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Meet the researchers - Professor Juan Valle

Prof Juan ValleInterview with Professor Juan Valle, Consultant and Honorary Professor of Medical Oncology, The Christie NHS Foundation Trust.

Professor Juan Valle was born in Peru and moved to the UK with his family when he was in his teens. From a young age he knew he would end up in the medical profession, even though he had no family members involved in medicine: “I don’t know why or how I knew this, I just did,” he says.

Based at The Christie NHS Foundation Trust in Manchester, he is working alongside Professor Caroline Dive and Dr Ged Brady from Manchester University on a PCRF-funded research project awarded in 2012.

How did you end up in the UK?
Both my parents were involved in the Methodist Church – they were both ministers - and so we moved around Peru with their various church postings. A posting in the UK saw us settle in Leeds where I took my O- and A-levels and then studied in Sheffield University Medical School. I graduated in 1989 and completed my general medical rotation in the Midlands before coming to The Christie NHS Foundation Trust to complete my exams.

Did your family stay in the UK?
My parents eventually returned to Peru. I’ve been married for 23 years; my wife is from Hawaii, so we’re very fortunate to have two such beautiful destinations when we visit our parents!

How did you come to choose a specialism that included pancreatic cancer?
To be honest, I didn’t consider cancer for a specialism at first; I’d had good early training with a variety of medical specialties and enjoyed gastro-intestinal medicine as my main interest (including dealing with patients in liver failure). But I felt it (gastroenterology) wasn’t quite enough.  I wanted a speciality that included things I enjoyed doing day-to-day. In Coventry, I had the privilege of working under Professor Bob Greave, a wonderful clinical oncologist, and his huge enthusiasm for his subject rubbed off on me. After my initial attachment to his team, I decided to do a second attachment in oncology to see if I enjoyed it as much the second time around - and I did. I came to The Christie to finish my medical exams and stayed on, and was able to combine both my interests through gastro-intestinal oncology.

In layman’s terms, what does your role entail and what do you like about it?
I’m a clinical academic, so for my role as a consultant, I run clinical trials at The Christie – either our own trials, or those funded through the NCRI or through industry. I also run regular outpatient clinics, reviewing patients’ chemotherapy treatments. As a professor, I also conduct research and am involved in several research projects, including the one funded by PCRF.

I definitely made the right career choice. I love working with patients.  These people are going through a terrible time following a life-changing, devastating diagnosis and it never ceases to amaze me how strong they are in these circumstances. I rarely hear anyone complaining about their situation; they just want to get on with their lives and be well. I’m humbled by their inner strength.  They are amazing people to spend time with; they keep me grounded and inspire me every day.

I’m passionate about ensuring that communication between the medical professionals and patients is as good as it can be. In my early career I’d seen bad news given very clumsily to patients, and knew there had to be a better way. Things are so much better nowadays as we all have specialist training in how to communicate (especially bad news); but for a long time, medics were either naturally good at talking to patients or not.  People and their families never forget how their diagnosis was broken to them and the manner in which it was communicated.

How hard is it to balance such a busy clinical role with conducting research too?
It’s hard! I’m in a full-time clinical post at the moment, so I’m essentially doing my research in my “spare time” – and there’s not a lot of that! But I’m delighted that through the University of Manchester I will formally split my time 50:50 between clinical work and research in the near future. I never want to give up working with patients, and this arrangement offers the best of both worlds.

What interests you about the research side of pancreatic cancer?
We have to keep moving forward with this disease. If I knew I’d be doing exactly the same thing in 10 years’ time and nothing had changed or that there were no new treatments for our patients, it would be completely demoralising. I want to play my part in changing the future for patients, and for that we need new insights and knowledge about this disease and new treatments to help more people to survive. I want to be involved in this.

Although I’m a medical oncologist, over last few years, I’ve been building close links with translational research groups, such as Professor Caroline Dive’s research group at Manchester University, and was extremely pleased to be a co-applicant on the PCRF grant. 

What is the aim of your PCRF-funded project?
It’s very exciting. There’s been a growing realisation that pancreatic cancer is not just one disease.  Just like recent research which revealed different and distinct types of breast or bowel cancer, we think that the same is true with pancreatic cancer. This could be the reason why current treatments which are similar for all patients, are only modestly effective.  We need to move away from a ‘one size fits all’ approach. In the future, treatments may be tailored to work against specific tumour types, so we need to know what these types are. Unfortunately for researchers, getting tissue samples from patients to analyse is very difficult - the pancreas is quite a deep and hidden organ and difficult to biopsy compared to melanoma (skin cancer) for example, where skin tissue is easily accessible.

Our PCRF project aims to develop an alternative to a tumour biopsy, by isolating and examining stray tumour cells or fragments that circulate in the blood – to develop a “liquid biopsy”, as it were. We believe this technique and the information we aim to find, have enormous potential for identifying certain characteristics of different tumour types which may affect survival and which may ultimately help us to tailor treatments accordingly.

There’s a huge amount of work to be done before we can reach this stage, and it’s a long term project, but we wouldn’t be doing it if we didn’t believe that it could contribute to the next major breakthrough for this disease. This is why our PCRF project is so important.

Hear more about the PCRF-funded project