 Welcome everyone and thanks for listening into this episode of our chat with the chair podcast today We're joined by Dr. Bill Regine the Isidore and Fanny Schneider-Foxman professor and chair of radiation oncology at the University of Maryland School of Medicine President of University of Maryland faculty positions Inc. an executive director of the Maryland proton treatment Center Dr. Regine you're an award-winning internationally recognized expert in the field of radiation oncology with accolades such as best doctor in America best doctor in Baltimore and top 1% of doctors from various Organizations you also serve in many leadership roles across our University of Maryland entities But tell us more about yourself your upbringing your personal and clinical interests and why you became a physician Sure, so I I grew up in Brooklyn, New York My parents are right off the boat from Italy. I just did well in school I think I got the work ethic from my parents. I enjoyed sports and Next thing you know people say oh you should apply to medical school So there I was the first one I have 48 because all of my mom's brothers all kind of moved to Brooklyn And they all have like four kids I've like 49 first cousins or something like and I was the first one to get a four-year degree from a university and People's like the teachers are like oh she go to med school. I go, okay I was and I was a chemistry major and physics minor and I had a job offer with GE to get an MBA that said you work in the lab for two years You get your MBA will give you a car and apartment is connected in New York And I only applied to five med schools and all these people are applying to like dirty med schools I had good grades. I'm like dude. I don't have enough money Like and my old man goes after you good enough you get in we hate to talk with a much more heavy accent And I got into Syracuse. I went to med school Syracuse I Was all set I was gonna be a sports medicine orthopedic doctor I was thinking about emergency medicine and there was a group of us who were like the gym rats We would after meds class we would go hang out and play basketball playing basketball I mean this guy get into it a little bit during the game and afterwards We kind of apologize to each other and he said, oh, I'm chief resident radiation oncology I'm like what the hell is radiation oncology and he started explaining the physics and I go Man that sounds pretty good. He goes. Oh come into the department and I was hooked then I went to residency at Jefferson and Philly and my first job out of Residency was st. Jude in Memphis, which was a phenomenal experience two years. I was taking care of kids I got to learn ground like on the ground floor of learning how to do really high innovative Surgery we call it we deliver high doses of radiation that rain very precisely on kids We were like one of the first in the country. So I got pretty excited But I don't want to keep taking care of kids So I did that for two years and then I moved to Kentucky where I became the vice chair of Radiation oncology and University of Kentucky in Lexington Eventually associate director of the cancer center. I got interviewed for like four chair positions and this was my fourth time I got interviewed at Maryland and I Was hooked. I thought it was an institution that was very much invested in the commitment to cancer and The academics that go with it that I was it was a no-brain as I came here in 2002 and I've been here Since it's been a phenomenal time When you think back through the entirety of your career, what would you say you're most proud of a? Disdepartment radiate when I came here in 2002 the you know if you look at metrics the department was ranked 41st amongst radiation oncology departments 41st in the country and NIH funding and and I Then was probably one of the youngest chairs in the country when I was hired in 2002 and in the opening line of my Awful letter from then Dean Wilson who hired me Lily says hey happy to make you Unaffected happy, but more for you to make you chair of radiation oncology and we would expect that you would make us top Top 10 in NIH research funding in five years And we hit it in the year for Year for we went from 41st in the country to number five in the country and ever since then by the way you measure research dollars now we We've ranked number one or two in the country But it's not just the research the other part that I'm really proud people come in my department Especially patients because that's the most important thing we do right everything when it's research education has to revolve around the patient People come in and they like oh my god like the energy in your department the attitude You guys take care of serious illness and everybody has a positive at everybody's upbeat no matter how hard I go Yeah, that's that's the I don't we want to call it my regime Italian family Like I treat us we're a team and I want to treat my team like we're family We're gonna be together most of the time might as well care for each other not just the pace of we care for each Other would take care of the patient But if you look at where we are so we hit this level of excellence and research when I came here the residency program was okay and now since then on a You know the ACG me right they did a review first review they go. Oh my god. You guys get no citations Next go around the last one. We got not only we get no citations. We got two commendations For some pretty innovative education stuff like I one of things we believe in You know 80% of cancer patients are cared for in the community, right? So we built community sites together with dr. Cullen and then the philosophy of the green and bound cancer center that We want to bring that as much as we can that access to innovative clinical trials Advanced technology to your backyard right people don't want to come from Hartford County downtown if you don't have to so we have that out there and Our residents and the faculty we hide it and we hire out there our outstanding that staying up with the literature There's the cutting edge of understanding and education and they teach our residents spend some time there So what that was one of the commendations that hey you really are Making it so that community experience is also part of the downtown academic experience patients come in our department and they are Absolutely blown away at the level of commitment investment at time passion and people so focused on them And that is so important to me In terms of how you care for a patient that leads into my next question. So in addition to Leading the department of radiation oncology you yourself provide patient care. What is your patient care philosophy? Yeah, like thinking that it can be a family member The other day I was on the phone person gets on the line. He says I have a patient for you doctor That's a great. I'm sitting here with my resident I put it on speaker and they go oh this patient has you know had a tumor removed from the leg He's really anxious You know hoping you can see I go. Yeah, we'll see him tomorrow now I had to juggle my schedule around my residents go. Yeah, but we have It's okay. We're figuring out. He's got cancer, right? We have that kind of team mentality um And everybody's it's like there is some truth, right? How The team behaves it starts from the top And I've been blessed with the the the folks on the radiation oncology team. They all are bad. They all believe it with me. So That's the big that's center point patient care is center point for all we do research and education Everything centers around a great patient experience What would you say makes a great physician? What are some characteristics of someone who would be successful in this career? You got to be committed to being a lifelong learner Cause things change so fast, right? It's one of the reasons I love The being in this act, you know academic environment with the residents, right? It Since we have to teach residents we can't help but being at the cutting edge in the latest in terms of research and publications We have journal clubs. We have conferences teaching rounds I think that's couldn't be a little bit harder outside of this atmosphere I think it's one of the strengths of when people come and get seen At a place like this is that it's it's much easier for me To be a lifelong learner and I think and they'll get me wrong. They're a great community docs But they have they have that quality. They're committed to continue to stay up to date And it's been challenged with COVID bringing a human touch to that experience with patients So my rule is we don't leave the room without putting a hand on the page So I'll either shake your hand. I'll put my hand on your shoulder And somebody taught me that when I was a third year and it makes a huge difference for sure Tell us about some of the research that's currently underway at the University of Maryland We do a lot. So some cool stuff include combining radiation Advanced technology radiation like proton therapy with heat or hyperthermia And when you put high it's interesting when you put hyperthermia with radiation, especially with proton It significantly enhances the effectiveness and the reason that's important is I tell people if I took the tumor out of everybody's body and radiated I can cure them all right Our challenge as a specialty is well tumor sits in the human body, right? So if it's in the chest or the breast the heart's there the lungs there if it's in the abdomen you got the bladder the rectum so that those normal tissue that surrounds the Tumor can limit how much radiation you can give right? I can't give that Full dose if I took it out of the body, right? But if I can add something like heat and what I'm talking about hyperthermia I'm talking heating tumors to temperatures to like a low-grade fever So it's not it's not like really burning the patient. So when you heat now instead of You know the radiation being equivalent to given let's say, you know 7,000 units I made it equivalent to being 10,000 units without Increasing the dose to the surrounding normal tissue. So we've lead that in this country Of sure and we got other cool things with protons. We're We're doing something called flash Radiation we have the ability in the the cyclotron and the accelerator of the proton To deliver all of the radiation dose that normally takes few minutes We've done some experiments that were leading edge in this country when we go. Hey, what if you deliver it deliver it all in literally a second It's that fast and we call it flash And what we found is when you in least in the lab when you treat tumor cells with flash The tumor cells die, but a normal cell around it. It's like they didn't even see it So now we're advancing that would be pretty cool, right? Like you just And we could treat tumors and not You know treat them to a dose get rid of them and not and do even less risk of normal tissue damage How do you see the field of radiation oncology changing over the next five to 10 years? Well, it's been changing a lot since I started 20 years ago So when I you know, I was like I said, I was one of the younger chairs and I remember, you know Okay, you're gonna get in front of all the chairs from surgery Give you a vision, right? So I literally said I go, uh, look, I think My vision for our specialty is we're gonna eliminate the use of surgery in the care of cancer People are like laughing like Now there are so many advances now. There are so many tumors that we treat now Where we've really decreased the use of surge for instance Brain tumors, right? We wanted we were the first in the area to have a gamma knife treatment Now we have something called the edge Which is the ability to deliver these high doses of radiation to tumors in the brain and years ago Patients would have had a craniotomy Now and we've now invented a machine Called the gamma pot where we're moving studies along where we envision early stage breast cancer Instead of getting a lot of patients get like a lump back to me now and then get radiation to the breath We can same principle as the gamma knife. We call it the gamma pot We can deliver a high dose to these really small breast tumors because a lot of patients get them found early because of mammograms That we think in the future might not even needive surgery So I I would say we are going to continue to grow as a modality And we'll do it together with surgeons, but we're not going to do the same level of cutting that we did years ago Why should physicians refer to the University of Maryland and what sort of patients would be appropriate for your department? Yeah, look, uh Member amongst all patients who get a cancer diagnosis 60% of those patients get radiation as part of their treatment. So we are major treatment modality for cancer So most anybody with a solid tumor radiation will likely play a role so I would say anybody with a cancer diagnosis should at least get an opinion and not just because it's Radiation oncology like when you come see and this is a reason to come see Us in radiation because when you see us All of the patients and this is why I'm proud of being part of the greener bound cancer center All patients who come and get seen by us are presented to what we call the cancer Specific multidisciplinary team. So when I see a head and neck cancer Once a week all the head and neck cancer specialist in chemo therapy surgery radio We're meeting and we're talking about the head and neck cancer patient. So all of us are putting The best of our toolboxes out on the table to come up with the best treatment plan for the patient So that that's the advantage And why a patient would want to see us and also, you know, just from the the innovation of technology Uh, we definitely have the most advanced you're going to have in the area from a radiation standpoint And then as a cancer program as well as a department of radiation We're going to have these the latest and innovative cutting-edge clinical trials for patients who might have really advanced cancers or you know might Want to be or have access to more advanced therapies that are coming down the pipeline So I think those are pretty good reasons to come see us We also the other other benefit of coming to see us for docs who say, oh, well, what if I see The patient goes there. I'll never see the patient. Well, we have this huge University of Maryland Radiation College is now a network, right? So we're at Hartford county in upper Chesapeake We're in annamarundo county at Baltimore Washington medical center. We're at easton hospital on the eastern shore We're at Howard county and Howard county general hospital We have the only proton center in the state of Maryland, right, which Specifically came of that 60 percent of patients who get radiation about 20 to 30 percent Will get a benefit from proton there. Well, guess what? We're the only proton center In the state and protons It's a charged particle when it delivers radiation. It really does it in a way that Minimizes even less exposure of normal tissue radiation. So our philosophy is we want to bring all of the cutting-edge innovative technology access to clinical trials as much as we can in your backyard certain things we can't Bring everywhere, right? You can't have a proton center. I mean, that was a 200 million dollar facility You can't put that in all those sites. She's not going to have a gamma power some of the hyperthermia stuff We had but 95 percent of state-of-the-art care and access to all those innovative stuff We built in all little centers. So when we see a patient anywhere, that's a pretty big swath of error, right? If they're anywhere near any of those sites and we go, oh They can get all that at Hartford county at eastern shore We send them back and they get treated there. So I think that's another big advantage of coming to see us For physicians who are listening in, what are the networking opportunities or opportunities to connect with you and your team? Well, one there'll be contacts that we're given after this day. We put on educational Symposiums, you know in January we put a best of radiation oncology We have a hyperthermia school We put in other educational symposiums that you can look on our website and We typically on any of these symposiums we have 60 70 people from the region come in And we interact. I think we pretty well know people like My faculty and staff We actually put we held tours for the proton center Usually if you can if it's more than we and I've had Since it's open we've done which was 2016 we've done over 400 tours Many of our physicians with their staff and we'll have a lunch For them some we've had dinner at the end of the day I was better for them and we'll do took this proton therapy is pretty cool The physics of how it's delivered that we educate them They're like here's the best the best tumor types that could benefit From proton therapy. So we're pretty extraverted group of faculty I'm pretty proud of so We're happy to connect with people anyway, especially if they can potentially benefit a cancer patient Before we close out is there anything else you think listeners should know about the university of maryland about your department About what's coming next in this field? I think the thing I want to highlight It's not just like when you come to see the radiation on college you're coming to see the whole University of maryland green about cancer team You know, what's pretty unique here is we had our people instead of nothing wrong with the community docs But community docs tend to be you know have to know the you know the the best of 10 different types of tumors, right? We have people who our careers are focused on two or three types of tumors So when you get seen in radiation college again, you're meeting you're going to get reviewed by medical oncology to do nothing but Take care of breast cancer or GI cancer or brain tumors saying what radiation doctors and surgeons and I think that's that's Pretty unique. That's hard to find and again We are also the department that very much wants to has partnered and stays connected with the community physicians at large so You know, we're always there to help and and again, I think Knowing that that's a unique feature. We have to offer is something that both not only patients, but referring physicians I think have have enjoyed having access to Thanks again for stopping by for chat with a chair brought to you by University of maryland faculty physicians, ink For more information about today's guest or to listen to additional episodes visit umfpi.org backslash podcast until next time