Giants of Radiation Oncology:

Frank Ellis, MBChB, OBE (1905-2006)

At the age of 5, Frank Ellis decided he was going to become a doctor. In school, he enjoyed physiology, disappointed that his chemistry lectures began with memorizing the periodic table. “I didn’t like memorizing isolated facts. I like things to be built up,” he later recalled. Ellis attended the University of Sheffield where an eye infection during his last year of training sent him to bed for almost two months in agonizing photophobia and pain.

It would not be until he was assigned to “poison gas” duty at Sheffield Hospital during World War II that he read about a new medication called sulfacetamide that could be used to treat people whose eyes had been exposed to nitrogen mustard. Although thankfully no citizens of Sheffield were ever exposed to the gas, Ellis’ eight-year struggle with keratitis cleared up after five days of treatment.

The eye infection scrapped his plans to travel to Africa after medical school, so a friend passed along a job posting for the newly created position of radium officer at the Royal Hospital of Sheffield. After the interview, Ellis was offered the position and accepted. The job included six months of funding for travel to learn about radium and an annual salary of £600 (roughly $9,000). In late 1930, the 25-year-old Ellis, still suffering from keratitis, left Sheffield for Middlesex Hospital in London where he learned to measure radium dose. He then embarked on a European tour through Belgium, Sweden and Germany.

Upon returning from his six months abroad, the energetic new radium officer was shown his new department, an empty operating room. Undeterred, he secured a table and a desk for his department, then went about organizing the radium and looking for business. Through thoughtful observations of his surgical colleagues’ techniques and human anatomy, Ellis became a passionate proponent of intraoperative and interstitial radiotherapy.

While observing the chief of surgery “fidgeting about” during a radium case, the frustrated surgeon stepped aside and asked Ellis if he would like to try. Recalled Ellis, “I did them all after that.” The chief of obstetrics and gynecology readily relinquished his brachytherapy cases as well. Ellis was soon performing 125-mg radium implants every morning including most weekends for almost 12 years.

Ellis planned each case using the tables included in a book he brought back from Germany. He also performed a cystoscopy on every gynecological patient prior to implant and even borrowed a portable x-ray machine from the children’s hospital to ensure his “spreader,” an early prototype of the Suit applicator, was in place. Ellis followed his patients closely, learning as he went, and dedicated one day each year to tracking down the dozen or so patients who had been lost to follow-up.

In 1934, Ellis began to use wedge filters made of wood and filled with rice flour, an innovative technique that allowed shaping of the beam while ensuring a uniform dose distribution. His graduate student and long-time friend, noted radiobiologist Eric Hall recalled, “[Ellis] was always thinking of something new, and that exasperated his colleagues who were more set in their ways.”

In 1943 and amid World War II, Dr. Ellis accepted a position as the first director of the radiotherapy department at Royal London Hospital. Concerned about the risk of contamination should a bomb hit the hospital, Ellis hired a moving van to transport their radium stock to a safer location. After the war, Ellis moved to the Churchill Hospital in Oxford, UK, where he built yet another radiotherapy department.

During this time, Ellis developed the concept of nominal standard dose (NSD), a revolutionary idea that for the first time allowed comparison of the effect of different radiation fractionation and protraction regimens on normal tissues. Ellis drilled into the hundreds of trainees who came to study under him that any statement was open to questioning and that improvement was always possible. He served as medical director at Oxford from 1950-1970 when he retired at the government mandated age of 65 and is considered by many to be Britain’s most eminent radiation oncologist.

In retirement, Ellis served as a visiting professor at numerous institutions worldwide and received many awards for his contributions to the field of radiation oncology, including the Order of the British Empire (OBE), bestowed by the Queen in 2000. He served as president of the British Institute of Radiology, received the Gold Medal of the Royal College of Radiologists and honorary recognition from the Hospital Physicists’ Association (which, by 1997, through a series of organizational mergers, had become the Institute of Physics and Engineering in Medicine and Biology), the American Association of Physicists in Medicine, the American College of Radiology, the American Society for Radiation Oncology, and many others. At the age of 100, he received an honorary Doctor of Science degree from his alma mater, Sheffield University.

A lifelong Christian and supporter of the Society of Friends, he believed in peace and the inherent goodness of people. He died in Oxford, UK, on February 3, 2006. He was preceded in death by his beloved wife, Dorothy, and survived by four children, and dozens of grand and great-grandchildren.

In 1993, an 88-year-old Ellis sat for a videotaped interview. Midway through the conversation, the operator zoomed in on the tie worn by the aging physician. Repeating gold figures of atoms surrounded by the serpents of the medical caduceus cascaded down a navy silk background. The tie was a gift from the Hospital Physicist Association Ellis said, and “represents my philosophy.” The atoms depict science, “the only truth we are sure of,” and the intertwined serpents represent “looking out for other people.” In his long career of care and discovery, Dr. Frank Ellis passionately pursued both.