← Becker’s Healthcare Podcast
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- [00:00]
A
Welcome to the Beckers Healthcare Podcast. I'm Elizabeth Gregerson, a reporter here at Beckers, and I'm thrilled Today to interview Dr. James McGee on the podcast. Dr. McGee was recently named the President of OSF Healthcare's Cancer Institute after serving as the founding director since its opening in February 2024. He also serves as vice president of physician services for the oncology service line at OSF Healthcare. Dr. McGee, thank you so much for joining me. I'm very grateful to share your insights with our podcast audience.
- [00:35]
B
Thank you for the chance.
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A
Absolutely. And before we dive in, could you introduce yourself and maybe just give a bit about your Background?
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B
I'm James McGee and I was born and grew up on a very small farm in central Illinois, right in the geographic center of the state of Illinois. And so my upbringing was entirely rural. In small towns, access to medical care was modest. Best most of my health care was given in a gymnasium in the grade school or high school as part of inoculations for polio and things like that. Never really saw physicians very much, but it became clear as time went by that the doctor in town usually had work to do even when everyone else in the midst of a recession or a downturn or a bad crop year. So it seemed like something to be interested in. So I did a look at a couple of volunteer opportunities. I tried to get a job and a summer job at a hospital and was excluded because all those jobs went to doctors kids. So I was this farm boy who, you know, couldn't really get much experience in healthcare, but kind of was interested in it, largely because it seemed like it was someplace where you could actually find work to do. And as time went by, I came to really enjoy that. And I went to medical school after college in a small college in downstate Illinois, and went to Loyola to medical school and then had the opportunity to spend my senior year at a Zulu hospital in the tall province of South Africa doing apartheid, 800 bed hospital roughly, with three doctors but tremendous missionary physicians. And then after that I had written to the director of the cancer center at the University of Chicago, where there were seven cancer centers in the United States that were comprehensive at that time and was able to get him to devise an oncology training program for two years where I didn't have to decide if I wanted to go into medical oncology or surgical or pediatric or radiation. And while there, I got to work with the grad students that Enrico Fermi had when he split the Adam for the first time at the UFC and got interested in the physics and so forth of radiology and radiation treatment. So went into radiation oncology and afterward was very interested in the surgical applications of that. So did a fellowship in brachytherapy or implant radiation at the university of Paris and was able to work with the people who were working with the curies and first people to do, you know, radium treatments and such, and got very well trained by them. And then, you know, as time went by, had the opportunity to come back to downstate Illinois. I always had an interest in trying to bring better cancer care to people in central Illinois, a very rural area. Typically, people that want advanced cancer treatments have to go to far, far away places with strange sounding names like Chicago and St. Louis. And that's really not something that our people do very well because it involves going to places that we just never go and dealing with the types of problems that there are in the cities and so forth. So we, we didn't really have access to research trials, didn't really have access to advanced radiation methods, you know, and that, that's kind of been my Life's work for 45 years, has been to really work on trying to improve access to modern therapies, especially in cancer for patients. And during that time, I was fortunate enough to become the chairman of the state of Illinois board of health for 10 years. And during that time learned that there was this crisis that was described about, you know, cancer rates, morbidity, advanced diagnosis, and so forth in parts of the city of Chicago, which were indeed very bad. However, when I looked at our rates in central Illinois, I found that we were just as bad and worse. And so millions of dollars were coming in to try to help the situation on the south side of Chicago, and nothing was coming in downstate Illinois. And they got a little better and we got a little worse. So at the end of that time frame, I was pretty discouraged, not only about access to care, but also about how severe the incidence was and the mortality and what impact that was having on the citizenry as far as, you know, people were just, you know, felt that getting cancer and dying from it was just inevitable. That's just, you know, kind of what happens in our family. That's. That's what happens in our social circles. So those types of experiences have led us to really want to concentrate on giving access to cancer research, to advanced treatment methods for patients in rural populations, and to study that so that those lessons can be extrapolated to other areas in the world. And also at the same time to really say, you know, this business of finding Cures for cancer is getting to be very expensive and elusive. And so we really should work on just not getting these cancers at all. So our cancer institute, while it's bringing in advanced research methods and advanced technologies, is focusing really heavily on working with our vast primary care network that OSF Healthcare has to try to bring more information to those primary care providers and to the patient populations about how to reduce their risk of cancer, how to identify their risk, how to modify that risk in order that we ultimately have fewer people getting cancer and certainly fewer people having advanced cancers that are largely going to be very expensive to have on maintenance therapies for years and years.
- [07:21]
A
Absolutely. So, yeah, I guess your background, you know, led perfectly into my next question, which are, you know, what are the top priorities in your new role? And it sounds like your background has really fueled, you know, the areas of importance for you today. You mentioned access to clinical research and prevention strategies. Are there any other priorities now that you've stepped in to the president role that you're focusing on?
- [07:48]
B
Well, we want to start to do more advanced radiation treatment methods that don't require so many trips and that don't involve so many side effects. We were able to get a proton unit from Varian Corporation, a lovely piece of equipment that allows treatment in ways that we can't do with X ray therapies. And we're able to do research on flash radiation, which is delivering radiation at very, very high dose rates, in which case there is the opportunity to see a marked reduction in the reaction of normal tissues to the radiation while preserving the tumor response. Our unit has been designed from ground up starting in 2017 with the idea that we would be able to develop aspects of flash radiation treatment with, with protons. That opens the door then to reducing the number of treatments. Because the flash treatment advantages are seen in patients when they get very few treatments, like three treatments rather than 30 treatments. You're giving a much higher dose each time, but you're doing it in, in a millisecond so that then the normal tissues just don't react. And you're also not treating a lot of blood circulating, carrying, you know, cancer fighting lymphocytes and so forth and so in, in that method. Then with a treatment giving in a very short period of time, say to the chest, you're not giving radiation for a few minutes while all the blood goes flowing through those vessels and is getting constantly radiated and killing off the cells in the immune system. So if we could reduce the number of radiation treatments in that method down from, say, 30 to 3. Obviously that starts to solve the geographic problem of people living far away from advanced therapies. You know, a lot of people could come here and stay for a week in our housing and get a treatment done during a week's time rather than having to say, well, I got to drive back and forth for six weeks or eight weeks. So that's, that's a big advantage. And then also of a children's hospital. And radiation is not very useful in children because of all the side effects on growth and tumor induction. Well, the hope with flash is that those children would be able to have radiotherapy and to do quite well, honestly. Another problem is that there's a lot of fairly ordinary or not so great treatments that go on. We do see a number of patients that come in with cancers that are recurring after prior radiation elsewhere. And sometimes that treatment's not been very good. So proton radiation allows us to consider a lot of patients for retreatment because protons just in general, not in the flash mode, but just in general, are able to shape the radiation just into tumors and not have the radiation exiting into other parts of the body that have already been treated, for example. So I think in that regard we're seeing that many patients that otherwise would just go home to die are able to get proton radiation and have a real chance at salvage, real chance at survival. I will add also that another major impact for us in radiation treatment has been building a very modern and advanced suite for brachytherapy or implant radiation. That's why I started working on in the 1980s in Paris. @ that time, I was able to work with Austrians coming in who wanted to develop high dose rate brachytherapy, where a single radiation source could be used to treat many patients. But instead of again, a treatment taking days of constant exposure to radiation, treatment could be given in a few minutes with a very intensely active radiation source being very tightly controlled in that way. Again, now we're able to have patients come in and have prostate cancers treated with high dose rate brachytherapy in 24 hours. A full course of treatment in 24 hours with brachytherapy, usually that if done with permanent seeds, then the radiation was present for weeks. With high dose rate, there's two bursts of radiation for curative intent treatment. One like on Wednesday afternoon, one Thursday morning, and then the applicator comes out of the prostate and the patient goes home. That is a wonderful treatment option for patients who say, well, you know, I can't drive down here for six weeks radiation treatment every day. So, you know, they can Come spend one night and get all their treatment done. So these are, these are the types of things that drive our thinking and these are the areas where we intend to put effort in clinical.
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A
Research. Perfect. Yeah. And I guess to kind of shift gears and maybe look forward a little bit. Where do you see the OSF Cancer Institute in five years or 10 years? Do you kind of have benchmarks that you're hoping to.
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B
Meet? Well, we're certainly already engaged in bringing in early phase clinical trials. Phase 1 clinical trials have started up and we've worked very hard to reduce the time to get from the proposal of a study to do to initiating that trial. We've worked very hard to get that down to a time of about 45 days, which allows us to be more attractive to industry, to give us access to do phase one trials and their, their drugs and so forth. We've also been very fortunate to have the opportunity to work on some early detection trials. And some of those, for example, were a blood test to determine whether or not a patient would likely benefit from low dose CT screening, pick up lung cancer if they've had a smoking history. We were really the first test site for that and that subsequently was going into more routine use. So that, so that, that type of thing self swabbing for certain gyn tract cancers. Those are the types of studies that we've been able to do already. And we're building our research base by adding research medical oncologists to our faculty. And that will help us also with. We now have a medical oncology team that's working on pancreas cancer advanced studies, phase one similar in lung cancers. So in five years, I hope that we'll have a full complement of research medical oncologists really addressing a whole number of issues that are currently, you know, difficult to deal with and difficult to treat and in a similar way, trying to do the same thing with our advanced radiation.
- [14:54]
A
Methods. Perfect. Well, I look forward to speaking to you again in five years to hear how all of that's going. Any of our listeners who may have heard me interview oncology leaders before know that I like to ask them what they're excited about or hopeful about when it comes to the future of cancer care. And so our audience, you know, isn't just oncology leaders, it's leaders from across the whole healthcare industry. And I'm always inspired when I talk to oncology leaders because I know how exciting the field is right now. All the innovation, like you said, the research discoveries that are happening. What are you excited about? And what would you tell our listeners to be hopeful about when it comes to the future of cancer.
- [15:36]
B
Care? I'm very hopeful that we'll figure out how to use genomic information to help predict cancer risks and how to mitigate those risks. I think that we have a lot of screening that we do that gets to be tedious, and then people kind of drop out of it or they miss a year here or there's. I'd like to think that we could become very personalized. Cancer risk determination, taking into account family history, but also personal factors that might be discernible even from the genome, and being able to really develop for the patient a profile of what screening and when would be most appropriate for them as an individual. And in a similar fashion, you know, some of the people that are at greatest risk of developing cancers are people who've been treated for a cancer. So in a similar fashion, when a person gets cancer treatment, then they need to have a very exquisite program of follow up that addresses the cancers for which they are now prone to get because of their exposure to various chemotherapy agents, to various radiation methods, et cetera, et cetera. So I think personalizing individual risk assessments and risk reduction rather than just saying everybody in the world needs to have a colonoscopy every, you know, 10 years, but getting it down to, well, you know, you need to get a colonoscopy at age 30 because of a certain factor, or you probably don't need a colonoscopy. Again, things like that. We have to get better at not just doing blanket assessments that everybody's the same in terms of cancer risk reduction and also in terms of survivorship. My own youngest daughter had a very, very serious cancer when she was in her mid-20s. And, you know, fortunately we were savvy enough to ever go to Cincinnati Children's Hospital for proton radiation rather than standard radiation. And that reduced her risk of getting this big chest tumor treated. That reduced her risk from getting bilateral breast cancers, cardiomyopathy, coronary artery disease, esophageal stenosis, pulmonary fibrosis, and chronic anemia dramatically from what would have happened if she'd gone ahead with what the type of standard radiotherapy that had been recommended at the center she was at on the east coast. So we're very aware that, you know, just having cancer treatment is, is fine. It's great, but it also initiates a whole set of problems that can occur for people down the road. And I think when I look at all this, I just hope that we're gradually getting to the point where we can detect cancers early and then rapidly move from first suspicion of cancer to confirmation of treatment then on on to actual effective treatment all the time keeping into mind the need to do those treatments that have the least long term side effects for the patient while improving the cure rate. And if we can then say okay this cancer is cured and here's what you have to do to make sure that you are minimizing the risk of getting into serious trouble with a follow up problem. I think if we can do that we've done a.
- [19:10]
A
Lot. Perfect. Well I think that's an amazing spot to leave it. Thank you so much for joining me on the podcast today. Been an amazing and very informative discussion. I invite our listeners to tune into more podcasts from Becker's Healthcare by visiting our podcast page@beckershospitalreview.com thank you again Dr. McGee and thank you to our listeners. I hope you all have a wonderful rest of your.
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B
Day. Thank you.