A discipline with great potential

A desire to cure people and understand more about cancers led Dr Richard Quek from Parkway Cancer Centre to focus on cancers like sarcoma, lymphoma and melanoma.

Why did you decide to become an oncologist?

When I was young, I wanted to be a dermatologist.

I had eczema on my big toe and I went to see a few GPs, but they couldn’t help. One of them even tried to pull the skin off my foot. That hurt like mad!

Finally, my mother brought me to a dermatologist. All he did was put a cream and a plaster over it. That simple gesture prevented the chafing and the pain went away immediately. So, for a long time, I wanted to do dermatology.

I eventually chose oncology because I felt that this was a discipline that was young and growing, and had a lot of potential for research.

Your specialty is relatively rare cancers: sarcoma (cancer in connective tissue), melanoma (rare in Singapore) and lymphoma. How did you end up focusing on these?

When I first started in oncology, what really got me going the most was managing patients with potentially curable cancers such as lymphoma.

These lymphoma patients are typically young with a full life ahead of them, their treatment tends to be very aggressive, and throwing in the curable nature of their disease gives rise to an intoxicating mix of sweat, toil and sense of purpose in my work, which I thoroughly enjoyed. And it led me down the path of lymphoma, seeking cure always, in my patients.

At around that time, an opportunity presented itself. The department had a service gap in the field of sarcoma. While we had good surgeons operating on sarcomas, the understanding of the disease and field of medical oncology in sarcoma was in its infancy.

As luck would have it, a world-renowned Visiting Professor from Dana-Farber Cancer Institute/Harvard Cancer Center in Boston came to Singapore to deliver a sarcoma lecture and I had the chance to catch up with him over a dinner at The Halia restaurant in the Botanic Gardens.

I managed to convince him to take me on as a fellow and thankfully, managed to secure a grant to pursue my advanced training and research in the field of bone and soft tissue sarcomas at Dana-Farber. The research became so productive that I ultimately spent a second year in Boston to complete my work.

As for melanoma, I would say my path was more fortuitous.

This happened around 2010 after I returned from my two-year fellowship. While the medical treatment for sarcoma/lymphoma is completely different from melanoma, the surgeons who operate on sarcoma and melanoma are, in fact, the same bunch of doctors. And they would regularly present their new melanoma cases in our sarcoma tumour board, which in turn forces me to self-learn the topic as I was the only medical oncologist in those tumour boards at that time!

What also sparked my interest in melanoma was the explosion of new scientific information in this disease ushering in a new paradigm of cancer treatment, not only in melanoma but the rest of the cancer world – immunotherapy.

You have been an oncologist for over a decade now. How do you deal with losing patients?

The group of patients that get me the most are the ones you are trying to cure. They’ve gotten the treatment and then they relapse. Those are heartbreaking and it’s especially hard when the patients are young.

I see quite a few of those because young people in their late teens and early 20s are over-represented when it comes to sarcoma and lymphomas.

One of the things I felt I had to do was to set up a support group for sarcoma patients in Singapore, in particular, the adolescents and young adults with sarcoma. I worked to raise funds and find a home for this group. Apart from fundraising, I also helped to develop support group programmes and pitch in with talks when called upon.

You are the founder of the Singapore Sarcoma Consortium and the Asian Sarcoma Consortium. What is the significance of these organisations?

When I first came back to Singapore after my fellowship, there were three things I felt were important that I wanted to do – to provide good state-of-the-art medical care to patients, to raise awareness of sarcoma in Singapore, and to build sarcoma collaboration and research in Singapore and beyond.

Sarcoma is rare, so it is important to pool together resources, which is why I started the Singapore Sarcoma Consortium.

Once that was done, we created the Asian Sarcoma Consortium so that we could have sites in Singapore, Malaysia, Thailand, Myanmar, the Philippines, Hong Kong, Taiwan and Japan, come together to focus on sarcoma research and education.

Thanks to this consortium, we were able to complete one of the largest angiosarcoma studies in the world, with 423 patients, based on an eight-site collaboration in six countries. Angiosarcoma is a very rare sarcoma subtype, it is only through strong international collaborations that we could pool together all these resources and data to study this disease.

Our holy grail is to run cross-country clinical trials, but it is not easy as different countries have different regulations. The regulatory hurdles will need time to overcome.

Tell us a little bit about yourself, your family and what you do to relax.

I am 45 years old, my wife is a homemaker and I have two children: a seven-year-old daughter and a two-year-old son.

My daughter is now in Primary 1, and it is my job to handle Mathematics and Mandarin while my wife handles English. When I come home at night, a lot of my time is spent teaching my daughter Hanyu Pinyin. In the first half of the year, it was a nightmare but things are now much improved. We are both learning!

On weekends, we go out for dinner as a family. I also cycle and swim with my daughter.

To relax, I keep up with the news. I read the New York Times and I also follow football (I’m a Manchester United fan). I also find it relaxing to think about my work. I think about difficult problems, trying to find answers to them. I don’t find that a chore at all.

I don’t watch movies though. I’ve not gone to the cinema since 2010, when I came back from my fellowship. The only time I watch movies is on the plane.

Written by Jimmy Yap



Tags: cancer doctor stories, rare cancer, sarcoma