Goin’ Out West

This article originally appeared in the Fall 2017 issue of Act Against Cancer.

William Cance, MDTalking to us on a hot June day from his office at the University of Arizona Cancer Center at Dignity Health St. Joseph’s Hospital and Medical Center, William Cance, MD, couldn’t help but bring up the heat. It was 108 degrees with clear skies and a lot of sun outside in downtown Phoenix. At the same time, in Buffalo, New York, where he lived a year earlier, it was … 66 degrees and partly cloudy.

Dr. Cance, a renowned oncology surgeon and physician-scientist, joined the UA Cancer Center in October 2016 as deputy director to lead clinical and research efforts in Phoenix. He hit the ground running, quickly getting a feel for the complex landscape of both the University of Arizona as well as the biomedical and health-care fields in the state.

Dr. Cance is a fellowship-trained surgical oncologist and is chiefly interested in developing innovative cancer programs and new cancer therapies. His research interests are centered on focal adhesion kinase (FAK), a critical survival signal in cancer cells and a promising therapeutic target being evaluated in several clinical trials using FAK inhibitors. He was the first researcher to identify and clone human FAK in 1993 and demonstrate its overexpression in almost all human cancers. Today, Dr. Cance is homing in on the biology of FAK and developing anti-cancer drugs that target the signal. He also is interested in the biological role of FAK in enhancing the survival of cancer cells.

Dr. Cance wasn’t just taken aback by Arizona’s hot weather, but also by its significance as a hotbed of medical research in the Southwest. He hopes to harness the energy radiating from Phoenix and Tucson to advance cancer research regionally and beyond.

“Partnerships with private industry, nonprofits, with the community physicians and community-based health-care systems are a top priority for the cancer centers and the National Cancer Institute,” Dr. Cance says. “I see tremendous potential, particularly with the great clinical volumes that are in Phoenix as well as the expansion of the service area — the Mexican-American and Native-American populations.”

Arizona draws “medical tourists” from around the world to some of the best clinical and research facilities in the nation, including the University of Arizona and Arizona State University, the Translational Genomics Research Institute (TGen), the Barrow Neurological Institute, Mayo Clinic and Norton Thoracic Institute. Dr. Cance aims to bring them all together in the name of cancer research and care in a series of public-private partnerships with the UA Cancer Center at the hub.

“The problem is, I believe cancer research is somewhat in the doldrums in many respects because many people want to have their own empire,” says Dr. Cance, speaking to the importance of collaboration among researchers. “I’m trying to build bridges and bring larger groups of people together, because I believe you can attack the problem more broadly with a bigger team. Cancer is just too big for one individual, for one institution.”

Dr. Cance spent the better part of his first 12 months at the UA Cancer Center establishing relationships and working with Dignity Health St. Joseph’s Hospital and Medical Center to get the UA Cancer Center in Phoenix better established and more widely recognized. The new facility, the UA Cancer Center at Dignity Health St. Joseph’s Hospital and Medical Center, is a 220,000-square-foot outpatient clinic and research building on the UA biomedical campus in downtown Phoenix. Patients began going there in August 2015.

His Efforts in His First Year Have Been Fruitful.

“I have seen a lot of enthusiasm on all sides for the potential for working together, from Dignity St. Joseph’s to Norton Thoracic Institute and the Barrow Neurological Institute. The incoming chief of Barrow wants to collaborate. The incoming scientists at the Norton are all becoming faculty and joining the UA Cancer Center. We are working with TGen and Arizona State, collaborating with them on their existing drug discovery approaches,” Dr. Cance says.

Dr. Cance elaborates on the process for fostering increased collaboration: “The first step is to build those relationships and find out where the synergies and shared interests are. It’s kind of like trying to put together a big program project grant or a SPORE (Specialized Programs of Research Excellence) grant, trying to find all the areas where there is the commitment and the interest.”

“Step two is integrating within the comprehensive cancer center realm in providing value to these groups through the Cancer Center,” Dr. Cance continues. “I believe you have to do that to move things forward. And once you do that, you need to have metrics, which will be clinical trial accruals, investigator-initiated trials, new grants and so forth.”

And as for Year Two?

“This process is a continuum,” Dr. Cance tells us. “We can’t just say, ‘This is a really cool collaboration. Look at this. This is really good.’ We need to show how it works. The challenge next year will be integration with the UA Cancer Center research programs and the disease teams. So that’s the big challenge for the next year.”

For example, Dr. Cance is teaming up with James Spivey, MD, new chair of internal medicine at Dignity Health St. Joseph’s, to lead a multidisciplinary effort in hepatocellular carcinoma that pulls from existing strengths of the clinical and surgical expertise of physicians and surgeons at St. Joseph’s. The idea is to connect them with people like the UA Cancer Center’s Peter Lance, MD, FRCP, and his outreach programs with the Navajo, who are disproportionately affected by liver cancer.

“Another thing that I want to do next year is put some ʻmeat’ around the investigator-initiated trials,” Dr. Cance says. Investigator-initiated trials (IITs) are developed and executed by research institutions, such as UA Cancer Center, rather than pharmaceutical companies, and are integral to the bench-to-bedside translational research that is a key characteristic of comprehensive cancer centers.

“I have been very impressed with the concepts for IITs that we have in Phoenix,” Dr. Cance continues. “We just met with Alan Nelson, the CEO of VisionGate, who is developing technology used for diagnosing lung cancer out of sputum samples. We want to partner with them in this and other areas to bring their new technology into our clinical research efforts.”

Dr. Cance concludes with his goals for expanding the Cancer Center’s reach into the larger research community: “I believe we really need to incorporate industry and the entrepreneurial side into our collaborations. There is a lot of evolution. And I love to put people together like that. The public-private partnerships are what I think we have to do more of.”

About Dr. Cance, Physician-Scientist

William Cance, MDAn avid researcher, Dr. Cance is the principal investigator on a 25-year R01 grant from the National Cancer Institute (NCI) focusing on focal adhesion kinase (FAK). He has been awarded numerous other grants from the NCI and National Institutes of Health, as well as the American Cancer Society, Susan G. Komen Breast Cancer Foundation and the U.S. Department of Defense.

Dr. Cance received his medical degree from Duke University School of Medicine and was the chief resident in the Department of Surgery at Barnes Hospital Washington University School of Medicine in St. Louis. He also completed two fellowships, one in surgical oncology at Memorial Sloan-Kettering Cancer Center in New York and the other in the Departments of Surgery and Microbiology and Immunology at Washington University School of Medicine. Dr. Cance holds eight U.S. patents, including a patent for kinase protein binding inhibitors and one for devices and methods for implementing endoscopic surgical procedures and instruments within a virtual environment. He also has four patents pending.

Dr. Cance is past president of the Society of Surgical Oncology, and a member of the American Association of Endocrine Surgeons, American Association for Cancer Research, American Surgical Association, Society of Clinical Surgery and American Society of Clinical Oncology, as well as a Fellow of the American College of Surgeons. In addition, he served on the editorial boards of the Annals of Surgical Oncology and the Journal of Clinical Oncology. He also served on the Board of Scientific Counselors of the National Cancer Institute.

He is author of more than 130 peer-reviewed publications and 10 book chapters and is founding editor in chief of the Society of Surgical Oncology-branded database of Complex General Surgical Oncology.

Life in the Valley of the Sun

Dr. Cance and his wife Jenn hiking in the Phoenix Mountain Preserve on Christmas Day 2016.What is life like in Phoenix and the Valley of the Sun for you?

My wife and I love it! It is such a livable city and it’s great to have all of the amenities of a city. We live in central Phoenix and are really enjoying everything Phoenix has to offer.

What are some of the things you’ve discovered that you like to do in the Phoenix area, or Arizona in general?

There are two tomato seasons for my garden. The spring and the fall. I don’t think I’ve ever had two tomato seasons in the same year, so I’m really excited about that. You can plant your fall tomatoes and you can plant your spring tomatoes. It’s great!

We love the proximity of the outdoors and the fact that it’s available all year. As Dr. Andrew Kraft said when I was going through my recruitment here, “Arizona has everything you want, you just have to get to the right altitude.”

We are really loving the diversity of Arizona and the fact that you can experience everything in just a short drive.

The summer is a good time for grant-writing, which is the reverse of everywhere I have lived. In Buffalo, you were stuck inside for six months during the winter so you did your grant-writing then. Here, you have three months where you get up early, get your outdoor activities in and then, during the day, it’s a great time for grant-writing.

In all honesty, how do you feel about the heat? Honestly!

Honestly, the 118-degree days are tough. My tomatoes don’t like it either. I had to get a sun cloth for them yesterday. But you know, by getting up early, it really just doesn’t bother us. You get up early when it’s the coolest and then you find other stuff to do during the heat of the day. We still go to the club and work out. I haven’t been to a Diamondbacks game yet in this heat.

They can close the roof to the stadium so the experience is entirely climate-controlled.

I didn’t know that! OK, cool!

Did you go to the Waste Management Phoenix Open?

No, I was too scared of the crowd. Is it good? I’ll have to check that out next year.

Favorite Arizona sports team?

The Diamondbacks are my favorite team because they support the UA Cancer Center.

Favorite restaurant?

Matt’s Big Breakfast would definitely be my favorite. For dinner, there are so many great places, it would be hard to pick just one, but I would say The Gladly, Dieci and L’Amore.

Photo 1: William Cance, MD

Photo 2: William Cance, MD

Photo 3: Dr. Cance and his wife Jenn hiking in the Phoenix Mountain Preserve on Christmas Day 2016.