The Directors: Mary Beckerle and Neli Ulrich on delivering cancer care across five states

Mary Beckerle, a whitewater kayaker, has advice for all the folks in the cancer field: never catastrophize, never panic. 

“Back in the day, I used to whitewater kayak, and you’ve got your paddle, and you’re in the water.

“And when you hit that rapid, the one thing you know you have to do is take that paddle and dig it into that wave and pull yourself through with gusto and with determination. And you can’t respond to this chop by just holding your paddle up in the air and going, ‘Uh-oh,’ or you lose every ounce of potential to shape the situation,” said Beckerle, who is also a cell biologist and CEO of Huntsman Cancer Institute. 

Beckerle appeared on The Cancer Letter Podcast with Cornelia Ulrich, chief scientific officer and executive director at Huntsman, and Karen Knudsen, CEO of the Parker Institute for Cancer Immunotherapy and former CEO of the American Cancer Society.

“I think one of the things that we can think about in this time is that all of us need to think about digging in with that paddle, going directly into the middle of the wave that’s coming at us and shaping it as much as we can, and continuing to move forward rather than just being tossed and turned,” Beckerle said.

“And I think that’s a good image for what the scientific community is really trying to do right now.”

Beckerle is stepping down as CEO at Huntsman on Sept. 1. She and Ulrich have been working hard to explain the value of science, NIH, and the contribution NCI-designated cancer centers make to the health of the nation.

All of us need to think about digging in with that paddle, going directly into the middle of the wave that’s coming at us and shaping it as much as we can, and continuing to move forward rather than just being tossed and turned

Mary C. Beckerle

“This has probably been one of my biggest jobs over the past six months—to communicate and be out there and help bridge that gap that has been maybe artificially raised by some people about science and policy,” said Ulrich.

“And really, I mean, what Mary said is so true. No matter where we go, people care about cancer, and no matter whether they are ‘red or blue,’ their families are affected by cancer. And we have had that strong bipartisan support and we continue to foster that. 

“Yes, a lot of it is there, maybe not as visible at times, but I think we should be optimistic about the future here.”

What Beckerle and Ulrich say to their elected representatives matters a lot. While the catchment areas of other cancer centers have at least two senators and at least one House member, the area served by Huntsman arguably has the largest congressional delegation in the U.S. 

That’s because three years ago, the institution that previously served Utah expanded its reach to Nevada, Idaho, Wyoming, and Montana (The Cancer Letter, April 1, 2022). That’s five states represented by 10 senators and 13 House members. 

All but two of the senators and three of the House members are Republicans.

Beckerle will be replaced in the CEO job by Brad Cairns, an epigenetics researcher (The Cancer Letter, July 11, 2025). 

Huntsman, the only NCI-designated comprehensive cancer center in Utah, serves 17% of the landmass of the contiguous United States. People who live in these rural and frontier geographies really face tremendous challenges and poor outcomes when it comes to cancer.

“What keeps me up at night is that not everyone in our area that we serve, and not everyone across the United States and the world actually has access to the incredible advances that are available. So, what I’m really interested in is, how do we change that? How do we bring the incredible science-based medicine that’s now available to people closer to where they live?” Beckerle said.

“It’s about access and also illustrating the value of our cancer center to communities that live far away from one,” Ulrich said. “And what keeps me up at night right now is how do we help our next generation to still see perspectives in science with everything that’s going on?”

Beckerle and Ulrich spoke to Paul Goldberg on The Directors, a monthly series on The Cancer Letter Podcast which focuses on the problems that keep directors of cancer centers up at night.

This episode is available exclusively on The Cancer Letter Podcast—on Spotify, Apple Podcasts, and YouTube.

Knudsen, appearing on the podcast as a discussant, said she thinks Beckerle and Ulrich’s “winning strategy,” is their “people first, but science forward,” approach.

“What you heard from both of them was a sense of urgency to take this innovation that’s happening in cancer prevention, detection, and cures, and push that science to people and enhance their ability to gain access to these breakthroughs,” Knudsen said.

“And you heard that through not just the way that they’re structured, but also their ambition for growth to coming to the community, working with the community, and then taking the excellence that they have in science and in patient care and granting access around this very large catchment area, catchment that they serve across five states.”

The American Society of Clinical Oncology sponsored this episode. ASCO plays no part in the editorial direction of this podcast.

Explore previous episodes of The Directors. 

Some highlights:

The cancer center’s founder, the industrialist Jon Huntsman, described himself as a member of the Cancer Party. 

Said Beckerle: 

Why cancer has so much support on Capitol Hill

The cancer center is building a second campus in Utah County

Said Ulrich:

How to accomplish serving a vast area of frontier states without brick and mortar

Said Ulrich:

Why is Beckerle leaving the job now

Said Beckerle:

Listen to the full episode on Spotify, Apple Podcasts, and YouTube.

A transcript of the podcast is available below:

Paul Goldberg: Welcome to the August 2025 episode of The Directors. This is going to be so much fun that we have scrapped our format that we usually use and are going to have a lot of fun talking about a lot of really interesting things. I have no idea where it’s going to go, but it’s going to go someplace very interesting.

With us, we have Mary Beckerle, who is stepping down as CEO of Huntsman Cancer Institute, and Neli Ulrich, who is the chief scientific officer and executive director of Huntsman. And the discussant is Karen Knudsen, who is a former cancer center director, former CEO of the American Cancer Society, and the CEO of the Parker Institute for Cancer Immunotherapy.

And here we go. Let’s get going. I guess my first question is going to be to Drs. Beckerle and Ulrich. Huntsman serves a vast geographic region. There’s rural population, frontier, indigenous. How are you tailoring the strategy to meet all of those needs?

And really, the most important question is, what’s keeping you up at night as you do this?

Mary Beckerle: Well, maybe I’ll start, because you asked what keeps me up at night right after you talked about our vast rural and frontier geography. And that’s actually what keeps me up at night.

What keeps me up at night is realizing that through the incredible advances in cancer research and the applications of our science in the clinic and with our communities, we have made such a difference in cancer outcomes.

And what keeps me up at night is that not everyone in our area that we serve, and not everyone across the United States and the world actually has access to the incredible advances that are available.

What I’m really interested in is, how do we change that? How do we bring the incredible science-based medicine that’s now available to people closer to where they live?

Cornelia Ulrich: Well, and maybe I’ll chime in.

I think you picked up on something that’s incredibly important, that it’s about access, and also illustrating the value of our cancer center to communities that live far away from one.

And I think that goes back to what we are all trying to do now as cancer center directors, to communicate better about the value of science and research to communities that traditionally have not been reached as much.

And by providing this access, I also actually mean we do a lot of work that is related to bringing our next generation of scientists here to Huntsman. We have training grants.

We have special programs for rural kids. I was just speaking to them. And what keeps me up at night right now is how do we help our next generation to still see perspectives in science with everything that’s going on?

Paul Goldberg: When the National Cancer Act was signed into law, the cancer centers were seen, from that moment on, as the conduit for bringing science to the people. And, Neli, as a population scientist, you watch that; right? You’ve got the front row seat.

Cornelia Ulrich: I live and breathe it. But I should say, when I came into this role as cancer center director, Mary Beckerle had already started an enormously successful effort of valuing community outreach and engagement and bringing that to the forefront for the cancer center.

So, I picked right up on that and ensured that we are doing whatever we can in those five states across the Mountain West. And a lot of that is through partnerships, through anchor organizations. We can talk more about what that means, but it’s important that we do what we can.

And it goes back to the value of cancer centers.

Mary Beckerle: I mean, I think it really does. And I think if you look at the map of the United States and you look at where we are in Salt Lake City, Utah, we’re the only NCI-designated Comprehensive Cancer Center in our state, but also, as Neli has pointed out and you pointed out, the five-state Mountain West, which I like to remind people, represents 17% of the landmass of the contiguous United States.

So, this is not a simple challenge to try and reach people over that enormous distance.

And I think one of the things, Neli, I think it would be great if you would share a little bit about some of the really pioneering work that you and your team have been doing to really illustrate that this is not something that we’re making up just looking at a map.

I mean, people who live in these rural and frontier geographies really face tremendous challenges and poor outcomes when it comes to cancer.

Cornelia Ulrich: Yes, happy to talk a little bit about that. I mean, when we decided to say the five states are the area we serve, it really formalized already existing activities and existing service and just made it a little bit more clear.

Yes, this is our commitment.

And we started an entire strategic planning effort specifically to the area we serve, which is what we call our catchment area. And it includes domains that range from training to policy to community partnership, clinical partnerships, data assessment, and everybody works very closely together.

And so, we’re talking about, or we’re implementing, remote care. We’re implementing training, as I said, for our students and next-generation scientists across the five states. And we think very actively, how can we—through research, for example, innovation and artificial intelligence and digital technologies—help bring care remotely or make it easier for people to be part of our research and our optimal care?

And one example is also clinical trials; right?

Some clinical trials that are happening now are really testing how can we reduce the amount of travel time that our patients spend coming here by condensing the treatment into shorter time periods, especially for radiation treatment. And about a third of our patients travel more than 150 miles.

So, it makes a big difference to be able to do that. And yes, I think we’re very, very committed to that. The entire cancer center pulls together and thinks about it, whether they’re clinicians or COE or data scientists or basic scientists. We have a lot of activities through that.

Paul Goldberg: Correct me if my numbers are wrong, they could well be, but I think you have the second largest catchment area of any cancer center other than Hawaii. And theirs is water. Yours is sand, rock, prairie. That’s correct; right?

Cornelia Ulrich: That is correct. And again, this was not about saying, “Hey, we want to go ahead and claim a large area.”

The point was to say there’s nobody else there who has made that formal commitment to work with those groups and those populations. And so, we also found that there’s a unifying theme across the five states, which is basically remoteness.

It’s being rural or even frontier—and frontier [means] fewer than three people per square mile. That is a very different challenge from what we think about when we stay in a town.

Mary Beckerle: Yes, I think when you think about the area we serve, this five-state Mountain West, all you have to do, I can look out my window here and I can see the edge of Salt Lake City, and then I just see vast open territory even from here.

And I think what Neli and our colleagues have really demonstrated is that this great distance really is a disparity for patients and community members. It causes higher death rates for cancer patients and worse outcomes, overall. And that’s now been demonstrated through their scientific efforts.

And I think that we feel this deep responsibility for these populations. And Paul, you’ve been around a long time, and you know that we always talk about, “You’ve seen one cancer center, you’ve seen one cancer center,” and all of us as a collective are trying to address the most challenging aspects of cancer.

But each of us has special ways in which we can contribute. And for us, one of those special ways is that we really want to focus in an area where we have unique populations, unique challenges.

There are rural populations all over the country, of course, and all over the world, but we’re sitting in the middle of really an amazing laboratory, a geographic community laboratory to really innovate. And we hope to be real leaders in figuring out how to address distance as a disparity and new ways to bring the astonishing advances in cancer care and screening and prevention to people closer to where they live. And if we can do that here in the five-state Mountain West, imagine what that will mean across the country and even globally, where of course there are many, many large rural populations.

Paul Goldberg: I love being Mr. Trivia today. The line, “You’ve seen one cancer center, you’ve seen one cancer center” is attributed to Joe Simone.

Mary Beckerle: Whom we love. Yes, we recruited him before we even had a building here, really. I mean, it was from Memorial Sloan Kettering after he had previously been cancer center director at St. Jude’s, and he was our founding chief clinical officer here and physician in chief.

And what an amazing leader and wise person Joe was. I miss him tremendously. He taught us so much.

And one of the things he really taught us is how we absolutely have to face the biggest challenge and figure out how to go after it.

Back in the day when he first came here, we didn’t even really have multi-specialty care; right?

So, he was a champion in really changing the landscape of cancer care delivery.

Paul Goldberg: I have no evidenced way of proving this, but I think he’s kvelling out there in heaven.

But how do you do what you’re trying to do without brick and mortar, especially since you’ve added those states? You’ve added four states; right?

Mary Beckerle: Yes.

Paul Goldberg: Recently.

Mary Beckerle: Yes, we’ve got five all together. We’ve added four new ones.

Cornelia Ulrich: Yes. So, maybe just for those who are not familiar with what those states are, it’s Idaho, Montana, Wyoming, Nevada, and, of course, Utah.

And so, again, we already had many, many activities and collaborations by the time we made that decision together with our external advisory board to say, “We, as the only NCI-designated cancer center in that area, want to really formally make this our catchment area.”

And then we quickly changed the name from “catchment area” to “area we serve.”

Now, without the brick and mortar, maybe I’ll start with that, and then Mary can talk a little bit about the actual brick and mortar that we are bringing there as well.

So, when we talk about partnerships, we mean that very seriously. We have a lot of collaborations, for example, with Federally Qualified Health Centers across the five states of the Mountain West. And that means that we are working with them, for example, by helping them implement cancer prevention activities in their electronic health record.

So, we provide the technical expertise. We go there, we understand how the clinic works, and then we set it up in a way that makes it easy for the clinicians and the patients to follow some of the key guidelines regarding screening, or tobacco cessation, or cancer survivorship interventions.

So, that’s one example of how you can do it without brick and mortar. We also have something that’s kind of a stellar program called Huntsman at Home. It was developed by Kathi Mooney and other colleagues that is really bringing nursing care and remote care to rural communities. And so, we can do that.

But the biggest opportunity, honestly, is using AI and other ways of being able to help patients, too. Let’s say they’ve been seen at Huntsman, they had their surgery here, they’re getting discharged. Now they may or may not have symptoms. We can remotely monitor those symptoms. We do a lot of research in that space that then AI is basically trying to tell us, “Hey, here’s a challenge. We need to jump in and help this patient get care or be reached out to.”

So, we have a lot of opportunities to use technologies, high tech and high touch, to reach people in remote areas. And by the way, it’s just as relevant in New York City because people don’t want to travel in the subway there either. And having remote care is going to be the future; right?

So, whatever we do here is just as relevant elsewhere. But, Mary, do you want to talk about our brick and mortar approach?

Mary Beckerle: We’ll talk about bricks and mortar. I think one of the key points, and this is maybe something Joe Simone would be proud of in the way we’re thinking about it, is that we see a challenge, and we are going to use the full dynamic range of opportunities to address that challenge.

So, it’s not no bricks and mortar, it’s not all bricks and mortar. It’s everything we can think of; right? So, Neli I think mentioned the critical role of collaboration and partnerships.

We want to leverage the activities and the wherewithal of our Comprehensive Cancer Center, and we do that through strategic partnerships. And it’s with other universities. It’s with other health systems.

We have a broad affiliate network that allows us to bring clinical trials and to support our colleagues with tumor board access, etc. So, partnerships are really key. And then of course, scientific innovation, and Neli gave some great examples.

But we also recognize that bringing physical presence of Huntsman Cancer Institute can also be really, really important to communities and populations.

So, we’ve just announced that we’re going to be building a second comprehensive cancer center campus for Huntsman Cancer Institute in Utah County, which is a southern county relative to where we are now.

And just put this in perspective, last year, we had between 40,000 and 50,000 patient visits from people in that area, driving from that area up to Huntsman Cancer Institute in Salt Lake City, over three and a half million miles traveled; right?

Think about the hours lost—and not just the patient, but whoever in their family came with them. And we also recognize that many people just say, “That’s too far to go.” And so, they don’t get access to the opportunities that we can provide, some of the unique opportunities we can provide, like access to certain clinical trials, etc.

So, we’ve decided that in addition to collaboration and partnerships and scientific innovation and discovery, we are going to have a broader geographic presence.

We’re becoming more of a system as a cancer center, and we’re really excited. We’re going to be investing in the facility alone over $400 million over the next several years.

We’re bringing not just clinical care, but also educational opportunities and engagement with new universities that are located in that county, Brigham Young University and Utah Valley University, as well as other academic institutions.

And we’re also going to come immediately with our science.

And I’ll let Neli talk about this, because one of the things that’s really the secret sauce, I think, of the NCI Cancer Centers program is the commitment to integration of research with clinical care.

So, we’re not just coming with clinical care, we’re coming with new research programs and new research programs that are going to inform our ability to detect cancer earlier, prevent it, and treat it.

Paul Goldberg: So, the new campus is, when you say comprehensive cancer center, you mean lowercase—all three, because the Comprehensive Cancer Center, with uppercase, is Huntsman still; right?

Mary Beckerle: This is going to be Huntsman Cancer Institute. It is like another campus of Huntsman Cancer Institute and will all be part of our NCI-designated Comprehensive Cancer Center that’s overseen by Dr. Ulrich.

Paul Goldberg: And that’s going to be serving the other states as well; right?

Mary Beckerle: Well, I think the way we think about it is that it increases our capacity.

We will have a location in Salt Lake City that will be able to span northward to help support patients and communities in need. And we’ll have a second center now about 35 miles south that will span southward into the more rural and frontier areas of our state.

And also, it’s much easier access from parts of Nevada, for example.

So, it’s just expanding our capacity, both to serve patients across this region, but also to deliver the science that gives us better outcomes for those patients.

Paul Goldberg: So, it’s closer to where the population is.

Mary Beckerle: And that’s what is really exciting. So, Neli should tell you about some of the scientific things that we’re going to be developing there that will amplify our impact.

Paul Goldberg: So, you’re going towards where the populations are?

Mary Beckerle: We’re going. Well, what’s interesting in Utah [is], Utah is undergoing its own kind of demographic transformation.

I mean, it is one of the fastest growing states and one of the fastest growing regions of the country. And this area of Utah County is growing so fast that in 40 years, it’s estimated that it’s going to be at least the size of Salt Lake County, which is where our major population hub is now.

So, think about Utah becoming more of a Twin Cities kind of state. And so, we’re going to have our comprehensive cancer center, Huntsman Cancer Institute with a campus that brings everything that we do, clinical care, research, education, and engagement of communities in these two locations.

And that will give us greater capacity to meet the needs of the broader population that we serve.

Paul Goldberg: Neli, I’m sorry. I’ve been cutting you off…

Cornelia Ulrich: No, no, no. These are really important questions.

So, first of all, this is still in Utah. I think that’s important, but it’s kind of a better gateway for many of our populations across the Mountain West. It has easier access through the freeway connections. It’s close to another airport that’s actually growing too.

But what I think Mary wants to say about and what you need to understand is, when we talk about a comprehensive cancer center, with not like, small Cs, it’s just that this is another campus where we combine both research and clinical care on the same footprint.

And so, we have a very large area, we’re just in Phase 1A. There’s more coming. But already as part of Phase 1A, there will be a research building that is going to house some really, really important areas, mostly dry lab, and I’ll tell you that in a second, and then the first hospital areas, which are focusing largely on outpatient.

And Phase 1B is already in process. So, we’re going to grow at that location.

And our first, and probably going back to our mission of really serving the communities of the Mountain West, our first research focus will be in data science and artificial intelligence, in healthcare transformation, and in community outreach and engagement.

And those three will actually all focus on what I just highlighted before as the opportunities that we have with making a difference, especially for our rural communities.

So, we are building the research community there with the strong intent to create synergies and interaction very actively for our community. And of course, they’re not in any way disconnected from what’s happening here at the Salt Lake campus, and they’re all faculty members at the University of Utah.

But for example, Brigham Young University is right around the corner. It has a fantastic computational sciences program. And so, we’re going to be able to have students from there who care about our mission, but bring their skills to it as well.

Paul Goldberg: That’s fascinating. So, I guess One Big Beautiful Bill Act and the potential cuts, or likely cuts to Medicaid—are you seeing how that’s going to affect you? Is it too early to tell?

Cornelia Ulrich: We did some projections, and yes, of course, it will affect us, just like others, but the effects are going to be seen more two years from now. What is challenging though across the mountain West, for example, the state of Montana, we work closely with them on what’s called a Persistent Poverty Center, a large grant from the National Cancer Institute that focuses on addressing persistent poverty, especially in indigenous groups.

And a lot of that is tied to implementation through SNAP and other programs, and also resources that are supplied through Medicaid.

So, we have not yet fully figured out what the impact of that will be, but I can assure you that we’re doing what we can.

One thing that’s important about those five states is also that we have now 10 senators that we are regularly engaging with as well as a large number of representatives in the house.

And so, it wasn’t quite intended as such, but we are now going and being the spokespeople for cancer to communities that may not have had a cancer center director visit them before.

And it’s been really important, rewarding, and quite productive to talk to our colleagues, our legislative colleagues from across those five states, and also showcase the value of the National Cancer Institute and how much they care about rural communities.

So, I’m just saying, here’s another facet of this area we serve that hopefully helps all cancer centers across the nation because we have this ability to communicate and show that we care.

Paul Goldberg: Well, this is great.

Mary Beckerle: I think this is huge. I think it’s a huge point, and I just want to put a little exclamation point on that, because, I mean, we have had here at Huntsman Cancer Institute—and Neli’s been a fantastic leader as well as many, many others here in our cancer center—but we have had relationships with the Departments of Health, with the elected representatives in these five states for a number of years already.

So, when I hear the good news coming out of Washington from the Senate Appropriations Committee, a return or a statement of the ongoing bipartisan support for biomedical research and, in particular, cancer research, it makes me feel so pleased and proud of our elected officials. But we know from our conversations with them over many, many years, they care deeply about the health of this nation.

They understand what the investment in biomedical research has done. And that’s why the NIH and the NCI have had such strong bipartisan support for such a long time.

And I think it’s been so great to see that the many relationships, I mean the ones that we have with the folks in the five-state Mountain West, but the ones all across the country that are other cancer center leaders and scientific societies and others have established and maintained, not just when we want to ask for something, but because we’re in a partnership with them to understand what they need from us to help advance health and to really share a commitment to improving conditions for the public.

So, I think it’s really exciting to see what’s happening with Senate appropriations. I know we still have many steps ahead, but I think it’s a tribute to those elected officials appreciating that we still lose one person every minute of every day in the United States to cancer, in spite of the incredible advances that have been made and their appreciation that research is the hope for the future.

And we need to continue to lead when it comes to cancer research and biomedical research in this nation.

Paul Goldberg: So, as my role as Mr. Trivia, let me put another exclamation mark on this, which is Vince DeVita, I believe, said that every cancer center has at least two senators and at least one House member.

So, you have 10 senators, and I don’t know the number of congress members, but it’s not small.

Mary Beckerle: No.

Paul Goldberg: Well, it’s actually small, relatively speaking, but that’s an amazing situation to be in. And a lot of them are red states. You had all of them actually. So, you had actually a real scare with your clinical research infrastructure, and that got cleaned up pretty quickly too; right?

Mary Beckerle: With our CTSA?

Paul Goldberg: Yes.

Mary Beckerle: Yes.

Cornelia Ulrich: Well, cleaned up is maybe an interesting term, but let’s put it like that. Yes. I mean, we definitely had an intense effort of explaining the value of a CTSA, and we are likewise doing this now at every visit to talk about the National Cancer Institute, the Comprehensive Cancer Centers, their unique role, and how they all have their different flavors and do different things.

But this has probably been one of my biggest jobs over the past six months—to communicate and be out there and help bridge that gap that has been maybe artificially raised by some people about science and policy.

And really, I mean, what Mary said is so true.

No matter where we go, people care about cancer, and no matter whether they are “red or blue,” their families are affected by cancer.

And we have had that strong bipartisan support and we continue to foster that. Yes, a lot of it is there, maybe not as visible at times, but I think we should be optimistic about the future here.

Mary Beckerle: We were taught by Jon Huntsman Sr., who was bold and ambitious and fearless and determined. And he used to go to Washington a lot, and he used to say, “When I go to Washington, I’m not a member of any party, except the Cancer Party.”

And that’s our perspective.

We want to work with everyone because everyone is touched by cancer and everyone appreciates that cancer is the second leading cause of death, and we need to do something about it. And we can if we are determined and we invest. So, we’re part of the Cancer Party.

Cornelia Ulrich: And maybe, Paul, something you may not know about me is, actually, my background is in nutrition.

And so, cancer prevention and nutrition and a lot of what is getting discussed about ultra-processed foods or how can we make America healthy again, I can talk to that quite effectively with the respective people who care about it.

And so, I think we all have to bring in our various talents and value that there is concern about health.

I mean, a lot of what is happening is because there’s a concern about health, and we just bring our own perspectives and meet them where they are.

Paul Goldberg: I’m glad we mentioned Jon Huntsman. He did such an amazing job under real pressure during that really difficult time for all of us, especially you, Mary, of course. All of us, really (The Cancer Letter, April 21, 2017, April 28, 2017).

Mary Beckerle: You’re speaking of 2017, I take it.

Paul Goldberg: Right, I am. I mean, I did get to talk to him. It was the most amazing thing. He had a lot to say about the Cancer Party, and how this is just not going to stick. I think we’re in a similar situation, albeit without him, but I think there are a lot of people carrying the banner.

Mary Beckerle: Absolutely.

Paul Goldberg: Yes. So, I guess you’re both rare examples of cancer center leaders who started as bench biologists, and then you come to successfully run science as well as the clinical work of the cancer center.

How did you do this? How did you pull it off? And what does it tell you about how to cultivate the next generation of leaders?

Mary Beckerle: That’s a great one. Neli?

Cornelia Ulrich: No, Mary. You start it.

Mary Beckerle: Okay, I’ll do it.

Well, I think that it’s actually extremely helpful to be a scientist because we are very comfortable with doing experiments and innovating; right? And in the cancer space, that’s what we really need. And I think second to that is, as scientists, we’ve been motivated by trying to make a difference in this disease.

And if you look at that vision of, in our case, delivering a cancer-free frontier, and put that at the tip of the spear every single day, you know that you have to become somebody who is agile when it comes to thinking about not just science, but clinical care integration, etc.

And you know that it takes a lot of collaboration and partnership to be able to function across such a broad, dynamic range. The key thing is attracting incredible talent, incredible people who are exceptionally gifted and dedicated, and bringing them together towards shared goals.

And there’s no more enjoyable and satisfying work than working in a Comprehensive Cancer Center because you know you’re making a difference every single day for people.

Cornelia Ulrich: Well, thanks, Mary. I think you said a lot of the things I wanted to say, but let me add a couple of other aspects as well.

First of all, there are a number of cancer centers directors across the nation that are very successful as PhD-level cancer center directors. And I think we all understand that nobody knows everything. It’s impossible. We all are working with diverse teams that bring different perspectives and skills and expertise, and as long as they all pull together on one string towards one mission, it works extremely well.

And so, that’s been my secret sauce as cancer center director, doing pretty well during the last review, is like, it’s not been me; right? I’m the convener, I’m the servant leader who finds that talent, brings it to the table and makes them all raise their voices and bring in their perspectives and advance the cancer-free, or deliver a cancer-free frontier, as we call it here at Huntsman. So, that’s been our mission.

We’re very unified and we have some very important guiding principles, which is patient and community first, united effort and excellence in all we do. And the united effort brings everybody together, whether that’s a clinician or a basic scientist or population scientist, or a COE person, because that’s what makes us tick and want to achieve our goals.

Paul Goldberg: Channeling Joe Simone a little more: “Leadership does matter.” But how many jobs is running the cancer center? Is it two? Is it three? Is it five?

Mary Beckerle: Four thousand right here. Four thousand jobs today for Huntsman Cancer Institute.

Paul Goldberg: Makes a lot of sense.

Cornelia Ulrich: It’s a lot of jobs. I mean, it makes it very exciting too; right?

I mean, we spend time sometimes, especially now, where we have so many challenges that affect our researchers, especially our junior researchers.

We are sometimes therapists.

We engage, we try to help. We’re motivators, we’re cheerleaders, we’re teachers, we are managers. We’re, I don’t know, scientists on the side as well, but it is important to have the time to be all of that and be engaged.

I take care of what we call the HCI community as much as possible through town halls, through emails, where I update everybody. I have new faculty lunches. I connect with our Huntsman Alliance for Postdocs, and try to keep everybody engaged and understand what their challenges are and help improve that.

Mary Beckerle: One thing to kind of build on what Neli just said, this Comprehensive Cancer Center, Huntsman Cancer Institute, really is the product of literally 4,000 people working each and every day, plus more than a million donors who have come behind us and with us and supported us, our community leaders who have sponsored us along the way.

And with our 4,000 people here at Huntsman Cancer Institute, one of the key things that I think is really important is that people really feel, no matter what they do each and every day, whether they’re a scientist, an administrator, a finance person, a clinician, an environmental services person, somebody in our culinary services, computer support, whatever, they all can see how their work is connected to our broader purpose.

I was really proud of a moment that happened not that long ago where we had a job candidate here, and he came a little early, came over the weekend and went into our cancer clinics and just started wandering around as a secret shopper and started talking to people.

And this was a couple of years ago, and he saw one of our environmental services people who was sweeping up the floor, and that person asked that person what they did, and the person said, “Well, I’m creating this space to really help to support our patients and their families.”

And then the job candidate said, “What’s going on out here in this? There’s a big hole in the ground out here.” And at that point in time, we were putting in our new proton therapy unit, and this environmental services person said, “Oh, I’m so proud of that. We’re putting in proton therapy, which is going to improve outcomes for our cancer patients, and it’s really cool, because it’s embedded in the mountain.”

Gave the whole, whole story.

And I thought, this is really where the action is. It’s every single person who’s here in our cancer center and all the cancer centers around the country kind of feeling a connection to that purpose that’s really deep and really meaningful, and drives them always to do their best.

So, that’s really, when you say who does it, it’s that, all those people.

Cornelia Ulrich: And that’s what will make us prevail too.

No matter what’s happening right now, this is just a small bump in the road. Or if you think in the Mountain West, when we go down rivers, or whatever, this is just chop of the water.

So, yes, it’s some bigger chop, but we’re going to prevail and we’ll do our chop.

Mary Beckerle: I love this chop thing. And, Neli, probably, is always prompting me because I used to kayak.

Back in the day, I used to whitewater kayak, and you’ve got your paddle, and you’re in the water.

And when you hit that rapid, the one thing you know you have to do is take that paddle and dig it into that wave and pull yourself through with gusto and with determination.

And you can’t respond to this chop by just holding your paddle up in the air and going, “Uh-oh,” or you lose every ounce of potential to shape the situation.

So, we’re here in the West, and we do a lot of sports out here, but I think one of the things that we can think about in this time is that all of us need to think about digging in with that paddle, going directly into the middle of the wave that’s coming at us and shaping it as much as we can, and continuing to move forward rather than just being tossed and turned.

And I think that’s a good image for what the scientific community is really trying to do right now.

Paul Goldberg: Yes, I keep thinking of aiming the nose of the kayak at the V.

Mary Beckerle: Exactly. Are you a paddler also?

Paul Goldberg: Just that very spot and then…-

Cornelia Ulrich: You have to go, you have to move.

Mary Beckerle: Are you a paddler also?

Paul Goldberg: I’ve done it a little bit.

Mary Beckerle: Yeah. See? It helps.

Paul Goldberg: I’m more of a biker, but yes. So, as leaders, what’s the most difficult paddle plan you’ve had to make in recent weeks? What’s been difficult?

Cornelia Ulrich: The interesting thing is that I feel like I’ve kind of gotten used to stuff coming our way. I remember in February, when the first thing that came on a Friday evening, our entire university leadership and me, where we’re like huddling over, how can we address this and all of that.

And now I think we have a little bit more distance, that we understand some things will come and some things will go; right? And we are doing our job to shape the future, and we’ve been quite successful with that.

Maybe one difficult thing was when we realized that this is going back to the CDC. The CDC has a chronic disease division, which funds a lot of activities across the Mountain West, including the Mountain West Prevention Research Center.

So, this is really what keeps Americans across the Mountain West healthy. It’s obesity prevention, it’s part of our cancer portfolio. And when that was at risk, along with several other important grants that are funded through this chronic disease division, as well as the screening efforts for the departments of health across those five states and our partners, our community advisory board, our Mountain West advisory board told us this is a problem.

So, that was hard.

And then we stuck in the paddle and said, “Okay, what can we do?” We created a document that said, here are the things that are happening. This is what’s at risk. Very brief writeup. And we made appointments with every single senator that we could reach and several appropriations-related individuals as well, and just said, “Well, look, this is probably entirely unintentional. Yes, there are issues with the CDC, but that’s not the point. Here is something that really matters to our communities that’s right now at serious risk.”

And I’m pleased to say that it sounds like every single one of those grants has continued and that this issue was raised; right?

So, this was a difficult moment, but it was also one where it was so clear what the message needs to be and what I as cancer center director have to do—to fight for our communities across the Mountain West.

Paul Goldberg: Mary, what’s next for you?

Mary Beckerle: Oh, I’m really excited. We’re at just such an incredibly strong place right now at Huntsman Cancer Institute.

And as we were discussing, we are embarking on the building of this new comprehensive cancer campus. Think about 25 years ago, this, now a million square foot facility was sitting on an empty hillside, and now we’re starting to build on our Lakeside Campus, the first phase of what will be our second comprehensive cancer campus.

So, it was the right time to kind of pass the baton, so to speak, because that whole initiative is going to be shaping over the next several years and really will come to fruition in the next five to 10 years and mature.

And it’s important, I think, for the next generation of leaders to be at the helm to shape that and to own it and to deliver it; right? So, it’s an exciting time and a good time for a transition. But I’m not going away, I’m staying on the faculty as a faculty member.

And after a sabbatical, I’m also joining the Huntsman Cancer Foundation board, which is our 501 (c) (3) independent organization that raises funds to support our cancer institute mission.

So, I’m going to stay engaged in a way that I hope will be very enabling for the great science and care that’s delivered here going forward.

Paul Goldberg: Well, maybe you could even add a gig as a columnist for The Cancer Letter.

Mary Beckerle: There you go.

Paul Goldberg: I’m very seriously suggesting that. But yeah, is there anything I forgot to ask?

Cornelia Ulrich: Well, just thanks for all you do. I think it’s been really wonderful to see how The Cancer Letter has stepped up and has not hesitated to raise important issues, has been an outlet and a voice for a lot of the concerns that are happening and the way forward.

So, thank you, Paul, for inviting us.

Paul Goldberg: And thank you.

Cornelia Ulrich: And thanks for all you’ve been doing over the past months.

Paul Goldberg: Thank you.

Mary Beckerle: Ditto on that, because I think, as Neli mentioned earlier, things are happening so quickly and it’s kind of a whiplash type of situation sometimes. And you know you can always rely on The Cancer Letter to have the integrated, updated information. So, it’s an incredibly important asset for the community. Very grateful for what you’re doing.

Paul Goldberg: Thank you.

Cornelia Ulrich: And maybe I’ll just say one more thing also. I’ve really enjoyed working with all my colleagues, cancer center directors, from the different flavors of the United States that all have stood together. And AACR has been a wonderful partner, AACI.

I think that’s what keeps us going, is to know that we as leaders have a really, really strong community to help face these challenges and overcome them. So, thanks to all of them as well.

Paul Goldberg: Well, we’re all the same team, Team Science.

Mary Beckerle: You bet.

DISCUSSANT

Paul Goldberg: Well, Dr. Knudsen, thank you for agreeing to be the discussant on this. What have you heard? What are your thoughts?

Karen Knudsen: Yes, well, greetings from here in the Bay Area in the Presidio, and I won the Discussant Lottery, because what we saw was leadership in action with Dr. Beckerle and Ulrich.

What an incredible team they have been as CEO and cancer center director, with just a legacy of real strength at that organization. But the two of them highlighted such important areas that I think that we should shine additional light on.

I think the first really is their winning strategy is around people first, but science forward.

And what you heard from both of them was a sense of urgency to take this innovation that’s happening in cancer prevention, detection, and cure, and push that science to people and enhance their ability to gain access to these breakthroughs.

And you heard that through not just the way that they’re structured, but also their ambition for growth to coming to the community, working with the community, and then taking the excellence that they have in science and in patient care and granting access around this very large catchment area, catchment that they serve across five states.

Paul Goldberg: Yes. Also, one thing I learned that I didn’t really think of, I mean I knew it, but 10 senators from red states. That’s a nice delegation.

Karen Knudsen: It’s a very nice delegation. And the legacy of Huntsman will not just be Drs. Beckerle and Ulrich, who I think are amongst the top cancer center directors that have ever served when you look at what they’ve accomplished, but also within that legacy as Jon Huntsman, clearly as they both articulated, they recognize, as every cancer center director does, that you’re not going to be able to succeed in this idea of reducing the cancer burden alone.

They each talked about incorporating partnerships like the burgeoning partnership with BYU and filling in their data science teams, the business community, volunteers, donors, but also policy.

This is something that I really, very much, obviously, believe to be true and certainly increased a focus on at the American Cancer Society, when I was leading that organization, is that I truly believe that that’s where the final definitive solutions happen is when there’s a policy change.

Patient navigation is a perfect example. We all knew that patient navigation was a really important thing to do. All the science said that, we deployed it in our clinics.

We all felt it, but the only way to really make that a reality and scale it was to have a policy push and have it become a reimbursable component of cancer care. It’s one of the things that Dr. Beckerle was alluding to as we got off the call today.

But Jon Huntsman is a perfect embodiment of just that and what a great partner for the two of them in Utah, because he understood that in his state to improve health there needed to be a better way to prevent and manage cancer, cure cancer when possible.

And he viewed the cancer center as a strong partner. He held them accountable, but also viewed them as a strong partner for getting this done. And then, I think, led by example in the government. So, good for them that they developed this real rich history of not just engaging volunteers and patients and communities, but also ensuring that elected officials came along and understood.

And you can hear Dr. Ulrich now, with a real sense of urgency to ensure that there’s a heightened awareness about the value of cancer centers.

Paul Goldberg: Also, I love that metaphor of kayaking, whitewater kayaking. That’s really all it is. You’re in a very difficult situation. You go through some rapids and you just basically split up one big scary looking rapid into a bunch of smaller, less scary looking rapids and point your nose at the V and plant that paddle. And that is…

Karen Knudsen: Well, these are fearless, brilliant women.

So, it’s a perfect analogy for them and to tackle things head on in a way that where there’s a strategy to win, just stick your paddle in randomly. And I thought what Dr. Beckerle talked about of… essentially I’m going to rephrase…scientists being very well positioned to run clinics and run the business. I think there’s nothing more true than that.

We as scientists are trained to challenge paradigms. You’re trained to hypothesis test, to use data to develop a next-best scenario or alternative scenarios to the norm and then continue to absorb what’s happening in the landscape around you and adjust accordingly.

I think there’s no surprise why there are a number of PhD directors who also ran the clinics and grew them very successfully. I think if you look at the data, those directors did exceptionally well, and that’s what she’s doing.

She’s assessing both of them, assessing the landscape around us, that choppy wave that they talked about, using the data that they have about the catchment area that they’re trying to serve, the science that they’re generating, the business model that they have, and determining how it needs to get shaped forward.

Dr. Beckerle talked about, and Dr. Ulrich talked about, the move out to get closer to patients.

Well, I think that makes perfect sense. As a healthcare person myself, the norms of how it is that we treat and identify cancer is changing rapidly. The business model, finally, in health care, all of a sudden there’s much more attention paid as there long should have been to how the customer feels, the patient, the person, or the potential patient who needs to be seen.

Why are we just conducting health care Monday through Friday, nine-to-five? Why are we just doing it at these academic centers or cluster centers where people need to travel long distances to come?

We’ve been seeing this as a trend across the U.S. for the last several years of getting care closer to individuals, and that includes cancer detection. Just look at all the at-home testing that’s starting to happen, but now technology is helping us escalate that in ways that we could not have predicted even five years ago.

So, I really appreciated as well Dr. Ulrich’s discussion about the incorporation of new technologies and AI.

That’s clearly going to be part of the answer to how to address rural populations. And it’s everything from optimizing remote visits to wearables to monitoring for individuals in a post-treatment setting and being able to hand off that care to a care team that’s closer to the patient so that they’re not having to go back and forth on these long distances.

They seem to have their eye on not just how to generate the cancer center of now, but how to generate the cancer center that’s going to be optimally effective for patients five years from now.

Paul Goldberg: Before November, you and I often talked about diversity, about the need for more women cancer center directors. So, what does it look like to you now? Where are we? What do we do? That’s a better question. What do we do?

Karen Knudsen: Yes, what do we do? I wish I had the answer to that. And I think part of the issue is maybe we don’t understand what the root cause is of why there’ve been so few NCI designated cancer center directors that are women.

Because when you look at the success of the group, Dr. Beckerle, Dr. Ulrich, Dr. Willman, just as Candace at Roswell. She’s just been an icon there. I mean, there are others, but not that many. Yoli Sanchez in New Mexico is one of the new women cancer center directors, but altogether we’ve not made a ton of progress.

And is that because not enough people aspire to do it? Is there something that is just fundamental to the decision-making process, is it that we’ve not had enough women that are deputy directors who were in that launch pad to go into the top seat?

I’m not sure, but it’s certainly something worth looking at, because the track record, again, of those directors has just been exceptional.

Paul Goldberg: The style, different style I think maybe. I don’t know.

Karen Knudsen: Maybe. Maybe.

Paul Goldberg: Maybe I have one question of… that’s usually my first question on The Directors, is what keeps you up at nights? So, what’s keeping you up at night now that you’re at PICI, and your other gigs?

Karen Knudsen: Yes. Well, I think part of coming to the Parker Institute was to stop staying up at night. To be actively part of a solution of thinking differently about getting breakthroughs to people.

So, our whole model is to fund high-risk, high-gain cancer therapeutic science. Embedded in our model is risk. That’s what we’re intended to do as an organization. And we actually generally don’t fund people. We fund centers of excellence, much like a cancer center, and have a commitment with them to be very agile on any given year, month, or day to shift what the funding priorities are so that we can go after the thing that is the most important for cancer cures.

Now, that’s not alone. We then embed within the tech transfer office of that organization so that we can look at all of the subject matter IP, all of the breakthroughs that are happening, and then launch early-phase companies.

So, we have 17 early-stage companies that we’ve launched that get those therapeutics to people in the form of clinical trials and really compress that timeline. When you think about the time that it takes for discovery, that’s happening in most organizations to get to the point of FDA approval for cancer, that’s between a 10 to 15 year timeline.

We see ourselves as the organization to compress that timeline because of the early-stage company capitalization and launch and then getting those into clinical testing.

We had a great win last week of the launch of DispatchBio, which we were the lead investor for. DispatchBio was born at one of our Parker Institute retreats, and it’s been incubating for the last couple of years that holds real promise for using technology to generate cell-based therapies that can be effective or immunotherapies that can be effective across solid tumors, which has been a real major goal for the field.

So, I love it. I’m excited about it, but like the cancer center directors or our center directors, we know we can’t do it alone. And so, thinking through who are the strategic partners that we need moving forward is part of… it’s not what’s keeping me up at night. I think it’s keeping me energized 24/7.

That’s the way I think about it as we go through and think about this: Take the nine years of learning of the Parker Institute and launch the next decade of success.

Paul Goldberg: That’s fantastic. Any other thoughts?

Karen Knudsen: Yes, I got a few thoughts I wanted to just kind of whip through.

One is distance as a disparity. So, I think that’s so eloquently phrased that we heard today, and it’s true not just in rural populations, it’s true in urban populations as well.

When I was running oncology at Jefferson Health in any given year, 16% of our patients missed care as planned cancer care because they didn’t have a ride because they just couldn’t traverse the distance, even if that distance was only 10 miles or five miles.

And you can imagine the difference in outcome if I can go to the chemotherapy center five days a week and you can only go three even though we live right next door to each other. So, I think that allowing technology to help solve that, I think is going to be really important. We are going to see cancer care at home. And there are cancer centers—Mayo is one that comes to mind, under Dr. Wilman—that’s really at the forefront as well of cancer care at home. And I know other cancer center directors are thinking about that and sharing notes with each other. I look forward to that.

But technology and AI is going to help solve for this and help as well get enrollment for cancer patients into clinical trials that are out in rural areas and make it accessible to them and to match patients to clinical trials. I see AI now, from my perch, as AI for good in health care.

I think too much of the AI right now in health care has been focused on the provider side of ambient scribes and helping physicians do their job. All really important work. But I think we’re starting to see that shift toward how do we make care more accessible to patients in a way that’s going to make their lives better?

And so, I’m excited about where that next wave is, and it’s a big bet that it’s not just we are making as a healthcare industry, it’s the whole of the country. I was reading the business news yesterday and 40% of GDP growth in the U.S. for the last quarter… 40% was attributed to the AI sector and largely in the form of data centers.

So, all this infrastructure is being built, let’s figure out how to leverage it and get it done so that we detect cancers earlier, we make it easier for patients to navigate to the right care the first time and to have as much of that care deployed to them as soon as possible at home or close to home and how do we get patients onto clinical trial.

I think about companies like Paradigm Health—disclosure, I’m on their board, but I’m on their board for a reason—because I really think they are going to solve for getting access to cancer patients to clinical trials in an interoperable way.

So, I’m bullish about technology and shifting business models. Loved what Drs. Beckerle and Ulrich had to say, because that’s clearly what’s on their mind, back to that, how do we stick the paddle in and then create that cancer center of the future, right now?

Paul Goldberg: That’s fantastic. Thank you very much.

Karen Knudsen: You bet.