COMMENTARY

Oncologists as a Force for Cancer Prevention?

David Kerr, CBE, MD, DSc, FRCP, FMedSci

Disclosures

October 16, 2015

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Hello. I'm David Kerr, professor of cancer medicine at the University of Oxford. I have recently been appointed as Editor-in-Chief of the American Society of Clinical Oncology's (ASCO's) new Journal of Global Oncology . It is a great honor and a topic that we will come back to later. We are planning to get the first issue online in September or October. More of that when it is more temporally appropriate.

One of the things that we have been asked to do by ASCO's editorial board is to be a campaigning journal. I like the sound of this. Rather than just providing a portal of entry for our colleagues who face the challenges of delivering cancer care in poor countries to report their experience, their wisdom, and their research and findings—this is a large reason why the journal was set up—it will also be a means for us to campaign for the issues that we think we might be able to help coordinate.

As a health policy person, I have always felt that if we speak together, if we coordinate voices together, our voices will carry further in the corridors of power than if we have a jumble of individuals. Often, in that cacophony of noise, it is difficult to discern a single message.

So with the associate editors and editorial board, a fantastic bunch, we had a wonderful discussion with the redoubtable Otis Brawley, a friend for many years who is the chief medical officer of the American Cancer Society and a distinguished public health physician. One of the items that we talked about was the physician as awareness raiser, as lobbyist, as public health or population doctor. I find this fascinating.

Oncologists as Public Health Physicians

We often have discussions on Medscape about precision medicine and about the molecular tools we use to tailor the treatment to individual patients. Of course, we cannot get away from the individual patients we see in the consulting room. But what about cancer physicians, as busy as we are, becoming population and public health physicians? Why not be thinking about how to send our message out about prevention, raising awareness, lobbying for better tobacco control, and seeing what we can do to modify lifestyles with diet, environment, and exercise? Because we are very much at the end of the food chain.

I know that we are busy and sometimes overwhelmed by the number of cases and the severity of diseases that we have to treat, but what a powerful voice we have!

As frontline cancer physicians and surgeons, I think that if we came together under the leadership of people like Otis Brawley, we could function equally as effectively—not only as individual physicians but in influencing the wisdom and behavior of whole populations around the idea of cancer prevention. For too long, we have abrogated responsibility. We have given that responsibility to public health physicians who have many other chores that they have to do. But I would love for you to consider how we, a community of cancer physicians, might be able to unite to deal with population health.

I would be very grateful if you post any ideas, thoughts, or challenges that you might have. Am I being typically absurdly naive? There's a germ of an idea here that we might be able to promulgate, the concept of personal physician meeting population physician.

Thanks for listening. As always, I am grateful for your additional thoughts on this. For the time being, over and out. Thank you.

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