International Physician Update

Treating Cancer with Radiation

New department chair Ted DeWeese says advances in research will soon allow patients to receive higher doses of radiation with fewer side effects.

The field of radiation oncology resembles no other in medicine. Its practitioners do not treat patients with drugs or surgery, like other physicians who deal with cancer patients. Nor are they radiologists, who take images expressly for the purpose of diagnosis. Instead, they are a combination of both, highly specialized physicians who treat cancer with the powerful energy of radiation. 

At most medical centers, this distinctive specialty has always had its own department. But at Johns Hopkins, where oncology evolved differently, the new Department of Radiation Oncology and Molecular Radiation Sciences did not make its debut until last summer. After conducting a national search, Hopkins leaders announced the department’s first chairman would be the homegrown Ted DeWeese.

Following his residency at Johns Hopkins in 1991, he worked his way up from instructor to associate professor in oncology and urology in seven years and became director of the radiation biology program in 2000. Known for his research in urologic malignancies, DeWeese devised the first adenoviral gene therapy trial for prostate cancer. He used a common cold virus as a “smart bomb,” targeting only cancer cells while leaving normal cells alone.

DeWeese says staggering advances in molecular-based technology are transforming the way clinicians treat cancer: “We will soon be able to see not only what’s in the organ we are interested in, but perhaps even the cells related to the tumor outside the organ.” What is more important, he says, clinicians will be able to see the function of the tumor and direct therapies specifically toward it.

Tumors respond far differently when radiation is delivered in a chronic low-dose fashion versus quickly, at higher rates, he says. But limiting risks and side effects to patients remains a challenge.

“There is a double-edged sword to all that precision,” DeWeese says. “If you’re right on target, precision is good, and if you’re off a little bit, precision is very bad.” Still, DeWeese is optimistic about designing ways to deliver radiation more accurately. Molecular techniques are already being used in nuclear medicine to watch the normal tissue function while irradiating the patient. And that has never been done before, DeWeese says.

To keep up with fast-paced developments like these, the department will soon be adding about 12 new members to its current staff of about 100. Some will be leading Hopkins’ medical physics research and a new division of radiation biology, with substantial new lab space. Says DeWeese, “It’s a new time for radiation oncology. “The expectations for research excellence are at their highest level. And we hope to attract physicians who can help us apply that groundbreaking research.”