Jason Paisley has one of the most important and interesting jobs that you’ve probably never heard of. As a medical physicist, he’s one of only about 9,000 in the United States.
Growing up in Jamaica, he thought he might become an engineer or a boat captain – maybe even an astronaut.
“Then I realized that Jamaica didn’t have a space program, I was like, ‘OK, well, I guess that’s out,’” he joked.
But Paisley’s interests, along with Jamaica’s STEM-focused school curriculum, motivated him to pursue a college degree in a different science-related field, chemistry. Then a job at a pharmacy and a bit of serendipity led him to discover the vocation he is passionate about today.
As chief medical physicist for Novant Health New Hanover Regional Medical Center, Paisley leads the medical physics team. A big part of his job is ensuring that every patient receiving radiation oncology treatment gets the correct amount of radiation. Entrenched in constant learning and research, he sees an exciting future for the world of medical physics, with the use of radiation therapy branching well beyond cancer treatment.
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Another form of light
Therapeutic medical physics, the practice of using radiation for medical treatments, is a complex field. Although neither visible nor tangible, radiation is a powerful form of energy that is naturally present all around us.
“It's just another form of light,” Paisley said. “There’s an electromagnetic spectrum and a very narrow band of it is visible light. … Radiation is a different color of light that you can't see. The energy is high enough, and we can manipulate it to do what we want.” In radiation oncology, that means Paisley is manipulating it to kill cancer cells.
In external beam radiation therapy, radiation is delivered through a machine directly to the cancer site. The radiation machines at New Hanover Regional Medical Center are linear accelerators, or LINACs. “They're essentially high-energy x-ray machines,” Paisley said. “If you take an x-ray, and really ramp up the energy, then you get therapeutic radiation.”
In the main radiation oncology building on South 16th Street in Wilmington, there are three LINACs, and the medical physics team is responsible for their safe operation.
“We perform daily testing of these,” Paisley said. “And that is just part of our commitment to quality.” Paisley and his team also regularly send a dose of radiation to an outside lab to make sure their measurements match.
Another form of radiation therapy, called brachytherapy, involves implanting tiny, sealed pieces of radioactive material inside the body. These implants may be temporary or permanent, but the radiation eventually dissipates. Paisley’s team is heavily involved throughout the process, from treatment planning to surveying the patient to make sure there’s no radiation before and after the procedure.
A hands-on job
All radiation treatment starts with an individual, customized treatment plan. Once the oncologist determines the treatment area and radiation dosage, Paisley and his team of treatment planners get busy.
“What we're looking for is, is this plan technically sound? Are there going to be any issues with it? And could it be better?” Paisley said. “Then, once it passes through our checks, the physician reviews it, and makes sure they're happy with it, because we look at plans very differently. Then we know that it's ready to be delivered to the patient.”
One of Paisley’s favorite parts of his job is evaluating and selecting technology and equipment, including thermoplastic masks and molds that are used when a patient receives radiation treatment with a LINAC.
A custom-made mask or mold ensures the targeted body part is in the exact correct position for each treatment, allowing the radiation delivery to be precise. Cancer of the head or neck requires a mask of the patient’s head. Some masks are open around the nose and mouth, while others cover the entire face. Paisley gets hands-on while selecting the best materials and vendors for masks and molds.
“I like to try the stuff on myself so I can evaluate it. Because otherwise how do you know what it feels like, if you never get one put on?” he said.
Where it started, where it’s going
We’ve all heard of using radiation to treat cancer, but Paisley’s job is still little-known. He said he was recently surprised when a woman at the grocery store commented on his T-shirt, which read “medical physics” on it, and knew exactly what that meant. It turned out that she’d received radiation treatments and learned how important the job is.
Even Paisley himself only discovered the field through “a complete accident.” After earning a chemistry degree from Wesleyan University in Middletown, Connecticut, he got a job in a pharmacy where radioactive medications were made. After the medications shipped out, Paisley didn’t know where they went. Curious, he did some research and started learning about the field of medical physics. He thought, “This is something I would like to do.”
Paisley applied to Duke University in Durham, North Carolina, and was accepted. He earned his master’s degree in medical physics in 2009, moved to Wilmington in 2012 and has been chief of medical physics for New Hanover Regional Medical Center since 2014.
Paisley never stops in his pursuit of knowledge and planning for what’s next to come in his fast-evolving field, even carving time out on his days off, spent with his wife and two children, for reading and research. He frequently attends conferences to learn about new radiology technology and is a volunteer examiner with the American Board of Radiology, the organization that certifies professionals in his field.
“I really like to learn, and so medical physics is a perfect job for that because there's always something that you're learning,” he said.
A big part of Paisley’s role is planning for what’s next. One development that he said is showing great progress is using radiation to treat osteoarthritis.
“It's something that is very popular in Europe. … Our team is doing it here in Wilmington,” he said.
This exploration and expansion into using radiation for new and different medical purposes is one of the reasons that Novant Health will soon begin a residency program in Wilmington for medical physicists.
“We know that we do a lot of good physics work here and we have all the tools to train physicists,” Paisley said. “So we thought, wouldn't it be neat if we could build a training program here in Wilmington, to help attract and retain physicists to this part of the state?”
Building the residency program, set to begin in July 2023, is a process that Paisley described as both a lot of a fun and a lot of work. His physics team in Wilmington worked with other Novant Health physicists in Charlotte and Winston-Salem to create the program. Paisley will get to pass on his love of learning to new medical physicists and train them within New Hanover Regional Medical Center’s radiation oncology program. Paisley is problem-solving and helping to save lives today, while ensuring the medical physics program continues beyond his tenure with new talent in the future.
“I don’t think it gets better than that,” he said.