Otis Brawley on progress in cancer diagnosis and management

Dr. Otis Brawley, the chief medical and scientific officer at the American Cancer Society, tends to be a polarizing figure for many in the prostate cancer community. He is not an advocate for widespread use of the PSA test in screening for prostate cancer. On the other hand, he is a strong advocate for the application of observational and expectant forms of management (watchful waiting and active surveillance) for men with low-risk forms of the disease.

Interviewed recently by MedPageToday, on the 43rd anniversary of the signature of the National Cancer Act in 1971 (setting up Richard Nixon’s “War on Cancer”), some of Dr. Brawley’s views on recent progress in the diagnosis and management of cancer are well worth being aware of. Some of his other views will probably still drive some members of the prostate cancer community to distraction!

5 Responses

  1. Crizotinib is one of the very few drugs to have an FDA-approved companion diagnostic kit available to identify patients likely to benefit from treatment. (The complete list is available on the FDA web site.)

    I have followed with intense interest (as a layman) the breakthroughs in understanding biology on a molecular level over the last 20 years. We are just starting to reap the fruit of that basic research as biotech companies figure out how to turn that knowledge into treatments (and, yes, make money). As we approach the new year, I think it is safe to say that the next 20 years will be far better than the last 20 for men diagnosed with prostate cancer. It will be a combination of less unnecessary treatment, and much better, more highly targeted interventions for those who do need treatment.

    I have endured prostate biopsy (no cancer found). I have had major prostate surgery (my prostate had gotten so large it cut off my urine flow completely … the surgeon cut into my bladder and removed 120 g of prostate tissue out through the bladder … so I know what it’s like to endure major prostate surgery and its side effects (including 4 months with a catheter). Point is, I haven’t had prostate cancer, but can empathize with those that have.

    Let’s drink a toast (in moderation) to the New Year. We have very good reasons to be optimistic about the future of prostate cancer care!

  2. Sounds like a plan to me!

  3. In 2004, at age 74+, I was diagnosed with Gleason 9 prostate cancer. Fortunately, I had an early warning by way of a sudden increase in my PSA level. There were no physical symptoms. I was treated with external radiation (IMRT) plus hormonal therapy. That was well over 10 years ago, with no recurrence, and I am still twitchin’ and bitchin’ as you can see.

    Manny Rosenbaum
    Oak Park, Michigan

  4. While Dr. Brawley may encourage expectant management, we should ask Dr. Brawley how a man knows he is low risk, if he never gets tested?

    Brawley himself, a man who falls into a high risk category and by most measures should at least get a PSA test, publicly acknowledges he does not get tested. So what credibility does he have to hold a position that pays $1.25 million?

  5. As indicated previously — Dr. Brawley is a polarizing figure!

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