What Drives My Why

 

My Personal Account

To this day, it still pains me to recall the time I nearly withdrew from my junior doctor training after experiencing three family deaths in quick succession over six months. I lost my dear mother-in-law to oesophageal cancer, my uncle to pancreatic cancer and then my grandmother to old age. The months leading up to their passing, their subsequent loss, and the aftereffects were truly devastating for my wife and I, both emotionally and physically.

A few years earlier, a close family friend, H.I.H. Prince Tomohito of Mikasa, had passed away from oesophageal cancer. Later, a senior colleague and friend, Professor Vincenzo Cerundolo, succumbed to lung cancer. Since then, I have also had friends diagnosed with cancer. What I wish to share is that both of these prominent figures played a significant role in shaping my ‘why,’ as they each inspired promises I made to them behind closed doors.

By this time, cancer had become deeply personal to me. What had fascinated me earlier, however, was the story of my aunt-in-law. Diagnosed with breast cancer age 34, she was later told at 45 – following multiple metastases – that she had only six months to live. Despite this, she radically changed her lifestyle and underwent various treatments, both conventional and unconventional. She went on to defy the odds and is now 77 years old. When I first heard her story, it was a defining moment for me. It made me realise first-hand that medicine can sometimes get it completely wrong, underscoring the importance of staying true to oneself: that each individual is an n = 1 and not merely a statistic.

 

My Professional Account

I studied molecular and cellular biochemistry as an Oxford undergraduate before moving into the field of cancer immunology, where I pursued a Ph.D. and conducted post-doctoral research in cancer immunotherapies. My interest in cancer biology and the interplay between the immune system and cancer led to some intriguing discoveries, nearly resulting in a patent for a cancer vaccine. However, feeling the need for a clinical dimension to complement my academic pursuits, I applied to graduate-entry medical school and was accepted. At the time, my intention was to become an oncologist and continue cancer research, combining the two disciplines.

During my medical training and rotations in oncological specialties, I decided to pivot from hospital medicine. Instead, I sought to carve out a role at the interface between primary care (general practice) and secondary care (hospital medicine) in cancer care. I subsequently chose to train as a GP with a specialist interest in oncology.

This decision was driven by the realisation that I could have a greater impact by focusing on lifestyle medicine, prevention, and early cancer diagnosis. With one in two people now expected to be diagnosed with cancer in their lifetime, intervening earlier offers clear benefits. I also wanted the breadth and depth of medical knowledge that general practice provides, enabling me to practice holistic medicine and view patients as individuals rather than as diseases. General practice has served this purpose well.

As a GP, I have cared for thousands of patients, managing various chronic diseases, including cancer. Providing good cancer care remains especially close to my heart. Interestingly, many management strategies for chronic diseases align with those for cancer, particularly in lifestyle interventions. Additionally, several ‘Hallmarks of Ageing’ overlap with the ‘Hallmarks of Cancer’, revealing universal truths (or at least correlations) about how we should approach the care, management, and treatment of chronic diseases of ageing. This realisation inspired my move into the ageing and longevity space, co-founding the Oxford Longevity Project and becoming a clinical advisor to Oxford Healthspan, a supplement company leveraging the power of autophagy. My hope is to translate this knowledge back into cancer care.

Helping patients navigate their cancer journeys has allowed me to witness the highs and lows: from diagnosis, treatment, and remission to recurrence and, sadly, death. The profound impact cancer has on individuals, their families, and their friends is something I would not wish upon anyone. My hope is that cancer will soon become a chronic illness we can learn to treat effectively—preventing, alleviating, delaying, and reversing its course, and, dare I say, one day curing it.

Looking to the future, I aspire to play a small part in leaving the world a better place for the next generation—including my daughter. I believe this is a responsibility we all share for the sake of humanity.

 

This is my ‘why,’ and I am dedicated to spending my working life striving toward this goal.

 

Dr Paul Ch’en   M.Biochem. D.Phil. B.M. MRCGP

1 January 2025