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Elizabeth Cheung

In a special series on how to take the city into the future, we talk to cancer expert Dr Janice Tsang
Q: What is your vision for Hong Kong?
A: To be a mediator between East and West. We should walk the extra mile and consider our role in the region
 
Dr Janice Tsang Wing-hang is quite happy to be left alone for hours at a time in her laboratory at the University of Hong Kong medical school, peering at cells through a microscope, but she would be happier still if more people could join her.
She wants to shine a spotlight on the work of scientists so that young people can recognise the value in doing research and the contributions they can make to mankind - and be tempted to join them.
More researchers would also enhance the city's status as a centre for scientific excellence and would in turn attract more talent and more groundbreaking research, says Tsang, who as an oncologist specialises in studying tumours.
Tsang herself has collected a string of accolades, including winning the young investigator award at the 2009 Hong Kong International Cancer Congress and an academic teaching award in 2013.
Wider collaboration would also help overcome the problem of inadequate funding. Hong Kong spent only 0.73 per cent of its GDP on research and development in 2012, compared to Singapore which shelled out 2.1 per cent. The lack of funding hampers research capabilities, Tsang laments, making it "hard to maintain the sustainability" of worthy projects that take a long time to gestate and produce results.
She argues that the city has no choice but to put more money into research in view of its rapidly ageing population, which has helped fuel a 20 per cent increase in the number of cancer cases over the past decade. "Ageing leads to cancer and cardiovascular disease, which is a big unmet need and health demand," warns Tsang.
But there is a shortage of oncologists - just 34 medical oncologists and 112 clinical oncologists serve the city. By contrast, obstetrics and gynaecology, the branch of medicine which deals with childbirth and the reproductive system, has 413 registered specialists.
Training at the undergraduate level for oncology is also inadequate - only one out of six cancer centres provides internships for junior doctors.
But there is also a talent problem, she admits.
Tsang, who meets medical students regularly in her work at the university, says young people are more focused on material goals than furthering their dreams. "They might just care about their jobs in the coming five years, getting married, having a child and purchasing a flat," she says, suggesting that social problems such as housing can influence the career path chosen by the brightest of Hong Kong's young people.
Materialism seems also to be a more feasible option in a gradually polarising society, she adds, blaming the insecurity caused by divisions in society.
Technology, with its ability to provide a quick answer to everything with just a few taps on a smartphone, has also played a part in people's desire for quick results. There is little patience left for painstaking research and discovery. And research requires time and effort. Failure is also a part of it - running hard up against a wall or down a blind alley.
The lack of long-term vision on R&D in Hong Kong, Tsang adds, could be discouraging people from seeing it as a career option or stopping them from even seeking backing for their ideas, whether that be from the government or private investors.
"The visibility on this issue in Hong Kong has to be wider, not just limited to the current political atmosphere," she adds, suggesting the focus on the politics of constitutional reform has been at the expense of other urgent matters deserving the public's attention and scrutiny.
Tsang laments one other aspect of Hong Kong - an unrelenting focus on efficiency, which leaves no room for those blind alleyways that may indeed prove to be a necessary diversion in research in order to find the right answers. In the same way, she says, when people are too goal-oriented, "you don't have any peaceful time to reflect and plan".
"So how can you plan your research properly? We end up getting stuck. We just want speed and productivity, but we don't even know what we are actually doing," Tsang says.
Hong Kong should also be more strategic in placing its scientific bets. She cites for example the fact that it has six cancer patient resource centres and two universities dealing with cancer for a population of 7.3 million.
That compares to Singapore with a population of 5.5 million and its one national cancer hospital.
"In some ways diversity [in Hong Kong] has been overly encouraged," she says, depleting the strengths at the top.
Similarly, Hong Kong had some strong research talents but they "don't know each other".
Tsang adds: "We need collaboration to draw them together. Some people in Hong Kong still think 'this is my own work and I do not want to share with you'."
Local researchers are divided across institutions and across areas of research. For a start, she says, "more collaboration should be done within universities, cross-faculty and cross-department".
As a city strategically located between East and West, Hong Kong can also be the place for cross-fertilisation of research ideas, she says.
She cites her own experience of promoting the Breast Oncology Group, which she established in February last year.
She hopes it will further research within the local community and update local standards and also bring on board research being conducted around the world.
To that end, it has joined the Breast International Group, a global network of scientists working on a cure for breast cancer. Hong Kong became the third Asian member after Taiwan and Japan.
"Someone needs to be the first person to start the fire and bring people together. Ideas will then flourish and lead us to the next step," says Tsang.
In Hong Kong, a lot of areas of research lack such collaborative platforms.
More collaborative research could also offer hope for Hong Kong patients, she says - if more clinical drug trials were carried out in the city, for example, it could help those patients willing to go for alternative treatments, financially and medically.
She points out that by this stage of clinical trials, the treatment is comparable to standard therapies, while the cost is borne in full by the research fund. Having more trials done in Hong Kong could also enhance the city's standing in the Western-led pharmaceutical world.
Currently, most landmark studies of drugs are conducted in the West before being introduced to Asia. Although locally generated data is not required to get drugs registered in Hong Kong, it is compulsory on the mainland.
Tsang, who also works in the HKU-Shenzhen Hospital, says this not only slows down drug registration across the border, but also pushes some desperate cancer patients to seek treatment outside the country.
The current problem provides an opportunity for Hong Kong to step up. "Can we conduct some Asia-driven clinical trials with other Asian countries?" she asks.
This way, drug registration can be speedier and researchers also gain a more immediate understanding of local patient reactions to the drugs. Hong Kong and other Asian cities also can gain a foothold in the drug industries, she says.
"We should invite more clinical trials to transform Hong Kong into a hub [of cancer drug research]," Tsang said.
A working mother with a four-year-old daughter, Tsang thinks a family-friendly working environment is vital in supporting the growing numbers of women in the medical profession.
She suggests a flexible, part-time approach to achieving medical specialisation, which right now requires at least six years of full-time training. "Flexible employment is not too common in the public sector … many people have left as they want to spend more time with their children and get a better balance in life," she says.
Society has also failed to appreciate the expectations placed on working women. "When parents or any family members need help, females are always expected to take care of them, no matter whether they are married or have children." And that goes for women scientists too, compared to their male colleagues who can fully immerse themselves in research, Tsang says.
As vice-president of the Women Doctors Association, Tsang wants flexible employment running over three to four years for female employees, to allow them more time with their families.
Tsang, who turned 40 last month, says she is lucky to have the full support of her husband, a medical doctor who has previously worked as a researcher. They split their household duties, including the care of their daughter.
Hong Kong is full of workers facing challenges on both their personal and professional fronts every day, she says. Even as the city itself is in the throes of political tension, they plod on, doing their best to shape the future.
Many, she says, abide by a fundamental belief best summed up by a Chinese quote: "If there is a mountain blocking your path, open a new road; if a road can't be opened, try another solution; if nothing else works, tune your attitude for change."
The Moving Forward series returns on Monday
 

DR JANICE TSANG

Dr Janice Tsang Wing-hang serves as assistant professor in clinical oncology at the University of Hong Kong medical school. After obtaining her medical degree from HKU in 1999, Tsang received further training in oncology at the Royal Marsden Hospital in London between 2004 and 2005, and received her specialist qualification in medical oncology in 2006.
Tsang is the first female homegrown medical oncologist at the HKU, and one of four medical oncologists serving in Queen Mary Hospital in Pok Fu Lam, the university's teaching hospital.
She has been involved in over 60 clinical trials in local and international experiments, and was responsible for getting Hong Kong into the international arena of cancer research. The Breast Oncology Group, founded by Tsang in February last year, took Hong Kong into the Breast International Group, a worldwide group of scientists involved in breast-cancer research.
Tsang is also involved in public service. She is the assistant dean of the HKU Medical School, and the director of the Cancer Centre at Queen Mary. Women's rights is another of her concerns, and she is the founding vice-president of the Women Doctors Association.
Tsang's active participation in scientific and local affairs has gained her recognition and accolades. She has been granted research and teaching awards and was presented with one of the Ten Outstanding Young Persons Awards last year.
Tsang's passion for medicine stems from her desire to help people. A Christian, she believes a doctor can relieve patients' physical symptoms as well as provide mental support. Working as an oncologist allows her to establish a close relationship with patients and hear their stories, she says.
Outside work, Tsang enjoys music and the performing arts. She has been playing piano and organ at her church for more than 25 years, and looks to focusing more on music in her later years.
 


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Focus

Hong Kong: fast, furious and headed for a crash, says cancer expert

Dr Janice Tsang laments one other aspect of Hong Kong - an unrelenting focus on efficiency, which leaves no room for those blind alleyways that may indeed prove to be a necessary diversion in research in order to find the right answers. Photo: May Tse

News

Hong Kong

The need for results and speed are destroying the time and space to reflect and plan, and research is only one area paying the price


In a special series on how to take the city into the future, we talk to cancer expert Dr Janice Tsang.
