Mark Holmes spent his last 16 months battling Stage 4 non-Hodgkin’s lymphoma, undergoing chemotherapy, committing his life story to home video for his kids to one day watch and wondering how he had gone from picture-perfect health to bedbound. When the former Air Force major died at 37 in 2020, he had no idea others from his base had developed the same cancer.
Three years later, a growing number of “missileers” — service members tasked with manning the nation’s nuclear missile launch control centers — have shared that they were diagnosed with cancer, and many have lymphoma. An unofficial crowdsourced document created by a Space Force officer and obtained by The Washington Post totaled 30 cancer cases tied to people who worked at Malmstrom Air Force Base in Montana over 50 years. Fourteen had lymphoma, and four, including Holmes, died, according to numbers tallied up last month. Most were men in their 30s and 40s, well below the median age of 67 for a non-Hodgkin’s lymphoma diagnosis.
An Air Force lieutenant colonel who commanded Holmes argued in a Jan. 11 letter that Holmes’ cancer was caused by the thousands of hours he spent in the subterranean missile bunkers at Malmstrom. The letter, written to help Holmes’s wife prove his death was service-related so she could obtain survivor’s benefits, pointed to radon exposure and a slew of other chemicals in the 1960s-era silos as potential causes of the cancer. The letter warned of “a growing list” of missileers with non-Hodgkin’s lymphoma, and other cancers, “exceeding normal rates for a population.”
“He was so healthy,” Jenny Holmes said of her husband. “He was fit. He exercised, ate healthily. He never had any concerns at all.”
The letter noted that the cancer cluster was being investigated by the Department of Defense Office of Inspector General after a complaint by another missileer who suffers from non-Hodgkin’s lymphoma. The IG declined to confirm an ongoing probe, but Gen. Thomas A. Bussiere, who leads Air Force Global Strike Command, said the Air Force School of Aerospace Medicine has started a formal investigation into the cases. A congressional inquiry has also begun, and there is mounting panic among the community of missileers. The discovery of the first nine cancer cases was first reported by the Associated Press.
Other missileers, who worked at Minot Air Force Base in North Dakota and F.E. Warren Air Force Base in Wyoming with near identical missile facilities, are now raising questions about their health. One former officer paid over $100 out-of-pocket for a blood test at a private clinic while he waits for Veterans Affairs to provide a full cancer screening. Meanwhile, the Holmes family is learning more about the carcinogens Mark was exposed to during more than 300 24-hour shifts deep underground where missileers await orders from the president in case the need arises to turn the launch key.
Holmes’ family wants more answers about what caused his cancer, and they worry about other service members who are exposed.
“It’s a waste of a good person,” Mark’s mother, Bev Holmes, said of her son. “For everybody who died or are in remission or still battling it, it’s a waste of their life. Their life is over or turned upside down, and it didn’t have to be.”
A military briefing outlining missileers’ concerns was shared with the Air Force surgeon general and other medical professionals in the branch to gather more information, said Air Force spokeswoman Ann Stefanek.
“We are heartbroken for all who have lost loved ones or are currently facing cancer of any kind and know that we have the responsibility to investigate any potential service-related risks to Airmen, Guardians or their dependents’ health,” she said.
Bussiere, who leads Air Force Global Strike Command, said in a statement that he had requested a formal investigation as soon as he was made aware of the presentation about cancer cases.
“We are working together to create courses of action moving forward,” Bussiere said in the statement, first reported by the Associated Press. “We are committed to remaining transparent during this process and we pledge to maintain an open dialogue with members, their families and stakeholders throughout this process. As we move through the next phases of evaluation, we will continue to provide updates, including pertinent information, as identified.”
Montana Sen. Jon Tester (D), chair of the Senate Veterans’ Affairs Committee, said he has asked the Air Force for a full accounting of the cancer cases and other illnesses at Malmstrom, which house 150 Minuteman III intercontinental ballistic missile silos, as well as other bases where missileers operate. He said any former or current missileers at the bases should be screened.
“These Malmstrom missileers and their families deserve answers about the reported incidence of rare cancers they’re experiencing, and I will hold the Pentagon accountable to get them,” he said in a statement to The Post. “I’m in close touch with DOD and VA leadership to identify every potentially impacted service member and veteran, and will be pushing to ensure we get them the health care and benefits they’re entitled to as we work to understand the full picture of what happened at Malmstrom and other sites.”
Veterans Affairs spokesman Gary Kunich told The Post that the department is working with the Defense Department to determine the size of the exposed population and evaluate them. Under the new Pact Act, which aims to help veterans exposed to toxic chemicals, lymphoma cancers are presumed service-connected for eligible veterans depending on the time and location they served, Kunich said. For veterans who are not eligible but believe they have service-related conditions, VA encourages them to file a claim for disability benefits, Kunich added.
The missileers’ cancer cases first came to light after a January military briefing by U.S. Space Force Lt. Col. Daniel Sebeck, a former missileer who described in a slideshow obtained by The Post how missileers learned of the cases. A former Malmstrom missileer was paired with another he had previously worked with on the base through the Wounded Warrior mentorship program and learned of their shared diagnosis of non-Hodgkin’s lymphoma. The missileer then discovered the obituary for Holmes, who was also in their operations group. Within a weekend, the missileer made calls to discover nine officers at that base had been diagnosed with non-Hodgkin’s lymphoma between 1997 and 2007, according to the presentation.
The slideshow briefed in January lists Sebeck as the leader of an effort to create a registry of cancer cases, which has garnered attention as word spread through Facebook groups and email chains between missileers. The growing information-gathering mission has formalized, and there is now an online form for impacted service members to share their information.
While those involved expect the efforts will yield more cases than currently reported, the numbers are already startling, according to experts.
Amitkumar Mehta, a director at the University of Alabama at Birmingham’s cancer center, said a dozen or more non-Hodgkin’s lymphoma cases at a workplace should prompt an investigation.
“I would be suspicious that there is something going on either related to chemicals, the lifestyle or the environment they are in together,” Mehta said. “Definitely there’s a red flag.”
Radon and polychlorinated biphenyls, which Air Force employees said they were exposed to, are often linked to cancer diagnoses, according to experts. Those chemicals can pose a stronger impact if they’re exposed to workers in cramped spaces with weak ventilation, experts said.
“Exposures and overexposures could have occurred, such that it would not at all be out of the question that these folks were overexposed to any number of chemicals that could be related to cancer,” said Marissa Baker, an assistant professor for the University of Washington’s environmental and occupational health sciences department.
Alex Ruiz, another former missileer, has helped his friend Sebeck connect with others in their small profession that numbers in the hundreds and expand outreach efforts to find more service members outside the missileer community. Even he had not previously comprehended the problem until Sebeck discovered it, he said.
“I’ve lost two friends that I didn’t even realize died in the last two years,” Ruiz told The Post.
Ruiz himself was diagnosed with melanoma in 2006 when he was 26. While the average age of those diagnosed is 65, according to the American Cancer Society, it’s also not uncommon in younger people. Still, Ruiz wonders whether his diagnosis is connected to his service as a missileer. He said the latest data showed 113 cancer cases identified at the three bases and others that ran nuclear missions. The Post has not seen the most recent version of the data sheet.
“This might have been a circumstance of this particular profession for so long, but now it is impossible to hide it,” he said.
The Association of Air Force Missileers has encouraged its members to seek testing and report health issues through the online form, executive director Jim Warner said. The group is waiting to see how the Air Force responds before determining how it will lobby the Pentagon.
“The big concern for us is, is this a Malmstrom Air Force Base problem or is this an ICBM [intercontinental ballistic missile] problem,” Warner said. “How far does this go? We have a lot of data that needs to be gathered and it’s too early to jump to any conclusions.”
The investigations underway are at their early stages, as officials in Washington try to get a better sense of the scope of the illnesses before probing causes, according to a Senate Veterans’ Affairs Committee staffer who spoke on the condition of anonymity to detail ongoing conversations. Investigators expect to encounter challenges with information gathering as they go back decades to review environmental hazards.
“It’s the same challenges across the board,” the staffer said. “How good is record keeping? How good is the data that was collected back then? What kind of exposures were people facing? How objective is the data? The problems we’re going to run into here are the same problems that we run into everywhere else. By and large, that data is not usually collected with some rare exceptions.”
Like with overseas burn pits, which came under greater scrutiny after service members reported inexplicable breathing complaints, toxins could affect each person differently, meaning that authorities will review other types of illnesses that could also be associated with the bases, the staffer said.
In a letter to Defense Secretary Lloyd Austin and Veterans Affairs Secretary Denis McDonough, Tester requested information on “cancers, diseases or conditions along with any available data on incidence rate.”
Dane Meadows, a 35-year-old former security forces officer tasked with providing protection to missileers and the weapons at Malmstrom, said he has connected with others who have neurological autoimmune diseases like his. Meadows, who has neuromyelitis optica, now lives in a nursing home in New York, bedbound and unable to sit up, walk or speak for sustained periods. Through Facebook, he has connected with six other officers with similar neurological issues, including one with the same atypical disease.
“It’s honestly hard to believe I went from a young Air Force officer, being hired to be a special agent, to practically homeless and fending for myself with a rapidly debilitating and potentially deadly disease,” Meadows said.
Meadows learned of Sebeck’s presentation through his Facebook contacts, and contacted the lieutenant colonel to describe his medical history, Meadows said.
Many of the service members who shared their stories with The Post described learning of a greater problem through word-of-mouth.
Cole Smith, a former missileer who worked at the F.E. Warren facility for five years, had stayed in touch with friends from the Air Force through his work as a screenwriter. Last week, three of those friends warned him of the cases at Malmstrom.
Because he is no longer in the Air Force, he doesn’t have health insurance through the government. While waiting to get an appointment at a VA clinic, plagued with aging technology and long wait times, he paid $100 for a non-Hodgkin’s lymphoma test at Quest Diagnostics. He tested negative. But he is still waiting to get a screening for other kinds of cancer. He has an appointment to see a primary care physician at VA in about two months, at which point he can finally book a screening.
“There’s a huge community of people out there over the last 60 years who have worked in the silos, the veterans,” Smith said. “And they should be taken care of.”
As he waits for his cancer screening, Smith said he fears learning of more diagnoses through his social network.
“If there really is a problem at Malmstrom, is it just at Malmstrom or is it at the other missile bases but we just haven’t started asking there yet?” Smith said. “We’ve just scratched the tip of the iceberg.”
Jenny Holmes said the toll of these cancer cases reaches further than those who signed up to serve. She worries for her children — Maddie, 11, Will, 9, and Anna, 5 — who will grow up without their dad. She works extra hours as a nurse in Colorado Springs so that she can pay for Will’s therapy and other expenses associated with their loss because the Air Force doesn’t consider his death due to his line of work, she said.
After her husband’s death, she had felt isolated from the Air Force community, left to mostly fend for herself, she said.
But since the effort to account for the cancer cases, Jenny has reconnected with her husband’s colleagues who have helped her file a claim for benefits. She has learned for the first time the hazards her husband was exposed to, and she thinks about what he had signed up for unwittingly, she said.
“You just don’t know,” she said. “You’re signing a ton of paperwork and then all of a sudden they send you down there.”
The Washington Post’s Kyle Melnick contributed to this report.