Professor KJ Patel
Oxford expert named Cancer Research UK's Chief Scientist
Professor Ketan (KJ) Patel is Director of the MRC Weatherall Institute for Molecular Medicine and the MRC Molecular Haematology Unit at the University of Oxford.
Following his appointment as the new Chief Scientist at Cancer Research UK in October 2022, Professor Patel spoke to us about his journey to this point, and what he sees for the future of cancer research.
A maverick decision
Incredible as it may sound, Professor Ketan (KJ) Patel feared he would not make it in science.
And it is surprising, because, during a 30-year career in cancer research, the self-effacing KJ has been responsible for key breakthroughs in the devastating condition that will affect one in three people.
He was recently made head of research of Cancer Research UK, which is the world's largest cancer research charity. This is on top of his day job(s) of leading Oxford's MRC Weatherall Institute of Molecular Medicine and the MRC Molecular Haematology Unit.
Oh, and he was also the very first Patel (a very common surname with some 20 million worldwide) to be made a fellow of the Royal Society.
'I thought my scientific career would end in failure'
And that, he says with amusement, is the key. Patels, all originating from the Gujarat region of India, are not expected to become scientists.
Professor Patel explains, science was not really seen as a respectable profession, either by his parents, or it seems, by the young KJ.
He took the precaution of qualifying as a doctor, to have something to fall back on, because, as he says, 'I thought my scientific career would end in failure.'
Most would not see a career in science research as a maverick decision, but he laughs, 'My mother kept asking why don't you become a cardiologist. It's much better paid.'
A revolution in cancer research
Happily, for us, the young KJ stuck with his research and is today set on helping the next generation of researchers take forward the challenge of cancer research – although Professor Patel is very far from done with his own.
Some things are simple and are made needlessly complicated. Some things are deemed complicated but are really very simple.
'We are living through a revolution in cancer treatment'
Then there are things which are complex, whichever way you look at them. But Professor Patel is very patient in trying to explain, in the simplest possible terms, the extremely complicated and important work he does.
Imagine you're talking to someone who knows absolutely nothing. He does not protest.
He comes armed with simple analogies to explain astonishing research and breakthroughs in our understanding of cancer: why it happens, what causes it to spread and how this spread could be stopped, so that you almost understand.
Professor Patel's awe-struck amazement at the advances made in his lifetime is infectious.
'We are living through a revolution in cancer treatment,' he says, astonished, as though he has not been responsible for some of that revolution.
In the last few years, his team at Cambridge was involved in one such important breakthrough: identifying how alcohol causes cancer, as well as understanding the ageing process and why cancer frequently emerges when we are older, showing that when you fail to repair broken DNA properly then you create changes that start the cell on its journey to become a cancer.
Deep roots in Kenya
And yet, he was nearly not a scientist at all, nearly not a doctor and nearly not a cancer researcher. KJ was born in Nairobi, where his parents had gone, in the dying days of empire, from their home in India.
'Idi Amin had thrown the Asians out of Uganda; there was concern the same thing would happen in Kenya,' he says. In the event, the Patel family remained in Kenya.
His father was a GP and the family settled in the capital. Nairobi was not the city it is today, and it was an idyllic time. The young KJ attended a prep school on the edge of the Nairobi National Park.
'I remember once, a cricket match had to be abandoned because there were giraffe on the edge of the pitch,' he says. KJ speaks of Kenya with great fondness and visits every year, retaining his Kenyan citizenship and having deep roots.
He only regrets he has not done something for the country of his birth. Professor Patel says, 'Perhaps one day I might contribute to new ways to treat snake envenomation which kills and maims many people in Kenya.'
The current ways we treat this is very primitive, and has not been impacted by the huge strides made in treating cancer for instance – he explains. Some of technologies used in new cancer treatments could so easily be adopted to transform the way we could treat venomous snake bites. Such is his determination, it is hard to believe he will not return to this at some point.
Coming to England in the mid-1970s must have been a shock for the schoolboy. He had come to senior school in the Wiltshire countryside and discovered Britain was 'quite xenophobic even under the then Labour government'.
It cannot have been improved by boarding school life. Professor Patel says he was introduced to the 'very violent' game of rugby. 'There was an odd shaped ball and these massive boys, all stampeding towards me – I threw the offending ball in the air and fled the pitch!'
He was not able to go home or see his parents for two years, as the cost of travel was too great – on top of the fees that the family had to pay.
'As soon as air travel became cheaper, I could go back once a year,' he says plainly, maintaining he was 'not a particularly distinguished student'. But he did sufficiently well enough to be able to choose between medicine and law.
Learning from the best
'I flipped a coin,' he smiles. 'It came down for law, but I decided to be a doctor instead and went to the Royal Free Hospital and medical school in London to train.'
It set the trend for his counter-intuitive future course. And perhaps the 'maverick' was born. Free from the constraints of school life, the medical student Patel decided very quickly that he did not fully want to take part in the medical school course of study. He was going to teach himself – or rather, he was going to learn from the best.
'I found I could walk into any London teaching hospital and sit in with the greats when they were seeing their patients,' he says, with typical enthusiasm. His optimism was not shared by the medical school, however: 'I was a terrible and somewhat argumentative student.
They nearly didn't let me take the final exams because I hadn't been to the lectures and they thought I wouldn't be up to the exams.'
Although quite unusual for a university professor, he has a 'don't do this at home' style approach to learning: 'You can teach yourself just about anything in 20 minutes from a YouTube video.'
Maybe he can, but perhaps this is best not followed by aspiring scientists and doctors.
But it was while studying for his final medical prize exams, he was told that he should read a new book on molecular biology. It proved to be an epiphany moment in his career, he says.
An introduction to Weatherall
'Someone gave me a very exciting white book by Sir David Weatherall (after whom the Weatherall Institute is named). It was the called The New Genetics and Clinical Practice. It was supposed to take a week to read but I was immediately transfixed and read it in a night. It was completely revelatory. It convinced me to learn molecular biology – the then newly emerging science of genes.'
Having designed his own medical course, the young Patel bought the standard textbook on molecular biology and worked his way through this, while working as a young junior doctor in the hospital.
By now, Mrs Thatcher was Prime Minister and the hospital was half empty, because of cuts to the NHS budget.
'There were no patients, and the wards were closed, so I had lots of time to read,' says Professor Patel, who decided that his next step should be to study the subject at the infamous Laboratory of Molecular Biology – LMB for short – in Cambridge, rather than becoming a practicing doctor.
A letter to a Nobel Prize winner
'It was the best place in the world, the birthplace of molecular biology, the place where Watson and Crick discovered the DNA double helix, where DNA sequencing had also been invented' – and where he wanted to go.
Eschewing more conventional methods of seeking entry, the then Dr Patel wrote to a lot of famous scientists at the LMB, asking if he could study with them. One, the Nobel prize winner Sydney Brenner, replied, sending him a handwritten note suggesting he write to the brilliant Professor Michael Neuberger.
In another don't do this at home moment, the young hospital doctor phoned the unsuspecting scientist and told him he was coming by train to Cambridge the next day and wanted to do a PhD with him.
'He took pity on me and accepted me,' says Professor Patel. 'He was a remarkable mentor and I found myself working in the most exciting environment, populated by leading figures of the 20th century, who were so nice and so normal. They talked to you as though they could learn something from you.'
Return to the Royal Free, and to Cambridge
Once his PhD was finished, with an eye to the future, and possibly under parental pressure, he returned to the Royal Free to complete his clinical training and qualify. It was not a happy return. The hospital had acquired a star doctor – one Dr Andrew Wakefield [who was to go on to start the scare over the MMR vaccine].
'I realised Wakefield's work was fundamentally flawed, and I kept telling my senior doctors and colleagues this which did not make me popular at all – there was no real culture there at that time to make sure one got things right!' says Professor Patel, causing him to return back to Cambridge.
It was fortunate all round. Returning to Cambridge, he started researching a new gene called BRCA2. Alterations in this gene are responsible for up to 10% of breast cancers.
The key question was what this gene did, and working with a team he showed that it was a key factor in fixing damaged DNA. Cancer associated alterations prevent BRCA2 from doing this vital function.
This was a ground-breaking discovery not just because it explained why inherited changes in this gene leads to breast cancer susceptibility, but also because it stimulated others to invent a completely new class of drugs to treat these cancers.
These drugs are now some of the most effective treatments for this common devastating disease. For KJ, this discovery led him to realise that the DNA in our cells is fragile, being constantly broken – so that is why it is essential to fix this.
But then what is causing the DNA in our cells to be constantly broken?
Understanding the impact of DNA mutations
According to Professor Patel, 'Our DNA sits inside our cells, which is essentially a large complex chemical reactor with all the basic reactions that provide the cell energy and burn this energy to enable cells to live and grow. A trade off of all this activity are byproducts that damage the DNA.'
He carries on, 'Perhaps our most impactful discovery was to identify a common class of such toxic molecules called aldehydes, they are in fact ubiquitous – for example when you have your evening gin and tonic.
'The alcohol in gin is converted briefly into one of these toxins, and the cell tries to quickly remove this, but if too much of this is formed then this damages the DNA.
'If this is not properly fixed then this can create the changes that lead the cell to become cancerous, so by chance this discovery explains why alcohol consumption can increase the risk to get cancer.'
Building on this more recent research shows that even alcohol abstention will not protect you from these toxins. It turns out the body produces a large amount of formalin, which is a well-known chemical used in embalming.
Without being able to clear these endogenous toxins and repair the damaged DNA they cause, life would not be possible. Just simply overwhelming these defences is enough to cause long-lasting damage.
A remarkable place to do science
Cambridge was to be Professor Patel's home for some 25 years and, he jokes, despite the discovery of how bad alcohol is for you, he is better known in the fens for drinking wine than for his cancer work.
'I am a serious wine taster and on a good day I can guess where a wine comes from by tasting,' he says with enthusiasm.
But then how does he square this hobby with his research on the cancer-causing properties of alcohol?
'Well we have to separate away knowing the facts from how one chooses to act on them – this after all is free will.'
After so many years at Cambridge, he took the opportunity to move to Oxford to lead the MRC Weatherall Institute of Molecular Medicine. He says he wants to give back and create an environment where other people can have similar opportunities to those he has had.
As for missing Cambridge, he is sanguine: 'Life's a continuum…As a first-generation immigrant, you are used to displacement and converting this into new opportunity. It is a great privilege to head this institution… I took over one week before lockdown. So, I had to learn leadership qualities very quickly.'
He adds, 'Oxford is a remarkable place to do science – with a stunning back drop.'
The 'Big Bang' of cancer research, and a new role for Professor Patel
It is important to Professor Patel, the qualified doctor, that his research has real world health implications. And he says with a sense of real excitement, 'We are now living though a 'Big Bang' of cancer research – the journey towards a complete understanding of cancer.'
He is thrilled to have been chosen to be head of research for Cancer Research UK, the biggest funder of cancer research in the world, and is amazed at the generosity of the 'remarkable people' who raise £400 million a year for cancer research.
'We won't be able to eradicate cancer, it's a fact of life,' he says. 'But we are already able to identify people who have a likelihood of getting some cancers – with routine screening.'
The next challenge, he says, is to be able to identify cancer in the earliest stage. 'If for example you're able to detect cancer-derived DNA which is shed in your blood, this might identify the disease earlier so that it can be removed.'
And he is also interested in the question of why older people suffer cancer as they age. The thing is, though, he says, 'Life is one large complex chemical process… there is no free lunch in the biology of life because it comes with an inherent destructive part.'
Using the analogy of a fire, Professor Patel says, 'There is a trade-off. When a fire burns it of course consumes fuel like coal or wood and turns this into ashes, and while one might be able to use the energy released in the fire to cook something, the flames and heat can also burn things around it.'
Having said that, Professor Patel talks of the massive strides that have taken place in the last few decades, which have seen such a huge step change in research.
Using old technology, it took many years and huge expense to sequence the first human genome – but now it takes hours to do this and a fraction of the cost. He says, 'The speed and scale of what can be done now to reveal the secrets of life is unprecedented…. we'll have to see how the next few years are going to go.'