Dr. Robert G. Bristow is the Director of the Manchester Cancer Research Centre (MCRC) at the University of Manchester in the United Kingdom.
Prostatepedia spoke with him about how and why he became a physician-scientist.
Why did you become a doctor?
Dr. Bristow: I was very interested in doing a PhD to understand how cancer cells actually divided. As part of my graduate studies, one of my mentors, a clinician-scientist, invited me to the clinic so that I would understand the implications of my research with respect to real patients undergoing real therapy. This was when I was in Toronto training at the University of Toronto.
From that experience, I realized three things. One is that the models that I’m using to try to understand how patient tumors respond to radiation and chemotherapy can be quite limited. Finding new ways to study cancer directly in patients would be profound.
The second is the reality that every patient is different and has a different story to tell; therefore, the impact of the cancer, as well as the impact of the cancer treatment on the patient can be very different, even if the biology might be exactly the same. That was a really important lesson to learn.
As I attended more and more of the clinics with my mentor, I saw that there really was a satisfaction in a career as a clinician-scientist; having the benefits of both worlds for basic and clinical research. You can ask clinical questions in collaboration with patients, but at the same time you can interrogate tumor resistance or side effects back in the lab and bring the information into the clinic. That is the real truth. I started off as a scientist, and I became a physician after meeting patients in real clinics with real clinical problems.
You’re saying that your role as a physician and your role as a scientist have a push-and-pull: each informs the other?
Dr. Bristow: That’s exactly right. Most days are terrific as they both feed off each other. But sometimes the laboratory studies do not go as well as planned as your experimental hypotheses are proven incorrect or the funding for studies is not optimal. Even with those setbacks, the reality is that when you go into the clinical realm, it’s just so rewarding and challenging.
The second part, of course, is that your favorite patients may, despite all of the best treatments that you try, not do well. In fact, some will even die of their disease. That really is an upsetting moment. The first time you’re a physician and that happens even though you think you’ve done everything right for that patient, just as you did the same for others, suggests that we don’t have all of the precise answers for an individual patient.
You’ve got to go back into the lab and work harder. It absolutely is a push/pull, but also it’s so rewarding to go back and forth. There’s a real challenge in terms of getting it right: to feed each area with the best ideas that will maximally impact on patients.