April 19, 2014 | by Kim Proescholdt
Meet City of Hope’s new chair of the Department of Surgery – esteemed pancreatic and hepatobiliary surgeon, researcher and author Yuman Fong, M.D. As one of today’s most respected and recognizable physicians in the treatment of cancers of the liver, bile duct, gallbladder and pancreas, Fong has pioneered and enhanced many surgical therapies now widely used around the world to treat these difficult diseases. He also coordinates and participates in many studies aimed at better understanding them and at their prevention and treatment.
Here he discusses how research plays a key role in developing new and improved cancer therapies and how the future of cancer surgery is “less invasive, more cures.”
What are your primary areas of research?
There are three primary areas of research I focus on – the designing of viral vectors for gene therapy (to destroy cancer cells), surgical technology and biological imaging.
When developing viral vectors for gene therapy, one must first understand how viruses work. All viruses attack their hosts and introduce their genetic material into the host cell as part of their replication cycle. The host cell then produces additional copies of the virus, leading to more and more cells becoming infected. With viral vectors, we take certain viruses and genetically modify and design them to attack and destroy cancer cells only while sparing normal tissues. By exploiting some of the characteristics of cancer cells, these viruses only replicate in cancer cells, ultimately destroying them.
Another area of immense research is surgical technology. “Less invasive, more cures” is my motto. Here I focus on developing new tools for use in the operating room. Using robotics and many other minimally invasive surgical devices, including needles and catheters, can make the therapies much simpler for patients.
With biological imaging, we look for ways of seeing and targeting cancers that is different than just using white light which is what we, as cancer surgeons, normally use to perform surgery. Now with the use of fluorescence, radiology and even antibodies that are labeled with radioisotopes, we have other methods to find, see and ultimately remove cancer.
What sparked your interest in hepatobiliary cancers?
Liver cancers are the most common solid tumors in the world, affecting many Asian populations and those in developing countries. The leading cause of liver cancer is viral infection with hepatitis B virus or hepatitis C virus. The cancer usually forms secondary to cirrhosis which is caused by these viruses. Liver cancer also happens in people who have injuries to the liver from environmental toxins. Overall, these cancers affect over a million people worldwide each year, with most succumbing to their disease. When I started in medical school, so few people were being helped and cured of these cancers. This was alarming to me and I felt a call to action to do something. It really does make for an important mission for me both professionally, but also very personally.
Additionally, most of the surgeries that involve these cancers are technically very challenging. I always tell people that the surgery I do is really my hobby. I welcome the challenge and since I’m also helping people, it all comes together very nicely.
How has the research and clinical practice in this area changed during your career?
When I first started in medical school, most of these cancers I now treat were incurable and terminal. Now, we cure more than 50 percent of the people we take to surgery with these cancers. And when I say “cure,” I don’t just mean living longer. I mean living to an old age. And that’s gratifying. To witness during my lifetime a body of cancer change from incurable to more than half the people being cured who are operated upon is very, very gratifying. It’s a big change and it’s continuing.
City of Hope focuses on collaboration between disciplines and between basic science research and clinical practice. What are some of the other things that appealed to you in coming here?
I’ve been offered chairmanships in the past. But what persuaded me in coming to City of Hope is its dedicated mission. Here, it’s about dealing with the cancer patient in all aspects. From understanding the cancer’s origin, to developing new therapies and testing them in patient clinical trials, it’s about delivering superior, compassionate patient care and providing support and education to patients and their families to help them during their journey. This is what I do. This is who I am.
City of Hope also feels like family. From when I came here as a visiting professor some 11 years ago, to recently interviewing for the surgery chair position, when you step foot on the campus, you feel a sense of welcome, as if you belong here. From the volunteers who greet you in the hallways, to the personnel who check you in at the clinics every day, to the clinical and other support staff, everyone I’ve ever met here has made me feel like I’m part of one big family. That, to me, is very important.
What do you do outside of work?
I like sports, all kinds of sports. And I feel fortunate that my own family shares this sentiment. We’re all very active. My wife and I enjoy spectator sports and coaching kid’s sports. We ride our bicycles everywhere we can and, no doubt, the Los Angeles area will provide for some nice scenery to enjoy this activity. I also have two children who are triathletes, even though one is in medical school with a hectic schedule. And back in 2008, I had the joy of coaching two of my children in the Beijing Olympics. What an experience!
My wife and I also love music, and Los Angeles has a wealth of cultural opportunities to enjoy that. I also enjoy cooking. I’m actually working on a cookbook for cancer patients. I know that when patients are undergoing treatment, they have less time to shop and cook. But it is important that they maintain nutrition. Treatment processes and procedures can disrupt a meal schedule, not to mention the cancer itself steals many of the nutrients. I believe that laying out the process for patients that includes meal plans and recipes is the right way to go. So I’m developing this cookbook as a great resource tool for them. Stay tuned on its release date!
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Learn more about advanced surgical cancer treatment options at City of Hope.