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Jefferson Physician Becomes President of American Cancer Society

Richard C. Wender, MD, is the first primary care physician to assume this office

Richard C. Wender, MD, Chair, Department of Family and Community Medicine, displays the American Cancer Society Southeast PA Region’s Cancer Control Award presented to him by, at left, Patrick Delaney, Regional Vice President, Southeast Region, PA Division of ACS, and Joseph Straton, MD, President, Board of Directors, Southeast Region, PA Division of ACS.  Don Walker Photography

Richard C. Wender, MD, Chair, Department of Family and Community Medicine, Jefferson Medical College and Thomas Jefferson University Hospital, was installed on November 16 as President of the American Cancer Society (ACS).

Dr. Wender is the first primary care physician to assume the presidency of the national society. He will serve for one year in the volunteer position.

A few weeks earlier, the American Cancer Society, Pennsylvania Division, Southeast Region, honored Dr. Wender with its Cancer Control Award in recognition of his exemplary individual achievements in the cancer field.

Dr. Wender has been involved with the ACS since the mid-1980s, serving at the local, divisional and national levels. He has also been a member of the Centers for Disease Control and Prevention’s prostate and colorectal cancer task forces. Since 2004, he has been a member of the Board of Directors for the National Colorectal Cancer Roundtable, and he has served as Co-director of the Cancer Research Foundation of America’s Colon Cancer Conference for the past three years.

In the following interview, Dr. Wender discusses his philosophies of cancer care and his agenda as new ACS President.

CancerCARE Newsletter: You began, in 1984, in what was then the ACS’ Philadelphia division, on the editorial board of a primary care physicians’ newsletter.
Dr. Wender: That was truly a labor of love. We involved physicians from the entire Delaware Valley – including many from Jefferson – as our experts. The newsletter marked the first time that the ACS recognized how critical primary care was to its mission. At the time, we called it a newsletter for primary care physicians, but now, I think a much better term is primary care clinicians, because effective cancer prevention and screening involves a collaboration between everyone involved in primary care – not only physicians but also nurse practitioners, physicians’ assistants, office staffs and PharmDs [Doctors of Pharmacy].

Now, you’re the first primary care physician to become national ACS President.
The time is right because, increasingly, we’re going to win the war on cancer by impacting lifestyle choices of patients regarding exercise, eating and tobacco use, by detecting cancers at the earliest possible stage through screenings and improved diagnostic tools, and by helping patients navigate through the complexities of cancer treatment. Primary care clinicians are critical in every step of that process; we are the front line in this war.

How is the war progressing?
We’ve made dramatic progress. The age-adjusted cancer mortality rates peaked around 1990. If you compare today’s age-adjusted cancer mortality rates to 1990’s, we’ve seen about a 16 percent reduction. In some cancers, such as lung cancer in men, prostate cancer, colon cancer, and breast cancer in women, it’s much more than that. And, as of just a few years ago, for the first time in history, fewer Americans were diagnosed with cancer than were diagnosed in 1990. So, we are now seeing declines both in the number of people diagnosed with cancer and in the number of people dying from cancer.

What accounts for this progress?
A great deal of it is due to changing the momentum in the battle against tobacco. In many parts of this country, we’ve “de-normalized” tobacco use. We’ve made it less affordable, much harder to smoke in public places, and eliminated a lot of the advertising so that the message is out there for young people that smoking is not a normal behavior. I think the state that’s shown the greatest progress with that is California.

But what we’ve also learned from California is that if you stop pouring money into the fight, you’ll start to lose some of the progress, because the tobacco industry is still out there and still spending billions of dollars to promote tobacco use to youth.

One area that we’re not doing well with tobacco is in the movie industry. Seventy to 75 percent of movies feature famous actors with cigarettes in their hands. And despite the fact that the tobacco industry is no longer allowed to pay studios for “product placement” in the movies, we still see smoking by famous stars in most films. One dramatic example was A Beautiful Mind, an Academy Award-winning film in which Russell Crowe played John Nash, a schizophrenic but brilliant mathematics professor. In the movie, Nash is portrayed as being a smoker, which didn’t seem unusual since the smoking rate among individuals with schizophrenia is high. But according to the biography on which the film was based, not only did Nash not smoke but he was violently anti-tobacco! So, there’s still a lot of progress to be made.

But I suspect we’ve reached an international “tipping point” on the banning of smoking in public places and the reduction in second-hand smoke. If Ireland, for example, where smoking in pubs was very popular, can go smoke-free, as they’ve done, it can happen anywhere in the world! The momentum will continue to build.

What else accounts for the progress against cancer accomplished so far?
The other areas where we’ve been most successful are preventive and early detection screenings like mammography and colonoscopy.

We’ve also had some dramatic successes through the products of outstanding research. We are entering an era of “targeted therapies” for specific genetic abnormalities that are found in one type of cancer. The most dramatic example of this is a drug called Gleevec®, which is used to treat chronic myeloid leukemia, a disease which was previously universally fatal. Through targeted therapies, to a great extent, we’ve converted cancer into a chronic disease and saved many, many people. So, in addition to continuing our investment in research – the ACS is the second-largest funder of cancer research in the world, behind the National Cancer Institute (NCI) – we advocate for the continuation of research funding through the NCI and for programs of the Centers for Disease Control and Prevention.

How would you assess Jefferson’s contributions to the war on cancer?
The Kimmel Cancer Center at Jefferson’s research program is extraordinary. We have some of the most accomplished, promising and brilliant researchers at Jefferson as exist anywhere in the world. It’s critically important that we support their work.

My department, Family and Community Medicine, is also doing a lot. We have funding from the tobacco settlement dollars awarded to Pennsylvania that we’re using to impact obesity at the community level. Obesity has long been linked to heart disease and diabetes, but not to cancer. Until the last few years, people didn’t realize how much cancer was caused by obesity; now, that’s been firmly established. Obesity is a root cause of cancer as well diabetes, heart disease and stroke.

The American Heart Association, American Diabetes Association and ACS are now working together on several projects, including a joint campaign called “Everyday Choices” to talk to the public about lifestyle choices. That kind of cooperation wouldn’t happen without the visionary, full-time staff leadership of each of those organizations, including the ACS’s Chief Executive Officer, John Seffrin. But primary care clinicians like me – and there are others as well, increasingly, in our national leadership – think in a broad perspective and recognize that the greatest successes we’re going to have are going to be collaborative successes.

So, as a primary care physician, you’ve always counseled patients on preventive care for all kinds of diseases, not just cancer.
I think that’s a different but valued perspective that I’ve brought to the ACS. I’m advocating for our looking in a crosscutting way at the issues that impact multiple diseases, and for looking at tools and systems of care that will impact all of the chronic illnesses. One of the reasons why I push so hard for that is because primary care physicians are very, very busy; they’re not going to use one set of tools just to be their cancer prevention tools and one set just to be their diabetes prevention tools and one set just to be their heart disease prevention tools. They want tools that can be combined into a system of prevention screenings.

Finally, what will you focus on primarily during your year as ACS President?
During my presidency year, the major area that I will be responsible for is a new ACS initiative tackling access to care. The U.S. healthcare system is on an unsustainable course. We spend more per capita than any country in the world on healthcare, and yet we do not rank at the top for quality of healthcare. Part of the reason for this is that we have 46 million Americans who are completely uninsured, who cannot afford even very basic care. We do not pay adequately for prevention or for primary care services. So, lack of access to high-quality care in a timely fashion is becoming a major contributor to cancer deaths, comparable in its scope to obesity and tobacco. The ACS is joining the effort to improve access to care for all Americans. We’ve outlined a goal to reduce cancer mortalities by 50 percent by the year 2015. That’s an unachievable goal if we don’t improve access to care.

So, I’ll be chairing the workgroup on access to care. I’m chairing a couple of policy review groups on looking at healthcare insurance. We’re working very hard to identify collaborators from every sector of society who share our concerns about access to care. And we’re trying to establish principles by which we can judge suggestions for reform.