Newsletter No. 546

04 # 5 4 6 | 0 4 . 11 . 2 0 1 9 vessels before a tumour is resected. For these reasons, surgery must come with chemotherapy. Researchers are looking into using the patient’s own immune system to eradicate any remaining cancer cells. Lastly, Professor Mok explicated the ways of controlling and living with cancer. Apart from chemotherapy, there is precision medicine, which is more effective while having fewer side effects. Stymieing tumour growth by attacking only genes causing cancer or simply, oncogenes, targeted drugs are one example of precision medicine. Another example is immunotherapy, which helps the immune system to identify and eliminate cancer cells. A way forward in cancer treatment, according to Professor Mok, might be giving immune cells the power to attack cancerous ones through the use of CRISPR. The Car and the Driver In his presentation, Professor Mok talked about cancer mainly from a technical angle; in the Q&A session, he clarified some commonly held conceptions of cancer with some apt analogies. A member of the audience said that one of his relatives was found to have a nodule in the lung through imaging. He was confused by the different interpretations of it by different doctors, some suggesting that it was benign and others, malignant. Professor Mok asked light-heartedly if the man had ever dated online. He then quipped, ‘Photos are unreliable.’ One should never come to a conclusion based solely on appearance or any single factor, he cautioned. With this analogy Professor Mok made us see that however advanced our medicine has become, there must be professionals who are serious about their work to harness it. Another member of the audience asked if ordinary people can benefit from the cutting-edge technology highlighted in the presentation through the public health system. Professor Mok answered with another analogy, ‘The same car can go either painfully slow or incredibly fast—depending on who’s driving it.’ He suggested that the technology is available at public hospitals; what must follow is the dedication of the people—medical professionals—who use it. Promises to Keep Professor Mok had actually touched on the fact that the people are every bit as important as the technology in his explication of targeted therapy. Targeted drugs are, after all, the hard work of scholars who tirelessly searched for oncogenes. Cruising on the long and winding road to a solution to cancer or indeed, any kind of knowledge, scholars must be driven by a strong will to reach the gate of wisdom. Jason Yuen T o live is to embark on all sorts of journeys, willingly or not. For the unfortunates, one of these journeys is that of fighting cancer. Adopting the title of a song by The Beatles, Prof. Tony Mok , Chairman of the Department of Clinical Oncology and the Li Shu Fun Medical Foundation Professor of Clinical Oncology, gave the talk ‘The Long and Winding Road to Conquer Cancer’ on 14 October. The talk marked the end of ‘The Pursuit of Wisdom’ public lecture series, an event celebrating CUHK’s 55th anniversary. With his iconic, debonair demeanour, Professor Mok shed light for a fascinated audience on how medical professionals walk with patients on the road to overcoming cancer. What Does It Mean to ‘Conquer Cancer’? Professor Mok began by unpacking the concept of ‘conquering’ cancer. It can mean getting rid of the disease, but it also means preventing and controlling it. Certainly, though, they all point to the idea of extending the patient’s life. He first dealt with prevention and noted that it comes in a primary kind and a secondary one: the former aims at stopping cancer from happening, while the latter is about early diagnosis. Focusing on lung cancer, his area of expertise, he named tobacco control as the main preventive measure since the mid-20th century and regulating e-cigarettes as the latest front; in the unfortunate case of having the disease, one will benefit from an X-ray or more so, a CT scan, through which the disease may be detected and treated at an early stage. Recently, experts have also discovered that nasopharyngeal cancer can be diagnosed early on through blood tests, though for now this method does not work with all types of cancer. Professor Mok then illustrated the means of getting rid of cancer. Tumour removals are one method, and since its verification some 70 years ago, cancer surgery has come a long way. Doctors can now operate with the help of robotic arms and therefore, with greater accuracy and efficiency—CUHK is well-regarded in Southeast Asia precisely for its robotic surgery. This can even be coupled with 5G technology and allow surgeons to operate from a distance in real time using robots. However, Professor Mok pointed out that it is still impossible to detect small tumours and thereby remove them. Also, cancer cells could have migrated via blood 人 生在世，情願與否，都要踏上種種征途，而對一些不幸的人來 說，抗癌之路正是其一。腫瘤學系系主任兼李樹芬醫學基金腫瘤 學教授 莫樹錦 便借用披頭四樂隊《漫漫長路》一曲，於10月14日 以「抗癌漫長路」為題演講，為中大五十五周年校慶節目「智慧的探索」 公開講座系列畫上句號。當日，莫教授以其一貫瀟灑撇脫的形象示人，向 聚精會神的觀眾娓娓道來醫者如何與病人同行，邁向征服癌症的大門。 征服也者，所謂何事？ 莫教授先解釋何謂「征服癌症」。「征服」 除有根治之意，亦指預防和抑制。當然， 三者皆以延年益壽為宏旨。他先談預防， 指其分為主次兩種：前者旨在阻止癌症發 生，後者意在及早發現病症。他以自己專 攻的肺癌為例，指禁煙乃上世紀中葉起 主要的預防手段，而最新戰線是管制電 子煙；若不幸患病，則可透過X光檢查或 更為有效的電腦斷層掃描，從速診治。近 年，醫學界亦發現鼻咽癌可在早期藉驗血 診斷，惟此方法尚未能用於所有癌症。 莫教授繼而講解根治癌症之法。切除腫 瘤固然是主要方式，而癌症手術自七十年 前確認有效至今，大有進步。現時醫生已 可借助機械臂施刀，如庖丁游刃，中大正 是以此蜚聲東南亞。這項技術將來更可與 5G科技結合，令醫生得以實時遙距操縱手術機械人，在千里之外救治病 患。不過莫教授強調，醫生仍未能偵測細微的腫瘤，進而除之，而癌細胞 亦可能早在腫瘤切除之前，已循血管轉移陣地。故此，手術須有化療輔 助。學者正研究利用病人自身的免疫系統，清理殘留的癌細胞。 最後，莫教授談到抑制癌症、與癌共存之道。現在化療之外，還有精準 治療，後者成效更為顯著，副作用也較少。對準致癌基因、阻礙腫瘤生 長的標靶藥物，正是精準療法的一例，而協助免疫系統辨認和消滅癌細 胞，亦屬精準療法。未來的抗癌方向之一，是利用CRISPR基因剪接技 術，賦予免疫細胞攻擊癌細胞的能力。 車與車手 在演講中，莫教授主要從技術角度論抗癌，來到答問環節，他以妙喻道 出抗癌另一關鍵。在場有人替家人發問，謂不同醫生對其肺片中的結節 判斷各異，有說良性、有說惡性，不知孰是孰非。莫教授打趣反問他有否 在網上交友，接着拋下精警的一句：「相片並不可靠。」他告誡道，面對 任何事物，都不能單憑外形或某一指標而下定論。 莫教授所言，提醒我們醫學如何昌明，也需醫者嚴謹的工作態度配合。 有人問到，一般人能否透過公共醫療系統，享用講座提及的先進科技。 教授再用比喻回答：「同一款汽車，有人開得很慢，有人開得很快。」他 指公立醫院已備各種抗癌技術，接下來便要靠醫護人員盡心運用。 上下而求索 在談及標靶療法時，莫教授已點出人與技術同樣重要。標靶藥的誕生， 還是有賴學者孜孜不倦、積極找出致癌基因。由是觀之，驅車在征服癌 症，以至從事其它學問的長路上，學者要由剛毅的心帶領，方能奔馳到智 慧的大門。 The long and winding road That leads to your door Will never disappear I’ve seen that road before It always leads me here Lead me to your door —The Beatles, ‘The Long and Winding Road’ 漫漫長路 通往你的大門 永不消失 我見過那條路 它總是把我帶到這裏 請你把我帶到你的門前 —披頭四《漫漫長路》 on the quest to defeat cancer Tony Mok And Miles to Go before I Sleep 莫樹錦 論抗癌之道 路漫漫其修遠兮