In Conversation with Professor Tracey O’Brien

28 Feb 2025

Leading with Purpose

This month, we had the privilege of speaking with Professor Tracey O’Brien, CEO and Chief Cancer Officer at the Cancer Institute NSW, and one of our valued Executive Learning Set members.

In recognition of the 25th anniversary of World Cancer Day on February 4, 2025, we wanted to hear from a leading voice in cancer care about the progress made, the challenges ahead, and the role of leadership in driving meaningful change. Tracey shared her insights on the critical role of awareness, the evolving opportunities in cancer care, and the leadership strategies that help navigate decision-making in a complex and rapidly evolving industry. Here’s what she told us:

World Cancer Day is a powerful reminder of the ongoing fight against cancer. From your perspective, why is raising awareness so crucial, and how can leaders in healthcare drive meaningful action beyond just one day.

Cancer affects us all. With one in two Australians diagnosed in their lifetime, it remains one of our greatest health challenges—accounting for over a third of disease-related deaths and placing the heaviest burden on our healthcare system. Beyond the statistics, cancer deeply impacts individuals and families, bringing physical, emotional, and financial strain that can last years. While survival rates have improved, prevention remains one of our most powerful tools. One in three cancers is preventable through healthy living—meaning 16,000 cancer cases in NSW alone could be avoided each year by taking simple but life-changing steps: moving more, eating well, and avoiding alcohol and tobacco. These are choices we can all make, and they can save lives.

As healthcare leaders, our role goes beyond raising awareness—we must drive lasting action by:

• Prioritising prevention – shifting investment toward stopping cancer before it starts.
• Driving early detection – ensuring more people participate in screening programs.
• Staying ahead of the evidence – using research and data to inform real-world impact.
• Strengthening partnerships – working across the sector to address inequities.
• Keeping people at the centre – ensuring our decisions reflect the needs of those affected by cancer.
• Honouring community trust – leading with integrity to create real, lasting change.

As a leader in cancer care and research, what do you see as the biggest challenges and opportunities in improving cancer outcomes in Australia and beyond?

Some of the Challenges are:

• Persistent inequities: Cancer outcomes are not the same for everyone. Aboriginal and Torres Strait Islander people, culturally and linguistically diverse (CALD) communities, LGBTQ+ people, and those in rural or socioeconomically disadvantaged areas can experience significant gaps in access, experience or cancer outcomes. We are tackling this at a national level, but more must be done to ensure equitable access to prevention, early detection, and world-class care.
• Workforce challenges: As cancer care becomes increasingly complex, delivering high-quality, safe care is strained by workforce shortages across multidisciplinary teams, spanning public and private health systems, as well as community, primary, and tertiary care. These challenges are further amplified in rural and remote areas, where access to specialist care is more limited.

The Opportunities:

• Advances in research and innovation: We are in a golden era of discovery, with emerging therapies that are less toxic and more effective than ever. We must sustain investment and collaboration in translational research to maintain this momentum.
• Clinical trials as a pathway to better care: Trials provide patients with access to cutting-edge treatments today while shaping the standard of care for the future. However, ensuring equitable access remains a priority.
• A strong strategic framework: The NSW Cancer Plan, now in its fifth iteration, provides a blueprint in my state for progress, developed with input from more than 80 organizations.  Similarly, the Australian Cancer Plan offers a national approach, aligning efforts across jurisdictions and fostering collaboration to accelerate impact.
• Early detection and screening: The rollout of the National Lung Cancer Screening Program is a landmark step. Lung cancer remains Australia’s deadliest cancer, and targeted screening will be a game-changer in improving early detection and survival.

As a senior executive and clinician, what leadership strategies help you navigate strategic decision making while managing the emotional demands of leading in cancer care?

Leadership in cancer care is both a privilege and a responsibility. The work is deeply personal—it requires intellectual rigor, strategic vision, and emotional resilience. My approach is guided by a few key principles:

• Keeping people at the heart of every decision: The real measure of success is the impact on individuals, families, and communities affected by cancer.
• Listening deeply: Engaging with my team, the cancer control community, and those with lived experience ensures our strategies are grounded in real-world needs.
• Bringing my whole self to leadership: Remaining authentic, purpose-driven, and connected to why we do this work. The challenges are complex, but our collective mission—to reduce the impact of cancer—is what drives us forward.