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- Hello, and thank you so much for tuning
- into the Becker's Oncology Leadership podcast.
- I'm Elizabeth Rygerson, a reporter here at Becker's,
- and today, I am talking to doctor James
- McGee.
- Doctor
- McGee is the president of the OSF Health
- Care Cancer Institute.
- Doctor McGee, thank you so much for taking
- the time to speak with me today.
- Sure. No.
- Before I dive into my questions, I'd love
- if you could share a bit about your
- background and your role at OSF
- and the Cancer Institute for our listeners.
- Well, I'm I'm, board certified in radiation oncology,
- and,
- grew up in a very rural environment
- in Central Illinois,
- extremely rural,
- And then, had
- training in Chicago, University of Chicago Northwestern, and
- then did
- the follow-up,
- training at the University of Paris in various
- aspects of, radiation treatment and then a master's
- in health care management, Harvard School of Public
- Health,
- and came back to, practice in, Central Illinois.
- And after,
- eight years in,
- Decatur,
- moved to Peoria and started a cancer program
- for OSF Health Care about about forty years
- ago.
- And, over that time,
- we've
- been able to develop more cancer treatment programs
- for people in rural environments,
- which is,
- the nature of our health care system.
- And our,
- big priority is always
- to give access to those
- types of treatments that people in rural environments
- usually,
- struggle to have. So
- we've put in a proton unit we for
- enhanced radiotherapy and put in a brachytherapy area
- for that type of access for patients.
- But our our main work in many regards
- has been to improve health,
- since we are a health care organization.
- And so we always focus on integrating with
- primary care
- and working on ways to improve early detection
- and prevention of cancers,
- so just to really try to
- improve the health of, our our populations
- in in rural environments.
- Absolutely. And I appreciate you kinda, you know,
- laying the land for our listeners to know,
- where, you know, where you're coming from and
- where OSF kind of stands in the broader
- landscape landscape today.
- I know you talked a lot about, you
- know,
- it's not just cancer. It's also, you know,
- general health and partnering with primary care physicians
- and all the different priorities
- that you probably are juggling and balancing,
- not just today, but in the coming months
- and years and and the vision for everything.
- What would you say, if you had to
- narrow it down, is your biggest priority
- at OSF Health Care Cancer Institute today?
- Well, the biggest priority is trying to prevent
- cancers
- and to detect them early. That
- that is our biggest priority.
- You know, we can treat cancers. We we're
- bringing in phase one research trials for
- strange and exotic cancers that, you know, very
- few people get. We're also doing a lot
- of, work
- in advanced radiotherapy
- techniques and they're agnostics.
- But in the end,
- you know, any patient that gets cancer, especially
- when it's found at a late stage,
- that that's really a failure of health care.
- Right? Mhmm. So our
- ten years ago, we started a program for
- low dose CT screening,
- and, now we're at very high rates.
- So probably the highest in the nation
- in terms of percentage of people in our
- roles of holistic health care who've
- met the criteria
- to warrant
- screening for lung cancer and who've had low
- dose CT screening done and are enrolled in
- a formal program for that. We've been able
- to get low dose CTs placed in our
- many hospitals across the landscape of rural Illinois
- and
- have engaged in research trials with blood tests
- to see who's most in need of getting
- those scans done. So that's really our emphasis
- is, you know, when you look at all
- these
- different
- health issues, cancer is obviously the one that
- keeps growing and keeps getting worse.
- And when you look look at sort of
- what you might call a heat map of
- where cancers are at,
- it's right right here in in rural America,
- especially in Illinois and Iowa
- and, extending into Indiana.
- So we're right in the midst of the
- worst of it, and that's that's our job
- is to reduce that incidence and the mortality
- from that.
- I think the way you,
- you phrase that is is so,
- important. And
- I, you know, cover so much about the
- new innovations and and, like you said, exotic
- cancers,
- and and everything, but, really, that prevention piece
- is so critical. So I appreciate you
- really honing in on that for our listeners.
- Are there any pressures you feel like cancer
- centers, oncology service lines, or maybe even, you
- know, rural cancer providers are facing right now
- that maybe isn't getting talked enough
- talked about enough?
- I think the problems of rural America are
- not being talked about enough.
- Mhmm. And in the midst of all that,
- you know, reimbursement's always
- a always an issue, always a problem.
- Access is an issue.
- Workforce is an issue. All those things,
- are major issues, and
- they're worse in rural America, it seems. I
- chaired the state of Illinois Board of Health
- for ten years. And during that time, we
- had a lot of crises,
- where people were, having high morbidity and mortality
- rates in various neighborhoods around Chicago.
- And a lot of projects were done to
- try to help those,
- individuals and those populations,
- so called underserved and, you know, less privileged,
- etcetera, etcetera.
- But whenever I came down here to Central
- Illinois and looked at our data versus Chicago,
- we were always worse, but nobody was sending
- us you know, those types of programs. So,
- I think that if you ask me what
- what we're facing right now is that we're
- not getting special attention like we should for
- rural America. As I know there are some,
- you know, fundings now for various research projects,
- etcetera, etcetera.
- But it's it's it's it's a major problem
- in terms
- of what where are all these cancers coming
- from? Are they coming from pesticides and chemicals
- put on crops?
- You know, where where is this where is
- this abundance of cancers really coming now that
- we're seeing
- less industrial pollution?
- We're seeing
- less smoking, and yet our incidence rates of
- cancers, especially on younger people
- and different organs, just keeps going up. So
- there's something that's going on that we're not
- tracking, we're not aware of,
- and we're not doing enough, you know, to
- really determine right now. So I think that's
- the big pressure that I see for us
- is we have all these people getting cancer,
- and we don't really know how to turn
- that around.
- Yeah. That's such a interesting point too because,
- you know, when I think about, you know,
- rural funding initiatives and programs that I've covered,
- You know, it's not just about the clinical
- care or it's not not just about, you
- know, providing access to treatment, that piece that
- you mentioned of, you know, why is it
- happening, how are we studying, you know, why
- these rates are going up. It's it's just
- as important,
- if not more important, you know, than than
- the treatment piece itself.
- Yeah. Very much so. You know, the treatment
- piece is, you know, based somewhat on access.
- But, you know, again,
- when you get these late diagnoses of advanced
- cancers, you're really spending a lot of money
- using a lot of resources
- and in the end, not having a very
- satisfactory outcome for so many people. So it
- it's the emphasis really has to move
- toward early detection and and prevention
- and, finding out why we're getting some of
- these cancers and what needs to be done
- to change that.
- Absolutely. Well, I'm gonna shift gears, make a
- hard left here right now because it is
- a Becker's podcast, podcast, and I do have
- to ask you about AI.
- So I'd love to know from your point
- of view,
- we are mindset around AI and, you know,
- where the technology is genuinely
- changing care, where is the hype kind of
- outrunning the reality of the technology,
- are you navigating safety concerns at the Cancer
- Institute, kind of what is,
- just taking your temperature there?
- Yeah. So radiation oncology is benefiting from AI
- because of the ability to do some of
- the tests that we do, like outlining
- tumors and normal volumes of organs to avoid
- in the treatment planning process.
- Some of those things can be done by
- AI, and it'll it'll save us time on
- each individual case, you know, that we're planning.
- In the medical oncology arena, I think it's,
- going to help us as we develop our
- own medical oncology practice. It'll help us to
- know where various patients are,
- what
- the dem demographics of those people are, etcetera,
- and allow us to really structure our practices
- to find ways to get experts in those
- cancers in front of those patients and vice
- versa. So I think there's a lot with
- scheduling in medical oncology and also then matching
- to clinical trials,
- that will be useful for AI to do.
- So I think it has, you know, a
- lot of promise in that regard.
- On the other hand, you know, you gotta
- keep your,
- hand on the switch. You know, the other
- day, we had a patient's,
- contours done. Treatment plan was developed,
- and was,
- almost ready to go, and it was realized
- that what what had been contoured as bladder
- was really a seroma from a prior lymph
- node dissection,
- and not the bladder itself at all. So
- that would have been that would have been
- a bad error had that, you know, gone
- forth. So so, you know, AI can present
- you with,
- opportunities for improvement,
- but
- you really have to realize that it's not
- perfect,
- and you have to not be lulled into
- complacency
- about double checking everything. So we we, feel
- like, you know, we're opting have its general
- day to day utility.
- But you're still gonna have to have smart
- doctors, in order to take advantage of of
- that,
- technology. And
- I don't think I don't think AI is
- gonna make,
- that
- equation change very much. Although, you know, just
- like today, you know, wanted to know how
- long a patient should be on,
- hormone medication for their problem. So put that
- in into open access
- AI, and, it said right immediately,
- you know, that it was,
- you know, for a period of,
- no more than six months. Okay. That's great.
- Got that. Gave the reference. I could have
- gone and looked that up in the reference,
- but I saved myself five minutes of of
- looking and searching for that
- by just asking that question on my phone,
- you know, of open evidence.
- So lot of lot of conveniences and so
- forth, but we we we have to be
- very very much in in line with doing
- what we've always done in terms of quality
- and safety.
- Absolutely. I love that kind of metaphor of
- keeping your hand on the lever. Right?
- I think it's something not all of our
- listeners will will agree with and relate to.
- The question I've been asking oncology leaders,
- you know, who are in the leadership position
- today, as you look towards the next generation
- of oncology leaders, you know, who are just
- joining the field or maybe working their way
- up,
- Is there any challenge or problem
- you think will be in their hands to
- solve that the field isn't
- fully tackling right now, but you see kind
- of in the future that they're those leaders
- are gonna have to figure out some solutions?
- Well, I think we have
- done a lot, you know, with cigarettes and
- so forth over the years.
- And and what we're not doing enough with
- is obesity.
- Right. You know, it's driving so many cancers
- developing, and it's also
- so hindering of patients being able to tolerate
- cancer therapies or even have some
- cancer therapies, certain surgeries, certain radiations.
- So, I think obesity is something that we're
- still
- turning our heads to a little bit, you
- know, ignoring,
- but it's it's a huge
- problem.
- And it's the new cigarette smoke. You know?
- It's the new thing. It's the new cause
- of cancer. It's the new thing that's everywhere,
- and it's it's the thing we have to
- do something about. So we have started a
- clinic,
- for, our cancer patients.
- You know, a lot of a lot of
- women have had treatment for breast cancer or
- GYN cancers who have hormonal imbalances, or maybe
- on some hormone medications, you know, suffer from
- a lot of weight gain.
- So we're looking, and have developed a clinic
- that integrates
- some of the resources of the cancer institute,
- including the teaching kitchen,
- and,
- general medical care, sometimes
- medications,
- also
- exercise training,
- various measurements of body mass,
- muscle, and fat. All of that is coming
- together in a in a clinic
- for our patients that, for example, are
- forty pounds overweight after breast cancer therapy,
- depressed about it.
- And so they're getting a lot of help
- from
- a little bit of psychological help, but then
- the reality of
- this is what in the teaching kitchen I'm
- learning. This is,
- something I've talked with them about GLP ones.
- I'm getting my exercise prescribed and getting my
- muscle mass and fat
- ratio measured on a regular basis, getting my
- weight checked, getting encouragement,
- going walking with a group of, like minded,
- patients,
- every every day,
- to get my exercise in. That that type
- of clinic is really starting to take off
- for us. I think I think that,
- is a way that we're trying to address
- this obesity epidemic in our patient population. And,
- you know, some of these people were in
- much better shape, you know, prior to getting
- cancer and having this, you know, treatment. So
- we we feel like that's a great step
- for us right there. That's that, I think,
- is,
- the big challenge, though.
- Absolutely. I think you're the first who may
- have answered that way.
- So I'm excited,
- to see kind of what, you know, comes
- from programs like you mentioned and and, like,
- you know, with the medications that you mentioned
- and the different therapies, you know, what
- what that future solution will be.
- Anyone who listens to the podcast knows my
- favorite way to end conversations with oncology leaders
- is asking them what's giving them hope about
- the future of cancer care. So I'd love
- to hear from you, doctor McGee, about what,
- you know, what's on the horizon that's giving
- you optimism when it comes to oncology.
- Well, we're doing a lot to improve access
- and decrease cost of care.
- So in radiation, for example, we're doing a
- lot of research with our proton unit on
- flash radiation therapy, which is, increasing the rate
- at which a radiation treatment is delivered,
- and increasing that dramatically,
- you know, changing from an output of, 2,500
- grads a minute to 700,000
- grads a minute. And in that scenario then,
- potentially, there's much less
- reaction of normal tissues to radiation,
- an equal reaction of tumor tissue to radiation,
- and the number of treatments with radiation can
- be reduced dramatically from, like,
- 30 to three.
- Oh. And so you you can you know,
- I think we have a hard time with
- the infrastructure we have now with radiation across
- the landscape because you've got
- many
- radiation machines scattered all over the place
- of varying quality.
- You have people under pressure financially trying to
- do as many treatments as possible
- in order to get compensation.
- I think what gives me hope are that
- there will be modalities
- like FLASH developed
- that would allow for
- the very expensive equipment to be used much
- better by larger groups of patients,
- but
- only,
- you know, in short intervals of time, not
- requiring, you know, moving to, you know, a
- faraway city for two months to get radiation,
- but maybe making, you know, a a short
- enough visit that you could come,
- stay in provided housing for a couple of
- nights and get your entire course of radiation
- treatment.
- And those types of things, I think,
- decrease
- cost of care,
- decrease overpopulation
- of
- equipment that's difficult to pay for and maintain
- and which drives a lot of unnecessary treatments,
- quite honestly.
- And I think if we can get our
- handle around things like that
- in many ways,
- that we'll be able to do a much
- better job
- of reducing cost, improving access for everyone,
- and, just making more sense out of all
- this.
- Amazing. Well, I appreciate you, you know, tying
- in that radiation oncology perspective too for our
- listeners because I think it's so key and
- crucial, to these kinds of discussions. And that's
- actually all the time we have for today.
- So I just wanna thank you again for
- taking the time out of your day to
- talk with me and, share your perspective with
- our listeners.
- Thank you. And thank you to our listeners
- for tuning in to Becker's Oncology
- Leadership podcast.
- I invite you all to check out even
- more Becker's Healthcare podcasts
- at beckerspodcastsdot,
- Thank you again to doctor McGee for joining
- me and to our listeners for tuning in.
- Have a great day.