New hand on the Cancer Center tiller

When Richard L. Edelson, M.D. ’70, came to Yale in 1986 as professor and chair of the Department of Dermatology, the Yale Cancer Center (YCC) was just a dozen years old and had fewer than 185 faculty members in its ranks. Edelson, a physician-scientist who had developed a treatment for a rare form of lymphoma, was one of them. By July 1 of this year, when Edelson took office as its fifth director, the Cancer Center had grown enormously. It now has 342 members from more than a dozen medical school departments and oversees 18 core facilities funded by a $2.1 million annual grant from the National Cancer Institute (NCI). It helps draw $118 million in cancer-related research funding to Yale investigators yearly, making it one of the more vigorous cancer research engines in the country.

Edelson, 58, credits that progress to two of his predecessors in the director’s office, pharmacology pioneer Alan C. Sartorelli, Ph.D., and former NCI Director Vincent T. DeVita Jr., M.D., HS ’66, as well as current YCC Deputy Director José Costa, M.D. “They did the heavy lifting,” Edelson said during an interview in mid-July. “Alan built the reputation the center enjoys today as a powerhouse in basic science and cancer pharmacology. And Vince, who is credited with having cured Hodgkin’s disease and is essentially the father of combination chemotherapy, has really laid out the framework for developing the center into a clinical powerhouse.”

Therein lies Edelson’s main challenge. Despite a worldwide reputation and key contributions to cancer research, Yale historically has not been able to draw the desired volume of cancer patients, especially for all-important clinical trials of new therapies. It was among the first centers designated a Comprehensive Cancer Center by the NCI, but until recently has not had the resources to meet all of its clinical goals. As a result, rumors abounded last year that the center might even lose its NCI comprehensive designation when the most recent five-year grant expired on June 30.

Instead, the NCI agreed to extend funding for a year. The university has agreed to fund the core facilities for two additional years, if necessary, while the center builds up steam and overcomes some of its growing pains.

Edelson said that is already happening. Both the university and Yale-New Haven Hospital have pledged resources, and the director predicted a new era of collaboration, cooperation and growth.

“I’m convinced we have the opportunity to develop field-shaping programs in every important area of cancer care,” said Edelson, who will remain chair of dermatology but is stepping down as deputy dean for clinical affairs, a position he has held for the past three years. “We have the people, we have the setting and we have the science.”

To solve a nagging space crunch in its patient areas, Edelson negotiated the immediate renovation of 25,000 square feet of clinical space in the Yale Physicians Building and elsewhere on campus, close to doubling the existing clinical facility. The long-term solution to the space problem, he said, will take the shape of a new Cancer Center building of approximately 170,000 square feet, to be open by 2007. Several possible locations around the medical center are under discussion.

One key to growth, Edelson believes, is rebuilding the Section of Medical Oncology, which is down in ranks but now has a new structure for appointments and promotions and a commitment to hiring new faculty. As part of his recruitment, Edelson gained approval to hire 18 to 24 new faculty members in cancer-related fields, about half of whom will be medical oncologists. “This will be the clinical engine that drives cancer care, and it is one of the best routes for new patients into trials,” he said. Edelson is also exploring arrangements with cancer facilities outside Connecticut that would bring Yale discoveries to a wider public while increasing the number of patients available for Yale trials.

“I don’t have the slightest doubt that we’re going to quickly succeed here. If I did, I wouldn’t have taken this job,” Edelson said.