• The McClelland Lab

    University Hospitals Seidman Cancer Center, Case Western Reserve University

     

    Our Mission:

    To Tangibly Foster Equity in Access to Cancer-Killing Radiation Therapy

    Regardless of Race, Ethnicity, Gender or Socioeconomic Status

  • The McClelland Lab Vision

    Our goal is to tangibly combat the pervasive crisis of diminishing healthcare access for vulnerable populations including but not limited to African-Americans, Native Americans, Hispanic Americans, Appalachia, and the economically disadvantaged. We study techniques with a focus on achieving equity in access to cancer-killing radiation therapy for the purpose of saving lives. Our multidisciplinary approach spans socioeconomic, genetic, imaging, and behavioral techniques to answer local, national, and international questions for improving the quality of care received by cancer patients both by advancing the ways in which cancer is treated with radiation and by advancing the understanding of patient decision-making, cost and access to appropriate care. We are integrated into the Seidman Cancer Center at University Hospitals Cleveland Medical Center and are located at the Case Comprehensive Cancer Center, which provides for a strong interdisciplinary research program.

  • Selected Publications

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    Out-Of-Pocket Cost Modeling of Adjuvant Antiestrogen and Radiation Therapy After Lumpectomy for Early-Stage Breast Cancer Across Medicaid and Medicare Plans

     

    Int J Radiat Oncol Biol Phys. 2024, in press.

    Following lumpectomy for early-stage breast cancer, the optimal adjuvant therapy (antiestrogen therapy and/or radiaiton therapy) for older women is debated. Granular details regarding the role of insurance in out-of-pocket (OOP) costs for patients are lacking. Our financial model used National Comprehensive Cancer Network guidelines in Medicare and/or Medicaid-eligible patients age 70+ with node-negative, early-stage, estrogen-receptor positive breast cancer for Medicaid, Original Medicare, Medigap Plan G, and Medicare Part D Rx plans to assess aggregate OOP costs. These data provide a level of transparency regarding the cost of adjuvant therapy in this patient population.

     

    Access full-length article here: 

    https://www.redjournal.org/article/S0360-3016(24)00351-1/abstract

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    Evolving Role of Proton Radiation Therapy in Clinical Practice

     

    JCO Oncol Pract. 2024, in press.

    While the most common form of radiation therapy (RT) in oncologic practice involves photons (x-rays) to deliver sufficient energy in an anatomically precise manner to cause indirect ionization of atoms, proton RT delivers positively charged particles with an appreciable mass, resulting in a physically and biologically distinct interaction with tissues and cancer. The number of proton centers in the United States has grown from 4 in 2004 to 31 in 2020. We discuss the challenges of proton therapy including the cost of building/maintaining centers (typically 50-200 million dollars, compared with 6 million for photon RT devices), insurance approval barriers, clinical situations requiring caution with proton RT, evidence-based comparisons of proton versus photon RT, and barriers to equitable access for all patients.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/38377440/

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    Insurance Denial of Care for Randomized Controlled Trial-Eligible Patients: Incidence and Success Rate of Peer-To-Peer Authorization in Allowing Patients to Remain Trial-Eligible

     

    Am J Clin Oncol. 2024 Feb;47(2):56-57

    Insurance denials for clinical trials serve as a pertinent barrier for patients to remain trial-eligible, hindering the overall advancement of healthcare. We present results from an ongoing oncology randomized clinical trial [Spine Patient Optimal Radiosurgery Treatment for Symptomatic Metastatic Neoplasms (SPORTSMEN)] regarding insurance denials and peer-to-peer authorization (P2PA) success rate in allowing patients to remain trial-eligible. Our findings indicate that a vigilant P2PA strategy focusing on highlighting National Comprehensive Cancer Network guidelines and the supporting Level 1 evidence resulted in a very high rate of reversing initial denial.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/37815344/

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    Invited African-American Radiation Oncology Grand Rounds Speakers: DEI or Die?

     

    Rep Pract Oncol Radiother. 2024 Jan;29(1):51-54

    Invitations for grand rounds presentation are a sign of national and/or international expertise, which plays a large role in the academic faculty promotion process. To shed light on potential barriers to career progression, we conducted a nationwide examination of the racial and gender demographics of invited speakers and the inclusion of diversity, equity and inclusion (DEI)-related talks among African-American radiation oncology speakers. Among speakers not of African-American race, the rate of DEI-related invited talk topics was 4.2%, while in African-American speakers it was 50% (p<0.0001). Targeted efforts to expand African-American representation in non-DEI topics are needed to ensure and expand diversity in Radiation Oncology.

     

    Access full-length article here: 

    https://journals.viamedica.pl/rpor/article/view/99359

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    Prehabilitation in Radiation Therapy: A Scoping Review

     

    Support Care Cancer. 2024 Jan;32(1):83

    Radiation therapy (RT) is a central component of cancer treatment with survival and long-term quality-of-life benefits across a spectrum of oncologic diagnoses. Prehabilitation aims to optimize health prior to anti-neoplastic therapy in order to reduce side effects, increase adherence to treatment, expedite post-treatment recovery, and improve long-term outcomes. Though prehabilitation has been studied in those undergoing cancer-related surgery, literature on prehabilitation in individuals undergoing RT had not been comprehensively explored. Based on limited current literature, prehabilitation appears to have a promising effect in reducing morbidity in adult cancer patients requiring RT and deserves further prospective study.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/38177946/

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    Out-of-Pocket Cost Modeling of Adjuvant Radiotherapy Duration in Standard-of-Care Early-Stage Breast Cancer Treatment Across Medicaid and Medicare Plans

     

    Pract Radiat Oncol. 2024 Jan;14(1):24-27

    For early-stage breast cancer (BC), the choice of radiotherapy (RT) duration (1- versus 3-weeks) is highly debated. Cost and financial toxicity are major concerns facing BC patients, and there remains limited granular details of the role of insurance in the aggregate cost of 1 week versus 3 weeks of RT for patients. This project disaggregated costs by insurance plan to increase the transparency of out-of-pocket (OOP) cost estimates in RT. This model (based on actual cost estimates per insurance plan rather than claims data) compared OOP costs across Medicaid and Medicare plans, allowing a more holistic informing of patients and providers regarding RT duration decision-making. Our findings that 3-week RT yields a 55% increase in OOP cost under Original Medicare versus 1-week RT provides real-world estimates of OOP costs directly related to RT, allowing for optimization of treatment decision-making and further expansion of this model in future studies.

     

    Access full-length article here: 

    https://www.sciencedirect.com/science/article/pii/S1879850023002448

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    Validation of Navigator-Assisted Hypofractionation (NAVAH) Program Survey to Aid American Indian Breast Cancer Patients

     

    Am J Clin Oncol. 2023 Aug;46(8):335-336

    The pronounced mortality rates observed among Native American/American Indian populations with breast cancer undescore the need to identify barriers to treatment and understand the underlying causes of these barriers. This is particuarly important in radiation oncology since radiation therapy is utilized in approximately half of all cancer treatment plans and is projected for increased in demand as the population ages. This pilot project aimed to validate a culturally sensitive survey investigating barriers to breast cancer treatment in American Indian populations for use in the NAVAH parent study. Our findings indicate that mistrust of the health care system (despite trust being present with individual healthcare providers) and distance to care remain significant barriers to receiving appropriate care. These concerns must be addressed to improve breast cancer outcomes in American Indian patients.

     

    Access full-length article here: 

    https://journals.lww.com/amjclinicaloncology/Citation/9900/Validation_of_Navigator_Assisted_Hypofractionation.109.aspx

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    Underrepresented Minority Composition of Invited Panelists at the 2021 ASTRO Annual Meeting

     

    Adv Radiation Oncol. 2023 May;8(3):101174

    The American Society for Radiation Oncology (ASTRO) annual meeting is one of the primary venues for Radiation Oncologists to present new research, network, and share innovations. The racial represenation of invited physician speakers at a recent ASTRO annual meeting was analyzed via the program list of all invited educational sessions and panel speakers, yielding a total of 182 cumulative speaking panels and 960 individuals who filled these panels. Our findings indicate that the proportion of underrepresented minorities receiving panel invitations at ASTRO remains minimal, and is virtually nonexistent outside of diversity, equity, and inclusion-related panels. Targeted efforts to increase underrepresented minority representation are needed to make tangible progress on this issue.

     

    Access full-length article here: 

    https://www.advancesradonc.org/article/S2452-1094(23)00003-9/fulltext

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    Navigator-Assisted Hypofractionation (NAVAH) to Address Radiation Therapy Access Disparities Facing African-Americans with Breast Cancer

     

    Rep Pract Oncol Radiother. 2022 Jul;27(3):583-588

    This program uses established survey-based methods to assess barriers facing African-American breast cancer patient access to patient navigation. NAVAH assesses the use of patient navigation to increase access to radiation oncology care and utilization of standard of care radiation therapy (RT) in African-American breast cancer patients, and objectively evaluates whether short-course RT reduces financial toxicity compared to standard fraction RT for breast cancer in African-American patients.

     

    Access full-length article here: 

    https://journals.viamedica.pl/rpor/article/view/RPOR.a2022.0064

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    Disparities in the Utilization of Radiation Therapy for Prostate Cancer in the United States: A Comprehensive Review

     

    Adv Radiation Oncol. 2022 Mar;7(4):100943

    Despite significant advances in oncologic care, health disparities remain numerous in radiation therapy for prostate cancer. Among the many demographic influencing factors (socioeconomic status, age, geographic location, insurance status, practice characteristics), the most prevalent disparity reported (by far) is race. Black men are 80% more likely to be diagnosed with prostate cancer than White men and are 220% more likely to die from prostate cancer-specific mortality. There has been very limited prospective research or high-level evidence focusing on identifying and reducing disparities to ensure quality and guideline-driven care for all prostate cancer patients.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/35494548/

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    Composition of the Current Academic Radiation Oncology Workforce in Comprehensive Cancer Centers

     

    JCO Oncol Pract. 2022 May;18(5):e740-e747

    In the first quantitative nationwide analysis of the academic radiation oncology workforce, all National Cancer Institute-designated comprehensive cancer centers were assessed. Fewer than 5% of the academic radiation oncology workforce are underrepresented minorities, and men are significantly over represented among senior faculty. Nearly 1/3 practice in New York, California, Massachusetts, Illinois, or the District of Columbia. The mean Hirsch index (h-index) is 8 for junior faculty, 18 for associate professors, and 40 for full professors.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/34919411/

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    Disparities in Patterns of Conventional Versus Stereotactic Body Radiotherapy in the Treatment of Spine Metastasis in the United States
     
    J Palliat Care. 2021 Apr;36(2):130-134

    The improved survival of patients even with metastatic cancer has led to an increase in the incidence of spine metastases, suggesting the need for a more aggressive palliative treatment than conventional external beam radiation therapy (cEBRT). In the first analysis of cEBRT versus spinal stereotactic body radiation therapy (SBRT) for metastatic spine disease, multivariable analysis revealed that non-Medicare or private insurance, African-American race, age 65+, living in a region with lower population, earlier year of diagnosis, and receiving treatment in a non-academic/research facility were associated with cEBRT. These findings raise questions about disparities in access to and delivery of care that deserve further investigation.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/33356987/

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    Impact of Hospital Volume on Mortality for Brain Metastases Treated with Radiation

     

    Rep Pract Oncol Radiother. 2021 Aug 12;26(4):626-634

    In the first analysis of the impact of hospital volume on patients receiving radiation therapy (RT) for metastatic brain disease, a nationwide retrospective cohort analysis was conducted over a six-year period for patients with metastatic brain disease from lung cancer, breast cancer, and colorectal cancer requiring RT. Hospital volume was stratified as high-volume (≥ 12 brain RT/year), moderate (5-11 RT/year), and low (< 5 RT/year). The effect of hospital volume on overall survival was assessed using a multivariable cox regression model. Hospitals performing 12 or more brain RT procedures per year have significantly improved survival in brain metastases patients receiving radiation than lower volume hospitals. This finding, independent of additional demographics, indicates that the increased experience associated with increased volume may improve survival in this patient population.

     

    Access full-length article here:

    https://pubmed.ncbi.nlm.nih.gov/34434579/

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    Predictors of Whole Breast Radiation Therapy Completion in Early Stage Breast Cancer Following Lumpectomy
     
    Clin Breast Cancer. 2020 Dec;20(6):469-479

    In the first examination of whole breast radiation therapy (RT) fractionation regimen [fraction size of 1.8-2.0 Gray (Gy) defined as standard fractionation (SFRT); 2.66-2.70 Gy/fraction as hypofractionation (HFRT)] on completion rate in early-stage breast cancer following lumpectomy, a nationwide observational cohort study of 100,734 early-stage breast cancer patients treated with RT after lumpectomy found RT completion rates to be significantly greater following HFRT (99.3%) versus SFRT (79.7%); patients receiving SFRT had higher odds of not completing RT [odds ratio (OR)=41.5; p<0.0001]. Patients residing > 10 miles from a treatment facility or of African-American race had lower odds of completing RT. These findings suggest compliance advantages of HFRT for early-stage breast cancer patients having undergone lumpectomy.

     

    Access full-length article here:

    https://pubmed.ncbi.nlm.nih.gov/32693964/

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    Tying Reimbursement to Best Early-Stage Breast Cancer Oncologic Practice
     
    JCO Oncol Pract. 2020 Oct;16(10):631-634

    Implementation of the Radiation Oncology Alternative Payment Model (APM) as law will represent a dramatic change in the financial incentives governing Radiation Oncology practice, thereby substantially influencing cancer care throughout the United States. Based on our modeling, which assessed historical fee-for-service standardized Medicare reimbursement for hypofractionation and standard fractionation, adoption of hypofractionated early-stage breast cancer treatment over conventional fractionation may result in a 46% increase in reimbursement for hypofractionation versus a 10% reduction for standard fractionation based on historical fee-for-service reimbursement. While the overall impact of APM on advanced cancer may have much to be desired, its role in tying financial incentives towards implementation of hypofractionation for early-stage breast cancer should be applauded.

     

    Access full-length article here:

    https://pubmed.ncbi.nlm.nih.gov/32530805/

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    Cost Analysis of Audiovisual-Assisted Therapeutic Ambiance in Radiation Therapy (AVATAR)-Aided Omission of Anesthesia in Radiation for Pediatric Malignancies
     
    Pract Radiat Oncol. 2020 Mar-Apr;10(2):e91-e94

    The cost of anesthesia is a source of financial burden for the families of children requiring radiation therapy (RT) to treat their cancer; furthermore, anesthesia is both invasive and traumatic. This study was the first to establish the cost-savings benefit (exceeding $38,000) of AVATAR-aided omission of pediatric anesthesia in RT, which has great implications for tangibly reducing the financial toxicity of pediatric cancer care.

     

    Access full-length article here:

    https://pubmed.ncbi.nlm.nih.gov/31574319/

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    Impact of the American Tax Payer Relief Act on Stereotactic Radiosurgery Utilization in the United States
     
    J Neurooncol. 2019 Oct;145(1):159-165

    Single-fraction stereotactic radiosurgery (SRS) is delivered predominantly via two modalities: Gamma Knife, and linear accelerator (LINAC). Implementation of the American Tax Payer Relief Act (ATRA) in 2013 represented the first time limitations specifically targeting SRS reimbursement were introduced into federal law. In the first study to examine the subsequent impact of the ATRA on SRS utilization in the United States, the ATRA provision mandating Medicare reduction of outpatient payment rates for Gamma Knife to be equivalent with those of LINAC SRS resulted in a significant short-term impact on the nationwide radiosurgical treatment of metastatic brain disease, serving as a reminder of the importance/impact of public policy on treatment modality utilization by physicians and hospitals.

     

    Access full-length article here:

    https://pubmed.ncbi.nlm.nih.gov/31485922/

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    Bridging the Gap in Global Advanced Radiation Oncology Training: Impact of a Web-Based Open-Access Interactive Three-Dimensional Contouring Atlas on Radiation Oncologist Practice in Russia
     
    J Cancer Educ. 2019 Oct;34(5):871-873

    One of the tangible hindrances to improving global oncology care is the training gap in the field of Radiation Oncology between countries with versus without formal multi-year dedicated residency programs. Under the auspices of the Russian Society of Clinical Oncology, our group developed a series of ongoing in-person contouring workshops in Moscow, Russia to help radiation oncologists lacking formal multiyear dedicated residency programs. We introduced the audience to the open-access web-based contouring program (eContour), as a visual aid and tool for daily practice. Our findings indicate that the combination of in-person contouring workshops with a free internet-based contouring program has increased the exposure of Russian radiation oncologists to up-to-date contouring guidelines and practices. This is an important and replicable step in bridging the knowledge gap for countries without dedicated radiation oncology residency training, and has significant implications for optimization of radiation oncology practice worldwide.

     

     

    Access full-length article here:

    https://pubmed.ncbi.nlm.nih.gov/29938298/

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    The Sin of Exclusion: Applicability of Trials Encouraging Omission of Radiation Therapy to Nonwhite Patients With Breast Cancer
     
    J Oncol Pract. 2018 Nov;14(11):635-638

    Over the past decade, there has been a wave of high-quality evidence supporting omission of radiation therapy (RT) for early-stage breast cancer with presumed applicability to patients regardless of race or ethnicity. The fact that trials such as CALGB 9343, ABCSG 8A and PRIME II have been widely accepted as applicable to all patients regardless of the racial and ethnic distributions in their makeup is a testament to how ineffective the NIH mandate (Revitalization Act of 1993) has been in adequately representing people of color, who remain markedly underrepresented in high-quality trials. Further clinical work is needed to validate the results of these studies when applied to real world populations, which consist of dramatically more nonwhite patients than in any of these three randomized trials.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/30423265/

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    The Pervasive Crisis of Diminishing Radiation Therapy Access for Vulnerable Populations in the United States, Part 2: American Indian Patients
     
    Adv Radiat Oncol. 2017 Aug 26;3(1):3-7

    American Indian/Alaska Native (AI/AN) patients with cancer disproportionally present with more advanced stages of disease and have the worst cancer-specific survival rates of any racial/ethnic group in the United States. The presence of disparities in radiation therapy (RT) access for AI/AN patients has rarely been examined. Nearly all peer-reviewed published progress in this area has been associated with the Walking Forward program (NCI Cancer Disparity Research Partnership initiative to address barriers to cancer screening among AI populations in the Northern Plains region). Given the similarities with cancer disparities of populations worldwide, the AI/AN experience should be included within the broad issue of a global shortage of cancer care among underserved populations.

     

    Access full-length article here:

    https://pubmed.ncbi.nlm.nih.gov/29556572/

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    The Pervasive Crisis of Diminishing Radiation Therapy Access for Vulnerable Populations in the United States, Part 1: African-American Patients
     
    Adv Radiat Oncol. 2017 Aug 3;2(4):523-531

    African Americans experience the highest burden of cancer incidence and mortality in the United States. The presence of disparities in access to radiation therapy (RT) for African American cancer patients has rarely been examined in an expansive fashion. Our findings reveal that RT access disparities for African Americans have been prominently studied in cancers of the breast, prostate, and gynecologic systems. Disparities in RT access for African Americans were prevalent regardless of organ system studied and often occurred independently of socioeconomic status. African Americans in the United States have diminished access to RT compared with Caucasian patients, independent of but often in concert with low socioeconomic status. These findings underscore the importance of finding systemic and systematic solutions to address these inequalities to reduce the barriers that patient race provides in receipt of optimal cancer care.

     

    Access full-length article here:

    https://pubmed.ncbi.nlm.nih.gov/29204518/

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    Impact of insurance Status and Race on Receipt of Treatment for Acoustic Neuroma: A National Cancer Database Analysis

     

    J Clin Neurosci. 2017 Aug;42:143-147

    Acoustic neuroma (AN) management involves surgery, radiation, or observation. Previous studies have demonstrated that patient race and insurance status impact in-hospital morbidity/mortality following surgery; however the nationwide impact of these demographics on the receipt of each treatment modality has not been examined. Our findings indicate that African-American race, elderly age, and community hospital treatment triaged towards observation/away from surgery; age also triaged towards radiation. Conversely, integrated networks triaged towards surgery/away from observation; comprehensive cancer centers triaged towards radiation. Medicaid insurance triaged towards surgery/away from radiation/observation; this may be detrimental since lack of private insurance is a known risk factor for increased in-hospital postoperative morbidity.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/28343920/

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    Morbidity and Mortality Following Acoustic Neuroma Excision in the United States: Analysis of Racial Disparities During a Decade in the Radiosurgery Era

     

    Neuro Oncol. 2011 Nov;13(11):1252-9

    Acoustic neuromas present a challenging problem, with the major treatment modalities involving operative excision, stereotactic radiosurgery, observation, and fractionated stereotactic radiotherapy. The morbidity/mortality following excision may differ by patient race. To address this concern, the morbidity of acoustic neuroma excision was assessed on a nationwide level. African Americans were 9 times more likely to die following surgery than Caucasians over a decade-long analysis. Given the relatively benign natural history of acoustic neuroma and the alarmingly increased mortality rate following surgical excision among older patients, African Americans, and patients receiving care from low-caseload surgeons, acoustic neuromas in these patient populations may be best managed by a more minimally invasive modality such as observation, fractionated stereotactic radiotherapy, or stereotactic radiosurgery.

     

    Access full-length article here: 

    https://pubmed.ncbi.nlm.nih.gov/21856684/

  • Selected Experimental Techniques

    We use a diverse approach to provide tangible solutions for addressing disparities in radiation therapy access facing cancer patients spanning the clinic and community. We utilize patient navigation, open access radiation therapy planning software, mathematical modeling, observational cohort studies, and short-course radiation therapy to identify and address disparities in access to optimal healthcare.

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    The PI - Dr. Shearwood McClelland III, M.D.

    Dr. McClelland received his undergraduate degree from Harvard College, where he graduated with honors in molecular biology. He received his MD from the Columbia University College of Physicians and Surgeons and completed radiation oncology residency at Indiana University, where he finished a fellowship in stereotactic radiosurgery. Dr. McClelland is Director of Spine Radiation Oncology at University Hospitals Seidman Cancer Center and Assistant Professor of Radiation Oncology and Neurological Surgery at Case Western Reserve University School of Medicine. In addition to healthcare disparities, Dr. McClelland’s clinical interests are in primary and metastatic brain tumors, trigeminal neuralgia, temporal lobe epilepsy, and spine tumors. His diverse interests are represented by his more than 190 peer-reviewed publications (including publications in The Lancet, The Lancet Oncology, and JAMA Oncology) and his service on several national committees including the NRG Oncology Brain Tumor Scientific Core Committee, the American Radium Society Appropriate Use Criteria Brain Malignancies Panel, the NRG Oncology Health Disparities Scientific Core Committee, the American College of Radiology Commission for Women and Diversity, the American Medical Association Radiology Section Council, the National Medical Association Executive Committee, the American Society for Radiation Oncology (ASTRO) Health Equity Education Committee, the ASTRO Early Career Committee, the SWOG CNS Working Group, the American Society of Clinical Oncology Trainee & Early Career Advisory Group, the American College of Radiation Oncology Ethics Committee, and the ASTRO Treatment for WHO Grade 4 Diffuse Gliomas Guideline Task Force. He is Chair of the National Medical Association Radiology & Radiation Oncology Research Committee, the ASTRO Early Career Liaison Subcommittee, and is co-chair of the NRG Oncology Rural Health Research Special Interest Group. Dr. McClelland is the Principal Investigator of an ongoing multicenter Phase II neuro-oncology randomized controlled trial and conducts research funded for more than $1.5 million by several agencies, including the National Institutes of Health, American Society for Radiation Oncology, Gilead Sciences, Susan G Komen and the Bristol Myers Squibb Foundation focused on eliminating healthcare disparities facing all cancer patients, while working to advance the treatment of central nervous system disease with radiation.

  • Meet Our Team

    We are a diverse group of clinicians, scientists and researchers committed to making fundamental and lasting changes in combating healthcare disparities facing vulnerable populations. Lab members to-date have secured more than $50,000 in grants and national awards.

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    Chesley Cheatham, M.Ed., MCHES

    Community Outreach Coordinator

     

    Chesley Cheatham received her M.Ed. from the University of Houston. She is the Director of Community Outreach and Engagement at the University Hospitals Cleveland Medical Center Seidman Cancer Center (since 2014), preceded by her serving as a Senior Health Education Specialist at MD Anderson Cancer Center. She uses her expertise to facilitate information regarding the Navigator-Assisted Hypofractionation (NAVAH) program between the Cleveland, Ohio community and the Seidman Cancer Center, where her work in reducing patient transportation barriers in receiving radiation therapy has been recognized by the American Cancer Society. She joined the McClelland Lab in 2021.

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    Yilun Sun, Ph.D.

    Biostatistician

     

    Professor Sun received his BS in Chemistry from Peking University in China, his MS in Biostatistics from the University of Michigan, and his PhD in Biostatistics from the University of Michigan. He is the Director of Biostatistics in the Department of Radiation Oncology at the University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine. He joined the McClelland Lab in 2021 and is currently utilizing his doctoral expertise in nonparametric statistical methods and early-phase oncology clinical trials to provide invaluable biostatistical guidance for several projects, including the Navigator-Assisted Hypofractionation (NAVAH) program and the Spine Patient Optimal Radiosurgery Treatment for Symptomatic Metastatic Neoplasms (SPORTSMEN) ongoing prospective clinical trial.

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    Ursula Burnette, M.A.

    Community Health Worker/Certified Patient Navigator

     

    Ursula Burnette received her community health worker certification from the Cleveland State University School of Nursing, and her MA in organizational leadership from Luther Rice College and Seminary. She received her patient navigator certification from the Susan G Komen Navigation Nation Patient Navigation Training Program. She joined the McClelland Lab in 2022 and serves as a full-time patient navigator for the Navigator Assisted Hypofractionation (NAVAH) program to increase radiation therapy access for African-Americans with breast cancer.

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    Tamika Smith, A.A.B.

    Certified Professional Patient Navigator

     

    Tamika Smith has worked as a senior lead patient navigator since 2017 involving multiple cancer disease sites for the Cleveland Clinic and Care Alliance Health Center. She received her patient navigator certification from the Academy of Oncologic Nurse and Patient Navigators (via the Patient-Centered Education and Research Institute). She joined the McClelland Lab in 2024 and serves as a patient navigator for the Navigator Assisted Hypofractionation (NAVAH) program to increase radiation therapy access for African-Americans and Hispanic-Americans with breast cancer, as well as for African-Americans with prostate cancer.

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    Ulysses Gardner Jr., M.D., M.B.A.

    Radiation Oncology Clinician-Researcher

     

    Dr. Gardner received his BS in Radiologic Science from the University of Alabama at Birmingham, his MBA from the University of Phoenix, and his MD from the Wright State University Boonshoft School of Medicine. Dr. Gardner is a resident (graduating class of 2026) in the Department of Radiation Oncology and Molecular Radiation Sciences at The Johns Hopkins Hospital. He joined the McClelland Lab in 2021 and has used his expertise to elucidate racial disparities in prostate cancer radiation therapy access in the United States, and to investigate nationwide barriers facing physician workforce diversity. He has recently conducted ASCO-award winning work on the disaggregation of gender and racial disparities in oncologic publications, and is leading the community outreach program to optimize equitable enrollment on the ongoing Spine Patient Optimal Radiosurgery Treatment for Symptomatic Metastatic Neoplasms (SPORTSMEN) multicenter Phase II clinical trial.

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    Christina Huang, M.D., M.S.

    Radiation Oncology Clinician-Researcher

     

    Dr. Huang received her BS in Biological Sciences from the University of Chicago. She received her MS in Clinical Research [through the Medical Student Training Applied to Research (MedSTAR) program] and her MD from the Indiana University School of Medicine. Dr. Huang is a resident (graduating class of 2026) in the Department of Radiation Oncology at the Duke University School of Medicine. She joined the McClelland Lab in 2021 and has used her expertise on several projects, including the elucidation of gender and racial disparities in the ASCO award-winning seminal comprehensive analysis of the United States academic radiation oncology workforce.

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    Teresa Easwaran, M.D., M.S.

    Radiation Oncology Clinician-Researcher

     

    Dr. Easwaran received her BS in Biology and a degree in cello performance from the Indiana Jacobs School of Music. A previous Howard Hughes Medical Research Fellow, Dr. Easwaran received her MS in Physiology and her MD from the Indiana University School of Medicine. Dr. Easwaran is a resident (graduating class of 2024) in the Department of Radiation Oncology at the University of Minnesota Medical School, and has conducted award-winning brain tumor research. She joined the McClelland Lab in 2022 and has helped analyze the impact of the Affordable Care Act on disparities in access to stereotactic radiosurgery and proton therapy in the United States, while winning an ACRO Global Radiation Oncology Workforce (GROW) Scholarship to broaden awareness and support for cancer education and treatment in developing countries.

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    Patricia Santos, M.D., M.S., M.P.Hc.

    Radiation Oncology Clinician-Researcher

     

    Dr. Santos received her BS in Neuroscience from Brown University. She received her MS in Biomedical Sciences from the Icahn School of Medicine at Mount Sinai, and her MD from the Perelman School of Medicine at the University of Pennsylvania; she is in the process of receiving her MPH from the Harvard School of Public Health. Dr. Santos is a resident (graduating class of 2024) in the Department of Radiation Oncology at Memorial Sloan Kettering Cancer Center. She joined the McClelland Lab in 2022 and is leading an analysis of radiation therapy access disparities facing Hispanic-Americans, while winning multiple ASCO awards for her work addressing adult immigrant cancer patients.

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    Yorleny Vicioso-Mora, M.D., Ph.D.

    Radiation Oncology Clinician-Researcher

     

    Dr. Vicioso-Mora received her BS in Biology from the State University of New York at Stony Brook. She received her PhD in Pathology/Cancer Biology and her MD through the NIH-funded Medical Scientist Training Program at the Case Western Reserve University School of Medicine, and has conducted award-winning cancer research. Dr. Vicioso-Mora is a resident (graduating class of 2027) in the Department of Radiation Oncology at the Duke University School of Medicine on the Radiation Oncology Research Scholar Track. She joined the McClelland Lab in 2022 and has helped lead analyses of the financial toxicity of virtual versus in-person residency interviews and radiation therapy access disparities facing Hispanic-Americans.

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    Louisa Onyewadume, M.D., M.P.H.

    Radiation Oncology Clinician-Researcher

     

    Dr. Onyewadume was born in Ibadan, Nigeria and received her BA in Chemistry from Smith College. She received her MD from Case Western Reserve University School of Medicine, during which time she received the Rottman Family Fund Award for medical outreach in Botswanna and recognition from the International Society of Magnetic Resonance in Medicine for brain tumor research; she subsequently received her MPH from the Harvard School of Public Health. Dr. Onyewadume is a resident (graduating class of 2028) in the Department of Radiation Oncology at the Duke University School of Medicine. She joined the McClelland Lab in 2022, serving as the Navigator-Assisted Hypofractionation (NAVAH) program research coordinator while leading award-winning analyses of radiation oncology health equity.

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    Forrest Kwong, M.D.

    Radiation Oncology Clinician-Researcher

     

    Dr. Kwong received his BS in Biology from the University of Washington where he worked in the basic science lab of Dr. Kevin Hybiske PhD studying Chlamydia mutagenesis, and his MD from the Oregon Health Science & University School of Medicine. He is a resident (graduating class of 2028) in the Department of Radiation Oncology at the MD Anderson Cancer Center. Dr. Kwong joined the McClelland Lab in 2022 and has led multiple analyses of stereotactic radiosurgical treatment of intracranial arteriovenous malformations.

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    Victoria Wu, M.Dc.

    Radiation Oncology Clinician-Researcher

     

    Victoria Wu received her BA from the University of Pennsylvania (Economics and Biology major; Neuroscience and Health Services Management minor) where she worked in the Health Equity and Policy Lab of Dr. Jennifer Prah PhD. She is a member of the Case Western Reserve University School of Medicine class of 2025, during which time she has served as a Memorial Sloan Kettering Cancer Center summer fellow under Dr. Fumiko Chino MD examining financial toxicity in cancer survivorship. She joined the McClelland Lab in 2022 and is leading American Radium Society award-winning analyses of financial toxicity in cancer care.

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    Elizabeth Obi, M.D.

    Radiation Oncology Clinician-Researcher

     

    Dr. Obi received her BA from the College of Wooster in Biochemisty and Molecular Biology where she worked on modeling the effects of p14 and p53 on common oncogenic pathways with Dr. Erzsebet Ravasz Regan PhD. She received her MD from the Case Western Reserve University School of Medicine, during which time she received the prestigious American Society for Radiation Oncology (ASTRO) Medical Student Fellowship award where she conducted breast cancer radiation oncology research at the Cleveland Clinic under the direction of Dr. Chirag Shah MD. Dr. Obi is a resident (graduating class of 2028) in the Department of Radiation Oncology at the Cleveland Clinic. She joined the McClelland Lab in 2022 and is leading analyses of spine stereotactic radiosurgery.

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    Laura Flores, Ph.D., M.Dc.

    Radiation Oncology Clinician-Researcher

     

    Dr. Flores received her BA in Philosophy from New Mexico State University with a focus on bioethics and clinical trial research. She received her PhD in the Patient-Oriented Research program at the University of Nebraska Medical Center College of Medicine where she is a member of the MD class of 2024 and was elected to the Alpha Omega Alpha honor medical society. She has been a Graduate Student of Distinction as a Yale Ciencia Academy Fellow, and has won the Harvard Medical School Walls Do Talk Award for inclusivity in medical school. Dr. Flores is a member of the residency graduating class of 2029 in the Department of Radiation Oncology at the University of Nebraska. She joined the McClelland Lab in 2022 and is leading nationally recognized analyses on reducing radiation therapy access disparities facing Native Americans, bioethics, and prehabilitation in radiation therapy.

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    Ifeanyi Ekpunobi, M.Dc.

    Radiation Oncology Clinician-Researcher

     

    Ify Ekpunobi was born and raised in Nigeria and emigrated to the United States to receive her BS in Biomedical Engineering at Saint Louis University. She is a member of the Case Western Reserve University School of Medicine class of 2026 and aspires to become a Radiation Oncologist. During her first-year of medical school, she served with Compassion for Action (working with local charities in Ohio). She joined the McClelland Lab in 2023 and is leading analyses on diversity, equity and inclusion among the Radiation Oncology workforce, bioethics, and stereotactic radiosurgery for spine tumors.

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    Eric Chen, M.D.

    Radiation Oncology Clinician-Researcher

     

    Dr. Chen received his BA with honors in Molecular Cell Biology from the University of California, Berkeley and his MD from the Case Western Reserve University School of Medicine, during which he received the Inclusion and Diversity Achievement Award. Dr. Chen is a resident (graduating class of 2024) in the Department of Radiation Oncology at University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine during which time he has performed American Cancer Society-recognized work on increasing access equity for patients requiring radiation therapy. He joined the McClelland Lab in 2023 and is leading ASCO-award winning analyses on the use of rideshare to reduce transportation barriers for oncology patients receiving radiation therapy.

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    Abizairie Sanchez-Feliciano, M.Dc.

    Radiation Oncology Clinician-Researcher

     

    Abizairie Sanchez-Feliciano was born and raised in Puerto Rico, receiving her undergraduate degree from the University of Puerto Rico (Rio Piedras Campus). She is a member of the Case Western Reserve University School of Medicine class of 2026, and joined the McClelland Lab in 2023 where she is leading analyses on expanding the Navigator-Assisted Hypofractionation Program (NAVAH) to tangibly reduce radiation therapy access disparities facing Hispanic-American patients; this work has been recongized with the 2023 American Society for Radiation Oncology (ASTRO) Medical Student Fellowship Award.

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    Nicholas Verdini, M.Dc.

    Radiation Oncology Clinician-Researcher

     

    Nicholas Verdini received his BS in Biology from Emmanuel College, after which he worked in the pediatric oncology branch of the National Cancer Institute under Dr. Terry Fry, MD developing CAR T cell therapies for pediatric ALL, and subsequently as an Intramural Research Trainng Award Fellow in the genitourinary malignancy section of the National Cancer Institute under Dr. Andrea Apolo, MD. He is a member of the Tufts University School of Medicine class of 2024 as part of the Health Justice Scholars Program, and is a member of the residency graduating class of 2029 in the Department of Radiation Oncology at Stanford University. He joined the McClelland Lab in 2023 where he is leading an analysis of radiation therapy access disparities facing Hispanic-Americans.

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    Michael Rooney, M.D., M.Sc.

    Radiation Oncology Clinician-Researcher

     

    Dr. Rooney received his BA in Biological Sciences (concentration in Animal Physiology) from Northwestern University, after which he received his MD at the University of Ilinois at Chicago where he was elected to the Alpha Omega Alpha honor medical society. Dr. Rooney is a resident (class of 2025) at MD Anderson Cancer Center. He joined the McClelland Lab in 2023 where he is leading ACRO award-winning analyses of equity in funding opportunities for early-career oncologists.

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    Erica Fleming-Hall, M.Dc.

    Radiation Oncology Clinician-Researcher

     

    Erica Fleming-Hall received her undergraduate degree at Morgan State University. She is a member of the Case Western Reserve University School of Medicine class of 2025, and joined the McClelland Lab in 2023 where she has spearheaded the Navigator-Assisted Hypofractionation Program (NAVAH) expansion to tangibly reduce radiation therapy access disparities facing African-American prostate cancer patients and is leading an invited overview of diversity, equity and inclusion in radiation oncology.

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    Olufela Jean-Koleoso, M.S., D.Oc.

    Radiation Oncology Clinician-Researcher

     

    Olufela Jean-Koleoso received his undergraduate degree at Pomona College, and his Masters of Science at Drexel University. He has served the United States as a Commissioned Officer First Lieutenant in the Army Reserves. He is a member of the Philadelphia College of Osteopathic Medicine class of 2024, and is a member of the residency graduating class of 2029 in the Department of Radiation Oncology at the University of Maryland. He joined the McClelland Lab in 2023 where he is performing analyses of the importance of faculty mentorship in creating and sustaining a diverse oncology workforce; this work has been recognized nationally by his selection to the National Medical Fellowships Health Equity Leaders Program.

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    Monique Westley, Pharm.D., D.Oc.

    Radiation Oncology Clinician-Researcher

     

    Monique Westley received her BS from Xavier University, after which she received her PharmD at Florida A&M University College of Pharmacy. She is a member of the New York Institute of Technology College of Osteopathic Medicine-Arkansas class of 2025 and aspires to become a Radiation Oncologist. She joined the McClelland Lab in 2023 where she has led American Radium Society award-winning work examing the impact of citation-based academic productivity on Radiation Oncology career advancement.

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    Maya Stephens, M.S., M.Dc.

    Radiation Oncology Clinician-Researcher

     

    Maya Stephens received her BS in Biology from Paine College, after which she received her MS in Global Health at Duke University examining the value of community health workers in addressing family planning needs in rural Ghana. She subsequently served as manager of the prestigious Suneja Lab in the Department of Radiation Oncology at the University of Utah where she conducted award-winning research under Dr. Gita Suneja MD MS before matriculating to the Medical College of Georgia class of 2027; she aspires to become a Radiation Oncologist. She joined the McClelland Lab in 2024 where she has worked to augment the Navigator-Assisted Hypofractionation (NAVAH) program to reduce breast cancer radiation therapy access disparities.

  • Clinical Trials

    Innovative, state-of-the-art cancer-killing clinical trials we are leading

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    Spine Patient Optimal Radiosurgery Treatment for Symptomatic Metastatic Neoplasms (SPORTSMEN)

    Phase II multicenter randomized controlled trial assessing the optimal radiation treatment [radiosurgery/stereotactic body radiation therapy (SBRT) versus conventional external beam radiation therapy (EBRT)] of symptomatic cancer that has spread to the spine for achieving pain freedom

    (ClinicalTrials.gov# NCT05617716)

     

    Creator: Shearwood McClelland III, M.D.

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    Radiosurgery Dose Reduction for Brain Metastases on Immunotherapy (RADREMI)

    Phase I multicenter study assessing the safety and efficacy of dose-reduced stereotactic radiosurgery with concomitant immunotherapy in treating cancer that has spread to the brain

    (ClinicalTrials.gov# NCT04047602)

     

    Creator: Shearwood McClelland III, M.D.

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    Navigator-Assisted Hypofractionation (NAVAH) Short-Course Radiation Therapy in Black Breast & Prostate Cancer Patients

    Single-arm clinical trial of Black/African-American breast & prostate cancer patients to assess the impact of patient navigation on radiation therapy (RT) completion, access to short-course RT, and financial toxicity

    (ClinicalTrials.gov# NCT05978232)

     

    Creator: Shearwood McClelland III, M.D.

  • Hello & Welcome!

    Thank you for your interest in joining The McClelland Lab. If you are a motivated, enthusiastic individual with a strong moral compass who is excited to learn and contribute to eradicating healthcare disparities in cancer care, you have come to the right place.

     

     

    Postgraduate Researchers:

    We are actively recruiting highly motivated postdoctoral research associates, staff scientists, community researchers, and biostatisticians. Please send a cover letter and CV to Dr. McClelland at drwood@post.harvard.edu.

     

    Medical Students:

    Medical students typically enter the lab as a summer research student between the first and second years of medical school. They may continue to be involved in research afterwards and/or set aside a dedicated research year in the lab.

     

    Undergraduate Students:

    We recommend that motivated students are willing to commit approximately 10 hours per week (the equivalent of a full summer) in the lab. If interested, please send a CV to Dr. McClelland at drwood@post.harvard.edu.

  • Special Thanks

    We cannot do this alone! We are grateful for the continued support of our patients, families, community and national partners, and benefactors.

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  • Donate

    Our research is conducted with the goal of eradicating disparities in cancer care. We continuously initiate and complete numerous research projects spanning multiple areas across all cancer types and locations. If you would like to financially support this important effort through your donation, please

    contact:

    University Hospitals Cleveland Medical Center

    Chesley Cheatham

    216-844-3814

    Chesley.Cheatham@uhhospitals.org

  • Lab Alumni

    Studs and stars who have helped contribute to our success

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    Alexandria Oliver, M.D., M.S.

    Lab Duration: 2021-2022

     

    Dr. Oliver received her BS in Biochemistry and Molecular Biology from Mercer University. She received her MS in Physiology and Biophysics and her MD from the University of Louisville School of Medicine. Dr. Oliver is a resident (graduating class of 2027) in the Department of Radiation Oncology at The Ohio State University Comprehensive Cancer Center. Her work in the McClelland Lab involved utilizing her expertise on racial disparities to help foster the Navigator-Assisted Hypofractionation (NAVAH) program, specifically to increase radiation therapy access for African-Americans with breast cancer.

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    Donnae Farquharson, M.S.

    Lab Duration: 2022-2023

     

    Donnae Farquharson received her BS in Exercise Physiology from the University of Miami, during which time she co-authored a basic science manuscript examining resveratrol preconditioning to protect limb function following rodent subarachnoid hemorrhage. She received her Masters of Science in Medical Physiology from Case Western Reserve University in 2023 and aspires to become a physician. Her work in the McClelland Lab involved assisting on nationally recognized projects spanning from NAVAH to diversity, equity and inclusion in the US Radiation Oncology workforce.

  • Awards

    2024 Fellowships at Auschwitz for the Study of Professional Ethics (FASPE) Medical Fellowship

    Dr. Laura E Flores, PhD MDc

    More information:

    https://www.faspe-ethics.org/announcing-our-2024-fellows/

    2024 American Radium Society Early Career Oncologist Award

    Monique N Westley, PharmD DOc

    More information:

    https://twitter.com/TheDrWood/status/1768747009077334246

    2024 American Radium Society Travel Grant Award

    Dr. Louisa Onyewadume, MD MPH

    More information:

    https://twitter.com/TheDrWood/status/1768743921159413843

    2024 American College of Radiation Oncology eContour/MIM Software Travel Award

    2023 National Medical Fellowships Health Equity Leaders Program

    Olufela A Jean-Koleoso, MS DOc

    More information:

    https://twitter.com/TheDrWood/status/1703870785088033132

    2023 American College of Radiation Oncology Dr. Luther Brady Educational Grant

    Dr. Michael Rooney, MD MSc

    More information:

    https://twitter.com/ACRORadOnc/status/1688960347276001280

    2023 National Institutes of Health / National Medical Association Travel Award

    2023 American Society for Radiation Oncology Medical Student Fellowship Award

    2023 American Society of Clinical Oncology Conquer Cancer Foundation Merit Award

    2023 American Radium Society Young Oncologist Travel Grant Award

    2023 Susan G Komen Career Catalyst Research Grant

    2023 Gilead Sciences Research Scholars Program Solid Tumor Award

    2022 American College of Radiation Oncology Global Radiation Oncology Workforce (GROW) Scholarship

    Dr. Teresa P Easwaran, MD MS

    More information:

    https://acro.org/page/ResidentGrantsWinners#GROW

    2022 American Society of Clinical Oncology Quality Care Symposium Conquer Cancer Foundation Merit Award

    2022 American Society of Clinical Oncology Conquer Cancer Foundation ASCO Employee Endowed Merit Award

    2021 Radiological Society of North America Trainee Research Prize

    2021 American Society of Clinical Oncology Conquer Cancer Foundation Merit Award

    2020 American Society of Clinical Oncology Conquer Cancer Foundation Blayney Endowed Merit Award

    2019 Radiological Society of North America Trainee Research Prize

    2018 Oregon Health & Science University Outstanding Research in Diversity and Health Disparities Award

    2018 American Society of Clinical Oncology Conquer Cancer Foundation Merit Award

    2018 American Radium Society Young Oncologist Travel Grant Award

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    Dr. Shearwood McClelland III, M.D.

    Department of Radiation Oncology

    University Hospitals Seidman Cancer Center

    Case Western Reserve University School of Medicine

    11100 Euclid Avenue

    Cleveland, OH 44106

    ph: 216-286-4149

    themcclellandlab@gmail.com