Sam Behjati divides his time between clinical work at Addenbrookes Hospital in Cambridge and research at the nearby Wellcome Sanger Institute. He writes:
As an academic paediatric oncologist, I probably don’t ever have a ‘normal’ day as I’m constantly juggling clinical work, research and family life.
However, the highlights of my week are my clinics on Fridays, when I roll up my sleeves to look after children and their families, and Tuesdays, when I meet with my lab group to discuss science. The other days are mainly filled with meetings, meetings and more meetings, and responding to emails. Although I try to keep research and clinical time separate, I catch up with my patients every morning remotely through emails, phone conversations and check what is happening on the ward. Occasionally, I get the luxury of a few hours of uninterrupted writing and thinking time which, far too often, tends to be on Sunday mornings. As is the norm for a paediatric oncologist, my days start early and finish late, interspersed with family time and household chores.
My research focuses on studying the origin of childhood cancer using the genetic information that is contained in cancer and normal cells.
Sanger offers cutting-edge equipment and laboratory pipelines that enable me to generate vast amounts of data. More importantly, the Institute is full of highly gifted researchers from diverse backgrounds that bring together incredible expertise about all things genetics. My own group comprises mathematicians, biologists, clinicians and even an astronomer, all from different corners of the world. We’re not focused on any particular disease. Instead, we study the development of a range of cancers (and sometimes of normal tissues, such as the placenta).
Questions about the origin of childhood cancer are, at their heart, considered ‘basic’ science. Nevertheless, our findings often have clinical implications. For example, we’ve found specific genetic changes (mutations) that are diagnostic of certain tumour types, and this knowledge is now routinely used in clinical practice. Usually, however, the clinical implications of our research findings are less tangible and mostly point to future directions and possibilities.
When studying the origin of the kidney cancer Wilms’ tumour, for instance, we found that in many cases there was a pre-existing cancer root in regions of normal-looking kidney tissue. Based on this discovery, we can now begin to ask the question whether it might be possible to identify children at risk of developing Wilms’ tumour through screening for the root. Although this idea remains fantasy at present, it’s exciting that our discovery allows us to think along such lines without sounding ridiculous.
My scientific expertise is becoming increasingly more helpful in my clinical work, as genetic information about cancers is entering clinical practice. In England, the NHS is now offering whole genome sequencing (WGS) to all children diagnosed with cancer. This rather fancy test provides a readout of the entire genetic code of tumours, which often contains useful information for clinical management. At Addenbrookes we hold a weekly ‘molecular MDT’ meeting, where we discuss the genetic data, which primarily allows us to assess whether we can tailor treatment for each child.
Although life is very busy juggling being a father, a clinician and a group leader, I feel indebted to the children and the families that I have cared for, who continue to drive me to understand - and ultimately, better treat - childhood cancer.
