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Brian Lehrer: It's the Brian Lehrer Show on WNYC. Good morning again, everyone. With us now, Bruce Ratner with his new book, Early Detection: Catching Cancer When It’s Curable. Bruce Ratner is a member of the board of Memorial Sloan Kettering Cancer Center and the Weill Cornell Medical Center here in New York. He lost his brother, the human rights attorney, Michael Ratner to cancer in 2016. Michael was a guest on this show multiple times as president of the Center for Constitutional Rights. In memory of Michael Bruce, created the Michael Ratner Center for Early Detection of Cancer.
You may know the name Bruce Ratner more for being the developer of Barclays Center and the Atlantic Yards Project in Brooklyn, former owner of the Nets. In conjunction with that, also the developer of Brooklyn's Metro Tech Center and the New York Times building in Manhattan, among other things. He's a former New York City Consumer Affairs Commissioner. Yes, it's the same Bruce Ratner.
We'll talk some about New York City real estate and housing issues, too, but mostly about the book in which Ratner and science writer Adam Bonislawski, explore the science and history of early cancer testing and propose major initiatives for cancer prevention, including more equal access for people underserved by the healthcare system, who not surprisingly, have higher rates of cancer mortality as opposed to cancer survival.
There's a relevant news story right now. The federal government's Preventive Services task force just this week recommended routine mammogram screening for women beginning at age 40 rather than 50 because of a rise in breast cancer among women in their forties. It's an example of the imperfect and ever evolving science of the risks and benefits of cancer screening. 15 years ago, the same panel had lowered the recommended routine screening age and now has reversed its own recommendation. The task force also declined to recommend certain other breast cancer screening, and that has become an instant controversy. We'll touch on that too. Again, the book is called Early Detection: Catching Cancer When It's Curable. Bruce Ratner. Hi, welcome back to WNYC.
Bruce Ratner: Thank you, Brian. You've certainly hit on a lot of really important points, and thank you so much for mentioning my wonderful brother who passed away. Anyhow, [crosstalk].
Brian Lehrer: I was going to invite you to start with a few thoughts about your brother. Do I see correctly that it was his death in 2016 that inspired you to pursue this as a central mission for you now?
Bruce Ratner: Yes, it was. Michael and I were very close. We're a year-and-a-half apart. People probably know this, but we shared pretty much the same values with respect to human rights. His passing was tragic for me, I think tragic for the world in terms of losing somebody that was so important in human rights. After that and after losing my mother from cancer when I was 30 years old, my only grandmother I had when I was five, I decided that I really had to look at cancer. What I discovered was that advanced cancers are essentially not curable. The only way really to cure cancer was catching it early.
I embarked on a book in 2016/'17 and have been working on and off on the book until until I finished it three months ago. It's a very important topic, and you're right, it does happen to come up today because of the USPSTF thing. I think the first thing to recognize is that cancer is not only my story, it's everybody's story. If we think about it, we all know, whether it be parents or friends or relatives or children or brothers or sisters, we all know people who have perished and died from cancer.
In many cases, it wasn't necessary if they had caught it early. Our government just doesn't put the money or the effort into early detection of cancer. It spends money on therapeutics and basic science, which it should continue to do. We've got to balance things out in a much more significant way. We can't have the same cancer mortality that we had for per 100,000 for 50 years. It hasn't changed except for the decrease in smoking, which has made some change. In terms of therapeutics, there has been essentially no change in mortality.
Brian Lehrer: Listeners who has questions or comments or stories about early detection and treatment of cancer, the science of it or is applied in real life or the disparities around that and how to eliminate them for Bruce Ratner co-author of Early Detection: Catching Cancer When It's Curable, 212-433-WNYC, 212-433-9692, call or text. We should say, Bruce, you're not a doctor or a biologist. You are a lawyer, a city official, and a real estate developer.
How did you approach writing this book without a professional background in this scientific and very technical subject that you tackled? Oh, we're fixing Bruce Ratner's mic. You might have heard he was a little muffled when he came on. We are correcting that. Again, listeners, you can call at 212-433-WNYC. Now we fixed the mic problem. Bruce, were you able to hear my last question?
Bruce Ratner: I think I did. I hope I did. Anyhow, tell me your last question again. Sorry.
Brian Lehrer: Being that you're not a doctor or a biologist, your career has been in different things, how did you approach writing this book without a professional background in the subject?
Bruce Ratner: First of all, I was a science major once in my life, and I have followed medicine. I've been on the board of Sloan Kettering for 20 years and Weill Cornell in the same period of time, plus I put my consumer advocate hat on and I got angry. Then I had a a helper in Bonislawski. Adam was very helpful. He helped me do the research. We interviewed over 100 different doctors and scientists. That's how we were able to do this. It's a really important subject.
Brian Lehrer: I see that just four cancers account for nearly half of US cancer deaths, lung, colorectal, breast, and prostate. One interesting thing to me in your book is where you focus on lung cancer screening, because I think many people who might know roughly about colonoscopies for colorectal cancer, mammograms for breast cancer, PSA tests for prostate cancer, as well as other methods of early detection for those three, they may not be aware of early detection methods for lung cancer, which it doesn't seem to me we hear about as much. What does [crosstalk]?
Bruce Ratner: That's a great point. Let's talk about that. The first comment is, you're right, there are four basic cancer screening tests. Here's the sad thing. While they represent 45% of cancers, only 14% of the people actually use those tests and actually get diagnosed. Lung cancer is absolutely the worst. Only 5% of people who are eligible for taking lung cancer screening actually do it. It is the number one killer, 160,000 people a year. The government does nothing to advertise it, nothing to push it as they have with colonoscopies. It is an outrage, frankly. It's remarkable.
We could save so many lives if people did the lung cancer screening. All they have to do is once a year get a low dose CT scan that takes probably less than a minute, and they're highly unlikely to die of lung cancer. Yet we all have friends, relatives, parents who died of lung cancer. It's really the low hanging fruit for screening and what we ought to be paying the most attention to.
By the way, here's a fact. There's a drug for lung cancer. It's called Keytruda. You see it advertised and there's similar drugs. It has $25 billion a year in revenue. The whole National Cancer Institute is only seven-and-a-half billion. Believe it or not, early detection is only $600 million is spent on early detection. It's honestly, again, putting my consumer hat on, I'm angry about it, and it really has to be changed.
Brian Lehrer: I think we have a lung cancer early detection caller. Mary Alice on the Upper West Side, you're WNYC with Bruce Ratner. Hello.
Mary Alice: Thanks so much, Bruce. I can't thank you enough.
Bruce Ratner: How are you?
Mary Alice: I'm doing great, because four-and-a-half years ago, my dad saw some news about your screening, had it done, they caught it. He was treated at Weill Cornell with the fabulous treatment, thank God, and he's alive today. It was January of 2020 and there's no way they would've caught it. It is a miracle. He continues to get screened. We all thank you with my family.
Bruce Ratner: I have to tell you that's very important. Thank you so much for saying that. What happened was, just before the pandemic, I did a pilot project in downtown Brooklyn, New York, low income projects, but it was broadcast over the whole city. We freely screened people, and we actually caught cancers, and apparently, your father was one of them. I'm so glad to hear that it worked out and we saved a life. I often think of that, so thank you for saying that. More of it has to be done, and that's really why the book was written.
I must say something. There are issues of disparity also that I could talk about forever. We were fortunate enough, your father was fortunate enough, but it ought to be available to everybody. There's so much money that has been spent on these drugs. Keytruda only extends life for on average 9.1 months. One treatment is $22,000. Revenues of $25 billion on a drug that on average extends life nine months. It's just not right. We spend nothing on pushing lung cancer screening, and it's got to be done. Frankly, all the screenings, even mammography. Mammography has enormous number of problems. In fact, one was mentioned today when you talk about the USPSTF.
Brian Lehrer: Now I want to jump off of what you just said about disparities, because I think these are the big two takeaways from your book. One is about lung cancer screening in particular, and the other, well, I'll just cite one of your chapter titles, which is Death by Zip Code. How bad are some of the disparities?
Bruce Ratner: Very bad. Let me give you a couple examples. First of all, say breast cancer. In the case of breast cancer, the instance of breast cancer for African American women and white women is approximately the same. Yet the mortality rate is 40% higher. Another example, in Washington DC Medicaid patients, 47% of Medicaid patients who get diagnosed with cancer follow through. The other 53% do not follow through and do not get treated. Those are incredible figures and unacceptable, and I could go on and on like that.
Every single area, even that USPSTF today, what it came out with. What it doesn't say is that it doesn't cover-- If you have dense breasts, you have to have other tests, really. You have to have ultrasound, really. You should even probably have an MRI. Guess what? It's not covered. Katie Couric has been a big advocate of that. We already increased disparities.
What the USPSTF did today was tragedy. They recommended screening every other year for women over 40, interval cancers. Cancers that come during that two-year period are 25% of all cancers, and the mortality rate is three-and-a-half times higher for interval cancers. What kind of recommendation is that? On top of that, they said end at age 74. Well, women get breast cancer regularly over 74. Probably 25% of all cancers are women who are over 74. Our government is doing us a disservice.
Brian Lehrer: We had a caller recently who's on Medicare, and as I remember the call, she was complaining that Medicare doesn't cover frequent enough mammograms. I think she may have been referring actually to that particular screening that you and many others have criticized, that the task force did not endorse the extra scans such as ultrasounds or MRIs for women who have what they call dense breast tissue. That's part of where the disparity comes up. As the reporting I saw, I think in the New York Times put it, the lack of recommendation there from the government means that insurers do not have to provide full coverage of additional screening for these women and the times noted that even Medicare does not cover that screening.
Bruce Ratner: Correct. What happened is the Obamacare required a recommendation by the USPSTF, particularly on breast cancer, that it be covered, but they don't cover people with dense breasts who need the additional two exams. I find that they are increasing disparities. This interval stuff is outrageous. I'm sorry to put on my consumer hat, but you're hearing my consumer hat, which is that what really got me disturbed is when I discovered all these amazing facts, the amount of money that's not spent on early detection of cancer, the lack of screening properly. There's so many different issues with even breast cancer screening, frankly, that ought to be improved upon. Even 3D tomography is a much better method than the normal mammography. That's not even emphasized. I could go on and on on so many different issues that ought to be changed.
Brian Lehrer: Like so many other disparities disproportionately affect low-income people, which is going to mean disproportionately people of color. You also mentioned rural people, and that's in terms of access, meaning, insurance and ability to get a doctor, even if you have insurance. You make recommendations to reduce disparities like media campaigns to make people more aware of screenings and their benefit, and also to deploy patient navigators to eliminate disparities. What are patient navigators, and how would they reach the underserved?
Bruce Ratner: I'm so glad you brought that up. That is what I call the bandaid solution, meaning that, unfortunately, we are not going to be able to change our social determinants. Things like education, things like having to have jobs that don't allow you to do the different kinds of screening that's necessary or follow-up. There are patient navigators. It was created here in the city by an African American doctor named Harold Freeman. He did it at Harlem Hospital 20 or 30 years ago. He did an experiment. He intervened with patient navigators, which I'll tell you about in a moment. He reduced mortality significantly by having patient navigators.
Patient navigators are people who, number one, help you through this system. We all know how difficult it is to go through the system. When you have cancer, it's even more difficult. You have to go for treatments all the time. You've got to make sure you have the right insurance. It goes on and on. What he did was on the day that somebody came in to see him, he opened on Saturday's breast cancer screening, and he right away assigned a patient navigator to make sure that they had insurance, to make sure that their appointment was set, to explain to them what exactly was happening when they got cancer.
Once they got cancer, to make sure that they could get to their treatment, that they had a way to get there. To make sure that there was food for their children. There's a food desert out there when you have cancer and you can't afford it. You can't work the same way you used to. You're recovering. Patient navigators, I think, are the real-- I don't want to say the final answer, but they certainly are one of the major answers. Guess what? It is not essentially covered by insurance patient navigators.
They just added some very slight reimbursement to like an hour-and-a-half a month for people who have cancer, but essentially, it's not covered by insurance. Patient navigators, we're not going to close that gap unless we have patient navigators. Actually, what's happening, actually, Brian, is this book is, yes, to sell books, but it's also a platform to talk as I'm talking now. The next step is going to be to try to increase screening in the city of New York by different models that we're working with Sloan Kettering, with Weill Cornell to increase screening. One of the most important things is this patient navigator system
Brian Lehrer: Van in Midwood, you're on WNYC with Bruce Ratner, author of Early Detection: Catching Cancer When It's Curable. Hi, Van.
Van: Hey. Thanks for having me on. I was a radiologist at Columbia. The NYP system got me all excited when that was mentioned. At any rate, so I actually have a startup, [unintelligible 00:17:46] NYU where we're using computer vision to help blind folks like me, and that's a long story. You could ask a blind radiologist. I wasn't when I was a radiologist, to help people navigate through interior spaces. We're actually going to be doing a pilot where we use our software to help blind folks get screening tests done for cancer screening, because the screening rates are much lower in the disability community. Healthcare facilities are quite poorly accessible in terms of disability. Something I just wanted to bring up. I'm glad you're raising awareness on disparities.
Bruce Ratner: I'm aware of what you've done, and I know that. Your Langone facility in Brooklyn is very important, particularly for low income. I've talked to people over there. We actually would like to get in touch with and include you in basically the Brooklyn initiative to increase screening, because it is very important. I'm glad you called and what you're doing is really important, because as you know, without patient navigators or people either of disabilities or low income, it's very hard to navigate this system. It's hard for everybody to navigate the system. What you're doing is great.
Brian Lehrer: Bruce, we're coming to the end of our scheduled time. Are you available to stay to the end of the hour because we have--
Bruce Ratner: I am available to stay to the end of the hour.
Brian Lehrer: Good. We have more very interesting and relevant calls. I have a few other things I want to bring up with you like how and when to believe the recommendations because they keep changing about different kinds of early detection screenings. We'll touch on some real estate stuff, too.
Bruce Ratner: We should also touch on multi-cancer early detection, like broader-based tests.
Brian Lehrer: What does that mean, multi-cancer?
Bruce Ratner: What happens is there are tests that can test up to 50 cancers through a blood test, but we can talk about that. It's a complicated subject, but an important subject.
Brian Lehrer: All right. We'll continue in a minute then with Bruce Ratner.
Bruce Ratner: Great. I appreciate that.
Brian Lehrer: His new book, Early Detection: Catching Cancer When It's Curable. Listeners, we had a really fun call-in that we were going to do for the end of the show today. I know some of you tune in for these end-of-show call-ins. We'll do it tomorrow, I promise. This is important, and we're getting great callers on this too with their personal stories. Brian Lehrer on WNYC. More in a minute.
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Brian Lehrer: Brian Lehrer on WNYC as we continue with Bruce Ratner, yes, the real estate developer of Atlantic Yards and Metro Tech and Barclay Center and all that in the more controversial part of his life. We're going to talk about that a little bit before the end of the show. He's the co-author of a new book called Early Detection: Catching Cancer When It’s Curable. That's been another one of his big interests for a long time.
Not only if you didn't hear the beginning of the segment because of the loss of his brother, the constitutional rights lawyer, Michael Ratner to cancer in 2016, but also he's been on the board of Sloan Kettering and Cornell Weill for many years and has been interested in this topic. Let's take another phone call that I think is right on point to one of the big points you're trying to make in the book. Marie in Wayne, Pennsylvania, you're on WNYC. Hi, Marie.
Marie: Hi. This conversation is breaking my heart and here's why. In January of 2023, I had a routine cardiology calcium index score, always being duly diligent in my screening processes. When that index came back, it was noted that there was a spot on my right lung. The cardiologist said, "Don't worry, no worries." I said, "Not so fast." I grew up with secondhand smoke. I've been a non-smoker my entire life. Never did anything with lung disease being prevalent in my family. I went to see a pulmonologist a week later. She said, "No worries, it's your call. Come back in a year."
I left with a CT scan script in my hand. Again, being duly diligent, I went back in a year, and had a CT scan prior to the visit, and my lungs had exploded with lung cancer stage four. It's just appalling to me that being a novice, naïve about lung cancer that I could have maybe pressed, I could have lied, said I've been a smoker for 50 years, whatever, but the pill that I am now on, and I got picked up for a clinical trial, which is a blessing, because the pills that I'm on, Tagrisso, costs $10,000 a month. I would think that insurance companies alone would be pressing for this kind of screenings. I can't even imagine how much this is going to cost in the long run, not only in money but also my life. It's breaking my heart listening to this.
Brian Lehrer: It's breaking my heart listening to you talk about yourself. I'm just curious, Marie, before Bruce response, if the recommendation that Bruce has been emphasizing for getting a lung cancer screening that's less known than the colorectal screenings and others, if you're sitting here thinking, "I wish I had known about that 10 years ago."
Marie: Yes. I have done everything right.
Bruce Ratner: I have to tell you something, I'm holding my heart, because that is a very sad case, and I'm so sorry this has happened to you. A couple comments. First of all, unfortunately, the test 20% of lung cancers are people who never smoke, and they're not eligible through insurance to get a lung cancer screen. There's not much to do about that. There doesn't seem to be a lot of incentive to do that. Unfortunately, it's hard enough to get the government to push lung cancer screening for people who smoke.
The first comment is it is outrageous, in my opinion, that there's not a way to deal with all of us who don't smoke. Second comment is your doctors who missed it, that is terrible, to see a lung cancer nodule and not follow it up. The rule usually is when you see a nodule, you come back three months or six months later to see if it's grown. If it's grown and it's solid, it's likely that there's a chance you have cancer. It was missed. I'm very sorry to hear that. It's an unfortunate situation you're talking about. My heart goes out to you. Things have to change because what happened to you should not have happened. That's really all I can say.
Brian Lehrer: I don't know if there's anything else you want to say, but I think it's really great that you told your story, because that's probably going to save somebody else's life.
Bruce Ratner: I hope it does. My hope is that the clinical trial is working and it's shrinking the tumor and so on, that you have good treatment. That's my wish.
Marie: Thank you.
Brian Lehrer: Thank you, Marie. This federal government Preventive Services task force recommendation for now routine mammograms for women beginning at age 40 rather than 50 because of a rise in breast cancer among women in their 40s. It's an example of the imperfect and ever-evolving science of the risks and benefits of cancer screening. Like I said at the beginning of the segment, I think PSA tests for prostate cancer screening have also gone back and forth.
I don't even know where that stands now as a recommendation. It might make a lot of people skeptical about getting these screenings at all because there might be downsides like getting freaked out when your situation is not actually serious. I wonder if you have any advice in this spark or just to say for how people can process the uncertainty and then do the right thing.
Bruce Ratner: There's a lot of different aspects of that. The first comment is that I would rather have a false positive than a false negative, meaning, false negative means it doesn't pick it up. If I have to deal with a false positive, it is uncomfortable, and I appreciate that. We deal with false positives all the time in life. We deal with false positives when we have a blood test and it comes out incorrect. We can deal with that. What we cannot deal with--
Brian Lehrer: It's not just feeling like, "Oh my God, I got a positive test." We know there've been mastectomies and other procedures that then been shown to be unnecessary in certain circumstances.
Bruce Ratner: Let's stop right there. Yes, you're right. There was a period of time around 2000, 2002, 2003, where prostatectomies were done more often than necessary. People had low grade prostate cancers ,and USPSCF stopped giving a recommendation to get PSA. Guess what happened? Within 10 or 12 years, mortality increased dramatically when they did that. Yes, there were prostatectomies that in fact were done for a period of time . That is much less common now. Now there are other tests that can be given when you get a high PSA to determine if it's cancer. Yes, that did happen, that there were prostatectomies that didn't probably have to happen.
I'm going to tell you a couple of facts though. One fact is the average urologist does on average three prostatectomies a year. You need to do 250 prostatectomies to be good at the operation. We don't have any standards. The UK has standards. Another example actually is mammography. In mammography, we only to get certified, have to do 480 mammographies a year. The UK is 5,000. The other problem we have is, basically, people are practicing medicine in the urology area who haven't done enough prostatectomies to do them right. It's a very difficult operation. Honestly, Brian, there are so many different issues in every question that you answer. Your real question is, do you get screened?
I say, you get screened. You have to be able to handle, your right, a false positive, and really get determined whether or not it's a false positive. Again, the both famous scientist on cancer is a guy named Dr. Vogelstein. His comment is, "I'd rather have false positives than false negatives." I think everybody would agree with that. A false negative is an extremely dangerous thing. A false positive does create anxiety. It does create issues. I'm not saying it's easy to handle, but it's a lot better than getting cancer. I hear all the time, the first thing people say to me is, "Oh, Bruce, too many false positives."
I just smile, because first of all, the number of false positives is much less than people understand. It doesn't happen that often. A false positive can mean in the case of, say, lung cancer coming back three or six months later for another scan. That is not exactly hard to do. I have two nodules. I go once a year to make sure that they haven't grown. I don't have that much anxiety. I'm used to it. I would rather come back every three months or every six months when I initially get a nodule and have a little bit of anxiety, but at least know that it's not cancer or is cancer. I really reject this false positive is a way to, I think, shut down screening. Honestly, every time someone says false positives, I smile.
I'm going to tell you something. There's a doctor on the West Coast who everybody knows Eric [unintelligible 00:29:59] who is very famous. He had a comment in The Times about four years ago, which said, "Oh my goodness, lung cancer screening is useless." Then he gave examples. He was wrong because lung cancer screening actually has very few false positives. To the extent that you get a positive test, all you have to do is come back three months later or six months later and get another scan and see whether it's grown. I must tell you, I really don't-- when I hear false positive, I just like-- I heard it the other day. Someone said to me, "Oh, Bruce, too many false positives." My comment is too many false negatives.
Brian Lehrer: I guess you also reinforce the idea that there is sometimes disagreement among professionals. I just have a--
Bruce Ratner: I would say this, professionals who really know, who really put the time into it, there's not much disagreement. It's often doctors who don't specialize in that area or don't really know it. The people who really are in this area do know it. I don't think you get too much disagreement about any of this, frankly.
Brian Lehrer: We have three minutes left. Let me touch for those three minutes on your other life-
Bruce Ratner: Sure.
Brian Lehrer: -as CEO of Forest City Ratner, the real estate development company that did Metro Tech and Barclays Center and Atlantic Yards and more. From what I've read, here we are around 20 years later and still only half the promised housing at Atlantic Yards. Including only about half the below market rate housing has been built. The company that was most recently supposed to push that forward has filed for bankruptcy. There're those in Brooklyn who would say to you, "Promises not kept." Fair criticism?
Bruce Ratner: It's fine to say. First of all, we did build 3,000 units of which 30% were affordable. Number one, that's a lot of units. Two, we built a Barclays Center, which I think everybody agrees has been really important to Brooklyn. Yes, we sold our company in '18. What happened is the Chinese company that bought it wasn't able to finish it. That's a shame. It's not the end of the world though. There were 3,000 units. We did get a Barclays Center, and sure, I'm unhappy that they didn't finish it. That really isn't the problem. The problem we have in this city is just not enough low income housing, period. That's really where the focus ought to be, instead of worrying about whether the units got finished. I'm happy to take-- blame it's not the issue really. I don't care. We need housing.
Brian Lehrer: On that, tenant advocates are so skeptical of developers, and argue that much more affordable housing could be getting built that would have enough profit to make it worthwhile rather than what seems like CRUM is only 20 or 20-- I'm citing their argument, "20% or 25% of the units below market rate. 30% in Atlantic Yard's case. Many New Yorkers believe on greed for bigger bucks rather than a reasonable profit for more affordable housing that would serve the public better." Any truth to that in your view?
Bruce Ratner: Let me comment about it. First of all, the word affordable means relatively high income. It used to be up to 130% of AMI or $100,000-plus. Even if you built, we can build 20,000 or 30,000 housing units a year in this city. Take a fourth of that number, that's 7,000 low income or rather affordable units a year. That is not enough. The history of low income housing and very low income housing has always been government. Every country in the world builds very low income housing and low income housing by the government.
Brian Lehrer: In our last 30 seconds, what's your policy recommendation along those lines?
Bruce Ratner: Very simple. The city and the state have to get together and do two things. One, fix the NYCHA housing that we have now, which will cost $10 to $20 billion over a period of four or five years. On a $250 million combined budget, they can afford to do that, number one. Number two, they have to build thousands and thousands of units of low income and very low income. It cannot be done by the private sector at 25% of 30,000 units a year. It's only 7,000 units a year. Even if everybody did everything they thought they could do, they would be "affordable" and not very low income. We're getting fooled, frankly. It's got to be the government and it always has been. The history of this country is that it's been the government. Most people don't like government. Sorry.
Brian Lehrer: I'm going to play that clip to to Kathy Hochul the next time she's on and say, "Bruce Ratner said this." Folks, Bruce Ratner wrote a book, co-author, really, of Early Detection: Catching Cancer When It’s Curable. Thank you for sharing this important information with us.
Bruce Ratner: Thank you, Brian. Thank you for the time. I very much appreciate it.
Brian Lehrer: Brian Lehrer on WNYC. Stay tuned for All Of It.
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