University of Vermont

The University of Vermont Cancer Center

James Discusses the National Cancer Act at 40

Ted James, M.D.
Associate Professor of Surgery Ted James, M.D. (Photo by Raj Chawla, UVM Med Photo)

In recognition of the 40th anniversary of the National Cancer Act and subsequent establishment of the National Cancer Plan and National Cancer Institute at the National Institutes of Health, Fletcher Allen Health Care’s One publication recently interviewed Ted James, M.D., University of Vermont associate professor of surgery and Fletcher Allen surgical oncologist. James serves on the board of directors for the New England division of the American Cancer Society and was recently named a Frymoyer Scholar.

Q: What are some of the most significant advances in cancer treatment over the past 10 years?

A: First, survival rates are higher, thanks to advances in systemic therapy, the discovery of new agents through clinical trials, and new combination therapy. Certain cancers, such as testicular and breast, have especially benefited from these advances.

Another important development is the use of targeted therapies, which affect only the cancer cells, sparing the patient’s non-cancerous cells. This approach has translated into greater efficacy with fewer side effects.

We are also focusing on prevention. For certain cancers, we are now able to identify high-risk patients, and when we identify these patients we can take a much more proactive approach – screening more frequently and using preventative measures to reduce the likelihood of cancer forming.

Cancer prevention starts with our patients. The American Cancer Society has stated that up to 50 percent of cancers can be avoided through lifestyle changes. Clinical studies have shown a connection between post-menopausal weight gain and breast cancer. We are working with our breast cancer survivors to maintain healthy body weights. And we encourage our patients to adopt other healthy lifestyle habits, such as regular exercise, healthy diets and not smoking.

Vaccines are also showing promise as preventive agents. The Hepatitis B vaccine and the HPV vaccine have contributed to reductions in liver and cervical cancer, respectively.

Another area where we are making progress is focusing on the barriers to high-quality cancer care. We are identifying underserved populations, and figuring out how to bridge the gap so that people have access to the care they need.

Patients sometimes come to me with a cancer diagnosis saying they’ve been told that nothing can be done. In reality, there’s often a lot that can be done to lengthen their survival and improve their quality of life.


Q: What are some of the ways in which Fletcher Allen is leading the field in cancer treatment?

A: First, we offer a coordinated team approach to cancer treatment. As a group, all members of the care team, including the surgical oncologist, medical oncologist, radiation oncologist, pathologist, radiologist, cancer dietician, and the nurse navigator, all meet with the patient to set goals, answer questions and develop a treatment plan. We have a wonderful cancer patient support program designed to address the various needs of patients diagnosed with cancer. We encourage our patients to be active participants in the development of their care plan. This team approach is not only tremendously convenient and comforting for the patient, but it ensures better outcomes. After each patient’s surgery, our multidisciplinary tumor board collaborates on the best approaches for post-surgical care.

As an academic medical center, we are involved in a number of clinical trials that are a significant source of new innovation. We make sure our patients know about these trials as well.

Our technology is a huge part of our success. We offer partial radiation – which targets the cancer but spares the healthy breast tissue. We employ state-of-the-art, minimally-invasive surgical techniques, removing the tumor with smaller incisions.

We also offer radiofrequency ablation, which involves inserting a needle into the tumor through the skin and “ablating,” or heating the cancer cells, which kills them.

Those are just a few of the techniques that are being done here. It’s important for people to know that we offer the highest level of care – and we provide this care with great passion and support. I’ve had patients who have come here with a diagnosis of cancer, then go to Dana Farber or Sloan Kettering for a second opinion – and they come back here. They tell me, “you know what? They’re not doing anything there that you aren’t offering here in Vermont.”


Q: What are the most difficult and most rewarding parts of your job?

A: Seeing patients suffer is the hardest part of my job. It’s also difficult when I see missed opportunities – when someone comes to see me with cancer that is advanced because of neglect or a lack of a timely diagnosis.

The most rewarding part of my job is my relationships with my patients. I meet them at such a difficult time in their lives, and we develop a strong bond. I see them at their diagnosis, and it’s amazing to see their resilience, and how they come out on the other side. I’ve learned so much from my patients.