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Dr. James D. Cox

The Future of Cancer Treatment

Dr. James D. Cox, head of the department of radiation oncology at The University of Texas M. D. Anderson Cancer Center in Houston since 1995, knows a good new thing when he sees it. Still, it took the urging of his wife and fellow UT M. D. Anderson oncologist/professor Ritsuko Komaki to overcome his initial skepticism of proton therapy. Both were sold on the emerging radiation therapy after visiting the then-new Proton Treatment Center at Loma Linda University Medical Center in Southern California in 1990, and once he became head of radiation oncology at UTMDA Cox was in a position to do something about it. He was instrumental in getting the Proton Therapy Center at M. D. Anderson funded — half by the university, half by private investors — and opened in 1995.

Proton treatment is the most precise form of radiation available to cancer doctors, and also has the fewest side effects. Like cancer treatment itself, which began in the 19th century but has seen the greatest advances in the last 30 to 40 years, it is a late bloomer. Proton therapy experiments began in nuclear physics labs in 1954, and the first cancer patients weren't treated until 1961. But nearly all the progress on proton therapy has taken place in the last 15 years, thanks to the UT M. D. Anderson operation, the only such facility located within a comprehensive cancer center, and a handful of others. Though now well past the "experimental" stage, proton therapy is still considered the most advanced treatment available, and an arena for new breakthroughs and refinements (such as Intensity Modulated Proton Therapy, or "pencil beam" scanning). As UTMDA oncologists like to point out, it almost crosses the line from a form of radiation to a form of surgery, and is widely considered the cancer treatment of the 21st century. UTMDA doubles as a treatment and a research center, and Cox feels the university provides an ideal setting for either.

"The advantage of M. D. Anderson is being able to provide patient care as team," he says, "and the goal is to make new treatments like proton therapy available to everyone. An academic environment leads to more creativity, because part of the emphasis is on bringing new things to patient care, to science in general. We can be critical of each other; we can push the envelope and each other to succeed in ways that haven't been done before."

Buoyed by that philosophy, UT M. D. Anderson Cancer Center research programs receive more grants from the National Cancer Institute than any medical institution in the nation. For Dr. Cox, cancer treatment and research "is a way of life. It's what I do almost all my waking hours."