Bob the Builder: Robert C. Young Is Giant of Cancer Care in Gynecologic Cancer

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Partner | Cancer Centers | <b>Fox Chase</b>

"If you stay at home too long, with too narrow a focus, you lose sight of what’s happening in the world."

Growing up in Columbus, Ohio, Robert C. Young, MD, knew he was interested in medicine from an early age. The son of a practicing surgeon, Young grew up around medicine and liked the idea of someday becoming a doctor himself.

“Even as a young kid, I always knew that I would go into medicine,” Young recalled. “So that’s what happened. My path diverged from my father’s when I got to medical school and realized that I was more interested in research and in internal medicine than in surgery.”

After high school, Young chose to attend The Ohio State University (OSU), which was nearby and where his father served as an adjunct professor of surgery from 1938 to 1958.

In addition to focusing heavily on his science and premedical courses, Young was very involved in student government and student leadership. He served in a number of student leadership roles throughout his tenure at the university, culminating in his election as the student body president his senior year. He didn’t know it at the time, but this student government seasoning would prepare him for his future extensive career in medical leadership.

After graduating with a BS in zoology in 1960, it was time to choose a medical school. Young’s father, a Harvard Medical School graduate, wanted his son to follow in his footsteps. However, the younger Young wasn’t so sure that Harvard was the right school for him. He spent some time exploring other prominent medical schools including Weill Cornell Medicine in New York, New York, and Johns Hopkins University in Baltimore, Maryland.

“When I went up [to Harvard] for an interview, it just didn’t fit,” he said. “I was particularly [interested in] Cornell; one of my friends at Ohio State had gone there and enjoyed it. I very much liked the idea of being in New York City. So it ended up being a fairly easy choice.

“It didn’t necessarily make my dad happy. But it was absolutely the right choice for me, and I ended up really thriving at Cornell.”

Soon after arriving in New York, Young quickly became enamored with the research side of medicine. While spending his summers working in the laboratory, he became very interested in hematology, particularly platelet function. He was able to publish a number of papers with his colleagues at Cornell concerning platelets and other hematologic subjects during his time in medical school and into his residency.

As the end of his residency loomed and the Vietnam War was in full swing, Young had a tough needle to thread unless he wanted to be drafted into the conflict. The National Institutes of Health (NIH) had a few public service programs at the time that Young saw as a perfect way to continue his hematologic research while also exempting him from the draft.

In 1967, Young joined the National Cancer Institute (NCI) Medicine Branch as a clinical associate. After 2 years in the program, he completed his postgraduate training as a senior resident in medicine at Yale New Haven Hospital.

Once his training was finished, Young returned to NCI in 1970 as a senior investigator and attending physician. Around this time, the National Cancer Act of 1971 was signed into law. The act represented a major turning point in the careers of many researchers including Young. Now there was an appetite for increased levels of cancer-related scholarships and the funding to make it happen.

When he first arrived at NCI, there wasn’t much happening on a national level in terms of research into ovarian cancer—NCI was funding fewer than 15 grants at the time. Organized clinical trials, animal models, and cell lines for investigation were basically nonexistent. Clinical trial structure was also severely lacking. It was here that he first put those political skills learned in college to good use.

“We began to systematically set up on a national basis, first the ovarian cancer study group, which subsequently, evolved into the Gynecologic Oncology Group,” Young said.

Around the same time, Young and his team began laboratory investigations into ovarian cancer. The team established human ovarian cancer cell lines, created animal models, and defined accurate surgical staging. Young and his colleagues acquired resources and investigators from across the country to build a robust, nationwide ovarian cancer research enterprise.

“I’m very proud of the fact that I was one of the major initiators of the attention that was ultimately brought to the problem of ovarian cancer,” he said.

Young served at NCI for nearly 20 years, eventually ascending to chief of the medicine branch. Early in his tenure, he was a part of the “Gang of Five,” along with Vincent DeVita, MD; George Canellos, MD; Philip Schein, MD, Dsc (hon); and Bruce Chabner, MD. DeVita and Canellos would also go on to win Giants of Cancer Care® awards.

The famous partnership was instrumental in creating the first curative regimens for diffuse aggressive lymphomas and Hodgkin lymphoma. The group developed some of the earliest adjuvant combination chemotherapies for early breast cancer and the first combination chemotherapy for advanced ovarian cancer. The combination of carboplatin and paclitaxel that evolved from their NCI research remains a major component of current therapy for advanced ovarian cancer. These personal relationships have stood the test of time and still mean a great deal to Young.

“That group is an extraordinary group. To have an opportunity to work with those people was incredible. Four out of the 5 of them became presidents of [the American Society of Clinical Oncology],” Young said. [We’ve] remained good friends, all the way along. We’ve kept in touch. We keep up in Zoom conferences. All our families grew up together; we know all each other’s kids and so forth. It’s a very lasting relationship, and one of the treasures in my life.”

Fox Chase—Small, Nimble, and Extraordinary

In 1988, Young thought it was a logical time to step down from the NCI and pursue a new challenge. After exploring his options, he decided the best fit was accepting a role as the president and CEO of Fox Chase Cancer Center in Philadelphia, Pennsylvania.

“I tell people, ‘I’ve had 2 jobs in my life.’ One was at the NIH and one was at Fox Chase Cancer Center. I had been at the NIH for 20 years; I had served as the chief of the medicine branch for 14 years, and I loved it there,” Young said. “But I realized that if I didn’t leave then, I probably never would leave. So I began thinking about opportunities.

“One of my colleagues had led Fox Chase—and was actually moving to the University of Alabama—and said, ‘You know, you really ought to take a look at this job. It’s an extraordinary place.’ I went up and looked at the job. And indeed, it was an extraordinary place. The interesting thing about it is that Fox Chase really developed around basic science. The hospital was initially a small part of the center but grew dramatically during the years that I was there.”

Young and his colleagues went to work building the major clinical enterprise of Fox Chase. The center is now part of Temple University and 1 of just 51 NCI-designated comprehensive cancer centers in the country. He was aided by an impressive array of collaborators including multiple members of the National Academy of Sciences. Young quickly found Fox Chase to be an exciting and fulfilling place to work.

“Fox Chase has a long and distinguished history of fundamental basic science research and was home to 2 Nobel Prize winners including Baruch Blumberg for the identification of hepatitis B and Ernie Rose for his identification of the ubiquitin system,” Young said.

Fox Chase also poached several of Young’s NIH colleagues, including oncology luminaries such as Robert F. Ozols, MD, PhD; Lori J. Goldstein, MD; Michael A. Bookman, MD; and Richard I. Fisher, MD. Young said the infusion of talent allowed the cancer center to build strong clinical research to go along with basic science excellence.

“A small and nimble freestanding cancer center provided the environment to build one of the strongest population science programs in the country under the leadership of Paul Engstrom,” he added.

Paul F. Engstrom, MD, joined Fox Chase in 1970 and established one of the nation’s first cancer prevention and control programs. He retired in 2018 after 45 years as a clinician and investigator but still serves as professor emeritus in the Department of Hematology/Oncology and serves as a special advisor to Fisher, the current president, CEO, and cancer center director at Fox Chase.

Young relished the opportunity to orchestrate and mold the entire enterprise from top to bottom. Fox Chase in 2007 established the Robert C. Young MD Chair in Cancer Research in recognition of his contributions and named the clinical care and population research building the Young Pavilion in his honor. Young remained at the cancer center until 2009, spending his final 2 years there as chancellor.

In 1989, Young was elected president of ASCO, an appointment he saw as a great honor. Initially, Young noticed a bit of a schism between the organization’s academic side, which had largely become ASCO’s focus, and the clinical practitioners working at the community level.

He sought to change all that.

“I put a number of community-based practitioners on major committees as leaders. One of the things that I did during my presidency was to bring in the leadership of many community organizations into the fabric of the ASCO leadership. I’m very proud of that,” Young said.

“Additionally, when I first arrived, there wasn’t any administrative organization and no full-time employees. We were managed by a contract operation that scheduled the meetings. We created the first permanent staff for ASCO. In fact, during my presidency, we hired the first full-time employee at ASCO.”

Scaling Back and Moving Ahead

Following retirement, Young remained in Philadelphia, a city he favors for its personality and accessibility to other locales. An avid traveler, Young has been able to use his research experiences and wide range of connections to see the world. With so many miles logged, Young has no shortage of favorite stops. He and his wife, Barbara, an artist and art conservator, have adventured everywhere from Vietnam and Cambodia to Egypt to a variety of destinations across Europe.

“I’ve had the opportunity with all of my research to go to Venice a number of times, and it’s an extraordinary place,” he said. “There’s just nothing like it in the world. Paris is also spectacular.”

In each place, he has strived to keep an open mind and focused on absorbing the local culture.

“You learn new things, you see new things, and your mind opens broader to the issues that are going on in the world,” Young said. “If you stay at home too long, with too narrow a focus, you lose sight of what’s happening in the world.”

In his personal life, Young, a former long-distance runner, enjoys walking and striving to maintain his physical fitness by working with personal trainers. He also likes slipping away to his cottage in Maine and spending time with his children and grandchildren. His daughter, Rebecca, has a PhD in ecology and teaches at St Lawrence University in Canton, New York, and his other daughter, Kathleen, has a master’s degree in social work and is a patient care coordinator at the OSU Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC—James).

Recently the Youngs moved back to Columbus, where they both grew up, to be closer to family.

Young is currently the president of RCY Medicine, a medical consulting company that leverages Young’s vast experiences to advise other entities on subjects such as strategic planning, grant design, cancer research, and physician conflicts of interest. He also serves on the board of directors for AVEO Pharmaceuticals, Inc.

Young enjoys the challenge of getting new cancer centers up and running. He was an advisor at Dana-Farber Cancer Institute in Boston, Massachusetts, for several years, and he has particularly enjoyed guiding newer facilities toward obtaining cancer center designation, critiquing their science, and laying a foundation for the next generation of caregivers. He’s had a hand in establishing major centers such as OSUCCC—James and the cancer centers at Indiana University, the University of Kansas, and the University of Oklahoma.

There are a lot of awards in cancer research around medical research. Some recognize real clinical advancements. Some recognize the clinical impact of novel therapies. Some awards are for laboratory discoveries. Young said the Giants of Cancer Care® award is unique.“

This one recognizes people who have really made a direct impact on patient care in a way that transformed the therapy that was available for those particular diseases,” he said. “That’s a really unique focus and one that we can’t forget because that’s actually the final common pathway for all of the research that goes on in medicine in general.”