Dr. Simon Sutcliffe’s next horizon

Q. You left the BC Cancer Agency after 8 years there. What are your future plans?

Dr. Sutcliffe: After 39 years in public health care, and heading up two major cancer organizations, increasingly I am interested in cancer control at a population level – specifically, in the interaction between developed and developing countries.

I came into the cancer world as a radiation and medical oncologist, so most of my professional life has been about the treatment of cancer. Over the past 10-plus years there has been an increasing realization that by focusing on cancer treatment we are focusing on populations that have cancer and also have access to treatment. We tend not to focus on the time period before or after they have cancer, or on all the populations that cannot access treatment equitably – yet this is the situation in the developing world.

My move now is to explore the principles of cancer control from a very population-focused view; that is, trying to see how cancer control can be understood in the context of different cultures and economies.

The challenge is how to find those relationships where you can do something meaningful and add some value. I will look at alliances of countries, for instance within the World Health Organization and the Latin America-Caribbean Alliance for Cancer Control. (By the way, at BCCA we are working internationally with the National Cancer Institute of Brazil, the government of Ireland, with China in cervical cytology, in Nigeria on cervical screening and in India in palliative care and early detection of oral cancer.)

So, this will be my fifth career. I have gone from cancer treatment (medical and radiation oncology), to cancer care in an institution, to cancer control in populations, and now to global cancer control.

Q. Having worked in the U.S. and South Africa before coming to Canada from England, you have always had an international perspective. You initiated and chaired the steering committee for the International Cancer Control Congress in Vancouver and in Brazil. Have international congresses stimulated your international interests?

A. A bit of history is that the 1^st International Cancer Congress in Vancouver in 2005 was a direct consequence of the Canadian Strategy for Cancer Control [i.e., the planning for the Partnership]. We wanted a forum to bring together people interested in population-based cancer control in different countries, to share and learn how to do cancer control at a national population level.

We found that there are a few countries moving down that road, such as Australia, New Zealand, the Scandinavian countries, France, Great Britain, some American states and Canada – in other words, part of North America, Western Europe and Australasia, but not Eastern Europe, or most of the world.

We had a handful of highly Westernized countries and a vast majority for whom this activity has not received priority. Our question became how to highlight and raise awareness of cancer control in countries that do not have all the resources of western Europe and North America.

What came across very strongly is that these conferences are all very well, but if you want to make it mean something in most of the world, you must focus on the contextual realities of these global populations. That is why the 2nd ICCC was in  Brazil, and that was also the beginning of the Latin American-Caribbean Alliance for Cancer Control.

Q. Could the Partnership have a leadership role among cancer control organizations internationally?

A. Yes, I believe that there is an advantage to the Partnership model for the international view. Like most of the world, we do not have infinite resources for cancer control – rather, we are finding ways to make the whole greater than the sum of the parts.

The added value the Partnership model brings is in demonstrating that we can do a great deal through partnership and use of existing resources. We are showing the value of creating a ‘whole’ that is very much more than the sum of the parts, without diminishing any of the parts that have been summed.

We are highlighting how existing institutional resources can be used to the greatest effect to benefit the whole population. And to be realistic, if we in Canada cannot demonstrate how strategic collaboration and cross-sectoral partnerships can enhance the health and well-being of our population, the challenges will be a daunting prospect for the rest of the world as it engages the evolving burden of cancer.

Q. As you played a key role in creating the cancer control strategy that forms the Partnership’s blueprint for action, and you are Vice-Chair of the board at the Partnership, you can take the long view of both the organization and its activities.

A.  The Canadian Strategy for Cancer Control came from a national workshop in 1996, when a number of people asked, “Shouldn’t Canada have a national cancer control plan?” We were all aware of disparities in patient outcomes across the country, despite having a single-payer system. Similarly, we all recognized that no single organization that existed then could change the big picture. Collaboration or partnership to create a Canadian, population-based cancer plan was essential.

That 1996 workshop was the genesis of a plan to reduce the disparities and help us learn how to improve the use of our collective resources in cancer control. The actual plan for a national cancer control strategy came out of the many multi-stakeholder working groups over several years, in a process that was managed by Health Canada, the Canadian Cancer Society, and the Canadian Association of Provincial Cancer Agencies.

Out of 158 recommendations, there emerged several priorities and I was appointed the first chair of the Governing Council. This was entirely a voluntary body, and it probably would have disbanded due to exhaustion of the volunteers if secure, ongoing and appropriate federal funding had not been established in 2006. (As well, it had no authority or levers for change.) Thanks to that funding, we are now implementing and deepening this plan for cancer control through the Partnership.

Simon Sutcliffe, MD, FRCP, FRCPC, FRCR

Simon Sutcliffe, MD, is Vice-Chair of the Board of Directors at the Canadian Partnership Against Cancer. A radiation and medical oncologist, his clinical practice and research have been in the areas of lymphoma, leukemia and endocrine malignancies; reproductive function in cancer patients; and immunodeficiency in cancer patients. After eight years as president of the BC Cancer Agency he is leaving that position in December 2008. Previously he was President of the Ontario Cancer Institute/Princess Margaret Hospital in Toronto.

Dr. Sutcliffe grew up near London, England, and studied or worked in the U.K., U.S. and South Africa before moving to Toronto in 1979. He has been a board member of the National Cancer Institute of Canada, the Canadian Cancer Society and other national and international bodies and committees. Dr. Sutcliffe chaired the International Cancer Control Congress, initially in Vancouver (2005), and the second in Rio de Janeiro (November 2007).

Dr. Sutcliffe participated in the creation of the Canadian Strategy for Cancer Control, 1998-2002, and chaired the Governing Council from 2002-2006. Its planning document is a foundational document of the Partnership.