University of Pittsburgh

The Science of Caring

Nancy Davidson earned a Harvard medical degree, won acclaim as a researcher, and attained success as a distinguished physician and professor at Johns Hopkins University. Now, she’s using all of her skills to lead the University of Pittsburgh Cancer Institute in the fight against malignant disease. Her specialty? Reclaiming lives disrupted by cancer.

Written by Jennifer Bails

Nancy Davidson at the entrance to UPCI’s Hillman Cancer Center with the sculpture “Circle of Care”

Nancy Davidson at the entrance to UPCI’s Hillman Cancer Center with the sculpture “Circle of Care”

“Are you going to die, Mommy?”

That was the first question Harriet Legum’s children asked when she came home from the hospital with the diagnosis she had long feared. Breast cancer. “I told them I wasn’t going to die, but I was just guessing,” recalls Legum, her voice trembling with the memory. The 41-year-old mother of two received the diagnosis in 1987, when breast cancer was still very much a disease of whispers, of unknowns.

Two years before, Legum had thought she felt a lump during a self-examination. Her family physician didn’t find anything and told her not to worry because, he said, women her age didn’t get breast cancer. Supposedly, she was too young to fret about the disease.

But the tiny mass in her left breast didn’t go away. It didn’t show up on a mammogram either, and another doctor offered the same opinion: The lump she felt didn’t exist. He gave her the names of two surgeons at nearby Johns Hopkins Hospital in Baltimore, assuring her they would return the same verdict. Soon afterward, though, a biopsy at Hopkins confirmed Legum’s dread, and the next day she underwent a lumpectomy to remove a malignant tumor.

The hardest part of that diagnosis, recalls Legum, was opening the door at home to tell her son and daughter that she had cancer. She then faced six weeks of radiation treatments to quash any remaining cancer cells. “But the reassurance from my oncologist made me feel that I was going to be OK,” she says, “or at least that everything was finally being done the right way for me.”

Legum focused on being a hands-on mom—playing backyard baseball, reading stories at bedtime—even during the weeks she endured radiation treatments. “My children knew I never let the disease get me down.”

The oncologist who empowered Legum to continue living her life to its fullest was Nancy Davidson. “There wasn’t a phone call she didn’t return or a conversation she didn’t have time for, even if I asked the same questions in three different ways,” says Legum.

Two decades later, Davidson is still doing a lot of listening as she plots her first moves in her new role as director of the University of Pittsburgh Cancer Institute (UPCI) and UPMC Cancer Centers. Ever since this renowned breast cancer expert arrived at Pitt from Hopkins earlier this year, plenty more people are clamoring for her ear—patients, doctors, research faculty, hospital officials, staff, journalists, and community leaders.

During an interview squeezed into her sole hour-long opening in a month of back-to-back meetings, Davidson affably admits: “I don’t have much free time these days.” In her role as director, she manages all aspects of UPCI’s cancer research, clinical care, and educational activities, which have grown exponentially since the institute’s founding more than two decades ago. She is only the second director in the venerable history of an institution that now ranks among the top-tier U.S. cancer centers.

Founding director and acclaimed oncologist Ronald Herberman stepped down in February after 24 years at the helm of UPCI to devote more time to his family and his own leading-edge research. He was initially recruited to Pitt in 1985, enticed away from a prominent position at the National Cancer Institute (NCI) by Thomas Detre, an emeritus distinguished service professor of psychiatry, who was then the University’s senior vice chancellor for the health sciences. The challenge was to build a nationally recognized cancer-center powerhouse in Pittsburgh. At the time, Herberman recalls, there wasn’t a multidisciplinary research institute of any kind in the region, so the task of building UPCI was especially daunting.

Working with a small staff in a cramped office in the former Eye & Ear Hospital in Oakland, Herberman aggressively began to recruit top national cancer researchers to his growing program. Remarkably, within three years, UPCI earned special NCI clinical designation, which brought prestige and a $1 million annual grant. Two years later, UPCI was recognized as a comprehensive cancer center, the youngest center ever to receive that impressive distinction.

Throughout the 1990s, the center continued to grow, as did efforts to find adequate space for its expanding research labs and clinical activities. In 2002, UPCI—with pioneering doctors and scientists scattered across Pitt’s campus—finally came into the limelight when its new home, the $130 million Hillman Cancer Center, opened not far from campus. Pittsburgh philanthropists Henry and Elsie Hillman provided the lead $10 million gift for the building that bears their names. By 2007, the institute ranked 10th in the nation for attracting funds from NCI, garnering nearly $200 million in federal grants. And some 36,000 patients from across the nation and the world seek expert care each year at Hillman Cancer Center—UPCI’s flagship treatment and research facility—along with a network of more than 40  locations in the region and abroad.

Today, as Nancy Davidson embraces her new leadership role at UPCI, she recognizes the world-class legacy she has inherited from Herberman.

“I have come to one of the best cancer centers in the country,” says Davidson, who also is Hillman Professor of Oncology and associate vice chancellor for cancer research, among other duties. “My overall goal is to take advantage of all the resources here to make a difference in how we take care of cancer, how we allow people to live beyond cancer, and how we prevent cancer.” She is well equipped for the job, with credentials as both a gifted clinician and an adept research scientist.

One of three children born of two geologists, Davidson spent her childhood years in Denver until high school, when her father took a post in India searching for phosphates for the fertilizer industry. “I think my parents taught us the importance of scientific rigor from the get-go. That was a huge part of our family and who we are,” she says. “But I always think they were a touch disappointed in me because, of course, people who do physical sciences are a good deal more serious than the biomedical scientists,” she jokes, poking some good-hearted fun at her parents.

Davidson originally set out to be an archeologist but was drawn to oncology while working in a liver cancer laboratory as a Wellesley College undergraduate. One summer during her studies at Harvard Medical School, she accepted a job doing breast cancer research at NCI.

“It was a life-defining event for me,” says Davidson, who earned a medical degree from Harvard in 1979. “I became captivated by the challenge of breast cancer—one of the first cancers where biology and cancer behavior were at the forefront of our thinking.”

At the time, some early research began to draw connections between hormonal changes and breast cancer. About 70 percent of breast cancers produce a certain protein that grows in response to the hormone estrogen. This estrogen-receptor protein plays a role in the development of some forms of breast cancer. Drugs designed to disrupt these estrogen-related molecular interactions were among the first cancer treatments to hone in on a specific biological pathway in the quest to stop the disease.

In her tenure as a medical staff fellow at NCI and later as the head of the Breast Cancer Program at the Sidney Kimmel Comprehensive Cancer Center at Hopkins, Davidson devoted much of her effort to studying how these targeted endocrine therapies worked as a way to refine and improve treatments, especially for premenopausal women with breast cancer. She published key findings on the role of hormones on the molecular and cell biology of breast cancer and the mechanisms that regulate the disease beyond the realm of pure genetics—for instance, how environmental factors can lead to cancer-causing changes in gene function without altering the DNA itself.

Dedicated to translating these promising lab discoveries into new medical treatments, Davidson helped organize the Translational Breast Cancer Research Consortium, a collaborative network of scientists from 16 academic medical centers working together to improve understanding of the disease and test new therapeutic strategies. She also guided major clinical trials for several first-line drugs, resulting in outcomes that now mean early breast cancer is no longer a death sentence for most women.

Davidson’s expertise as a scientist also is brought to bear in the clinic, where she forms close, lasting bonds with her patients as she helps them navigate their cancer journeys. And she doesn’t shy away from the tough challenges, either. In fact, she receives referrals from physicians nationwide for some of the most complicated and difficult cases. Her experience and her work have taught her that hope isn’t a fantasy.

“I am a better doctor for people who have problems, and there’s no question that someone who has a diagnosis of cancer has a problem,” Davidson says. “But the common concept of oncology—that cancer equals death—is just not the case anymore. There are many, many people who develop cancer, get appropriate therapy, and then move on with the rest of their lives.”

It’s not just Davidson’s scientific and clinical skills that qualify her to lead UPCI, her colleagues say. It’s also her experience as a leader—modest, unassuming, highly efficient, and relentlessly effective. “She’s a scholar. She’s a superb physician, and she has experience leading a very large organization,” says Pitt’s Allegheny Foundation Professor and chair of pharmacology John Lazo, who cochaired the search committee for a new director. “I don’t care whether Pittsburgh won the Stanley Cup and its sixth Super Bowl—bringing Nancy Davidson here is better than both of those championships put together.”

In addition to filling her distinguished roles at Johns Hopkins, she recently ended a term as president of the American Society of Clinical Oncology, the world’s largest organization of cancer physicians. At ASCO, she worked to craft federal legislation to improve access to care for uninsured cancer patients and established a task force to devise ways to rein in the skyrocketing cost of cancer treatment, says the organization’s CEO, Allen S. Lichter.

“Nancy is a natural leader and people want to follow her,” says Lichter. “She articulates her positions well and has a special way of being direct without being blunt. She’s a good consensus builder and commands a well-deserved level of respect among her peers. These are the types of things that make her a significant leader and what will make her a tremendous success at Pitt.”

Since arriving in Pittsburgh, Davidson has been on a steady learning curve as she gets acclimated to her new job and new home. She and her husband—Thomas Kensler, a chemoprevention expert who has joined Pitt’s Department of Pharmacology—have settled into a condo within walking distance of Hillman Cancer Center. Their son recently graduated from college, while their daughter is working toward her master’s degree in international health at Hopkins.

Hillman Cancer Center

Hillman Cancer Center

First on Davidson’s agenda is working to renew the center’s NCI core grant, which will sustain key functions and prime future progress. Another goal is to help ensure that scientific discoveries move more quickly from bench to bedside, so patients throughout UPCI’s affiliated hospital network—and ultimately cancer patients everywhere—benefit quickly from the University’s innovative research. She seeks to cement Pitt’s strengths in fields such as cancer immunology and virology, while enlisting departments such as computational and structural biology to figure out what makes cancer cells tick at the most fundamental level.

Moving forward, Davidson—who has won numerous awards and honors throughout her career—also will begin to grapple with helping UPCI to fulfill its aspirations of being among the top five academic cancer centers in the country. “Of course, our most important ranking is how we do with our patients and against cancer,” she says.

That means making a difference for people like Harriet Legum, who remained cancer-free for 20 years after her 1987 lumpectomy. Legum was so grateful for Davidson’s care that she went on to raise $2.5 million to endow a chair and fellowship in breast cancer research at Hopkins. Davidson was the first recipient.

Two years ago, a routine ultrasound turned up another small tumor in Legum’s breast. Immediately, she called Davidson for advice, and together they decided a mastectomy would be the best option, along with ongoing hormonal therapy. So far, there has been no recurrence. For Legum, survival means more happy and healthy days ahead to spend with her family. “Nancy saved my life twice, and I’m so grateful and blessed for that,” she says. “Pitt is very, very lucky to have her.”

Davidson is aware of the profound impact her work has on the lives of women like Legum. This helps her stay focused on her ultimate mission at Pitt—to bring the world closer to a cure for all types of cancer. Although progress has been made in recent decades, cancer still is responsible for about 560,000 deaths annually and is expected to outstrip heart disease by next year as the leading killer of Americans.

Cancer, which is actually a collection of more than 200 diseases, remains a complex and formidable foe. In her role with UPCI, Davidson will continue to build an impressive arsenal of experts, technologies, and scientific firsts to disrupt and dismantle malignant processes. And she’ll rely on another strength, too: “I have learned from my patients that people are amazing in the way they operate under adversity of all types, that people are survivors.”