July 4, 2024 • 36 mins
In this special episode of Inside Cancer Careers, we hear from Dr. Karen Knudsen, CEO of the American Cancer Society (ACS). Dr. Knudsen shares her career journey into science and the path that led her to her current leadership role at the ACS. She shares her story of finding the right mentor, asking the right questions, and being open to new opportunities.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
[UPBEAT MUSIC}
OLIVER BOGLER (00:02):
Hello and Happy Independence Day! In honor of the 4th of July Holiday we are off,
and are posting an episode from Season 1 featuring the CEO of the American Cancer Society.
If you haven’t heard it, take a listen to the inspiring story of what is going on at the ACS,
and how Dr. Knudsen’s career path led her to this key leadership role in cancer. Enjoy!
(00:25):
[music changes]
Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute.
I'm your host Oliver Bogler. I work at the NCI, in the Center for Cancer Training.
On Inside Cancer Careers we explore all the different ways that people join the
fight against disease and hear their stories.
Today we are talking to Dr. Karen Knudsen, CEO of the American Cancer
(00:47):
Society about how curiosity and strategy combine to make progress against disease.
Listen to the end to hear Dr. Knudsen’s
recommendation and to have chance to take Your Turn.
It's an honor to welcome Dr. Karen Knudsen to the pod. Welcome.
KAREN KNUDSEN (01:03):
Thank you so much for having me,
Dr. Bogler. It is just an honor and a pleasure to be here.
OLIVER (01:07):
Dr. Knudsen is the Chief Executive Officer of the American Cancer Society and its advocacy
affiliate the ACS Cancer Action Network. She was the first woman to hold those positions. Before
ACS, she was on faculty, and held leadership positions at Sidney Kimmel Comprehensive Cancer
Center at Jefferson Health, including serving as the executive vice president of oncology services,
overseeing both care delivery and research. Her research was focused on precision medicine for
(01:32):
advanced prostate cancer with a focus on relapse, a significant problem in that disease. And I
should mention that Dr. Knudsen also serves on NCI's Board of Scientific Advisors. Dr. Knudsen,
I'm always interested in how people find their way to science as a career. What got you started?
KAREN (01:47):
Yeah, so I actually don't come from a family that's full of physicians
or scientists. It's just something that I wish I could understand even in myself.
I think I was just naturally curious about science, and followed that path,
and it's steered me in the right direction, that curiosity, I think, my whole career.
OLIVER (02:06):
Your primary interest was in biology. That's what you studied at George Washington
University. You moved into molecular biology. That seems natural. People of our generation
were drawn to that field. But then cancer, how did you get interested in cancer?
KAREN (02:19):
Yeah, it was a really interesting journey that I wish I could say was planned, but really
wasn't. So in fact, you know, as a child growing up, I had always thought I would go become a
physician, because I thought that if you enjoyed science, that that's what you should do. Again,
I didn't know any scientists, so I didn't know how to go about becoming a scientist, nor did it
honestly even enter my mind. So I went to George Washington. They have a wonderful biology program
(02:45):
where you can have a very rich ability to get to know your professors very quickly, you know,
starting your sophomore year. So I started interning in a lab, and in that laboratory,
they really recognized how much I loved science and nominated me to work at the National Cancer
Institute at Frederick for the summer. And so I interned with Dr. Garfinkel at NCI Frederick,
(03:09):
and it was at the time that the HIV epidemic was really in its peak, and really,
lack of understanding about retroviruses was profound. And so the Garfinkel lab study Ty1,
retrotransposition, and it was thought that this was a way for
us to understand how HIV worked. And so I was very excited, in retrospect,
(03:31):
to get involved in that because I could draw a clear line behind the science and helping someone,
which I think was my driver. So after those experiences, and I was using yeast
genetics as a model system, which was very exciting at the time, and still is for me --
OLIVER (03:48):
Yeah?
KAREN (03:49):
But it is the case that, you know, I decided to make a shift and that what I really
loved was science in the way that you can generate breakthroughs that can truly help more people than
you could seeing individuals come to your clinic every day. So this led to this going to UCSD and
getting my PhD with a focus in molecular biology. I loved yeast genetics, so yeast genetics was what
(04:10):
actually brought me to cancer. At the time that I was there was the time that all of the cell cycle
genes were being identified, and the way that that happened in part was that mutational analyses or
mutational strategies had been performed at in fission yeast, Schizosaccharomyces pombe,
and those new mutant lines, which were sensitive to radiation, distributed across the world in
(04:34):
different laboratories, and I was given one to work on, Schizosaccharomyces pombe rad1,
which was highly radiation sensitive. And so through complementation strategies,
I cloned rad1. It is now known to be what now we know is part of the 911 complex for DNA repair. It
got me really interested in cell cycle, really interested in checkpoints, and then of course,
(04:54):
you started to envision, well, what do you do with this information if your goal is to help someone?
And so that linked to cancer, uncontrolled cell growth and cell cycle, it started to
really resonate with me, and still right up until the moment that I stepped into my role as CEO of
the American Cancer Society have a very active funded lab where a core component of what we did
(05:15):
was always cell cycle, and I'm very proud of my trainees and what they were able to discern but
that's how I came to cancer was love of science, being in the right place at the right time,
and being able to track it to something that I wanted to do, and that's help people.
OLIVER (05:29):
Fascinating. I mean, it's interesting that you say, you know, when you were younger, you were
thinking of being a medical doctor, right? And then experiencing science gave you that other
perspective. That's a lot of what we're trying to achieve with this podcast is to help people see
all the different ways that you can participate in the cancer community. So was prostate cancer a
disease that you were particularly interested in? Was it just a good model or how did that happen?
KAREN (05:52):
Yeah, great question. So in my doctoral work, it was certainly all about cell cycle, and I
loved it, and I loved the intricacy and the logic of cell cycle and cell cycle gone awry in cancer,
but for my fellowship, I recognized within myself that I needed to make that next step,
the next step toward more of a direct line for helping someone, in other words,
(06:15):
translation. And so I thought about that, as I thought about what mentor I would go work for,
and so I, you know, I had the benefit of having all these wonderful labs around me in San Diego,
and the interview that really resonated with me was with Dr. Web Cavenee,
who was also I know your mentor, too. We had a little time to be in each other's labs --
OLIVER (06:36):
Indeed.
KAREN (06:36):
-- And boy, what a great, great decision I made. You know, when I sat down in his office, I
realized his mind was aligned with mine, which is the reason that we do this. The reason that we do
cancer research is we're aligned towards solving for a problem that is a real life human problem,
and I loved that. And so when I decided to join Web's lab, that was probably one of the most
(07:00):
pivotal decisions I made in my scientific career, and I thought I would be joining his brain tumor
group or his rhabdomyosarcoma group. Of course, I knew him from the cell cycle world as being
the person who had identified tumor suppressors through studying retinoblastomas and I was very
interested in the RB1 gene. And much to my surprise, after I had already agreed to come,
(07:22):
he sat me down in his office and said, "Here's the thing, Karen. All of this work is happening right
now in the world in breast cancer." And it was at the time that women had really started to demand
more, more clinical trials, more research being done in breast cancer. He said we're
going to make gains over there, we, the oncology community. He said but the counterfoil to that is
prostate. And you know, the population is aging. Prostate cancer is going to become even more,
(07:45):
frequently diagnosed, which was already the number one diagnosed cancer of men in the country, not,
you know, like number one malignancy. And he said, we've got to do something about it,
because we actually don't understand advanced disease. And I thought, well, what do I know about
prostate cancer? But the more I started to look into it from the clinical point of view,
from the point of view of what is the clinical problem that needs to get solved,
(08:08):
it was a lack of understanding of how it is that hormone action drives uncontrolled cell growth in
the prostate. Now this starts to resonate with me. It's like, okay, nobody understands -- everybody
understands prostate cancer needs testosterone, but nobody knows how to make that link between
what testostero ne does, and how cells get the go grow signal. Understanding that the
(08:29):
androgen receptor is present in, you know, many tissues, almost every tissue in the body,
what's unique about the prostate, that it gets a go grow signal from testosterone. I thought,
oh, okay, I'm probably uniquely positioned to figure that out. And so then pulling together
all these wonderful nuclear receptor people that were all around me at the time, you know,
(08:50):
I had to of course understand androgen receptor and nuclear receptor signaling
in order to link that to cell cycle, and so I was able through partnerships and learning
with the community around me, able to put together what I think was a pretty
unique research program that led to new nodes of opportunity, new understanding of hormone action,
but also new nodes of opportunity for treatment in prostate cancer. And then all these years later,
(09:14):
you know, co-writing clinical trials using CDK4/6 inhibitors in combination with hormone therapy.
Bingo. I mean, it was really -- it just felt like it kind of all came home when that started
to happen. It was -- I was in the right place at the right time, but going to Dr. Cavenee's
lab was the most important choice I made to get to the path where I am right now.
OLIVER (09:34):
And I think you highlight a very interesting and important point,
which is being able to identify the right question at the right time in
the right environment is so critical to finding work that can make impact.
KAREN (09:46):
Yeah, and I mean, and I think that's -- I'm very proud of my trainees,
and it's the thing that we talked about a lot in the lab all the time. You know, every year,
we would set aside some time to say all right, here's our body of work. Here's our body of work
in the context of the whole environment around us, and there were no sacred cows. And, you know,
we'd say like, what are we uniquely positioned to answer that we can do faster and more thoroughly
(10:10):
than another lab? Like, why would we want to go into this particular area? And I think that kind
of rigor in thinking actually allowed us to shape and change beyond just cell cycle and to add new
types of thinking in the lab about the importance of understanding hormonal control of DNA repair,
and then ultimately being able to contribute to PARP inhibitors as, you know, breakthrough
(10:32):
approvals for prostate cancer because of that work was really meaningful. And it's because we
had such a good tie to the clinic. So, you know, we were constantly thinking about what are the
clinical problems that we're trying to solve? What are we good at, at modeling? What is better for
somebody else to do because it's just not our sweet spot? And then what resources, meaning
people and infrastructure, do I need if I'm going to attack this particular scientific problem?
OLIVER (10:56):
Interesting perspective. Often the kind of research that you did, that I did, is called
curiosity-driven research, but I'm hearing from you that it's curiosity plus strategy.
KAREN (11:05):
Yeah, I think that's right. I think that ultimately, is how I lead the lab. I think that
now when I watch my previous trainees that are, you know, now professors and in pharma,
I think it's how their mind works, too. And it was really not me saying, here's the strategy.
What I loved about it, what I really, really loved about it was being able to sit with my team every
(11:29):
year - we do a retreat, right - and sit and think with them about what is the right thing for us,
and hearing their view, their points of view. You know, when you get to that go/no-go part
on a experiment, a go/no-go part on a project, it's nice to have the divergence of thought,
so that you can ultimately come as the head of the lab to make,
(11:52):
hopefully the right decision, not that I always make the right ones.
OLIVER (11:56):
Who does, right? So around 10 years or so ago, you started taking on some leadership
roles in the Sidney Kimmel Cancer Center. You've already kind of told us how strategic
your approach was to your science, so I can imagine that was a natural step,
but what motivated you to take on those kinds of responsibilities?
KAREN (12:14):
Yeah, so when I left my fellowship, my first faculty appointment was in Cincinnati at the
University of Cincinnati School of Medicine, and I was again, right place, right time. You know,
all these brilliant minds had been hired in Cincinnati, right out of their fellowship.
Everybody was, you know, very excited about having this groundswell of knowledge of cancer,
but I also recognized that I needed to stay very current, again, with what was happening in the
(12:38):
clinic, so I was very lucky to have a urologist, Bruce Bracken, and a radiation oncologist who
kind of took me under their wing and we started to work together in partnership, and we formed
this what we called the prostate cancer working group, and that way, I could explain to him the
kinds of things we were doing. They were telling me the problems that they had in the clinic,
(12:59):
and we set about trying to solve those together. A missing component was medical oncology,
and ultimately, that's why I started thinking about going elsewhere, because at the time,
it just was not a missing component, and when you study advanced disease, it's very hard
not to have a robust GU oncology program right there. I think they have one now,
but at the time, it was just kind of missing, so okay. So I was amenable to recruitment,
(13:22):
and when Jefferson came calling in Philadelphia, they said we want you to start the process -- we
want you to take -- we have all the stuff. We have all the pieces. We have urology, rad onc,
med onc. We have a risk clinic, and we have this massive, diverse patient base, and we've got
scientists, but we don't have anybody to anchor them all together. Okay, so now you're speaking
my language. So they wanted me to come and start the prostate cancer program. So I did that,
(13:47):
and I find a lot of personal satisfaction in building teams. I've learned that about myself
through the years. And so I put that together for Jefferson. We started a program that became part
of our official programs at the NCI through our NCI-designated cancer center, but we also expanded
it to the entirety of Philadelphia. So we started a prostate cancer working group that included
(14:09):
every prostate cancer researcher or clinician who wanted to that we could find from Temple,
from Penn, from Wistar, and we met once a month, and we put together -- we did work, and which was
great, and so I loved that. And so then when you start to be that person, people started to ask
you to do other things that require team assembly, so probably not known by the external world very
(14:33):
much, but I actually served as the first Vice Provost at Jefferson. So my whole goal there was
to -- I was charged by the Provost to put together the clinical and the basic research teams. And at
that time then, it was also the Deputy Director of the Cancer Center. So ultimately, you know,
the institution made a change, asked me to take on the cancer center right on the precipice of
(14:54):
this massive expansion that I actually didn't know was going to be planned. Nor did I think anybody
really in the know except our new CEO, so we were a three-hospital system in Center City, Philly. We
had great science. The prostate cancer group was ticking and humming. It was really phenomenal,
and then we had this incredible opportunity to expand because we went from three hospitals
(15:18):
wholly owned and operated with a big prostate cancer base to ultimately, by the time I left,
16 hospitals wholly owned and operated. Now it's 18 across two states. And so I had the opportunity
to think about how we take all the awesome research that we do, and put that into practice
by putting clinical trials out into the community and setting up four different advanced care hubs
(15:40):
with clinical trials so that we actually had an opportunity to get breakthroughs, to get
the research that was happening in Jefferson and beyond out to people, and I loved that.
OLIVER (15:50):
Phenomenal. I mean it sounds like yet another opportunity to make more of an
impact and an exciting time also to be there. You obtained an MBA. I don't know if that was
coincident with this or what the timing there was, but what was the reason for that?
KAREN (16:02):
So in at Jefferson Health, we were ultimately a 33,000-employee $11-billion company,
and I reported to the CEO. And he's a brilliant guy, Steve Klasko. He's absolutely brilliant. And,
you know, I, I learned a lot from my C-suite colleagues, but what I saw (one person's opinion)
(16:24):
is that as we went and expanded and assumed these community hospital systems that did cancer care,
but had not a lot of expertise in clinical trials, and sometimes they were employed,
and sometimes they were not employed, sometimes they were happy that Jefferson had come over,
and sometimes they were deeply skeptical about what was going to happen, I realized that we were
(16:44):
going through this rapid merger and acquisition and doing it, I'm going to call it in an academic
medicine kind of way. And I thought to myself, that there must be a better way, and I'm not
going to learn it listening to the echo chamber in academic medicine, and so I'm going to go get my
MBA. So I sat with my CEO, and I said this is what I'm going to do. And what he said to me,
which I think was brilliant, is he said, "Look, go get your MBA. You go do that thing." He said,
(17:09):
"But don't -- do not focus on healthcare. In fact, get away from the healthcare people,
because if you really want to break some things and make change, you've got to hear from people
with external points of view." And it was great advice. So I learned about M&A from people who
were bankers and in finance. And, you know, it's an executive MBA program, so you're working with
people who are already in a C-suite, or just below the C-suite and want to be, but you learn
(17:33):
a lot from each other. I learned so much that I didn't expect to learn about people strategy
and managing, you know, human capital, which you don't ever learn about in science, and so that was
really valuable to me, but I also realized what an advantage you have as a scientist, because you
are -- you don't realize it, but you are trained with a business mindset, right, because when
(17:56):
you're running a lab, you're running a business. You have to think about strategic priorities and
finances and human and managing people, but you also have a real comfort with hypotheses and a
real comfort with being wrong, and a real comfort with using data to guide your decision, which like
It shocked me that some people in the business world just like they actually don't know how
(18:19):
to statistically analyze data, and they don't lean on it like I do. So if there's one thing I brought
to the American Cancer Society is that we are a data-driven organization. If you want me to run
in Direction A, you better tell me why B is wrong, and A is the right way to go, and I'm going to ask
you for every piece of data to understand that. And so it's like it's very freeing. I actually
(18:39):
think that scientists are uniquely positioned to be business people, (one person's opinion).
OLIVER (18:44):
That's, that's really interesting,
that combination of thought processes. We're going to take a quick break. When we come back,
we'll talk to Dr. Knudsen about her work at the American Cancer Society.
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[music ends]
All right, and we're back. Dr. Knudsen, your move to the American Cancer Society,
from academia to the nonprofit world, represents another career pivot. Same
question, what motivated you to take this leap?
KAREN (20:27):
Yeah, if you would have ever asked me if I would do what I'm doing right now sitting here in
Center City, Philadelphia, I would say absolutely not. I loved my job. I was the EVP of Oncology
Services. I found great satisfaction in taking the clinical teams and delivering the best possible
cancer care in every corner that we covered, and also getting the science there, right, and
(20:51):
ensuring that our science is addressing the needs of our catchment area and leaving nobody behind,
and developing cancer screening strategies to bring out to the community instead of asking them
to come to Jefferson, again, using data-driven research solutions. So I loved all of that,
and then I got this call to look at the CEO position at the American Cancer Society, and
(21:14):
like you and like other cancer leaders, you get these calls kind of regularly, right? But I was
very thankful to ACS because I was an ACS grant holder, right? When I needed research as a cancer
center director, I had an IRG grant that gave me pilot funds to spawn what were really amazing new
ideas from my faculty. So okay, I was appreciative of that. I was also the president of the AACI,
(21:40):
the Association of American Cancer Institutes, which is largely an advocacy organization,
and that's where the 106 cancer centers in the US hang together every year, link arms and push for
common sense policies to help cancer patients. And the ACS had been our partner there too, so I
really respected that part of it, but the thing that really got me about ACS was the fact that
(22:02):
a lot of our cancer patients were in Center City and came to our safety net hospital in Jefferson.
And so the difference in outcome between someone who can come to chemotherapy five days a week,
versus someone who can only come three days a week because they don't have transportation,
is huge. So this what I call basic blocking and tackling of cancer care, housing, transportation,
(22:27):
digital literacy, information about cancer, education of the caregiver, all of that stuff,
which I now call Patient Support at ACS, was how we got our patients to care. And so I was very
thankful to ACS, because of all these things, but especially patient support. So I got a
call from ACS, and they asked me to take on this job, and they told me something I didn't know,
(22:49):
even though I'd known about ACS my whole career. What I didn't know is that this 100-plus-year-old
organization was actually not at all 100 years-plus. It was brand new, because ACS
had been a federated model. It had been multiple separate organizations with many CEOs and multiple
strategies and multiple different areas of emphasis across the country, which explained
(23:14):
a lot to me. It explained why I was touching and feeling something at ACS in Philadelphia
that's very different than someone might touch in DC, or in Los Angeles or in a rural community,
because they were truly separate organizations. So what they explained to me is that they had
gone through a business transformation, which I considered to be a good word, and they put
together these multiple into one, one ACS, and it was legal, it was financial, as one unit,
(23:43):
but it was not yet strategic. So now you're speaking my language, right, because now I have
an opportunity to take previous teams, meaning the federated models, and put them together in the
name of cancer for the greater good, and so I had this series of meetings with the board, because I
had no reason to leave Jefferson. I loved what I did. And if I was going to do it, I was not
(24:04):
going to be the keep-the-trains-running CEO, I was going to say we're going to have to have a greater
impact than we have right now and define that with data and metrics, and really, act where we are
uniquely positioned to act and not someone else. So I had a series of meetings with the board -
OLIVER (24:20):
Of course.
KAREN (24:20):
-- I gave them tough talk. Here's what's wonderful. We got to do more of this. And here's
some stuff that I don't know it belongs to ACS, and some of that was with research,
and some of it was with advocacy, and some of it was with patient support. I had thoughts about
how to structure this to make it more impactful across the country in everything that we do. And
I didn't realize that that's what they were looking for, but I think they were looking
(24:42):
for someone to come in and really be a change agent, and for a positive. It's always been
an amazing organization, always, but clearly ready for logarithmic growth in other ways,
and so I feel very humbled and honored and absolutely delighted to lead this organization.
We have so much more to do, and we do a huge amount of what we do in partnership, including,
(25:07):
the NCI even advocating for NCI funds. It's one of the things I can do as a CEO that you,
you know, can't do from within the NCI, but we can and we know how important that is. So
every day is a good day because I know we're doing good in the world, and I love that. <<
OLIVER (25:22):
And we're deeply grateful for that advocacy. Obviously, it's critical. So I mean,
you broke quite a few barriers in taking on this role. As I mentioned already,
you were the first woman to be the CEO. You're also the first CEO to come from cancer science
and to have been a leader of a cancer center, so the transformation, you've implemented pillars,
advocacy, patients support, discovery and development. How's that transformation going?
KAREN (25:45):
It's going really well and I credit my executive team. So one of the one of the things
that I wanted to dismantle was the idea that ACS is a location, right? We work in 5,000 communities
across the country, so I had no ambition to relocate everyone to Philadelphia or to Atlanta
or to any main location. So I really hired the best and brightest to lead these pillars,
(26:07):
but before I talk about them, because I want to mention those guys for a minute, the foundation
of everything that we do, right, rests on health equity, and cancer care equity in particular. And
so it was surprising to me that we had not yet put in a chief diversity officer. So my first -- one
of my first moves was to put in place our chief diversity officer, Tawana Thomas Johnson, who is
(26:28):
a rock star of my world, and when I talked about strategic choices, things that we are
uniquely poised to act on that maybe, you know, setting aside things that we shouldn't act on,
if it doesn't align to our commitment to health equity or to cancer care equity,
that's a somebody-else thing. Everything really has to stand true to that. So she's got a big
role. You know, she shapes everything we do, all pillars. And so our vision of what it is
(26:54):
that success looks like is ending cancer as we know it for everyone. I always call this
the eight words that define us, but those two words are more powerful than the rest, right?
OLIVER (27:02):
Yeah.
KAREN (27:02):
So and because there are things that we can uniquely do in that space that are harder to
do for a government program, but we can. And so putting that person in place was just, I think,
I'm very blessed to find her already within ACS, and so she knew it, she knows it and,
you know, she does magical things like goes out and ensures that 1,500 health equity ambassadors
(27:23):
are trained to go out and work in communities for prevention and screening that are, you know,
movers and shakers in their communities, and it makes a difference. And then we
measure ourselves by how well we do. So all of our organizational goals hang on things like impact,
like lives touched through prevention screening, not just did we do a screening activity,
but did we enhance screening as a result, right? So these are the kinds of things that we put into
(27:47):
play as an executive team that are really what we can do as ACS. So then standing on that foundation
of health equity are the pillar, so, you know, research is, of course, incredibly important.
Our research team in Atlanta continues to just, you know, set the single book of truth for the
nation on cancer incidence and mortality and trends, but then we also have the extramural
(28:07):
program. So what are the kinds of things that ACS should be funding that is complementary,
but non-redundant with the NCI or other funding agencies? So we went on the listening tour of the
cancer centers. I polled my peer group, my brother and sister cancer center directors,
asked them what they prioritize, and we've started to shape our research priorities accordingly. Now,
(28:28):
in order to have somebody lead that, I needed just the right Chief Science Officer, so this is where
I have to apologize to you because I stole him from the NCI, and that's Bill Dahut. Dr. Dahut is
amazing, another rockstar in my world, and just absolutely revolutionizing our ability to have
impact through discovery. He is terrific. I know you guys already know that. So he is wonderful,
(28:52):
but as much as these breakthroughs happen, access to those breakthroughs, we know is only happening
for a percentage of people in this country, and that's where advocacy comes into play, so this is
a 501(c)(4), so that's -- you know, in business jargon, what does that mean? It means that you
can and do lobby, and a lot of the battles that are fought in the name of health equity happen at
(29:12):
the state level. A perfect example is biomarkers. You know, we've just gone state by state to ensure
that all these wonderful oncology agents that require biomarkers to match a patient to therapy
are covered in the state plans, because guess what team? They weren't. And so Illinois was the
first one that, you know, with our push, passed this into law, and then other states followed,
(29:34):
Arizona, Rhode Island, Louisiana. But all of those advocacy wins came because we have the data from
research and experience with our patients, right, the last pillar, patient support. So
that's all of the places that cancer patients fall through the cracks. That's the transportation,
the lodging, the patient navigation, the patient education, prevention and screening programs.
(29:58):
And so finding just the right person to lead that was challenging because this is a new construct,
not new activities, but new in terms of thinking about who is going to be the strategic head of
that who thinks about, from a data-driven way, what patients need now and what they're going to
need five years from now? So I had the bliss and honor of leading that at the beginning,
(30:18):
and so we hired Dr. Arif Kamal out of Duke, a medical oncologist who leads patient support.
And I should also mention that advocacy required no new hire. I mean, Lisa Lacasse, who's the
president of ACS CAN is absolutely first rate, and to watch her masterfully acquire e verything she
needs to know from patient support and research in order to have advocacy push forward in ways
(30:45):
that truly improve lives, like millions of lives with one signature, she's phenomenal.
OLIVER (30:51):
I mean, I could talk to you for hours about your strategy,
but we don't have the time today, but I do refer our listeners to the
in-depth interviews you've given to the Cancer Letter and elsewhere where you take
a much deeper dive into the into this incredibly interesting strategy. I do want to take a slight
pivot and ask you about career advice. You've -- your career has obviously been phenomenally
varied and interesting, and has presented you with many different challenges. Our listeners,
(31:14):
people who are listening and thinking, "Wow, that's very interesting," what advice
would you give to people listening if they're interested in the kind of work that you've done?
KAREN (31:21):
Yeah, I mean, I'm very willing to, you know, talk to people if they
have any questions about things that they think particularly that I did or didn't
do. Always is important to understand. But the advice that I generally have given to my team,
my lab, and my trainees and faculty was always be willing to take the call,
(31:43):
you know? Understand what drives you and what you're -- where you really excel,
but also really want to continue to grow, and when someone calls you and says, I want you to
think about a thing, don't just discount it. Take the call, because only two things will happen,
one of two things will happen. One, you'll either feel great about what you do, right? Like, "God
no, I want to stay in what I'm doing right now, because I absolutely love it," and this -- like,
(32:07):
this is it. This is my buoyancy point. This is what I want to do. Or you'll think, "You know,
I never thought of that before." And maybe you'll see yourself in that role. Maybe you won't. But
it's the case, it may get your mind thinking to how close to your ultimate goal is it? And so I
think just taking the call and being willing to explore is a really important thing to do.
OLIVER (32:30):
Well, thank you so much for sharing all these insights,
and we wish you of course continued good luck at the American Cancer Society, and excited to see
what you accomplish there. We're going to take a quick pivot and go to a segment that we call Your
Turn because it's a chance for our listeners to send in a recommendation that they would like to
share. If you're listening, then you're invited to take your turn. Send us a tip for a book,
(32:50):
a video, a podcast or a talk that you found inspirational or amusing or interesting. You
can send those to us at nciicc@nih.gov. Record a voice memo and send it along. We might just play
it in an upcoming episode, but I would like to invite our guest Dr. Knudsen to take her turn.
KAREN (33:06):
Oh, boy, this is really hard. Of have all the things I could say off the top of my mind,
here's -- since we did talk about career and career advice, I also think a corollary
to that is motivating people. And so one of the things that I really enjoy,
and I used it with my faculty at Jefferson, I used it with my trainees, and I've used
it here at ACS, is it's a little bit dated in terms of the actual content, but the examples,
(33:30):
but the messaging is absolutely on point. It's Simon Sinek on ‘why’, on teaching people why
it is that you do what you do, that people are attracted to the why you do what you do, not the
what you do. And he has this incredible podcast of TED Talks that tells you -- gives you some insight
about why the Wright Brothers, despite the fact that they had very little funding and no training,
(33:53):
were successful in flight versus someone who was actually very well resourced from the government
and had all the right technical training and the background. It talks about why it is that
Apple was so successful as a company in coming up with different types of strategies. It also talks
about Martin Luther King, and how it is that he stood out amongst all the very important
people and orators and those who were trying to motivate others in the civil rights movement.
(34:19):
And his philosophy on how it is that Martin Luther King was so successful in his messaging,
I think is applicable to everyone, irrespective of what it is that you do, but I think especially
when you're trying to describe your role in solving for cancer and ending cancer as we know
it for everyone. I really think it's insightful, and so something I would highly recommend.
OLIVER (34:39):
Well, thank you, and I'd like to make a recommendation as well. Like many, I've become
intrigued by the advent of large language models in AI and the possibilities they open
today and the promises they make for tomorrow. Of course, there's also risks as with any new
technology. One of the most important guides to this world for me is The New York Times podcast,
Hard Fork. It's hosted by two very knowledgeable tech journalists who keep it light and real,
(35:02):
and they really know their stuff. You can find it wherever you listen, and we'll put
links in the show notes for this podcast, and the series of TED Talks that Dr. Knudsen recommended.
That’s all we have time for on today’s episode of Inside Cancer
Careers! Thank you for joining us and thank you to our guests.
We want to hear from you – your stories, your ideas and your feedback are always
(35:24):
welcome. And you are invited to take your turn to make a recommendation
we can share with our listeners. You can reach us at NCIICC@nih.gov.
Inside Cancer Careers is a collaboration between NCI’s Office of Communications and
Public Liaison and the Center for Cancer Training.
It is produced by Angela Jones and Astrid Masfar. A special
(35:46):
thanks to Lakshmi Grama and Sabrina Islam-Rahman.
Join us every first and third Thursday of the month when new episodes can be found wherever you
listen – subscribe so you won’t miss an episode. I'm your host Oliver Bogler from the National
Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.
If you have questions about cancer or comments about this podcast, email us at NCIinfo@nih.gov
(36:12):
or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.
We are a production of the U.S. Department of Health and Human Services,
National Institutes of Health, National Cancer Institute. Thanks for listening.
[UPBEAT MUSIC}
OLIVER BOGLER (00:02):
Hello and Happy Independence Day! In honor of the 4th of July Holiday we are off,
and are posting an episode from Season 1 featuring the CEO of the American Cancer Society.
If you haven’t heard it, take a listen to the inspiring story of what is going on at the ACS,
and how Dr. Knudsen’s career path led her to this key leadership role in cancer. Enjoy!
(00:25):
[music changes]
Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute.
I'm your host Oliver Bogler. I work at the NCI, in the Center for Cancer Training.
On Inside Cancer Careers we explore all the different ways that people join the
fight against disease and hear their stories.
Today we are talking to Dr. Karen Knudsen, CEO of the American Cancer
(00:47):
Society about how curiosity and strategy combine to make progress against disease.
Listen to the end to hear Dr. Knudsen’s
recommendation and to have chance to take Your Turn.
It's an honor to welcome Dr. Karen Knudsen to the pod. Welcome.
KAREN KNUDSEN (01:03):
Thank you so much for having me,
Dr. Bogler. It is just an honor and a pleasure to be here.
OLIVER (01:07):
Dr. Knudsen is the Chief Executive Officer of the American Cancer Society and its advocacy
affiliate the ACS Cancer Action Network. She was the first woman to hold those positions. Before
ACS, she was on faculty, and held leadership positions at Sidney Kimmel Comprehensive Cancer
Center at Jefferson Health, including serving as the executive vice president of oncology services,
overseeing both care delivery and research. Her research was focused on precision medicine for
(01:32):
advanced prostate cancer with a focus on relapse, a significant problem in that disease. And I
should mention that Dr. Knudsen also serves on NCI's Board of Scientific Advisors. Dr. Knudsen,
I'm always interested in how people find their way to science as a career. What got you started?
KAREN (01:47):
Yeah, so I actually don't come from a family that's full of physicians
or scientists. It's just something that I wish I could understand even in myself.
I think I was just naturally curious about science, and followed that path,
and it's steered me in the right direction, that curiosity, I think, my whole career.
OLIVER (02:06):
Your primary interest was in biology. That's what you studied at George Washington
University. You moved into molecular biology. That seems natural. People of our generation
were drawn to that field. But then cancer, how did you get interested in cancer?
KAREN (02:19):
Yeah, it was a really interesting journey that I wish I could say was planned, but really
wasn't. So in fact, you know, as a child growing up, I had always thought I would go become a
physician, because I thought that if you enjoyed science, that that's what you should do. Again,
I didn't know any scientists, so I didn't know how to go about becoming a scientist, nor did it
honestly even enter my mind. So I went to George Washington. They have a wonderful biology program
(02:45):
where you can have a very rich ability to get to know your professors very quickly, you know,
starting your sophomore year. So I started interning in a lab, and in that laboratory,
they really recognized how much I loved science and nominated me to work at the National Cancer
Institute at Frederick for the summer. And so I interned with Dr. Garfinkel at NCI Frederick,
(03:09):
and it was at the time that the HIV epidemic was really in its peak, and really,
lack of understanding about retroviruses was profound. And so the Garfinkel lab study Ty1,
retrotransposition, and it was thought that this was a way for
us to understand how HIV worked. And so I was very excited, in retrospect,
(03:31):
to get involved in that because I could draw a clear line behind the science and helping someone,
which I think was my driver. So after those experiences, and I was using yeast
genetics as a model system, which was very exciting at the time, and still is for me --
OLIVER (03:48):
Yeah?
KAREN (03:49):
But it is the case that, you know, I decided to make a shift and that what I really
loved was science in the way that you can generate breakthroughs that can truly help more people than
you could seeing individuals come to your clinic every day. So this led to this going to UCSD and
getting my PhD with a focus in molecular biology. I loved yeast genetics, so yeast genetics was what
(04:10):
actually brought me to cancer. At the time that I was there was the time that all of the cell cycle
genes were being identified, and the way that that happened in part was that mutational analyses or
mutational strategies had been performed at in fission yeast, Schizosaccharomyces pombe,
and those new mutant lines, which were sensitive to radiation, distributed across the world in
(04:34):
different laboratories, and I was given one to work on, Schizosaccharomyces pombe rad1,
which was highly radiation sensitive. And so through complementation strategies,
I cloned rad1. It is now known to be what now we know is part of the 911 complex for DNA repair. It
got me really interested in cell cycle, really interested in checkpoints, and then of course,
(04:54):
you started to envision, well, what do you do with this information if your goal is to help someone?
And so that linked to cancer, uncontrolled cell growth and cell cycle, it started to
really resonate with me, and still right up until the moment that I stepped into my role as CEO of
the American Cancer Society have a very active funded lab where a core component of what we did
(05:15):
was always cell cycle, and I'm very proud of my trainees and what they were able to discern but
that's how I came to cancer was love of science, being in the right place at the right time,
and being able to track it to something that I wanted to do, and that's help people.
OLIVER (05:29):
Fascinating. I mean, it's interesting that you say, you know, when you were younger, you were
thinking of being a medical doctor, right? And then experiencing science gave you that other
perspective. That's a lot of what we're trying to achieve with this podcast is to help people see
all the different ways that you can participate in the cancer community. So was prostate cancer a
disease that you were particularly interested in? Was it just a good model or how did that happen?
KAREN (05:52):
Yeah, great question. So in my doctoral work, it was certainly all about cell cycle, and I
loved it, and I loved the intricacy and the logic of cell cycle and cell cycle gone awry in cancer,
but for my fellowship, I recognized within myself that I needed to make that next step,
the next step toward more of a direct line for helping someone, in other words,
(06:15):
translation. And so I thought about that, as I thought about what mentor I would go work for,
and so I, you know, I had the benefit of having all these wonderful labs around me in San Diego,
and the interview that really resonated with me was with Dr. Web Cavenee,
who was also I know your mentor, too. We had a little time to be in each other's labs --
OLIVER (06:36):
Indeed.
KAREN (06:36):
-- And boy, what a great, great decision I made. You know, when I sat down in his office, I
realized his mind was aligned with mine, which is the reason that we do this. The reason that we do
cancer research is we're aligned towards solving for a problem that is a real life human problem,
and I loved that. And so when I decided to join Web's lab, that was probably one of the most
(07:00):
pivotal decisions I made in my scientific career, and I thought I would be joining his brain tumor
group or his rhabdomyosarcoma group. Of course, I knew him from the cell cycle world as being
the person who had identified tumor suppressors through studying retinoblastomas and I was very
interested in the RB1 gene. And much to my surprise, after I had already agreed to come,
(07:22):
he sat me down in his office and said, "Here's the thing, Karen. All of this work is happening right
now in the world in breast cancer." And it was at the time that women had really started to demand
more, more clinical trials, more research being done in breast cancer. He said we're
going to make gains over there, we, the oncology community. He said but the counterfoil to that is
prostate. And you know, the population is aging. Prostate cancer is going to become even more,
(07:45):
frequently diagnosed, which was already the number one diagnosed cancer of men in the country, not,
you know, like number one malignancy. And he said, we've got to do something about it,
because we actually don't understand advanced disease. And I thought, well, what do I know about
prostate cancer? But the more I started to look into it from the clinical point of view,
from the point of view of what is the clinical problem that needs to get solved,
(08:08):
it was a lack of understanding of how it is that hormone action drives uncontrolled cell growth in
the prostate. Now this starts to resonate with me. It's like, okay, nobody understands -- everybody
understands prostate cancer needs testosterone, but nobody knows how to make that link between
what testostero ne does, and how cells get the go grow signal. Understanding that the
(08:29):
androgen receptor is present in, you know, many tissues, almost every tissue in the body,
what's unique about the prostate, that it gets a go grow signal from testosterone. I thought,
oh, okay, I'm probably uniquely positioned to figure that out. And so then pulling together
all these wonderful nuclear receptor people that were all around me at the time, you know,
(08:50):
I had to of course understand androgen receptor and nuclear receptor signaling
in order to link that to cell cycle, and so I was able through partnerships and learning
with the community around me, able to put together what I think was a pretty
unique research program that led to new nodes of opportunity, new understanding of hormone action,
but also new nodes of opportunity for treatment in prostate cancer. And then all these years later,
(09:14):
you know, co-writing clinical trials using CDK4/6 inhibitors in combination with hormone therapy.
Bingo. I mean, it was really -- it just felt like it kind of all came home when that started
to happen. It was -- I was in the right place at the right time, but going to Dr. Cavenee's
lab was the most important choice I made to get to the path where I am right now.
OLIVER (09:34):
And I think you highlight a very interesting and important point,
which is being able to identify the right question at the right time in
the right environment is so critical to finding work that can make impact.
KAREN (09:46):
Yeah, and I mean, and I think that's -- I'm very proud of my trainees,
and it's the thing that we talked about a lot in the lab all the time. You know, every year,
we would set aside some time to say all right, here's our body of work. Here's our body of work
in the context of the whole environment around us, and there were no sacred cows. And, you know,
we'd say like, what are we uniquely positioned to answer that we can do faster and more thoroughly
(10:10):
than another lab? Like, why would we want to go into this particular area? And I think that kind
of rigor in thinking actually allowed us to shape and change beyond just cell cycle and to add new
types of thinking in the lab about the importance of understanding hormonal control of DNA repair,
and then ultimately being able to contribute to PARP inhibitors as, you know, breakthrough
(10:32):
approvals for prostate cancer because of that work was really meaningful. And it's because we
had such a good tie to the clinic. So, you know, we were constantly thinking about what are the
clinical problems that we're trying to solve? What are we good at, at modeling? What is better for
somebody else to do because it's just not our sweet spot? And then what resources, meaning
people and infrastructure, do I need if I'm going to attack this particular scientific problem?
OLIVER (10:56):
Interesting perspective. Often the kind of research that you did, that I did, is called
curiosity-driven research, but I'm hearing from you that it's curiosity plus strategy.
KAREN (11:05):
Yeah, I think that's right. I think that ultimately, is how I lead the lab. I think that
now when I watch my previous trainees that are, you know, now professors and in pharma,
I think it's how their mind works, too. And it was really not me saying, here's the strategy.
What I loved about it, what I really, really loved about it was being able to sit with my team every
(11:29):
year - we do a retreat, right - and sit and think with them about what is the right thing for us,
and hearing their view, their points of view. You know, when you get to that go/no-go part
on a experiment, a go/no-go part on a project, it's nice to have the divergence of thought,
so that you can ultimately come as the head of the lab to make,
(11:52):
hopefully the right decision, not that I always make the right ones.
OLIVER (11:56):
Who does, right? So around 10 years or so ago, you started taking on some leadership
roles in the Sidney Kimmel Cancer Center. You've already kind of told us how strategic
your approach was to your science, so I can imagine that was a natural step,
but what motivated you to take on those kinds of responsibilities?
KAREN (12:14):
Yeah, so when I left my fellowship, my first faculty appointment was in Cincinnati at the
University of Cincinnati School of Medicine, and I was again, right place, right time. You know,
all these brilliant minds had been hired in Cincinnati, right out of their fellowship.
Everybody was, you know, very excited about having this groundswell of knowledge of cancer,
but I also recognized that I needed to stay very current, again, with what was happening in the
(12:38):
clinic, so I was very lucky to have a urologist, Bruce Bracken, and a radiation oncologist who
kind of took me under their wing and we started to work together in partnership, and we formed
this what we called the prostate cancer working group, and that way, I could explain to him the
kinds of things we were doing. They were telling me the problems that they had in the clinic,
(12:59):
and we set about trying to solve those together. A missing component was medical oncology,
and ultimately, that's why I started thinking about going elsewhere, because at the time,
it just was not a missing component, and when you study advanced disease, it's very hard
not to have a robust GU oncology program right there. I think they have one now,
but at the time, it was just kind of missing, so okay. So I was amenable to recruitment,
(13:22):
and when Jefferson came calling in Philadelphia, they said we want you to start the process -- we
want you to take -- we have all the stuff. We have all the pieces. We have urology, rad onc,
med onc. We have a risk clinic, and we have this massive, diverse patient base, and we've got
scientists, but we don't have anybody to anchor them all together. Okay, so now you're speaking
my language. So they wanted me to come and start the prostate cancer program. So I did that,
(13:47):
and I find a lot of personal satisfaction in building teams. I've learned that about myself
through the years. And so I put that together for Jefferson. We started a program that became part
of our official programs at the NCI through our NCI-designated cancer center, but we also expanded
it to the entirety of Philadelphia. So we started a prostate cancer working group that included
(14:09):
every prostate cancer researcher or clinician who wanted to that we could find from Temple,
from Penn, from Wistar, and we met once a month, and we put together -- we did work, and which was
great, and so I loved that. And so then when you start to be that person, people started to ask
you to do other things that require team assembly, so probably not known by the external world very
(14:33):
much, but I actually served as the first Vice Provost at Jefferson. So my whole goal there was
to -- I was charged by the Provost to put together the clinical and the basic research teams. And at
that time then, it was also the Deputy Director of the Cancer Center. So ultimately, you know,
the institution made a change, asked me to take on the cancer center right on the precipice of
(14:54):
this massive expansion that I actually didn't know was going to be planned. Nor did I think anybody
really in the know except our new CEO, so we were a three-hospital system in Center City, Philly. We
had great science. The prostate cancer group was ticking and humming. It was really phenomenal,
and then we had this incredible opportunity to expand because we went from three hospitals
(15:18):
wholly owned and operated with a big prostate cancer base to ultimately, by the time I left,
16 hospitals wholly owned and operated. Now it's 18 across two states. And so I had the opportunity
to think about how we take all the awesome research that we do, and put that into practice
by putting clinical trials out into the community and setting up four different advanced care hubs
(15:40):
with clinical trials so that we actually had an opportunity to get breakthroughs, to get
the research that was happening in Jefferson and beyond out to people, and I loved that.
OLIVER (15:50):
Phenomenal. I mean it sounds like yet another opportunity to make more of an
impact and an exciting time also to be there. You obtained an MBA. I don't know if that was
coincident with this or what the timing there was, but what was the reason for that?
KAREN (16:02):
So in at Jefferson Health, we were ultimately a 33,000-employee $11-billion company,
and I reported to the CEO. And he's a brilliant guy, Steve Klasko. He's absolutely brilliant. And,
you know, I, I learned a lot from my C-suite colleagues, but what I saw (one person's opinion)
(16:24):
is that as we went and expanded and assumed these community hospital systems that did cancer care,
but had not a lot of expertise in clinical trials, and sometimes they were employed,
and sometimes they were not employed, sometimes they were happy that Jefferson had come over,
and sometimes they were deeply skeptical about what was going to happen, I realized that we were
(16:44):
going through this rapid merger and acquisition and doing it, I'm going to call it in an academic
medicine kind of way. And I thought to myself, that there must be a better way, and I'm not
going to learn it listening to the echo chamber in academic medicine, and so I'm going to go get my
MBA. So I sat with my CEO, and I said this is what I'm going to do. And what he said to me,
which I think was brilliant, is he said, "Look, go get your MBA. You go do that thing." He said,
(17:09):
"But don't -- do not focus on healthcare. In fact, get away from the healthcare people,
because if you really want to break some things and make change, you've got to hear from people
with external points of view." And it was great advice. So I learned about M&A from people who
were bankers and in finance. And, you know, it's an executive MBA program, so you're working with
people who are already in a C-suite, or just below the C-suite and want to be, but you learn
(17:33):
a lot from each other. I learned so much that I didn't expect to learn about people strategy
and managing, you know, human capital, which you don't ever learn about in science, and so that was
really valuable to me, but I also realized what an advantage you have as a scientist, because you
are -- you don't realize it, but you are trained with a business mindset, right, because when
(17:56):
you're running a lab, you're running a business. You have to think about strategic priorities and
finances and human and managing people, but you also have a real comfort with hypotheses and a
real comfort with being wrong, and a real comfort with using data to guide your decision, which like
It shocked me that some people in the business world just like they actually don't know how
(18:19):
to statistically analyze data, and they don't lean on it like I do. So if there's one thing I brought
to the American Cancer Society is that we are a data-driven organization. If you want me to run
in Direction A, you better tell me why B is wrong, and A is the right way to go, and I'm going to ask
you for every piece of data to understand that. And so it's like it's very freeing. I actually
(18:39):
think that scientists are uniquely positioned to be business people, (one person's opinion).
OLIVER (18:44):
That's, that's really interesting,
that combination of thought processes. We're going to take a quick break. When we come back,
we'll talk to Dr. Knudsen about her work at the American Cancer Society.
[music]
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[music ends]
All right, and we're back. Dr. Knudsen, your move to the American Cancer Society,
from academia to the nonprofit world, represents another career pivot. Same
question, what motivated you to take this leap?
KAREN (20:27):
Yeah, if you would have ever asked me if I would do what I'm doing right now sitting here in
Center City, Philadelphia, I would say absolutely not. I loved my job. I was the EVP of Oncology
Services. I found great satisfaction in taking the clinical teams and delivering the best possible
cancer care in every corner that we covered, and also getting the science there, right, and
(20:51):
ensuring that our science is addressing the needs of our catchment area and leaving nobody behind,
and developing cancer screening strategies to bring out to the community instead of asking them
to come to Jefferson, again, using data-driven research solutions. So I loved all of that,
and then I got this call to look at the CEO position at the American Cancer Society, and
(21:14):
like you and like other cancer leaders, you get these calls kind of regularly, right? But I was
very thankful to ACS because I was an ACS grant holder, right? When I needed research as a cancer
center director, I had an IRG grant that gave me pilot funds to spawn what were really amazing new
ideas from my faculty. So okay, I was appreciative of that. I was also the president of the AACI,
(21:40):
the Association of American Cancer Institutes, which is largely an advocacy organization,
and that's where the 106 cancer centers in the US hang together every year, link arms and push for
common sense policies to help cancer patients. And the ACS had been our partner there too, so I
really respected that part of it, but the thing that really got me about ACS was the fact that
(22:02):
a lot of our cancer patients were in Center City and came to our safety net hospital in Jefferson.
And so the difference in outcome between someone who can come to chemotherapy five days a week,
versus someone who can only come three days a week because they don't have transportation,
is huge. So this what I call basic blocking and tackling of cancer care, housing, transportation,
(22:27):
digital literacy, information about cancer, education of the caregiver, all of that stuff,
which I now call Patient Support at ACS, was how we got our patients to care. And so I was very
thankful to ACS, because of all these things, but especially patient support. So I got a
call from ACS, and they asked me to take on this job, and they told me something I didn't know,
(22:49):
even though I'd known about ACS my whole career. What I didn't know is that this 100-plus-year-old
organization was actually not at all 100 years-plus. It was brand new, because ACS
had been a federated model. It had been multiple separate organizations with many CEOs and multiple
strategies and multiple different areas of emphasis across the country, which explained
(23:14):
a lot to me. It explained why I was touching and feeling something at ACS in Philadelphia
that's very different than someone might touch in DC, or in Los Angeles or in a rural community,
because they were truly separate organizations. So what they explained to me is that they had
gone through a business transformation, which I considered to be a good word, and they put
together these multiple into one, one ACS, and it was legal, it was financial, as one unit,
(23:43):
but it was not yet strategic. So now you're speaking my language, right, because now I have
an opportunity to take previous teams, meaning the federated models, and put them together in the
name of cancer for the greater good, and so I had this series of meetings with the board, because I
had no reason to leave Jefferson. I loved what I did. And if I was going to do it, I was not
(24:04):
going to be the keep-the-trains-running CEO, I was going to say we're going to have to have a greater
impact than we have right now and define that with data and metrics, and really, act where we are
uniquely positioned to act and not someone else. So I had a series of meetings with the board -
OLIVER (24:20):
Of course.
KAREN (24:20):
-- I gave them tough talk. Here's what's wonderful. We got to do more of this. And here's
some stuff that I don't know it belongs to ACS, and some of that was with research,
and some of it was with advocacy, and some of it was with patient support. I had thoughts about
how to structure this to make it more impactful across the country in everything that we do. And
I didn't realize that that's what they were looking for, but I think they were looking
(24:42):
for someone to come in and really be a change agent, and for a positive. It's always been
an amazing organization, always, but clearly ready for logarithmic growth in other ways,
and so I feel very humbled and honored and absolutely delighted to lead this organization.
We have so much more to do, and we do a huge amount of what we do in partnership, including,
(25:07):
the NCI even advocating for NCI funds. It's one of the things I can do as a CEO that you,
you know, can't do from within the NCI, but we can and we know how important that is. So
every day is a good day because I know we're doing good in the world, and I love that. <<
OLIVER (25:22):
And we're deeply grateful for that advocacy. Obviously, it's critical. So I mean,
you broke quite a few barriers in taking on this role. As I mentioned already,
you were the first woman to be the CEO. You're also the first CEO to come from cancer science
and to have been a leader of a cancer center, so the transformation, you've implemented pillars,
advocacy, patients support, discovery and development. How's that transformation going?
KAREN (25:45):
It's going really well and I credit my executive team. So one of the one of the things
that I wanted to dismantle was the idea that ACS is a location, right? We work in 5,000 communities
across the country, so I had no ambition to relocate everyone to Philadelphia or to Atlanta
or to any main location. So I really hired the best and brightest to lead these pillars,
(26:07):
but before I talk about them, because I want to mention those guys for a minute, the foundation
of everything that we do, right, rests on health equity, and cancer care equity in particular. And
so it was surprising to me that we had not yet put in a chief diversity officer. So my first -- one
of my first moves was to put in place our chief diversity officer, Tawana Thomas Johnson, who is
(26:28):
a rock star of my world, and when I talked about strategic choices, things that we are
uniquely poised to act on that maybe, you know, setting aside things that we shouldn't act on,
if it doesn't align to our commitment to health equity or to cancer care equity,
that's a somebody-else thing. Everything really has to stand true to that. So she's got a big
role. You know, she shapes everything we do, all pillars. And so our vision of what it is
(26:54):
that success looks like is ending cancer as we know it for everyone. I always call this
the eight words that define us, but those two words are more powerful than the rest, right?
OLIVER (27:02):
Yeah.
KAREN (27:02):
So and because there are things that we can uniquely do in that space that are harder to
do for a government program, but we can. And so putting that person in place was just, I think,
I'm very blessed to find her already within ACS, and so she knew it, she knows it and,
you know, she does magical things like goes out and ensures that 1,500 health equity ambassadors
(27:23):
are trained to go out and work in communities for prevention and screening that are, you know,
movers and shakers in their communities, and it makes a difference. And then we
measure ourselves by how well we do. So all of our organizational goals hang on things like impact,
like lives touched through prevention screening, not just did we do a screening activity,
but did we enhance screening as a result, right? So these are the kinds of things that we put into
(27:47):
play as an executive team that are really what we can do as ACS. So then standing on that foundation
of health equity are the pillar, so, you know, research is, of course, incredibly important.
Our research team in Atlanta continues to just, you know, set the single book of truth for the
nation on cancer incidence and mortality and trends, but then we also have the extramural
(28:07):
program. So what are the kinds of things that ACS should be funding that is complementary,
but non-redundant with the NCI or other funding agencies? So we went on the listening tour of the
cancer centers. I polled my peer group, my brother and sister cancer center directors,
asked them what they prioritize, and we've started to shape our research priorities accordingly. Now,
(28:28):
in order to have somebody lead that, I needed just the right Chief Science Officer, so this is where
I have to apologize to you because I stole him from the NCI, and that's Bill Dahut. Dr. Dahut is
amazing, another rockstar in my world, and just absolutely revolutionizing our ability to have
impact through discovery. He is terrific. I know you guys already know that. So he is wonderful,
(28:52):
but as much as these breakthroughs happen, access to those breakthroughs, we know is only happening
for a percentage of people in this country, and that's where advocacy comes into play, so this is
a 501(c)(4), so that's -- you know, in business jargon, what does that mean? It means that you
can and do lobby, and a lot of the battles that are fought in the name of health equity happen at
(29:12):
the state level. A perfect example is biomarkers. You know, we've just gone state by state to ensure
that all these wonderful oncology agents that require biomarkers to match a patient to therapy
are covered in the state plans, because guess what team? They weren't. And so Illinois was the
first one that, you know, with our push, passed this into law, and then other states followed,
(29:34):
Arizona, Rhode Island, Louisiana. But all of those advocacy wins came because we have the data from
research and experience with our patients, right, the last pillar, patient support. So
that's all of the places that cancer patients fall through the cracks. That's the transportation,
the lodging, the patient navigation, the patient education, prevention and screening programs.
(29:58):
And so finding just the right person to lead that was challenging because this is a new construct,
not new activities, but new in terms of thinking about who is going to be the strategic head of
that who thinks about, from a data-driven way, what patients need now and what they're going to
need five years from now? So I had the bliss and honor of leading that at the beginning,
(30:18):
and so we hired Dr. Arif Kamal out of Duke, a medical oncologist who leads patient support.
And I should also mention that advocacy required no new hire. I mean, Lisa Lacasse, who's the
president of ACS CAN is absolutely first rate, and to watch her masterfully acquire e verything she
needs to know from patient support and research in order to have advocacy push forward in ways
(30:45):
that truly improve lives, like millions of lives with one signature, she's phenomenal.
OLIVER (30:51):
I mean, I could talk to you for hours about your strategy,
but we don't have the time today, but I do refer our listeners to the
in-depth interviews you've given to the Cancer Letter and elsewhere where you take
a much deeper dive into the into this incredibly interesting strategy. I do want to take a slight
pivot and ask you about career advice. You've -- your career has obviously been phenomenally
varied and interesting, and has presented you with many different challenges. Our listeners,
(31:14):
people who are listening and thinking, "Wow, that's very interesting," what advice
would you give to people listening if they're interested in the kind of work that you've done?
KAREN (31:21):
Yeah, I mean, I'm very willing to, you know, talk to people if they
have any questions about things that they think particularly that I did or didn't
do. Always is important to understand. But the advice that I generally have given to my team,
my lab, and my trainees and faculty was always be willing to take the call,
(31:43):
you know? Understand what drives you and what you're -- where you really excel,
but also really want to continue to grow, and when someone calls you and says, I want you to
think about a thing, don't just discount it. Take the call, because only two things will happen,
one of two things will happen. One, you'll either feel great about what you do, right? Like, "God
no, I want to stay in what I'm doing right now, because I absolutely love it," and this -- like,
(32:07):
this is it. This is my buoyancy point. This is what I want to do. Or you'll think, "You know,
I never thought of that before." And maybe you'll see yourself in that role. Maybe you won't. But
it's the case, it may get your mind thinking to how close to your ultimate goal is it? And so I
think just taking the call and being willing to explore is a really important thing to do.
OLIVER (32:30):
Well, thank you so much for sharing all these insights,
and we wish you of course continued good luck at the American Cancer Society, and excited to see
what you accomplish there. We're going to take a quick pivot and go to a segment that we call Your
Turn because it's a chance for our listeners to send in a recommendation that they would like to
share. If you're listening, then you're invited to take your turn. Send us a tip for a book,
(32:50):
a video, a podcast or a talk that you found inspirational or amusing or interesting. You
can send those to us at nciicc@nih.gov. Record a voice memo and send it along. We might just play
it in an upcoming episode, but I would like to invite our guest Dr. Knudsen to take her turn.
KAREN (33:06):
Oh, boy, this is really hard. Of have all the things I could say off the top of my mind,
here's -- since we did talk about career and career advice, I also think a corollary
to that is motivating people. And so one of the things that I really enjoy,
and I used it with my faculty at Jefferson, I used it with my trainees, and I've used
it here at ACS, is it's a little bit dated in terms of the actual content, but the examples,
(33:30):
but the messaging is absolutely on point. It's Simon Sinek on ‘why’, on teaching people why
it is that you do what you do, that people are attracted to the why you do what you do, not the
what you do. And he has this incredible podcast of TED Talks that tells you -- gives you some insight
about why the Wright Brothers, despite the fact that they had very little funding and no training,
(33:53):
were successful in flight versus someone who was actually very well resourced from the government
and had all the right technical training and the background. It talks about why it is that
Apple was so successful as a company in coming up with different types of strategies. It also talks
about Martin Luther King, and how it is that he stood out amongst all the very important
people and orators and those who were trying to motivate others in the civil rights movement.
(34:19):
And his philosophy on how it is that Martin Luther King was so successful in his messaging,
I think is applicable to everyone, irrespective of what it is that you do, but I think especially
when you're trying to describe your role in solving for cancer and ending cancer as we know
it for everyone. I really think it's insightful, and so something I would highly recommend.
OLIVER (34:39):
Well, thank you, and I'd like to make a recommendation as well. Like many, I've become
intrigued by the advent of large language models in AI and the possibilities they open
today and the promises they make for tomorrow. Of course, there's also risks as with any new
technology. One of the most important guides to this world for me is The New York Times podcast,
Hard Fork. It's hosted by two very knowledgeable tech journalists who keep it light and real,
(35:02):
and they really know their stuff. You can find it wherever you listen, and we'll put
links in the show notes for this podcast, and the series of TED Talks that Dr. Knudsen recommended.
That’s all we have time for on today’s episode of Inside Cancer
Careers! Thank you for joining us and thank you to our guests.
We want to hear from you – your stories, your ideas and your feedback are always
(35:24):
welcome. And you are invited to take your turn to make a recommendation
we can share with our listeners. You can reach us at NCIICC@nih.gov.
Inside Cancer Careers is a collaboration between NCI’s Office of Communications and
Public Liaison and the Center for Cancer Training.
It is produced by Angela Jones and Astrid Masfar. A special
(35:46):
thanks to Lakshmi Grama and Sabrina Islam-Rahman.
Join us every first and third Thursday of the month when new episodes can be found wherever you
listen – subscribe so you won’t miss an episode. I'm your host Oliver Bogler from the National
Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.
If you have questions about cancer or comments about this podcast, email us at NCIinfo@nih.gov
(36:12):
or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.
We are a production of the U.S. Department of Health and Human Services,
National Institutes of Health, National Cancer Institute. Thanks for listening.
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