Inside LIVESTRONG’s push into the fire service, and why its president believes support for a cancer diagnosis should arrive as fast as the truck does
Everybody remembers the wristband.
Yellow, a quarter-inch of silicone, stamped with a single word — LIVESTRONG — that most people wore without ever asking what stood behind it. For a few years in the 2000s, it showed up on wrists at construction sites, at little league games, and at firehouses across North America, until it became less a symbol and more a piece of the cultural furniture — familiar enough that most of us stopped asking what that one word actually meant.
Behind that one word is an organization that has spent nearly three decades trying to answer a question the medical world has been slow to ask: what happens to a person after cancer enters their life? LIVESTRONG has supported more than 10 million people living with, through, and beyond a diagnosis since 1997. Lately, its attention has turned toward a group of people who are usually bad at accepting help: firefighters.
That turn toward the fire service is what led CRACKYL to reach out to LIVESTRONG CEO Suzanne Stone. It’s also what put her organization at the center of the First Responder Ride for Resilience, a 343-mile bicycle route from Boston to New York City that finishes at the 9/11 Memorial on the eve of the 25th anniversary of 9/11. One mile for every FDNY firefighter lost that day.
Stone did not come to this work through the fire service. She came to it through cancer itself, through the institutional realization that surviving treatment and surviving the years afterward are two different problems. What she has learned since turning her organization’s attention toward firehouses is the subject of this piece, built from her own words about what an outside organization can offer a culture that has spent generations training itself not to ask for anything.
A Community Built to Be the Helper
Ask Stone what separates firefighters from the rest of the cancer community she serves, and she doesn’t hesitate.
“This is a community whose entire identity is being the helper, not the helped. We’ve learned that a firefighter will move heaven and earth for a brother or sister with cancer and then downplay their own diagnosis as part of the job.”
Anyone who has worked a shift knows exactly what she means. A member gets sick, and the firehouse becomes a machine built for exactly this purpose. Shifts get covered without being asked. Meals show up at the door. Someone starts a group chat, someone else knows a guy who knows an oncologist, and within a day the entire crew has organized itself around a single mission: get our person through this. That machine runs beautifully when it’s pointed at somebody else, and it stalls the moment the diagnosis belongs to the person usually running it.
Stone has watched this pattern enough times to build a theory around it: “In most of the cancer community, a diagnosis is a shock. In the fire service, it’s unfortunately almost expected.”
Firefighters have absorbed enough research, enough departmental briefings and enough personal loss to know that cancer is occupational math now, not bad luck. In 2022, the International Agency for Research on Cancer made it official, classifying firefighting itself as carcinogenic to humans. Federal data backs it up – firefighters are diagnosed with cancer at higher rates than the general population, and they die from it more often, too.
Knowing the odds hasn’t made the diagnosis easier to absorb. It has arguably made it easier to minimize. When an entire profession has been told for years that this is simply part of the job, there’s a real risk that acceptance curdles into silence, that a firefighter treats a biopsy result the way they’d treat a sore back — something you don’t bother the crew about. Stone’s read on that dynamic is blunt: the acceptance can keep firefighters from reaching for support they have unquestionably earned.
The diagnosis rarely stays contained to one person, either. A spouse becomes the one tracking appointments and insurance paperwork at midnight. Kids notice a parent missing from a game they had never missed before. The crew absorbs the schedule disruption because that’s what a firehouse does when one of its own goes down.
“A diagnosis doesn’t just hit a biological family,” Stone says. “It impacts the whole firehouse family.”
Where 10 Million People Led LIVESTRONG
To understand why Stone is having this conversation at all, it helps to understand what LIVESTRONG became once the wristband stopped being the headline.
The organization’s founding purpose was narrower than its current one: support people affected by cancer so they have the best possible quality of life. In the late ’90s, that meant showing up in a medical landscape almost entirely focused on treatment, with little institutional interest in what happened to a patient once treatment ended. LIVESTRONG helped establish survivorship as its own field of study inside cancer care, the once-radical idea that surviving the disease and surviving the years that followed required two different kinds of support.
“The wristband put us on the map, but it was always about what the wristband stood for,” says Stone. The organization’s current definition of survivorship starts earlier than most people would guess. It’s not at the end of chemo, not at the five-year mark oncologists love to cite, but at diagnosis itself. The day someone hears the word is the day LIVESTRONG considers them a survivor, because that’s the day their life changes and doesn’t change back. “Surviving is just the beginning.”
Everything the organization offers flows from that definition: help understanding a diagnosis, emotional support, guidance on fertility preservation before treatment begins, rebuilding physical strength once treatment ends, and navigating the financial, insurance and employment questions that show up uninvited alongside the medical ones. All of it free, and all of it, according to Stone, built around a simple premise: nobody should have to figure any of this out alone. “There’s a real human on the other end of that. No one navigates alone.”
For the moments that don’t fit inside office hours, LIVESTRONG built Ellis, a companion app available around the clock for the three-in-the-morning questions that show up after a diagnosis, or the night before a scan, or the moment someone remembers something they meant to ask the doctor. There’s also a free guidebook, meant to function as a map for a road nobody wants to be driving down.
None of it comes with an expiration date, which matters more than it might first appear. Stone points to the end of active treatment as one of the most overlooked and loneliest stretches of the entire experience.
“The moment treatment ends can be one of the loneliest parts in the whole journey,” she says. “The appointments stop, the casseroles stop, everyone expects you to go back to normal, and you’re standing there wondering who you are now.”
If someone finished treatment five years ago and they still fear recurrence, Stone wants that person to know the door hasn’t closed. That fear, she says, is survivorship, too, and LIVESTRONG is there for it just the same.
A Phone Call, Then 343 Miles
Every organization eventually has to answer a harder question than what it does: why it decided to do it here, with this community, right now.
For LIVESTRONG’s move into the fire service, the answer starts with a single phone call. The wife of a firefighter reached out to Stone with a story about a bicycle ride through the Irish countryside that honored the victims of 9/11, and a simple question, “Could something like that happen here?”
“We dream big at LIVESTRONG,” Stone says. “So we went really big.”
What came back was the First Responder Ride for Resilience, developed alongside Friends of Firefighters and the Boston Fire Cancer Foundation, the latter founded by Boston firefighter Kevin Ranahan and his brother after his brother’s own cancer diagnosis. The number of miles was never up for debate once the concept existed: 343, one for each FDNY firefighter lost on Sept. 11, 2001, starting in Boston and ending at the 9/11 Memorial in Manhattan on Sept. 10, 2026.
Stone is careful about how she frames the timing. This isn’t a ride built to look backward.
“Twenty-five years after 9/11, this is not a historical look back. It is a present-day crisis.”
Mental health was written into the route from the start, not bolted on afterward. Riders will walk through the Glade at the 9/11 Memorial, the section that honors everyone who has died since from illness and injury connected to that day. An equine therapy team will meet the group in Stamford, giving riders a chance to decompress before the final push into New York.
“Cancer is not just a physical disease,” Stone says. “It comes with fear, grief, identity loss, and for this community, it can come on top of trauma that has already been experienced on the job.” For 9/11 responders specifically, she added, that day never really ended.
“You can’t support someone through cancer while ignoring everything else they’re carrying,” she says.
Trust Travels Better Than Outreach
Here is the part of Stone’s answers that should matter most to anyone reading this in a firehouse: she knows an outside organization can’t simply announce itself into this community and expect to be believed.
She’s learned that firefighters respond to people who understand the job in their bodies, not just on paper — people who’ve lived the physical toll and the emotional one firsthand. That’s a large part of why Kevin Ranahan matters so much to this partnership. When a resource arrives through someone who’s already inside the house, it stops feeling like charity and starts feeling like family looking out for its own.
“When it comes from inside the house, resources are trusted and it becomes a feeling of family support, not someone from the outside offering help,” Stone says.
That, in her view, is part of what makes the ride itself effective as an outreach tool in a way a brochure never could be. It’s physical. It’s shoulder-to-shoulder. Stone has watched people find healing through action they didn’t know they needed until they were already moving through it.
“They never want to come off the truck,” she says. “They never want to stop showing up for us. This is us showing up for them.”
The Whole House Gets the Diagnosis
One of the more overlooked pieces of Stone’s message is who, exactly, LIVESTRONG considers a survivor.
It isn’t only the firefighter in the treatment chair. The spouse managing appointments at midnight qualifies. The kids who notice their parent missing from the stands qualify. The crew restructuring the schedule to cover for someone who needs to be somewhere else qualifies, too. Stone calls this the ecosystem around a diagnosis, and every piece of it is eligible for LIVESTRONG’s support, free, because helping the people around a survivor is itself a form of helping the survivor.
“Cancer happens to all of them,” she says. It’s fitting, given how this entire relationship started, with a firefighter’s wife making a phone call because she thought her community deserved something better than what existed. Stone sees that instinct as common in this world. Family members are often the ones who reach out first, before the firefighter themselves.
“They shouldn’t have to carry that alone,” she says.
What Progress Actually Looks Like
Ask Stone where the field still falls short, and she doesn’t reach for diplomacy.
Survivorship support, she says, is still treated across most of the medical system as optional, a bonus resource for people resourceful enough to go find it, rather than a built-in piece of the standard of care. Someone finishes treatment, gets handed a follow-up schedule, and is wished good luck on the way out the door. Mental health support trails behind as an afterthought in far too many cases, and Stone believes that failure needs the fastest correcting in exactly the communities where the risk is occupational, and the culture still leans toward toughing it out.
Her definition of success for the next decade is specific enough to hold her organization accountable: every firefighter diagnosed with cancer connected to survivorship support starting on Day 1, without having to ask, without having to decide whether they deserve it.
“As automatically as the truck rolls when the tone drops,” she says.
After Sept. 10
Stone doesn’t want the First Responder Ride for Resilience finish line mistaken for an ending. The money raised and the relationships built with Friends of Firefighters and the Boston Fire Cancer Foundation are meant to outlast the ride itself, funding resources built specifically for first responders and shaped by what this community has spent months teaching LIVESTRONG about itself.
Her ambition beyond the ride is almost disarmingly simple: “What I’d love is for every firehouse in America to know our name so the day someone in their house gets a diagnosis, they don’t have to figure it out alone,” Stone said.
“The ride ends Sept. 10, but we’re just getting started.” — Suzanne Stone
Firefighters or family members looking to connect with LIVESTRONG can start at livestrong.org
