Hoosier Cancer Research Network recently welcomed Richard C. Zellars, MD, as a member of the Board of Directors.

Dr. Zellars joined the Indiana University School of Medicine in January as professor and chair of radiation oncology, and is a researcher at the IU Simon Cancer Center. Prior to this, he was associate professor of radiation oncology and assistant director of clinical trial accrual at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. His research is focused on the safety and efficacy of radiation for the treatment of breast cancer.

As a radiation oncologist, Dr. Zellars enjoys the technological aspects of his work; but it’s the personal contact with patients that he loves the most. “There’s something special about cancer patients,” he said. “A lot of the barriers to interaction with other people kind of fall to the side, because they’re really concentrating on getting better. I see them back after their treatment for follow-up, and it’s like visiting an old friend.”

A native of Newark, N.J., Dr. Zellars grew up in a home where education was highly valued. He earned his undergraduate degree at Bowdoin College, and went on to medical school at Johns Hopkins, where he intended to pursue urology. However, during a sub-internship toward the end of medical school, he lost interest in this surgical sub-specialty.

“I was in an existential crisis,” said Dr. Zellars. “What was I going to do?”

Through the encouragement of a friend, Dr. Zellars pursued a rotation in radiation oncology at the beginning of his last year of medical school. “I fell in love with it by the third day,” he said.

Reenergized on his career path, Dr. Zellars followed medical school with a radiation oncology residency at the University of Michigan and then took a position at the University of Texas at San Antonio. He was attracted to UT in part by the institution’s highly acclaimed breast cancer program.

“I was always interested in working with medical oncologists, and I had a great collaboration with them during the four years I was there,” he said.

When several of the medical oncologists left San Antonio, Dr. Zellars felt it was time to move on as well. Following a transitional year at Georgetown, Dr. Zellars answered an invitation to return to Johns Hopkins.

At Johns Hopkins, he designed and led clinical trials exploring partial breast irradiation (PBI) with concurrent chemotherapy. The approach had been highly successful in some forms of cancer, but in past studies, women who received whole-breast radiation with concurrent chemotherapy suffered severe burns. Dr. Zellars’ proposal was controversial, eliciting a range of responses from skepticism to outright hostility.

Yet, the question was worth asking: If you reduce the area that receives radiation, will the toxicity decrease? In the end, he said, “cooler heads prevailed,” and he received approval for his study testing PBI with concurrent Adriamycin.

Dr. Zellars and his team were expecting about 20 percent of trial participants to receive third-degree burns (about half the percentage of those who received burns with whole-breast irradiation). However, none of the patients on Dr. Zellars’ study received third-degree burns.

“It was a wonderful surprise, and the patients loved it,” said Dr. Zellars. “What normally would be a six-month treatment had decreased to seven weeks. So, it really allowed patients to get back to their loved ones and livelihood.”

Dr. Zellars continues to explore partial breast irradiation, now focusing on estrogen receptor (ER) negative cancer. Some studies suggest that ER negative women may not be good candidates for PBI due to a higher rate of recurrence.

“When that information came out from other studies, we went back and looked at our two previous studies and looked at the women who had ER negative disease, and none of them had a recurrence,” he said.

Dr. Zellars hopes his current study will help determine whether patients with ER negative cancer might benefit from PBI treatment.

During his time at Johns Hopkins, Dr. Zellars also developed an interest in health disparities, fueled in part by what he observed in the communities surrounding the institution.

He became the director of a summer program called CUPID — Cancer in the Underprivileged, Indigent, or Disadvantaged. The program is designed for medical students who have an interest in addressing disparities in oncology care among underserved populations.

Dr. Zellars also worked to address the lack of minority representation in clinical trials. The problem, he noted, is nationwide, and is rooted in societal issues that go far deeper than treatment options alone.

“There have been abuses in the past with minority patients, and it’s thought that many minority patients think that they’ll be abused again,” he said. “It’s that fear that prevents them from participating, which also prevents them from having a full list of treatment options.”

In the two years that he worked with the accrual program, Dr. Zellars helped to develop a multi-faceted response that included addressing issues within the institution — physician attitude, ease of access, welcoming and thanking people who participate on clinical trials — as well as issues within the community, such as a general fear and lack of knowledge about clinical trials.

Dr. Zellars remains strongly interested in issues of health disparities, and has begun thinking about how a CUPID-like program might work in Indiana.

“The CUPID program in Baltimore tended to concentrate on urban, disadvantaged people because we were in an urban environment,” he said. “In Indiana, there are clearly rural areas that are underserved.”

In his new role as the chair of radiation oncology at the IU School of Medicine, Dr. Zellars oversees radiation at IU Health Methodist Hospital. His goals for the program include working toward greater standardization of radiology services and the development of new, unique therapies within a multi-disciplinary environment that includes not only surgical, medical, and radiation oncologists, but also nursing, social work, plastic surgery, and psychiatry.

Learn more about Dr. Zellars’ PBI studies in the Johns Hopkins publication A Spectrum of Achievements (see page 23).

About Hoosier Cancer Research Network:

Hoosier Cancer Research Network (formerly known as Hoosier Oncology Group) conducts innovative cancer research in collaboration with academic and community physicians and scientists across the United States. The organization provides comprehensive clinical trial management and support, from conception through publication. Created in 1984 as a program of the Walther Cancer Institute, Hoosier Cancer Research Network became an independent nonprofit clinical research organization in 2007. Since its founding, Hoosier Cancer Research Network has initiated more than 150 trials in a variety of cancer types and supportive care, resulting in more than 300 publications. More than 4,600 subjects have participated in Hoosier Cancer Research Network clinical trials.