up at 3 o’clock in the morning and I put post-it notes on things, thinking I wasn’t going to make it through,” the lieutenant said. “I felt that sick and I was in that much pain.”

Her hair fell out. She slept for days at a time. She described a “metal taste” in her mouth from the chemo treatment.

“If I drank coffee it was like chewing on a battery,” Lt. Stanley said.

When she did get out of the house, other than for a medical appointment, she would rarely go farther than Mashpee Commons to get her mail or read a book at Starbucks, she said.

“No matter how many stories I tell, or how many lectures I give, unless you’ve been told, ‘you have cancer,’ you don’t understand,” Lt. Stanley said.

Despite the side effects of the chemotherapy and the sense of purposelessness she described before she recovered enough to return to work, the lieutenant said that the most painful part of her experience was being unable to tell her mom.

“The hardest part is my mother has Alzheimer’s,” she said.

Lt. Stanley was on her dock along Great River, having just learned of her diagnosis from a voicemail, when she made the decision not to tell her mother, she said.

“She would understand it when you tell her, she would be sad and then 15 minutes later she would still be sad but not know why she was sad,” the lieutenant said.

Before Lt. Stanley was diagnosed with cancer, the firefighter said she was her mother’s primary caregiver and would visit her mom at her home in Worcester once or twice a week.

“My mother still knew who I was when I was diagnosed,” Lt. Stanley said. “I was my mom’s rock.”

The day after her diagnosis, Lt. Stanley said she visited her mom.

“It was really hard because I had to be with her and not cry. I just wanted to bawl. I just wanted to hug my mother and cry,” she said.

“The only person I need in my life was my mom and I didn’t have her,” the lieutenant said. “I couldn’t tell her I have cancer and I had to keep a smile on my face to protect her.”

Once she started her cancer treatments, Lt. Stanley said she didn’t have the energy to drive to Worcester.

A friend drove her once but, “it was just hard for me to get up there and then be with her and be high and happy so she wouldn’t pick up on it, because she reads emotion,” the lieutenant said.

The only time Lt. Stanley wore a wig was when she was with her mother, she said.

“In the course of that year, we’d lost my mother completely, meaning she has no idea who we are anymore and that’s the hardest thing,” Lt. Stanley said.

“There’s no rhyme or reason when her Alzheimer’s accelerated but I kind of blamed it on the cancer because once I started treatment I probably only saw her maybe two or three times,” she said.

Then, in the early hours of the morning one day last summer, Lt. Stanley said, she received a call from the Worcester police that her mother had wandered out of her house.

“I had to find a facility for my mother and then move her into the facility, prep her house to be sold, and then I had surgery in July, and then we sold her house in August,” the lieutenant said, “So it was a hell of a year.”

“If anyone asks me about anything,” Lt. Stanley said, “I’m more angry about the cancer because it took time away from my mother.”

Pay It Forward

The cancer diagnosis came just days before Lt. Stanley planned to join a group of friends for a motorcycle trip to Vermont.

At first, she cancelled.

Then, as she drove home from visiting her mother, the day after her diagnosis, the lieutenant received a call.

It was Dan O’Connell, or “Flippy,” as she calls the Dennis firefighter, who also battled cancer and was the first person Lt. Stanley told of her diagnosis. She recalled their conversation.

“How’s the ping pong balls doing?” he said.

“They’re bouncing, they’re spinning,” she replied.

The now-retired Dennis firefighter asked if she was still going on her trip to Vermont.

“No,” Lt. Stanley told him, “because I was just diagnosed with cancer.”

“Yeah, you were and you’re not dead yet, get your butt on the bike and go,” she said he told her. “What are you going to do, sit at home and just let the brain take over?”

So, Lt. Stanley met with the group of 30 bikers at Dunkin’ Donuts the next day, she said.

The lieutenant said she had only told two of her friends of her diagnosis and wasn’t ready for the whole group to know.

“We’re biting our lips,” she said, “I told them, ‘quick hug and then walk away from me because if you hug me too long I’m going to bawl.’”

The lieutenant described “holding a front” as she waited in line to order a coffee with the other bikers.

As she stood in line, dressed in her biker gear, she said an older man, whom she guessed to be in his 70s or 80s, said to her, “Damn you look hot. You’re smokin’.”

“Most of the time I’d be kind of embarrassed,” Lt. Stanley said, “but I just looked and said ‘Thank you,’ because here I am, just spiraling into this hole of cancer and this guy just says to me, ‘You look amazing.’”

The other bikers looked up from their phones and giggled, she said.

“That guy has no idea I was diagnosed with cancer 48 hours earlier. Nobody in line knew what was going on,” Lt. Stanley said. “I got on my bike and I’m bawling my eyes out on the highway, 495, because I’m like ‘I got cancer,’” she said, “but I’m thinking back to that one guy that made that one comment that changed my whole day.”

“It’s the small things and having cancer, as bad as it was, has its good side, it made me appreciate things a lot more,” the lieutenant said.

Though Lt. Stanley is back at work, she said she is not in the clear yet.

“You don’t get cancer-free,” she said. “You’ve got this window of dealing where the cancer could come back so the five-year mark is the huge goal.”

February 13 will be Lt. Stanley’s one-year mark.

In the meantime, she recalls those who helped her through her cancer, in ways big and small.

Mr. O’Connell, the former Dennis firefighter, “has become my captain,” she said.

“Now I’ve switched roles,” Lt. Stanley said. “Unfortunately, other people have been diagnosed with breast cancer. Right now I’m helping a fellow sister firefighter that has breast cancer.”

She also recalled the meal train her CrossFit friends organized, the Christmas lights a former patient hung on her house when she was going through treatment, and the notes of well-wishers that she hung on her wall.

“Just like everybody helped me, I’m going to help others,” the lieutenant said. “What comes around goes around. Pay it forward.”

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