Smith Apisarnthanarax, MD

Why do you practice radiation oncology?

My first real exposure to cancer was through my grandmother, who lived in Thailand. She had metastatic thyroid cancer that left her paralyzed for most of the time that I knew her, and I think that experience planted the seed for what would become my calling. What I like about radiation oncology is that it’s a very visual field of medicine; we rely on anatomy and imaging, and that speaks to the artist in me. This specialty is also a nice combination of sophisticated technology, biology, direct patient care and teamwork. At Fred Hutch, we really do our best to make sure that we’re always thinking outside the box, doing what’s right for each individual patient.

What personal experiences have informed your approach to care?

Several years ago, I was hospitalized for a life-threatening illness, and it gave me a greater appreciation for what my patients go through. For example, I had to wear compression boots that squeezed my calves every 30 minutes to prevent blood clots from forming. They were standard procedure for someone like me who was in the hospital for a long period of time and couldn’t move around, but they were incredibly uncomfortable and made it impossible to sleep. Sometimes it’s the little things —like those cuffs —that we as physicians may not think twice about, but they can have a big impact on a person’s well-being. Having had that experience in the hospital, I never dismiss any of my patients’ complaints or concerns as trivial. Being diagnosed with and treated for cancer is one of the most arduous experiences there is; your quality of life is always a priority for me.

Provider Background

Specialty: Radiation Oncology

Area of clinical practice

Genitourinary cancers, skin cancers

Gastrointestinal cancers, prostate cancer

I am a board-certified radiation oncologist with expertise in several radiation modalities including proton therapy, a type of external beam radiation that precisely targets tumors while minimizing exposure to healthy tissue. I treat patients with prostate cancer and gastrointestinal cancers, which can affect organs such as the esophagus, liver and pancreas. Prior to joining Fred Hutch, I was an assistant professor and associate residency program director at the University of Pennsylvania Perelman School of Medicine.

My research is focused on optimizing proton radiation treatments for liver cancer. Historically, radiation wasn’t used to treat liver tumors, so there is much to learn about safely delivering potentially curative radiation doses and how to integrate radiation with other available treatments. I’m also interested in how functional imaging of the liver, which examines the organ’s physiological activities, can be used to improve radiation treatment planning and predict responses to cancer therapy.