By Ching-Hon Pui, MD, Leah Sherwood - Last Updated: February 8, 2024
Dr. Pui, Co-Leader of the Hematological Malignancies Program at the St. Jude Children’s Research Hospital in Memphis, Tennessee; Director of the China Program at St. Jude Global; and an American Cancer Society professor, discusses his lifelong commitment to being a pediatric oncologist.
Where did you grow up, and when did you know you wanted to be a physician-scientist?
When I was in middle school, I saw a movie about the touching story of a young boy who was exposed to radiation from an atomic bomb explosion and later died of leukemia. This narrative left an indelible impression on me. I have always wanted to help children with leukemia. However, I had no idea what I wanted to be when I was growing up in Hong Kong. As my senior year of high school drew to a close, I approached my favorite biology teacher for advice. He encouraged me to become a medical doctor. My parents, who had not been afforded the opportunity to go to school, always emphasized the importance of education to me and my two brothers and three sisters. They dreamed that at least one of us would become a doctor one day.
Since we could not afford tuition at the medical school of the Hong Kong university, I went to study at the National Taiwan University, where I was granted a full scholarship. After I graduated from medical school, my brother, who was studying at the University of Minnesota, encouraged me to join him in the United States. After a year as an intern in St. Louis, I was granted a residency at St. Jude. It was during my time at St. Jude that I encountered the same movie that had profoundly affected me in middle school. Recognizing St. Jude as the ideal environment for fulfilling my passion for aiding children with leukemia, I decided to make it my lifelong commitment. Thus, I have dedicated my entire career to St. Jude, a place where my aspirations align seamlessly with the impactful work being done.
Were there any particular mentors who shaped your career path?
I was lucky that Joseph Simone, MD, who was the Chief Medical Officer and later became the third director of St. Jude, took an interest in me. When I was a junior faculty member, he assigned me to report the results of the TOTAL Therapy Study IX, the flagship protocol of St. Jude. St. Jude has always had a strong acute lymphoblastic leukemia (ALL) study team, which generates and builds up a rich database. Joe would encourage me and others to take advantage of it to publish and share the results with colleagues around the world. He provided me with the inspiration to do the same for junior faculty who came after me.
I also was very fortunate that William Evans, PharmD, who is one of the smartest people I have ever met, joined St. Jude one year before I did, and became the institution’s fifth director. We share the same research interest and regularly brainstorm with each other to come up with projects and develop new protocols. We have collaborated on a lot of research, merging his basic science and laboratory expertise and my clinical and translational experience. We have co-authored over 200 publications.
I have also been blessed by the strong support of St. Jude’s other directors, Arthur Nienhuis, MD, and now James Downing, MD, who provided resources and promoted me academically.
All my interactions with these incredible mentors and colleagues made me the person I am today. I am not a particularly vocal person, partly because of my upbringing in Asia more than half a century ago, where students were discouraged from speaking up. Therefore, I teach and mentor people by example.
How do you approach patient care?
Patient care is my priority, and I treat my patients as if they were my children. I make sure we offer them the best treatment at the earliest possible time. I am very grateful to numerous colleagues who helped me achieve this goal over all these years. Being a pediatric oncologist is very rewarding, and my patients have taught me how to be courageous and resilient.
What still needs to be done in pediatric ALL?
Although we have raised the cure rate to more than 90%, we still have a lot of work to do. We need to push the cure rate toward 100% and, of equal importance, improve the quality of life for patients and their families. We need to replace toxic chemotherapies with novel molecular therapeutics, immunotherapies, and cellular and genetic treatments. We also need to find ways to identify patients so we can safely shorten the current treatment duration of two to two-and-a-half years.
Surviving patients suffer from many side effects, and many of them die earlier than their siblings due to the treatment-induced complications or development of second cancer. In this regard, at least 5% of patients have a cancer susceptibility gene. We need to identify not only these patients but also their family members who carry the gene for monitoring and intervention to reduce the risk and provide early treatment of second cancer. We also need to develop cost-effective treatments or other mechanisms to make curative treatments available for patients who reside in low- and middle-income countries. Finally, the observations by epidemiologists that children who attended day care or had microbial exposure early in life have a lower risk of developing ALL suggest that some preventive measures could be developed.
What would people be surprised to learn about you?
I like action movies, such as Mission Impossible. Also, I wake up at 4 am to start answering the more than 200 emails a day I receive from individuals who live all over the world, including Asia and the Middle East. Anything related to a patient, I always answer. It is my weakness.
Ching-Hon Pui, MD, is Co-Leader of the Hematological Malignancies Program at the St. Jude Children’s Research Hospital in Memphis, Tennessee; Director of the China Program at St. Jude Global; and an American Cancer Society Professor. He is also the 2024 recipient of the Society of Hematologic Oncology Emil Freireich Distinguished Pioneer Award.
Original Source: Get to Know ... Ching-Hon Pui, MD | Blood Cancers Today