Mark Carey joined the department in 2010 as a Clinical Professor in the Division of Gynaecologic Oncology. He completed his medical degree and Obstetrics & Gynaecology residency at the University of Western Ontario, a fellowship in Gynaecologic Oncology at the University of Toronto and McMaster University, and a research fellowship in the Department of Systems Biology at the University of Texas, MD Anderson Cancer Centre. He runs his research program through OvCaRe and has funding through private donations and his medical corporation to support his laboratory staff. He is Co-Investigator on a recent grant award from the Cancer Research Society with Dr. Cheng-Han Lee, and has done contract research for investigational drug testing. His laboratory has been supported as well by research funds from Dr. Dianne Miller and the Division of Gyn Oncology, the BC Cancer Agency, the Carraresi Foundation OvCaRe Research Grant, and VGH and UBC Hospital Foundations. Mark regularly supervises PhD and MSc candidates and is a member of the department’s Research Advisory Committee.
What is your day job?
It depends on the week! I have 2 day jobs: half my time I spend doing research, and half the time I do clinical work. As a result of the Division’s clinical care model, I am able to alternate my weeks between research and clinics. Somehow the jobs don’t seem confined to the “day”, so the day job becomes a night job…but that’s OK.. its all good.
What is your primary research focus?
We are concentrating our efforts in the laboratory on low-grade serous cancers. We have developed a number of cell lines building on the work of OvCaRe and Nelly Auersperg’s. We are now using these cell lines to explore a number of questions using new targeted drugs. This is a rare cancer with limited treatment options so much work needs to be done. Because the cancer is uncommon it is challenging to secure research funds, but we keep trying. We hope as we grow that we can use our experience as a model for research for other rare gynecological cancers. As a result of our work we have formed a network, or community of practice. We are planning to capture clinical information secure more biobanked tissue for research across the country. We are really excited at how this is developing.
Recently Dr. Cheng-Han Lee (Pathology BCCA and VGH) was awarded a CRS grant and we are a Co-PI on his grant. We are going to apply some of our knowledge and experience in the therapeutic realm to study carcinosarcomas of the uterus. We are really excited about this collaboration.
I’m also involved in an interdisciplinary research project with Drs John Havelock, Neeraj Mehra, Lily Proctor and Ji-Hyun Jang. We are going to start a formal protocol to look at the role of hysteroscopic endometrial resection to preserve fertility in patients with atypical hyperplasia and early endometrial cancer who fail anti-hormone therapy. We have a great team and are looking forward to working together.
What drew you to the subject?
OvCaRe had been doing some work in this area. Alicia Tone and Michael Anglesio, working with David Hunstman had sequenced some of these cancers and Michelle Woo and Clara Salamance had established some of these cell lines. So the ground work was in place to start working on this it seemed to be a good fit with the OvCaRe program. I also have had an interest in hormones and cancer and these low-grade serous cancers are frequently treated with anti-hormones. We were also interested in the fact that these cancers are generally chemo-resistant and this seemed to be an interesting model to study further.
What do you find are the biggest challenges in pursuing research while being a clinician?
One of the big things in terms of challenges is funding. It’s a very competitive environment right now, so I think one needs to be fairly creative in terms of funding sources. Our team has been really fortunate to have the support of OvCaRe, both in-kind support and funding, and that’s really gone a long way to help us get established. But the funding issue is a huge, huge challenge. Only 10-15% of grants are funded. Our reviews have been improving considerably but studying a rare cancer is not without its headaches. With precision and personalized medicine, molecular characterization of cancers expands the opportunites to study rare cancers as we may find similarities to exploit from what we learn about other completely different types of cancer. For individual patients however, whether you have a low-grade serous cancer or a high-grade ovarian cancer, the fact is that the long-term prognosis is similar. Patients with rare cancer are becoming funding advocates as the implications of these cancers to the patient can be devastating, and so the need is there for funding. Having more time would help though, I guess I should have concentrated my research efforts on cloning!
What are the greatest supports for your research?
Well my wife and my family of course, as my wife (she is my biggest supporter) is working on the weeks I do research! I have tried to get the kids to work but they don’t seem to be too interested… yet. The three other big supports have been the OvCaRe program and our Division and Department. The OvCaRe program has been supportive in terms of providing us with lab space and the in-kind support and the infrastructure support for the lab to function. Dianne Miller and the internal grant system have been supportive of us with invaluable start-up funds. This has been a big boost for our laboratory group. I must say that I have an increadible team in the lab and we enjoy working together. I now have a lab manager Marta Llaurado (our former post-doc), and a technician position shared by Amy Dawson (former graduate student), and Hannah Kim, a previous co-op student. We also have Maegan Bruce our current co-op student and Josh Hoenisch who is now in the Master’s program in Reproductive and Developmental Sciences. I am very fortunate to have such a great group of individuals to work with, they are very committed and have lots of great ideas. We also very much enjoy working with all the talented OvCaRe team members, it’s a great group to be a part of.
The Department of Obstetrics and Gynecology has also played a huge role in the development of our research program. The Department has done all the leg-work hiring our great laboratory staff. I very much appreciate the support of the deparment in terms of securing the lab positions and all the human resource work that has gone along with this. Geoff Cundiff, Andrea Sherrington, Andi Martin and Brian Nelson have all helped us immensely. Thanks much!. We have also benefited from the Scientific Research and Experimental Development Tax incentive program. These funds go a long way to help hire our staff. I would be happy to chat with any other members of the Department that might be interested in using this program to help their research.
I want to also mention the support from two committed families. We wouldn’t be here right now if it hadn’t been for the funds these two families have donated to our research program. Both families have lost very special loved-ones to ovarian cancer. We have received support from the MacKenzie-Lawler family, and just recently we received a large donation from the Janet D. Cottrelle Foundation. Janet’s Foundation, and her husband Rob Collins, have been instrumental in supporting ovarian cancer research.
Finally, our professional association, the Society of Gynaecologic Oncology of Canada (GOC) has helped us develp a community of practice to track outcomes on low-grade serous cancer across the country. It’s hard for any one clinician or center to appreciate how these patients are doing in terms of their outcomes or what sorts of treatments, or sequencing of treatments is beneficial for them because the disease is rare. GOC has helped us engage 30 professionals from across the country who are interested in helping to develop a prospective database. It’s been gratifying to see the level of interest in this initiative and the commitment shown to advance treatment for patients with this disease.
You’ve been successful in obtaining for funding for your research- what advice would you give to others?
I think it’s really important to have a mentorship structure in place. Having the right mentorship, or a mentorship group, to help people develop the right connections from the outset. It has to be planned early for younger investigators or clinicians that want to pursue a research career. Clinician-investigator programs may be very helpful in this regard. I think the difference between success in this realm lies not necessarily with receiving the additional training, which a lot of people do, but the training has to be linked with successfule research group like OvCaRe, also providing the needed mentorship along the way. This support and expertise is invaluable in order to foster career development and successful grant funding. Of course, winning the lottery would help!.
What are your future plans and goals?
Well, our research team wants to really establish ourselves as one of the leading centres for research in low-grade serous cancers. But not just my lab- the plan we have a collaborative research initiative, and we’ve got some interesting ideas about how to do clinical trials in smaller groups of patients. We hope that we can transform the system to help support the kind of research that we’re doing, and I think that we’re on the right track in light of the support that we’re getting so far. Sometimes the big obstacle is just the way the system works and so some of those things have to change. We want meaningful results to come from the work that we do, so that the research can be immediately applied in some way to patients- that’s our focus.
When you aren’t busy being a clinician and a researcher – what do you do?
Well I like to spend time with my lovely family and friends….I am a very lucky person to have such wonderful family and friends, but I also like music, so I write music, and I have a couple of friends that I met through music circles that I work with to record it and it’s a lot of fun. I like to ski, and do other sports (biking) when I have time- it’s just the time pressures. So for the most part when I have a little free time it’s family and friends and I just need a bit more time to start a couple of new songs.