ASCO chief medical officer advises to get into ‘good trouble,’ not accept status quo

Julie R. Gralow, MD, FACP, FASCO, knows the impact science and research can have on patient care and has dedicated her medical career to working with patients with cancer to better their lives.

Gralow, ASCO Chief Medical Officer, received the Healio Lifetime Disruptor award, which recognizes her leadership in the field of hematology-oncology. She has consistently pushed the field forward through innovative treatments, practice management, patient care and research.

In addition, Gralow founded the Women’s Empowerment Cancer Advocacy Network (WE CAN) and is revered as a pioneer in global oncology as well as an early adopter of social media for furthering the collaborative missions of oncology.

“It is a huge honor to win this award. I’ve had a wonderful and fantastic career, but I am not ready to stop anytime soon,” Gralow told Healio.

She spoke with Healio about her career accomplishments and ongoing work in the field of oncology, as well as her goals for continuing the work for many years to come.

Healio: What does it mean to you to be a disrupter?

Gralow: Being a disruptor means doing what’s right and not doing something just because it’s the way it’s always been done. It reminds me of John Lewis’ ‘good trouble’ — if you know something is right or if something can be done better, keep pushing for it and do not accept the status quo. Know that we can always do better. That is how I have tried to live my life and my career. At this point in my life, being a disruptor includes a lot more mentoring and supporting of young, up-and-coming oncologists and encouraging them that things can change and should change, and that we need to be vocal in order to do our part in the change.

Healio: What advice do you have for other women in the field?

Gralow: Women have different concerns, especially with work-life balance. We are fighting for that to be recognized, including time off for childbirth, child rearing, accommodations for nursing and more.

Much of the criteria for career progression in academics are related to timelines of publications and grants. Promotions are on a timeline and if not promoted in a certain number of years — or if we don’t have a certain number of publications in a certain amount of time — then we get dinged for it. However, all of that does not work if someone has followed a slightly different life path by taking time off and having children, for example. It is important to prioritize your life over your work. Many people say there is no such thing as work-life balance, and really, you can never perfectly balance it all, but place your priorities in the right place.

Going beyond the family aspect, it is also important to take time off to renew yourself and nurture and pursue the things that you can’t do in a conventional 9-to -5 job. As women, we must do what nurtures us.

Healio: What are you working on now to continue to disrupt the field of oncology?

Gralow: I have the amazing opportunity in this relatively new role as ASCO Chief Medical Officer to have an impact much more broadly than I did in my previous position as a professor in Seattle. I have been a clinical trialist for decades, and within the National Clinical Trials Network, we’ve been working on simplifying clinical trials — making them easier to conduct and for patients to have better access. In my current role at ASCO, I can help simplify clinical trials and improve access to clinical trials for patients by getting rid of much of the eligibility criteria and other requisites that make it too hard for patients to participate.

At ASCO, we have many projects going on to enhance accrual of clinical trials for underserved populations, for decentralizing clinical trials and making them more patient centric. We can also conduct pilot trials and issue recommendations. We can influence and work closely with the FDA and the NCI on all important issues.

Prior to my role with ASCO, I had a strong interest in global health. I was an affiliate professor of global health and a medical oncologist for 30 years in Seattle. One of the key action items I’ve discussed with my colleagues at ASCO is how we can move the needle in helping our members and their patients gain access to essential cancer medicine globally, including in low- and middle-income countries. We have held multiple summits and we’ve joined a coalition, the Access to Oncology Medicines (ATOM) coalition, that is led by the Union for International Cancer Control. We are working with multiple stakeholders to help get the key essential cancer drugs listed on the WHO Model Lists of Essential Medicines — most of which are off patent, generic and low-cost — available globally.

We also have an ASCO initiative aimed at professional well-being and working to get the joy back into the practice of oncology. We are trying to address the factors that contribute to burnout in our profession and have created a taskforce that focuses on work in this area, which will hopefully make a difference there as well. These are some of the things that we are working on that will hopefully disrupt the current status quo.

Healio: Is there anything else that you’d like to mention?

Gralow: When I was junior in my career, there were two paths I took in which multiple people above me discouraged me from going in those directions.

The first was partnering with patients back in the mid ’90s. When I started my faculty position, multiple people told me that I was getting too close to my patients. When we started Team Survivor Northwest, which is an exercise organization for women impacted by cancer, I ran, hiked, biked and got out there and encouraged women living with cancer and cancer survivors to get out and be active. I was next to them doing it all with them. During that time, I was told that it is not professional to be out there on weekends doing all these things with patients, but I found that it was one of the most rewarding things in my life. Founding Team Survivor Northwest, which is still going strong 30 years later, was outside the routine, but incredibly important to me.

Second, when I got invited to participate in a project on breast cancer in Ukraine back in the late ’90s, I became very interested in global oncology. My eyes were opened as to what was going on in the rest of world, and I was told many times, “You’re gone too much, you can’t travel internationally this much, this won’t work and you shouldn’t do it.” But I kept doing it, and even partnered with patients globally, which was one of the biggest outcomes of the Ukraine project — helping to start patient support groups and introduce the Ukrainian cancer survivors to other cancer survivors from the former Soviet Union. We helped them connect regionally and addressed barriers. We called this project the Women’s Empowerment Cancer Advocacy Network (WE CAN). This advocacy work later translated to work in Africa, where Fred Hutchinson Cancer Research Center developed a strong relationship with Uganda Cancer Institute. I was privileged to meet Ugandan women cancer patient advocates and start an African version of WE CAN.

Those are examples of things that combined my passions, accelerating progress in cancer care and research and improving the lives of cancer patients. I see a big part of my role at this stage of my career as being a convener — I have the ability to connect people, especially in my ASCO role, and making those connections and relationships can go a really long way. It is satisfying to be able to make those connections and make a difference for the practice of oncology and the outcomes of patients, not just in the U.S., but globally.

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Julie R. Gralow, MD, FACP, FASCO, can be reached on Twitter @jrgralow.