An NCI-designated Comprehensive Cancer Center
By Abe Rosenberg | February 14, 2018
Physician on a Mission
Just how much does Yuman Fong, M.D., travel?
He casually tosses off a number, knowing full well the impact it will have.
“I think more in terms of distance rather than in days or weeks,” he said. “Last year I flew 300,000 miles.”
That's 12 times around the world, more or less. But don't envy his frequent flyer account. He sure doesn't.
“Are you kidding?” he asked. “The last thing I need is another free trip!”
Ralph Waldo Emerson (and Aerosmith) may have said, “Life is a journey, not a destination,” but for City of Hope's globetrotting Surgery Department chair and The Sangiacomo Family Chair in Surgical Oncology, the opposite is the case. Fong doesn't particularly enjoy traveling; in fact, he carefully schedules his many trips to require as little time as possible in actual transit.
It's what's waiting for him on the ground that matters most: knowledge and relationships. He's “willing to go anywhere” to accumulate both.

Teacher Becomes the Student

From Cuba to Calcutta, across Asia, throughout Europe and North and South America (the list he provided named over two dozen countries), Fong's go-anywhere philosophy has taken him everywhere. Some visits last only a few hours. But each carries a specific purpose.
“I travel as an ambassador, a matchmaker, a facilitator and a student,” he says.
He clearly relishes the “student” role most of all, a bit of a surprise. Fong, who joined City of Hope in 2014 after more than two decades at New York's Memorial Sloan Kettering Cancer Center, is a world-renowned surgeon with unparalleled expertise in cancer of the liver, pancreas, bile duct and gallbladder. He's a pioneer in both the operating room and laboratory, who's developed breakthroughs ranging from new surgical instruments to genetically modified, cancer-killing viruses.
Master teacher, for sure. But student?
We're all students, really,” he asserted. “It's how we grow, how we stay relevant. The world is changing so fast. What can we see and learn elsewhere that will make us better? If someone has invented something new and important, we have an obligation to go see it.”

Retaining What Works

The lessons learned can be both big and small. For example, Fong never misses an opportunity to observe an overseas colleague at work.
“I love watching other surgeons,” he said with delight, though he admits the feeling is not always mutual. “Some surgeons sometimes feel a little intimidated having me there. Maybe they thought I was judging them. But I just want to learn!”
Other times, Fong brings home valuable insights about an institution, or even a country's entire medical system. He's especially impressed by those who do more with less.
“Hong Kong for example,” citing his birthplace. “Their medical expenditure per patient is one-eighth that of the U.S., yet their life expectancy is the highest in the world!”
It's a theme he returns to often, as he hopscotches the globe in his mind.
“I went to Cuba with the American College of Surgeons to see how they handle health care at such a lower cost. In Asia, whether it's China, Japan, Thailand, over and over again I see places with fewer resources, yet they manage to adapt American-style health care (not American-style budgets) by filtering out what's unnecessary and retaining what works. The cream always rises to the top, and it teaches me.”

‘You Must Travel’

More often than not these days it is Fong doing the teaching, helping health care professionals bring out their best, sometimes by design, sometimes by serendipity.
A favorite example happened in Thailand, where he was invited to assist in setting up a cancer center in Bangkok. While he was there, Princess Chulabhorn Mahidol (the youngest daughter of King Bhumibol Adulyadej and Queen Sirikit and a formidable scientist herself) dispatched Fong to northern Thailand with the Thai health minister to see a region with an alarmingly high rate of liver cancer.
“The problem turned out to be a parasite found in koi pla, a local dish made primarily of raw fish,” he recalled. “By re-educating people, they're bringing the disease rate down.”
Fong insists the Thailand experience, like so many trips he's made, simply cannot be replaced by a Skype session or any other kind of remote conversation, not even in our ultra-connected, mega-digitized world. Meeting people face-to-face is crucial, he said.
You create stronger relationships,” he said, “and you also have more influence, when you meet people on their own ground. When you see people in their own setting, it makes all the difference in the world.”

So Much to Learn

He adopted that philosophy early on, not long after arriving in the U.S. and fast-tracking through high school, Brown University and Cornell Medical College. He was awarded the James IV Association Traveling Fellowship, which funds outstanding young surgeons in the U.S., Canada and the British Isles to travel to learn. It's a throwback to an earlier century when aspiring American physicians would routinely go overseas to learn from European “masters.” Fong's James IV scholarship “taught me that you must travel.”
When he travels now, his reputation and that of City of Hope precede him, and willing audiences await him. As a surgeon and scientist, he now embraces a double mission.
“We want to present our scientific programs to the world,” he declared. “Especially our groundbreaking work in gene-based therapy, like CAR T cell treatment. We're looking for collaborators in more places,” not only to help others, but to expand the general knowledge base. “The genetic population in, say, China, is very different from our own ... so there's much we can learn.”
The second part of the mission is to expand the worldwide understanding and adoption of robot-assisted surgery. City of Hope is dominant in the field with over 11,000 robotic procedures since 2003. Fong, an acknowledged leader in robot-assisted liver and pancreatic surgery, finds himself increasingly called upon to help medical institutions around the world ramp up their robotics departments.
Fong helped train Chinese surgeons after the government, which previously had made robotic surgery available only to the military, opened up its policy to civilian medical centers. China made a heavy investment in the technology, while Fong provided the human expertise and teaching skills. “And now,” he said proudly, “three of the busiest robotic surgery machines in the world are in China.”

Part of One Big Family

The knowledge can flow both ways when Fong taps into his worldwide connections. When a young colleague, City of Hope surgeon Yanghee Woo, M.D., showed an interest in robotics, she asked Fong for advice. Fong sent her to South Korea to study with the acknowledged “guru” of the field, Dr. Woo Jin Hyung at Yonsei University.
“The training was amazing,” recalled Woo, who focused on stomach surgery. “I saw more gastric procedures in that one year than I would have encountered in a decade in the U.S.”
Other colleagues realize the powerful benefits of having such a globally recognized authority in their midst.
“Dr. Fong has done a lot and seen a lot,” exclaimed Edwin McCarthy, vice president of City of Hope's Center for International Medicine. “He understands different health systems, and how our expertise can be used to make patients’ lives better in other countries.”
And not just in other countries. All that travel notwithstanding, City of Hope is home, and Fong forges profound connections with patients, many of whom call him “fantastic,” “a human being with feelings and compassion,” and “truly the greatest surgeon.”
“Dr. Fong is a rare resource,” added McCarthy. “He is a gifted and compassionate surgeon who touches the lives of patients and families on a personal level.”
The feeling is mutual, as Fong told an interviewer shortly after he arrived at City of Hope:
“City of Hope feels like family ... 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.”

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