“Questions are raised when dealing with patients, but are answered in the laboratory.”

Juan Miguel Cejalvo

Juan Miguel Cejalvo (Valencia, 1984), an oncologist trained at the Hospital Clínico Universitario de Valencia, has been selected to do his thesis at IRB Barcelona under the PhD for Medical Doctors (PhD4MD) programme. He has already joined Roger Gomis’ Growth Control and Cancer Metastasis group, where he will perform the basic research for his project. Aleix Prat, from IDIBAPS, will lead the clinical part of this project. Both Roger Gomis and Aleix Prat have extensive experience in cancer research, especially breast cancer and metastasis. Promoted by IRB Barcelona, CRG, IDIBAPS and VHIR, the PhD4MD programme seeks to train a new generation of physician-scientists in order to facilitate the transfer of biomedical discoveries to patients.

Why did you decide to apply for the PHD4MD programme?

This project seemed like a good opportunity to develop translational medicine, which is what helps us answer the questions posed by patients every day. Five years’ training in medical oncology makes you realize how important research is. In fact, at the end of my studies, I spent two years doing clinical research into the development of new therapeutic strategies—a project that perfectly combined clinical and basic research. And this experience motivated me.

What attreacted you most about the programme?

This programme combines basic and clinical research, which is what interests me. Here I will focus on breast cancer and metastasis, one of the major problems patients face. We know that between 20% and 25% of them will relapse. Studying the molecular mechanisms that enable the metastatic cells to remain in dormancy for so long and then wake up and generate these macrometastases will allow us to develop therapies to prevent relapse, or, if metastasis occurs, to make it chronic or even stop it from spreading.

What advantages does being a doctor bring to research?

When you treat patients with similar characteristics, they don’t all respond in the same way. This raises many questions, and to understand what happens we must go to the lab in search for answers. Translational medicine allows us to continue the research conducted in the lab and in the clinic, and apply it to our patients. I intend to combine clinical research and translational medicine, in order to achieve dual oncologist-scientist profile.

Few doctors do research, why is that?

I think that more and more doctors are willing to do research, particularly in fields like oncology. It also depends on where you have been trained. As a doctor in a hospital devoted mainly to the clinical aspects of disease, you often don’t even consider the possibility of other options. Setting your patients aside to study cells or mice doesn’t cross your mind. As a doctor, patients are very important to me too; I'm here precisely to offer better care. I believe that new knowledge is generated in the laboratory, not at the bedside; this allows us to ask the more biologically relevant questions. But in turn, the best way to apply this knowledge is to use a clinical approach. The questions are raised when dealing with patients, but are answered in the laboratory. I believe this is key to discover novel and more efficient therapeutic strategies.

How did the change from hospital to lab go?

It hasn't been easy. After all the time you have spent studying and working on a particular thing, it's like starting from scratch, you have to change your mindset. For example, clinicians and researchers don’t speak the same scientific language, and also the way of working is really different. In the hospital, you sit beside your patient and you help that person and make decisions with them. But here you have to build and develop a project; if you mess up, you have to go back and possibly start again. In addition, patient feedback is immediate. You help the patients to get better, to cure or turn their illness into a chronic condition, and also managing end-of-life symptoms using palliative medicine. Cells don’t speak to you. You could spend hours working and not reach any conclusion. It’s much more frustrating. In medicine, your reward is almost immediate. In research, you have to work hard to achieve success...but in the end, I think it's worth it. (Albert Ros Lucas)