Latest / Becker’s Healthcare Podcast / Dr. James McGee, President of OSF HealthCare Cancer Institute

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Dr. James McGee, President of OSF HealthCare Cancer Institute · Becker’s Healthcare Podcast

0:00
Welcome to the Becker's Healthcare Podcast. I'm Elizabeth
0:03
Gregersen, a reporter here at Becker's, and I'm
0:06
thrilled today to interview doctor James McGee on
0:09
the podcast.
0:10
Doctor McGee was recently named the president of
0:13
OSF Health Care's Cancer Institute
0:16
after serving as the founding director since its
0:18
opening in February
0:20
2024.
0:21
He also serves as vice president of physician
0:24
services for the oncology service line at OSF
0:27
Health Care. Doctor McGee, thank you so much
0:30
for joining me. I'm very grateful to share
0:32
your insights with our podcast audience.
0:35
Thank you for the chance.
0:36
Absolutely. And before we dive in, could you
0:39
introduce yourself and maybe just give a bit
0:41
about your background?
0:43
I'm James McGee, and I was, born and,
0:46
grew up on a very small farm in
0:48
Central Illinois right in the geographic center of
0:50
the state of Illinois.
0:52
And so my,
0:54
upbringing was entirely
0:56
rural,
0:57
in small towns.
0:59
Access to medical care was,
1:01
modest.
1:03
Best most of my health care was given
1:04
in a gymnasium in the grade school or
1:07
high school,
1:08
as part of, some inoculations for polio and
1:12
things like that.
1:14
Never really saw physicians very much, but, it
1:18
became clear as time went by that, the
1:21
doctor in town usually had work to do
1:23
even when everyone else was, in the midst
1:27
of a recession or a downturn or a
1:29
bad crop year So it seemed like something
1:32
to be interested in. So I, did a
1:35
look at a couple of,
1:38
volunteer opportunities.
1:39
I tried to get a job and a
1:41
summer job at a hospital and was excluded
1:44
because all those jobs,
1:46
went to, doctor's kids. So I I was
1:49
this farm boy who, you know,
1:52
couldn't really get much experience in health care,
1:55
but,
1:56
kind of was interested in it largely because
1:58
it seemed like it was some place where
1:59
he could actually find work to do.
2:02
And, as time went by, I came to
2:04
really enjoy that. And,
2:06
I went to medical school after college,
2:10
in
2:10
a small college in Downstate Illinois.
2:13
And, I went to Loyola to medical school
2:15
and then,
2:16
had the opportunity to spend my senior year
2:18
at a Zulu hospital in in the tall
2:21
province of South Africa doing apartheid.
2:24
800 bed hospital roughly with three doctors,
2:28
but,
2:29
tremendous missionary,
2:31
physicians.
2:32
And then,
2:33
after that, I had written to the,
2:36
director of the cancer center at the University
2:38
of Chicago where there were seven cancer centers
2:40
in in The United States that were comprehensive
2:43
at that time. Right. And was able to
2:46
get him to devise an oncology training program
2:49
for two years where I didn't have to
2:50
decide if I wanted to go into medical
2:52
oncology
2:53
or surgical or pediatric or radiation.
2:56
And while there, I, got to work with
2:58
the,
2:59
grad students that Enrico Fermi had when he
3:01
split the, ADAM for the first time at
3:04
the, you know, UFC.
3:05
And I got interested in the physics and
3:08
so forth of,
3:09
radiology and radiation treatment. So,
3:12
I went into radiation oncology and afterward was
3:15
very interested in the surgical applications of that.
3:18
So did a
3:19
fellowship in brachytherapy
3:21
or implant radiation at the University of Paris,
3:24
and,
3:25
was able to work with the people who
3:27
were working with the Curies and first people
3:30
to do, you know, radium treatments and such,
3:33
and
3:34
got,
3:35
very well trained by them. And then, you
3:37
know, as time went by,
3:39
had the opportunity to, come back to,
3:42
Downstate Illinois.
3:44
I always had a interest in trying to
3:46
bring,
3:47
better
3:49
cancer care
3:50
to people
3:51
in Central Illinois, a very rural area.
3:54
Typically, people that want advanced cancer treatments have
3:58
to go to, faraway places with strange sounding
4:01
names like Chicago and St. Louis.
4:03
And that's really not something that,
4:06
our people do very well because it involves,
4:10
going to places that we just never go,
4:14
and,
4:15
dealing with
4:16
the types of problems that there are in
4:18
the cities and so forth. So we we
4:20
didn't really have access to research trials, didn't
4:23
really have access to,
4:25
advanced radiation methods, you know, and that that's
4:28
kind of been my life's work for the
4:30
past
4:32
forty five years has been to really,
4:35
work on trying to improve
4:38
access to
4:40
modern therapies, especially in cancer,
4:43
for patients. And,
4:46
during that time, I was fortunate enough to
4:48
become the chairman of the state of Illinois
4:50
Board of Health for ten years.
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And during that time,
4:54
I learned that,
4:55
there was this crisis that was described about,
4:59
you know, cancer rates, morbidity, advanced diagnosis, and
5:02
so forth,
5:04
in parts of the city of Chicago, which
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were indeed
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very bad.
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However, when I looked at our rates in
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Central Illinois,
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I found that we were just as bad
5:14
and worse.
5:15
And and so
5:17
millions of dollars were coming in to try
5:19
to help the situation on the South Side
5:20
Of Chicago,
5:22
and nothing was coming in Downstate Illinois.
5:26
And they got a little better, and we
5:28
got a little worse.
5:29
So at the end of, that,
5:32
time frame, I was pretty discouraged not only
5:34
about
5:35
access to care, but also about how severe
5:38
the incidence was and the mortality,
5:42
and, what impact that was having on the
5:45
citizenry as far as, you know, people were
5:47
just, you know, felt that getting cancer and
5:50
dying from it was just inevitable. That's just,
5:52
you know, kinda what happens in our family.
5:54
That's
5:55
that's what happens in our social serve circles.
5:59
So,
5:59
those those types of experiences have, led us
6:03
to really
6:04
want to concentrate on giving access to cancer
6:08
research,
6:09
to advance treatment methods for patients in, rural
6:12
populations,
6:13
and to to study that so that those
6:16
lessons can be extrapolated to other areas in
6:18
the world.
6:20
And,
6:21
also at the same time to really say,
6:24
you know, this this business of finding cures
6:26
for cancer is getting to be very expensive
6:30
and,
6:30
elusive.
6:32
And so
6:33
we really should work on just not getting
6:35
these cancers at all. So our our cancer
6:38
institute,
6:39
while it's
6:40
bringing in advanced research methods and advanced technologies,
6:44
is focusing really heavily on working with our
6:47
vast
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primary care network that OSF HealthCare has
6:52
to try to bring
6:54
more,
6:55
information to those primary care providers and to
6:58
the patient populations
7:00
about how to reduce their risk of cancer,
7:02
how to identify their risk, how to modify
7:06
that risk,
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in order that we, ultimately have fewer people
7:10
getting cancer and certainly fewer people having advanced
7:13
cancers that are largely,
7:15
you know, gonna be very expensive to have
7:17
on maintenance therapies for years and years.
7:21
Absolutely.
7:21
So, yeah, I guess your background, you know,
7:24
led perfectly into my next question, which are,
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you know, what are the top priorities in
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your new role? And and it sounds like
7:30
your background has really fueled, you know, the
7:33
areas of importance for you today.
7:35
You mentioned
7:37
access to clinical research and prevention strategies. Are
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there any other priorities now that you've stepped
7:43
in
7:44
to the president role that you're focusing on?
7:47
Well, we want to,
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start to do
7:50
more advanced
7:52
radiation treatment methods that don't require so many
7:55
trips
7:56
and that don't involve so many side effects.
7:58
So we're we were able to get a
8:00
proton unit from Varian Corporation, a lovely,
8:04
piece of equipment that allows treatment in ways
8:07
that we can't do with X-ray therapies.
8:09
Mhmm. And we were able we were able
8:12
to do research on flash,
8:14
radiation, which is delivering radiation at very, very
8:17
high dose rates,
8:19
in which case there is the opportunity
8:22
to see a marked reduction in the reaction
8:24
of normal tissues to the radiation
8:27
while preserving the tumor response.
8:30
So that our unit has been designed from,
8:33
ground up starting in 2017
8:35
with the idea that we would be able
8:37
to develop aspects of flash
8:40
radiation,
8:41
treatment with with protons.
8:44
That
8:45
opens the door then to reducing the number
8:47
of treatments because the flash,
8:51
treatment advantages are seen in patients when they
8:54
get very few treatments, like three treatments rather
8:57
than 30 treatments.
8:59
You're giving a much higher dose each time,
9:01
but you're doing it in in a millisecond
9:05
so that then the normal tissues just don't
9:07
react. And you're also not treating a lot
9:09
of blood circulating, carrying, you know, cancer fighting
9:13
lymphocytes and so forth. And so in in
9:15
that method then with the treatment giving in
9:18
a very short period of time, say, to
9:19
the chest,
9:21
you're not giving radiation for a few minutes
9:23
while all the blood
9:26
goes flowing through those vessels
9:28
and is getting constantly radiated and killing off
9:31
the cells in the immune system.
9:34
So if we could
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reduce the number of radiation treatments
9:38
in that method down from, say, thirty to
9:41
three,
9:42
obviously, that starts to solve the geographic problem
9:45
of people living
9:47
far away from advanced therapies.
9:49
You know, a lot of people could come
9:50
here and stay for a week in our
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housing
9:53
and get a treatment done during a week's
9:56
time rather than having to say, well, I
9:57
gotta drive back and forth for six weeks
9:59
or eight weeks. Right. So that's that's a
10:02
big advantage. And then also, we have a
10:03
children's hospital and, you you know, radiation is
10:06
not very useful in children because of all
10:08
the side effects on growth
10:10
and tumor induction. Well, the the hope with
10:13
FLASH
10:14
is that those children would be able to
10:16
have radiotherapy
10:17
and to do do quite well.
10:19
Honestly, another problem
10:21
is that there's a lot of, you know,
10:23
fairly ordinary or not so great,
10:26
treatments that go on. And so we do
10:28
see a number of patients that come in
10:29
with cancers that are recurring
10:32
after prior radiation elsewhere.
10:35
And sometimes that treatment's not been very good
10:38
so proton radiation,
10:41
allows us to consider a lot of patients
10:43
for retreatment,
10:46
because
10:47
protons just in general, not in the flash
10:49
mode, but just in general,
10:51
are able to shape the radiation just into
10:54
tumors
10:55
and not have the radiation exiting into other
10:57
parts of the body that have already been
10:59
treated, for example. So I think in that
11:02
regard, we're we're, seeing that many patients that
11:05
otherwise would just go home to die or
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able to get proton radiation and have a
11:10
real chance at, salvage, real chance at at
11:13
survival.
11:14
I I will add also that another major
11:16
impact for us
11:18
in radiation treatment has been, building a very
11:21
modern and advanced suite for brachytherapy or implant
11:24
radiation.
11:26
That's why I started working on in the
11:28
nineteen eighties in Paris.
11:30
At at that time, I was able to
11:32
work with the Austrians coming in who wanted
11:34
to develop high dose rate brachytherapy
11:37
where a single radiation source could be used
11:39
to treat many patients.
11:41
But instead of, again, a treatment taking, you
11:43
know, days of
11:45
constant exposure to radiation, treatment can be given
11:48
in a few minutes with a very intensely
11:50
active radiation source,
11:52
being very tightly controlled.
11:54
In that way, again, now we're we're able
11:57
to have patients come in and have prostate
12:00
cancers treated with high dose rate brachytherapy,
12:03
in twenty four hours, a full course of
12:05
treatment in twenty four hours with brachytherapy.
12:08
Use use usually that if done with permanent
12:11
seeds, the then the radiation was present for
12:13
weeks.
12:14
With high dose rate, there's two bursts of
12:17
radiation for curative intent treatment.
12:20
One, like, on Wednesday afternoon, on Thursday morning,
12:23
and then the applicator comes out of the
12:25
prostate and the patient goes home. That is
12:28
a wonderful treatment option for patients who say,
12:31
well, you know, I can't I can't drive
12:33
down here for six weeks of radiation treatment
12:36
every day.
12:37
Mhmm. So, you know, they can come spend
12:39
one night and get all their treatment done.
12:42
So, these are these are the types of
12:44
things to drive our thinking, and these are
12:46
the areas where we intend to put effort
12:48
in clinical research.
12:50
Perfect. Yeah. And I guess to kind of
12:52
shift gears and and maybe look forward a
12:54
little bit, where do you see the OSF
12:57
Cancer Institute in five years or ten years?
12:59
Do you kind of have benchmarks that you're
13:01
hoping to meet?
13:02
Well, we're we're certainly already engaged in bringing
13:05
in early phase clinical trials. Mhmm. Phase one
13:09
clinical trials have have, started up, and, we've
13:13
worked very hard to reduce the time to
13:15
get from
13:17
the proposal
13:18
of a study to do to initiating that
13:21
trial.
13:22
We've worked very hard to get down that
13:24
down to time of about forty five days,
13:26
which allows us to be more
13:28
attractive to industry to give us, access to
13:31
do phase one trials and their their drugs
13:34
and so forth. We've also,
13:37
been very,
13:39
fortunate to have the opportunity to work on
13:41
some early,
13:42
detection trials. And,
13:44
some of those, for example, were a blood
13:47
test,
13:48
to determine whether or not a patient would
13:49
likely benefit from low dose CT screening,
13:52
pick up lung cancer if they've had a
13:54
smoking history.
13:56
We were, really the first test site for
13:59
that, and, that,
14:00
subsequently was, going into
14:03
more routine use.
14:05
So that so that that type of thing,
14:07
self swabbing for,
14:09
certain g GYN tract cancers,
14:12
those are the types of studies that we've
14:14
been able to do already.
14:16
And we're building now our, research base by
14:19
adding
14:20
research medical oncologist to our faculty,
14:23
and that will help us also with, we
14:26
now have a, medical oncology team that's working
14:29
on, pancreas cancer advanced
14:32
studies phase one, similar in lung cancer. So
14:35
in five years, I hope that we'll have
14:37
a full complement of research medical oncologists
14:40
really addressing a whole number of, issues,
14:44
that are currently, you know, difficult to deal
14:46
with and difficult to to treat. And in
14:49
a similar way, trying to do the same
14:51
thing with our,
14:52
advanced radiation methods.
14:54
Perfect. Well, I look forward to speaking to
14:57
you again in five years
14:58
to hear how all of that's going.
15:01
Any of our listeners who may have heard
15:02
me interview oncology leaders before know that I
15:06
like to ask them what they're excited about
15:08
or hopeful about when it comes to the
15:11
future of cancer care. And so our audience,
15:13
you know, isn't just oncology leaders. It's,
15:17
leaders from across the whole health care industry.
15:20
And
15:21
I'm always inspired when I talk to oncology
15:23
leaders because I know how exciting the field
15:25
is right now, all the innovation, like you
15:27
said, the research discoveries that are happening.
15:30
What are you excited about, and what would
15:32
you tell our listeners to be hopeful about
15:34
when it comes to the future of cancer
15:35
care?
15:37
I'm I'm very hopeful that we'll figure out
15:39
how to use,
15:41
genomic information
15:43
to help predict,
15:45
cancer risks and how to mitigate those risks.
15:48
I think that, we
15:51
have a lot of screening that we do
15:53
that
15:54
gets to be tedious, and then people kinda
15:56
drop out of it or they miss a
15:57
year here or there. I'd like to like
16:00
to think that we could become very personalized
16:03
cancer risk determination,
16:06
you know, taking into account
16:08
family history, but also personal factors that might
16:11
be discernible,
16:12
even from the genome
16:14
and being able to really develop for the
16:17
patient a
16:18
profile of what screening and when would be
16:21
most appropriate for them as an individual.
16:24
And and in a similar fashion,
16:26
you know, some of the people that are
16:28
at greatest risk of developing cancers are people
16:30
who've been treated for a cancer.
16:33
So in a similar fashion,
16:36
when a person gets cancer
16:38
treatment,
16:39
then they need to have a very exquisite
16:42
program of follow-up
16:44
that addresses the cancers for which they are
16:47
now prone to get
16:49
because of their exposure to various
16:52
chemotherapy agents, to various radiation methods, etcetera, etcetera.
16:56
So I think personalizing
16:59
individual risk assessments and risk reduction
17:02
rather than just saying everybody in the world
17:04
needs to have a colonoscopy every, you know,
17:06
ten years.
17:07
But getting it down to, well, you know,
17:09
you need to get a colonoscopy at age
17:11
30,
17:12
because of a certain factor, or,
17:15
you probably don't need a colonoscopy
17:17
again, things like that. That that
17:19
we we have to get better
17:21
at not just doing blanket assessments that everybody
17:24
is the same in terms of cancer risk
17:26
reduction,
17:28
and also in terms of survivorship. My own
17:30
youngest daughter had a very, very serious
17:34
cancer when she was in her mid twenties.
17:36
And, you know, fortunately,
17:39
we were savvy enough to ever go to
17:41
Cincinnati Children's Hospital for proton radiation rather than
17:44
standard radiation, and that reduced her
17:47
risk
17:48
of getting this big chest tumor treated.
17:51
That reduced her risk,
17:53
from getting
17:54
bilateral breast cancers,
17:56
cardiomyopathy,
17:57
coronary artery disease,
17:59
esophageal stenosis,
18:01
pulmonary fibrosis,
18:02
and chronic anemia
18:05
dramatically
18:05
from what would have happened if she'd gone
18:07
ahead with what the type of standard radiotherapy
18:10
that had been recommended at the center she
18:12
was at on the East Coast. So
18:15
we're we're
18:16
very aware that, you know,
18:19
just
18:20
having cancer treatment is is
18:23
fine. It's great.
18:25
But it also initiates a whole set of
18:27
problems
18:29
that can occur for people down the road.
18:30
And I think
18:32
when I look at all this, I just
18:33
hope that we're gradually getting to the point
18:35
where we can
18:37
detect cancers early
18:39
and then rapidly move from first suspicion of
18:42
cancer to confirmation of treatment then on on
18:45
to actual effective treatment,
18:47
all the time keeping into mind the need
18:50
to do those treatments that have the least
18:52
long term side effects for the patient while
18:54
improving the cure rate. And if we can
18:57
then say, okay. This cancer is cured, and
19:00
here's what you have to do to make
19:01
sure that you are minimizing the risk of
19:04
getting
19:05
into serious trouble with a follow-up problem. I
19:07
think if we can do that, we've done
19:09
a lot.
19:11
Perfect. Well, I think that's an amazing spot
19:13
to leave it. Thank you so much for
19:15
joining me on the podcast today. It's been
19:17
an amazing and very informative discussion.
19:20
I invite our listeners to tune in to
19:22
more podcasts from Becker's Healthcare by visiting our
19:25
podcast page at beckershospitalreview.com.
19:29
Thank you again, doctor McGee, and thank you
19:31
to our listeners. I hope you all have
19:33
a wonderful rest of your day. Thank you.