Director of Palliative Medicine
Education and Experience
- Yale University School of Medicine (New Haven CT)/ (1979)
- Hospital of the University of Pennsylvania (Philadelphia PA)/ Internal Medicine (1982)
- Virginia Commonwealth University Health System (Richmond VA)/ Intermal Medicine Hematology/Oncology (1987)
- Hospice and Palliative Care, American Board of Internal Medicine (2008)
- Medical Oncology, American Board of Internal Medicine (1987)
- Internal Medicine, American Board of Internal Medicine (1982)
- Sidney Kimmel Comprehensive Cancer Center
Director of Palliative Medicine
- Advanced Pain Management
- Breast Cancer
- Hospice and Pallative Medicine
- Medical Oncology
- Palliative Care
26. Hillner BE, Smith TJ. Cost effectiveness and other assessments of adjuvant therapies of early breast cancer. Oncology. 1995;9(11S):129-34.
27. Franzak FJ, Smith TJ, Desch CE. Marketing cancer care to rural residents. J Public Policy Marketing. 1995; 14:76-82
28. Desch CE, Hillner BE, Smith TJ. Economic considerations in the care of lung cancer patients. Curr Opin Oncol. 1996;8:126-32.
29. Smith TJ, Hillner BE, Neighbors DN, McSorley PA, Le Chevalier T. Efficacy and cost effectiveness of chemotherapy for non-small cell lung cancer: results from a clinical trial comparing vinorelbine, vinorelbine plus cisplatin, and vinorelbine plus cisplatin. J Clin Oncol.1995;13:2166-73.
30. Smith TJ, Penberthy L, Desch CE, Whittemore M, Newschaffer C, Hillner BE, McClish D, Retchin SM. Differences in initial treatment patterns and outcomes of lung cancer in the elderly. Lung Cancer 1995;13:235-52.
31. Smith TJ, Bodurtha JN. Ethics in Oncology: Balancing interests of the patient, oncologist, and society. J Clin Oncol. 1995;13:2464-70.
32. Bennett CL, Smith TJ, George SL, Hillner BE, Fleishman S, Neill B. Free Riding and the Prisoner''s Dilemma: problems in funding economic analyses of phase III cancer clinical trials. J Clin Oncol. 1995;13:2457-63.
33. Smith TJ. Decision Analysis in Oncology. Oncology 1995;9S:37-46.
34. Desch CE, Penberthy LP, Newschaffer CJ, Hillner BE, Whittemore J, McClish D, Smith TJ, Retchin SM. Factors that determine the treatment for local and regional prostate cancer. Medical Care 1996;34:152-162.
35. Hillner BE, Desch CE, Carlson RW, Smith TJ, Esserman L, Bear H. Tradeoffs between survival and breast preservation for three initial treatments of ductal carcinoma of the breast. J Clin Oncol. 1996;14:70-77.
36. Desch CE, Smith TJ. Defining treatment aims and end-points in older patients with cancer. Drugs & Aging 1995;6:351-357.
37. Hillner BE, Smith TJ. Cost-effectiveness analysis of three regimens using vinorelbine(Navelbine) for non-small cell lung cancer. Seminars in Onc.1996;23 (S):25-30.
38. Smith TJ. Economic analysis of CSFs. Curr Opin Hemat 1996;3:175-179. Teague KE, Brown JA, Meyer JM, Kahn MJK, Smith TJ, Bodurtha JN. Teaching efficacy of a medical education module on genetic testing for breast cancer. J Cancer Educ. 1996;11:196-202.
39. Hillner BE, Penberthy L, Desch CE, McDonald MK, Smith TJ, Retchin SM. Variation in staging and treatment of local and regional breast cancer in the elderly. Breast Cancer Research and Treatment 1996;40:75-86.
40. Hillner BE, McDonald MK, Penberthy L, Desch CE, Smith TJ, Maddox P, Glasheen WP, Retchin SM. measuring standards of care for early breast cancer in an insured population. J Clin Oncol 1997;15:1401-1408.
41. Winn RJ, Smith TJ. The American Society of Clinical Oncology Guideline Program. Pharmacy Practice Management Quarterly 1996;16:31-38.
42. Smith TJ, Desch CE, Grasso MA, McCue MJ, Buonaito D, Grasso K, Johantgen ME, Hackney MH, Shaw JE, Simonson CJ. The rural cancer outreach program: clinical and financial analysis of palliative and curative care for an underserved population. Cancer Treatment Reviews 1996;22S:97-101.
43. Hillner BE, Smith TJ. Cost effectiveness and other assessments of adjuvant therapies for early breast cancer. Oncology 1995;9S:129-134.
44. Desch CE, Smith TJ. Economic considerations in the care of lung cancer patients. Current Opinion in Oncology 1996;8:126-132.
45. Smith TJ, Hillner BE, Schmitz N, Linch DC, Dreger P, Goldstone AH, Boogaerts MA, Ferrant A, Link H, Zander A, Yanovich S, Kitchin R, Erder MH. Economic. Analysis of a Randomized Clinical Trial to Compare Filgrastim-Mobilized Peripheral Blood Progenitor Cell Transplantation and Autologous Bone Marrow Transplantation in Patients with Hodgkin and Non-Hodgkin Lymphoma. J Clin Oncol. 1997;15:5-10.
46. Bennett C, Smith TJ, Weeks J, Bredt J, Feinglass J, Fettting J, Hillner B, Somerfield M, Winn R. Use of hematopoietic colony stimulating factors: Am Soc Clin Onc Survey. J Clin Oncol 1996;14:2511-2520.
47. Hillner BE, Kirkwood JM, Atkins MB, Johnson ER, Smith TJ. Economic Analysis of Adjuvant Interferon-alpha B in High Risk Malignant Melanoma. J Clin Oncol 1997;15:2351-2358.
48. Hillner BE, McDonald MK, Desch CE, Smith TJ, Penberthy LT, Maddox P, Retchin SM. Costs of care associated with non-small cell lung cancer in a commercially insured cohort. J Clin Onc. 1998;16:1420-1424.
49. Smith TJ, Hillner BE, Mitchell RB. Editorial. Decision analysis in non-small cell lung cancer: not back to the modeling board, back to the bedside. J Clin Oncol 1997;15:870-872.
50. Milanese S, Hansen LA, Desch CE, Honeycutt C, Tesfaye F, Smith TJ. Impact of histamine and histamine-2 receptor antagonists on quality of life and anti-tumor response: results of a pilot trial. Eur J Cancer. 1998; 33(14):2436-2437.
51. Smith TJ, Desch CE, Hackney MH, Shaw JE. How long does it take to get a do not resuscitate order? J Palliat Care 1997;13:5-8.
52. Smith TJ, Somerfield MR. The ASCO experience with evidence-based clinical practice guidelines. Oncology 1997;11(Suppl 9):1-5.
53. Bloomfield DJ, Krahn MD, Neogi T, Panzarella T, Smith TJ, Warde P, Willan AR, Ernst S, Moore MJ, Neville A, Tannock IF. Economic evaluation of chemotherapy with mitoxantrone plus prednisone for symptomatic hormone resistant prostate cancer, based on a Canadian randomized trial with palliative endpoints. J Clin Oncol.1998, 16:2272-2279.
54. Smith TJ, Somerfield MJ, Desch CE, David M. Would oncologists want chemotherapy if they had non-small cell lung cancer? Results of a 1997 survey. Oncology. 1998;12:360-65.
55. Desch CE, Grasso M, McCue M, Buonaiuto D, Grasso K, Smith TJ. A rural cancer outreach program lowers patient care costs and benefits both the rural hospitals and sponsoring academic medical center. J Rural Health, 1999;15:157-167.
56. Smith TJ, Schnipper LJ. The American Society of Clinical Oncology Program to Improve End of Life Care. J Palliative Medicine. 1998;1:221-230.
57. Penberthy L, Retchin SM, McDonald MK, McClish DK, Desch CE, Smith TJ, Hillner BE, Newschaffer CJ. Predictors of Medicare costs in elderly beneficiaries with breast, colorectal, lung, or prostate cancer. Health Care Manag Sci 1999;2:149-60.
58. Smith TJ. Health service studies in the terminally ill patient. Cancer Treat Res.1998;97:81-97.
59. Hillner BE, McDonald MK, Desch CE, Smith TJ, Penberthy LT, Retchin SM. A comparison of patterns of care of nonsmall cell lung carcinoma patients in a younger and Medigap Commercially insured cohort. Cancer 1998;83:1930-7.
60. Desch CE, Penberthy LT, Hillner BE, McDonald MK, Smith TJ, Pozez AL, Retchin SM. A sociodemographic and economic comparison of breast reconstruction, mastectomy, and conservative surgery. Surgery, 1999; 125:441-447.
61. Hillner BE, Smith TJ, Desch CE. Hospital and physician volume or specialization and outcome in cancer treatment. J Clin Onc. 2000;18:2327-2340.
62. Somerfield MR, Stefanek ME, Smith TJ. A systems model for adaptation to somatic distress among cancer survivors. Psycho-oncology, 1999, 8:334-343.
63. Smith TJ, Hillner BE. Clodronate reduced the incidence of bony and visceral metastases in patients with breast cancer and tumor cells in the bone marrow. Evidence-Based Medicine. 1999;4:43.
64. Smith TJ, Hillner BE. Tamoxifen should be cost-effective in reducing breast cancer risks in high- risk women. J Clin Onc. 2000, 18:284-286.
65. Bennett CL, Weeks JA, Somerfield MR, Feinglass J, Smith TJ. Use of Hematopoietic Colony Stimulating Factors: Comparison of the 1994 and 1997 Am Soc Clin Onc Surveys Regarding ASCO Clinical Practice Guidelines. J Clin Oncol, 1999,17: 1-6.
66. Arthur DW, Schmidt-Ullrich RK, Friedman RB, Wazer DE, Kachnic LA, Amir C, Bear HD, Hackney MH, Smith TJ, Lawrence W. Accelerated Superfractionated Radiotherapy for Inflammatory Breast Carcinoma: Complete Response Predicts Outcome and Allows for Breast Conservation. Int J Rad Onc Biol Phys.1999; 44:289-296.
67. Bennett CL, Bishop MR, Tallman MS, Somerfield MR, Feinglass J, Smith TJ. for the Health Services Research Committee of Am Soc Clin Onc. The association between physician reimbursement in the US and use of hematopoeitic colony stimulating factors as adjunct therapy for older patients acute myeloid leukemia: Results from the 1997 Am Soc Clin Onc survey. Ann Oncol, 1999;10:1355-1359.
68. Hillner BE, Weeks JC, Smith TJ, Desch CE. Pamidronate in prevention of bone complications in metastatic breast cancer: a cost effectiveness analysis. J Clin Onc, 2000, 18:72-79.
69. Smith TJ. Future strategies needed for palliative care. Seminars in Radiation Oncology, 2000, 10:254-261.
70. Smith TJ. Tell it like it is. J Clin Onc, 2000; 18:3441-3445.
71. Smith TJ, Girtman J, Riggins J. Why Academic Divisions of Hematology/Oncology Are in Trouble and Some Suggestions for Resolution. J Clin Onc. 2001;19:260-264.
72. Smith TJ, Hillner BE. Ensuring Quality Cancer Care by the Use of Clinical Practice Guidelines and Critical Pathways. J Clin Oncol. 2001; 19: 2886-2897.
73. Coyne P, Ramakrishnan V, Smith TJ. Nebulized fentanyl improves patients perception of breathing, respiratory rate, and oxygen saturation in dyspnea. J Pain Symptom Management, 2002; 23: 157-60.
74. Smith TJ, Staats PS, Deer T, Stearns LJ, Rauck RL, Boortz-Marx RL, Buchser E, Catal E, Bryce DA, Coyne PJ, Pool GE; Implantable Drug Delivery Systems Study Group. Randomized clinical trial of comprehensive medical management of refractory cancer pain vs. comprehensive medical management plus intrathecal implantable drug delivery systems. J Clin Onc. 2002; 20: 4040-9
75. Quillin JM, Boardman CH, Bodurtha J, Smith T. Preventive gynecologic surgery for BRCA1/2 carriers-information for decision-making. Gynecol Oncol. 2003; Oct;83(1):168-70
76. Smith TJ, Cassel JB, Coyne PS, Hager MA. A high-volume specialist palliative care unit and team may reduce in-hospital end-of-life care costs. J Pall Med. 2003;6:699-705.
77. Smith TJ. Medically appropriate follow up of the patient with lung cancer: an evidence based approach. Seminars in Oncology, June 2003:30;361-368.
78. Smith TJ, Coyne P, Staats P. Implantable drug delivery systems: what is the evidence? Supportive Cancer Therapy. 2004:1:1-5.
79. Smith TJ, Coyne P. How to use implantable intrathecal drug delivery systems for refractory cancer pain. J Supportive Oncology. 2003:1:1-4.
80. Smith TJ. We can reduce the cost of in-hospital end of life care. Oncology Times. 2003;225(11):4-6.
81. Penberthy L, McClish D, Manning C, Retchin S, Smith TJ. The Added Value of Claims for Cancer Surveillance: Results of Varying Case Definitions. Med Care. 2005 Jul;43(7):705-12.
82. Smith TJ, Swainey C, Coyne PJ. Pain Management, including Intrathecal Pumps. Curr Oncol Rep. 2004 Jul;6(4):291-6.
83. Coyne PJ, Hansen L, Laird J, Buster P, Smith T. "Massive Hydromorphone Dose Delivered Subcutaneously Instead of Intrathecally : Guidelines for Prevention and Management of Opioid, Local Anesthetic and Clonidine Overdose." J Pain Symptom Management 2004: 28/3:273-276.
84. Smith TJ, Coyne PJ, for the Cancer Pain Trial investigators. Implantable drug delivery systems (IDDS) after failure of comprehensive medical management (CMM) can palliate symptoms in the most refractory cancer pain patients. J Pall Med. 2005; 8(4):736-42.
85. Smith TJ, Coyne PJ, Smith WR, Roberts JD, Smith VS. Use of an Implantable Drug Delivery System for Refractory Chronic Sickle Cell Pain. Am J Hematology. 2005; Feb;78(2):153-4.
86. Smith TJ, Coyne PJ, Staats PS, Deer T, Stearns LJ, Rauck RL, Boortz-Marx RL, Buchser E, Catal E, Bryce DA, Cousins M, Pool GE. Intrathecal implantable drug delivery systems give sustained pain control, less side effects, and possibly better survival for six months: results of a randomized clinical trial vs. comprehensive medical management. Ann Oncol. 2005; May;16(5):825-33. Epub 2005 Apr 7.
87. Khatcheressian J, Cassel JB, Lyckholm L, Coyne P, Hagenmueller A, Smith TJ. Improving palliative and supportive care in cancer patients. Oncology (Williston Park). 2005; Sep;19(10):1365-76; discussion 1377-8, 1381-2, 1384 passim.
88. Khatcheressian JL, Smith TJ. (Ed) Randomized Trial of Long-Term Follow-Up for Early- Stage Breast Cancer: A Comparison of Family Physician Versus Specialist Care. J Clin Oncol. 2006;24:1-3.
89. Matsuyama R, Reddy SN, Smith TJ. Why do patients choose chemotherapy near the end of life? A review of the perspective of those facing death from cancer. J Clin Oncol. 2006; Jul 20;24(21):3490-6.
90. White K, Stover KG, Cassel JB, Smith TJ. Nonclinical outcome of hospital based palliative care. J Healthcare Management. 2006;51:253-265.
91. Sterling RK, Lyons CD, Stravitz RT, Luketic VA, Sanyal AJ, Carr ME, Smith TJ, Hackney MH, Contos MJ, Mills SA, Kuhn JG, Nolte ME, Shiffman ML. Percutaneous liver biopsy in adult haemophiliacs with hepatitis C virus: safety of outpatient procedure and impact of human immunodeficiency virus coinfection on the spectrum of liver disease. Haemophilia. 2007; Mar;13(2):164-71.
92. Hillner BE, Smith TJ. Do the large benefits justify the large costs of adjuvant breast cancer trastuzumab? J Clin Oncol. 2007; Feb 20;25(6):611-3.
93. Kelso CM, Lyckholm LJ, Coyne PJ, Smith TJ. Palliative care consultation in the process of organ donation after cardiac death. J Palliat Med. 2007; Feb;10(1):118-26. Review.
94. Khatcheressian J, Smith TJ. Review: adding cytotoxic drugs to a chemotherapy regimen increases tumor response rates and toxicity, but not survival in metastatic breast cancer.ACP J Club. 2007; Jan-Feb;146(1):5.
95. Lingerfelt BM, Swainey CW, Smith TJ, Coyne PJ. Nebulized lidocaine for intractable cough near the end of life. J Support Oncol. 2007; Jul-Aug;5(7):301-2
96. Chao BH, Cline-Parhamovich K, Grizzard JD, Smith TJ. Fatal Loeffler''s endocarditis due to hypereosinophilic syndrome. Am J Hematol. 2007; Oct;82(10):920-3.
97. Matsuyama, RK, Grange C, Lyckholm LJ, Utsey SO, Smith TJ. Cultural Perceptions in Cancer Care among African-American and Caucasian Patients. Jrnl Ntl Med Assoc. 2007; 99(10):1113-1119
98. Khatcheressian J, Smith TJ. Symptom-oriented follow-up of early breast cancer - as good as conventional control and sparing resources. Onkologie. 2007; Sep;30(8-9):410-2.
99. Grange C, Matsuyama RK, Ingram K, Lyckholm LJ, Smith TJ. Identifying supportive and unsupportive responses of others: Perspectives of African-American and caucasian cancer patients. J Psychosoc Oncol. 2008;26(1):81-99.
100. Chao BH, Stogner-Underwood KA, Kiev J, Smith TJ. Intrathoracic malignant peripheral nerve sheath tumor in neurofibromatosis 1. J Clin Oncol. 2008 May 1;26(13):2216-8.
101. Quillin JM, Bodurtha JN, Smith TJ. Genetics assessment at the end of life: suggestions for implementation in clinic and future research. J Palliat Med. 2008 May-Jun;11(3):451-8.
102. Harrington SE, Smith TJ. The role of chemotherapy at the end of life: "When is enough, enough?" JAMA. 2008; Jun 11;299(22):2667-78.)
103. Coyne P, Smith T, Bobb B, Lyckholm L. Epidural Screening Before Intrathecal Analgesia. J Pain & Palliative Care Pharmacotherapy 2008; 22:69-70.
104. Smith TJ. Magnesium supplements for menopausal hot flashes. J Clin Oncol. 2009 Mar 1;27(7):1151-2. Epub 2009 Jan 26.
105. Dow LA, Matsuyama RK, Ramakrishnan V, Kuhn L, Lamont EB, Lyckholm L, Smith TJ. Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directives. J Clin Oncol. 2010 Jan 10;28(2):299-304. Epub 2009 Nov 23.
106. Cassel JB, Hager MA, Clark RR, Retchin SM, Dimartino J, Coyne PJ, Riggins J, Smith TJ. Concentrating hospital-wide deaths in a palliative care unit: the effect on place of death and system-wide mortality. J Palliat Med. 2010; Apr;13(4):371-4.
107. Smith TJ, Dow L, Virago E, Khatchressian J, Matsuyama R, Kuhn L, Lyckholm L. Giving honest information to patients with advanced cancer maintains hope. Oncology (Williston Park). 2010; May; 24(6):521-5.
108. Smith TJ, Coyne PJ, Parker G, Dodson P. Pilot trial of a Patient-specific Cutaneous Electro-stimulation Device (MC5-A Calmare) for Chemotherapy Induced Peripheral ] Neuropathy. J Pain Symptom Manage. 2010; Dec;40(6):883-91.
109. Newport K, Patel S, Coyne P, Lyckholm L, Dow LA, Smith TJ. The PSOST a sign out tool for Practitioners Orders about Life Sustaining Treatment. J Palliat Med.. 2010; Sep;13(9):1055-8.
110. Cassel JB, Kerr K, Pantilat S, Smith TJ. Palliative care consultation and hospital length of stay. J Palliat Med. 2010 Jun;13(6):761-7. Review.
111. Quillin J, Bodurtha JN, Siminoff LA, Smith TJ. "Exploring Hereditary Cancer among Dying Cancer Patients A Cross-Sectional Study of Hereditary Risk and Perceived Awareness of DNA Testing and Banking" J Genetic Counseling, 2010 Oct;19(5):497-525.
112. Roberts SB, Coyne PJ, Smith TJ, Lyckholm LL. Palliative Use of Aminocaproic Acid to Control Upper gastrointestinal Bleeding. J Pain Symptom Mgmt. 2010; Sep;40(3):e1-3. Epub 8/1/10
113. Lyckholm LL, Coyne PJ, Kreutzer KO, Ramakrishnan V, Smith TJ. Barriers to Effective Palliative Care for Low- Income Patients in Late Stages of Cancer: Report of a Study and Strategies for Defining and Conquering the Barriers. Nurs Clin N Am. 2010; 45:399409
114. Salloum RG, Smith TJ, Jensen GA, Elston Lafata J, Using Claims-Based Measures to Predict Performance Status Score in Lung Cancer Patients. Cancer. 2011 Mar 1;117(5):1038-48.
115. Cassel JB, Jones AB, Meier DE, Smith TJ, Spragens LH, Weissman D. Hospital mortality rates: How is palliative care taken into account. J Pain Symptom Manage. 2010; Oct 27. [Epub ahead of print]
116. Cassel JB, Webb-Wright J, Holmes J, Lyckholm L, Smith TJ. Clinical and financial impact of a palliative care program at a small rural hospital. J Palliat Med. 2010; Nov;13(11):1339-43. Epub 2010 Oct 30.
117. Hillner BE, Smith TJ. Explaining Marginal Benefit to Patients. Clin Cancer Res. 2010; Dec 15;16(24):5981-6.
118. Hillner BE, Smith TJ. Allocating cancer-directed expenditures-tension between prevention, early detection, and treatment. Recent Results in Cancer. 2011;188:1-9.
119. Swetz KM, Smith TJ. Palliative chemotherapy: when is it worth it and when is it not? Cancer J. 2010; Sep-Oct;16(5):467-72.
120. Matsuyama R, Balliet W, Ingram K, Lyckholm L, Smith TJ. Will patients want hospice or palliative care if they dont know what it is? J Hosp Pall Nursing. 2011; 13:41-46.
121. Coyne PJ, Wozencraft CP, Roberts SB, Bobb B, Smith TJ. Dexmedetomidine: exploring its potential role and dosing guideline for its use in intractable pain in the palliative care setting. J Pain Palliat Care Pharmacother. 2010 Dec;24(4):384-6.
122. Roberts S, Wozencraft C, Coyne P, Smith TJ. Dexmedetomidine as an adjuvant analgesic for intractable cancer pain. J Palliat Med. 2011; Mar;14(3):371-3.
123. Quillin J, Bodurtha JN, Siminoff L, Smith TJ. Physicians Current Practices and Opportunities for DNA Banking of Dying Cancer Patients. J Oncology Practice May 2011:183-187
124. Smith TJ*, Dow LA, Virago E, Khatcheressian J, Matsuyama RM. A pilot trial of truthful decision aids for patients with metastatic advanced cancer. J Support Oncol; 2011;9:7986 doi:10.1016/j.suponc.2010.12.005
125. Park H, Parker G, Dodson P, Boardman C, Morris MM, Smith TJ. Oral magnesium reduces hot flashes in breast cancer survivors. Support Care Cancer. 2011; 19:859863
126. Smith TJ, Hillner BE. Bending the cost curve in cancer care. N Engl J Med. 2011; May 26;364(21):2060-5.
- Palliative Care
1984- Richmond Friends Meeting, Richmond, VA
1985-97 Mountain of Trash (community cleanup and recycling), Co-coordinator, Ashland
1991-92 Pamunkey Regional Library, Hanover County, Childrens Story Hour Reader
1994-American Medical Teams for Africa, World Health Organization/American Medical Teams for Africa Cancer Pain Relief Programme, Tanzania-Zanzibar, Director of Cancer Palliative Care Programs
1994- Free Health Clinic, Richmond, VA, Physician Cross-Over
1995-99 American Cancer Society, Hanover County Unit, Board of Directors
2000- Salvation Army Boys and Girls Clubs Camp Happyland, summer camp physicals
2004-Ashland Friends of the Library Board
2007-11 Chris Desch Foundation Board, Founding Member
2008-11 Patrick Henry Half Marathon, Richmond Road Runners, Medical Director