publication date: Jan. 25, 2019
Conversation with The Cancer Letter
Brawley aims to create a “huge collaboration” in research on disparities
Otis W. Brawley was named the Bloomberg Distinguished Professor of Oncology and Epidemiology at Johns Hopkins University.
Brawley will lead a broad interdisciplinary research effort of cancer health disparities at JHU’s Bloomberg School of Public Health and the Johns Hopkins Kimmel Cancer Center, focusing on disparities in the prevention, detection, and treatment of cancer in the U.S. and worldwide.
In his role as the associate director for community outreach and engagement at Hopkins, Brawley will focus on programs for underserved populations throughout the cancer center’s catchment area. Also, he will teach undergraduate and graduate students in the Department of Epidemiology in the Bloomberg School, the Department of Oncology at the School of Medicine, and the university’s Krieger School of Arts and Sciences.
And he will see patients. “I will continue to see patients for as long as I am a physician,” said Brawley, who will be seeing prostate cancer patients. “Seeing patients is what keeps me grounded.”
Brawley was most recently the chief medical and scientific officer for the American Cancer Society (The Cancer Letter, Nov. 9, 2018). He is also a former director of the Georgia Cancer Center at Grady Memorial Hospital in Atlanta and former professor of oncology and hematology and deputy director for cancer control at the Winship Cancer Institute at Emory University.
Brawley is a member of the National Academy of Medicine and a recent recipient of the Martin D. Abeloff Award for Excellence in Public Health and Cancer Control from the Maryland State Council of Cancer Control.
“My jobs are to do outreach and engagement, to do health practices work, to continue much of the health disparities work that I had already been doing at the American Cancer Society,” Brawley said. “I anticipate that moving to Hopkins will allow me to have some academic freedoms to get involved in the political process, influence policy in ways that you just cannot do from a not-for-profit foundation.”
Brawley is the 39th Bloomberg Distinguished Professor at Hopkins. The program is backed by a $350 million gift from Michael R. Bloomberg, a Johns Hopkins alumnus, founder of Bloomberg Philanthropies, World Health Organization Global Ambassador for Noncommunicable Diseases, UN Secretary-General’s Special Envoy for Climate Action, and former New York City mayor.
Brawley spoke with Paul Goldberg, editor and publisher of The Cancer Letter.
First a trick question: What do Michael Bloomberg, Sidney Kimmel and David Koch have in common?
It is ironic that those three names would be in my letterhead. I am the Michael Bloomberg Distinguished Professor in the Sidney Kimmel Cancer Center, sitting in the David H. Koch Cancer Research Building.
So, what is the job?
I have been given a tremendous opportunity, and that opportunity is to come to Johns Hopkins and work with some amazing people, some amazing people who do great epidemiology, great prevention work, great outreach, great advocacy—and come here and work with them, and actually try to explain to the people of Baltimore, the people of Maryland, and the American people how you can apply good science to oncology, to cancer medicine, to public health and how we can reduce the rate of death from cancer by applying good science.
At the same time, I have an opportunity to show them how we are slowing down our progress in cancer by applying bad science.
What’s the war chest for this?
In many respects, the war chest is of infinite depth. In many respects, the well is unlimited. What I have are resources of a number of incredibly gifted people here at Hopkins.
The attraction of coming to Hopkins was, there already is just an amazing group of people working here doing health disparities research, doing health practices research, and I get to come here and work with the A-team.
These are folks, many of whom I have known and admired for my entire career, some of whom I have had the opportunity to work with very successfully. And now, I get to work with them on a daily basis.
Are you going to be focusing this group that’s already there, plus building onto it?
We have the opportunity to work with the current group as well as to bring additional talent in, and really build an institute that will be looking at community outreach, health practices and cancer control.
So, you’re recruiting?
What are the jobs? How many people?
That has not been totally determined yet. But I can tell you I already have office space. That’s a big thing in the academia.
Yes, the Koch building.
The first day I arrived, they said, “Oh, here’s your office, and here’s several additional offices for faculty members, and here’s some cubicles for graduate students.”
That way I have space both in the medical school, and I have space in the School of Public Health.
So, you’re focusing the outreach and engagement, among other things; right?
My jobs are to do outreach and engagement, to do health practices work, to continue much of the health disparities work that I had already been doing at the American Cancer Society.
I anticipate that moving to Hopkins will allow me to have some academic freedoms to get involved in the political process, influence policy in ways that you just cannot do from a not-for-profit foundation.
Can you tell me, roughly, what you think the low hanging fruit would be?
Well, clearly low hanging fruit is, you know, I have a number of contacts in Washington. I talk to a number of elected officials as well as policymakers on a regular basis. I’ve been doing that for 20-plus years. Now I’m very close to Washington, and I think I can speak more openly and freely with those policymakers.
I also have the ability to write and to publish.
How then, can one center move the needle on problems that are so engrained?
I don’t think it’s actually just one center that can move the needle.
I’m hoping that there’s a community of cancer control expertise across the country at a number of places and I’m hoping that from this position I’m going to be able to work with cancer control experts across the country and organize all of this.
And, you know, I’m not suggesting that we’re going to create a union of cancer control experts, but we’re going to create a huge collaboration.
And part of the job is not just outreach into the community of Baltimore, Md. That is a big part of it. I actually look at being able to work in Baltimore, Md, and use that as a laboratory to demonstrate what things can be done in terms of cancer control and education, as well as in terms of changing the communities’ outlook on health care.
But I also think that we, as a group of cancer control experts, can really come together from universities far and wide. You know, there’s some amazing talent in cancer control, which is really a discipline that came up in the 1970s out of the National Cancer Act.
We are at a point in time where we have defined many of the causes of cancer, and now we just have to organize ourselves and constructively start applying what we know in cancer control science.
I am going to focus on the large number of lives lost because of lack of good care as well as wasted medical care that often feels good, but is not based in good science and is really a waste of resources that increases the number of people with poor outcomes.
Well, if I may express an opinion, it’s good to see NCI require outreach and engagement in such a very clear way, because here is the institute basically saying, “Go out there and help somebody.”
There’s some very, very smart people at the National Cancer Institute who understand science, who understand cancer control.
I think what you see, is one of the most important moves that the National Cancer Institute has made over the last 40 years. They are calling the cancer centers to get involved in community outreach and engagement.
And it is the National Cancer Institute telling its 60-plus NCI designated cancer centers, “You need to give to your communities, you need to take what we as a community of scientists have discovered and be a tool to implement that good science in your communities.”
And Baltimore is one fine place to do it.
Well, anything we missed?
Too much of what I hear of called “cancer control” is not based in science, and actually increases disparate and poor outcomes for blacks and for whites; for the rich and for the poor. What this country needs is some leadership in implementing cancer control based in scientific fact. And that’s what I plan on doing.