University of Washington
William Grady is a Gastroenterologist at the University of Washington Medical Center and the Fred Hutchinson Cancer Research Center in Seattle, Washington. He has been working with the Arizona State University PS-OC since its inception and has noticed changes in the way in which clinicians in the program think about cancer.
William Grady: Largely what I think the PS-OC has accomplished to date has been to open up the ideas about cancer biology bringing in the principles of physics, but probably, more importantly, the mind set of testing novel theories. Really what is allowing us to do is reconsider our preconceptions about how cancer cells behave and think about them in a new light, but in a way that is structured enough so that we would be able to design experiments and test the new concepts.
Pauline Davies: And you actually see patients. What is your speciality?
William Grady: I’m a clinician but I’m actually a gastroenterologist. So a lot of the work I do clinically with cancer is to actually try to prevent cancer from forming as opposed to actually treating cancer. The other thing that I do related to that is I manage patients who have hereditary cancer syndromes. So I am the Medical Director for our GI cancer prevention program clinic. So all the things that we are talking about, the PS-OC, are things that I deal with on a daily basis.
Pauline Davies: So what of those practical guys doing the frontline work. Why did you want to get involved in the PS-OC?
William Grady: That’s a great question. I think part of it is personal because I really enjoy the idea of studying problems, trying to solve problems. But I think more importantly for me, it was a way to think about cancer from a different perspective and I thought that was important because even though we’ve made gains in our treatment and prevention of cancer, there’s still a long way to go and I think our ability to ultimately, optimally treat cancer in whatever form, is going to depend on things that come out of organizations like the PS-OC.
Pauline Davies: Now I noticed that when I first started coming to PS-OC meetings a few years ago, that people were concentrating on the genome - or that would be the prevailing view amongst a lot of people who didn’t come from the physical sciences perspective. But now in this meeting today, we’ve been hearing a lot about the epigenome.
William Grady: That’s a great point. Not only have we been hearing about the epigenome but what we’ve also been thinking about a lot, through the PS-OC, are non-genomic, even non-epigenomic aspects to cancer biology and to the evolution of cancer. I tend to be a cancer geneticist in the terms of the research that I do, so I still tend to think of cancer as predominantly being a genetic disease, although I think some of the points that were brought up today - is that evolution of cancer is still predominantly selection for a particular phenotype - I do tend to think that that’s true. And as a consequence of that it’s made me think, well probably the genetics of it - maybe it’s a majority of the influence on the cancer behavior. But I’ve definitely changed my thinking about the way cancers form and the way cancers behave and I think about it a lot more from a non-genomic aspect, and I think that’s one of the major contributions that the PS-OC has been able to make, making us think about cancer formation and cancer behavior in a more global sense. And that’s so important because it makes us reframe the way we think about cancer treatment.
Pauline Davies: Can you give me some examples?
William Grady: Probably some of the best examples are thinking about the way tumor cells behave in their extra-cellular environment and how that can change the way the tumors behave and respond to therapies. And so we need to think about therapies that aren’t directed specifically at tumor cell proliferation or tumor cell apoptosis but are also directed at the extra-cellular environment that the tumor cells are in, and to consider how that will influence the way the cells respond to the therapy but also how they may develop resistance to those therapies.
Pauline Davies: Can you see any of the work that is being done in the PS-OC actually translating into clinical practice in years to come?
William Grady: I certainly think so. One of the challenges for the PS-OC is that the PS-OC has been charged with addressing some of these really big questions about cancer and that takes time to even be able to come up with the big questions and then come up with the big questions in a way so that we can actually test ideas about why cancer cells behave the way they do. It’s still relatively early on for the PS-OC and I think we’ve made a lot of gains with regards to framing some of the questions and with bringing together the participants so that we’re being productive. I think we’re in a great position to be able to take this approach to the next level so I’m hoping we have the opportunity to do that.
Pauline Davies: And this meeting, have you found it exciting?
William Grady: I think this meeting is very exciting because what it has allowed us to do is to think concretely about the sorts of things that the PS-OC has been able to accomplish and probably to clearly articulate what some of the theories are that have been developed and to think carefully about the data that we have currently that support those theories and also to think about what we need to do in order to be able to refute or support the theories that have been developed.
Pauline Davies: And what’s the most memorable thing that you’re going to take away from this meeting?
William Grady: I think the most memorable thing will be the multifaceted concepts that are involved with cancer cell evolution and some of the theories surrounding that. That seems to be a recurring theme throughout a number of the sessions that have been occurring at this meeting.
Pauline Davies: Thank you very much.