Wood named to new endowed chair in lung cancer research

The magnitude of lung cancer is underappreciated by most lay people and many health professionals, according to Dr. Douglas E. Wood, associate professor of surgery in the Division of Cardiothoracic Surgery who has been named the first holder of the UW Endowed Chair in Lung Cancer Research.

Douglas Wood with CAT scans of lungs in the background.

Lung cancer is the most common cause of cancer-related mortality among both men and women in the United States. It causes more deaths than breast, prostate and colorectal cancer combined. Lung cancer is the leading cancer killer of women in the United States, and is continuing to rise at an alarming rate. This year an estimated 180,000 new cases of lung cancer will be diagnosed in the United States. Washington state will likely have more than 3,000 new cases, according to Wood.

The Endowed Chair in Lung Cancer Research is funded with private donations that will help meet a critical public need for studies of better screening and treatment. Despite its widespread prevalence and high mortality, comparatively little public funding is dedicated to lung cancer research.

“There is no strong political advocacy for people who have lung cancer, the way there is for many other serious illnesses, despite the enormous numbers of people who are diagnosed and die from lung cancer each year,” Wood said.

Many people still consider lung cancer a death sentence, unaware that medical science is making inroads on the disease. The cure rate has nearly doubled over the past 30 years; survival rates have also increased. Wood mentioned a few reasons: newer surgical techniques to remove some forms of cancer previously considered inoperable, promising new agents for chemotherapy, and advances in knowledge about the biology of lung cancer, its mechanisms and predictors of aggressive behavior in tumors.

At the UW, Wood and his colleagues emphasize more meticulous ways to stage lung cancer. Before a tumor can be detected through uncontrolled growth and enlargement, a change occurs in tumor cell metabolism. Positron emission tomography (PET) scans may alert physicians to signs of cell proliferation and can be a more sensitive, specific marker of malignancy than standard X-rays. Wood is a co-investigator with Dr. Hubert Vesselle, assistant professor of radiology, who recently received a $1.3 million grant from the National Institutes of Health to explore lung cancer biology using FDG (18-fluor-deoxy-glucose) and fluorothymidine PET scans. They hope to determine if these are more sensitive in monitoring lung tissue for malignancies and in determining the extent of the disease and its prognosis.

Wood was also a co-investigator on a four-year NIH funded study, completed this year, on the epidemiology of glutathione transferase and lung cancer. The human glutathione system, part of the body’s immune responses, is being explored in several cancer studies.

In addition, Wood and his associates are testing more aggressive surgical techniques to clarify the extent of tumors and thereby more accurately stage the disease. This information is critical in advising patients on new surgical procedures for lung cancer resection, or in choosing more complicated combined therapies that employ surgery, chemotherapy and radiation.

While tumor biology research may in the long run create more effective lung cancer treatments, Wood believes more immediate gains may result from developing a standardized lung cancer treatment algorithm and assuring that it becomes widely used throughout the United States. At present, he said, lung cancer management varies from community to community, as do survival rates. He said more uniformity and consistency is needed in treatment design, so that more patients will be given a recognized standard of care. Currently, a patient with lung cancer might receive very different recommendations, depending on where he or she goes for care.

“If physicians can get agreement on, acceptance of and education about a well- organized treatment algorithm, then I believe the prognosis for patients will improve,” Wood said. “This should be our first priority, because it will have more impact on the greatest number of patients in the shortest amount of time.” Detection of lung cancer in its earliest stages has been difficult because there have been no simple screening tools, like Pap smears for cervical cancer or mammograms for breast cancer. Most people learned they had lung cancer inadvertently. During a visit to the doctor for a bad case of the flu, or a hospital admission for routine surgery, their chest X-ray revealed a malignant mass.

“Until recently, screening for lung cancer was thought to be ineffective in reducing mortality. Most cases were not recognized until they were in an advanced stage,” Wood said. “However, over the past year new data are indicating that low-dose chest computed tomography (CT) scans of high-risk patients may provide a sensitive screen for lung cancer in its early, more treatable stage. The evidence to date is compelling and suggests that we could identify curable lung cancer sooner.”

Wood mentioned that there have been many discussions on the most appropriate use of tobacco-settlement dollars in Washington state. Some have suggested that a portion of the settlement go to improving the treatment of people afflicted with tobacco-related diseases, particularly in the area of outcomes research in lung cancer therapy, and in standardizing screening and treatment programs.

Even if every single smoker quit today, researchers estimate that doctors will still be treating people suffering from tobacco-related lung cancer for decades. A national survey showed that most Americans do not feel that lung cancer patients deserve their fate, and instead believe that lung cancer patients should receive the same level of treatment as someone suffering from breast or prostate cancer.

In addition to being a noted lung cancer researcher, Wood has done much to educate other physicians about treatment and research. He has taught many visiting surgeons who seek advanced training at the UW because of its reputation in lung cancer care. He has also supervised many cardiothoracic surgery residents interested in researching this disease. Wood serves on multidisciplinary care committees of the Seattle Cancer Care Alliance, which hopes to speed the dissemination of new knowledge and cancer treatment protocols to the region’s hospitals and physicians.

Wood, 42, is a 1979 graduate of Harvard College and a 1983 graduate of Harvard Medical School. He completed his residencies in surgery and cardiothoracic surgery at Massachusetts General Hospital in Boston. In 1998 he was listed among Seattle’s Best Doctors and The Best Doctors in America. This spring he was among the Best Cancer Specialists named by Good Housekeeping magazine. He was appointed this year to the Non-Small Cell Lung Cancer Panel of the National Comprehensive Cancer Care Network. ¶

Leila Gray