New Haven’s normally mild-mannered chamber of commerce president gives a piece of his mind
Anthony P. Rescigno is president of the Greater New Haven Chamber of Commerce, a 217-year old business group that represents 1,800 members in 15 municipalities throughout south-central Connecticut. Before assuming his current job in 2000, Rescigno was the Republican first selectman of his hometown of North Haven.
In a tough economy, how is chamber membership holding?
[New Haven’s economy is] in a very interesting place, with a very strong health-care sector, education sector. There are companies that are doing really well, but there are many companies that are hurting.
Clearly the smaller companies are reeling, because there are not a lot of places to cut back — their expenses are already low. The income side is not there and they are having a hard time weathering the storm. Our job is to [help] get them through it.
Helping find ways to save, money, maybe do some things differently. We have lots of businesses that are doing fairly well, too, and we have lots of companies that are in that center-point, saying, ‘Hey — we’ve survived,’ and are now looking to do more marketing and branding, where in the past they may have felt they didn’t have to do it.
Have you gotten any feedback about the jobs bills [H.B. 6801; see story this issue] or the other efforts of the Malloy administration and state government?
For the most part, the business community is giving the governor a little slack. They were clearly not happy with the tax increase, they’re not happy with some of the initiatives like the [mandated paid] sick leave bill and unionizing health-care workers. They’re clearly upset with those, but they understand also that the governor walked into a mess and they see him as someone who is working hard and trying to initiate some things. So they’re cutting him some slack and waiting to see what happens.
Do you think this is true of smaller companies, too?
They’re less tolerant; they don’t have time to be focused on it. They’re in a survival mode and they’re less understanding. There are more people, frankly, in an uncertain place because of the federal government and the lack of clarity on what their costs are going to be next year — whether it’s personal taxes or business taxes, health care costs. What businesses have done is they’ve re-calibrated. They’re doing more with less — using technology, using part-time people, contractors. Lots of companies are doing fairly well. But once again it’s not because their income is up; it’s because their expenses are down.
So is it fair to say no companies are really looking to add jobs at this point?
Yes. There are isolated cases of companies looking for people, but overall the majority are just holding back. The only way we’re going to see a robust employment situation is when both consumers and businesses feel confident that they know what there costs are going to be. In a lot of cases even if they know their costs are [rising] they can make decisions. But when they don’t know at all, it’s worse.
But New Haven’s economy overall isn’t doing as bad as some other Connecticut cities.
What I see is that we have this very strong health-care sector and a very strong education sector that includes the other universities, not just Yale. And lots of smaller companies that are feeding off of that — lawyers and accountants, insurance, printers. When you make the comparison we’re probably better off [than other markets], but it’s nothing to write home about.
You’re a lifelong Republican, though not of the intransigent vein. If Gov. Malloy asked you to sit down to take the temperature of the business community, what would be your message?
We would tell him he clearly has to keep taxes down. He would say, ‘I had to do what I had to do.’ What we would say is you have to make the business community feel like we’re in a competitive situation with [other states] so they want to do business here — and you have to be sincere about it. If they see a lot of waffling and hedging they’re not going to have the confidence that there is somebody thinking about business up at the Capitol — and that’s not just the governor but the legislators, too. I’ve told him and he said maybe one too many times, but they have to get these regulations under control and how long it takes [companies] to get a permit to do something.
Do you think they will?
We had Dan Esty, who’s the new commissioner of the Department of Energy & Environment Protection [DEEP] at a [late October] meeting here and we were extremely encouraged by what he’s doing. He’s already taken the handcuffs off his people in some cases to give permits. He claims it’s a top priority and he seems to get it. Frankly, unless he’s a terrific con artist he made a strong commitment.
How much damage did the governor do to his relationship with the business community over the taxes, sick leave and the union issues?
I don’t think you can say you’re a ‘business-friendly state’ and then do things like that. I think the unionizing health-care workers sounds like it may be challenged in court. As far as the sick leave, there are some that buy into this notion that it ‘only’ applies to companies with 50 employees or more. We point out to people that once you go down that slippery slope it will be 35 employees or more. I think it is a hard sell [to convince people that Connecticut is getting more business-friendly], but there is a yearning to believe that we’re going to do things a little bit differently.
Your view of him personally?
This governor is focused; he’s doing things. One of the things I do hear from business people is we may not agree with everything [Malloy does], but he is doing things. He’ll make the case to give him more time.
What do your members think of state government spending taxpayer dollars on large companies to relocate to or expand in Connecticut?
Although we’re a large chamber, 95 percent of the [member] businesses are smaller companies. What we’re hearing from them is this is not fair. What we’ve done is to say to the governor and to economic development, is we need a package for small business. We’re starting to see that. [Editor’s note: On November 2 the General Assembly passed a “jobs bill,” H.B. 6801, that included some loans and grant funds directed to small businesses.] They have to show that they understand that across Connecticut and the country, 95 percent of businesses are small businesses.
Isn’t that ‘support’ really just lip service from people in government? Isn’t their belief more that small companies just feed off large ones and aren’t wealth-creators in their own right?
Whenever I talk to a business group I say we need to support that person who wants to open up a beauty salon. That person can hire four people. I don’t think it’s lip service for me. I’d rather have 200 companies hire two people each than look for someone who is going to come in with 400 people. I don’t think that’s the way this [state] is going to grow. I am seeing a very positive feeling by the people that the governor is putting in place. I have my glass half-full.
You’re hosting the chamber’s annual Business Expo on November 16. What do you think will be the feeling in the room that day, how much anxiety do you think is out there about 2012?
That’s a tough question, but I think most people are feel pretty good about where they are. These are people who have jobs and run companies, they’re putting their best foot forward — they have to be optimistic. If I came into this office every day saying how terrible things are, that’s just not going to work. We have to be realistic and live within the parameters, but I think a lot of the people who will be at the Expo will be feeling good about the robust feeling they get when they come to that kind of event.
How do we get those large companies that may not be headquartered here to think about the local business environment more?
We do it every day of the week, and we succeed for the most part. We have companies that are not [headquartered] here but they [employ] local people that have to make businesses work. We get their attention by saying, ‘How can we help you?’ — whether it’s a bank president that reports to Charlotte, N.C. [e.g., Bank of America] or the AT&T [Connecticut] president, we need to work with those people. When First Niagara [Bank, headquartered in Buffalo, N.Y.] people came into town a year ago [after acquiring New Haven’s NewAlliance Bank], we embraced them. We don’t tell businesses what to do: ‘You bought this company, you thought it was a good decision, we support you and want to work with you.’ For the most part we get lots of cooperation, because in addition to [local managers] being genuinely decent individuals with a community mindset, they want to succeed.
Do you sense a growing anti-business attitude in the general population?
I think that business people understand that there are businesses that have pushed the envelope. But what I hear is that, especially in this whole banking issue, is that the government is equally culpable in pushing Fannie Mae and Freddie Mac to give [mortgage] loans [to borrowers who didn’t meet existing standards of creditworthiness]. But there is a general discontent about high salaries and executives.
What are you hearing about bank lending from both the banks and your member companies who want to borrow from them?
It is obviously a lot more difficult to get money than it was. The question is: What are you comparing it to? Most people are under the impression that banks are lending, but [borrowers] have to be in really good shape. What I’m hearing from banks is that they are spending enormous amounts of money to meet regulatory requirements the government has now placed on them.
How strong is demand for credit?
My sense is that the business people are getting itchy to do things. Most businesses are not interested in being in a retrenching mode or stabilizing mode. They want to grow — that is the instinct of business. It’s been a long time now that they’ve been holding back.
What do you hear from the health-care companies about the market and health-care reform?
I think they’re in a tailspin. If [Obamacare is implemented] by 2014 they will be restricted as to how much they can spend on administrative costs, and they’ve got tons of anxiety about this. Businesses in general have no confidence in this. It’s almost like 100 percent [believe] that this isn’t going to be a money-saver.
Put on your old GOP hat for a minute. Where do you see the Republican Party in Connecticut going, and will we ever return to being a two-party state?
I think of it as a one-party state, and I don’t think there is a lot of hope of changing. This is a very liberal state. We’re going to elect liberal politicians and there is not a lot of hope, frankly, and I am a very conservative person. The unions have lots of control of this state. Look at what that legislature looks like. A lot of these folks believe that business [owners] are just a lot of fat cats and that companies can afford to give employees everything employees need. Once again: 95 percent of the businesses in this state have 50 employees or less, and they are struggling to stay alive, to make payroll, to live within the regulatory environment.
What about GOP prospects in upcoming congressional races and statewide elections?
A lot is going to depend on the individual and the mood of the country. I’m optimistic in that regard, and that we pick up some gains on the state level. I’m hoping that the folks that are up there [in Hartford] who are more liberal wind up being reasonable. Frankly, we are seeing people who are being more reasonable and understanding there are two sides. Our job is to convince the folks in control that you cannot be for employees and against employers. You have to be for employers as well.
Lauren Meris Filiberto has joined the New Haven law firm of Murtha Cullina, LLP as an associate in the firm's Litigation Department. Filiberto represents clients in the area of immigration law, including filing employment and family based visa and green card petitions and applications for naturalization. Filiberto earned a bachelor’s degree from the University of Vermont in 1999, and her JD from the University of Connecticut School of Law in 2005. She is admitted to practice in Connecticut and the Second Circuit Court of Appeals. She is a member of the Connecticut Bar Association, Fairfield County Bar Association, and the American Immigration Law Association.
The New Haven law firm Wiggin & Dana appointed partner Patti Melick to the firm’s Executive Committee for a four-year term. Melick has been with Wiggin and Dana since 1995. She is also a member of the firm’s Pro Bono, Charitable Contributions and Associate Professional Development Committees. Her practice is focused primarily on companies in the life sciences industry, including pharmaceutical, biotechnology, chemical, diagnostic and medical device companies. She has more than 20 years' experience in cross-border mergers and acquisitions and complex strategic alliances, licensing and global partnering transactions. Melick was graduated summa cum laude from Lehigh University, Phi Beta Kappa, and earned her JD from the University of Chicago Law School.
Quinnipiac University has appointed Andrea Hogan director of global education. She will be responsible for oversight of the university’s study abroad programs and services for international students. A New Haven resident, Hogan previously was director of international services at the University of New Haven. She holds a bachelor’s degree in Spanish and psychology from the University of Connecticut and earned a master’s degree in multicultural education from Southern Connecticut State University.
The Quinnipiac University School of Law has named Denée Page of Naugatuck assistant director of admissions. She will assist the law school in attracting and enrolling a diverse class, represent the school at recruiting fairs across the country; manage the Student Ambassadors program; oversee the school’s Web and social media content; and assist in the production of view books and other publications. Page holds a BA in English from Indiana (Pa.) University and a JD from Roger Williams School of Law, where she worked as an admissions recruiter before coming to Quinnipiac.
An innovator in the field of sustainable food systems, Mark Bomford has been appointed the director of the Yale Sustainable Food Project, a comprehensive program that has helped spearhead a national movement across college campuses to change the way people eat and think about food. Bomford comes to Yale from the University of British Columbia (UBC) to guide Yale’s food consciousness-raising program into its second decade. At UBC, Bomford founded and managed the Centre for Sustainable Food Systems, a far-reaching and multi-faceted organization that includes a 60-acre “learning and research” farm — the last working farm in the city of Vancouver — and 150 academic and community programs linking people to their source of food and, through food, to one another. Bomford earned a B.Sc. at UBC in agroecology, a degree that combines the sciences of agriculture and ecology within a socioeconomic context.
Bob Slate has joined Operation Fuel as its small business advocate. His responsibilities include coordinating Operation Fuel’s pilot program for small companies, which will provide energy grants and energy conservation training to state-certified women- and minority-owned businesses. Slate also is an adjunct professor at the University of Hartford and the University of Connecticut. Previously he was a communications associate at Universal Health Care Foundation of Connecticut. A resident of West Hartford, Slate is a graduate of Harvard University.
Grace Peiffer of Fairfield has been appointed director of employer relations in the School of Business at Quinnipiac University. In that role she will establish links and networks to employers and build relationships to enable undergraduate and graduate students to expend career opportunities through internships and full-time employment. Peiffer will also manage the School of Business mentorship program and be a liaison for the academic clubs and collaborate with professional organizations to create outreach for students. Peiffer was born and raised in Poland and earned her bachelor’s degree in business administration from Central Connecticut State University with a concentration in management information systems.
State Treasurer Denise L. Nappier was inducted into the Connecticut Women’s Hall of Fame October 25 at a ceremony at the Connecticut Convention Center in Hartford. She joins 96 previous inductees including Gov. Ella T. Grasso and Katharine Hepburn. The first African-American woman elected to serve as a state treasurer in the U.S. and the first to be elected to statewide office in Connecticut, Nappier is Connecticut’s chief elected financial officer, overseeing approximately $52 billion in state funds.
Richard Strompf, who joined Post University in 2006 as a professor in the Master of Human Services degree program, has been promoted to dean of the newly renamed John P. Burke School of Public Service at the Waterbury university. Strompf received his master’s and doctoral degrees in clinical psychology from Florida Tech as well as an undergraduate degree in psychology from Geneseo State University (SUNY) in Geneseo, N.Y.
The U.S. Senate voted May 17 to confirm the nomination of Yale University Deputy General Counsel Susan L. Carney to serve as circuit judge on the U.S. Court of Appeals for the Second Circuit. Carney will fill the seat of Circuit Judge Barrington D. Parker, who assumed senior status in October 2009. President Barack Obama first nominated Carney to the Second Circuit on May 20, 2010. Carney has provided legal counsel to Yale in its Office of General Counsel since 1998, serving as deputy general counsel since 2001. From July through December 2008, she was acting general counsel. She holds an AB from Harvard College and a JD from Harvard Law School.
James H. Gatling, president and CEO of New Opportunities Inc. in Waterbury, has been named chairman of the Waterbury Regional Chamber. In 2008, Gatling was awarded the chamber’s Malcolm Baldrige Leadership Award. Last year he was named one of the 100 Most Influential Blacks in Connecticut by the Connecticut Conference of the NAACP. He earned a Ph.D. in business administration from LaSalle University, an MBA in management from the University of New Haven and a BA in chemistry from Hampton Institute.
The Prospect advertising and marketing firm Worx Branding & Advertising has named George O’Shea vice president for business strategy. O’Shea previously headed business development for Proteus Design (now Motiv Design) in Boston, which crafted the strategic vision for the Keurig Coffeemaker. In his new position he will work primarily with consumer and retail brands.
The Advisory Council of the Connecticut Society of Certified Public Accountants (CSCPA) has elected Michael L. Kraten, CPA of Milford chairman for the organization’s 2011-12 activity year. The 25-member Advisory Council’s charge is to counsel the CSCPA board of directors and to appoint a nominating committee each year. Kraten is the president of Enterprise Management Corp. in Milford and an accounting professor at Providence College.
The Connecticut Society of Certified Public Accountants (CSCPA) has also elected Noelle A. Taddei, CPA of North Haven president-elect for the organization’s 2011-12 activity year. Taddei is an associate professor of accounting at Post University in Waterbury.
The New Haven Symphony Orchestra (NHSO) has named Elaine C. Carroll of West Haven interim executive director, effective June 1. Carroll previously was the orchestra’s director of development. The appointment comes after Executive Director Natalie Forbes announced her resignation from the symphony in February. Carroll earned a master’s degree in performing arts administration from NYU and a baccalaureate degree from the University of North Carolina/Chapel Hill.
Ronald S. Harichandran, chair of the Department of Civil and Environmental Engineering at Michigan State University, has been appointed dean of the Tagliatela College of Engineering at the University of New Haven, effective August 1. Harichandran has taught at Michigan State University since 1984. He earned a Ph.D. and M.S. in civil engineering from MIT.
Gov. Dannel P. Malloy has named Mark Raymond the state’s new chief information officer. On June 2, he will take over operations at the Department of Information Technology (DOIT) and oversee its consolidation into the Department of Administrative Services. One of his first responsibilities will be to establish a joint labor/management committee to review the delivery of technology services and make recommendations on ways to provide those services in a more efficient and effective manner while reducing the costs associated with hardware and software procurement, licensing and consultants. Raymond is a graduate of the University of Connecticut.
Heather Dacey of Guilford has joined Page Taft Real Estate in Guilford as a residential broker. Page Taft is an exclusive affiliate of Christie’s International Real Estate.
Lee Deer has been promoted to general manager of Three Belles Marina in Niantic. Previously he was yard manager for the facility.
The Bethany branding and marketing communications firm Mason Inc. has hired Jaclyn Carey of Milford as brand manager. She will be responsible for accounts including Yale-New Haven Health’s Epic Project, the Yale Center for Clinical Investigation, and Enthone, a specialty chemical company.
Connecticut Innovations Inc. (CII), the state’s quasi-public authority responsible for technology investing and innovation development and administrator of the Connecticut Clean Energy Fund (CCEF), has named Bryan Garcia president of CCEF. A member of CCEF’s staff for six and half years from 2000 to 2007, Garcia returns to CCEF after serving for four years as program director of the Yale Center for Business and the Environment.
HARTFORD — Basement Systems Inc. of Seymour, led by Business New Haven 2009 Businessperson of the Year Larry Janesky, is among the 2011 class of inductees into the Connecticut Business Hall of Fame. The other four inductees are the Channel 3 Kids Camp in Andover, Bloomfield Bicycle & Repair Shop, Central Connecticut State University's (CCSU) Institute of Technology & Business Development, and Mike Albert, president and founder of Pilgrim Furniture City in Southington.
A statewide induction ceremony and networking event will take place from 8 to 10 a.m. May 20 at the Connecticut Laborers’ Council, 475 Ledyard Street, Hartford. To learn more phone 860-523-7500 or visit ctbhof.com.
Remembering the unforgettable Herb Pearce
NEW HAVEN — Some 600 people crowded into Trinity Church on the Green April 27 to bid a final farewell to Herbert H. Pearce, who had passed away April 18 — just three days short of his 95th birthday.
Pearce died of leukemia, with which he had been diagnosed two years earlier. At that time his doctors gave him three months to live. Twenty-four months later he concluded what his daughter called a “perfect life” with a “perfect death” — calling a family meeting on Saturday, April 16, kissing all the hospice nurses the next day, Sunday, and leaving this life on Monday.
The mourners — actually, “celebrants” is a more accurate description — included the cream of New Haven’s business community as well as politicians and leaders of the non-profit community. That diversity reflected the vast sweep of lives touched by Pearce during his nine and a half decades on earth.
Herb Pearce founded the real-estate company that bears his name in 1958 after two decades working for New Haven’s A.C. Gilbert. He was hired there for 25 cents an hour — $10 a week. By age 27 he had 1,000 people working for him.
He was a tireless advocate for his hometown. He was instrumental in the development of the Whitney Grove mixed-use residential and commercial development in the late 1980s. In spite of the financial problems that dogged the project, Pearce believed that maintaining a strong residential base was key to the future of the center city — an instinct that proved prescient.
In the 1980s he was a driving force behind the creation of the bridge that opened Universal Drive in North Haven to commercial development. That bridge is known today as the Herbert H. Pearce & Donald B. Lippincott Commemorative Bridge in honor of Pearce and partner Lippincott’s work to make it a reality.
Pearce was remembered by his friend, retired banker and businessman F. Perry (Buck) Wilson, who recalled Pearce’s misadventures on the links as well as odd culinary predilections. He wouldn’t eat anything green (which pretty much put the kibosh on salads and vegetables), and in restaurants he was legendary for ordering one of his favorites — onion soup without the onions. “This always confused the waiters,” Wilson noted.
Three of his grandchildren — Bradley and Hope Fleming and Matthew Sawyer — recalled how Pearce loved to do “all the grandfather things” except one: allowing himself to be called “Grandpa,” because he thought it made him sound old. He was in his 70s at the time. So instead the grandkids called him “Herb.” Same as everyone else.
Pearce’s highly accomplished daughter and successor at the helm of H. Pearce Co., Barbara L. Pearce, delivered the “keynote” remembrance, covering “nine and a half decades in nine and a half minutes.” She spoke of her father’s three gifts: “a gift for life, and gift for friendship and the power of positive thinking.”
More than once I have heard Barbara Pearce attribute her father’s success to “rat-like cunning.” Not only does this sound unkind — I think it is also inaccurate.
For one thing, rats aren’t “cunning” — that’s an anthropomorphization. As the most adaptable species on earth (human beings are No. 2), rats are supremely opportunistic.
So was Herb, who had an uncanny aptitude to find the most promising opportunity in any set of circumstances arrayed before him.
Beyond that, what always impressed me most about Herb Pearce, above and beyond his sheer drive and will, was the magnetism of his personality. He was the kind of person you just wanted to be around — to breathe his air.
There’s a saying in sales — that customers buy from the person they want to be. Who in his or her right mind would not want to be Herb Pearce, who lived each day as though it were his last?
The final “hymn” of the service was a popular song from another time and place:
O when the saints go marching in,
O when the saints go marching in,
O Lord, I want to be in that number
When the saints go marching in.
Whatever else one might say about Herb Pearce, this much is certain: He is definitely in that number.
Oncologist Cardinale on rapidly evolving courses of care
Joseph Cardinale, MD, is medical director of the Fr. Michael J. McGivney Center for Cancer Care and chairman of the Radiation Oncology department at the Hospital of Saint Raphael. Cardinale has been a member of the attending staff at HSR since 1985 and he has served as section chief of Radiation Oncology since 1997. He was named medical director of the McGivney Center in 2000 and he also serves as medical director of the McGivney Center Cancer Center/Hamden Campus, which opened in 2009.
How do providers decide on introducing a new technology or new therapy — is it driven by the technology or the market, or something else?
The primary factor is the interest and expertise in the physicians in that department. It makes no sense if no one knows how to use it — unless their interest is in learning how to use it. Most of the decisions are driven by expertise and interest and also having the need as far as patient care.
So in your area you have robotic surgery.
We have two very different types of robotic equipment. One is the da Vinci Robot, which is used by surgeons and is a type of laparoscopic instrument. The laparoscopic arms are robotically controlled and the surgeon can see much, much better, it has a ten-times magnification and [displays] in three dimensions — [users] have extreme control over their visualization and movements. That has been a big advance in surgical techniques for a variety of different diseases. The other type we have is a Cyberknife for robotic radiosurgery. It’s a robotic arm. It’s actually the same robotic arm used in the Mercedes [automobile] factory for doing spot welding and it is ultra, ultra-precise. A neurosurgeon out in California had the idea of mounting a very precise radiation unit unto one of those robotic arms and it turned out be a very significant invention.
That came from a practicing physician?
He was training in Sweden on the Gamma knife, which is similar name but a very different technology. He felt there were improvements that could be made, and he came up with and eventually partnered with people in industry to develop it further.
Do robotics have an impact on those who might not have the manual skills we would typically expect in a surgeon or older physicians?
I’m not a surgeon, so I am not in my area of expertise. But my impression is that it still requires a good amount of dexterity and three dimensional visualization.
What types of cancers are on the rise in New Haven? Is it different from the nation at large?
Overall cancer incidence has decreased in the United States very slightly over the past couple of years. We still see a lot of lung cancer. Prostate cancer took a very big rise with the advent of PSA testing in the early ‘90s and has since leveled off.
So we discovered more cancers. People didn’t necessarily develop more.
Right. There is a pool of people that if the test wasn’t available would have been diagnosed later. It was also true [of breast cancer] when mammography became more utilized.
Is there an overall direction you see cancer treatment going?
The treatment of cancer is really multi-modality — surgeons, medical oncologist who administer the drugs, radiation oncologist…We all work very closely and as a team in many, many cases to develop the treatment plan that usually will encompass more than one treatment modality. As far as drugs, the newest [developments] are targeted therapies where the chemotherapies we’ve used in the past — and still use, to a large degree — are called cytotoxic agents, and they have a fairly broad cell-killing effect. The newer drugs are targeted at very particular areas of the cell. They have the potential for greater efficacy and a lot less side effects.
The biggest advances that we’ve made over the years in terms of increasing our cure rates is early diagnosis. We’ve made some headway in the treatment and improving our cure rates through treatment, but they pale in comparison to the effect that finding a cancer earlier would have. Early diagnosis is truly the key.
Hasn’t that been questioned in the case of prostate cancer?
There is a lot of controversy right now with prostate cancer and whether [early diagnosis] really affects survival — but we learned that lesson many years ago with the use of pap smears for cervical cancer. It is rare to see an advanced cervical cancer any more. In fact, cervical cancer has decreased because of the ability to find disorders that would lead to cervical cancer and treat them before they actually do.
Colon cancer is along the same lines as we screen better using colonoscopies. Polyps are able to be detected and removed. The incidence of fatal colon cancers is decreasing, and the same is true with breast cancer. We’re finding breast cancers earlier with the use of mammography, and the earlier the stage, the better the survival [rates]. I personally believe that there will be a time the same will be true with prostate cancer. The problem with prostate cancer is that the natural history is so long. Prostate cancer is relatively slow-growing compared to other cancers. So if one is diagnosed early, it takes a long time to demonstrate whether the early diagnosis will really impact someone’s survival.
Will we see a lot more innovations in surgical technology?
Technology is improving a lot of surgery in neurosurgery, for example. There is technology now that basically navigates the surgeon through the areas of the brain to allow them to do much more precise surgery and to cause less injury. Techniques in thoracic surgery with laparoscopic involved and things using ultrasound that allow them to better see where they are directing their instruments. I think they’ll be continued improvements [in surgical technology].
There have been questions raised about the prevalence of cancer among minorities. Is this a detection issue, or do higher cancer rates stem from other factors?
I think it is more the detection issue. Lower-income people are less likely to seek medical care and to undergo evaluation that could lead to early diagnoses. Yesterday we did a free prostate screening — we do that twice a year. We do a free head and neck screening, we do a free skin cancer screening, we have a program [at HSR called Sister to Sister to help those who can’t afford mammography or cervical cancer screening.
The 2010 health-care debate brought a proposal by a government panel to reduce the frequency of mammograms to reduce overall costs to the system. There was much pushback from cancer doctors including here in Connecticut, but the recommendations did come from cancer researchers and physicians. How do we appropriately address a question like this?
Whenever you talk about technology and how one is going to approach a population, not an individual, there is a cost associated with that. One has to analyze the cost versus the potential benefit and that’s where the controversy arises. Every time you have a screening test or enact some kind of policy, you know you’re not going to catch 100 percent of the people. I don’t make this kind of policy, but my assumption what they’re trying to do is develop guidelines that will have a threshold that they’ll catch a certain number but knowing it’s not going to be 100 percent. I think that’s why there is a big controversy with PSA test because of the costs involved.
There has been controversy also about additional tests for women where traditional mammography may not find early cancers in women who have what is referred to as ‘dense’ breast tissue. How is this handled now?
The problem is with mammography itself. If the breast is very dense, one can easily miss some of the findings that would lead to a breast cancer diagnosis. Now [recent Connecticut] legislation requires a mammographer to put in their report that there is dense tissue, then the person can be screened further with ultrasound or an MRI.
What is the most important piece of advice that readers should take away from this?
I believe in screening and early diagnosis, and I want people to really understand that is something they should not be afraid of doing. The cancer treatments that have developed over the years have improved so much that when someone is diagnosed early, the changes in one’s life is generally quite minimal and people can live a normal life with current treatment.
Since you specialize in prostate cancer and many of our readers are men, why don’t we leave them with a specific recommendation on screening?
Men without any risk factors should start being screened at the age of 50. If one has a risk factor like a first-degree family relative that has prostate cancer or African Americans, [age] 45 or 40.