Family physician to head American Cancer Society

In November, Richard C. Wender, MD, alumni professor and chair of the Dept. of Family and Community Medicine at the Jefferson Medical College of Thomas Jefferson University in Philadelphia, became the first primary care physician to serve as president of the American Cancer Society. The ACS was founded in 1913 as the American Society for the Control of Cancer and holds the distinction of being the world's largest voluntary health organization.

Dr. Wender began his involvement with ACS in 1985 when he volunteered to edit a newsletter for primary care physicians published by the organization's Philadelphia division. Within a few years, he moved through the ranks as president of local, state and regional ACS chapters and eventually landed on the group's national board.

Dr. Wender recently spoke with AMNews about why this first represents an important point in the cancer society's history.

Question: What does the fact that the American Cancer Society will have a primary care physician as president mean?

Answer: It has some symbolic value, but I think far more importantly a very practical value that addresses our major health issues.

I can bring my expertise and perspective about how the ACS can bridge the interfaces between people who have never been diagnosed with cancer but who are at risk for it; people who have a cancer that's not yet been diagnosed but could be through early detection and screening; people who have been diagnosed with cancer but who are struggling to negotiate and navigate our complex health system; and survivors who now number over 10 million.

Q: What type of professionals were the previous ACS presidents?

A: In the past, the president reflected the need for the ACS to organize cancer care -- so, the previous presidents were radiation oncologists, oncologists and oncologic surgeons. [Organizing care] is still a major goal of the organization but certainly not the only one.

If you look who's becoming president now and who will be president after me, it really reflects the transition of ACS to being more and more public health focused.

The person following me is Elmer Huerta, MD, MPH. Although he is a medical oncologist, he has completely left the practice of oncology and is now one of the leading forces in the world for preventive health care -- particularly for Spanish-speaking populations. Following Elmer is Elizabeth Fontham, MPH, DrPH, from Louisiana State University in New Orleans. She will become the first nonphysician to be president of the ACS.

Q: What is on the agenda for your presidency?

A: I will have a particular focus on access to care, and we have set for ourselves a preliminary goal of having health care be the leading domestic issue in the 2008 presidential election. Our data show that lack of access to care may become a greater cause of cancer-related deaths than tobacco. That's pretty profound.

Q: What are your thoughts on how to improve access?

A: The ultimate goal is to eliminate uninsurance. Uninsurance is the single greatest barrier to access. I would contrast the situation here to a country such as India where I spent a little time. In India, most of the population is uninsured but health care for cancer patients is relatively affordable. People do not presume that if you are uninsured you can't be treated. In the United States, even rather simple measures are relatively expensive so that an uninsured person and someone who has a low income truly believes -- and is usually correct -- that they can't afford any aspect of care.

Q: What do you think is the next big thing in our battle against cancer?

A: On the research side, the future advances are going to be in the use of proteomics and nanotechnology to find cancers at stages earlier than we ever imagined. It may be conceivable that almost all cancers are curable if you can find them at the molecular diagnostic phase rather than at the macro phase when we're looking at a picture of a tumor. The development of low toxicity targeted therapy is happening right now and offers great promise.

But let's face it. Let's say we do develop new forms of early detection and targeted treatments. If somebody is uninsured, the likelihood that they will have that opportunity to take advantage of that technology is very, very slim. We can't stop until we've addressed that barrier to care.