An Interview with Dr. Paul Han
Paul Han, MD, MA, MPH, director of the Center for Outcomes Research and Evaluation at the MMC Research Institute, is the Principal Investigator for the recently announced Maine LungCAPS initiative, a program designed to improve the prevention, early detection and treatment of lung cancer in Maine.
MCF: What drew you toward a career in medicine?
Paul: I grew up in several small towns in Ohio, the son of a United Methodist minister. My upbringing instilled in me a sense of commitment to helping others, and influenced me to pursue medicine as a career. Somewhat indirectly, I think it also got me interested in bioethics, decision making, and uncertainty—areas that have come to be the focus of my research.
MCF: You have a strong background in bioethics, risk-management and behavioral research, all of which are relatively new fields. Have these ideas influenced the way you view cancer as a disease?
Paul: I do feel my background and interest in these particular areas have had a strong influence on how I view cancer, both as a clinician and researcher. They have given me a deep appreciation of how cancer and cancer treatment are not only physical and technological but also psychological, social, and ethical problems. They have helped me take a more holistic, multi-disciplinary approach to tackling the problem of cancer in both my clinical work and research.
MCF: What prompted your current focus on lung cancer?
Paul: I am interested in lung cancer for several reasons. First, it is highly prevalent and the leading cause of cancer mortality in our country and in Maine. Second, it is preventable. Third, there is a new screening test for lung cancer—low-dose CT—that has been shown to be effective in reducing lung cancer mortality; however, this test has pros and cons, and individuals need to decide for themselves whether it makes sense for them based on their own values. Health professionals have a responsibility to help individuals make these decisions—through a process known as shared decision making. This is a major focus of my research, and it heightens my interest in lung cancer.
MCF: How did the Maine LungCAPS idea emerge?
Paul: The idea for the Maine LungCAPS Initiative emerged when the Bristol-Myers Squibb Foundation approached me, along with two of the Initiative’s other co-leaders—Natalie Morse from MaineGeneral Prevention Center and Lisa Letourneau from Maine Quality Counts—to explore what was happening in Maine in terms of lung cancer prevention and screening. The Foundation suggested that we consider collaborating to develop a statewide initiative devoted to improving access to lung cancer prevention and screening services to Maine residents, particularly those living in rural underserved communities. The three of us subsequently had several conversations to brainstorm different ideas. We had not worked together before, but realized we had a very unique opportunity to capitalize on the strengths of our respective organizations, and also engage other partners throughout the state towards the greater good of fighting lung cancer. Working with our talented partners, we developed a plan of work for the Maine LungCAPS Initiative.
MCF: What do you see as the biggest challenge for the Maine LungCAPs initiative?
Paul: I think the size and scope of the project, which involves multiple activities carried out by multiple individuals and organizations—many of whom have not worked together before—is a significant challenge that will require a great deal of coordination and active engagement of our partners. The Maine LungCAPS Initiative also brings together health care organizations that “compete” in the health care marketplace. However, I have faith that our Initiative’s focus on the greater good of the health of our population, and on cooperation and sharing of information, will help us overcome these challenges.
MCF: What aspect of the Maine LungCAPSs initiative are you most excited about?
Paul: I am excited about several aspects, but particularly about the possibility of bringing together diverse organizations—each with their own strengths—to achieve more than any individual organization could achieve alone to reduce suffering and death from lung cancer, particularly among rural underserved communities in Maine. Because I’m also a scientist, I’m also very excited about developing and testing innovative approaches to lung cancer prevention and screening.
MCF: What improvements do you see on the horizon for lung cancer care?
Paul: It’s hard to single out any one thing, but I’d have to say lung cancer screening with low-dose CT. For the first time, we have an effective method of detecting lung cancer early enough so that it can be treated. However, another exciting aspect of lung cancer screening that is on the horizon is “risk-based” or “precision” screening—the use of statistical “risk prediction” models to determine which individual persons are at higher or lower risk of lung cancer, and to target screening accordingly. This new approach hasn’t been fully evaluated yet, but may help patients and physicians make more intelligent decisions about whether to undergo screening or not.
MCF: When you meet someone with a recent cancer diagnosis, what's your advice to them?
Paul: My advice to anyone newly diagnosed with cancer is to know that you are not alone—there are dedicated and excellent cancer clinicians and cancer care resources all around the state, as well as patient support groups and communities of cancer survivors who can help you in your journey, as difficult as it may be. My own work in palliative care has also taught me that palliative care is an integral part of good cancer care: it’s not a separate or either-or part of medical practice. Palliative care focuses on maximizing a person’s quality of life and ensuring that medical treatments are consistent with a person’s goals and values. When a cancer doctor listens carefully and responds to his or her patient’s concerns, and deals with the patient’s pain or emotional suffering as well as the tumor, he or she is practicing good palliative care. It is the kind of care that all cancer patients should receive.