U-M Comprehensive Cancer Center: It Started With Notes on a Napkin

This month, we celebrate an impressive milestone with the 25th anniversary of our U-M Comprehensive Cancer Center’s NCI designation. To commemorate this wonderful moment in our history, I asked Center director Max Wicha to share some of his reflections of the past and hopes for the future. Max has been a member of the UMHS family since 1980, when he joined the faculty as an assistant professor of internal medicine in the Division of Hematology/Oncology. Since then, he has emerged as a passionate leader in the fight to understand and ultimately cure cancer, and as a world-renowned breast cancer expert. As we celebrate this silver anniversary, we celebrate Max’s dedication to medicine and to Michigan, as well as the incredibly talented, compassionate and engaged faculty, staff, patients and families who comprise our Cancer Center community. Congratulations to everyone who is creating the future of health care for cancer patients and their loved ones.

U-M Comprehensive Cancer Center: It Started With Notes on a Napkin

mw-2013There are certain moments in life that might seem mundane and ordinary at the time, but become quite consequential and important. Like joining U-M colleagues for dinner in the mid-1980s when I was chief of the Division of Hematology/Oncology at Michigan. We grabbed a napkin and doodled ideas about what it would take to develop a cancer center at Michigan.

Those notes from a late dinner quickly translated into a huge effort by many talented people to pool our resources, create a cancer center and earn cancer center designation from the National Cancer Institute.  We did it, and announced our NCI designation to the world 25 years ago in September 1988. Since then, it’s been the unwavering focus on innovation and collaboration in patient care and research by each and every person connected to the Cancer Center that allowed us to grow into one of the national leaders in research and patient care.

Outpatient cancer care looked very different in those days. Patients seeking a diagnosis and treatment came and went from the medical campus several times – often over the course of three weeks – to see a surgeon, and medical and radiation oncologists. Nobody thought to coordinate appointments with specialists, and this long, drawn out process was confusing and downright scary for patients. And it wasn’t unusual for each specialist to have a different recommendation to the patient on the ‘best’ treatment option. Again, most medical centers weren’t thinking about bringing doctors together to reach a consensus opinion on a treatment plan or to coordinate care. We decided to challenge the notion on a large scale.

Our breast center care model proved that the “radical” idea of coordinating outpatient care into teams of doctors from all departments seeing cancer patients, as well as nurses and other professionals, was a good model. Our model – including tumor boards with oncologists, radiologists and pathologists to coordinate care – worked, and to the great satisfaction of our breast cancer patients. Getting our new building in 1997 allowed us to duplicate this model for other kinds of cancer and fully realize our plan for comprehensive, collaborative patient care. Today, genetic analysis is transforming cancer care, and our latest innovation is to become the first cancer center in the country to add a molecular pathologist to a tumor board to provide that analysis. In time, all patients will have access to this kind of personal, precision treatment planning!

timeline-promoIn those early days at the Cancer Center, we started bringing together research teams across very different disciplines to focus on the cancer problem. Michigan had a great history in research, but at the time, research was typically organized around administrative departments, not diseases. This made interaction across these departments more difficult. We knew that no single researcher or lab could make the kinds of advances that will lead to a cure for cancer. We are proud of the fact that collaboration was part of our model long before this became popular. And starting in 1997 when the new cancer center building opened, we challenged existing dogma even further, because now the cancer research labs were located together, encouraging even more collaboration and innovation. As a result, our Cancer Center has been extremely successful in team science and we have more funding from NCI than any university-based cancer center in the country.

And our research model keeps getting better. Cancer Center researchers collaborate with 10 different schools from across the university and our labs are now close to each other in the North Campus Research Complex. Each school represented at the NCRC is recognized nationally as a top 10 school and only Michigan has so many top 10 schools and colleges working together in the same space on the cancer problem.

As an example for why this is important, my own lab, which was the first to discover stem cells in breast cancer, works closely with Sunitha Nagrath, Ph.D., from Chemical Engineering. Dr. Nagrath is developing microfluidic devices for isolating and studying cancer cells. Together, we study how cancer stem cells circulate in the blood and how they respond to cancer therapies. In the not too distant future, we hope patients can skip the painful biopsies and instead get a blood draw and quick genetic analysis to see if a therapy is working, or what other therapy might work better. Our own Cancer Center researchers will make major contributions in developing those targeted therapies, hopefully curing more patients.

Looking ahead to the next 25 years, I would like to see us become an international center for this new kind of personalized medicine.

Part of the reason for our clinical and research success is that the institution has been extremely supportive of us, from developing the Cancer Center in our early years, to ongoing investment of considerable resources. Its support has allowed us to develop so many outstanding programs – and without that kind of support from leadership, none of this would have been possible.

It’s been such a wonderful experience to lead this effort for 25 years. We moved from humble beginnings at a great research university to become one of the leading cancer centers in the world. And I believe our legacy is strong and will go forward another 25 years; perhaps this will be the place where cancer is finally cured.

maxwicha

Max Wicha, M.D.
Director, University of Michigan Comprehensive Cancer Center

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