University of Michigan’s Impact on the Future of Cancer Care

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Four University of Michigan faculty members have served as president of the American Society of Clinical Oncology, a rare distinction that only two other institutions can claim. ASCO is the world's leading professional organization for physicians and oncology professionals caring for people with cancer. 

In this episode, Nicole Fawcett, director of communications for the Rogel Cancer Center, sat down with four past ASCO Presidents and talked about the importance of the society, the impact it has had on cancer care and research as a whole and the impact here at U-M. 

Participants:

Allen Lichter, MD, FASTRO
Doug Blayney, MD
Dan Hayes, MD
Lori Pierce, MD 

Transcript

Nicole Fawcett:

Welcome to the Cancer Aware Podcast, where we'll discuss cancer prevention, treatments, the latest in research, and important news around cancer, brought to you by the University of Michigan Health Rogel Cancer Center.

Nicole Fawcett:

The Rogel Cancer Center has a strong history of leadership in the cancer field. Four University of Michigan faculty members have served as president of the American Society of Clinical Oncology, a rare distinction that only two other institutions can claim. ASCO is the world's leading professional organization for physicians and oncology professionals caring for people with cancer. Today we're joined by these four physician researchers and leaders.

Dr. Allen Lichter:

I'm Allen Lichter. I'm a longtime U of M person, was chair of radiation oncology, then dean of the medical school, and then served for 10 years as the CEO of ASCO.

Dr. Dan Hayes:

I'm Dan Hayes. I'm a medical oncologist. I'm the Stuart B. Padnos Professor of Breast Cancer Research, and I've been here about 25 years.

Dr. Lori Pierce:

And I'm Lori Pierce. I'm a radiation oncologist. I was brought to Michigan by Dr. Allen Lichter, and I have been at Michigan since 1992.

Dr. Doug Blayney:

I'm Doug Blayney. I'm also a medical oncologist, also brought to the University of Michigan by Dr. Lichter and other colleagues in 2003. I was ASCO president in 2009, and I left the University of Michigan shortly thereafter to join my family in California. And now live in Ann Arbor again.

Dr. Dan Hayes:

And I was remiss, I was also brought to the University of Michigan in 2001 by Dr. Lichter, and I was president in 2016-'17.

Dr. Lori Pierce:

And I guess I didn't mentioned my year. I was ASCO president in 2021.

Dr. Allen Lichter:

And I was ASCO president '98-'99.

Nicole Fawcett:

Fantastic. Thank you all for joining us today. Well, Dr. Lichter, since you are the linchpin who brought everyone together, maybe we'll start with you. Can you tell us a little bit about what ASCO is? What does it do? What role does this serve?

Dr. Allen Lichter:

Well, ASCO is a rather unique medical professional society. It was founded in 1964 at a time when there were no oncologists. The field did really not start formally until the early '70s. And ASCO, its founding documents specifically said this was not to be a society of solely chemotherapeutists was the name that they used. It was to be for all cancer specialists.

And so it formed as a unique multi-specialty society. And what's also unique is that the field of medical oncology, once it was established, simply forgot to found the American Society of Medical Oncology. It's the only specialty in medicine that does not have its own dedicated specialty society. It used ASCO and it uses ASCO to this day. So we represent in many respects all of oncology, but uniquely represent medical oncology.

Our role is really an educational organization, sponsor the most important meetings, publish the most important journals. We're interested in cancer policy. We're interested in cancer research, and all our work is dedicated to making cancer care better.

Nicole Fawcett:

And you mentioned it's a society for medical oncologists, but you are the one who are responsible for the radiation oncologist joining in. Am I right?

Dr. Allen Lichter:

Well, ASCO was fond of touting how wonderful a multi-specialty society it was. And one year at the annual meeting, at the business meeting, I looked up on the dais, the whole board was there. And I stood up and said, "That's interesting, you're all medical oncologists, and yet you say this is a multi-specialty society."

It stopped the conversation for a minute or two and that was the end of that. And then some months later, I got a call and they said, "We're dedicating seats to surgical oncology, pediatric oncology, and medical oncology," and I was appointed to the board. There was not an election at that time. And I went from there.

Dr. Dan Hayes:

You've told me they said, "Okay, Mr. Smart Guy, you asked for this."

Dr. Doug Blayney:

And I think you raise a nice point, Allen, because before I came to Michigan, I was in what was then called private practice where we owned the practice and we were responsible for getting patients and building a business. And we did clinical research in our practice. And gee whiz, why couldn't we have a voice as the private practice in this wonderful professional society? And lo and behold, we did and it's worked out well. As you point out, the policy initiatives that have been undertaken I think have been good for everybody in that.

Dr. Allen Lichter:

When I first got on the board, it had 12 members. I think it has over 20.

Dr. Lori Pierce:

It's about 20-22.

Dr. Allen Lichter:

20-22, mostly because we've extended to community oncologists to international oncologists and so forth.

Dr. Lori Pierce:

You were very convincing in your arguments. Because by the time I came along, one of the things that really spoke to me about ASCO was how receptive they were to nonmedical oncologists, how my voice mattered. And that was actually while I had my own society, ASTRO, American Society of Radiation College, which is very important, I really liked the fact that ASCO truly was multidisciplinary and they seem to really want my feedback. I like that very much.

Dr. Dan Hayes:

Actually, to back up what Doug was saying, when I grew up, ASCO was basically filled with ivory tower-penned medical oncologists who cared a lot about academics. And what 65 to 70% of the patients in this country are not treated by academics, they're treated by community physicians. And what I saw when Lori and I were on the board together, but I saw Allen starting to recognize this and starting a whole committee for community oncologists and bringing in affiliates that had begun in each state to come in and actually meet with us.

And you may not remember this, but you said I should be at those meetings when I was president. So I made a point of going to those meetings. I think that really has changed the complex... Were you the first community oncologist?

Dr. Doug Blayney:

Joe Bales was. I was the second.

Dr. Dan Hayes:

Former trainee by side.

Dr. Doug Blayney:

Yeah.

Dr. Dan Hayes:

It's changed the complexion for the better. Academics are still very much involved in running a lot of it. But the one thing that Allen sort of hit on, we now have I think 45 or 50,000 members.

Dr. Lori Pierce:

50,000 plus.

Dr. Dan Hayes:

Yeah. I think we're the largest professional cancer organization in the world. But the whole time I was on the board and president, we had discussions in the board. They were contentious at times, but they were never, "This will help me buy a new boat, or this will help me get a fancy second house." They were always what's best for our patients. And that's what the community oncologists really were taking time out of their practice to be on that board to make sure we did things that would be good for our patients. I'm proud of that.

Dr. Doug Blayney:

On the other topic, and we'll maybe get to this, but the multidisciplinary nature of ASCO was a model for the multidisciplinary care of the cancer patient, I think. When my colleagues, Bessede and others, gee whiz, why should I be involved with ASCO? Because you'll meet some smart people in radiation and surgical oncology and the pediatric. Kids doctors can teach us some things too. And when I came to Michigan, that was my introduction to multidisciplinary cancer care. And again, that I think speaks to that.

Dr. Allen Lichter:

Docs have a unique ability to start dividing themselves into smaller and smaller entities. So there's subspecialty societies and sub-subspecialty societies. ASCO has retained this very large model for our practice, the way we practice multidisciplinary as well.

Dr. Lori Pierce:

The diversity of opinion is so very important. You think outside the box and get different people's perspective. The makeup of the ASCO board now is very diverse in so many ways, diverse in terms of disciplines, diverse in terms of race and ethnicities, in terms of geographics. And that variability, that really comes together in really coming together with a very inclusive set of recommendations from ASCO. I love that about ASCO.

Nicole Fawcett:

So for each of you, what was your term as president like and what issues did you focus on and what do you think has been the long-term impact of that work? Why don't we go around the room? I'm always inclined to start to my left. So do you want to start again, Dr. Lichter?

Dr. Allen Lichter:

Well, when I became president, we had just recently hired our first full-time CEO. Prior to that, we were managed by a professional society management organization called Bostrom out of Chicago. We hired John Durant out of the University of Alabama, and we started to build a staff.

So a lot of my presidency was involved in working on that. And it was a time where we focused a lot on clinical research, trying to get insurance companies and Medicare to pay for the routine costs of care. When you're part of a clinical trial, it's hard to believe that that was considered verboten at that time.

Nicole Fawcett:

It was Medicare.

Dr. Allen Lichter:

Medicare and we were able to get that eventually passed. And the other thing that I recall so vividly is this was a time when assisted suicide in the late '90s was an active topic of conversation. And we did a lot of work on that and especially really trying to introduce palliative care into our work.

Nicole Fawcett:

What do you think has been the legacy of what you started?

Dr. Allen Lichter:

Well...

Dr. Dan Hayes:

We don't have time. All of us are here because of him.

Dr. Allen Lichter:

Yeah.

Dr. Dan Hayes:

Let's pass this around.

Nicole Fawcett:

Okay, sounds good.

Dr. Dan Hayes:

There are mistakes made, but.

Nicole Fawcett:

Do you want to go next, Dr. Hayes?

Dr. Dan Hayes:

Well, I was not kidding. All of us are here because of Dr. Lichter and the things he did in ASCO were astounding. After he was president, his staff, who were unbelievably professional, again because of you, in my opinion, told each of us we had to have a theme. And so I think we had to go around, but my theme was just what ASCO can do for you if you're a medical oncologist or a patient or a radiation oncologist, whatever.

We cover all these bases. And probably I think the two or three things that I really got out of being it besides having a great deal of fun was the growing interest of global oncology, which really hadn't existed. And I've had very little or nothing to do with it. But again, because of Allen, I began to understand that when I see patients in my clinic, my total in my career I helped 1,000 women in breast cancer, maybe 2,000, I don't know.

When I do some research, if it pays off, maybe I'll help 20,000 or 100,000. But as president of ASCO, because of the global reach it has, we were reaching millions of people. And that hit me about halfway through our presidency that this is really neat. And that here I am at the University of Michigan, but helping millions of people around the world with the policies and the education and the research presentations. And again, something I was really proud of.

Dr. Allen Lichter:

And Dan created a fellowship for international young medical oncologists to come to the US and spend a year under mentorship in an academic center and fostered the careers of dozens of bright international students.

Dr. Dan Hayes:

I just looked this up. We've had 18 people do this. They have to sign a piece of paper saying they'll go back home. We didn't want to start a brain drain. And their institutions have to sign a piece of paper saying there'll be a job for you when you come back home. We've had them from Africa, from South America, from Asia. I'm actually pretty proud of this one. And it's been fun to meet these kids. I guess they're not kids, but they are to me, through the years.

Dr. Doug Blayney:

My theme was quality. That really started when I came to U of M in 2003 from a private practice world and said, gee whiz, here's the University of Michigan. It's a top 10 cancer center, but we have to compete with regional and local. But how do we do that? Well, among other things, it was let's measure the quality of cancer care that we deliver and prove that the U of M is better than our competitors. That is a long story.

But eventually I published some work on quality improvement that we did here at the U of M. When I was ASCO president, I started, that was my theme. We ended up starting a meeting that's now persisted for 15 years. It's one of the only quality themed meeting in the world actually in cancer. It draws young people and non-physicians did that. We also expanded the Quality Oncology Practice Initiative, which was measuring quality. And we developed...

Dr. Dan Hayes:

Explain that a little better because people won't know what it is. That's important.

Dr. Doug Blayney:

You can't improve something if you can't measure it, the COPE measure. Well, there are several that are quantitative measures of quality of cancer care. Not just I'm better than you because I'm at the U of M or whatever, but here's how our outcomes and our processes are better. As part of that measurement, we said, gee whiz, how do we measure quality?

Well, gee whiz, everybody's got an electronic health record. Let's see if we can extract data from the electronic health record and use that to measure quality. That had some stumbles along the way. It may not have been the right time to do it, but others have done it and made a business out of it.

Dr. Dan Hayes:

Which began to certify practices, which really, in my opinion, changed a lot of what was going on.

Dr. Doug Blayney:

Because everybody wants to be better.

Dr. Dan Hayes:

And I've gotten off of airplanes and airports in the middle of nowhere and there's a big sign that says, "Come to our practice. We're ASCO/COPE certified," as a matter of pride for those practices. And I thought, that's pretty cool.

Dr. Allen Lichter:

I'll tell you an interesting story. When I first became CEO, during the first week, I had some papers brought to me, "Dr. Lichter, please sign these." I said, "What are they?" He said, "This is to transfer COPE to the NCQA. We're dumping it." And I looked and I said, "I don't think that's a good idea, and I wouldn't sign it."

Dr. Doug Blayney:

Well, God bless you.

Dr. Lori Pierce:

So my presidency was unique. So my theme was equity, every patient, every day, everywhere. And I chose that theme because if you look at statistics, you know the certain populations of patients for almost every type of cancer do worse. And so I chose equity not knowing that it would resonate. And then between the time that I chose it and the time Dan became president, the pandemic happened, George Floyd happened, a lot of other things happened, and equity ended up being the right thing.

ASCO could not have been more supportive of that theme. And I will go down in history as being the only ASCO president who never had an in-person meeting for the entire year because of [inaudible 00:16:02] which is unfortunate in some ways, but in some ways it really highlighted the theme of equity. Because we know that during COVID, there were certain... Well, everyone was affected. There were certain populations who were affected more than others.

So I'm good with that because I think it made a significant change in ASCO. And actually during that year, ASCO has always been focused about improving care for all populations, but we upped our game a bit during that year. And one of the things that we did was we created a site self-assessment tool for enrollment in clinical trials because we were very focused on increasing all adults and clinical trials. The pediatric population does this well. The adult population does not.

So we created an instrument, which I won't bore you with the details, but basically the way I summarize it is let's say you have 100 people who come into your cancer center and five going clinical trials last month. That's great. What happens to the other 95? What processes do you not have in place that perhaps institution A has and institution B does not? And so you individualize what you do.

We also created the Oncology Summer Internship, which is a program I'm very proud of, which helps to bring all medical students and increase awareness of oncology and the importance of equity of care. And so the first year we had I think five institutions. This is now the fifth year. We have 14. The first year we had I think 29 students. Now we have 70. So institutions have to apply for that program.

But if you're accepted, then up to five of your medical students finishing up the first year of medical school get to have this four-week immersive experience understanding what oncology is all about, and they get to shadow doctors at their institutions. ASCO has a four-week didactic plan. It is an extremely important program. And then I'll add one more thing. I know I'm going over time.

So I didn't know until today that when you were president, Allen, you were able to get Medicare patients to have routine care costs paid for as a part of being on a clinical trial. So during my presidency, we worked on Medicaid. Because for patients who went on clinical trials, private insurance and Medicare patients would have their routine care costs covered. Medicaid patients were not. And so these were the poorest patients.

And yet if you needed to see the doctor or have a blood draw or whatever, they couldn't have that paid. But if they were treated outside of a clinical trial, they could have that paid. So it's a disincentive for Medicaid patients. So after years and years of advocating this with ASCO, it was changed during my year. So I was just so, so pleased that now all patients, no matter what type of insurance, have those routine care costs so it's not a barrier to go in clinical trials.

So I was mentioning the Oncology Summer Internship and University of Michigan is one of the programs. We started participation in year two, which was actually the year after my presidency. And this year will be our fourth year to have students. It's so exciting having now been a part of planning and creating OSI to now be on the other side of it and to have students dissipating at the University of Michigan.

And the feedback from students, it is so competitive because they apply to those of us who leave the program and we have to somehow select students who will participate. And the enthusiasm for going into oncology, it is palpable. And so it's really great to see.

Dr. Allen Lichter:

And Laura, you also helped lead the Leadership Development Program in ASCO. One of the things that we wanted to do was to start to bring younger faculty members, practice members, et cetera, et cetera, into a Leadership Development Program and try to replace ourselves. And that has worked well. And Michigan continues to have people deeply involved in the society.

Dr. Lori Pierce:

We as ASCO has been wildly successful. It's also very difficult to pick the people coming into that because of all of the amazing oncologists who want to be a part of the LDP program. And University of Michigan in particular has had quite a line of successful participants in the LDP program. And yes, I was mentor of that for a few years.

Dr. Dan Hayes:

This actually gets back to my theme, which was what ASCO does for you. And the reason I bring that up, this is one of the many things that ASCO does. Building a career in medicine in general, but especially in academics, is not easy. And one of the things that many folks who are especially in academics put on their CV to build their career is what they have done with ASCO. Lori and I were reviewing what U of M has had.

And in the last I think five years or eight years, our division, visual medical Oncology, has had at least 25 of our faculty members beyond either committees that run the science at ASCO, committees that review the grants, committees that develop educational programs, committees that go to the feds and talk about policies, and most importantly maybe, committees that write guidelines for how other doctors treat patients with cancer.

And we have at least eight of us, including myself, who have been on such committees, write guidelines, and several chairs of the guidelines all out of U of M. I know we keep shining Allen's shoes, but I think all this began with his being a president and then being CEO and Doug coming in and Doug talked me into going on the board or running for the board and then running for president.

And I was really proud when Lori got nominated and elected. And then each of us has worked hard to get our younger people involved in there. The LDP program, at least, I personally have had three former trainee... Current trainee and three others. They're not trainees, they're young faculty members. And you've had one or two?

Dr. Lori Pierce:

We've had two.

Dr. Dan Hayes:

Two?

Dr. Lori Pierce:

Right.

Dr. Dan Hayes:

In radiation oncology.

Dr. Lori Pierce:

Who've both gone on to be chairs.

Dr. Dan Hayes:

It's an incredible program. Actually one of my trainees, who was in the LDP, is now my boss.

Dr. Doug Blayney:

I think the LDP program, I can't help but think it had its roots at the University of Michigan. When I came here in 2003 and Dr. Lichter was the dean, I was encouraged to go to the business school with my administrative counterpart and take a year-long course in the business school to develop leaders. Well, great. We tried it out at U of M and now it's national. So there you go.

Dr. Dan Hayes:

Well, Lori threw it out, but two of the LDP radiation oncologists are now chairs of departments of other institutions in this country.

Dr. Lori Pierce:

The increasing number of medical oncologists who have been very active and ASCO committees and guidelines. Same with radiation oncology. I think over half of our clinicians are actively on committees or have been in leadership positions at ASCO. And I'm sure the same applies to surgical oncology. So Michigan is extremely present in the organizational structure of ASCO.

Dr. Dan Hayes:

We're looking for the fifth president.

Dr. Lori Pierce:

I got some ideas.

Dr. Doug Blayney:

When I first got booking into quality, I stumbled across a University of Michigan professor, who wasn't an oncologist, Avedis Donabedian, who was in the public health school, and he had the vision. Somebody asked him, what's quality? And he said, "Well, quality is when you love your patient." Well, that sounds hokey, but truly when you get down to it, you can measure it. But if you really love your patient and want to do the best for your, that's the short definition of quality I've come across.

Dr. Allen Lichter:

Well, he founded the field of quality measurement. Before him. It didn't exist and he brought it to life.

Dr. Doug Blayney:

Yeah, there you go.

Nicole Fawcett:

What do you think it is about Michigan that has fostered this? You've mentioned this a few times, how you've pulled each other in and then you're also mentoring the next generation and bringing them up. Is there a special environment here?

Dr. Allen Lichter:

It's so cloudy here. We never go outside. So we work constantly to try to get...

Nicole Fawcett:

Find something else to do.

Dr. Lori Pierce:

Michigan is highly collaborative. And so when you have someone such as Allen and the leadership and you collaborate together and you see the benefits of ASCO in this case, I think that all comes together. The special sauce of Michigan is the collaboration. Look at the schools and colleges and the whole mentality. It is working together. And I think that's what you're seeing in terms of translating leadership from ASCO into future leaders of ASCO.

Dr. Doug Blayney:

And I practiced medicine in Southern California and in Northern California and here in Michigan. And I agree with what Dr. Pierce just said that it's very collaborative. The faculty are great, but also the community docs. There's plenty to do here. They work together. We founded here in Michigan the Blue Cross Blue Shield has supported quality consortia.

Lori has been leader of one. I led one for a while. And the community docs here really get along. And it's a compact enough state where you can really do experiments and understand what's going on in the community with your fellow docs. So I think that's part of the secret sauce as well.

Dr. Dan Hayes:

We came here from DC. I was at Georgetown. And the day we came to look at houses as we were in the car going from the airport to Ann Arbor on tax day, April 15th, and it was snowing. And my wife didn't have a thing to say. And I finally looked at her and said, "Well, honey, April showers bring May flowers. Don't lose our snow showers." Actually, one reason...

I came here for a variety of reasons, not the least of which is because Allen was the dean at the time, and the man I worked with at Georgetown was coming to be chair of medicine and happened to be a good friend of Allen's in the first place. But the other is because although I grew up in Indiana and I have three degrees in university and I hated the University of Michigan based on sports alone and nothing to do with academics, Ohio State, Purdue, and Michigan were all ranked at that level for me.

The real reason is because this place was set up for people who want to do what we do, to do it and do it well because of the collaborations that Lori laid out and because the leadership believed in the missions of taking great care of patients and doing great research and teaching. And those are three things that all four of us are dedicated to. We're allowed to do it and to do it successfully.

And that attitude, I think, is exactly what we saw at ASCO, especially after Allen became the CEO in my opinion. And we were allowed to take what we did here and expand it. As I said earlier, suddenly we're touching millions of people instead of tens or thousands even. I know it sounds corny, but I think that's a really special secret sauce if you like at U of M.

Everything is here. All the schools are here because... So if I want to collaborate with the School of Engineering, In Indiana there wasn't one. I'd have to go to Purdue, God forbid. But here I can just drive two minutes and suddenly I'm dealing with engineers. I've had two or three grants with the engineers out here. School of Public Health is just across the street and so on and so forth.

And this place has been really special because of that. I don't know who set that up, you probably do, but it really made it a great place for me to accomplish what I wanted. And by the way, if I said we're going to move, my wife would divorce me. She loves this place now. I couldn't get her out of here with a crowbar.

Dr. Lori Pierce:

Now, I will say the closeness of the schools and colleges as our number one... It's our primary way that we're successful in recruiting people. Having had a role in central campus, that whole mindset is across the university. And so being able to work across schools, not having those silos, that is our secret sauce for sure.

Dr. Dan Hayes:

And the expectation of excellence, I would say on top of that. I'm sorry to interrupt you about it.

Dr. Lori Pierce:

To follow up your comment, I'll also say that football was certainly not the reason that I came. Because I remember one of the times my recruitment trips, he took me to a football game. I was like, whoop-de-doo.

Dr. Allen Lichter:

That did it, Lori.

Dr. Lori Pierce:

Now I'm a football fan. No. Had nothing to do with my decision.

Nicole Fawcett:

He saw that coming.

Dr. Doug Blayney:

Well, after I was here a year, I bumped into Allen. I said, "Allen, the only thing that hasn't met my expectation is the football tickets." And he said, "Well, Doug, I'll send somebody around from The Victors Club to talk to you. I know it sounds like a lot of money, but you can pay it off."

Dr. Dan Hayes:

Well, one other thing during my presidency is I talked about people just clamoring to do stuff for ASCO who want to be on committees and stuff. And I had 250 open spots to fill, and I had over 2,000 applications to do that. And so I was talking to Allen's successor, Cliff Hudis, and said, "This is crazy. People want to work for us and we don't have a way to do that. And they want to work for free. They want to volunteer." And so he said, "Well, let's start something and we'll call it a volunteer corps."

I thought, oh, I like that. And so we set that up so that people from U of M or anywhere for that matter can go in and see what ASCO has to offer in terms of what they want to do, the committees and all these sorts of things. And then they can specifically say, "Well, I want to be on that committee, or I want to do that." Whereas I had people calling me and saying, "I want to do something for ASCO, but I don't know what to do."

Dr. Lori Pierce:

Create a bench for ASCO.

Dr. Dan Hayes:

Yeah, I think it's been pretty successful now to help both ASCO figure out who to choose, but also the people in different centers and institutions and community about what are the options that they could do, the opportunities. So I think that's been pretty good.

Nicole Fawcett:

So setting itself up for the next generation or for future leaders or for more people to... Anybody else have any final thoughts? Are we poised at Michigan to continue this legacy of leadership? Do you think that we'll see more involvement moving forward?

Dr. Lori Pierce:

Absolutely. I mean, the infrastructure is there. The mentorship is there. And you can see, you can predict, we will have a fifth president.

Dr. Dan Hayes:

I know who he is.

Dr. Allen Lichter:

I think it's safe to say that ASCO has formed an important piece of each of our careers. It certainly has been foundational in my career being president. At the time that I was president, the dean of the medical school left to become a dean elsewhere. He was the interim dean, and I had stepped down as department chair.

I was approached to be the interim dean in part because I had a national reputation inside ASCO and shown that I could lead organizations. And then I transitioned from interim dean to permanent dean. And then at the end of my deanship, ASCO called and said, "Would you like to become the CEO?" So I spent a critical 15 or 20 years of my life inside ASCO. It made my career.

Dr. Doug Blayney:

I'm looking forward, many of us are looking forward next week for the annual meeting. It's a big scientific meeting and drawing people, oncologists and others from all over the world. I think one of the themes we'll see is that there's a lot more ways to treat cancer that are multidisciplinary, but also aren't just from the chemotherapists. There's immune treatments and all kinds of cellular-based therapies coming along. I think the theme is clinical research.

It's important to find out how these treatments work in people in a structured, orderly way. Hopefully that will continue. I think I happen to believe and want to believe that it will continue. But also there's been a de-escalation of the treatments that are still effective, but are less toxic. And again, that's been done and experimented in an ordered structured way so that all the treatments, radiation, chemotherapy are less toxic today than when I think most of us started.

So I think that's something I'm at a very small part of and we all had a part in that, but I think that's been a big boon for patients, along with supporting them through, frankly, a difficult time in their life and getting them through to get on with things.

Dr. Dan Hayes:

At a time that we've seen a pretty major reduction in mortality from cancer, breast cancer mortality is about, not quite, but about half of what it was 30 or 40 years ago, again, with less toxicity, can now cure 50% of patients who have metastatic melanoma with immunotherapies. I thought I would never say that. It's unbelievable. It really is something. When I got elected, I called about 10 or 15 of my buddies who had been presidents of ASCO, including two of them sitting here.

Lori, you were... And I had a series of questions I wanted to ask, but at the end of the phone calls, then I said, "Okay, open mic time. Tell me your biggest thrill." And almost every one of them said, "The saddest day of my career was when I had to quit being president of ASCO." And I think the four of us would agree with that. I hated to see it end. I just had a great time.

Dr. Lori Pierce:

Actually, I was good because I've continued to be very active, and I'm chairing other committees in ASCO. So I'm finding other ways to support ASCO. And actually, one other point, you asked us earlier, Nicole, what about our legacy? I've been asked that before. I think it's hard to have a legacy in ASCO.

If you go to an organization that is so well run, it's hard to create a legacy in a year. And what you hope to do is to take a great organization and make it even greater. And I think the people around this table have accomplished that. So I don't know if that creates a legacy, but I think in our own way, we left a mark on the organization.

Nicole Fawcett:

You can see, and all of you talked about different programs and things that you introduced that are still impacting the field and impacting the next group of people who are coming along too. So there's a legacy there.

Dr. Lori Pierce:

Pretty proud of that actually.

Dr. Dan Hayes:

I don't think any of us would say my legacy is I did something monumental that led to a cure. I think it's the people we've trained and the people we've helped do that in the long run treat people better or take better care of patients. George Kanellis, when he was president, he was one of my mentors. And instead of giving a talk about how great research he had done, and he talked about a lot of the things he had done like this, and at the end he said his greatest clinical experiment were the fellows he had trained.

And I was in the audience in tears. But I think that's how we all feel is that the people we've trained and helped succeed are probably the biggest part of our legacies. I don't know if you guys agree with that, but.

Dr. Lori Pierce:

That's a part of it.

Nicole Fawcett:

So thank you all for your time today, for your service to the oncology community, and for the impact that you've had on the field and on people with cancer.

Nicole Fawcett:

Thank you for listening. And tell us what you think of this podcast by rating and reviewing us. To stay up to date on what's happening in the cancer world, follow us on X @UMRogelCancer. You can explore additional episodes at www.rogelcancercenter.org/podcasts. Cancer Aware is part of the Michigan Medicine Podcast Network.