Mar 08, 2022
By Aaron Tallent
In 1920, Marie Mattingly Meloney, then editor of a women’s magazine called The Delineator and the first woman to win a seat in the U.S. Senate press gallery, was granted a rare interview with Marie Sklodowska Curie. In the course of their discussion, Ms. Meloney learned that the first woman to win a Nobel Prize and first person to win two Nobel Prizes needed a gram of radium to continue her research. She and her late husband, Pierre, found her first gram in 1898 through refining and processing tons of mineral ore. Madame Curie’s research with that gram laid the foundation for radiation therapy, and she even stayed in Paris to protect it during World War I. However, the original radium was given to doctors to use for cancer treatment, and she could not afford to purchase more. The price of radium in 1920 was $100,000, roughly $1.4 million today.
“Marie Meloney started the Marie Curie Radium Fund and through a national campaign raised $100,000 and bought Marie Curie that gram of radium,” said ASCO chief medical officer and executive vice president Julie R. Gralow, MD, FACP, FASCO. “They succeeded primarily through small donations from women throughout the country, including numerous prominent women academics who rallied around the cause.”
In their own sphere of influence, ASCO and Conquer Cancer, the ASCO Foundation, have worked for decades to provide that proverbial gram of radium to help elevate women in oncology and cancer research at every stage of their career. Through research funding, network support, and industry leadership, both organizations will continue these efforts and have future plans to provide platforms for women in oncology.
“ASCO has had a longstanding commitment, along with Conquer Cancer, to support efforts to bring equity across not only the workforce, but across the cancer community as it relates to research and the delivery of quality cancer care. This is not a year-to-year effort but in perpetuity for the organizations,” said Nancy R. Daly, MS, MPH, Conquer Cancer CEO.
Leadership and Perseverance
In 1964, ASCO’s founders held their first meeting at the Edgewater Beach Hotel in Chicago. Among those seven founders was Jane C. Wright, MD, FASCO, who served as the secretary/treasurer for ASCO from 1964 to 1967. The director of cancer research at New York University Bellevue Medical Center, Dr. Wright was the highest ranked Black woman at a nationally recognized medical institution in the country at a time when there were only a few hundred Black women physicians in the United States. Dr. Wright’s leadership in oncology over her 40-year career elevated the field; her research contributions included developing the technique of using human tissue culture instead of laboratory mice to test the effects of therapies on cancer cells and demonstrating that methotrexate could treat breast and skin cancers.
“Dr. Wright finished medical school in 1945 and interned at Bellevue Hospital in New York City, long before the Civil Rights Act, and she was able to persevere, not only given her gender, but also the fact that she was Black,” said Ms. Daly.
Perseverance is key in medicine, but it was even more critical for the pioneering women of oncology and cancer research. Madame Curie’s and Dr. Wright’s stories are just two examples, but advances that moved the field forward did not come without an unwavering determinedness.
Today, when someone learns they carry a BRCA1/2 gene mutation, they immediately speak with their physician to discuss options for monitoring or reducing risk for breast and other cancers. They then begin taking steps to see if other family members carry the gene mutation as well. And we now have a new class of highly effective cancer therapies, PARP (Poly-ADP ribose polymerase) inhibitors, that target cancers with genes defective in DNA repair, primarily BRCA1/2. In the 1970s and 1980s, the idea that certain breast cancers were hereditary was generally met with extreme skepticism, but geneticist Mary-Claire King, PhD, changed that through her research and determination.
Prior to the discovery of BRCA1, the study of genetics was generally considered useful only in diseases with a simple genetic tie, such as Huntington’s disease and sickle-cell anemia, but not in complex diseases like breast cancer. From 1974 to 1990, Dr. King worked tirelessly to identify a genetic marker that accompanies the presence of breast cancer in families, ultimately convincing the National Institutes of Health (NIH) that her research was worth funding. In 1990, she and her research team identified the marker that is now known as BRCA1. For Dr. Gralow, who had the opportunity to work with her beginning early in her own career at the University of Washington, Dr. King’s relentlessness was as critical as her intellect in this advancement.
“She was a real force, and it wasn’t just her brilliant, scientific mind. It was that she didn’t back down. Nobody believed at the time that there could be a possible genetic basis to cancer, but she knew this was right and that it needed to be studied,” said Dr. Gralow. “Another reason why she was such a strong role model for me was that she also used her expertise in the fledgling field of genetics and genomics for human rights and social justice purposes, including identifying children taken from their families in war-torn Argentina.”
ASCO’s first woman president, Ruth Rose Ellison, MD, used her term from 1974 to 1975 to push for the use of a multidisciplinary approach to treatment. The potential for utilizing different combinations of surgery, radiation therapy, and chemotherapy in oncology was still emerging and needed more research and clinical guidance. Dr. Ellison advocated for this to ASCO’s approximately 800 members during her presidency.
Since Dr. Ellison, eight more women have served as ASCO president. Two of the last four were Lori J. Pierce, MD, FASTRO, FASCO (2020-2021), and Monica M. Bertagnolli, MD, FACS, FASCO (2018-2019); Lynn M. Schuchter, MD, FASCO was elected for the 2023-2024 term.
“ASCO has made a concerted effort to ensure diversity and inclusion in their leadership ranks. A direct result of this effort has resulted in more women achieving the honor of having served as president of ASCO. This is a powerful optic to young women physicians,” said Sandra M. Swain, MD, FACP, FASCO, who herself served as ASCO president from 2012 to 2013. Dr. Swain is currently a professor of medicine and associate dean for research development at Georgetown University Medical Center and vice president of genetic medicine at MedStar Health.
Supporting Women in the Early Stages of Their Research Careers
Among the many ASCO initiatives supported by Conquer Cancer is a substantial portfolio of research and mentorship grants. In 1984, the first Young Investigator Award (YIA) was granted to Judith Salmon Kaur, MD, a fellow at the University of Colorado Health Sciences Center. Dr. Kaur, who is one of only two Native American oncologists working in the United States, received the grant to study the development of monoclonal antibodies which could lead to targeted treatments for melanoma.
Receiving the YIA “was wonderful, and it powered me to think that I could do cancer research and that having access to funds for someone early in the career could make a difference. It also connected me to ASCO very early in my career,” said Dr. Kaur, medical director for the Native American programs in the Mayo Clinic Cancer Center.
In the nearly four decades that have followed the first YIA, Conquer Cancer has increased the number and types of grants and awards that it provides. “Since Dr. Kaur received a YIA more than 38 years ago, Conquer Cancer has awarded 562 additional YIA and Career Development Award (CDA) grants to women in oncology and has created YIA and CDA grants exclusively for female researchers,” Ms. Daly said. “I think that it is critical for women to get that recognition from an organization like Conquer Cancer, ASCO’s foundation. Once they have the acknowledgement within their institution that they got an ASCO grant, that then leads to other opportunities.”
While these grants advance breakthrough research, they also ensure women have the resources to sustain a long cancer research career. To date, 98% of all Conquer Cancer grant recipients remain active in research.
“I was an early recipient of an ASCO Career Development Award in 1995 when I was transitioning between fellowship and junior faculty, and it allowed real protected time so I could think and do research, apply for other grants, and write papers. I guess you could say that was my gram of radium,” said Dr. Gralow.
Women Who Conquer Cancer: Formalizing the Commitment to Women Who Conquer Cancer: Formalizing the Commitment to Elevate Women in Oncology
ASCO and Conquer Cancer recognize that, despite progress toward gender parity, more work needs to be done in supporting women in oncology and research. Women make up only 35.2% of the oncology workforce and early-career women cancer researchers receive 30% less NIH research funding than their male counterparts.1 A December 2021 Health Affairs study also found that, on average, women earn an estimated $2 million less than men over a 40-year career.2
To begin addressing this disparity, in 2013, during her ASCO presidency, Dr. Swain founded the Women Who Conquer Cancer (WWCC) initiative to support the work of women researchers. This groundbreaking program is dedicated to funding women conducting oncology research and creating a network for those doctors to highlight the work they’re doing to help their patients. Dr. Swain created WWCC in part because she found herself being the only woman at the table for much of her career, and knew that needed to change to advance oncology.
“I really didn’t have women role models during my career, and I think it makes a difference. In general, we as women don’t promote ourselves as much as men. I really wanted to have a platform where we could promote young women in their careers,” she said.
Since its launch, WWCC has raised nearly $6 million in support of women in oncology, and has awarded grants to more than 40 YIA and CDA researchers. The first recipient was Yanyan Lou, MD, PhD, for an investigation of tumor microenvironment immune phenotypes in epithelial-mesenchymal transition and EGFR tyrosine kinase inhibitor-resistant non-small cell lung cancer. Additional recipients include Molly Taylor, MD, MS, for testing a resilience-building program for young people with cancer, and Catherine Handy Marshall, MD, MPH, to explore the impact of cardiovascular disease risk factors on cancer outcomes.
“It has been extremely rewarding for me to see how the WWCC program has taken root and grown into a successful platform from which so many young women physicians have benefitted. Seeing the enthusiasm and passion and the numerous contributions these young investigators have made to the field of oncology is truly rewarding. These researchers are our future and to see how successful they are makes me want to keep supporting them as much as possible,” said Dr. Swain.
WWCC has also awarded 11 WWCC Mentorship Awards which recognize extraordinary women leaders in oncology and role models who have excelled as a mentor and have demonstrated outstanding commitment to the professional development of women colleagues as clinicians, educators, and researchers in oncology. Recipients in 2021 were Jennifer A. Ligibel, MD, FASCO, and Lorna Awo Renner, MBChB, MPH, FRCPCH, FGCPS. Dr. Ligibel is an associate professor at Harvard Medical School who has mentored young researchers in studying the impact of lifestyle interventions, such as physical activity and weight-loss interventions, on breast cancer outcomes. Dr. Renner, head of the Paediatric Oncology Unit at Korle Bu Teaching Hospital, mentors the next generation to help fight disparities for women in oncology, particularly in Ghana, where there is a shortage of pediatric oncologists.
Connecting and Supporting Women Oncologists Globally
Dr. Swain, Dr. Gralow, and Dr. Kaur all agree that connectivity and transparency are key to supporting women in oncology. Oncologists typically mentor people of all genders during their career. Understanding how their different experiences, challenges, strengths, and attributes, including those which may be gender-influenced, can be recognized and capitalized on will help them achieve their full potential.
For example, it is important to acknowledge that more women are the primary caregiver for an adult loved one. AARP’s latest report on caregiving in the United States found that an estimated 61% of all adult caregivers are women.3 This number has likely risen during the COVID-19 pandemic. A 2021 analysis from the Federal Reserve Bank of Minneapolis found that nearly 3 million women left the workforce in 2020.4 Medicine is not immune to this trend: a survey of frontline health workers conducted by The Washington Post and KFF found that three in 10 are considering leaving the profession.5
“It’s about awareness and understanding of the different experiences and perspectives that we bring to the table. It is also about continuing to rethink what we value and how each person can contribute,” said Dr. Gralow.
Dr. Kaur has participated in many forums and programs elevating women in her nearly 40-year medical career. She believes that ASCO and other medical societies would be stronger in this area if they pooled their resources.
“ASCO has had many female role models in leadership in the organization since I started with it in the 1980s, but we rarely have those organizations speak together to women’s groups. I have wondered if we could develop a forum for women leaders in ASCO and other organizations to discuss what each is doing,” she said.
ASCO Connection created the Women in Oncology blog to provide a dedicated space for sharing challenges, insights, and best practices for navigating careers, personal growth, and professional development. Recent posts discussed the challenges facing women oncologists in the Middle East and North Africa (see p. 24) and the experiences of balancing being a physician and mother during the COVID-19 pandemic. All ASCO members are encouraged to contribute; contact firstname.lastname@example.org if you are interested in authoring a post.
“In the business world, it has been shown that when you support women in their jobs, you actually do better financially. I think you will see the same parallel in medicine that if we support women, we will do better as far as progress in health care and oncology care,” said Dr. Swain.
Looking to the Future
Moving forward, ASCO and Conquer Cancer will continue increasing efforts to support and elevate women in oncology. They are seeking long-term, sustained funding to improve equity in oncology care and cancer research.
“Our commitment is to double Conquer Cancer’s entire fundraising effort over the next 5 years, going from raising $30 million to $60 million. If we fulfill this goal, we will double our support in cancer research,” said Ms. Daly.
If ASCO, Conquer Cancer, and other organizations are successful in continued efforts to achieve gender equity in oncology, more may share the experience Dr. Kaur had while in medical school.
“My daughter was 3 years old, and she had only met a few women in our class that I had over to study from time to time. At a party, I introduced her to one of the men in my class and she looked at me and said, ‘Mom, I didn’t know men could be doctors, too’,” Dr. Kaur said with a laugh.
Supporting Women With Cancer
Gender disparities impact providers, and they also impact patients. Many cancer treatments affect fertility and ovarian function temporarily or permanently in women and cause sexual side effects that can be physical, mental, or emotional. Dr. Gralow said that recognizing these challenges helped put her on the path to specializing in breast cancer.
“I realized my patients were more comfortable telling me—as opposed to my older male counterparts—about the issues they were facing once they were done with treatment, such as early menopause. A lot of them would tell me that they felt lost after treatment ended and were left on their own to deal with the side effects,” she said.
The pressure to exercise and be healthy can also be challenging for patients struggling after treatment. This prompted Dr. Gralow to co-found Team Survivor Northwest, an exercise and fitness program for woman cancer survivors in Seattle.
“It’s kind of like Women Who Conquer Cancer. You’re out there supporting each other, and women who have gone through the program are the biggest mentors and cheerleaders for the new people coming into it,” she said.
Early in her career, Dr. Gralow was also active in a Ukraine Breast Cancer Project, which was funded by the U.S. Agency for International Development, her first experience in global oncology. That helped lead to her founding the Women’s Empowerment Cancer Advocacy Network (WE CAN), which supports patient advocates in low- and middle-resource countries.
“We were able to bring breast and cervical cancer patient advocates, initially from the former Soviet Union, Eastern Europe, and Central Asia, together to network with each other to learn about their work and how they could be supportive. Then it grew to East Africa,” she said.
In 2018, Dr. Gralow received the ASCO Humanitarian Award for her global work in empowering women with cancer and survivors.
(Timely, oncologist-approved information to help patients better understand and manage their side effects is available at Cancer.Net, ASCO’s award-winning patient information website)
- 2021 Snapshot: State of the Oncology Workforce in America. JCO Oncol Pract. 2021;17:249.
- Whaley CM, Koo T, Arora VM, et al. Female Physicians Earn An Estimated $2 Million Less Than Male Physicians Over A Simulated 40-Year Career. Health Aff (Millwood). 2021;40:1856-64.
- AARP, National Alliance for Caregiving. Caregiving in the United States 2020. May 14, 2020. Available at: https://www.aarp.org/ppi/info-2020/caregiving-in-the-united-states.html. Accessed Jan 14, 2022.
- Boesch T, Grunewald R, Nunn R, et al. Pandemic pushes mothers of young children out of the labor force. Federal Reserve Bank of Minneapolis. Feb 2, 2021. Available at: https://www.minneapolisfed.org/article/2021/pandemic-pushes-mothers-of-young-children-out-of-the-labor-force#_ftn1. Accessed Jan 14, 2022.
- Kirzinger A, Kearny A, Hamel L, et al. KFF/The Washington Post Frontline Health Care Workers Survey. Kaiser Family Foundation. Available at: https://www.kff.org/coronavirus-covid-19/poll-finding/kff-washington-post-health-care-workers/. Accessed Jan 14, 2022.