When the cancer reaches the stage where it is no longer controllable, his lesson is simple: “You can always do something for the patient. Patients fear only two things—pain and abandonment. Even if you're no longer able to treat the cancer, you can always treat the patient by addressing pain and other non-cancer issues. “Then you're not abandoning them, you're doing your most important job as an oncologist.” Dr. Bosl, who served for nearly 2 decades as the chair of MSKCC's Department of Medicine and made major research contributions to the treatment of testicular and other germ cell tumors, has continued to emphasize those messages throughout his career spanning 4 decades. Although he stepped down as department chair in 2015, he continues to write papers with the Germ Cell Cancer Collaborative Group and serve as an informal adviser to center leadership. “As far back as I can remember, I told everyone I wanted to be a doctor. I don't remember wanting to be anything else.” —George J. Bosl, MD Born and raised in Cleveland, Ohio, he attended Catholic primary and secondary schools and graduated from John Carroll University in University Heights, Ohio, and Creighton University School of Medicine in Omaha, Nebraska. An avid basketball player, Dr. Bosl says that one of the big appeals of Creighton over nearby Ohio State, where many of his friends went, was the chance to live in a dormitory that was close to the gym. Creighton proved a fortuitous choice in other ways as well. The then-new Department of Medicine chair, George Clifford, MD, who had arrived from New York's Memorial Hospital for Cancer and Allied Diseases, affiliated with The New York Hospital, the Cornell University Medical College, and MSKCC at the time when Dr. Bosl started medical school, took an interest in his career and encouraged him to go east for his internship and residency at Cornell University Medical College's internal medicine training program at The New York Hospital and Memorial Hospital for Cancer and Allied Diseases. After completing his internal medicine and chief residency at these institutions, Dr. Bosl and his wife moved back to the Midwest, where he completed his oncology fellowship at the University of Minnesota at Fairview. The two had expected to stay in Minneapolis, but MSKCC came calling again with an offer to join its faculty in 1979, and he has remained on board ever since. Throughout his career, Dr. Bosl has garnered a wealth of honors, including the Patrick M. Byrne Chair in Clinical Oncology at MSKCC in 1995, the 2005 MSKCC Excellence in Medicine Award, the 2015 American Society of Clinical Oncology Distinguished Achievement Award, and the Mastership designation from the American College of Physicians in 2016. Dr. Bosl is widely credited with significantly expanding MSKCC's Department of Medicine during his tenure as chair; he enlarged the program to include specialists in cardiology, gastroenterology, endocrinology, general internal medicine, dermatology, survivorship, and several others. “We were top heavy on the cancer side, and we felt we needed to make all of these services equally strong,” he says. During his tenure, the faculty grew from 120 to 350 members, research funding rose from $10 million to more than $150 million, and the house staff training program more than doubled. He also oversaw the reshaping of the center's hematology/oncology training program, which, though clinically very strong, needed a greater emphasis on cancer biology and translational research. “I turned that over to Dr. Dean Bajorin, who has taken it to heights I didn't even dream of at the time,” Dr. Bosl says. “In parallel with that was my interest in training house staff and fellows in caring for patients with cancer, as well as how to incorporate biology into clinical trials to push the field forward.” A piece of those efforts included development of MSKCC's Transitional Year Residency Program, which provides medical school graduates with an additional opportunity to get their feet wet in patient care before entering their subspecialty training. “Everybody knows George is a great administrator—he became chairman in 1997 and really dramatically built up the Department of Medicine, but I knew him from different aspects—as a researcher, a mentor, and working side-by-side with him in the clinic,” notes MSKCC medical oncologist Robert J. Motzer, MD, a longtime colleague. “He's a real family man, compassionate, fair, very focused, and a fantastic clinician.” The two first met when Dr. Motzer came to MSKCC as an intern in 1982 and had the chance to observe Dr. Bosl caring for patients. He chose Dr. Bosl as his oncology fellowship research mentor, and eventually, the two formed the first MSKCC combined oncology practice. Dr. Motzer credits Dr. Bosl with having made several key research contributions to the oncology field. One of the first was incorporating etoposide into cisplatin combination chemotherapy for the treatment of testicular cancer—a protocol that remains a standard treatment regimen. The disease is now highly curable; even patients with widely metastatic cancer have an 80% or higher cure rate, Dr. Bosl notes. In addition to Dr. Motzer, Dr. Bosl has trained a number of fellows who have gone on to make important contributions, including MSKCC medical oncologists Dean F. Bajorin, MD, the Frederick R. Adler Senior Faculty Chair; David G. Pfister, MD, chief of the Head and Neck Oncology Service and associate deputy physician-in-chief of Strategic Partnerships; David H. Ilson, MD, PhD, who specializes in esophageal cancer; Han Xiao, MD, vice chair of Oncology Operations; and Darren R. Feldman, MD, who specializes in genitourinary cancer. Another major contribution from Dr. Bosl was the development of a risk-adapted therapy model to predict risk outcomes for germ cell tumors. The model divides patients into favorable-and poor-risk groups and helps clinicians to determine the extent of therapy that each patient should receive. “The original risk stratification was based on the primary site, the number of sites of metastasis, and, most importantly, blood markers,” he explains. Developed in 1983, the model uses human chorionic gonadotropin and lactate dehydrogenase serum markers to predict outcomes of cisplatin combination therapies.1 Dr. Motzer notes that the concept of using risk-adapted therapy in germ cell tumors has provided direction for the center's entire genitourinary cancer research program and has led to risk-adapted models in kidney, bladder, and prostate cancers. The original model also prompted further randomized trials in germ cell tumor treatment, including studies examining whether adding the drug bleomycin was necessary in treatment protocols.2 Ultimately, a number of institutions developed riskadapted therapy models, and this led the International Germ Cell Cancer Collaborative Group to create a single model containing most of the clinical factors from the original MSKCC model. Moreover, Dr. Bosl recognized the importance of translational research before many others, says Dr. Motzer. Recognizing the need to integrate tumor biology into his research, he worked with MSKCC geneticist Raju Chaganti, PhD, to establish one of the early translational research programs in 1990. Their work established the isochromosome 12p as a clinical diagnostic marker for germ cell tumors and enabled cisplatin therapy to be directed for patients with an unknown primary site.3 Germ cell tumors are unique in many ways, including their ability to transform into a completely different malignancy, according to Dr. Bosl. Originating in germ cells—the cells that should have given rise to sperm—these tumors have the ability to change into any other tissue. “Many had thought that the presence of 2 different malignancies, either simultaneously or subsequently, had to be independent tumors, but Dr. Chaganti and I were the first to show that many of these non-germ cell malignancies did in fact originate in the germ cell tumor,” he says.4 While focusing on germ cell tumors, Dr. Bosl also managed patients with throat cancer. His efforts on this front led MSKCC to become one of the first institutions to study the hypothesis that the larynx could be spared in patients with larynx cancer or with other head and neck cancers that threatened the larynx.5 He and his colleagues then went on to apply the same principles to treating both oropharynx and hypopharynx cancers. Because men with germ cell tumors generally have highly curable disease, Dr. Bosl also focused his attention on issues such as late effects of chemotherapy on both renal and gonadal function.6, 7 He predicted cardiovascular consequences, which later were demonstrated by other scientists. These issues, along with concerns over late effects of childhood cancer treatment, led him to establish MSKCC's survivorship program. When he finally decided to retire as department chair in 2015, Dr. Bosl was eager to spend more time with family. He and his wife have 2 sons, 1 daughter, and 8 grandchildren—all of whom live out of state. Making time for family was always a high priority, although it was not always easy because he commuted 33 miles each way to work from Long Island. Still, he found time to coach his sons' basketball and baseball teams for 10 and 8 years, respectively. Dr. Bosl is enormously proud of all his children. His sons, like him, played sports: Both sons played college basketball, and 1 is a triathlete. He and his wife also enjoy traveling and have hiked in areas ranging from Alaska to Italy's Amalfi Coast. He is not through at MSKCC, either: In July 2019, he was named MSKCC ombudsman. The position was designed to provide a confidential pathway for staff to discuss potential conflict-of-interest issues, although many also come to him seeking advice on both career and workplace politics. Advising others who are just beginning their medical careers seems an appropriate way to wrap up his own. “If I had an overarching trio in my life, it was faith, my family, and MSKCC,” he says.