Changing the world one tumour at a time

Published on 5 August 2022

Self-confessed failed retiree Ian Cree tells us what it means to hold the world’s top pathology job at the World Health Organisation and the lightbulb moment in his career that made him fully appreciate the positive impact of his work.

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Ian’s time at Dundee didn’t stop at graduation. After completing a degree in Medicine in 1982 and then a PhD in Immunology in 1987, he re-joined the University in 1989, but this time as a staff member, becoming a Senior Lecturer and Consultant Pathologist. A varied career in pathology, studying the causes and effects of disease, across different institutions followed.

Fast forward to the late 2010s, and most of Ian’s contemporaries in the medical field were settling into retirement. He, on the other hand, was offered an opportunity that was too good to turn down.

"I describe myself to some extent as a failed retiree," said Ian. "At around 60 years old, most colleagues of my age were stepping out of the field, but I got the opportunity to become the Head of the WHO Tumours Classification Group."

The Group is responsible for publications that provide an evidence-based classification of all cancer types to enable diagnosis and research worldwide, otherwise known as the Blue Books.

"I was very lucky because that job very rarely comes up," he continued. "It’s the only real international job in pathology.

“The Classification of Tumours is the organisational framework that underpins the diagnosis of every cancer worldwide. That means that when you call something a particular tumour type in Japan and you treat it with something and it does well, you can apply that in Britain.

"It’s a big job. It’s one of the top jobs I’ve done. I coordinate around 3,000 pathologists and others from different disciplines and one of the things I’ve done is made it much more multidisciplinary by engaging with other disciplines, who now have a major role in diagnosing cancers."

Ian’s work within his current role has a direct impact on most cancer patients worldwide by providing the international standards for diagnosis and cancer research, but there is one moment in his career that made him realise the true impact and importance of his work.

"While I was Director of Translational Oncology Research Centre and Cancer Laboratory in Portsmouth I ran a clinical trial on ovarian cancer patients who had recurrent ovarian cancer, which is obviously not good news at all," he said.

"At the end of the trial, the success rate was incredible. We expected a 10% or maybe 20% response rate. We got 65% response rate in these patients, which is absolutely extraordinary.

“At the end of the trial, the success rate was incredible. We expected a 10% or maybe 20% response rate. We got 65% response rate in these patients, which is absolutely extraordinary.”

Ian Cree, alumni

"I wrote it up, thought nothing of it and went on to other things. Years later I got a phone call from a group of ovarian cancer patients who asked if they could come and visit the laboratory. When they arrived they said, ‘four of us here were on your trial’. This was a few years after the trial had finished. I said ‘how is this possible? You should all be dead’.

"In fact, they had been responders on the trial and not only had they responded but had pretty much stayed free of disease as a result. That was an absolute surprise.

"Hearing 'I’m here because of you' is incredible, but this is not why you do research. You do research because you can influence a much larger number of people. The Blue Books, for instance, influence all with cancer, because the diagnosis depends on it."

Despite his extensive training and time teaching, Ian admits he could not have foreseen where his career would lead to when he was an undergraduate at Dundee.

"I never thought in a million years I would be where I am now," he said. "I’ve been able to study diseases for over 40 years because of the training I received in Dundee.

"Dundee gave me training in pathology which at the time was unparalleled. It was brilliant. Back then, the new medical school had just been built and it was one of the very few that had a facility like that. It was obviously going places as a university."

Ian had links to Dundee well before he started his studies. His father was originally from the city, and they regularly travelled from England to holiday in Scotland’s sunniest city.

"I think I was the only one of my friends who’d been north of Birmingham. People didn’t travel up to Scotland much from England at the time, and it was regarded as a very odd thing to do. I loved it.

"What’s been fascinating to see is how Dundee has changed. When I was there, I remember going along the old Hawkhill and being blown over by the wind between the big jute mills. Now the jute mills have gone, and the University has expanded.

"I never thought I would leave Dundee but life moves on and you go in different directions."

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