Josh Palma, with the Texas oncology group, on his final day of treatment after a long nine-month journey, and a month before lab results would show he was in remission.
When a mysterious bruise appeared on his shoulder in June 2024, one firefighter thought little of it. Weeks later, he would be fighting for his life with a diagnosis of APL leukemia, enduring 41 days of chemo, isolation, and crushing fatigue. What emerged from that struggle was not just survival, but a mission: to build a symposium that unites firefighters, families, researchers, and leaders in the fight against occupational cancer.
Around June 20, 2024, I noticed a deep blue bruise on my left shoulder, though I couldn’t recall any injury. I brushed it off – maybe roughhousing with the kids – and went on with my day. A few days later, another larger bruise appeared on my forearm. That’s when I went to my doctor, who ordered labs and prescribed steroids.
On July 2, at 4:10 p.m., my phone rang. My oncologist told me I had likely drawn the “unlucky lucky card” – APL leukemia. He told me to pack a bag and head straight to the hospital. That night, my wife and I arrived at the ER. It was the last calm moment before the storm.
The heavy bruising that occurred easily in the early stages of Josh’s leukemia journey. There is a tattoo closer to his forearm, but the bruises on his back and tricep show how large and deep the bruises would become in less than a day sometimes.
41 Days Inside
By Day 2 in the hospital, my platelet count had dropped to just 8,000 (normal is 150,000+). A bone marrow test confirmed it: APL leukemia, a rare but aggressive form of blood cancer.
The first three weeks of chemo nearly broke me. My immune system collapsed, and suppressed issues – gout, GI pain, excruciating headaches – flared up. Fatigue became constant. The final weeks were quieter but no less draining, leaving my body exhausted and fragile.
Brotherhood in the Battle
What got me through wasn’t just treatment, it was people. My faith carried me, but the true lifeline was family, friends, and the fire service community. A few firefighters I barely knew reached out to share their own cancer journeys. Their honesty and encouragement gave me perseverance when mine ran thin.
One of those firefighters, who later passed from esophageal cancer, will never know how deeply his words carried me. It was his support – and the collective support of many – that planted the seed for what would come next.
A Mission is Born
During my treatment, I connected with legislators, trying to drive change, and I began to see the need for more education and shared resources. Out of that realization came the idea of a cancer symposium that would bring people together: firefighters, researchers, families, and leaders, to fight back against this disease that’s taking too many of us.
Josh in the hospital, where he was constantly hooked to an IV. “The bed seemed as if it was more a part of me than something used for sleep,” he says.
The Flower Mound Cancer Symposium
On March 4, 2026, the Flower Mound Firefighter Foundation will host the Flower Mound Cancer Symposium at the Bob Bolen Public Safety Complex in Fort Worth, Texas.
We are proud to have the Honorable Mike and Rosie Moncrief, GRAIL, and the Vincent Genovese Memorial Foundation as sponsors. Dr. Alberto Caban-Martinez and his team from the University of Miami’s Sylvester Comprehensive Cancer Center will present cutting-edge research, studies, and prevention practices. Additional sessions will address legislation, cancer screening, and the family impact of diagnosis.
“My wife Rosie and I have been truly honored to be embraced by the Fort Worth Fire Department, and in turn, we’ve proudly adopted the brave men and women of the FWFD as part of our extended family,” says Mike Moncrief. “Through this relationship, we’ve come to understand the impact of cancer among firefighters, caused by frequent exposure to carcinogens in the line of duty. This deeply moved us and has driven us to become actively involved in the fight against occupational cancer.”
The Moncriefs have supported their cancer support group, as it worked at every level, from City Hall in Fort Worth to the Texas Legislature, as well as the halls of Congress in Washington, D.C., advocating for awareness, prevention, and stronger protection for firefighters everywhere.
“While we’ve seen meaningful progress, there is still much work to be done,” Mike Moncrief adds. “That’s why Rosie and I are both delighted and humbled as one of the sponsors for the Flower Mound Firefighter Foundation’s important event. We hope it helps to inform, support, and empower not only the firefighters but also the families who stand beside them every day. Thank you for allowing us to be a part of this mission. May God bless you all, and please, stay safe.”
Megan Hall, PhD, Vice President of Medical Affairs at GRAIL, says, “Occupational cancer is the No. 1 cause of line-of-duty deaths for firefighters, and we understand the concern this can create for the health and safety of first responders. That’s why GRAIL is committed to supporting cancer screening for firefighters, and is proud to sponsor the Flower Mound Firefighter Cancer Symposium.”
This symposium isn’t just about science. It’s about connection, hope, and honoring those who stood by me in my darkest days.
Why It Matters
Cancer is a growing and devastating threat in the fire service. But with knowledge, connection, and collective action, we can shift the tide. My story began with a bruise, but it won’t end there. This symposium is a chance to take that pain and turn it into progress, for me, for my brothers and sisters in the fire service, and for the families who love us.
Save the Date: March 4, 2026 — Flower Mound Cancer Symposium, Fort Worth, Texas. Register online with TEEX.
