Until the federal government…addresses entitlement spending, the NCI, which is funded by discretionary spending, will continue to get its funding shortchanged. That’s catastrophic for the future of cancer research.
— Robert C. Young, MD
Robert C. Young, MD, ASCO Past President, longtime leader of Fox Chase Cancer Center, and an internationally recognized expert in lymphoma and ovarian cancer, is a forward-looking doctor who is confident about something not in his future: retirement. “I’ll never quit working; I’m just not wired that way,” Dr. Young told The ASCO Post.
Finding a Natural Fit in Medicine
Dr. Young grew up in Columbus, Ohio, the son of a solo-practicing surgeon. “Although most people don’t jump at the idea of following in one of their parent’s footsteps, I did. My father practiced in the golden age of surgery, a time of huge advances, and he was extraordinarily happy with his career. On weekends, he’d take me on hospital rounds. It was incredibly exciting, and seeing how much my father enjoyed taking care of his patients rubbed off on me. So, wanting to become a doctor was a natural thing for me, and I never swayed from it,” said Dr. Young.
Throughout high school, Dr. Young’s interest in medicine and science continued to grow. After graduating, he went to Ohio State University, which he said was “about 5 minutes from my home.” In contrast to the extravagant nail-biting college process in which today’s applicants and their parents go through, Dr. Young explained that in his youth, it was a much simpler affair. “I don’t think I applied to another college. Ohio State was a good school and it was right around the corner. Also, at that time any kid who graduated from a credible high school could go to a state school. It just wasn’t a big deal,” said Dr. Young.
The sheer size of Ohio State’s campus and the variety of subjects offered intrigued Dr. Young. “During my premedical courses, I could fit in a bunch of political science, history, and economics courses also. I became very interested in student government and campus politics, and in my senior year I was elected president of the student body,” said Dr. Young, adding, “Ohio State was a great experience in that I got to study a full range of subjects that truly broadened me as a person, before I got to med school, because then it was medicine from morning till night.”
After graduating from Ohio State in 1960 with a BSc degree in zoology, Dr. Young felt the urge to leave his home state and attend medical school somewhere other than the Midwest. “My father had gone to Harvard Medical School, and he wanted me to also. I applied to several top schools, Harvard included; I was accepted at Harvard and was also accepted at Cornell University Medical College. I had some friends there, and quite frankly the idea of living in New York City was very appealing. So that’s where I went, which was kind of a bummer for my dad. But I explained that when I went on interviews at Harvard, it just didn’t seem like the right fit, and he understood,” said Dr. Young.
Although Dr. Young’s first inclination was to become a surgeon, once at Cornell, he became very interested in research, especially in the laboratories doing work in hematology. “In those days, every member of the faculty wanted grants, and compared with today, they were easy to get. And a researcher could give a young medical student $500 to work all summer in his lab, and that’s what I did during my summers. Early on, I decided that instead of surgery, I wanted to do internal medicine,” said Dr. Young.
From Hematology to Oncology at the NCI
It was the early 1960s, and the Vietnam War was raging. To fill the military’s need for soldiers during a hugely unpopular war, the draft was casting an ever-widening net. Dr. Young explained that a physician coming out of medical school had few choices. “One was taking your chance with the draft, which at that time was very risky. Then there was the Berry Plan, in which you deferred your military obligation until after you finished your residency. I was in my senior year, so it was getting close to crunch time. I was working in a hematology lab, and a senior clinician suggested I look into the National Institutes of Health’s (NIH) public health service programs because they exempt you from the draft,” said Dr. Young.
He was eager to continue his hematologic research while avoiding the draft, so he applied to the very competitive NIH program and was accepted into the clinical associate program at the National Cancer Institute (NCI), which, in effect, transferred his activities from hematology to oncology. After 2 years in the NCI program, Dr. Young took a senior residency position at Yale University. In 1970, he received an invitation from the NCI to serve in its medicine branch after he finished his residency, a tough decision at the time.
“Although I had a number of solid options, the NCI position seemed to be the most interesting, so I took it, and it turned out to be the second best decision I’ve ever made, the first being marrying my wife. As luck would have it, I returned to the NIH in 1970, the year before the National Cancer Act was signed, so there was a huge increase in funding and many opportunities to get involved in the latest research. I was part of a group of five investigators that developed the first curative regimens for Hodgkin lymphoma and diffuse aggressive lymphomas,” said Dr. Young, adding, “We were called the ‘Gang of Five,’ and of that gang, four of us became ASCO presidents: myself, Vince DeVita, George Cannellos, and Phil Schein. Bruce Chabner, the fifth, also had an equally distinguished career as Director of the Division of Cancer Treatment and Clinical Director of Oncology at Massachusetts General Hospital,” said Dr. Young.
Dr. Young was at the NCI for about 17 years. Toward the backend of his tenure, on a request from Dr. DeVita, who was NCI Director at the time, Dr. Young took charge of the cancer centers branch, which gave him the opportunity to visit many of the country’s centers. “We wanted to see how the centers could best leverage the scientific information coming out of the NCI. When at Fox Chase Cancer Center, Dr. Young met the president, John R. Durant, MD, who was leaving his position. “John suggested I take a look at filling his position as Fox Chase President and CEO. I was interested, and after several meetings with the board, I was offered the position. In a sense, I’ve had two jobs my whole life, Chief of the Medicine Branch at NCI, and President and CEO of Fox Chase,” said Dr. Young.
The Evolution of ASCO
In 1989, Dr. Young served as President of ASCO, which was a much different organization than today’s global leader in oncology. “The first meeting that I attended at ASCO was in 1968 and we had about 200 people. It was a half-day session immersed in the American Association for Cancer Research (AACR) meeting. We were still a fairly small enterprise at that point, and most of the data were from simple trials, testing the application of chemotherapy to a variety of tumors,” said Dr. Young.
By the time he was President in 1990, the ASCO Annual Meeting had grown to about 4,000 attendees strong. “We finally broke from the AACR and had our own meeting, and it was a full meeting with a lot of randomized trials being presented and a lot of basic science data being explored. Looking back, it’s hard to believe but it was during my presidency that the Society hired its first full-time employee and set up an office in space owned by an independent law firm. Prior to that, ASCO’s meeting was managed by an event planner. So this was really the beginning of ASCO as an independent organization managing its own enterprise,” said Dr. Young.
He continued, “Up until then, ASCO had always been seen as an academic oncology organization, with a clinical emphasis. It became clear that we needed to involve private practice oncologists more actively. However, there was tension between the academic and private practice worlds. My father was a clinical academic professor, but he was also a private practitioner, so I had previous experience with the issue. We set up an ASCO community affairs committe and asked Dr. Joe Bailes, a prominent community oncologist, to chair it. And since then, the Society has made every effort to balance the needs of both academic members and those in clinical practice.”
Looking Back, Looking Forward
Asked what have been the major advances over the course of his career, Dr. Young responded, “First would be the cure of childhood leukemia, certain lymphomas, and testicular cancer. These advances proved that chemotherapy can cure some systemic cancers. The second major advance was the use of adjuvant therapy in common cancers such as breast and colon cancers. The third was the basic understanding of the biology and mechanisms that drive cancer causation. And finally, I’d cite the hugely successful anti-tobacco campaign that has occurred over my lifetime, saving millions of lives.”
Dr. Young currently works independently in the consulting field, covering a wide array of needs and venues, from cancer centers to the pharmaceutical industry. “My work allows me to continue addressing problems that I find interesting and challenging. I like to stay up-to-date and fully immersed in the exciting world of oncology,” said Dr. Young.
He added a cautionary note, “I worry deeply about the NIH funding issue. Until the federal government, no matter which party is in charge, addresses entitlement spending, the NCI, which is funded by discretionary spending, will continue to see its funding shortchanged. That’s catastrophic for the future of cancer research.”
Does Dr. Young’s busy schedule allow some time for unwinding with leisure activities? “I like to connect with my daughters and my five grandchildren, and I’m an avid birdwatcher, so I do quite a bit of birding. I also travel to meetings. In fact I was at the recent AACR meeting and caught up with Bruce Chabner there. Our wives came along so they had breakfast together,” said Dr. Young.
Two of the “Gang of Five” still sharing time at a scientific cancer meeting. Some things never change. ■