Meet Dr Vincent, the first professor of urology at Cambridge in 800 years

 

MALAYSIANSKINI | Dr Vincent J Gnanapragasam was elated when Cambridge University approved to lift his title to professor this year.

By then, he had been serving as a lecturer in urology at the university for 13 years.

To satisfy his curiosity, Vincent went to the university’s library to see if he had any predecessors

“I asked the Cambridge University library, has there ever been a readership or a professorship in urology?

“The librarian said it doesn’t look like there’s anything,” Vincent recalled during a virtual interview with Malaysiakini recently.

A difficult but rewarding journey, Vincent said he was proud of being where he is now, and shared his story of how a young boy from Petaling Jaya grew up to be the first-ever professor of urology at one of the oldest surviving universities in the world.

Son of a surgeon and a nurse

Born in 1969, young Vincent grew up in Section 5, Petaling Jaya. His father was an ear, nose and throat (ENT) surgeon while his mother was a nurse.

“My dad was the first in his family to go to university. From a young age, there was a lot of emphasis on education,” Vincent recalled his childhood.

He went to La Salle Primary School alongside his brother, while his sister went to Assunta.

Keen on having his children receive better education, Vincent’s father sent him to a public boarding school in Singapore, where he spent his teenage years.

“I was very active in a lot of things back then, always curious about the different aspects of life like arts and music.

“I often found that these activities really helped me in education, the broad base of knowledge which extended beyond the subjects I was studying,” he remembered.

Vincent said he picked up guitar and drums when he was young, and once even formed a band with his friends, but never went far down the musical road.

He has always been fascinated about discovering more about things he did not know about, which he believed is a quality that helped him in medicine, the field he went on to pursue after secondary school.

Having first moved to the UK to study medicine in 1988, Vincent later found his interest in urology, which was partly influenced by his exposure to his father’s career in ENT.

“I was interested in the practical aspects of medicine due to my father, but the reason I like urology is that it has a very good mix of the medical and surgical aspects.

“That’s what attracted me,” Vincent said, adding he found the field interesting as doctors deal with a wide range of problems from benign ones like kidney stones, to difficult ones such as prostate cancer.

“In fact, I was very impressed by the commitment of the urologists,” he said on his observation while in medical school.

Polishing his CV

Vincent graduated from Newcastle University with a degree in medical science and MBBS, carrying the title of medical doctor.

“Even then, my thoughts were more to become a consultant, working in a standard practice, or maybe become a urologist,” he said, not aware that he will spend the next decades in the field of research.

While continuing his days in the UK working as a medical officer, Vincent was trying to polish his CV and came across a professor of urology at his alma mater, who offered him a job in the lab.

Despite his interest in the field, Vincent admitted he had not done any urology research up to that point.

“I said okay, I’ll come along, and the group was very kind, they accommodated me,” he recalled, and the fresh grad took the opportunity to learn about molecular biology techniques, research works in labs, and writing research papers.

Working in the Newcastle University lab sparked his interest to continue further in the line of urology research, and Vincent eventually secured funding from Cancer Research UK to pursue a doctorate in philosophy (PhD).

It was a busy season for him afterwards, as he continued to do academic research training, before moving into a consultant job and was a commissioned scientist before a professor approached him.

The professor was from Cambridge University, and he invited Vincent to be a university lecturer there.

Vincent gladly accepted the job, and from then on his work was split between teaching, practising, and researching in urology, particularly on prostate cancer.

Prostate cancer

“This might be a strange thing to say, but people always think cancer needs treatment, and that’s not always the case,” Vincent said as he started to explain about the research field he specialises in.

He said as his research deepened into the field of prostate cancer, he became interested in understanding the true benefits of treatment and how some people might not need prostate cancer treatment at all.

“Prostate cancer is a complicated disease, in fact, many men will get prostate cancer and most men will live with prostate cancer.

“Trying to decide who needs treatment is actually difficult,” he said, as operations can have serious side effects on patients, including leakages, loss of erection and other impacts.

“I became particularly interested in understanding the true benefits of treatment, and that led to the development of research tools to better risk-stratify patients,” Vincent added.

As a result, he and his team developed a web tool called Predict Prostate, which was incorporated by the UK's National Health Service (NHS).

The tool helps patients diagnosed with non-metastatic prostate cancer, meaning cancer that will not spread to other parts of the body, to make an informed decision on whether further treatment is needed.

The tool was launched two years ago, patients can get individual information for themselves to weigh the risk and benefit of receiving treatment for prostate cancer.

Vincent explained the medical field had long established that many men can live with prostate cancer without struggle as it is a slow-growing cancer compared to others.

“So if you treat someone with a slow-growing cancer that’s unlikely to cause trouble, then it can cause side effects which are no benefit for them.

“Instead, we can do surveillance or monitoring of cancer, which is to keep an eye on it, and if things change then you give treatment,” he said.

Citing his and others’ research, Vincent said in many situations, there is no difference between a person receiving a treatment versus someone who did not, especially in those in the early stages of cancer.

“It was impossible in the past to be sure who needs the treatment, hence why we developed this tool.

“So that’s the evolution of a long line of research in an area that I’m particularly interested in,” Vincent said on Predict Prostate.

Treatment not so straightforward

Moving forward, the urology professor believes that the field of urology and prostate cancer in particular will become busier with an ageing population worldwide.

“Ironically, prostate cancer didn’t exist a couple of hundred years ago, because people didn’t live long enough.

“The longer you live, the higher the risk, hence why I said having prostate cancer doesn’t mean it will affect you in your natural lifetime.

“A lot of people may not need treatment (for prostate cancer) as other things might happen, like heart troubles,” he said.

Now, with the knowledge that prostate cancer treatment can cause unnecessary risk of serious side effects, Vincent said more men are opting for surveillance to preserve their quality of life.

Besides the development of Predict Prostate, Vincent’s team at Cambridge also developed the Cambridge Prostate Biopsy Device (CamProbe), which is a safe, low-cost device that eliminates infection and sepsis risks when taking biopsies.

At the moment, conventional biopsy procedures require an ultrasound probe of the back passage, and a biopsy needle will be inserted through the back passage to reach the prostate.

That procedure, Vincent explained, creates a high risk of infection. The CamProbe on the other hand, allows biopsies to be taken through the perineum, the area between genitals and anus.

The new device cuts down the risk of infection, as well as the tissue trauma and pain for the patient.

“The key thing about the device is it’s a simple device and can be used anywhere. We’re hoping to make it low cost and hopefully, it will be rolled out next year,” he said.

Reader to Professor

Vincent’s hard work and contributions in the urology field earned him the title reader last year.

A readership is an academic title used in the UK and some Commonwealth countries universities, given only to senior academics with a distinguished research reputation.

The title used to sit between the hierarchy of lecturer and professor at Cambridge University.

This year, the university decided to make changes to academic titles by abolishing the reader title. Hence, all previous readers are now to be referred to as professors.

That makes Vincent the first-ever professor in urology at the university, but he noted that these titles are more personal recognition of an individual’s contribution rather than a work position.

“It means it is created for you. When I retire the title will be defunct, it’s not a role which is then passed to the next person,” he explained.

Vincent added for his readership last year, he had only earned it after going through lots of work, including reviews by multiple committees.

“They have to agree you have achieved certain standards to be appointed to the readership. You have to contribute to research and teaching a lot, on top of other general contributions.

Not an easy journey

Looking back, Vincent said his journey has been a difficult one, as he had to face countless rejections and disappointments before reaching where he is now.

“Too many to give you one,” he said, noting that throughout his career, applying for research grants usually only have a 10-20 percent chance of success rate.

“It can be very demoralising, after trying and getting rejected multiple times.

“But I will say this. Whenever I had challenges and problems, there’s something an old retired consultant once said to me: ‘You do the best you can with what you have’,” Vincent recalled.

That has been his motto ever since, and he believes strongly in perseverance and self-reliance.

“When you start to rely on others for success or to give you things, or you start thinking that you lack this and that to succeed, then you will definitely fail. It means what you have comes from other people.

“But if you can be self-reliant, and you do whatever you can, then that is success. It doesn’t matter about the title or what position you reach,” he said.

Losing his mother

Besides determination and self-belief, Vincent also has a family in the UK now. Married to another university lecturer and a father of three, he said he spends most of his free time with his family.

“If I’m not at work, I’m with my family. We like travelling as a family, we like food and I like to cook.

“You can imagine as a Malaysian, good food and the varieties of it are always important,” he said.

“My children are all starting to attend university, so maybe in years to come I’ll have more time to join societies, organisations or that kind of thing,” he added.

The Petaling Jaya-born professor mentioned he missed the weather, food and his family back in Malaysia.

“Sadly, my mom passed away this year, and we couldn’t go back to attend her funeral due to the pandemic,” he revealed.

Vincent’s mother has been suffering from dementia for some time and was taken care of by his sister.

“We couldn’t be there when she passed away, that was quite sad. But really by that time, she couldn’t have recognised a lot of people so in a way I think it was a blessing for her to pass on because living with dementia is very difficult,” he said.

Vincent contended that despite what people might assume from his family background, the reality was tougher than it seems, and he had worked very hard when given the opportunity.

Vincent also mentioned his father as a figure that shaped his life principles, recalling his father’s sacrifice for his children.

“My dad wanted to educate his children well, and he knew he didn’t have enough money. So he went to Sabah to be the first ENT surgeon there,” Vincent said.

In order to save more money for his children, Vincent’s father would give up renting a room or a house while working in Kota Kinabalu, instead opting to live at the back of the shop lot he was working in.

“That’s how he could put the money aside for our education. That example showed me that I have no excuse but to work hard,” he said.

Malaysia needs equal opportunity

However, Vincent admitted that having even opportunities is also crucial for a person to succeed.

He encourages everyone to pursue education at all costs, no matter the field, and grab the opportunity when it is given, while also imploring those with power to give out opportunities equally.

“At the end of the day, being given an even opportunity is very important because you never know where the next Albert Einstein or Nelson Mandela may come from.

“Opportunity, education, and equality are three things that made an organisation successful.

“I had the chance to have all of those but that doesn’t mean it was without challenges,” he said.

Commenting on his birth country Malaysia, Vincent thinks that if the country can address the issue of equality in education, then it can stop the brain drain that the country is experiencing.

“I hope more opportunities will be available for anyone anywhere, and also for Malaysians, especially the youngsters.

“Because that is what makes an institution, an organisation, or a country successful. If you don’t have those, then you will never see the best price,” he said. - Mkini