DECATUR -- Millikin University President Patrick White ducked out of the president’s house at No. 4 Millikin Place recently, planning to revive his running habit.
The first person White saw was one of his neighbors, Dr. James Wade, who was also running. With no ready excuse to avoid it, White began running with Wade -- against White’s better judgement.
“I stayed with him for about a mile and we had a nice conversation in which Jim talked about the international oncology conference he was attending in Chicago, with my contribution to the conversation being, ‘Oh, is that right?” said White, breathing heavily to mimic his condition during that run. “Then we parted, with him leaving me like I was standing still … which I was at that moment.”
But Wade, medical oncologist and founder of Cancer Care Specialists of Illinois, doesn’t just run at a fast pace. He’s been on the forefront of declining cancer rates both from a research and practice standpoint. And Wade helped bring those declining cancer rates to Decatur.
“Jim Wade has added to the intellectual, economic and health capital of Decatur,” White said while introducing Wade at last week's Millikin Institute for Science Entrepreneurship speaker series event.
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While treatments for cancer are fairly recent and constantly evolving, the disease itself dates back to the beginning of human history and even before.
“Cancer is as old as complex living creatures,” Wade said. “Dinosaurs got cancer. And contrary to the popular myth, even sharks get cancer.
“Now we have DNA mass sequencing, polymerase chain reaction, fluorescence in situ hybridization, the Western blot, the Southern blot, RNA, micro RNA, circulating tumor cells or cell free DNA. Before that, we fumbled around and tried to learn from people who knew what was going on.”
After finishing medical school, his fellowship and his residency, Wade established a medical oncology and hematology practice in Decatur in 1984.
“There was a lot of enthusiasm at that time,” Wade said. “Oncology was a new field and there were all these new chemotherapy drugs coming out.”
Wade’s practice in Decatur, which also extended to the surrounding area, flourished. But in the 1990s, Medicare provided a bump in the road.
“Medicare decided there was too much cancer treatment going and we were clearly using drugs inappropriately,” Wade said. “When the FDA approves a drug, it’s for a very specific indication. And though medical science will publish papers that show its use is effective treating other illnesses, it costs millions of dollars to go back to the FDA and change the label.
“So science had advanced far beyond what drug companies had the FDA certify their drug for. Medicare thought they’d save a lot of money by limiting the use of drugs to the on-the-label reasons and let the drug companies apply to the FDA.”
A law expanding Medicare coverage of cancer drugs was drafted -- the Rockefeller-Levin Medicare Bill. But it got stuck in U.S. Congressman Phil Crane’s Health Care Sub-committee of the House Ways and Means Committee.
Crane was a representative from Illinois and his district included Zion, the home of Cancer Treatment Centers of America’s Midwestern Regional Medical Center. In the late 1980s, Wade had been part of a group that helped CTCA identify its chemotherapy toxicity problem and knew CTCA co-founder and then-vice chairman Robert Mayo.
“I called Bob Mayo and talked to him about the issue,” Wade said. “He told me they’d actually taken care of Congressman Crane’s wife and he was very good friends with him, and he’d help us.”
Wade and Mayo met with Crane in Washington D.C., talked to him about the importance of the bill and got him to change his vote. The bill went through Crane’s sub-committee, then the health care committee, then it got passed.
“That bill helped save Medicare beneficiaries across the county,” Wade said. “Now, I’m not a real fan of Cancer Treatment Centers of America, but sometimes you have to get out of your field and get involved. I’m not a politician, I’m not a lobbyist. But to save patients, we had to do those things. And sometimes you have strange bedfellows.”
Wade was part of the the breast cancer prevention trial involving tamoxifen -- a drug first proven to treat breast cancer in the 1960s, first seen by Wade during college in the 1970s and first approved for use in the U.S. in the 1980s.
By the 1990s, scientists began realizing it could be used to help prevent breast cancer.
“What the trial we were involved with found was that incidents of the disease were cut in half by the application of tamoxifen,” Wade said. “It got approved by the FDA for cancer prevention purposes and still is to this day.”
Proscar, a treatment and prevention agent for prostate cancer, and raloxifene, an alternative to tamoxifen, were also tested in Decatur.
As Wade’s Cancer Care Specialists of Illinois practice grew, it eventually ran out of space.
“We weren’t meeting the needs of our patients and we weren’t efficient,” Wade said. “We couldn’t provide everything under one roof that we wanted.”
The idea for a cancer center in Decatur began in the early 2000s, but it didn’t become a reality until 2007. Finally, in Nov. 2009, the 55,400-square-foot Cancer Care Center of Decatur opened.
“We asked our patients what they wanted, we began a planning committee and we visited other cancer centers across the county,” Wade said. “We put together a partnership between us and Decatur Memorial Hospital. It’s now a hallmark of how to do integrated cancer care.”
Since, Cancer Care Specialists of Illinois -- with 16 locations and Central and Southern Illinois -- has grown from 2,900 new medical oncology patients in 2012 to 4,550 in 2016.
Wade said when he first began practicing in Decatur, there were doctors talking about having nearly beaten cancer and touting high cure rates, but a closer look showed there was a long way to go.
“We were involved in this study in which patients were randomized into one of four treatment groups -- three of the latest, greatest treatment, or the standard treatment that went back 30 years?” Wade said. “What was found was they were all the same.”
Wade said it’s a lesson his profession has to keep learning -- survival rates can always get better and there’s always more to learn. It's why Wade continues to be involved in several tests to screen and fight cancer.
"It gets harder every year -- the new trials are infinitely more complex," Wade said. "We have to understand the molecular biology of the disease, what are the mutations within that particular cancer and why a treatment works or doesn't work.
"And we have to stop the deja vu. We've taken these chemotherapy drugs about as far as they can go in many of these diseases. We have to find a new model and paradigm. We can't keep throwing the same drug at these conditions. We can't be satisfied."