August 1, 2017

Mathematical Mind: Jack Cuzick’s Talent For Statistics Led to Pioneering Advancements in Cancer Prevention

Jack Cuzick sitting behind desk

Long before he was elected to the Royal Society, or made pioneering advances in cancer treatment, long before he was honored in person by Queen Elizabeth II, Jack Cuzick ’74 was pretty good at baseball.

Growing up in the shadow of the Standard Oil refinery in El Segundo — “basically a baseball town,” he quips of the Southern California city known for oil and aviation — Cuzick played “the game of failure” with fervor, and he played it well. At 15, his squad won the Babe Ruth League World Series, with Cuzick outshining teammates who would go onto storied MLB careers and posting a league-record batting average of .732 over four games. For any other kid, this might have sparked dreams of going pro.

But he was really good at math.

Eventually, baseball took a backseat to his preternatural talent, and Cuzick pursued undergraduate, master’s, and doctoral degrees in mathematics—the last at Claremont Graduate University—before finding work in theoretical statistics at Columbia University. At Columbia, Cuzick developed a keen interest in clinical trials.

“I decided I wanted to learn something about real clinical trials,” he says. He soon joined a team at Oxford University, where he also became interested in epidemiology, the study of disease incidence, distribution, and control. “I thought I would just get a grounding on that, then go back to pure mathematics, but I discovered that I liked the real questions as much as the theoretical ones, so I really never left.”

It was the beginning of a journey that would see him make revolutionary advancements in cancer detection and prevention and place him alongside scientific peers like Charles Darwin, Dorothy Hodgkin, and Isaac Newton, all fellow members of the Royal Society.

The Math Path
Being mathematically talented at a young age, Cuzick says, “made you a little bit of an outcast.” He took to sports to fit in.

Cuzick recalls blue-collar fathers like his encouraging physical activities of all kinds. He took an extra shining to baseball to supplement his math talents, playing all the way through his undergraduate years at Harvey Mudd College.

But it was the unlimited realm of mathematics that captivated him. And for Cuzick, attending a college devoted entirely to science, technology, engineering, and mathematics was a personal revelation.

“I was always sort of different because I had these abilities,” says Cuzick. “To come to Harvey Mudd and be around 100 new students who came in with the same background, with the same issues, and the same love of scientific things was just a great awakening for me—just for the sort of ability to feel comfortable about myself.”

Thankfully, Cuzick found his mathematical niche, sparking a long and successful career in cancer screening and prevention—a calling you might not expect for a mathematician.

“I think that mathematics is a sort of open door to a whole lot of things,” he says. “Some people in mathematics would just go on to do pure mathematics and stay in sort of an ivory tower. Pure research. But if you want to go out into the world, there is no better calling card than to come out with a mathematics degree and be able to offer quantitative help to a whole range of fields. That’s what I ended up doing. It’s been a very great career.”

Cuzick has been instrumental in the development of chemopreventive breast cancer medications for at-risk women. Most notably, he is regarded for groundbreaking research on the drug tamoxifen, an estrogen inhibitor that has been used for decades to treat and, more recently, to prevent certain types of breast cancer. He currently directs the Wolfson Institute of Preventive Medicine and heads the Centre for Cancer Prevention, both at Queen Mary University of London, where he is the John Snow Professor of Epidemiology.

Recently, Cuzick was appointed a Commander of the Order of the British Empire for contributions to the field of cancer prevention and screening, an honor presented to him by Queen Elizabeth II.

“It was fantastic moment for my family,” says Cuzick, who has dual citizenship, though his wife and two children are British. “[Being] in the palace with the Queen around was really something special. For me, the greatest joy is the work itself, but it was a great honor to be recognized for it. The recognition is fantastic, but the work is even more wonderful.”

Cracking Cancer
Given his line of work, Cuzick is often asked: Are we close to a cure for cancer?

But it’s not so simple.

“The thing is cancer is not one disease, it’s 100 diseases,” Cuzick says. “We are making steady progress, but there’s not going to be an overnight cure. The key discoveries are already making a difference now: We are not thinking about cancer treatment as only related to its site, whether lung cancer or stomach cancer, but the actual genetic mutation in the cells that actually cause the cancer.”

And he says prevention is key. In a recent trial, Cuzick discovered the simple measure of taking a low-dose aspirin starting at age 50 has a notable preventive effect on a range of cancers, including colon/rectal cancer, stomach cancer, and esophageal cancer.

“A great analogy is heart disease, where people don’t think twice about taking a statin to lower the risk of heart disease, but there is a certain kind of fatalism about cancer,” he says. “Many people believe there is nothing you can do about cancer; you either get it or you don’t. We know that’s not true. There are a lot of things you can do to prevent cancer.”

Asked whether working in the field can be draining, Cuzick is surprisingly upbeat.

“One of the advantages of working in prevention is that it’s very positive
in outcome,” he says. “You’re not really involved in end-of-life cases where all you can do is provide palliation. You actually can do something to prevent cancer from happening. Ultimately, that’s a lot more effective.

“The best way forward is try to prevent this disease from occurring in the first place.”