Governor Brown's Cancer Battle
- Governor Jerry Brown was diagnosed with cancer three times during his second tenure as governor of California from 2011 to 2019.
- Now 83, Governor Brown battled basal cell carcinoma in 2011, prostate cancer in 2012, and again in 2017. He also lost his chief-of-staff, Nancy McFadden, to ovarian cancer in 2018 while still in office.
- Prostate cancer can be treated with radiation. Technological advancements have enabled doctors to increase the radiation dosage over the years. “The reason that we’ve become more successful in treating prostate cancer over the last 30 years with radiation is that we’ve been able to get a higher dose of radiation into the prostate,” explains Dr. Patrick Swift, clinical professor of radiation oncology at Stanford.
It has been 10 years since Governor Brown was elected back into the office for an unprecedented third and later fourth term, stepping into a power vacuum created by the state’s decision to recall the election of its Democratic governor.
Read MoreBrown Battles Cancer in Office
After a term-limited Schwarzenegger exited the office, Governor Brown returned to the State House for a third and fourth term.
During those two terms, he was diagnosed with cancer three times, underwent treatment for prostate cancer twice, and lost both his most trusted aide and his dog to the disease.
Governor Brown’s cancer journey began with two basal cell carcinoma diagnoses, the second of which required him to undergo reconstructive surgery on the side of his nose when it was removed in 2011 soon after he entered office.
The following year, Brown, then 74, was diagnosed with prostate cancer for the first time.
He never spoke publicly about his battle. His office almost always refused comment while often instructing media members to reach out to Dr. Eric Small, the University of California San Francisco oncologist who oversaw Governor Brown’s treatment.
It was never revealed what stage the cancer was, only that it was “localized” and he had a “good prognosis.”
Governor Brown underwent radiation treatments to beat the disease, only to have it return five years later.
He was diagnosed again in early 2017, at which time Governor Brown vowed that he would not miss a day of work while receiving treatment similar to his previous battle with the disease.
"Fortunately, this is not an extensive disease, can be readily treated with a short course of radiotherapy, and there are not expected to be any significant side effects," said Dr. Small at the time.
He went on to write in an email sent to the press at the time that “the prognosis for Governor Brown is excellent."
Adjusting After Cancer Loss
Governor Brown successfully beat cancer once again but lost two special people in this life to the disease around that time.
In December 2016, California’s First Dog Sutter Brown lost his battle with cancer five years after taking up residence in the State House with Governor Brown and his wife, Anne Gust Brown.
Then, in 2018, Governor Brown suffered a devastating loss when his chief-of-staff Nancy McFadden passed away at the age of 59 from ovarian cancer.
"Nancy was the best chief of staff a governor could ever ask for," Brown said in a statement at the time. "She understood government and politics, she could manage, she was a diplomat, and she was fearless."
A Lifelong Politician
The lifelong politician exited office soon after that but has remained a major player in the California political scene.
Governor Brown’s political career seemed predestined from the start, having been the son of another two-term California governor, Edmund Brown.
He also attempted to run for president in 1992, challenging eventual winner Bill Clinton for the Democratic nomination. That bid fell short, but once reelected in California; he claimed the rare distinction of being both the oldest and second-youngest ever to hold that post in state history. And he remained the only governor of any state to have dated Linda Ronstadt.
Treating Prostate Cancer With Radiation
Governor Brown was put on a treatment plan that included radiation therapy during both of his cancer battles.
“So radiation plays a very important part in the treatment of prostate cancer patients across the entire spectrum of the disease, from a patient that has very, very early, localized, and highly curable disease to patients that have had, years of the disease and it’s widely spread, and they need radiation for palliative purpose,” explains Dr. Patrick Swift, clinical professor of radiation oncology at Stanford.
The radiation used is then tailored to each patient’s specific needs.
For instance, a patient like Governor Brown, who is newly-diagnosed with cancer would be informed that radiation is only one of the options for their treatment.
“It’s helpful to be able to explain to the patient how we make the recommendations for radiation and what the alternatives to radiation are,” notes Dr. Swift. “We then look at what the different side effects of the treatment area and the expected success rates, and then try to help the patient decide as to which treatment approach best fits their needs.”
Doctors then discuss with the patient the risk factors of surgery versus radiation, says Dr. Swift, who stresses the importance of seeking a second opinion in these cases.
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Advancements in Radiation For Prostate Cancer
External beam radiation therapy has been used in the treatment of prostate cancer for the past 50 years.
“External beam radiation therapy is the delivery of radiation treatments from the outside of the body, usually using machines the most common being the linear accelerator, but there are others that are out there to aim the radiation at the targets within the body,” explains Dr. Swift. “The targets within the body for prostate cancer are either the prostate alone, the prostate plus seminal vesicles, or the prostate plus seminal vesicles and lymph nodes of the pelvis.”
The procedure begins with the patient lying on a linear accelerator table each day for an extended period of time to get the radiation delivered in short bursts.
“The duration of the overall course of treatment is something that is in flux. The standard treatment, when we talk about standard treatment using external radiation therapy, it was usually eight to nine weeks of daily treatments Monday through Friday to deliver a set dose of somewhere around 80 grade to the prostate,” says Dr. Swift. “Over the last 10, 15 years, we’ve done remarkable things with our technology that allow us to aim much more carefully, reduce the amount of radiation that nearby critical structures get, and thereby get a higher dose in a quicker period of time.”
This has now allowed for the length of treatment to be much shorter than the eight to nine weeks.
TechTEc
This is referred to as “dose escalation,” which Dr. Swift points out “has been shown in several studies to improve the chance of control of the disease” in patients.
“Dose escalation means getting a higher total dose into the prostate where the cancer is. Dose escalation has been difficult, though, because the higher you push the dose, the greater the chance you could risk injury to the bladder, urethra, rectum, small bowels,” explains Swift of the drawbacks of the procedure.
“So in the last two decades, we have found ways to really identify exactly where the prostate is real-time while you’re treating, and by doing that, you can reduce the margin of where you’re treating the radiation too, eliminating or reducing the dose of radiation to nearby critical structures.”
How Radiation Is Used to Treat Prostate Cancer
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