Dr. Jim Cleary continues to serve as the head of the UW-CTRI Data and Statistical Management Committee, even after moving from Wisconsin and the UW Carbone Comprehensive Cancer Center (UWCCC) to Indiana to become the director of the new Walther Supportive Oncology Program at Indiana University School of Medicine (IU). Dr. Cleary is an oncologist and an international leader in palliative care.
“As an oncologist, particularly with head and neck cancer, smoking is still a significant issue,” Cleary said. “There is some evidence that, in those patients for whom we control disease, post-therapy symptoms such as pain can be worse in smokers. As a palliative care physician, it is still common to find patients with advanced disease smoking. It then becomes an issue of balancing their prognosis and survival with their choices and the effort required to quit. I raise it as a possibility with them.”
An Australian-trained medical oncologist and palliative-care physician, Dr. Cleary came to the United States 24 years ago. He began working at UW in 1996. He met UW-CTRI Director Dr. Michael Fiore and began a long-standing partnership with the center.
“Tobacco control and palliative care have been long-standing components of the UWCCC’s cancer-control program,” said Dr. Cleary. “So, as I joined the cancer-control program on arriving in Madison, Mike Fiore was a key player. I became co-leader of the program with Dr. Pat Remington and increased my interactions with Mike—both through cancer control and through the work of Dave Gustafson and the CHESS (Comprehensive Health Enhancement Support System), which had both tobacco-cessation and palliative-care modules. Another factor that cannot be ignored was that we most often interacted at Madison and Chicago airports as we carried these Wisconsin Ideas further afield.” He quipped, “as an oncologist who has done clinical trials and who is involved in cancer control, I think I was an easy target for Mike to invite.”
Both doctors have had a global impact to help prevent cancer. For example, Fiore has played a role in encouraging physicians in countries like Italy and China to quit smoking and help patients follow suit. Cleary said knowledge of tobacco dependence is helpful to his work in global palliative care and cancer control.
“Meeting with an African minister of health or an Asian hospital CEO or cancer center director and having an understanding of the broad spectrum of cancer control gives my promotion of palliative care more credence,” Cleary said. “If I can talk about cervix cancer prevention and screening, and tobacco control even for a few minutes, it helps with the relationship. My field gets more traction because of the traction tobacco control has. There is much to learn from legislative efforts in tobacco control as it relates to palliative care. This is a particular focus of the Union for International Cancer Control and its Mackay Center for Cancer and the Law in Melbourne, Australia.”
Cleary said the move to Indiana was not because of dissatisfaction with UW; it was because of a significant endowment that will allow the growth of global palliative care work at IU. He is delighted to have emeritus status at UW and to continue helping UW-CTRI perform high-quality research.
“There are many social dynamics that can be involved with smoking as it decreases in society,” Cleary said. “Grandkids may not visit often because Grandpa smells of tobacco. I am aware of heavy smokers for whom hospice workers have struggled to visit because of the smoking. Getting medical oxygen into the home can be very difficult when someone continues to smoke. So quitting is important all the way around.”