Meet the Team Canada of Cancer Research: A Q&A with Dr. Robin Urquhart

Dr. Robin Urquhart’s upbringing in rural Newfoundland and her personal connection to cancer have shaped a career built on ensuring equitable access to high-quality cancer care for all Canadians.

Today, she pursues this mission as the co-lead of the Marathon of Hope Cancer Centres Network’s Atlantic Cancer Consortium and as a researcher and subject-matter expert in several MOHCCN funded projects and Working Groups. She’s also an Associate Professor at the Department of Community Health and Epidemiology at Dalhousie University in Halifax, Nova Scotia, the Canadian Cancer Society (Nova Scotia Division) Endowed Chair in Population Cancer Research, the Scientific Director of the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH), a Senior Scientist with the Beatrice Hunter Cancer Research Institute and an Affiliate Scientist at the Nova Scotia Health Authority.

We sat down with Dr. Urquhart to learn more about her path to cancer research, her current projects, and her vision for transforming cancer care through collaboration and innovation. We hope you enjoy this conversation as much as we did.

MOHCCN: Why did you become a cancer researcher? Was there a particular moment or experience that led to this decision?

Dr. Urquhart: This is a big question! I grew up in a rural Newfoundland community, which was quite isolated and had limited access to healthcare providers or hospitals. As a child, there were lots of people in my extended family – aunts, uncles, young cousins – who were diagnosed with cancer. All of them died relatively soon after their diagnosis, with limited care or supports. When I was 9 years old, my dad became quite ill and was eventually diagnosed with pancreatic cancer. We spent countless days travelling back and forth between home and St. John’s (a 7-hour drive away, on the best of days) so he could access specialist care. He died, at home without any medical support, the week after I turned 11. Less than 4 years later, when I was 14, my mom was diagnosed with pancreatic cancer and died a few months later. I was her primary caregiver during those months, and when she died, there was not even a family physician in our entire area. Her last days were spent in incredible pain and distress. These experiences led me to my career as a cancer researcher, especially one focused on issues related to access, quality, and disparities in cancer care.

Cancer research is difficult: progress is slow and for every step forward there may be quite a few steps backwards or sideways. What inspires you to keep going? What life lessons have you learned through cancer research?

Progress is slow, but it happens! Truthfully, I am inspired by the people I work with every day. My research and clinical colleagues, my students, and those with lived experience who give their time so generously to make sure the research we do is better and more relevant to those affected by cancer. I often sit back in amazement when I sit in a room (most likely a virtual room these days) and see everyone’s passion and dedication to cancer research. The Canadian cancer research community is incredibly collaborative and collegial. I have truly learned so much from my colleagues. From a life lesson standpoint, I think cancer research has taught me the importance of people and perseverance. No one researcher can do it alone, nor will they do it overnight. Research is a team sport and progress is typically incremental, with so-called “breakthroughs” coming after years or decades of investigation, discovery, and understanding.

How would you explain your current research focus to a cancer patient or their family member?

I was trained as a cancer health services researcher. In essence, that means I study how cancer care is delivered, the quality-of-care people receive, and the impact on patient and health system outcomes – things like survival, quality of life, patient and family experience, wait times, and costs. However, my research today spans clinical research and trials, health services research, and population health (e.g., studying how the social determinants of health impact cancer outcomes). From a TFRI perspective, my research is focused on investigating access to and inequities in precision oncology, and designing and testing ways to improve people’s access to precision oncology, particularly for people who live in underserved communities (e.g., people who live in rural and remote Canada).

What impact do you hope your research will have on cancer treatment and the outcomes for patients?

I hope my research benefits patients and their families. That sounds simple, but it’s not. So much of the incredible research we do never actually gets to the point of benefiting patients. This is for many reasons, including the fact that it is very difficult to change health systems. My research is very applied and often sits in a somewhat unique space, at the intersection of research and patient care. Every now and then, this gives me the remarkable opportunity to see my research impact decisions around care delivery or new programs, services, and policies.

Just like Terry Fox united Canadians nearly 45 years ago, the Marathon of Hope Cancer Centres Network is uniting researchers, clinicians, patients and administrators from cancer treatment and research institutions across Canada to accelerate precision medicine. How important is this collaboration and what impact do you think it could have on cancer research and treatment?

Collaboration in cancer research is critical to our ability to control cancer. As we know, cancer is a collection of many different diseases, with different molecular features that determine a person’s prognosis, how they will respond to treatment, and so on. We have to understand what is happening at the cellular level to develop effective therapies (and effective prevention strategies). The development of cancer is, of course, influenced by both our genetics as well as our environments (that is, where and how we live, work, and play). In addition, although cancer affects all segments of our population, the burden of cancer is inequitably shared across sub-populations. Therefore, intervening to prevent cancer and to save lives will require research that spans many diverse areas, from molecular biology and genetics to epidemiology and population health, behavioral and social sciences, and health economics, planning, and policy. In essence, cancer research exists on a spectrum that exists from cells to society and we need all relevant disciplines at the table to understand these big challenges.

 As I reflect on this question, I recall that more than a decade ago, I published a paper about the importance of interdisciplinary research and collaboration in precision oncology. My premise was that we need collaboration between biomedical scientists, clinical trialists, epidemiologists, and health economists (amongst others) if we are to achieve the vast potential of precision oncology for Canadians. I am thrilled and honored to be a part of the Marathon of Hope Cancer Centres Network, which has brought these diverse research disciplines and perspectives to the table. I believe this Network, fueled by collaboration, commitment, and a common purpose, will transform our ability to understand cancer and reduce the cancer burden in Canada.

If a researcher, clinician, patient or donor asked you why the Marathon of Hope Cancer Centres Network is important, what would you tell them?

In many ways, I see the Marathon of Hope Cancer Centres Network as the realization of Terry’s vision when he started in St. John’s, Newfoundland 45 years ago. Canada’s cancer researchers are world class and have contributed extraordinary advances in our understanding of cancer and its treatment. The Marathon of Hope has brought together this world class expertise to create an incredibly rich resource for cancer research and to build the mechanisms we need to ensure our scientific advancements make their way into patient care more efficiently than ever before. Most importantly, in an unprecedented effort, the Network has united cancer researchers and clinicians across the country with a common purpose: to ensure patients, regardless of where they live or their circumstances, have access to precision diagnostics and therapies that offer the best chance at living a long, quality life with and beyond cancer.

 
What does Terry Fox mean to you? How does Terry inspire you?

I grew up in rural Newfoundland, in an isolated community, well before the Internet age. Yet, Terry Fox was someone I, my family, and my entire community knew about and deeply admired. Perhaps that was partly because every person in my community was impacted in some way by cancer. But I think it was also that we saw a young man demonstrating such selflessness and perseverance and hope in the face of a life-threatening diagnosis and life-altering treatment. That he had the audacity to dream so big. And the physicality of it all. He ran nearly a marathon a day for 143 days straight! I’ve never run a marathon in my life. Today, it is these same traits that inspire me: his perseverance, selflessness, and courage when experiencing such adversity.