Despite breakthroughs in drug therapies and diagnostic technologies, prostate cancer incidence in the U.S. has increased 3.0% per year. At the same time, prostate cancer mortality is declining at a slower rate than the previous two decades.
As chief clinical officer and interim president at City of Hope Phoenix, Alan Bryce, MD, is focused on elevating awareness of men’s health issues. Dr. Bryce spoke to Becker’s about the opportunities health system leaders have for proactive innovation within men’s health.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What work still needs to be done to elevate awareness of men’s health issues? Can you expand on what hospital and health system leaders should know specifically?
Dr. Alan Bryce: I would say the fundamentals of good health are things we’ve understood for centuries: Prevention is better than treatment. It always starts with trying to help people establish healthy habits and live healthy lives on a daily basis.
Without question, the foundation of good health and men’s health is always going to be diet and exercise. We know this, but we also know it’s a struggle.
From a health system leader perspective, a lot of our focus is on education and on preventative health. Helping people live healthy lives is a challenge in our country, because we know primary care is under-resourced. We do a good job dedicating resources to extreme health events — cardiac care, cancer, orthopedics, trauma. But what do we do to try to be proactive? How do we help people live their healthiest lives and intervene before they get into trouble?
Q: Can you talk a bit about what City of Hope is doing in this area?
AB: This era of technology and AI is giving us enormous data. The question is how to use it wisely. At City of Hope, we’re focused on health maintenance and prevention: What is the right intervention early, and how can we use technology to support it?
We are also deeply committed to basic science. City of Hope has a proud history in diabetes research. Today, our researchers are studying how fat cells age and what changes as metabolism shifts in midlife and late life. Understanding the mechanisms opens the door to interventions.
Think about wearables. Patients now have a tremendous amount of daily health data thanks to wearables. What we haven’t yet done is prospectively analyze how to use this data for preventative health purposes or whether there are very early interventions that make sense. Can we really personalize health care? That’s where we want to apply research.
At the end of the day, our work is about combining research and clinical care to improve outcomes for today’s patients and future generations.
Q: How can healthcare leaders support incorporating men’s health initiatives within their organizations?
AB: As a prostate cancer physician, I’ve seen how early detection creates complexity. PSA testing saves lives, but it’s also controversial. Some people don’t want to know something that might not affect them for 20 years. For some, the psychological burden of knowing is worse than the condition itself. That tension between population health and individual health is real.
Genetic testing and risk assessment are becoming more important. Genetic signatures can help us understand risk for cancer, Alzheimer’s, heart disease or even drug metabolism. To use that information responsibly, we need big data and decision-support tools for clinicians. Patients already walk in with genetic reports or wearable data and ask, “What do I do about this?” We need systems — especially EMR tools — that filter and interpret data so physicians can focus on the patient in front of them.
The aging population makes this even more urgent. As baby boomers move into the 65-plus bracket, healthcare demand will rise sharply, but capacity and funding are not keeping pace. Preventative health and screening are more important than ever.
Distance from care is also a social determinant of health. About 80% of Americans receive cancer care at community hospitals, not big academic centers. City of Hope works to build systems that bring our expertise into those hospitals, instead of requiring everyone to travel to large centers. Big data and complex care require system-wide collaboration, not just local efforts.
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