7 questions with Memorial Sloan Kettering Cancer Center's Dr. Craig Thompson

It's an exciting time to lead a cancer center.

The rapid pace of scientific medical discoveries, the development of new diagnostic systems and therapies and the promise of hundreds of clinical trials lends clinicians and leaders of cancer specialty hospitals optimism that the patients they treat on a daily basis will soon no longer face the disease at all. The Obama administration's precision medicine and cancer moonshot initiatives only add to this momentum.

Craig B. Thompson, MD, is one of those leaders. Dr. Thompson has served as president and CEO of Memorial Sloan Kettering Cancer Center since 2010. For 11 years prior to joining MSK, Dr. Thompson was affiliated with Philadelphia-based University of Pennsylvania, first as a professor and scientific director, then as director of the university's Abramson Cancer Center and associate vice president for cancer services of the University of Pennsylvania Health System.

He received his medical degree in 1977 from the University of Pennsylvania Medical School and received clinical training in internal medicine at HarvardMedicalSchool Dr. Craig Thompsonin Boston and in medical oncology at the Fred Hutchinson Cancer Research Institute at the University of Washington in Seattle. Dr. Thompson has published more than 350 peer-reviewed manuscripts and more than 85 reviews in the fields of cancer biology and immunology.

Here, Dr. Thompson took the time to answer our seven questions.

Note: Responses have been lightly edited for length and clarity.

1. What is the No. 1 issue facing your patient population today?

Patients come to MSK because they are told they have cancer. This is often the most serious illness they've experienced in their lives. They come to us to confirm their diagnosis and to explore and discuss treatment. Many patients enroll in clinical trials because they are state-of-the-art or because we can offer them hope with the development of new therapies and modalities, especially in the new field of immuno-oncology.

Cancer is a disease many of our patients are unlikely to have already faced in their lives. They come to us with all of their concerns and fears.

2. What is the biggest issue facing your organization?

The biggest problem for our organization is the fact that we — and many of the other hospitals involved in cancer care — are becoming increasingly successful. Today's cancer patient wants therapies to be more accessible. Once the initial scare of the diagnosis is over and they begin their treatment plan, patients don't want to be in a complicated hospital setting. They want a treatment setting that is more conducive to their lives, that will enable them to continue their jobs and take care of their families.

However, cancer can affect every organ of the body; hospital resources are difficult to replicate in the outpatient setting. The question is, how can we increasingly deliver effective cancer care on the outpatient side?

Today, 90 percent of cancer patients receive care in an outpatient setting. It used to be 10 percent. We expect that by 2025, 85 percent of the patients we treat will never spend a day in the hospital unless they have surgery or a complication from treatment.

3. What is your biggest goal for MSK in 2016?

Right now, so much has been learned in cancer diagnostics, particularly the ability to go beyond organ-site specific diagnosis. It is no longer enough to say "breast cancer," "lung cancer" or "colon cancer." Our No. 1 goal is the effective implementation of molecular diagnosis to personalize therapy. We are incorporating precision medicine and immuno-oncology, and combining them with traditional forms of cancer therapy, including radiation and chemotherapy.

4. What is your reaction to the Obama administration's national cancer moonshot initiative? How do you see this initiative affecting cancer care?

The cancer moonshot initiative is, in its broadest sense, a unique opportunity for leaders of the medical, science and political communities to advance an ambitious and important goal. Better understanding the genome will help us make strides in bringing new scientific results into new therapies.

One thing we've learned is cancer is not just one disease. It's really as many as 400 diseases — each person and tumor is different. Despite the announcement of the cancer initiative, there is not just one goal. There won't be one treatment for all cancer patients.

The initiative is exciting, but will it really accelerate the rate of breakthroughs for treatments for cancer patients? Scientific research that underpins our understanding of cancer can produce treatments and ultimately help us lower the risk for cancer. The moonshot's goal of accelerating the pace of transition from research to treatment is something everyone can embrace. No one would argue that we couldn't use more funds. But the important issue isn't the amount of money the administration has assigned for the initiative. The more important issue is recognizing the significance of molecular diagnosis to pair patients and their tumors with the most effective treatment options and creating the regulatory changes necessary to enable it.

5. How do you think the NIH's goal to get 1 million people to volunteer their medical and genomic data will impact research and development for precision medicine?

I don't believe that with our state of knowledge on aggregating data the approach will be technically feasible in this decade. To bring together medical and genomic data is cost-prohibitive in the current healthcare climate and not scaled sufficiently to recognize the genetic diversity of the American population.

It will be a big struggle to aggregate all of the healthcare data — Americans often change jobs, insurers and providers. Their medical data is not all in one system. There are also challenges around the willingness to share all of that information from health records and DNA.

It would be more practical to start with a specific disease population for whom we need to understand the underpinnings of why the disease arises. The Cancer Genome Atlas program was program like this from the NIH that was more limited in scale but very successful.

6. What do you think are the main differences between leading a cancer hospital and a non-specialty hospital?

We are unique in that we only take care of one major disease. MSK is the oldest and largest private hospital serving cancer patients. We've existed for more than 130 years. Our doctors are subspecialists; they don't just treat cancer, each treats a single specific form of cancer. They become the thought and practice leaders of one of 400 different malignancies.

To do that and effectively deliver diagnoses, we've developed various diagnostic approaches. We've built the largest suite of interventional radiology to get the most accurate reading of tumors. At any one time, we have about 800 clinical trials open. We see one of our major missions as bringing new therapeutic approaches to cancer patients. More than one-third of our patients are offered clinical trials.

7. How would you describe your leadership philosophy?

It's difficult to explain your own leadership style, but in thinking about mine what comes to mind is the importance of leading by example. I've practiced medicine for more than 20 years and worked in a research lab for 30 years. I've walked in the shoes of the physicians, scientists and caregivers that come to work every day at MSK. By positioning myself to facilitate their mission, I can effectively lead the organization. My staff think of me as a football coach.

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