“Every minute counts when you only have a few months left to live,” said Dr. Paul Read, professor of radiation oncology at the University of Virginia Cancer Center. He has devoted his medical career to finding better ways “not to treat the cancer, but to treat the patient,” he said.
For those with “treatable” cancers, that means bringing to bear all of the resources at his disposal. But for those in advanced stages of the disease, his streamlined process can improve the life they have left, reducing their pain – and the time they spend in medical offices. The process maintains the high level of care but condenses a treatment course that previously might’ve taken two to three weeks into a same-day procedure.
A dedicated Wahoo, Read racked up the equivalent of four UVA degrees, including certification for his residency: An Echols Scholar, he earned his B.S. in chemistry in 1986, finished UVA Medical School in 1990, his radiation oncology residency in 1995, and completed a Ph.D. in molecular physiology and biological physics in 2000. Currently, he serves as medical director and vice-chair of the radiation oncology department.
Read connects his commitment to improving people’s lives with “the history of excellence and pioneering spirit that Thomas Jefferson envisioned for our faculty and students.” Here he talks about what drives him and what the streamlined treatment accomplishes for many patients.
Q. What led you into medicine, and radiation oncology specifically?
A. I have no family members in medicine, but was drawn to the profession at an early age by a wonderful pediatrician that I had. The idea that you could prevent, and cure patients of, diseases fascinated me, and I was determined even in grammar school that I wanted to be a physician and help do what I could to make people’s lives better. This is still a driving passion for me.
Once in medical school, I looked at lots of possible career choices and ultimately decided on radiation oncology, since it was a perfect blend of physics, biology and clinical medicine. The concept of curing patients with targeted invisible beams of energy going through patients at the speed of light drew me to this field. To this day, thoughts of how we can improve the targeting of the radiation to reduce toxicity, improve cure rates of cancer and make the overall process more patient-friendly drive my clinical care.
Q. You and your team came up with a streamlined method for administering radiation treatment. Does this work for only certain kinds of cancer?
A. The radiation treatment process is complex and current radiation planning and quality-assurance processes take days at most centers. Our team thought that modern radiation equipment and software could be used to streamline this process to treat patients more rapidly.
For many patients with curable cancers, such as breast and prostate cancer, it is very reasonable to spend a few days to optimize the treatment and then start that course of treatment, since many of these patients will receive weeks of daily treatments. However, for patients with pain from cancer spread to bone, we wanted to expedite their treatment.
There was already clinical trial data that one high dose treatment is as good as five or 10 treatments. We wanted to build on that information to develop a program that delivered highly targeted radiation that almost doubled the single treatment dose and that did so in a single day with a CT scan, treatment planning, quality-assurance measurements and treatment delivery all in a four-hour procedure.
The concept and initial research was funded by a UVA Buchanan Award and was completed as part of a $2.5 million Healthcare Innovation Award [from the Centers for Medicare and Medicaid Services]. I was the principal investigator of this award that included this program and several other palliative care initiatives to improve the quality of health care and of life for patients with advanced cancer.
Q. Why is this treatment practice more beneficial for patients and their families?
A. The program is called STAT RAD. “Stat” means right away. The idea is that if patients have pain and only have a short time to live, we should be able to help them with palliative treatment that is effective, minimally toxic and convenient.
The average number of treatments for cancer spread to bone in the United States is about 10 treatments, despite data suggesting that for up to a third of patients, one treatment is just as good.
This STAT RAD program turns a treatment course that may take two to three weeks and converts this into a same-day treatment procedure. This is much more convenient for patients, and with the high doses that we are using in clinical trials, we are finding that patients have rapid pain relief, frequently within a week of treatment.
Q. You went to UVA as an undergrad through medical school and residency, right? What made you decide to stay here?
A. I love the UVA institution and its traditions, and more importantly, I wanted to contribute to the history of excellence and pioneering spirit that Thomas Jefferson envisioned for our faculty and students. I believe that traditions are just history if they are not invoked in your daily pursuit of excellence. They lose their meaning if you are not a part of them.