By: Elizabeth Chorney-Booth
Dr. Charlie Butts, senior medical oncologist at the Cross Cancer Institute, has treated patients with lung cancer for a long time and has seen a lot of changes in the field of cancer care. While decades of working in an area of oncology that tends to involve difficult and heartbreaking prognoses can be challenging for a physician, Butts is motivated by the knowledge that he can improve his patients’ survival rate — as well as the patients that come after them — by helping advance new treatments through groundbreaking clinical trials.
Butts grew up in Nova Scotia and completed his medical training at Dalhousie University in 1985 before starting a family practice. But the scientist in him — he has a background in biochemistry — led Butts down a new path. He did his oncology training at the University of Ottawa and the Ottawa Regional Cancer Centre. After finishing the training in 1993, he returned to Halifax to treat patients with cancer, eventually choosing to specialize in thoracic malignancies, and more specifically, lung cancers. Before too long, the prospect of making a widespread difference by participating in clinical trials research called to him. In 1998, Butts moved across the country to accept a position at the Cross Cancer Institute in Edmonton, which has a robust culture of participating in various clinical trials at almost every stage of the process.
“The only way to get better is to look for new ways to do things and to develop new treatments,” Butts says. “When I was in Halifax, we had fairly active clinical trials, though nowhere near the size of what we have at the Cross. Part of the reason to move here were all the opportunities working at the Cross affords in terms of clinical research and teaching, with the residency training program here, as well.”
Much of what makes clinical trial work so meaningful, especially over the course of a long career, is the opportunity for doctors to see the real-life impacts of their research. Since going into oncology, he’s seen five- year lung cancer survival rates go from 10 per cent to 25 per cent and higher, resulting from new treatments and medications tested on patients like his at the Cross and other institutions enrolled in clinical trials. Twenty-five per cent is still a relatively sobering rate of survival (but a huge deal for that 15 per cent of patients affected). However, Butts believes there’s potential to improve that rate substantially, as we’ve seen in many other types of cancers, such as breast and prostate cancers. It’s that promise that keeps him pushing forward.
“One of the most rewarding things for an oncologist is to be involved in clinical trials that make a difference to patient outcomes and change the standards of practice. Not only do your patients benefit from being in the trial, but patients everywhere benefit from that research,” Butts says. “The difference you make is magnified because it can be applied everywhere and not just with the patient in front of you today.”
Since Butts started at the Cross, his research can roughly be broken down into three areas that have positively impacted patients with thoracic cancers. Firstly, one of his most significant and successful clinical trials projects has been the study of how adjuvant chemotherapy — that is, chemo given after a different form of primary treatment, rather than acting as the primary treatment itself — following the surgical resection of non-small cell lung cancer could lead to longer-term survival for patients. Secondly, Butts experienced similarly successful results with trials exploring the introduction of immunotherapy drugs. And, thirdly, he has helped to expand the understanding that not all lung cancers are the same and that some respond to specific treatments differently. The treatments Butts helped pioneer through these trials have become accepted standards of care, changing how oncologists approach lung cancer.
While patient care remains his primary passion, over the years, Butts has taken that calling to a higher level by becoming involved with medical leadership roles in Alberta. From July 2019 to December 2021, he served as the acting medical director of the Cross Cancer Institute, as the associate senior medical director, Cancer Care Alberta for Alberta Health Services’ Cancer Care, and as the Edmonton zone clinical department head of oncology for Alberta Health Services’ Cancer Care, in addition to many other roles held over the years. (These days, Butts still sees patients and does clinical trials research, but is no longer in a medical leadership role.) While these positions put a lot on Butts’ plate, he views them as tools to make an even bigger difference for Albertans with cancer.
“Being involved in the trials is one thing, but medical leadership and being able to help promote our clinical trials unit, and to advocate for the clinical trials in terms of support and access for patients, can magnify the impact you have,” he says. “If you can do something to change the system, you potentially impact every patient who walks in the door — not just here at the Cross, but anywhere in the province.”
Butts has also mentored and inspired his colleagues, both in those leadership roles and through his patient practice and clinical research. Dr. Randeep Sangha, a fellow oncologist and clinical researcher at the Cross, says Butts is “on the Mount Rushmore of Cross Cancer Institute influential leaders.
“It is uncommon to find a leader able to juggle the spheres of being a clinician, researcher, educator and administrator. He has performed these roles throughout his career to such a high level that he is widely respected by his colleagues locally, nationally and internationally. He is humble, calm, professional and an excellent mentor for all oncologists.”
Butts credits the Alberta Cancer Foundation for supporting clinical trials work and promoting the concept of this research, which makes patients more aware of what clinical trials are and how they can benefit not only their own treatment, but that of future patients. He says Albertans’ pioneering spirit has made our population particularly open to participating in clinical research, which is part of what has made research at the Cross so rewarding.
“We’ve come a long way with lung cancer treatments, but we still have a long way to go,” Butts says. “That’s what really drives us here at the Cross. It’s all about trying to get access to new treatments for our patients. The drive to be able to do better for our patients is never going to go away.”
Three Questions with Dr. Charlie Butts:
Q: What do you do to relax?
“I like to spend time with my wife; that’s number one. We still have a place in Nova Scotia we go to every summer, and it’s very relaxing for us. I also like to cook, and I’m a big sports guy. I watch a lot of sports and I curl a couple times a week.”
Q: If you weren’t in your current job, what would you be doing?
“When I started university, I was going to go into journalism to become a sports broadcaster. If I had an alternative career that I could pick, that probably would be it.”
Q: Where do you get your best ideas?
“One of the fortunate things about being at a place like the Cross is you have a lot of colleagues. Talking to them and hearing what they’re doing is an important way to get ideas.”