Season 2, Episode 13: Making an Impact Through Collaboration and Community Engagement

Listen and Subscribe to Inside Cancer Careers

• Apple Podcasts
• Spotify Podcasts

Episode Guests

Raymond N. DuBois, M.D., Ph.D.

Dr. DuBois is the director of MUSC Hollings Cancer Center and the associate provost of cancer programs at MUSC. As a physician-scientist, DuBois is passionate about cancer research and patient-centered care. He drives the strategy to strengthen and grow Hollings’ impact on cancer care in South Carolina.

An international leader in the cancer community, DuBois has more than 30 years of research experience and over 20 years of concurrent leadership experience, including senior roles at MD Anderson Cancer Center and Vanderbilt-Ingram Cancer Center. He was elected to the National Academy of Medicine in 2019, which places him in the company of an elite group of internationally renowned scientists and doctors.

 

Marvella E. Ford, Ph.D.

Dr. Ford is a tenured professor in the Department of Public Health Sciences at the Medical University of South Carolina (MUSC), where she is the Associate Director of Population Sciences and Community Outreach and Engagement at the NCI-designated Hollings Cancer Center, where Dr. Raymond DuBois is Director. She completed her undergraduate training at Cornell University and she completed her graduate and postdoctoral fellowship training at the University of Michigan.

Dr. Ford leads several federally funded cancer disparities-focused research grants, including an NCI Partnerships to Advance Cancer Health Equity (PACHE) U54 grant titled “South Carolina Center to Reduce Cancer Health Disparities (SC CADRE)” with Dr. Judith Salley from South Carolina State University, a historically Black university. Dr. Ford is also a multiple principal investigator (MPI), with Drs. David Marshall and Craig Lockhart, of an NCI-funded Minority and Medically Underserved Community Oncology Research Program grant. She is an MPI of the MUSC Hollings Cancer Center’s first Stand Up To Cancer grant, with Dr. Robert Winn, Director of the Virginia Commonwealth University Massey Cancer Center. She previously co-led an NIMHD-funded R01 grant with Dr. Nestor Esnaola to test the effectiveness of a multi-level patient navigation intervention in increasing receipt of lung cancer surgery in Black people diagnosed with early-stage lung cancer. 

Dr. Ford is the author/co-author of more than 115 peer-reviewed scientific papers. She co-edited the 2017 and 2020 Advances in Cancer Research volumes titled “Cancer Disparities” and “Cancer Health Equity,” respectively, and has published nine book chapters. 
 

Show Notes

Ray DuBois, M.D., Ph.D. 
Marvella Ford, Ph.D. 
MUSC Hollings Cancer Center 
CDC’s Best Chance Network partners with South Carolina 
Hollings HPV Vaccination Van 
South Carolina Cancer Health Equity Research Training Youth Enjoy Science Program (SC CHEER YES) 
South Carolina Cancer Disparities Research Center (SC CADRE) 
Mark Foundation for Cancer Research 
Emerging Leader Award 
Endeavor Award for Team Science 

Ad: NanCI – Connecting Scientists mobile application 

Your Turn Recommendations: 

Mobituaries (podcast) 
Pivot (podcast) 

Transcript

Oliver Bogler:
Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute where we explore all the different ways people fight cancer and hear their stories. I'm your host, Oliver Bogler from NCI's Center for Cancer Training. 
Today, we're talking to two leaders of the Hollings Cancer Center at the Medical University of South Carolina with a focus on their community outreach and engagement work. This work is an important element in the National Cancer Plan overseen by the President's Cancer Panel, the subject of our last episode.
Today we will learn in more detail how that works in one of the NCI Designated Cancer Centers. Listen through to the end of the show to hear our guests make some interesting recommendations and where we invite you to take your turn. 
So it's a pleasure to welcome Dr. Ray DuBois, the Director of the MUSC Hollings Cancer Center, Associate Provost for Cancer Programs at MUSC, and also Executive Chair of the Mark Foundation for Cancer Research. Welcome.

Ray DuBois:
Thank you. Thanks, Oliver.

Oliver Bogler: 
I want to mention that Dr. DuBois is one of my mentors. We worked together at MD Anderson from 2010 to 2012, including on global collaboration projects and academic affairs. 
It's also a pleasure to welcome Dr. Marvella Ford, professor in the Department of Public Health Sciences at MUSC and associate director of the Hollings Cancer Center for Population Sciences and Community Outreach and Engagement. Welcome.

Marvella Ford:
Thank you.

Oliver Bogler:
So in our last episode, we learned that the President's Cancer Panel, which leads the National Cancer Plan, is focused on dynamic and sustainable community engagement as an essential component to achieve equitable cancer care and control. The panel has pointed to the NCI-Designated Cancer Centers as key partners in that work. As director of one of those centers, what's your perspective, Dr. DuBois?

Ray DuBois:
Well, we take this very seriously and we are in a state that, you know, has a lot of needs and highly rural areas with a lot of impoverished individuals. So it's very important. We're the only NCI Designated Cancer Center in the state of South Carolina. And we have reached out to develop programs and other initiatives that go across the entire 46 counties in South Carolina. 
We do a lot of cancer education, we do screening. You'll hear from Marvella, she set up programs where individuals, once they do get screened and have an issue, they can get put into the health system appropriately to get worked up. And so we don't leave people at the altar with a lump or bump. We want to make sure that the outcome is really good for all of our citizens of the state.
We've reached out to our historically Black colleges to help with training and education and get more of those individuals in the pipeline. And we are working with our state legislators and have been able to get more resources from the state to help with this effort. Most recently, we're working on a statewide prostate cancer screening initiative, and Marvella has been heavily involved in that. It still hasn't come totally to fruition, but it's a constant conversation. 
So this is really a crucial part of our mission at the Hollings Cancer Center. It was one of the visions that Senator Hollings had when he created this cancer center because he knew there were underserved populations and that having a central place that was working on reaching out and having, you know, impact in several different ways with cancer would really result in us achieving his vision.

Oliver Bogler: 
Dr. Ford, community outreach and engagement fall into your associate director portfolio at Hollings. What are your thoughts?

Marvella Ford: 
As Dr. DuBois said, I mean, our state has some really glaring disparities. So 27% of our state population is made up of Black people and our median household income is $10,000 less than in the US as a whole. We have a higher percentage of our state population that lives below the poverty level. So, you know, the challenges that we face are not totally unlike those of a developing nation in our very rural and underserved areas. 
And so we understand as the only National Cancer Institute Designated Cancer Center in the state of South Carolina, our catchment area, is the entire state. And we're really responsible for taking the message of cancer screening, prevention, early detection and treatment across the state, as well as survivorship. 
And so when we understand that the cancer, mortality rates and cancer incidence rates are really driven by a lot of these underlying disparities. We know that those are the focal areas that we need to target because if we want to improve outcomes for all people in the state, we have to address the disparities.

Oliver Bogler: 
So the outreach work that you lead, Dr. Ford, how does that look in practice? Do you yourself travel across the state? Do you invite people to come to Charleston?

Marvella Ford:
Yes, that's such a great question. I think our model is somewhat unique. So community engagement is really a lot about partnership building and about relationship building. It's about identifying key community groups, whether they're religious organizations or fraternal organizations, sororities, community centers, and really building long standing and long-term partnerships with those organizations and with those individuals. And it's individual by individual and organization by organization. 
And over time, we have built a tremendous network of partners in every single county of our state. And building a partnership means that these communities are trusting us to bring the Hollings Cancer Center programs to their community members. And for all of the activities that we do, we don't recruit to any of them. We rely on our trusted community partners, our ambassadors, our representatives, our community leaders who actually do the recruitment to these programs that we have in communities across the state. 
And we go in with humility. We go into the communities, we thank them for opening their doors and allowing us to come in. And every time we go, we build new partners who are at the events and at the programs that we're holding who want us to come back to their groups in those communities and the groups that they're a part of, other groups. 
So, it kind of has a snowball effect where we build these trusted relationships and partnerships. And that also means that having a partnership means that if someone in a community that's three hours away, is having a large event with multiple church groups and they need a speaker on, let's say, breast cancer screening, we have to show up because having a partnership means that they show up when we have programs and we show up when they have programs. 
So yes, absolutely, my team and I travel all across the state. One example is on August 3rd, we were invited to give a cancer screening presentation to a group that's having a family reunion. The family reunion is on an island that is only accessible by boat. So this is going to be, we've done family reunions before, but this is going to be truly an adventure. So, but that's a new partnership for us.

Oliver Bogler: 
That sounds like true outreach, adventurous outreach. I hope the weather is good that day. So you've mentioned screening in what you were telling us. Clearly, that's one area of emphasis. You're trying to encourage communities, particularly in the more remote and rural areas, to participate fully in cancer screening. What are other elements?

Marvella Ford: 
We have a number of programs that are ongoing. Some of them are newer than others, but one of our longstanding programs is our large mobile health unit for breast and cervical cancer screening. And we partner with the CDC's Best Chance Network. So we receive funding from the CDC through our state health department to provide breast and cervical cancer screening to uninsured and other women.

And as Dr. DuBois said, we take responsibility for the people we screen. So from the minute a woman steps foot on our mobile unit for breast and cervical cancer screening, she becomes our patient. And we take responsibility for her from that time through the screening process. If diagnostic workup is needed, we're with her through the navigation process. If treatment is needed, we navigate the women through the treatment process. And so we don't just screen like a million people who are underserved and then tell them, you know, you had an abnormal result. You really need to do something about that. You know, that's not really, that's just creating more stress and anxiety in people who already have so many factors in their lives to deal with. They may have food insecurity, housing insecurity. So the women we screen become our patients, they are our patients. 
We also have a fairly new human papillomavirus mobile vaccination program and we're really excited about this. We're one of the first in the country to initiate such a program and we presented our model last year at the annual mobile health clinics conference in Pennsylvania last year, and our presentation actually won second place. But we also published a paper last year in the Journal of Clinical Medicine describing the first-year results of our screening program. And what's exciting about that is we're continuing to build on our model of building relationships with community partners. 
And so we're working primarily with school districts across the state, working with school nurses in those districts to take the mobile HPV vaccination program to the schools. And many of the children that we're screening, that we're vaccinating, we are also providing other childhood immunizations as well. So, other vaccinations. So, a lot of the kids would have soon received letters telling them, they could not return to school because they didn't have their childhood immunizations, but because we're able to go, we're not only able to bundle the HPV vaccine with these other childhood immunizations, we're helping to fulfill the school district's mission of keeping those kids enrolled in the schools.

Oliver Bogler:
Dr. DuBois, there's a lot going on at Hollings, right? In addition to what we've already talked about, you have over 130 cancer scientists in 20 different departments. You have over $44 million in research. And you also offer over 200 clinical trials. How does all that academic and clinical research work integrate with your role in the state?

Ray DuBois:
Well, that's a really good question. What our health system has been doing, Oliver, is that they have acquired or partnered with about 14 different community hospitals across the state. And they're strategically located in some of these areas that Marvella is talking about that really do need more attention. 
So there's, for example, one of our regional hospitals is in Florence, which is in a certain region of the state, another one is in Columbia, and then so and so and so and so. So what we've done is we have reached out to those places and we've started doing clinical research. A lot of the research initially has been focused on, you know, non-treatment trials, so they're intervention or non-intervention trials. We've got some screening research where we're looking at traditional screening for lung cancer and then also doing liquid biopsies in those patients to see if there might be some markers that give more information about who should get more attention if there is a nodule or something that's found on the CT scan. 
And so we have literally accrued hundreds of these patients to those trials. And now we're at a point where we're setting up research pharmacies, research staff from the clinical trials office to have regional treatment trials underway in these regions as well, because those individuals, like Marvella said, they don't even have transportation. They don't have means to be able to get down to Charleston to participate in a trial. So we need to have these regional sites functioning so that we can offer these trials to everybody in the state in a way that they can utilize them based on their needs and their economic situation and other things.
So this is another one of our objectives and we also have an NCORP grant, one of the minority NCORP grants, one of the 13 or 14 in the country. Those have really helped bring additional trials into some of these areas and we've expanded those sites as well to accommodate the minority populations.

Oliver Bogler:
And for the research side, I mean, we are in competition in 2024 for talent, right, with Silicon Valley and, you know, other sectors that are very attractive to young people. And of course we want them to come into cancer research. What does Hollings do in the, in its geographic area to try and bring those people in to our world?

Ray DuBois:
Yes, we have obviously the training and education program that's part of the NCI CCSG grant. And working along with Marvella, we've created programs for high school students that come spend the summer here and do research project. One of our students, Victoria Jordan, was a White House scholar, and she's gone on to do great things after, you know, sort of this initial phase of getting involved in the cancer field.
We just recently met with the president of the College of Charleston here and we are setting up an undergraduate program where they can actually take some courses here, spend some time either in a clinical situation or in the research lab. And we have had some of those students matriculate through our system and they've done quite well. We just want to offer it to, there's over 20,000 students there and get those young individuals involved more in the cancer field. 
We're collaborating with Clemson University on some artificial intelligence projects and getting some of their computer science folks and others involved more in cancer bioinformatics and other areas. As I said earlier, Marvella's got great projects underway with the historically black colleges and universities in the state.
As I said earlier, Marvella has great projects in the brain with historically black colleges and universities in the state so that we can open our doors to that segment of the population as well.

Oliver Bogler: 
Dr. Ford, would you like to add anything to it?

Marvella Ford: 
Absolutely. So Dr. DuBois mentioned Victoria Jordan, who is a student at South Carolina State University. She worked with us for two summers, working with Dr. Mike Ostrowski at the Hollings Cancer Center and did fabulous research. And she, with letters of recommendation from our scientist, received a Barry Goldwater Award. Those are very prestigious awards, and that allowed her to to spend this coming summer working as a health policy intern with Congressman Clyburn in Washington, D.C. So those are the kinds of connections that we're able to make. 
We've had other students who came out of South Carolina State University, which is an HBCU, who completed our MPH program or our pharmacy program. Several of them are in medical school coming out of that program. So we've been tracking the outcomes of our summer undergraduate cancer research training program and our high school training program. And since 2007, 81% of the undergraduate students, these are underrepresented students who have received training through our program at the Hollings Cancer Center, have gone on to enroll in graduate or professional schools in STEM fields. And 88% of the high school students have gone on to enroll in four-year colleges or universities in STEM fields. And that is really significant for these high school students in particular because the graduation rates of the schools that they're coming from are fairly low. So the fact that they've graduated and enrolled in four year schools with STEM majors is really fantastic. 

Oliver Bogler: 
Yeah, great numbers. So Dr. Ford, you're also the principal investigator of a U54 grant from the National Cancer Institute, titled South Carolina Cancer Disparities Research Center, SC CADRE. Can you tell us about that, please?

Marvella Ford:
Yes, so this is a partnership with South Carolina State University, which is again, a historically black university here in South Carolina. And our partnership started in 2011 when we had a P20 grant from the NCI's program to address cancer health equity led by Dr. Sanya Springfield. That P20 led to our first U54 grant award in 2017.
We were one of the first institutions to successfully make the transition from a P20 grant to a U54 grant. So this is a partnership that has lasted through this grant mechanism for over a decade. It's going on 15 years now. And through our U54, South Carolina Cancer Health Equity Grant, SC CADRE, we have trained numerous undergraduate students, early-stage investigators. Our early-stage investigators have received career development awards. They've received R34s and other grants. And we're very excited to show the capacity that we're building at South Carolina State University. 
Through this grant mechanism, we established their first ever bio repository. We were able to renovate space in the biology department at South Carolina State University, which is led by Dr. Judith Salley. And now we have a fully functioning biorepository with Brady printers and freezers and all of the equipment that they need. So we're able to successfully transfer samples from our regional health network sites, which Dr. DuBois mentioned, many of which are located in very rural areas with large populations of Black patients. And we are transferring the samples to South Carolina State University's biorepository so that now their investigators have access to these samples from very diverse populations to enable them to now apply for federal funding at rates that they previously were not able to do.

Oliver Bogler: 
The goal of the research is to understand molecular mechanisms of cancer disparities, right? So these samples are vital to that.

Marvella Ford: 
Absolutely, the samples are vital and in our renewal application, we're really focusing on the relationship between obesity and cancer and looking at the underlying mechanisms. So we've established a new component called the glycolipidomics component. So we're looking at the effects of lipids as well as advanced glycation end products and looking at the biological mechanisms underlying the relationship between obesity and cancer.

Oliver Bogler: 
Dr. DuBois, you're the director of the Hollings. So, gotta ask you, what's next for your cancer center? What are the next five years going to be all about?

Ray DuBois:
Well, we're in the process of putting that strategic plan together. We're on the final sort of glide path of sort of dotting the I's and crossing the T's. But essentially, our goal now is we've been NCI designated for 20 years. We want to become a comprehensive cancer center, which is a bigger step and requires more exceptional performance in all of the areas that get judged. So. We're setting our sights on doing that at our next renewal, 2028. And we've got everybody working together to make that happen. 
We did extremely well on our last renewal. So, we're in a good position to do that. And by expanding our clinical trials network, I think that's going to really help to help at least accomplish one of the big goals we need to make that happen. In our treatment trials, we're already accruing over 30% of our patients are African American. So we have one of the highest minority accruals of some of the 72 cancer centers. And we are very proud of that and we want to maintain that kind of participation. So that's our big goal. 
We're constantly growing and recruiting individuals. Since I started this role in 2020, we've recruited about 55 new faculty. And we need to recruit about another 30 over the next three years to get to where I would like to see us at, basically. We're also planning new clinical space that will roll out over the next five years. And then we're in the process of acquiring a significant increase in our research lab space.

Oliver Bogler:
Sounds like some exciting times ahead for the Hollings.

Ray DuBois: 
Yeah, I think Senator Hollings would be very proud of where we're at right now if he were still alive. I think he would give us all a pat on the back.

Marvella Ford: 
And Dr. DuBois, you started with the vision of Senator Hollings and I remember hearing him speak and he said, you know, he was driving down one of the main streets in Charleston one day and saw a lot of black patients lined up to go to what was then the Charity Hospital, which was the only hospital they could go to. And he said in that moment, he made a vow to himself that he would create a cancer center where all people could come and receive care. And that's really what the Hollings Cancer Center is. It's for all people and we're really proud of the diversity of our patient population and our clinical trial enrollments.

Oliver Bogler:
You're living up to that vision.

Ray DuBois:
Yes, definitely.

Oliver Bogler: 
Fantastic. We're going to take a break. And when we come back, we'll talk to our guests about careers and get some advice. 

[music]
Cancer researchers, are you drowning in a sea of scientific papers? Wish there was a way to cut through the noise and find the research that truly matters to you? Look no further than NanCI, the revolutionary new AI-powered app from the National Cancer Institute.
NanCI isn't just another research publication app. It's your personal research assistant, designed to understand your unique interests and connect you with the most relevant papers, people, and events in the field. Imagine being able to chat directly with research papers, ask questions, and get instant answers. That's the power of NanCI's AI-driven "chat with paper" feature.
But NanCI is more than just a conversation starter. It's a networking tool, helping you discover new connections and build your professional network. It's a learning tool, recommending papers you might not have found on your own and helping you quickly get up to speed in new research areas. Simply declare an interest by bookmarking papers on a topic into a folder and NanCI helps you stay up to date.
Whether you're a seasoned researcher or early in your career, NanCI can help you take your work to the next level. By harnessing the power of AI, NanCI is transforming the way cancer research is done.
Download NanCI for iOS today from the Apple App Store! That is N-a-n-C-I. Experience the future of research for yourself. 
[music ends]

Oliver Bogler: 
OK, we're back. Dr. DuBois, always a question that fascinates me. What was the first thing that got you interested in science and medicine? Was there like a moment of awe that you can remember?

Ray DuBois: 
Yeah, I mean, I've thought about that a lot and I did come at this career in a very unusual way because I was really the first person in my family that went to college. And so there weren't a lot of mentors around sort of giving me advice. And I came from a farming and ranching community and initially was really interested in agriculture and livestock and things like that. So I went to college on a Houston Livestock Show and Rodeo scholarship. 

Oliver Bogler:
Tell us more about that because how do you get that scholarship? There's a process, right?

Ray DuBois: 
Yeah, there's a process. It's through the Future Farmers of America organization at that time, and they only had four for the whole state. So one way was to show, participate in the livestock show and so show livestock. And I was lucky one year I got a grand champion at our local show. And so…

Oliver Bogler:
That's a cow, right?

Ray DuBois: 
Well, it's a steer. 

Oliver Bogler:
It's steer, okay.

Ray DuBois: 
And that was really helped me, you know, get some glam with my CV and things like that. And so I started off in college majoring in agricultural education and was really more interested in, you know, animal science and things like that. 
But right after I got to college, I met a new recruit that had just come to the university from Stanford and he had been involved in purifying nerve growth factor and epidermal growth factor. He needed some help in the lab and so I started working with him on nights and weekends and my job was to purify epidermal growth factor for use in the lab. You couldn't buy it at that point. 
So I got really involved in a biochemistry project, basically the cold room and grinding up tissues and things like that. And it just really went from there. I was really excited to come from this mush of tissue into a purified growth factor that we could use to grow cells and things like that. So it was just something I'd never been engaged in, but I really, really enjoyed it and wanted to pursue it. And it just sort of ballooned from there.

Oliver Bogler: 
Fantastic. Dr. Ford, how about you? What got you started on your path to science?

Marvella Ford:
Yeah, thank you. I'm, I always wanted to do something with other, with people. So, my high school guidance counselor was part of a network of guidance counselors, that was initiated by Cornell University. And so she is the one who introduced me to Cornell. I hadn't heard of it, didn't know anything about it, but she, helped me with my application and then, when it was time to get interviewed because all students, all applicants had to be interviewed by someone who was a graduate of Cornell. I actually didn't have transportation to get to the interview because both of my parents worked. So they arranged for me to participate in the interview by phone. So I was already doing, I guess, telecommunications for outreach at that time. And so we had a wonderful phone interview and I got accepted.
And then when I was at Cornell, my undergraduate advisor was Dr. Josephine Allen, who's the first black woman in the history of Cornell to ever get tenure. And it was really a blessing that she was my advisor because she told me about a program at the University of Michigan that she had graduated from, and that's a dual doctoral program. 

So basically, it's called Social Work and Social Science. So you do all of the work to receive a PhD in social work and a PhD in social psychology in the psychology department. So there were two master's degrees, two sets of qualifying exams, and then the PhD kind of, I mean, the dissertation unified both disciplines. So I think that kind of ability to melt together two different disciplines really prepared me for the work that I'm doing now and the ability to have some flexibility of thought and to try to see things from the perspective of another discipline and really doing transdisciplinary work.

Oliver Bogler: 
Yeah, I think that's really important in tackling complex problems like cancer. So fascinating stuff. Dr. DuBois, so the experience you described was a Texas A&M right? And you are a Texan, I think, right?

Ray DuBois:
Yeah, Texas A University. Yes, yes. And I did participate, you know, certainly riding horses and, you know, local rodeo stuff. But I was definitely not a professional. And the scholarship was more academic, I think, than active rodeo.

Oliver Bogler: 
So then when you kind of caught the science bug, so to speak, at Texas A&M you did kind of a tour of Texas, right? You did your doctoral work, your PhD at UT Southwestern, then your MD from UT Health San Antonio. Tell us more about those years. What were they like? What were the challenges you faced?

Ray DuBois:
Well, you know, at that time, you're just sort of a blank slate. So you're not really worried about all these other, you know, issues that could come up. So when I applied for UT Southwestern, my advisor at A&M said, you know, since you've never been out of the state, you may want to stay local and, you know, have a more supportive environment because I had thought about Stanford and some other places.
So I did go to UT Southwestern and that was a wonderful experience as a graduate student there in the biochemistry department. Very supportive, very small student body. There were only three students in my year or so and quite a big department. So I got involved in these mono-oxygenase enzymes that detoxify toxins that come into the liver and started a whole new area of, you know, understanding how they were induced by certain factors in the environment. And then one of my rotations was actually in the OB-GYN department, looking at their role in steroid metabolism in pregnant women. And I really started going to some of the clinical conferences and got really interested in translational research. 
And at that point, I mean, I clearly, I wasn't far enough along to have enough experience to know exactly what to do, but I thought it would be a good idea to get an MD degree as well. One of the policies they have at UT Southwestern is they won't take any of their own graduate students into medical school because they don't want to have an alternate path for that. So I applied to just all of the schools in the state, and I got accepted to most of them outside of Dallas. So San Antonio was close to home, so I decided to go there and also continued my research in liver research lab there. 
Got involved in purifying a novel seleno protein and spent some time at the NIH in Terry Stadtman lab. Actually, she was one of the pioneers in seleno protein metabolism and that was a wonderful experience. And then it just sort of went on from there. I did my clinical training at Hopkins. I was able to get a position in Dan Nathans’ lab who was a Nobel Laureate for his discovery … role in the discovery of restriction enzymes. And mainly because he was a good friend of Dr. Stadtman’s, she gave me a recommendation. And it's just amazing how these network connections end up helping you down the road. And then did all the training there and then went to take my first faculty position at Vanderbilt rose through the ranks and then eventually came to MD Anderson, like you said.

Oliver Bogler:
Right, right. So you did your MD and your PhD in sort of the hard way, right? 

Ray DuBois:
Reverse, yeah. Yeah.

Oliver Bogler:
Yeah, a lot of people do combined programs, but you discovered your interest in medicine while you were already training to be a scientist.

Ray DuBois: 
Correct. And you know, the MD -PhD track wasn't really well developed during that time. This was like in the late 70s, early 80s. And I don't even know if they actually had a formal program there or not. But for me, it worked really well because I got a very strong background in science before going into medicine. So I had a different, I think it gave me a different perspective about going through the medical school process.

Oliver Bogler:
Interesting. Dr. Ford, so you have focused your work on social determinants of health and behavioral and community factors and community engagement and things like that. I wonder, how did you come to this area and you mentioned your two PhD track that you trained in. Was that a way that you got connected with this particular area?

Marvella Ford:
Actually, I was interested in the area initially, mainly because there were so many older people in my family who had died before I was born. So I never knew any of my grandparents on my father's side of the family or my mother's side of the family. All of them died before I was born. And I just had a real interest in trying to understand the causes of these early deaths and trying to look at systematic or systemic factors that could be addressed so that other people could enjoy their families for longer periods of time. So that has long been an interest. 
And from the time I was a sophomore in college, I was reading all the articles on health equity were coming out of the University of Michigan. At the time, Dr. James Jackson and his team had the Program for Research on Black Americans. And so when I talked with my advisor and we talked about the PhD program at Michigan, I was thrilled because when I went there, I had a chance to take classes and to work with people whose papers I had been reading for years while a college student. And when I look at the title of my dissertation, it's so similar to what I'm doing now. So the title of my dissertation was ‘The Effects of Perceived Control on Health Services Utilization Among Older African American Adults’. So it's very, very similar to the work I'm still doing today because it's just, it's just been such a long standing interest and starting from a personal level.

Oliver Bogler: 
So you've been in the field for a while. Can you give us your perspective? Have things gotten better or have you, do you understand the social determinants of health in more detail and how to tackle them?

Marvella Ford:
I think things have absolutely gotten better. I think there's a broader understanding of these social determinants or social drivers of health. And we're now developing, you know, for many years, the process was on documenting the disparities. And now we're moving to interventions to address the disparities. 
So one intervention that Dr. DuBois mentioned is patient navigation. This is such a fantastic multi-level intervention that can address systemic health system barriers, individual level barriers, and then provider level barriers to not only access to care like screening, but also to cancer clinical trial participation. 
Dr. Robert Winn talks about high touch, high tech. And so, I think what we're seeing is that with a lot of medically underserved patients, high touch is required. If people have a lot of fear and mistrust, then we have to rebuild the trust and become trustworthy. And we do that by relationship building. And that's what we used to call face time before Facebook started. When I was in college, we called it face time.
And that's just going where people are, going to their community, showing up when we say we're going to show up, doing what we committed to doing when we get there, and then being available to the communities when they call on us, when they need our support. That's how we build trust. And building trust can go a long way to improving adherence to cancer screening and also willingness to enroll in a cancer clinical trial.

Oliver Bogler:
Dr. DuBois, you're a physician and a scientist and you have in your career done both. You've taken care of patients and you've run a wet lab research group, right? I mean, one of those jobs isn't enough. Tell me how you, how do you do them both?

Ray DuBois: 
Well, I think, you know, initially I was aligning my research with my clinical interest. And certainly at Vanderbilt, I was, you know, really interested in individuals who have a high risk factor for colon cancer. And so, you know, these familial adenomas polyposis patients and Lynch syndrome patients were ones that I was particularly interested in and trying to see if there's any way we could prevent them from getting cancer as early as they were and, you know, it helped formulate questions for the research lab that I think were really valuable early on. And certainly intervening there with some nonsteroidal anti-inflammatory drugs or aspirin-like drugs was a proof of concept that you could do something about it. 
And now we're really digging into the sort of tumor microenvironment in these pre-cancer lesions. And we're finding very early on, even before they become cancer, the immune system is really allowing them to sort of evade attack from T-cells and eventually degenerate into a full-blown cancer. And there might be something we can do very early on to turn that process around. 
And so this has really come full circle back to very basic mechanisms in the tumor microenvironment and we're really excited about cancer intervention and prevention and early detection because of all the technological advances that have occurred over these years.

Oliver Bogler:
Phenomenal, I don't know how you do it. Both things. 

Ray DuBois: 
Yeah, well, it's time management.

Oliver Bogler:
We'll get those secrets from you in a moment. Dr. Ford, you have publicly shared about your own experience as a breast cancer patient at Hollings. I wonder if you'd be willing to share with our audience a little bit about that. And I'm particularly curious, has that informed or changed the way you do your community outreach work?

Marvella Ford: 
Yes, thank you. It's a very insightful question. So, you know, I had been working to try to work with communities to increase rates of breast cancer screening and treatment adherence. And then to suddenly hear the words, ‘you have breast cancer’, was really a game changer because it really helped me to understand what that experience is like from the perspective of a patient. 
And so I think it's helped me to become more empathetic and more understanding of the process and the journey, but also of the success, you know, because we know that with early detection, we have much better treatment outcomes. And so there's kind of now a built-in testimony when we go out to communities because, you know, being able to share my own experiences and my own journey, and the successes and the successful outcomes because of the treatment, the great treatment that I received at the Hollings Cancer Center. 
But one thing that it also taught me was at the time my office was located in the Hollings Cancer Center. Now I'm in Hollings space, but not physically in the building. And I remember one day when I went into the radiation oncology department, received the treatment, and then five minutes later I was sitting at my desk. But as I walked down the hall to my desk, I looked and I saw a lot of other women who had traveled pretty far to get to their appointments. And I just thought that the benefits that I have should be available to everyone. Like, I'm not special. Everyone should have access to a mammogram. Everyone should have access to really high quality breast cancer treatment and great doctors, great physicians, great nurses, great care teams. That should be for everyone.

Oliver Bogler:
Yup, thank you for sharing that. So Dr. DuBois, you've had such a remarkable career. It's impossible to cover it all in this episode. But I want to focus my last question about your career on this one aspect that I find particularly interesting, which is that you took on the role of executive chair of the board of the Mark Foundation for Cancer Research a couple of years ago. What does the Mark Foundation do and why did you take this role on?

Ray DuBois: 
Yes. Well, you know, another part of our jobs is trying to find enough funding to support the cancer research and there, you know, you know better than me what the crunch is on these federal agencies like the NCI and others. And, you know, clearly there's a lot of great opportunities now because of all these technological advances. We need more resources to fund cancer research. 
So the founder of the foundation contacted me over a couple of years ago and wanted to know if I would be interested in helping, you know, oversee some of the activities of the board and, you know, and I had had a lot of experience with foundations. I worked with the Kleberg Foundation in Texas, and I was the chair of the AACR Foundation board. And then I was vice chair for the Stand Up to Cancer Foundation for 14 years. So...

Oliver Bogler:
See, I told you there was, there was too much to get through.

Ray DuBois:
So I had all this experience, but I didn't want to give up my current job. I said, you know, this is not going to be a full-time job, but I'm happy to lend my expertise. And we were finally able to work out a situation where we were able to do that. And we fund, at the Mark Foundation for Cancer Research, globally in 14 different countries. His father had died from renal cell cancer before the new therapies were developed. So we're focusing on translational science where we take a very important basic finding and get it into the clinic. We've given out already in about six or seven years over $200 million in grants. We're on track to, you know, over the next 10 years to fund quite a bit of research. So we go for the high impact, high risk reward, high reward type science that we think will really make a difference. 
And we have an Emerging Leader Award that goes to younger folks that are on the right track. We have some other mechanisms an Endeavor Award for team science. And then we do Centers. We have very few centers now, but it's a more multidisciplinary Team Science Award. And then we've collaborated with the CRUK to fund some Grand Challenges Awards as well. And it's been very rewarding to be able to bring these resources to bear and really show that by doing the highest impact science, we can hopefully down the road affect outcomes and develop newer, better treatments or early detection methods. 
And I just came back from a wonderful early detection workshop that we held in New York with the top people around the world who were participating. We're putting our team and our ideas together to come up with a new generation of early detection diagnostics. And I think it's possible, given enough resources and attention, that we can do something that's going to have an impact.

Oliver Bogler: 
Sounds like another fascinating opportunity to make a difference. 

Ray DuBois: 
I think so.

Oliver Bogler: 
Dr. Ford, my last question. I wonder what advice you might have for our listeners. Maybe they're just thinking about cancer research as a career direction. Maybe they're already engaged with cancer but still finding their place. What would you say to them?

Marvella Ford:
I would say be open. You know, I love what Dr. DuBois said that something about being a blank slate or a sponge or something. I would say soak up all the knowledge, soak up everything. Go to the talks, go to the seminars, you know, learn about things that make you uncomfortable because sometimes it's uncomfortable to learn new things. That's how we grow. If we just stay where we are, we don't continue to grow. So always be open, always learn. I mean, we're lifelong learners. And so, and make connections. I would say be kind to everyone because some of the people you meet might become your mentors later or you might work with them later. So, or you might mentor them later. So it's really all about relationships and maintaining those relationships over the course of your career because, and you just never know where your career path will take you.

Oliver Bogler: 
Dr. DuBois, same question for you. What do you tell the early career people around you?

Ray DuBois:
Sure. I think there are some traits that Marvella referred to that are extremely important. One is perseverance. I mean, I think you have to spend a certain amount of time on an individual project or track to accomplish something before you can go to the next stage. 
For me, as you mentioned earlier, time management's been really important. And luckily, I was born and raised in a rural agricultural community, so we always got to work early. We worked late and so that wasn't an unusual thing to do. And I, even now I get to work around 6:15 and then I, you know, stay, stay at it for a while and then take some calls at home virtually in the evening. And, but it's not, it's just always been a part of my life. So I don't see that as a slog. And when you're really passionate about something, it's a lot easier to spend the time and effort on. But perseverance and not giving up too easily on things is really important.

[music]
  
Oliver Bogler:
Now it's time for a segment we call your term 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, a video, a podcast or a talk that you found inspirational, amusing or interesting. You can send those to us at nciicc@nih.gov, record a voice memo and send it along. We may just play it in an upcoming episodes. 
Now I'd like to invite our guests to take their turn. Let's start with you, Dr. Ford.

Marvella Ford: 
Yes, so I think what's inspiring to me is not any particular book, but listening to other people's journeys and learning from them. I love hearing stories about other people's career paths. I mean, I was just on an external advisory board meeting with someone who is the director of a cancer center and I found out he used to be a state trooper. So I mean, just learning from other people's career paths. And I find that very inspiring. 
And I think the community members are so full of wisdom. They have such great knowledge that I think just kind of sitting at their feet and listening to them talk, because their experiences have brought wisdom.
You know, one example is when I was at Henry Ford Health System, we were doing a focus group with black women and we were using a very well validated epidemiologic survey, but we were evaluating it for use in this particular population. And so for some reason, the order of the questions asked about the number of children, who had been born to the person, and then whether any of the children had died during childbirth, and then how many of the whether they breastfed the baby. It listed child by child. And it's funny when you parse it out that way, one of the focus group members said, well, if my child had died, I wouldn't have breastfed my child, right? I mean, just very practical interpretation of the question that was not the intention of the you know, renowned people who put the survey together. And so that was a case where I took it back to our head epidemiologist and we all reviewed it and just were amazed. No one had ever pointed that out before. It came from a community member.

Oliver Bogler:
Thank you. Dr. DuBois.

Ray DuBois:
Well, you know, I've gotten involved recently in this podcast called Mobituaries. I don't know if you're familiar with it, but he, Mo Rocca is a TV personality and what he's done is looked at some interesting individuals whose lives made some impact one way or the other, just like Marvella said. And then he puts together the podcast based on that. And the one that I really got started with was one on what they call the orphan train.
So the orphan train was a train that really usually went from New York out west and in the south southwest and brought young children that had been either abandoned or in part of foundling homes to these other places. And it turns out that my grandmother was on the orphan train. So she came from New York to Texas when she was only basically one and a half years old.
And I remember talking to her about this experience and, you know, it was really pretty dramatic to, you know, be taken from your environment there. She was left on their doorstep when she was just a few weeks old and then lived in this family home for a year and a half and then put on a train. And then you don't know what you're going to get when you end up in these little towns. And so she ended up in Runge, Texas, great family that took her under their wing.
She did extremely well and she still remembered, you know, bits and pieces of that train ride. But all of these kids just scattered all over the West and there are a lot of stories that have come out of that. But he did a really nice segment on that and interviewed some of these individuals. And, you know, it's sort of a way to look at history in a sort of different perspective. Mobituaries.

Oliver Bogler: 
I'm going to check that out. Mobituries. That's really cool. Thanks. I'm going to check that out. I'd like to make a recommendation as well as well. It's also for a podcast, and I've been listening to this one quite regularly for over a year now it's called Pivot and it's hosted by Kara Swisher and Scott Galloway. Swisher of course, is a renowned tech journalist who's been on the beat since the advent of the internet age and has a no-nonsense style that seems to disarm many of the tech giants she talks to. leading to fascinating interchanges. And Scott Galloway is an NYU business professor and entrepreneur with a very interesting perspective as well, on many current issues that are well thought out and grounded in his worldview. They have great chemistry, excellent guests, and cover tech and the modern world in a very fun and fascinating way. They give a great business perspective to the exploding field of AI, which regular listeners of my podcast will know I'm obsessed with. And it really complements my other favorite podcast, which is the New York Times' Hard Fork, which really goes onto the tech side. So that's my recommendation. 
Well, I really want to thank both of you, Dr. Ford, Dr. DuBois, very much for spending time with us and sharing your insights. Thank you so much for being on the pod.

Ray DuBois: 
Thanks, Oliver. Thank you, sir.

Marvella Ford: 
Thank you for having us. Thank you.

[music]
Oliver Bogler:
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 welcome. And you are invited to take your turn and make a recommendation to 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.
Join us every first and third Thursday of the month wherever you listen – subscribe so you won’t miss an episode.
If you have questions about cancer or comments about this podcast, you can email us at NCIinfo@nih.gov 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.