When Helene Brown, a cancer control pioneer who jokingly described herself as “the first in a long line of political oncologists,” delivered the keynote address at the Oncology Nursing Society annual meeting in 1990, she set forth bold predictions for the ensuing 20 years of the field: appointments conducted over “computerphone,” major genetic breakthroughs, and universal healthcare.
Much of Brown’s address is recorded in an article published in The Cancer Letter covering the June 1990 joint meeting of the Oncology Nursing Society, the American Association for Cancer Research, and the American Society of Clinical Oncology, titled “ONS, ASCO, AACR Growth Surge Continues; Flex Political Muscles During DC Meetings.”
Brown, who at the time was head of cancer control at UCLA Jonsson Comprehensive Cancer Center, had recently completed a six year term on the National Cancer Advisory Board.
Brown died in October 2020. A larger-than-life figure, Brown is remembered by The Cancer Letter’s Paul Goldberg as “a four-foot-something-tall human internet, an exchange of presumably reliable information. Moral outrage blasted like a big tuba through the drumbeat of her brutal observations. Betrayal of public trust made her blood boil” (The Cancer Letter, Oct. 16, 2020).
The nurse is key to all.
Helene Brown
“When I think about cancer control, cancer advocacy, speaking truth to power—all done with incredible grace, no small amount of sass, and a bold sense of humor—I can think of no one other than Helene Brown,” Patricia A. Ganz, director of cancer prevention and control research at the UCLA Health Jonsson Comprehensive Cancer Center, said at the time.
“Helene was instrumental in the success of early tobacco control efforts, programs for the early detection of both cervical and breast cancer, genetics as a tool for the individual risk of developing cancer, and the dissemination of credible, relevant health-related information to the public,” said Jerome Yates, a retired oncologist who has practiced and administered research at Roswell Park Comprehensive Cancer Center, the University of Vermont, NCI and the American Cancer Society.
“She would laugh when others, mostly men, would describe her as ‘formidable,’ ‘pushy,’ ‘difficult,’ or ‘aggressive.’ Some called her ‘that woman,’ which she took as a symbol of respect.”
It takes a bold vision to see into the future, and some of Brown’s 1990 predictions, like the future of molecular genetics and telehealth, are spot on—despite the term “computerphone” evoking a retro-futuristic image of flying cars in our present world of HIPAA-compliant Zoom calls.
Brown’s predictions for “cancer control in the 21st century”
In her keynote address, excerpted in The Cancer Letter on June 8, 1990, Brown made several key predictions:
On biotech and molecular genetics
“It appears that in the coming 20 years biomedical research will push forward the boundaries and will have found that there are some 210 genes that cause cancer,” Brown said. “They will have been mapped so that we know exactly where they are located on the chromosomes and they will have been sequenced so that we know precisely when in the life cycle they become oncogenes. We will have at hand the means to manipulate them back to normalcy and ONS members can begin to seek retraining for other occupations.
“The marriage of biotechnology and molecular genetics is very close to uncovering the secret of life….When the final chapters in the history of cancer are written, I believe that the turning point will have been when we were able to manipulate genes and their messages….If this can change the course of cancer, it will hold true for every disease that may be in any way genetically caused.”
On cancer prevention and control
Brown predicted that by the year 2010, “at least 80 percent and perhaps as much as 90 percent of the disease will yield. This is based in part on the death of the tobacco industry, better therapies, greater opportunities for prevention and early detection, and the discovery of vaccines and other interventions that will turn off the process even after it has begun.”
On incidence rates and aging population
Brown noted that by the year 2010 there will be 40 million Americans over age 65, 27 million over 75, and a half million over age 100. “Since cancer is a disease predominantly of the older age groups, the incidence may stay high for a good while longer.”
On universal health care
“If a universal health care system is not in place by 2000 I will be horrifyingly surprised.”
On hospital facilities
“Hospital census will continue to decline through the coming 10 years and then it is expected to rise as the population ages. The shift to home care is evident but will be short lived. With fewer and fewer families as we know them and more of the alternative shared living, there will need to be more homes for the retired, the ill, and the disabled.
“There will be medical complexes that are huge. Besides the usual facilities available now in single unit hospitals, there will be connected nursing homes, rehab and mental health centers, homes for the retired and disabled, and community health centers specializing in preventive, personal, and diagnostic medicine.”
On telehealth
“In home diagnostic kits with monitoring devices will be par for the course and the doctor will ‘face to face’ with the patient via computerphone.”
On the future role of doctors and nurses
“By 2010, the doctor may well be the human biologist and a new kind of health advisor to patients, business, industry, etc., with the care of the patients in the hands of primary care oncology nurses in cancer and primary care nurses in other fields as well.
“The nurse is key to all. It is the nurse who will design these medical complexes because they best know what is good, what works and what does not work. They will use their knowledge base and skills more in the preventive health center because they convey confidence, they have the expertise and they will truly be the health change agents of the 21st century.
“With political action by ONS and others, we will have funded and accomplished the research that tells us how to prevent cancer or how to detect it earlier or how to treat it to the top of the state of the art. The nurse will be the full active partner of the physician as they create an advisor and delivery team. Nurses then will become architects, congresspersons, senators, physicians, attorneys, builders, and ethicists, to name a few choices, after their careers have been fulfilled in nursing.”
More about Helene Brown
- ONS, ASCO, AACR Growth Surge Continues; Flex Political Muscles During DC Meetings
By The Cancer Letter, June 8, 1990 - “Political oncologist” Helene Brown dies at 91
By The Cancer Letter, Oct. 16, 2020 - To Wage New War On Cancer, Advocates Plan A Campaign Inspired By Earth Day
By The Cancer Letter, Oct. 31, 1997 - Milken Calls For Renewed War On Cancer, $20 Billion A Year International Effort
By The Cancer Letter, Nov. 24, 1995 - Bureaucrats, Administrators, and Politicians
By Less Radical, Nov. 1, 2024
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