When we think of advocacy, we often picture legislative battles and policy hearings. But what does it really look like when a for-profit company partners authentically with patient advocates to remove barriers to cancer screening? In a candid conversation with Bryan Goettel, Director of Advocacy and Alliance Relations at Exact Sciences, we discover that modern advocacy encompasses far more than lobbying—it’s about aligning missions, building trust, and leveraging the most powerful tool in healthcare: the personal patient story.
What Advocacy Really Means in Healthcare
Bryan begins by clarifying a distinction that matters deeply in the cancer community: advocacy isn’t limited to policy work, even though that’s often what people assume. “In its simplest form, it’s really working toward a cause that we believe in,” he explains. At Exact Sciences, that cause is centered on screening and creating pathways to remove barriers so everyone has access to recommended screening methods.
This broader definition proved crucial when Bryan Goettel first came to Exact Sciences. The company didn’t even have a dedicated advocacy department—it all fell under public relations. But as evidence emerged about rising colorectal cancer cases in people under 50, there was a clear need for a different approach. Between 2016 and 2018, Exact Sciences became a leader in working with the advocacy community to lower the screening age from 50 to 45, demonstrating how a company could collaborate hand-in-glove with patient advocates to influence medical guidelines and ultimately save lives.
The Power of the Patient Story
If there’s one thread that runs through every successful advocacy effort, it’s authenticity. “There is no substitute for the deeply personal story that somebody who has been personally affected by cancer can tell,” Bryan emphasizes. A colleague from a nonprofit or even a company executive might walk into a Congressional meeting with data and statistics. But when a patient who has lived through colorectal cancer—or lost someone to it—shares their experience, that’s what resonates and sticks.
This is why Exact Sciences invests so heavily in building relationships with individual advocates. It’s not just about gathering voices; it’s about recognizing that people like Tim McDonald bring lived experience that no marketing campaign could ever replicate. These are the voices that move legislators, inspire policy changes, and ultimately drive systemic change.
Measuring Impact Beyond Numbers
One of the most challenging questions in advocacy work is also one of the most important: How do you measure success? Traditional metrics like clicks and impressions don’t capture what advocacy actually accomplishes. Bryan acknowledges this complexity honestly. “Advocacy, it can be harder” to measure than digital metrics, he says. Yet success markers do exist—some are obvious, like when the American Cancer Society’s guidelines shifted the recommended screening age to 45, while others are more nuanced.
Real impact might be ensuring that patients can access follow-up colonoscopies without out-of-pocket costs, or simply removing logistical barriers that prevent screening from happening. These victories are meaningful but harder to quantify. Bryan’s approach is to work closely with advocacy partners to identify and track progress together, recognizing that the work is often a long-term process.
A perfect example: the Cologuard Classic golf tournament, which has evolved into a powerful platform. This year brought together 17 different colorectal cancer advocacy organizations and 360+ survivors and loved ones. The event generates media coverage, builds community, and most importantly, inspires individual advocates to find their voice. People who arrived uncertain about advocacy leave energized and confident, ready to share their stories with their communities and policymakers.
The Tricky Business of Trust: For-Profit Company, Genuine Mission
Working as an advocate for a for-profit company presents unique challenges and opportunities. “We have to work to build that level of trust for people to see that we’re in this for more than just trying to get more people to utilize our products,” Bryan explains. This trust-building is at the core of what makes the Cologuard Classic so special—it’s a platform where Exact Sciences can prove that their commitment to the cancer community is genuine.
The State Grant Program with Fight Colorectal Cancer illustrates this approach in action. Rather than simply writing checks for events, Exact Sciences recognized that advocacy organizations struggle with replicating national-level work across 50 different states. The company’s solution? Help fund state-level advocacy efforts for seven years running—a sustained, meaningful partnership that addresses real challenges these organizations face.
The Cost of This Work: Grief, Loss, and Purpose
There’s something rarely discussed in advocacy circles, but Bryan and Tim address it directly: the profound emotional toll of building relationships within the cancer community. You’re getting to know extraordinary people—then you lose them. Some people you just met a year ago become dear friends, and suddenly they’re gone.
Bryan reflects on losing Jill McDonald, an ambassador with Fight CRC, and Mike Mancini, both individuals he came to know and care about deeply. “Even if I only get to know some of these individuals... as painful as the loss is when we lose somebody like that, the memories that were created through the time of knowing them, and the purpose that it also brings to the work, I have no regrets,” he says.
Tim offers a perspective that captures the heart of why both he and Bryan do this work: “The pain of losing somebody is only eclipsed by the joy of knowing them.” It’s a recognition that advocacy in healthcare isn’t clinical or detached. It’s deeply human, and that humanity is exactly what makes it powerful.
The Next Frontier: Screening Below Age 45
If resources were unlimited, what would Bryan prioritize? Research into colorectal cancer prevention for people under 45. The cases are rising, but demonstrating that screening benefits outweigh harms below that age is scientifically complex and extremely expensive. A trial of Cologuard in people under 45 would require enrolling tens of thousands—potentially over 100,000 people—to find enough cancers to demonstrate effectiveness. That’s where advocacy needs to create space for investment that the market alone may not justify.
Getting Involved: Finding Your Role in Advocacy
For anyone interested in joining the advocacy movement around colorectal cancer, the entry points are numerous. A simple Google search will reveal local and regional advocacy organizations. Different groups have different strengths and approaches—recognizing that each has its own “sweet spot” helps potential advocates find the right fit.
Bryan emphasizes an important principle: “It’s not up to the organization to tell you what they need. It’s for you to figure out what your strength is and how you can help the organization.” Whether you’re skilled at social media, storytelling, community building, or policy work, there’s a place for you in this movement.
Final Thoughts
What stands out in Bryan’s approach—and what makes Exact Sciences’ advocacy work distinct—is the genuine commitment to partnership. This isn’t a company using patients as a marketing tool. It’s a company recognizing that its most important work happens not in laboratories or boardrooms, but in relationships built with people who have the courage to share their stories and fight for change. That’s the future of advocacy in healthcare: authentic, long-term partnership grounded in shared mission and mutual respect.
