In this blog post, hear from Fred Hutch's Dr. John Kang regarding treatment decisions for lung cancer, take a closer look at the new Fred Hutchinson Cancer Center brand, and get to know our proton therapy director, Randall McClure.
Lung cancer is one of the most aggressive types of cancer — and the deadliest. It is also one of the most common; about 237,000 patients are diagnosed in the U.S. each year.
The good news is that, as smoking becomes less common, the number of lung cancer cases is decreasing. Smoking isn’t the only risk factor for lung cancer, but it is the biggest. This is why lung cancer screening through low-dose CT scans is usually only done for people 60 to 80 years old who have a 30-pack-year smoking history and who have smoked (or quit) within the past 15 years. Other risks include exposure to asbestos and radon gas.
Non-small cell lung cancer (NSCLC) makes up 80 percent of lung cancer diagnoses. About 20 percent are small cell lung cancers, and there are a few other very rare types. Lung cancer can generally be treated with radiation if the tumor has not spread.
“We call it ‘definitive intent radiation,’ which means that the goal is to get rid of the cancer,” says lung cancer expert Dr. John Kang. “It falls under local therapies, like surgery, because it targets just the area of the tumor. Systemic therapy would be something like chemotherapy, which travels throughout the body. Often, radiation is used in addition to surgery and chemotherapy.”
The doctors who treat patients at Fred Hutchinson Cancer Center – Proton Therapy work with all types of radiation, including protons. They carefully consider each case, sometimes consulting with the medical physics and dosimetry teams, before making a recommendation. Dr. Kang likes to compare two plans — one for proton therapy and one for intensity-modulated radiation therapy (IMRT) — to see which has the best chance of destroying the tumor while causing minimal damage to the heart, lung and esophagus.
“I favor proton therapy for more advanced stage III cancers, which means they are either very large or the cancer has spread to many lymph nodes, or when the tumor is located close to the heart, as protons can reduce toxicity to organs close by,” says Dr. Kang. “I favor IMRT or stereotactic body radiotherapy (SBRT) when the tumor is small or surrounded by air.”
Because the proton beam is affected by the density of the material it passes through, air can create a challenge. As the patient breathes, the volume of air in the lungs fluctuates. This can affect where the proton beam releases most of its energy. However, where the proton beam passes through consistent material, such as the dense tissue in the center of the chest, protons can minimize the radiation dose to critical organs like the heart. Research has shown that an excess radiation dose to the heart can lead to heart failure or other problems later in life.
Research on treatment options is ongoing. At our proton therapy facility, our radiation oncologists participate in a number of clinical trials, including the ADMIRAL trial and the CASPIAN-RT trial, which are both led by our medical director, Dr. Jing Zeng. ADMIRAL looks at potentially avoiding radiation to the mid-chest area by starting immunotherapy earlier, and CASPIAN-RT looks at delivering higher doses of radiation therapy over a shorter time after chemo- and immunotherapy. “Studies similar to CASPIAN-RT have shown much longer survival rates with local therapy on top of systemic therapy,” says Dr. Kang. If patients would benefit from joining either trial, their doctor will let them know.
Dr. Kang became interested in lung cancer treatment while doing his medical rotations at the University of North Carolina at Chapel Hill and The University of Texas Southwestern Medical Center. He was fascinated that patients could be treated without needing surgery. He worked with several pioneers in the field of radiation for lung cancer, which inspired him to take this path. Now, Dr. Kang is exploring machine learning for predicting radiation therapy outcomes. He is studying whether these predictions could someday reduce the need to create comparative plans between proton therapy and SBRT/IMRT.
Dr. Kang enjoys treating lung cancer. “The disease is tough and aggressive,” he says. “You have to remain on your toes, but it is also very fulfilling to be able to fight back and make a real difference for almost every patient.”
By now, you have probably read about the merger between Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance. The new entity, Fred Hutchinson Cancer Center, combines the two areas of expertise that Fred Hutch and SCCA were each best known for — research and patient care — into a single entity that links research and treatment, discoveries and patient care.
Curing and preventing cancer demands new thinking, new science, new therapies, and close collaboration among the best leaders, doctors, researchers, nurses, administrators, and staff in the field. By using the insights from Fred Hutch’s world-class researchers and the most advanced technologies available, our physicians can provide leading-edge care options, better outcomes and individualized treatments for each patient in Fred Hutch’s clinical setting. So, although it may be a little confusing at first to see a new name and logo, rest assured that this change is making the care you receive even better.
Our new logo and brand reflect the mission of the integrated organization. First, the colors reflect the partnership between the legacy organizations, as well as the new relationship with UW Medicine.
“The colors in our logo are a nod to our legacy,” says Kimberly Ovitt, VP and chief marketing and communications officer. “Navy blue for Fred Hutch, gold for SCCA and purple for UW Medicine. The multicolored icon also reflects our commitment to diversity, equity and inclusion. And it’s not just through the use of the different colors, but with the colors aligned in shapes that move upward and forward.”
If you look closely at the logo, you will notice that the upper right-hand corner forms an arrow that breaks away from the base shape. This symbolizes that our organizations are coming together to accelerate our impact and helping people break free from devastating diseases.
There is also a hidden “H” in the white space created by the launching arrow. “This represents all that we don’t yet know about curing cancer, but that we believe will be discovered by Fred Hutch, and which provides hope for people today and in the future,” says Ovitt.
The arrow invites you to look:
If you have any questions about the merger, the brand or what it means for your care, please contact our Marketing Manager at firstname.lastname@example.org.
Randall McClure has worked at Fred Hutchinson Cancer Center for more than 17 years. During this time, he’s held many positions and has built lasting relationships with patients and staff. Terry McDonnell, VP and Chief Nursing Officer at Fred Hutch, lauds McClure’s rise in the organization: “Randall McClure started in 2006 and built a career with us through taking on various roles, pursuing education and dedicating service to our mission. After working as a Unit Attendant (courier), he moved on to Team Coordinator in the film room. He then worked evenings and weekends at the main reception desk while he pursued a degree in Radiation Therapy. Through the years, he progressed to Supervisor and Manager of South Lake Union’s Radiation Oncology department.” Now, McClure has been offered the opportunity to manage Fred Hutchinson Cancer Center – Proton Therapy. He was both excited for a new challenge and sad to say goodbye to some of his long-time colleagues.
“The team here at the proton therapy facility has made me feel welcome,” he says, “and has impressed me with their compassion and high-quality care.” McClure says this patient-focused, welcoming culture makes it an honor to join the proton therapy team. McClure and his wife, Amanda, have two daughters who are the sole motivation for all he does in life. “It may sound cliché or cheesy, but all my decisions are made are in service of being the best father I can be,” he says. His older daughter is passionate about ballet and currently dances at Pacific Northwest Ballet. What very few people know is that ballet runs in the family: McClure was also trained in ballet, among other dance styles. His piqué and châinés turns are still pretty impressive, he says!
McClure’s younger daughter loves soccer and plays right wing on a premier team in West Seattle, where they live. “I coached her recreational team for a while,” he says, “but I decided to leave her training to the experts now.”
Like many in the PNW, McClure is happiest when spending time with his family in the outdoors and is particularly drawn to the water. During the pandemic, he and his kids built a sailing dinghy, which McClure says was an amazing project and a great learning opportunity. Their plan is to put the boat in the water around Alki and sail over to Blake Island to camp for a night or two.
McClure is also an avid gardener, and he says the only limit to his gardening is time. He and his kids almost always have some gardening experiment in the works, whether it’s growing ferns from wild-gathered spores or a mushroom log from home-acquired spore sprints. The family’s favorite hybrid tomato to grow is the Sungold, strongly recommended for a “sweet like candy” taste. When not outside, McClure loves the game of chess and has not yet lost a game to his daughters.
If you see McClure around and have the time, please say hello. “I would love to get to know you and learn what drives and motivates you,” he says. “I want to provide outstanding care to all of our patients.”
Get once-a-month updates about proton therapy, including science and medicine news, survivor stories, staff profiles and more.