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Pioneering new ways to beat cancer

Dr. Fang-Fang Yin last year left the United States, the country where he made his name as a pioneer of a new cancer therapy, and returned to China to lead the Medical Physics Graduate Program at Duke Kunshan University. Below the professor explains how he got here and shares some wisdom for finding your purpose in life.

A student knocked on my office at Duke Kunshan University and walked in saying, “I’m a bit lost in life. Can I have a chat with you?”

He was standing across from me, not knowing what he wanted to do, feeling generally dissatisfied. When facing these sorts of situations, I always offer to share my own experiences. I believe everyone goes through these moments at some stage in their life.

Looking back through my life, I moved to the countryside from the suburbs of Ningbo, was one of the first to sit the relaunched college entrance examination, studied physics at Zhejiang University, changed majors to further my studies in the United States, and went on to help Duke University establish a medical physics department. Now, at the age of 65, I have returned to China to teach at Duke Kunshan.

Many American colleagues were shocked at my decision to return to China. Over the past 30 years, I have helped the Duke University School of Medicine establish a medical physics program and clinical physicist training program, improved radiotherapy clinical subjects, trained many students, written many radiotherapy and quality assurance guidelines, and was awarded the title of Gustavo Montana Distinguished Professor at Duke University. All of these are considered significant achievements in the United States, but I still chose to return to my hometown.

It has been in my mind for a long time to do something for the cause of medical physics and radiotherapy in China. At first, I didn’t even know what medical physics was about, but life is full of contingencies and necessities. I experienced confusion and faced difficult choices, struggles and sacrifices. Medical physics has been intertwined with my life.

Seizing opportunities

After graduating from Ningbo High School, I went to the countryside, only to find there were too many people working there. I knew I would have to leave in the future.

A sense of confusion washed over me. Should I join the military or go to university? My preference was to study, but back then, going to university required certain conditions and opportunities.

For this reason, I worked very hard in the countryside for two years. Life at that time was tough. Rice seedling transplanting relies entirely on human labor. Sometimes, I would get up at two or three in the morning and work until nine or 10 at night, with my body immersed in mud and insects crawling up my arms.

During this time, although very tired, I did not feel any pain. I did the work conscientiously, taking medicine when sick and washing my clothes when they got dirty. Looking back, it was a memorable life experience, teaching me how low-income groups live, what matters most in life, what I should focus on doing and what to think about.

In 1977, the spring of technology brought a movement of agricultural modernization. However, people were unfamiliar with technology and thought modernization could be left for another day.

To showcase “technological achievements”, machines were used to press the seedlings into the ground quickly. As a result, the seedlings transplanted by the machine could not grow, and most had to be replanted by hand.

The experience of transplanting rice seedlings taught me an important lesson: advances in science and technology cannot be achieved in a year or two. They require time, the accumulation of knowledge, and continuous testing and improvement before application.

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Then suddenly that year, the news arrived that we could apply for college. I decided to continue my education and was admitted to Zhejiang University, where I was presented with another world.

Entering the world of medical physics

Opting for a physics major in college was an unexpected path for me. During the college entrance examination, my first preference was solid state electronics. However, upon admission, the name of the major changed to solid state physics.

After a year of study, our professor, who has a strong admiration for luminaries like Zhenning Yang and Zhengdao Li, shifted our academic focus toward theoretical physics, an area that was not my main passion back then.

After graduating from college, I was assigned to teach general physics in Shanghai. Although many considered this an excellent job, I remained steadfast in my desire to pursue further education abroad and applied to a physics program at a university in the United States.

Upon arriving there, the prevailing trend in physics was the study of superconductivity. In 1987, the Nobel Prize was awarded to a German-Swiss team credited with the initial discovery of superconducting materials.

I wondered whether superconductivity could be applied to the field of biology, so I went to observe what was happening at the local hospital. There I contemplated how to integrate principles of physics with medical knowledge.

We previously relied on electroencephalography (EEG) to measure electrical activity in different parts of the brain, but it provided imprecise information. I wondered whether superconducting materials could provide a more detailed understanding of a patient’s pathological condition since they could measure extremely weak magnetic fields without direct contact.

This further led me to contemplate whether we could use them to measure the magnetic field distribution in memory regions to understand how memories are formed. I found this fascinating and decided to pursue a doctoral degree in this direction.

Eventually, I was admitted to the University of Chicago, and through a stroke of luck, I found myself staying in the Department of Medical Physics. It was from this point onwards that I began to delve deeper into the field of medical physics.

 A new approach for fighting cancer

Medical physics is a vast interdisciplinary field that explores how modern physics can be applied to diagnosing and treating diseases.

One of the main focuses of medical physics is medical imaging. Our work involves ensuring that various medical imaging devices are of optimal quality. Additionally, we provide feedback to medical imaging equipment manufacturers regarding clinical imaging requirements, how it should be designed, what standards it should meet, and how to improve it if those standards are not met.

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Another significant facet of medical physics is radiation therapy (RT) utilized in cancer treatment. Our role involves designing methods to safely and accurately apply radiation to eliminate cancer cells.

While surgically removing tumors is an option for some cancer patients, it is not always feasible for tumors that are difficult to excise completely. Radiotherapy that eliminates cancer cells with radioactive rays offers the advantage of destroying cancer cells without the need for surgery.

Medical physics was still a niche field in the United States back then. Many of my classmates who studied physics with me switched to computer science, but I was determined to excel in medical physics.

Over the following 30 years, as computer technology advanced, the field gradually took shape, transitioning into the era of precision radiotherapy.

In 2000, at Ford Hospital, a woman in her 40s was diagnosed with lung cancer, and the cancer cells had metastasized to her spine. Despite several rounds of tumor removal surgery performed by neurosurgeons, the cancer cells kept recurring in her spine after each operation. Consequently, only palliative care measures could be taken.

At that time, I was participating in a multidisciplinary conference when surgeons approached me to express their sense of helplessness about the patient’s condition.

They said that the patient’s situation was deteriorating, and they were running out of options. They inquired whether it was possible to attempt a single-session radiation surgery. I responded, “Let’s give it a try.”

The technology had just advanced enough to make radiation surgery possible. We intricately designed the radioactive source, ensuring that the rays were directed precisely, like countless sharp arrows, targeting the tumor tissue to eliminate cancer cells while minimizing harm to healthy tissue. After a week, the patient was able to walk and came to us to express her gratitude.

The success of this surgery gained attention across the United States, leading industry insiders who had previously not acknowledged this treatment method to promote it nationwide.

Subsequently, this therapeutic approach came to be known as stereotactic radiosurgery. As one of its pioneers, I also participated in developing relevant treatment guidelines in the United States.

Numerous equipment manufacturers sought to collaborate with us during that period for our knowledge of clinical requirements and technological implementation, and also for our prioritization in patient comfort, effectiveness and safety in our treatment approach. At that time, most of the imaging therapeutic devices in the United States were either designed by medical physicists or developed with our assistance.

Returning to China

With advanced technology and an increasing number of cancer patients, the medical physics industry has been continuously growing and expanding in the United States. But on July 31, 2023, I returned to China. I was torn about whether to do so.

While remote work offered flexibility, I recognized the importance of being physically present for specific tasks. Ultimately, I embraced a new challenge and dedicated myself to my homeland.

In 1996, I began exchanging ideas with experts in the industry in China. Ten years later, I co-founded the Sino-American Network for Therapeutic Radiology and Oncology (SANTRO), bridging radiotherapy exchange between China and the United States.

In 2008, collaborating with the domestic Society for Radiation Oncology, we co-hosted the Annual Meeting of Radiation Therapy and spearheaded quality control for a multinational clinical radiotherapy trial. As a result, I have gained a profound understanding of radiotherapy in China.

I have observed that China’s medical physics expertise still lags behind international standards, especially in talent cultivation and education. This area requires attention, and I aspire to be part of the vanguard in addressing these gaps.

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Talent development is not a quick endeavor; it requires five to 10 years of dedicated effort. Rushing the process makes it difficult to establish a top-tier discipline. This reminds me of 1977, during my time in the countryside, when there was a rush to achieve agricultural mechanization. Instead of saving time, it ended up wasting resources. Education follows a similar principle.

Medical physics with Chinese characteristics

In 2013, we made vigorous efforts to introduce Duke University’s medical physics discipline to Duke Kunshan University. While the medical physics program at Duke Kunshan University was based on the Duke University model, I aimed to imbue it with distinct Chinese characteristics. The results have been gratifying.

Over the past decade, through our team’s dedication, the medical physics program at Duke Kunshan has garnered recognition from students, parents and colleagues alike.

I often share with students that pursuing a career in medical physics entails both sacrifices and rewards. It may mean working during the day and conducting research during evenings and weekends since research often lacks fixed hours.

Providing precise radiotherapy for cancer patients in clinical settings may demand a significant time commitment. However, when you realize that your efforts can result in more accurate, effective and safe treatments for patients you will find that every sacrifice is worthwhile. Medical physics is a discipline with a profound sense of purpose.

Looking back on the life I’ve lived and every decision I’ve made, I feel confident that I’ve made the right choices.

Years later, some classmates who had shifted from the physics department to other industries approached me, expressing their interest in transitioning to medical physics.

They remarked that I had shown great foresight. Actually, I did not possess extraordinary foresight, I merely followed my interests and was totally committed to pursuing them.

Returning to the perplexed student visiting my office, I did not prescribe a course of action for him. Instead, I asked him, “What do you aspire to do?”

Once I understood his aspirations, I could guide him step by step on how to pursue them, encouraging him to strive for excellence while preparing for the worst-case scenario.

And importantly, I assured him: I’ll do my best to help you!

  • This story first appeared in the WeChat channel of Duke Kunshan University Graduate Programs.

About the author

Yin currently serves as the director of the Medical Physics Graduate Program at Duke Kunshan University. He earned bachelor’s and master’s degrees in physics from Zhejiang University and Bowling Green State University in the United States respectively. He was awarded his Ph.D. in medical physics by the University of Chicago. A Gustavo S. Montana Distinguished Professor, he was previously director of radiation physics in the Department of Radiation Oncology at Duke University. For more on Yin’s background and research interests click here.

About DKU’s graduate programs

Duke Kunshan has five master’s programs: Master of Engineering in Electrical and Computer Engineering, International Master of Environmental Policy, Master of Science in Global Health, Master of Management Studies, and Master of Science in Medical Physics.

DKU’s graduate programs immerse students in intercultural environments and equip them with the skills to understand and address global challenges, now and in the future. These programs propel experienced professionals and recent graduates into the next dynamic phase of their career.

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