Learn more about our Member Spotlight of the month, Dr. Jianyu Rao from his conversation with Membership Committee Member Ms. Po Chu Fung.
Member Spotlight Interview
1. Please tell us about your background and training.
In the mid-1980s, after graduating from Shanghai Medical University I was working as a Field cancer epidemiologist on several large clinical trials and epidemiology studies at the Cancer Institute, Chinese Academy of Medical Sciences in Beijing, China. This project was a collaboration between China and the National Cancer Institute in the U.S. The main goal of this project was to do research on early cancer detection and prevention. Our group was trying to use the chemo-preventive approach to reduce cancer incidences in high risk populations. We focused on finding biological markers that can be used to detect pre-cancerous lesions so that the chemoprevention can be more effective.
There were two groups that I collaborated with; one group was pathologists from UCLA, directed by Dr. Roberta Nieberg, who was doing research on esophageal cancer using the balloon abrasion technique to collect esophageal brushing samples. Target population of this project was a place called Linxin in China, which had a very high incidence of esophageal cancer. Another group was headed by Dr. George P. Hemstreet, an urologist from the University of Oklahoma, who later became my mentor. In 1987, Dr. George P. Hemstreet invited me to come over as a visiting scholar to do research in his laboratory. For several years, we developed a technique called “quantitative fluorescence image analysis,” which allows multiple biomarker analysis including DNA ploidy, oncogene protein, growth factor receptors, etc., on single cell basis on cytological specimens. In 1994, after passing the national medical license exams, I started my pathology residency training in both AP/CP, and additional cytology fellowship training at UCLA. I have stayed at UCLA as a faculty in the division of Anatomic Pathology ever since.
2. How did you first find out about cytology?
While I was working at the Cancer Institute in China and later as a research scholar at the University of Oklahoma, my earlier involvements with the cancer biomarker studies provided an opportunity for me to learn about Cytology. I was amazed that a single cell from Cytology specimen can offer a very simple means for cancer surveillance and detection, such as screening Pap smears, urine cytology and esophageal brushing cytology.
3. What drew you to this profession?
After spending six or seven years in the laboratory as a biology research scientist, I’ve become much more interested in the clinical aspects of cancer diagnosis in Pathology, especially in Cytology. Because of my previous experience working on urine and esophageal cytology specimens, and particularly, the opportunity to learn from Dr. Dorothy Rosenthal, who is one of the leading figures on this topic, I had decided to choose UCLA as the starting point where I got my training as a Pathologist, and specialized in Cytopathology. One thing unique for my situation was that I received a NIH Grant to study cancer biomarkers prior to my residency training. At UCLA, I was able to combine my residency training with my research.
4. Tell us about an interesting case or situation that you’ve encountered in your practice.
With any cases that I sign out every day, potentially, there be a very unique one, because each case represents a different patient. There is always something intriguing, stimulating, and challenging every day; there is never any boring moment in Cytology.
5. What do you like best about being a cytopathologist?
As a cytopathologist, I try to provide as much information as possible to the clinicians, based on however limited or small samples that I have. I believe Cytology plays a very important role and is the forefront in contributing to not only management of diseases, but also and probably more importantly, preventing the diseases. The best example is cervical cancer screening. We all know that it is one of the most widely used and cost-effective ways to screen for pre-cancerous changes of cervical cancer, and it remains an effective method in reducing the incidence of cervical cancer worldwide. It is a very rewarding career knowing a simple test can make a big difference in terms of disease prevention and patient care.
6. What do you value most about your membership in the ASC?
The ASC is a very well organized professional society. It not only provides a platform for the pathologists and cytotechnologists in the US, but also for the clinicians, scientists, and other medical professionals from around the world. It creates a center stage for all of us to exchange ideas, to network, to collaborate on projects, and also to learn and be inspired from each other. The ASC Annual Scientific Meetings also provide wonderful opportunities for young, aspiring pathologists and cytotechnologists to network, to showcase their research projects, and to participate in many of the activities in the organization.
7. What are your thoughts about the future of Cytology?
As I mentioned before, morphology-based Cytology is a very effective and simple method to detect and analyze disease processes, and it will continue to be in the forefront of patient health care. Obviously, Cytology by morphology alone also has its limitations. For example, morphology can tell us if the tumor is cancerous, but it won’t be able to tell us how the cancer is going to behave, whether the cancer will spread or not, or how the cancer is going to respond to treatment. That is why biological/molecular markers are important, and should be added on top of the morphological analysis to further characterize the tumors and guide therapy or preventive measures.