Petros Grivas, MD, PhD
Associate Professor, Division of Medical Oncology, University of Washington School of Medicine & Associate Member, Fred Hutchinson Cancer Research Center; Seattle Cancer Care Alliance
Interview by Chara Koutsioumpa, PhD candidate, Harvard Medical School
1) Dr. Grivas, thank you for joining us for today’s discussion. To get started, can you share with us your current research and clinical focus?
First of all, thank you for giving me the opportunity to discuss with you today. I’m always very honored when the HBA reaches out – I can’t believe it was about 2 years ago when I was at a very nice dinner with junior colleagues from HBA and we had a nice discussion in New York City.
Briefly, I graduated from the University of Patras medical school, then l pursued my Ph.D. there too and I moved to the US in 2007. I subsequently did my residency at Drexel University College of Medicine / Hahnemann University Hospital, in Philadelphia, afterward my fellowship at the University of Michigan, where I stayed as a Clinical Lecturer for a year, and then I moved to Cleveland Clinic in Cleveland as Assistant Professor. I stayed there for three and a half years and then moved to the University of Washington and Fred Hutchinson Cancer Research Center in Seattle, where I am the Clinical Director of the Genitourinary Cancers Program. I am focusing on clinical research, especially clinical trials aiming to develop novel therapeutics in the field of genitourinary cancers, in particular urothelial cancer, a research domain that I have loved and have been focusing on for the last 10 years. It’s something I enjoy very much every single day, along with taking care of patients, mentoring trainees, and serving my administrative duties. Even though I am currently almost exclusively involved in clinical research and do not work in the lab myself right now, I still have frequent lab meetings with colleagues of mine who are in the lab to discuss common projects and translational research collaborations. When I design clinical trials, am always thinking about what biospecimens we can collect, what can be informative for the lab work, for example, blood, urine, tumor tissue, and more recently stool collection for microbiome research studies.
2) Being a clinician, researcher and mentor, can you describe what a typical day looks like for you?
It’s a very busy day and I think the key teaching point here is that you have to love what you do and what you choose as a career pathway, because what you seek and long for might come and you have to be ready for it. As I briefly mentioned, I wear many ‘hats’, and the most important hat is that I am a clinician, I see and take care of patients with urinary tract cancers, (upper and lower urinary tract urothelial cancer), prostate cancer – which is the most common cancer in men – and testicular cancer as well. I take care of patients on Mondays and Tuesdays, 2 full days of clinic when the clinic is my focus. I am notorious for taking time with my patients, particularly new patients, as I need to establish a good rapport and make sure that they feel comfortable with me and establish a ‘team spirit’, which is critical for moving forward.
Moreover, I have research responsibilities, being a PI in multiple clinical trials, that of course comes with many responsibilities, e.g. with regulatory aspects, assessing budget, safety, and adverse events, etc.; overall a lot of paperwork. I am also wearing an administrative ‘hat’, as I serve as the Clinical Director of our Program, with 9 medical oncologists as Faculty, advanced practice providers, nurse team, research team, administrative staff, financial analysts, program manager.
Finally, I try to do a lot of mentoring of mentees, residents, fellows, medical students which gives me plenty of joy. I try to pack all of these non-clinical responsibilities for Wednesday – Friday, and the key here is to be efficient and learn how to prioritize. I am personally an overachiever and I had to learn how to prioritize and focus on one task at a time efficiently and productively.
3) At what point did you decide to pursue your current clinician/scientist pathway? What experiences helped you make that decision?
Thinking back at my time at the Medical School of the University of Patras, a wonderful institution, I had a very nice combined mentorship by clinical mentors, but also laboratory-based mentors. This actually had such a big impact on me that throughout my career I have kept both of these aspects of mentorship, even during fellowship. During my fellowship, I used to live a “double life”, as a physician scientist, with one main focus being my clinical training – particularly critical at this stage- and then spent evenings, and weekends in the lab, satisfying my inherent curiosity and interest for science and for the lab. At the end of my fellowship, I was trying to figure out what to do, as these both grew in parallel, and I had to make a choice. I thought deeply about and asked for advice from my mentors, and I would like to highlight here the importance of mentorship at every step of your career journey. I decided that what makes me the happiest is this short-term satisfaction/reward from taking care and treating patients. However, even though I left the lab and focused on being a clinical investigator, I took all of these experiences with me, which have been very enriching, and in particular now as I am doing clinical research, it is much easier to speak also the language of my translational research colleagues and incorporate translational research in my work.
4) Which are the most important challenges you faced along the way and what are some highlights from your trajectory that would be helpful for young researchers/scientists?
I think it is very important to think about what you want to do in life early on. In Greece, we have to take this exam, the pan-Hellenic exam, and basically decide on our career and life pathways at a very young age. In the US, on the other hand, folks have this ‘buffer time’ during college and get to decide later in a probably more informed stage. It would be useful as an advice for younger mentees to write down on a paper on how they would like their life to be in 5-10 years from now. This is a very useful exercise to plan ahead, by first defining the goals and then making strategic decisions about how to attain them. In my case, putting this theory in practice, I was lucky that I knew I wanted to become a physician. But growing through medicine I came across 3 dilemmas; 1) a clinical vs lab-based career, which we discussed before 2) which specialty (medical oncology was always in my mind, even before medical school) 3) where to do my training in Greece or in the US.
Regarding the decision of which specialty to follow, I saw once more the importance of taking advice from mentors about how to best use my strengths, and also to see opportunities to improve and get constructive feedback – which has critical value, and is unfortunately often overlooked in Greece. After those discussions, my love for Oncology grew stronger and the decision was easy at the end.
For making my 3rd big decision, which was also a very difficult one, am very grateful and happy to have chosen the option of pursuing a career in the US. Even though I have my family (parents and extended family) and many friends, who I love, back in Greece, when I realized that I wanted to maximize my potential by making the most impactful research in oncology, take care of patients in the best way I can, the best option was to come to the US. During making that decision, I was actually talking to one of my mentors, who told me “think about what you want to do in life – you can choose to be an eagle, who can go to any peak he wants”. And I am not saying that this is the best decision for everyone, it is actually a personal decision based on what makes you happy and fits your purpose and interests in life.
With regards to challenges, I would say that this decision of moving to the US and making the sacrifices that came with it, including going far from home and family, initially felt huge, but it was manageable. Another important aspect, while navigating life and career, is to always do what is legally and ethically correct. I will give you a small example here. While I was in the process of matching for internal medicine residency in the US, I got a call from Drexel that invited me to do my residency there, however if I accepted that position, I would have to withdraw my name from the ‘matching’ process. After a week, and of a lot of deep thought of possible scenarios, I let them know that I accepted the position. About 2 hours later, I received an interview invite from Beth Israel Deaconess at Harvard Medical School, which I ultimately declined, even though this was also a very well sought-after clinical training program at Harvard. Going through this ethical dilemma and keeping my word, always led me the right way. For people who like to read books, the words of Kazantzakis resonate well; “you have to take the difficult, uphill road”, and this is true across life, medicine and academia.
5) What is a future outlook you would like to highlight?
One piece of advice I would like to give is that you should never put limits on yourself. There is also not a big secret to academic success, instead it is hard work, hard work, which I cannot highlight enough; mentorship, make sure you show up -on time-, deliver your tasks very well and recognize opportunities for yourself and even create them. We cannot forget the Ancient Greek statue of opportunity, which had the hair in the front of its face so that you grab “the opportunity from the hair” when it comes to you. It is also very important to interact, socialize, network, meet, and establish connections with people. My last quote is that patients and people in general, will never forget how you made them feel, so always stay positive and smile with genuine kindness.