First person profile: C. Norman Coleman, MD: A leading radiation and medical oncologist, Dr. Coleman has worked to improve cancer prevention, treatment, and quality of life on a global level.

Abstract

A renowned radiation oncologist who is also board-certified in internal medicine and medical oncology, Dr. Coleman serves as the associate director for the Radiation Research Program and as a senior investigator in the Radiation Oncology Branch at the National Cancer Institute (NCI). He also is the senior medical advisor in the Office of the Assistant Secretary for Preparedness and Response in the US Department of Health and Human Services. In that role, which he has held since 2004, he spearheaded the development of a blueprint for the country's response to radiological, nuclear, and pandemic threats. Having traveled extensively, Dr. Coleman is passionate about improving cancer prevention, treatment, and quality of life on a global level. In 2013, he became a founding member of the International Cancer Expert Corps (ICEC), a nongovernmental organization aimed at improving cancer care in low- and middle-income countries and in indigenous populations in upper-income countries. “He's a wonderful person and a natural leader,” says David Pistenmaa, MD, PhD, Dr. Coleman's longtime friend, mentor, and ICEC colleague. “When things don't look promising with our NGO, he finds ways to keep us going. And he brings people together to make the world a better place.” As evidence of that, Dr. Coleman has received numerous awards, including the 2018 Ellen L. Stovall Award for Innovation in Patient-Centered Cancer Care from the National Coalition for Cancer Survivorship and the 2011 Samuel J. Heyman Service to America Medal for his work on emergency health preparedness following a radiological or nuclear incident. Dr. Coleman envisions ICEC as functioning similarly to the US Peace Corps, where, through public and private partnerships, academics, practitioners, and other volunteers mentor and assist clinicians and researchers in low- and middle-income countries. ICEC's ultimate goal, he says, is to assist such countries in developing leading cancer programs that meet world quality standards. He points to 1 highly successful example that he and several colleagues helped to foster through the NCI: the King Hussein Cancer Center in Jordan. With international guidance, this small medical facility has become the premier cancer center in the Middle East and is now part of ICEC. “Cancer is a good common enemy,” Dr. Coleman says. “People don't want to be told what to do, but there's so much we can learn from one another. They can teach us how to solve problems with limited resources, and we can help them figure out how to develop their own programs.” ICEC continues to seek funding and recruit mentors, including retirees and early-career faculty. As for the latter, Dr. Coleman and his colleagues are hoping to tap into the new generation of medical providers, who, he observes, “are much more interested in doing socially conscious things.” To that end, he and his colleagues are working to find ways of supporting early-career oncologists so that global health can become a highly valued career path, he says. His work at the US Department of Health and Human Services requires him to problem-solve on a different track. Dr. Coleman has devoted most of his recent efforts at the agency to helping experts solve the personal protective equipment shortage during the coronavirus disease 2019 pandemic. In the early 2000s, however, he focused on nuclear terrorism response and led a group of experts in creating plans to manage a variety of emergency scenarios and developing a website that guides providers on how to care for victims in a radiation crisis. These plans were put to the test in 2011 when an earthquake and a tsunami struck Japan, damaging the Fukushima nuclear power plant and causing radiation leakage. “I was in Japan for 3 weeks working with people from other agencies and experts from around the world to help them get through it,” he says. “All the preparation we did was very timely.” In addition to these major projects, Dr. Coleman continues to lead research into developing molecular-targeted radiation therapy. A new paradigm for radiation therapy known as focused biology describes radiation as a biological dose in addition to the traditional physical dose in grays. Dr. Coleman's laboratory has demonstrated that using radiation as focused biology can induce a change in cancer cells that renders them more susceptible to targeted drug and immune-based therapies. In June, he and his colleagues published an article in Clinical Cancer Research detailing the promise of this technique, which is known as radiation-induced adaptive response.1 Dr. Coleman attributes much of his interest in understanding the basic mechanisms of radiation treatment to his love of mathematics, in which he majored at the University of Vermont. He later attended Yale College of Medicine, which he praises for not holding examinations. Instead, the school requires that students take national boards, complete a thesis, and do laboratory work. “Their approach was, if you have to compete on exams to learn basic knowledge, there's a problem,” he says. “So, we weren't competing with each other—we were working together.” Recalling a time when Dr. Coleman visited his family for dinner many years ago, Dr. Pistenmaa remembers how his colleague entertained his 2 young daughters by sitting them down on each knee and making up a detailed story to a picture book. “He was making it up faster than I could have read a written book to them,” he says. “That's how fast his mind works. He's a prolific writer, and he can type as fast as he thinks. We have an agreement. He writes, and I edit.” After Stanford, Dr. Coleman moved on to Harvard Medical School in 1985 as professor and chairman of the Joint Center for Radiation Therapy. During his tenure, he expanded the radiation oncology requirement from 3 to 4 years and developed a program that enabled medical students and faculty to create partnerships with underserved communities near Boston. That successful project serves as a model for ICEC's international work. In 1999, Dr. Coleman left Harvard to lead the NCI's Radiation Oncology Branch and Radiation Research Program. “Government is a really interesting place to work,” he says. “You can accomplish things you can't do elsewhere.” In addition to his busy professional life, Dr. Coleman is a dedicated athlete. Along with his wife, Karolynn, a psychotherapist and meditation teacher, he has gone on mountain treks around the world. He is also an accomplished triathlete who has participated in Ironman competitions. Last year, he and Karolynn cowrote and published the book Mindfulness for the High Performance World, which details a skills-based approach toward reducing stress and improving life balance. Their children live in California, where their son works for Twitter and their daughter works for NBC News. “They're both very capable with great senses of humor, and because we've traveled so many places with them, they're comfortable in almost any situation,” he says. “My hope is that 25 years from now, everyone around the world has access to some reasonable level of the full spectrum of cancer care.” —C. Norman Coleman, MD