Cancer Prevention: How a division came together

The commitment to ending cancer through prevention isn’t new for MD Anderson, but it has evolved over time.

The institution’s Division of Cancer Prevention and Population Sciences began as a fledgling program with just 35 faculty and staff members in 1979. Today it’s one of the largest and most respected prevention programs in the nation.

Over the past four decades, the division’s success and growth required strong institutional dedication and just the right catalyst to get things started.

That initial push came from Charles LeMaistre, M.D., the second president of MD Anderson. “Dr. LeMaistre possessed a longtime interest in cancer prevention,” says Bernard Levin, M.D., the first vice president and head of the division. “He really believed this was an important new direction for the institution. It would never have happened without him.”

LeMaistre bolstered the existing cancer prevention program by raising it to new prominence and formally creating the Division of Cancer Prevention. He envisioned recruiting a multidisciplinary group with an initial focus on tobacco, says Levin.

However, LeMaistre’s efforts were not met without controversy. Levin, who’s now retired and living in New York, recalls opposition from senior scientists and clinicians who either did not understand the vision or thought resources were better used elsewhere.

Nevertheless, with LeMaistre’s support, Levin was able to turn the dream into reality. He recruited leading faculty in the field of prevention, which helped MD Anderson build a strong reputation in the cancer prevention community.

“These were really first-rate people,” Levin says. “The prominence of these individuals at a national level helped establish this as an effort of high quality. It was pulling its own weight in every sense.”

For 13 years, Levin oversaw expansion of research and clinical services, new departments and even a new division name. When he retired, he transferred the reigns to current vice president and division head, Ernest Hawk, M.D., who he describes as “the clear choice.”

Hawk focused first on clarifying the division’s four mission-oriented domains — research; clinical care; education, training and mentoring; and cancer control — all with a focus on translating research into services that benefit individuals, future generations, and the community at large. This required better communication across departments and establishing a clear vision for progress in each of these domains, he says.

“The vision was much aligned with the institution’s vision to be a change agent in cancer prevention,” says Hawk. “It was all about making science relevant to the clinic and the patients we serve as well as to the broader public.”

Hawk’s vision was aided by “transformative” philanthropic gifts, which established the Duncan Family Institute for Cancer Prevention and Risk Assessment and the Lyda Hill Cancer Prevention Clinic.

Now with more than 500 faculty and staff, the division continues to provide high-quality care to patients and to help implement and disseminate evidence-based actions in public policy, public and professional education, and community-based services.

Responding to a growing need to better understand and demonstrate the value of all aspects of cancer care, Hawk led the creation of the Department of Health Services Research. The department’s goal is to study health care delivery and its outcomes, so that safety, timeliness, effectiveness, efficiency and equity of care will be better measured and promoted. Researchers use a patient-centered approach that addresses each person’s cultural, socioeconomic and medical needs. Research focuses on healthy individuals, those currently battling cancer, and those who have completed cancer treatment.

The cancer prevention and control platform, part of MD Anderson’s Moon Shots Program™, is committed to extending prevention efforts beyond MD Anderson’s walls, particularly for the uninsured and underserved.

“Serving those in greatest need is something I think everyone in our division is very passionate about, but it’s hard to reach all the places where it’s needed,” says Hawk. “So I think we’ve been creative in trying to study and serve those communities in a variety of ways.”

With a foundation in stellar research, Hawk looks forward to continued success for the division. As new discoveries clarify the connections between lifestyle factors and cancer risk, MD Anderson will continue to translate those discoveries into actionable interventions.

“It’s the greatest place in the world for these types of initiatives,” Hawk says.

The evolution of cancer prevention at MD Anderson

When it was created in 1979, the Division of Cancer Prevention, which is now known as the Division of Cancer Prevention and Population Sciences, was focused on three main areas: Preventive Epidemiology, to identify markers of risk; Health Maintenance, to detect and remove cancers early; and Health Education, to disseminate information on the causes of cancer and lifestyle changes to health professionals and the public. Much has changed in the past 40 years. Here’s a look at some of the highlights:

1978
The Texas Legislature appropriates $160,810 for “prevention” at MD Anderson.

1979
The Division of Cancer Prevention is created on Sept. 1, 1979, with a staff of 35 (including faculty). It was formalized as an integral part of the institution’s mission in 1980.

1986
The Department of Cancer Prevention and Control — the division’s only department — oversees four main programs: Clinical Epidemiology, Nutrition, Community Oncology and Behavioral Research.

1988
All prevention activities are placed under the direction of the VP for Academic Affairs.

1989
The division expands to two departments, Cancer Prevention and Control and Patient Studies. Its programs include Clinical Epidemiology, Nutrition Research and Application, Behavioral Research, Prevention Clinic, Professional Education, Outreach Activities and the Cancer Prevention and Detection Program.

1991
Bernard Levin, M.D., is named ad interim vice president of Cancer Prevention.

1992
The Department of Behavioral Science is created.

1994
The Division of Cancer Prevention is formed on Aug. 1, 1994, and Levin is named vice president and division head. In December 1994, the division expands to three departments: Behavioral Science, Epidemiology, Clinical Cancer Prevention and one core, the Basic Science Laboratory.

2004
To better reflect its expanded scope, the division is renamed the Division of Cancer Prevention and Population Sciences. 
Health Disparities Research becomes the division’s fourth department.

2007
Levin retires as vice president and division head in August. In November, Ernest Hawk is named vice president and division head.

2008
The Duncan Family Institute for Cancer Prevention and Risk Assessment is created.

2010
The Department of Health Services Research is created.

2012
The Moon Shots Program and the Cancer Prevention and Control Platform are created.

2013
The Lyda Hill Cancer Prevention Center is established.