What’s it like to… be a cancer surgeon?

By Mr Daniel Leff, Consultant in Oncoplastic Breast Surgery at Imperial College Healthcare NHS Trust and Reader in Breast Surgery at Imperial College London

I became curious about surgery as a speciality in my final year of medical school training at Imperial. In my early post-graduate years, I finally decided upon a career in surgery when I witnessed the direct impact it had on improving patient outcomes. I relished the technical challenge of balancing the cancer surgery on one hand, with the need for high-quality aesthetic outcomes on the other.

Currently, I work with a team of four other consultant surgeons delivering quality, high-volume breast cancer surgery and breast reconstructive surgery. The results of our work are very visible to patients. We have a far better understanding of how our surgeries impact physical appearance, psychological well-being and quality of life.

As a Reader in Breast Surgery, my academic interests broadly lie in developing innovative systems to improve the quality of care by enhancing surgical precision and performance. My research work is highly multidisciplinary and sees me collaborate with engineers, physical scientists and computer scientists across many centres within the department, such as the Imperial Cancer Research UK Centre and the Hamlyn Centre.

I feel incredibly grateful to have so many rewarding aspects of my job. There is no doubt that treating cancer patients, seeing them recover and supporting them and their families through the emotional journey of a breast cancer diagnosis is immensely rewarding.

Academically, there is tremendous satisfaction in securing a major grant award for your work or getting that high impact paper published following painstaking research. However, most rewarding of all is the education and supervisory role I undertake. This may include seeing a junior surgeon progress to take on more operative responsibility, or the great privilege of helping a Clinical Research Fellow achieve a project grant or recognition for their work.

My greatest challenge is achieving balance. My clinical and academic roles are extremely demanding, but I enjoy them both hugely. The potential danger is to devote too much time to one aspect at the expense of the other. The demands of patient care must always be prioritised, and at the same time, the academic endeavour is incredibly important. Balancing my time outside of work for my family and personal pursuits is also critical and something I am learning to prioritise.

I’ve been fortunate to be awarded two Cancer Research UK grants in my career. The first was to lead a trial testing an intelligent knife (the iKnife) for breast cancer surgery. In this validation study, we hope to develop a system to reduce the burden of follow-up surgery by helping surgeons remove all of the cancerous tissue. The second one was to co-ordinate a UK-wide team to develop a novel, flexible robot for early breast cancer detection and precision treatment (MAMMOBOT). I was also incredibly humbled to receive the inaugural Issac Gukas Medal in 2016 for my achievements in the Master’s degree in Oncoplastic Breast Surgery.

It is tremendously rewarding to have such a direct impact on patients’ lives through my job. I really hope to continue making a positive difference in people’s lives, whether this be through the patients I treat, the innovations we are developing to improve surgery, or the teams in which I work and lead.

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