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Bold Plans for Cancer Care at Yale

June 29, 2022

Forty-eight years ago, a high school senior from Boston submitted a college essay that got the attention of the Yale Admissions Office. He wrote that he had hemophilia and considered himself lucky because it had broadened his experiences, and that he thought of his diagnosis “as nothing but a positive.” It spurred instead of deterred him.

That determined, irrepressible young man, Eric Winer, was admitted to the Yale College Class of 1978. He went on to Yale School of Medicine and then did his internship and residency at Yale New Haven Hospital. His wife, Nancy Borstelmann, earned an MPH at Yale School of Public Health, and two of their three children were born in New Haven.

After leaving Yale, Dr. Winer spent thirty-four years building a distinguished career at Duke and at Dana-Farber Cancer Institute as a breast cancer clinician and researcher. In February of 2022, he returned to his medical school roots, becoming director of Yale Cancer Center and physician-in-chief of Smilow Cancer Network. “I never thought I would move back to New Haven,” he said, “but I’m as happy as I can be here.” His plans, like him, are bold.

He returns to Yale after earning many laurels. His research has altered clinical practice and improved treatments and outcomes for patients with breast cancer. He has won awards, collected honors, and served in significant national leadership positions, most recently as co-leader of the National Cancer Institute’s Breast Cancer Steering Committee, and as the newly-elected president of the American Society of Clinical Oncology (ASCO). Along the way, he published more than 350 papers and mentored dozens of young oncologists. The steady focus of Dr. Winer’s research has been to use general discoveries from clinical trials to more finely calibrate treatment for individual patients at each

stage of breast cancer—the best drug or combination of drugs, the most effective dosages, the duration of treatment that balances benefits against disagreeable side effects.

“I am data-driven and believe we need to respect the results of large clinical trials,” he explained, “but we also have to recognize that different patients and different tumors require different types of therapy.” In addition, he has studied how lifestyle factors such as diet and exercise can influence tumorigenesis and cancer outcomes. “It’s really impossible to have a full understanding of cancer in an individual without understanding more about that individual,” he continued. “Every time we start a course of therapy, we have to be willing to adjust it based on each patient’s reaction.”

Knowledge about breast cancer and its treatment have grown phenomenally over the last two decades, partly because of Dr. Winer’s contributions. Most forms of the disease are now curable, and even individuals with metastatic breast cancer can do well for many, many years. Dr. Winer predicts that in a decade or so, no one who receives appropriate care will die of breast cancer. “I think our biggest challenge will be making sure we can deliver care to everyone who needs it,” he said.

Meeting that challenge is on his long to-do list for Yale Cancer Center and Smilow Cancer Hospital, where most of his time is devoted to overseeing both clinical care and research. He does not expect to have much time to conduct independent research or see large numbers of patients, but he will be maintaining a presence in the clinical world seeing patients with breast cancer every Thursday morning. “At this point in my career, I don’t need to be up on a podium presenting a paper,” he said. “Making other people successful and helping other people’s research is what matters to me now.” That’s what appealed to him about the chance to run Yale Cancer Center—the opportunity to

build something on a bigger scale. “The Cancer Center will look very different in five years,” he said. “We’re going to become far more nationally and internationally prominent. I am pushing change, and at the same time, we want to tackle cancer care disparities here in Connecticut.”

For starters, Dr. Winer says the cancer program must get much bigger and serve more patients. That means recruiting many more physicians and researchers. He praises many aspects of the program, starting with the “phenomenal” basic science, and he has been impressed by the collaborative and supportive environment within the Cancer Center and Hospital.

“But we have work to do,” he added. “The reason I was recruited is that people recognize Yale isn’t where it needs to be in terms of national prominence. We’re going to build an efficient and highly productive clinical research enterprise that will be able to rapidly complete cutting edge clinical trials. We’re also going to use our broad network across the state to tackle the problem of healthcare inequities in Connecticut. I feel passionate about making progress in this area.”

Dr. Winer says that everything he does, including administrative decisions, is influenced by his experiences taking care of patients who have taught him what does and does not work. “If we pay attention to our patients, we learn so much about what to pursue in our research and how to provide the care in clinic. We can strive to provide the best care today and learn how to make it ever so much better in the future—that’s what drives me to build an even stronger cancer center and programs at Smilow that focus on patient experience,” he said.

This philosophy may stem from his own medical history. The medical innovation called Factor VIII allowed him to live a full life despite hemophilia. He has had to deal with a number of medical complications stemming from his hemophilia, but dramatic medical advances have allowed him to lead a very full life. Nonetheless, he understands firsthand the benefits and the risks of medical therapy. “I don’t remotely define myself by my health challenges. That said, we are all an accumulation of our life experiences, and for me, personal experiences with the health system have likely affected my approach to patient care and research. I think the single biggest lesson I’ve learned over the years is that if you scratch below the surface, most people have had to deal with some difficulties or even tragedies in their lives. There are very few people who live in perfect houses surrounded by a neat white picket fence. On so many levels, the adversities we face bring us all together.”

In Boston, Dr. Winer was an avid participant in the Pan-Mass Challenge bike ride to support cancer research at Dana-Farber. He has been training on a Peloton all winter and plans to participate in this September’s Closer to Free Ride, riding with his oldest son who scored a bike in exchange for his promise to participate. As most know, Closer to Free is the annual fundraising bike ride held for Smilow Cancer Hospital and Yale Cancer Center. He is recruiting others to ride as well to raise money for research and cancer care at Yale. “I’m all in,” he pledged.

Submitted by Emily Montemerlo on June 29, 2022