If you want to successfully fight cancer, Dr. Michael Birrer says you need to get in line.
Birrer is director of the UAMS Winthrop P. Rockefeller Cancer Institute, a post he has held since the end of last year. An internationally recognized medical oncologist specializing in gynecologic cancers, Birrer leads all cancer-related activities at UAMS, including serving as director of the institute’s Cancer Service Line.
“It allows me to see everything that’s going on with patients,” Birrer says of the service line, which provides coordinated care involving all the health systems a patient will encounter on their journey to becoming cancer free. In a service line, each surgeon or specialist knows what the other is doing and no one winds up at cross purposes.
“It means that every aspect of cancer care is within this service line,” Birrer says. “That would include radiation, it would include surgery, it would include chemotherapy. So we look at that and we can coordinate all of it so the patient has a very positive experience.”
In his career, Birrer has come to appreciate the coordinated way of doing things. He values the sharing of knowledge and a systematic, harmonized approach that gives an oncologist a clear snapshot of a patient’s case and makes the necessary resources readily available.
“I’ve been in institutions that don’t function that way,” he says.
As Rockefeller Institute director, Birrer is in many ways trying to make the service line concept work on a large scale for UAMS. He has come aboard during the push to become a National Cancer Institute (NCI) Designated Cancer Center, which would clear the way for new revenues, resources and talent that would make UAMS a high-profile, one-stop shop for coordinated cancer treatment in the region.
Until now, many of the state’s cancer patients have been forced to go to the University of Texas M.D. Anderson Cancer Center in Houston or the Stephenson Cancer Center in Oklahoma City in search of the appropriate clinical trial or treatment.
“There is no reason a cancer patient in Arkansas should have to leave the state to get the right care,” Birrer says.
With the NCI designation, important treatments would be available locally so cancer patients wouldn’t have to leave Arkansas and others might come to the state for care, while physicians, scientists and researchers would travel to UAMS to participate in research and trials. From an economic standpoint, the designation would create a projected 1,500 jobs over five years and generate an economic impact estimated at $72 million.
UAMS could be ready to apply for NCI designation in as soon as two years, but Birrer more conservatively estimates three to five.
“I think it will dramatically affect the entire state,” Birrer says. “That’s why everybody is on board and it makes a lot of sense, and that’s why I’m here.”
Shifting Focus
A former Harvard Medical School professor, Birrer came to Arkansas after directing the O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham.
His interest in medicine was influenced in part by his older brother, who attended medical school, and Birrer’s own scientific curiosity.
“I was very much interested in science, and then combining that with an opportunity to help people pretty much determined it was the logical choice,” he says.
A New Jersey native, Birrer completed his medical degree and doctorate of philosophy in 1982 in the Medical Scientist Training Program at the Albert Einstein College of Medicine in New York. He served his internship and residency at Massachusetts General Hospital, where he realized cancer treatment and research were improving by leaps and bounds. Inspired, Birrer entered the Medical Oncology Fellowship Program at the National Cancer Institute in Bethesda, Maryland.
“This was the early to mid-’80s,” he says. “It was beginning to explode in terms of the science and the ability to actually help patients. Before that it was pretty primitive and therefore not very exciting.”
Birrer’s interest in what became his specialty, gynecological cancers, was influenced when he was volunteered to serve on a gynecological cancer tumor board. It was the kind of opportunity, Birrer says, that isn’t particularly sought after.
“It gets shoved down to the most junior faculty member, which was me,” he says. “I was just enamored of the diversity and richness of the biology and science of gynecological cancers and the fact that these are serious diseases and these ladies needed help. … My whole lab shifted its focus to gynecological cancer.”
Birrer was appointed professor of medicine at the Harvard School of Medicine and was director of Gynecologic Medical Oncology at Massachusetts General Hospital and the Gynecologic Oncology Research Program at the Dana-Farber/Harvard Cancer Center.
He thought he’d retire while at Harvard, but in 2017 Birrer, attracted by the academic environment, took over his position at the O’Neal Comprehensive Cancer Center, and while in Birmingham he also served as professor of medicine, pathology and OB-GYN.
“While I was there I was asked, ‘Would you be willing to take a look at UAMS because we want to build from the ground up this cancer center and get it to NCI designation.’”
Birrer liked the challenge and was particularly encouraged by the muscle the state was putting behind the effort, muscle that includes Gov. Asa Hutchinson and the Arkansas Legislature. In last year’s General Assembly, lawmakers in both houses unanimously approved a series of taxes that would generate an annual $10.5 million to help UAMS achieve its goal.
Finding a faculty and state government all on the same page, like the elements of a good cancer service line, was a big attraction for Birrer.
“I think NCI designation is very important, and part of the reason I came is because it’s been recognized as important,” he says. “They all get it, and that’s not always the case.”
Zooming In
The NCI Cancer Centers Program was created as part of the National Cancer Centers Act of 1971 and recognizes facilities in the U.S. which meet standards for transdisciplinary, cutting-edge research focused on new methods of preventing, diagnosing and treating cancer.
A number of boxes must be checked to earn NCI designation, but in general it means an institution has established scientific excellence with the capability of conducting a diversity of research approaches.
Birrer says to achieve the designation UAMS needs to raise its research investment from around $10 million to $20 million, demonstrate a reach to “all four corners of Arkansas” and conduct research that accounts for factors disproportionately affecting Arkansas cancer patients, like obesity and smoking.
The cancer institute also needs to raise the number of patients in clinical trials from about 100 to 300, which Birrer hopes to see accomplished in two years, and to of course increase its number of researchers.
“The National Cancer Institute will look at that and see how well we do it,” he says. “Most importantly they’ll look at our clinical trial structure.”
UAMS cancer clinics have close to 150,000 patient visits a year and have approximately 150 faculty members involved in cancer-related research and clinical activities. Patients from as many as 50 countries came to the Rockefeller Institute last year.
“I’m just very impressed with this place,” Birrer says. “It’s got a wonderful graduate school and medical school, very robust education efforts. The research is outstanding. I think from a cancer standpoint we need to make it better, but the research is terrific and the clinical service is wonderful.”
Birrer is tasked, among other things, with beefing up the staff of physicians and researchers in order to achieve the necessary level of clinical trials and research funding.
“He’s run an NCI designated cancer center already,” UAMS Chancellor Cam Patterson said of Birrer in January. “He knows how the game is played.”
Patterson noted then that Birrer already had a number of talented people lined up, but of course Birrer didn’t expect to be conducting so many job interviews via Zoom. Like everyone else, he has had to adjust his methods thanks to the COVID-19 pandemic.
“When it exploded in February and March I think we all were a little bit taken aback about the depth and extent of it,” Birrer says. “I do think the national response and in particular the UAMS response has been nothing short of spectacular because it’s a big issue.”
Birrer said a pool of close to 100 applicants was reduced to about 20, all via Zoom meetings, with follow-up interviews to be held on campus in July.
Getting the Picture
Unfortunately, gala fundraisers don’t lend themselves to the Zoom platform, and UAMS has postponed its Gala for Life, originally scheduled for Oct. 2, to next year. The black tie event, which was set to celebrate its 25th anniversary, is traditionally one of the biggest events of the social year, and the 2019 gala, at which Patterson announced Birrer’s hiring, raised a record $1.2 million to help with the NCI designation.
“There are components to what we do here that may not be very obvious, but the gala is a huge fundraising and, I think, branding event for us,” Birrer says.
UAMS is filling the space on the calendar with a “Be a Part of the Cure” telethon on Sept. 2, with Gala for Life co-chairs Natalie and Win Rockefeller chairing the telethon event. The telethon will be broadcast on KATV, Channel 7, and is expected to feature local celebrities, including Hutchinson, while also educating the public on UAMS’ progress toward the NCI designation.
Money raised by such events has also been put to work on the third, sixth and seventh floors of the institute, which will house, respectively, the state-of-the-art breast cancer center, an outpatient chemotherapy infusion center and Phase I unit for drug trials and multidisciplinary clinics and offices.
The projects are expected to be completed in the fall, and Birrer also touted a new surgical annex and energy plant on campus.
“This was done by monies from the institute, UAMS and a substantial amount of philanthropic dollars,” Birrer says. “I have to say I’ve been just very impressed and enamored with the generosity I’ve found here in Arkansas. The amount of people who want to give substantial dollars to cancer care is very impressive.”
For Birrer, whose career has taken him from the northeast to the mid-south, it has been encouraging and reassuring to see that, when it comes to fighting cancer, the people of Arkansas are willing to get in line, too.
“I would just say that, personally, my wife and I are very, very happy to be here,” he says. “I often say to Cam Patterson, I’ve not met anybody at UAMS I haven’t liked. It’s a very friendly place. The transition from Birmingham to Little Rock has been seamless. We just love the people we’ve run into.”
What’s On?
While conducting ground-breaking cancer research, the UAMS Winthrop P. Rockefeller Cancer Institute is also carving new fundraising territory thanks to its “Be a Part of the Cure” event.
With the annual Gala for Life postponed to Oct. 2, 2021, due to COVID-19, UAMS is shifting gears with the televised program on Sept. 2. The telethon-style event, a first for UAMS, will broadcast from the KATV Channel 7 Call Center and allow supporters, patients, caregivers and people from the 37-county viewing area to phone in and pledge support.
Be a Part of the Cure is not replacing the Gala for Life, but it is an opportunity for UAMS to share its message beyond the traditional gala supporters. Doctors, researchers, patients and caregivers will speak throughout the day and the event will be livestreamed on Facebook for those outside the viewing area.
Gala for Life chairs Natalie and Win Rockefeller are chairing the event.
Be a Part of the Cure
Wednesday, Sept. 2, 11 a.m. – 6:30 p.m.
KATV, Channel 7
INFO: 501.686.8998 or 501.686.8995, Cancer.UAMS.edu
WRCI Cancer Treatment by the Numbers
- UAMS sees cancer patients from all 75 counties in Arkansas
- 4 most common cancers in Arkansas — lung, colorectal, breast and prostate — treated at UAMS, along with other cancers and rare tumor types
- 22,000+ unique patients per year
- 5 shared resources that facilitate research: biostatistics, bioinformatics, genomics, proteomics and translational pathology
- 138,000 patient encounters per year
- 143 faculty cancer researchers who are aligned into four distinct research programs: cancer biology, cancer prevention and population sciences, developmental therapeutics and DNA damage and host response