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SUNDAY, 27th JUNE 2010
Mickky could be hiding in Taleigaon - Whistle Blower................Pg 18 Secular India and Women - Sajla Chawla....................................Pg 19 Net of Fish, Faith and Celebrations - Conchita Goes Proenca......Pg 20 Conflict Resolutions - Juliet D’Souza...........................................Pg 20 My name is Swagatam - Bevinda Collaco......................................Pg 21 Messenger of God - Bharati Pawaskar........................................Pg 22
Right on TARGIT A Goan doctor pioneers a revolutionary new cancer treatment Dr Jayant Sharad Vaidya recently made international headlines when he pioneered a new technique of administering radiation during breast cancer surgery that can save women six weeks of post-operative radiotherapy treatment. Breast Surgeon, Oncologist and Breast Cancer Specialist in London, Dr Vaidya is one of our very own, born and brought up in Panjim. REMEDIANA DIAS spoke to him about the secret of his success
Dr Jayant Vaidya along with Jeffrey Tobias dicussing the TARGIT concept.
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s humans we all like to read or hear inspiring stories. This is the story of Dr Jayant Vaidya. It demonstrates that reaching your target and achieving your goals needs hard work and perseverance to accompany new ideas and scientific rigor. Trained as a surgical oncologist, Dr Jayant Vaidya is a breast cancer expert who specialises in the diagnosis and treatment of diseases of the breast. He is a Consultant Surgeon at the Whittington Royal Free and University College London Hospitals. His private breast practice is at the London Breast Institute at the Princess Grace Hospital, where he runs a One-Stop Breast Clinic and sees emergency cases. Dr Vaidya is among three experts in the UK who have achieved a breakthrough in the treatment of breast cancer after a 10-year trial involving 2,000 women patients that demonstrates that a single dose of targeted radiation given during surgery for breast cancer is just as effective as the standard sixweek course of radiotherapy given after surgery. His team involved doctors and experts from 28 centres in 9 countries. The trial, called targeted interoperative radiotherapy (TARGIT –A Trial), was led by Dr Vaidya along with oncologists Jeffrey Tobias and Michael Baum. The new approach means selected patients receive just one dose of radiation during surgery to remove breast cancer. A probe is inserted into the breast, so that it can target the exact site of the cancer. In his PhD thesis at University College, London (UCL) Dr Vaidya pio-
Dr Jayant Vaidya with his family
for this. The new treatment would mean that many more women who contract breast cancer could conserve their breasts. TARGIT saves time, money and breasts. It will change the way of thinking about breast cancer and its treatment. The study suggests that in selected patients, the whole breast does not need to be treated, and that the radiation dose can be much lower. Besides, TARGIT eradicates the very highest risk area – around the part of the breast from which the tumour was removed. TARGIT is given in a single dose via an intra-operative probe. The conventional surgery is extended by just 30 to 40 minutes while the patient is asleep under anaesthetic. The cancer is taken out and the radiation goes in as soon as the surgery is complete, rather than weeks after. The interesting thing is, this interna-
Dr Jayant Vaidya and Michael Baum doing one of the first TARGeted Intraoperative radioTherapy operations in 1998 neered the concept of targeted intraoperative radiotherapy (TARGIT or IORT) to deliver radiotherapy to women at the time of surgery. He was featured on BBC’s ‘Tomorrow’s World’
Dona Paula (now run by the Manipal Foundation) and later went on to become one of India’s most prominent anti-tobacco activists, he studied at People’s High School and Dhempe College in Panjim, and did his MBBS from Goa Medical College (GMC). He qualified in surgical oncology from Bombay University and the National Board. His
tionally renowned doctor is one of our very own. Dr Vaidya hails from a prominent family of doctors from Goa. Son of the late Dr Sharad Vaidya, who pioneered the Goa Cancer Hospital at
Breast Cancer Conference (EBCC), the European Cancer Conference (ECCO), the Milan Breast Cancer Conference and the San Antonio Breast Cancer Conference. He has been invited to contribute to several books on breast cancer. His book ‘Fast Facts – Breast Cancer’ has just been published. He has also featured in ‘Time’ magazine and ‘Reader’s Digest’. His main research interest is understanding the natural history of breast cancer and how to treat it with maximum effectiveness and minimal harm. His work on intraoperative radiotherapy was inspired by his original laboratory work in 1994-5 that led him to the idea that breast cancer treatment with surgery and radiotherapy needs to be focussed and targeted. Working with Prof Michael Baum, he developed the concept, tools and the surgical operative procedure to give targeted intraoperative radiotherapy to the tissues immediately around a breast cancer, after it is surgically removed. He called it TARGIT- for TARGeted Intraoperative
Dr Sharad Vaidya and Dr Nirmala Vaidya
Dr Jayant Vaidya during a lecture tour in India – aiming to bring it back to the Tata Hospital.
REMEDIANA DIAS spoke to Dr Jayant Vaidya over the telephone; not so much about his achievements, which are now in the public domain, but about himself, what inspires him and much, much more. Excerpts from an exclusive interview: What is the secret of your success? I keep my mind fresh with new ideas and have the ability to see the glass three quarters full. I think it is always important to think big and to try to for it with a positive attitude. I believe if you reach for the stars you will emerge at least on the moon. The catch phrase, ‘how and why?’ and ‘lets do it’ sums up my attitude to life. I believe life is about the dreams you live, and the plans you make happen. I have learnt that for making something happen, one needs to believe in it strongly and persist, persist, persist. My father made it happen; he made Goa India’s first tobacco-free state 13 years ago. I think challenges are the best times of your life. To make things happen, a leader needs to instil the excitement of the challenge in those around them. I have always had support from my family, friends and colleagues. Without that, I could not have done anything. What makes you happy? I derive happiness from the things in life that one cannot attach a price tag to, like my family and friends and the smiles of my patients. I am in high spirits when I find a new question to solve or a new idea that can change the world. I love living every minute of my life. When I wake up every morning, I look forward to the mysteries and surprises each day will unravel, and I love to live each moment to the fullest. We are not here for a long time, and must create the most cheerful times for our near and dear ones. I believe destiny helps those who are inspired and truly committed. Choose what you enjoy and enjoy whatever you have chosen wholeheartedly, couple it with genuine hard work, and you are likely to be successful. If you are passionate about what you do, you may falter but you will never fail.
PhD is from UCL in London, and he is a Fellow of the Royal College of Surgeons (FRCS). At the age of 17, Vaidya qualified to be a National Scholar, and received a scholarship throughout his medical education. He has worked at the Tata Memorial Hospital, Mumbai, the Royal Marsden Hospital, UCL, and the University of Dundee in Scotland. He is currently a Senior Lecturer and Consultant Surgeon at UCL. His clinical practice is busy. He has extensive experience in all aspects of breast surgery, including lumpectomy, wide local excision and quadrantectomy for breast cancer, sentinel node biopsy / axillary sampling, axillary clearance, and targeted intraoperative radiotherapy. Dr Vaidya also works with plastic surgeons for breast reconstructive surgery. He is well versed with multidisciplinary approaches to breast cancer treatment and works very closely with a team of top medical oncologists, radiotherapists, radiologists and pathologists, as well as specialists in psychosocial care. Mr Vaidya is considered a world opinion leader in breast cancer. He has over 180 original publications on varied subjects, and has given over 80 invited talks, including at the European
radioTherapy. The TARGIT procedure has been now been used in over 2,000 women, as part of the international TARGIT-A trial, conducted in 28 specialist cancer centres worldwide. It achieved more than 98 per cent durable local control, a remarkable result. The results were reported in ‘Lancet Online First’ on 5 June 2010. His recent collaborative translational research work suggests that TARGIT treatment may also change the tumour micro-environment, making it less conducive for tumour growth. A new TARGIT-B trial, currently underway, will indicate whether the TARGIT boost is superior to the standard postoperative boost because it is accurately timed and targeted. It will save women taking breast cancer treatment a prolonged course of radiotherapy, which can mean 20 or 30 visits to the hospital over five to six weeks, with unfortunate side effects including pain, burns and loss of hair. Dr Vaidya and his colleagues believe that for Britain’s beleaguered National Health Service (NHS), it could significantly reduce waiting lists for breast cancer treatment and save as much as £15 million a year, after costing in the initial outlay for new equipment.
Describe yourself as a person… I am very curious about the world and my thirst for knowledge does not get quenched easily. I am a perfectionist, simply because it comes instinctively. I believe in excelling, because all of us must aspire to be the best we can. The two together add up to what I believe is a formula to achieve a goal – inspiration and persistence in hard work. I strive to get the most value from my time. I cannot easily differentiate work from play, because I enjoy both. I can go on doing it uninterrupted for many hours, sometimes to the annoyance of those around me. One of my strengths is the way I work with people of different backgrounds and of different capabilities. I believe that every one of us has some great qualities. I find that time is something I am always hoping to have more of. I always try to keep an ear tuned to the stories behind my patients’ medical complaints. I try to spend as much time listening as I can, without getting behind schedule. One’s actions are a means of self expression. I am a diligent and meticulous person, and I don’t believe there can be any substitute for hard work. I love the exactness of science – even when there is uncertainty. Tell us something about your life in Goa. I have the best family in the world. Both parents were my role models. My father, besides being an excellent surgeon, pioneered and successfully led the anti-tobacco movement in India, helped by my mother. My extended family was always inspiring and encouraging me. I had great fun during school (at the old Mushtifund and People’s) and college (Dhempe, Goa Medical, Tata Memorial) days. My wife and children contribute in a major way to my scientific endeavours, not just in making a fantastic home but with a huge intellectual input as well. They are all great on their own. My teachers, whether at school, college or home, have been the major influences in my life. The first and foremost of these were my parents and my siblings. I have a loving and supporting family that influenced me in many positive ways. During school, I had some dynamic teachers who opened my mind to myriad possibilities. My aunts, uncles, cousins and grandparents and many close friends stimulated and inspired me. Even as a child, I wanted to be a scientist, to find new things, to do research and to change the world for the better. What do you enjoy doing when you are not working? I enjoy reading books – both fiction and non-fiction – science and philosophy. And I love photography. I love how technology can enhance our lives. My perspective of life includes the full realisation of how small we are both in terms of time and space, compared to the universe. When you look back, what gives you the greatest sense of fulfilment? That is an interesting question. Completion of a task gives fulfilment. That way, performing a surgical operation is very fulfilling, because one begins and ends within a short span of time and one has already done something good. Research takes longer, but has bursts of ideas coming on a regular basis and has the potential to make a much larger impact. A satisfied smile from a patient can make the longest day the most fulfilling. I like my late evening postoperative ward round – it keeps my patients safe and gives me a good night’s sleep. The little things should mean as much to you in life as the big things. In the future, I would like to see a peaceful world filled with happy people. As an internationally known doctor, what lessons have you learnt that have stayed with you till this day? Keep an open mind and let it fly freely – encourage wild ideas – but test them with thoroughness, and inspire others around you. Follow your dreams, persist in the face of all calamities, and maintain strict integrity with science and truth. Always be kind.
The international steering committee and the Data Monitoring committee of the TARGIT –A Trial.
(Contact Dr Jayant Vaidya at: jayantvaidya@gmail.com)