Otis Brawley, M.D., executive vice president and chief medical officer of the American Cancer Society, spoke on campus as the Department of Urology’s Visiting Professor.
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Otis Brawley, M.D., doesn’t mince words, whether he’s talking to a small audience on the UT Health Science Center San Antonio campus or giving interviews that end up on the front page of national newspapers.

Dr. Brawley, executive vice president of the American Cancer Society and its chief medical officer, gave a noon lecture on Friday, March 20, as the Department of Urology’s Visiting Professor.

He spoke warmly of his longtime affiliations with Ian Thompson, M.D., professor and chair of the Department of Urology; Brad Pollack, Ph.D., professor and chair of the Department of Biostatistics; and Charles Coltman, M.D., professor in the Department of Hematology and Medical Oncology, president emeritus of the Cancer Therapy & Research Center at the UT Health Science Center and associate chair of the Southwest Oncology Group.

Dr. Brawley’s forthright opinions are the product of a childhood in Detroit, education at prestigious institutions (University of Chicago, Case Western Reserve University and Johns Hopkins University) and a professional career at the National Institutes of Health, Public Health Service clinics and finally, leadership of the American Cancer Society.

His opinion, backed by graphs filled with statistics, is that America doesn’t really want health care reform.

Dr. Otis Brawley visits with Brad Pollack, Ph.D., UT Health Science Center professor and chair of the Department of Biostatistics.

Brawley: 'Poverty is the driving carcinogen, not race’
“If we were serious about wanting to decrease mortality from cancer, more women in their 50s would be getting mammograms,” Dr. Brawley said, citing data that only 50 percent of women in this age group get mammograms. “Imagine if we could boost that number to 80 percent.” It might reduce a troubling trend that shows breast tumors are more advanced at the time of diagnosis in black women than in white women. While many observers have called this finding a racial disparity, Dr. Brawley disagreed. “Poverty is the driving carcinogen, not race,” he said, adding that studies show low-income women, both African American and Caucasians, have worse tumors at diagnosis than high-income women.

Obesity major cause of cancer, Brawley adds
Obesity, like poverty, also adversely affects patients’ cancer care. “Obesity is the second biggest carcinogen in America, next to tobacco,” he said. Overweight breast cancer patients are more likely to be undertreated with chemotherapy than women of a healthy weight. He noted a similar pattern with patient’s educational status. “College graduates are more likely to receive the standard of care when it comes to cancer treatment than patients with less than a high school degree.”

Five recommendations for health care reform
After Dr. Brawley discussed the social and economic barriers to providing adequate health care for all, moderator Ian Thompson, M.D., professor and chair of the UT Health Science Center Department of Urology, asked Dr. Brawley to choose five things the Obama administration should do to make reform happen. He said:

• “Set up a national health board and decide what health insurance must pay for
  
• “Make tobacco use illegal
  
• “Improve grade-school programs that teach healthy habits
  
• “Make it possible for all hospitals to share patients’ health records
  
• “Enable the public to make rational health decisions by giving them balanced, objective information.”