Q&A with Dr. Robert Mannel

Gynecologic oncologist Robert Mannel, M.D., is director of OU Health Stephenson Cancer Center at the University of Oklahoma Health Sciences and holds the Rainbolt Family Endowed Chair in Cancer. Additionally, he serves as associate vice provost for cancer programs at the University of Oklahoma Health Sciences and is a professor in the Department of Obstetrics and Gynecology at the OU College of Medicine. Dr. Mannel is a co-chair of NRG, part of the National Clinical Trials Network of the National Cancer Institute, and his clinical and research interests are focused on ovarian, endometrial and cervical cancers. He has published more than 200 scientific articles dealing with the management of gynecologic malignancies. He completed medical school at the University of Texas Medical Branch at Galveston, his residency at Baylor Scott & White Medical Center, and a fellowship at the University of California, Irvine.

What prompted you to enter a career of cancer patient care and cancer research?

One of the greatest blessings in my life has been my journey as a cancer physician. During my obstetrics-gynecology residency, I was quite content taking care of young healthy women and then, I got exposed to what is known as gynecologic oncology – cancer of the uterus, ovaries, cervix, etc. It was transformative because I met the most amazing patients. It was their strength, their grace under duress, their compassion, their giving attitude that made me realize that this was a very special group of patients and a special calling to be a part of and that’s what started my oncology journey.

My interest in cancer research came from the realization that too many of these wonderful patients were dying. Today, even if we practice the absolute best cancer care - meaning no limitation of resources and 100% best decisions made - 35% of our patients are still going to die. The only way we can change that is through research.

So hand in hand with patient care, there is an unspoken commitment that every time we take care of a patient, we’re going to learn something that’s going to make our care of the next patient better and more effective. Our vision statement at Stephenson Cancer Center is that we are going to eliminate cancer in Oklahoma and beyond. And we believe in that. We’re part of a team - locally, nationally, and internationally - that’s committed to fulfilling that goal through research in our patient care activities.

What do you want patients and their families to experience at Stephenson Cancer Center?

Our vision at Stephenson Cancer Center is to eliminate cancer in Oklahoma and beyond. Well, how are we going to accomplish that? That’s where our mission statement comes in. Our mission is to provide patient-centered, research-driven, multidisciplinary cancer care. Let’s take each of those one at a time. What does patient-centered care mean? It means that the patient is the center of all activity. Resources are brought to bear by medical oncologists, surgical oncologists, radiation oncologists, supportive care specialists like palliative care, genetic counselors, physical therapy, occupational therapy, cancer nutrition and research nurses—everybody dedicated to helping you as a patient on your journey battling cancer. It’s a different way of thinking about healthcare.

The second part of our mission statement is research driven. If we continue to deliver the best possible care, we will be stuck where we are right now, with a third of our cancer patients dying. Good research integrated into patient care brings tomorrow’s therapies here today. We are committed to that. And then finally, multidisciplinary care means a willingness to share in decision-making, to share in expertise, and bring that all to bear. We do that through tumor boards and through patient care conferences. We’re always looking at ways to mobilize resources that a particular patient needs to be successful in their journey.

Describe the dedication of clinicians, researchers, and staff in earning NCI designation and renewal.

Medicine is no different than anything else we do, and there are recognitions of excellence. In cancer care, the absolute highest award given is National Cancer Institute (NCI) Designation. It's like winning the gold medal at the Olympics. And in order to achieve that, just like an athlete winning the gold medal at the Olympics, you don't just show up one day. You don't just train for a month or so. You spend decades honing your team. You recruit. You create a great team and system that allows you to be part of this national network. So that's what happens here. At the cancer center, there are clinical care teams with physicians, advanced practice providers, nurses and clinical staff. But that's only part of the story. There are well over 1,000 people in the cancer center dealing with cancer activities, including people in the lab, laboratory researchers, laboratory technicians, clinical research teams and those working with financial toxicity, patient navigation, etc. It’s a huge team.

And so, to become NCI-designated, everybody needs to be part of that team. Everybody at the cancer center, whether it’s the physician taking care of the patient, the research nurse, the front desk person, a PhD in the lab, a laboratory technician—everybody understands that they’re part of our vision to eliminate cancer in Oklahoma. And they’re part of the reason we’re going to accomplish that goal. It’s a commitment. It’s not a job. It’s a commitment up and down the team.

What are some of the top patient care achievements during the first five years of Stephenson Cancer Center’s NCI designation?

Oh, there are so many aspects to consider; it would be hard to pinpoint just one. However, I would encourage you to revisit our mission statement and explore the incredible teams we have established to provide patient-centered, research-driven, multidisciplinary cancer care. When I mention “bringing tomorrow's therapies here today,” it's not just words. We have close to 30 drugs where we were part of the first in human clinical trials. For example, the very first patient in the world to receive mirvetuximab was at the Stephenson Cancer Center. This drug is now FDA approved in the battle against ovarian cancer nationwide. This exemplifies the commitment of our physicians and staff. Every day, there are interactions at the Stephenson Cancer Center that make a difference not only in the lives of people here but also in the lives of countless individuals throughout Oklahoma, the country, and indeed, the world.

What are some of the top research and clinical trial achievements during the first five years of Stephenson Cancer Center’s NCI designation?

I believe it's crucial to highlight some key aspects that truly set us apart. We play a significant role in the expansive research networks facilitated by the National Cancer Institute. A pivotal component of this network is clinical research, focused on exploring new therapies and innovative ideas for fighting cancer in patients. The largest global network dedicated to cancer clinical trials is the National Clinical Trials Network (NCTM), sponsored by the National Cancer Institute. Within this network, we've consistently stood out as a top enroller, surpassing all other institutions in the country by enrolling more patients in clinical trials over the past eight years. It's noteworthy that we aren't the largest cancer care delivery system in the country; in fact, we're considered small.

Yet, due to the unwavering dedication of our team and our commitment to our patients, we stand as a national leader. This achievement is not by chance but a result of the collective efforts of every individual on our team. I take great pride in our team's commitment, which includes not just physicians but also clinical trials office staff, regulatory experts, data managers, information technology specialists, and research nurses. They operate in our clinics with exceptional skill, providing excellent care to research patients dealing with complex cancers. This is something we should be immensely proud of here in Oklahoma.

What do you see Stephenson Cancer Center accomplishing over the next five years of its NCI designation?

In the realm of cancer, achieving National Cancer Institute (NCI) designation is a huge milestone. After a decade of holding NCI designation, institutions become eligible to apply for the even more prestigious status of National Cancer Institute - Comprehensive Designation. We've recently obtained our second designation, marking about six years into this journey. Within the next three to four years, our aim is to position ourselves to apply for comprehensive cancer center designation.

The transition from NCI designation to comprehensive designation requires not only a deepening of research efforts but, more importantly, a demonstration of increased impact, particularly within the designated catchment area. Our catchment area encompasses the entire state of Oklahoma. Consequently, we are investing heavily in efforts to go beyond the walls of our buildings, reaching out into the community and expanding our clinical care delivery network to provide NCI-level care to all citizens of Oklahoma. We’ve already established a second site in Norman. Additionally, we are legislatively mandated and actively working to open a site in Tulsa.

But beyond that, we are dedicated to various outreach activities focused on prevention, screening, treatment, and survivorship, specifically targeting rural areas. Collaborating with our American Indian partners, where health and cancer mortality disparities are most pronounced, is a critical part of our mission. Therefore, expect to see a growing presence of the Stephenson Cancer Center throughout the state, engaging in multiple initiatives and partnering with other healthcare delivery systems to truly make a lasting impact.

What is most gratifying to you about serving as director of Stephenson Cancer Center?

I believe that satisfaction comes in many ways. Personally, my greatest satisfaction has been the opportunity to pull together resources, recruit, and support this remarkable team. Our team is truly exceptional. Fighting cancer, unlike golf, is not an individual sport – it’s a team sport. Recognizing that each team member plays a different yet immensely important role in our success is crucial. For me, the most satisfying aspect has been playing a small part in bringing together this incredible team. I take pride in knowing that when the time comes to pass the baton to another cancer center director, this is organic, and it will persist and evolve, continually improving. That, for me, is the greatest source of satisfaction.

Anything else you’d like to add?

Cancer is the most complex disease we deal with, and the solution to the cancer problem has to be very comprehensive. No single part of our society can conquer cancer on its own. It takes bringing together university resources, healthcare system resources, state resources, and philanthropic contributions. It involves many disparate communities sharing a common goal and coming together, giving of their time and resources to attack cancer. In Oklahoma, all of us who call Oklahoma home have benefitted from the commitment of the state , the philanthropic community, the University of Oklahoma, and the OU Health care delivery system. Cancer can be defeated, but the reality is that you can’t do it alone. It takes all aspects of our society working towards the same goal.

However, by bringing people together and pooling resources not only can we be in the game, but we can also emerge as a winner and a leader in cancer care and research. This is precisely what we are demonstrating now. Therefore, I believe the Stephenson Cancer Center is something every Oklahoman can be proud of because everyone has contributed, whether through their tax dollars, philanthropic contributions, volunteering, or working at the cancer center. Our collective responsibility is to honor and amplify that investment.