Society’s Gold Medal Awarded to Trailblazing Trio

Congratulations to this year’s trio of 2024 ASTRO Gold Medal recipients, May Abdel-Wahab, MD, PhD, FASTRO, Paul Harari, MD, FASTRO, and Mack Roach III, MD, FASTRO. These leaders have contributed tremendously to the field through their clinical patient care, research, teaching, mentorship and service. Although each recipient has traversed a unique course, commonalities are evident. All three found medicine early on, the importance of mentorship was a core value that both helped and motivated them to perpetuate that role, and all have possessed a relentless curiosity to uncover more radiation oncology solutions for cancer patients through their practices and clinical trials. Read more about each medalist’s special journey.

May Abdel-Wahab, MD, PhD, FASTRO, serves as the Director of the Division of Human Health at the International Atomic Energy Agency (IAEA) in Vienna, Austria. From an early age, she was drawn to medicine, inspired by personal experiences and influential mentors, including an uncle who was a pioneering radiation oncologist. Her career has been marked by a steadfast commitment to advancing research and education in the field while addressing disparities in health care access and providing care to underserved populations.

Dr. Abdel-Wahab’s extensive clinical expertise includes leadership of prostate and gastrointestinal radiation oncology programs at renowned institutions such as the Cleveland Clinic and the University of Miami. Among her many contributions are the implementation of new clinical programs in prostate brachytherapy and selective internal radiation therapy (SIRT) for liver tumors.

In addition to Dr. Abdel-Wahab’s work on various phase I-III trials, such as trials on calcifediol in recurrent prostate cancer and collaboration through her lab with Nobel Laureate Andrew Schally on the effect of antagonists of Growth Hormone Releasing Hormone on radiation response that generated interesting data. Her research on spinal cord gliomas has furthered understanding and treatment of these complex conditions, and she has worked with the National Cancer Institute (NCI) and the convened experts to set the research agenda for spinal cord gliomas for the following five to 10 years in the United States. In the prostate cancer realm, her studies on the induction of second malignancies in irradiated prostate cancer patients has enhanced the understanding of the relative contribution of different treatments. She also led to the development of a novel method of measuring Androgen Receptors (AR) through flow cytometry in Radiation Therapy Oncology Group (RTOG) clinical trial patient samples and how this affects treatment response.

These examples exemplify Dr. Abdel-Wahab’s passion for scientific inquiry and her dedication to advancing cancer research.

As a respected educator, Dr. Abdel-Wahab has mentored numerous radiation oncology residents throughout her career, fostering the next generation of leaders in the field.

Dr. Abdel-Wahab initiated discussions with radiation oncology society leaders globally to support research, education, communication and information sharing. This effort led to the formation of the International Radiation Oncology Society Network where current leaders of radiation oncology societies from all regions regularly convene to coordinate common approaches and activities and discuss issues common to the specialty.

Dr. Abdel-Wahab highlights the importance of “translating what radiation oncologists already know through their experience in the clinic to a health economic argument on why investing in radiotherapy is cost-effective and a great investment.” She has been able to achieve this through individual scholarly pursuits and also through her leadership of Lancet Oncology commissions, such as the Lancet Oncology commission on radiotherapy and theranostics, where reports are used to advocate for investments in radiotherapy and imaging at the global and national level. The report of the latest commission will be first launched at the ASTRO session this year.

In her global health endeavors, Dr. Abdel-Wahab has chaired ASTRO’s Health Care Access and Training Committee, helping to launch the Minority Fellowship, now known as the Medical Student Fellowship. Her work leading the planning committee of the international Integrated Healthcare Enterprises (IHE) in radiotherapy supported enhanced connectivity in radiotherapy. She has also played a pivotal leadership role in international initiatives such as the IAEA’s Rays of Hope initiative, which focuses on improving radiotherapy services in underserved regions globally in over 80 countries.

Her strategic vision has strengthened global partnerships and elevated the visibility of radiotherapy in cancer care. Mary Gospodarowicz, MD, FASTRO, describes her impact: “These many agendas are steadily pursued with her understated tone and humility. Dr. Abdel-Wahab serves as a highly knowledgeable ambassador of the real value of radiotherapy to the entire world and has transformed the IAEA’s Division of Human Health to be the leading convener of thoughtful and productive conversations on radiotherapy around the globe. Even more importantly, she has done so in a fashion that strengthens every participant.”

Dr. Abdel-Wahab’s activities extends to influential forums, such as the United Nations Taskforce on Non-Communicable Diseases, among others. At the IAEA, she has led significant projects such as the expansion of the IAEA Dosimetry Laboratory — to continue to enhance quality of radiotherapy worldwide — and the development of the ROVER-CeLP platform for innovation in education, including in low-resource settings. Her contributions to publications such as the World Health Organization’s (WHO) “Priority Devices for Cancer Care” and WHO-IAEA’s “Setting up a Cancer Centre” and other similar publications have been instrumental in integrating radiotherapy as part of the cancer care continuum and in global health strategies.

Looking ahead, Dr. Abdel-Wahab anticipates further advancements in diverse areas from proton therapy, stereotactic body radiotherapy (SBRT) and automation, to theranostics, enhancing personalized medicine and improving patient outcomes. She adds that “modular, more robust and efficient technologies can change the face of radiotherapy in years to come.” She also emphasizes the need for equitable funding and efficient utilization of existing radiotherapy resources to address global disparities in cancer care.

Receiving the ASTRO Gold Medal is a profound honor for Dr. Abdel-Wahab, recognizing her exceptional contributions and the esteem of her peers.

When considering this year’s Annual Meeting theme, she acknowledges that “maintaining wellness is challenging; as physicians, we’re trained to prioritize others’ needs over our own.” However, given the challenges in the demanding field of oncology, advocacy for more support and better organization of activities to foster healthier work-life balance in medicine is needed.

Dr. May Abdel-Wahab’s career exemplifies excellence in radiation oncology, with her transformative impact resonating globally. Her leadership and vision continue to inspire advancements in cancer treatment and health care equity worldwide.

Paul Harari, MD, FASTRO, recently completed 17 years as chairman of the Department of Human Oncology at the University of Wisconsin, currently serves as principal investigator for the Wisconsin H&N SPORE Grant and is a member of the UW Carbone Cancer Center Senior Leadership Council. His illustrious career began with medical school at the University of Virginia. Dr. Harari recalls that during his internship year in internal medicine, he became exceedingly interested in cancer and the curative potential of radiation. He noted that while cancer is frightening, patients are highly motivated to do everything recommended to improve their chances of survival. This dynamic motivated Dr. Harari to get to know his patients well and respond to their questions in a way they could best understand, equipping them to gain confidence in their care teams to face a difficult situation. The challenge and complexity of head and neck cancer inspired his deep commitment over 35 years to create prospective tumor boards, advance multidisciplinary care and improve treatment techniques.

Over his four-decade-plus career, Dr. Harari’s impact is as wide as it is deep. He served as director of the radiation oncology residency training program at the University of Wisconsin, impacting residents in highly formative years, and was President and Board Chair for ASTRO in 2017-2019. During his 17 years as the Jack Fowler Professor and Chairman of the Department of Human Oncology, the department faculty membership doubled while total research funding more than tripled. He designed and led multiple phase II and III international clinical trials that have impacted clinical practice in head and neck oncology. He served as Chair of the inaugural ASTRO/ASCO/AHNS Multidisciplinary Head and Neck Cancer Symposium in 2007 that has become highly successful and now attracts >1,000 attendees. Dr. Harari recently led the Wisconsin H&N SPORE grant to successful renewal through 2027. He has authored more than 300 articles and book chapters, including publications demonstrating the promising impact of the EGFR molecular growth inhibitor cetuximab to enhance the effects of radiation in cell culture and animal model systems, ultimately supporting clinical advancement of cetuximab as a radiosensitizer. Cetuximab received FDA approval for the treatment of head and neck cancer in combination with radiation in 2006. His laboratory research program has been continuously funded for 34 years, with a major focus on examining the capacity of promising new molecular agents to augment the impact of radiation on tumor control.

Ever the born teacher, Dr. Harari has delivered over 350 national and international invited lectures, including the ASTRO Refresher Courses. He has earned multiple Teacher of the Year awards and served over 40 visiting professorships at institutions worldwide. He served as Chair of the ASTRO Education Council, which represents the Education Committee on the ASTRO Board, overseeing all educational activities. His expertise led to testifying before Congress in 2019, specifically on the increasing burden of prior authorization that impedes physicians from selecting the best cancer treatment approach. His testimony helped drive the Increasing Seniors Timely Access to Care bill closer to becoming a law.

As policy works to keep pace with research, looking ahead, Dr. Harari is excited to witness the next generation of research discoveries and advances for cancer patients. He anticipates the most significant changes to include RO’s continued increase in treatment precision and diminished treatment side effects by sparing normal tissues. He noted that we are increasingly well positioned to marry advances in technology and cancer biology to significantly increase benefits and improve outcomes for future cancer patients. He identified theranostics as an area that is rapidly advancing among the most vibrant programs in the world at the University of Wisconsin under the direction of colleague Zach Morris, MD, PhD.

Dr. Harari’s many years of mentoring were recognized in 2023, when he was selected as one of three recipients of the ASTRO Mentorship Award. He has a growing legacy of mentees, many of whom are leaders in advancing patient-centered cancer care as comprehensive ROs. Catheryn M. Yashar, MD, FASTRO, describes his steady influence: “He guides with a wise and gentle hand, ready with humor when necessary and unafraid to tackle the difficult.” And now, regarding the Gold Medal, Dr. Harari said, “Recognition from peers in the field you love is wonderful. This award reflects my good fortune to have had inspirational mentors and outstanding institutions at which to learn, practice medicine, perform research and gain leadership skills.”

Dr. Harari noted that in his department, he has placed special emphasis on team science and team spirit, “using common sense efforts to celebrate one another, support one another, taking time to create opportunities for people to connect within and beyond the hospital, ensuring that team members float all boats higher, not just their own boat.” Considering this year’s Annual Meeting theme, he elaborated, “It’s important to the future of health care to have well-supported, healthy, well-balanced health care providers. If providers are overstressed, how can they focus most effectively on patients? Capable, motivated, well-trained and well rested providers can deliver exceptional care for cancer patients. This is an important formula to strive for in health care around the world.” Dr. Harari knows: among the 17 clinical departments at University of Wisconsin, his has consistently ranked number one in provider wellness. We would do well to listen.

When reflecting on his accomplishments, Dr. Harari was quick to note that what he’s most proud of is his family, “my wife and four children, they have enabled my career to flourish.” He also has enjoyed his role as mentor and is grateful for those who set that example, including early career mentors and teachers: J. Robert Cassady, MD, FASTRO – clinical; Eugene Gerner, PhD – lab research; Wendell Lutz, PhD – radiation physics; and Jack Fowler, PhD, DSc – radiobiology. As one who graciously shares the spotlight, Dr. Harari extends congratulations to the other Gold Medalists for their brilliant careers. “If you are fortunate enough to love your field and love taking care of patients, incredible things can happen.”

Mack Roach III, MD, FASTRO, has filled many roles in his career, including Professor of Radiation Oncology and Urology at the University of California San Francisco, and Director, Particle Therapy Research Program and Outreach. These roles had their educational start at Morehouse College, which Dr. Roach attended with his aunt’s residence as his homebase. Morehouse has many notable alums including Martin Luther King, Jr., who was mentored by Dr. Roach’s aunt’s first husband, (who was the chair of Religion and Philosophy while King was an undergraduate there). His aunt’s second husband was baseball great Hank Aaron. Surrounded by such a standard of achievement, Dr. Roach was naturally motivated to consider what kind of impact did he want to have, particularly in medicine, even more so within oncology. With access to his first uncle’s library, and motivated by the truth that the great equalizer is that everybody gets 24 hours a day, he studied fervently and committed to making improvements in social justice. “When you’re brought up in an environment of people that are legendary, that are game changers, doing tremendous things, it allows you to believe that your aspirations are realistic.” Surrounded by this perspective, he had the confidence to believe that he could and should make an impact in medicine, while being an advocate for social justice.

Dr. Roach’s interest in RO was rooted in a natural fascination with physics, further enhanced by an innate artistic ability to visualize 3-D. The equation emerged: physics + cancer = RO, especially after an encounter with a close family friend with cancer. While at Stanford Medical School, he dug further into the field to learn that prostate cancer was one and a half to two times more common in African American men and that they had a higher mortality rate. Pursuing RO became that much more relevant and urgent to him.

With Dr. Roach’s many motivations, his contributions to research have been sizeable. As his career progressed, he helped clarify how to optimize hormone therapy, as well as “newer” radiotherapy techniques, while using innovative imaging to help in defining targets and evaluating outcomes. Over decades, for prostate cancer specifically, he has served as lead investigator in multiple phase III trials, instrumental in providing the largest number of recruitments and developing the first model to predict disease-specific and overall survival. He also generated many studies on the influence of race on cancer outcome and challenged long standing dogma contesting inherent racial differences in cancer outcomes. Iris C. Gibbs, MD, FASTRO, observed: “His efforts in devising predictive equations and leading significant phase III trials in prostate cancer have positioned him as a key figure in the field, with a profound impact on patient treatment protocols.” After all, how many physicians can claim a formula named after themselves? The “Roach Formula” expressed the initial equation to estimate the risk of lymph node and seminal vesicle involvement. Dr. Roach was the leader in development of strategies to evaluate heavy ion radiotherapy in the U.S., and his research has inspired new ways of radiation treatment delivery, including both technical innovations and strategies for improving patient care.

Not one to be relegated to the lab bench, Dr. Roach’s efforts have also focused on social justice, as evident when he made sure that a community hospital continued to provide RO services when funding was threatened. Upon receiving an award for his efforts, he noted his embarrassment, stating that an award should not be given for something one is supposed to do. With a profound sense of what one should do, Dr. Roach has been an influential mentor and pioneer, advocating for diversity, equity and inclusion within health care delivery and treatment. He has had an unwavering focus on mentorship especially for underrepresented minorities and women, as exhibited by his ASTRO committee service, both on the Committee for Diversity and Disparity (now the Health Care Access and Training Subcommittee), and as an International Education Subcommittee Co-chair.

Dr. Roach reflected that mentoring is critical as an African American radiation oncologist, as younger professionals need to see others who look like them. Notably, he was the first African American to be chief resident in medicine at Highland Hospital in Oakland, California, the first in medical oncology at UCSF, the first to train in radiation oncology at Stanford, to join the faculty in the Department of Radiation Oncology at UCSF, and chair of radiation oncology at UCSF. Mentoring is critical to help others have confidence to question the status quo, to stand up against dogma, and he is proud of expressing new ideas over his career. Thirty years ago, Dr. Roach told others that prostate cancer was not inherently more aggressive in Black men, to disagreement across the field. Twenty-five years ago, he suggested that MRI guided targeting of selected areas should be used to treat part of the prostate, reducing toxicity and having more success. Funding agencies were not supportive and turned down grant applications. Yet he stayed the course, published papers, and 20 years later, other researchers have confirmed those ideas. Whether dogma about race or technical medical concepts, he noted the importance to speak truth to power. He shared with people what he sincerely believed, and frequently he was correct. “I did it because it was the right thing to do.”

Dr. Roach shared that the Gold Medal bears significance for him because it serves as evidence that people cared, and that they were “open-minded enough to appreciate what I did,” especially given that his ideas often went against the grain. This mindset clearly caught the attention of others, as President Obama appointed him to serve on the National Cancer Advisory Board for seven years. Dr. Roach mused: “My career has far exceeded my expectations. But my focus has always been to do your best. I didn’t necessarily set out to be chair of the department, a tenured professor, or do large trials — I just focused on doing the best I could.” He concluded: “If you don’t have confidence in yourself then you won’t challenge dogma. If you see something that you believe is true or not true, then you should not be intimidated. Confidence is very important, you need opportunities, you need mentors, and you need to work hard. Those have all been central for me. If I didn’t have all of those things, I would not be here.”

ASTRO’s 2024 Gold Medal recipients will be recognized and celebrated during the Awards Ceremony on October 1, in Washington, DC.