The Doctor's Doctor
Working behind the scenes, but hugely important to modern oncology – what exactly does a pathologist do?! We spoke to our Head of Anatomic Pathology Prof. António Lopez-Beltran about his career and the role of a pathologist in cancer diagnosis and treatment.
Introducing Prof. António Lopez-Beltran
Since April 2014, Prof. António Lopez-Beltran has been head of Anatomic Pathology here at the Champalimaud Centre. In this interview, he talks about the path he has taken to becoming one of the most well respected uropathologists on the planet.
Pathologists are often referred to as the “doctors’ doctors,” but what does this mean? What exactly does a pathologist do?
If it was easy to define a pathologist, we would be seen as much, much more important than we are right now! I get this question wherever I may be in the world. In fact, it is a joke among pathologists that we are constantly asked “what is it that you actually do?! Technically, a pathologist is a physician that produces analyses of tissues or fluids from patients. We are still dealing with patients, but we are not physiologists, so we are not interested in the normal function of things – we are only interested when they are abnormal.
Why did you decide to become a pathologist?
When I was at medical school, I was very interested in research, using logic to solve problems. So I was very active as a student in biomedical research. I spent some time with microbiology and neurophysiology and I learned a lot but then I discovered histology and afterwards pathology. At that time, pathology was probably the most scientific part of medicine, so I chose that direction because I wanted to be on the frontline of medical research.
So I discovered my field for myself. And I have to say, when I started using microscopes, I simply fell in love!
Why did you choose to work at the Champalimaud Foundation?
Firstly, I chose this place because they chose me! I was already working with the Foundation when I was working in Barcelona. The Foundation didn’t have a pathology unit at the time, so they outsourced to an international lab in Spain and I was the director of pathology there. Eventually, as the Foundation grew, they needed to have their own pathology unit, so it was natural for me to make the change. There was a specific relevance for me here because I have a particular interest in the diagnosis and treatment of prostate cancer. My whole life before I came here, I had been looking for a place to do pathology related to oncology. This is what I was interested in. Besides, I already knew and liked Lisbon very much, so it was just a good fit for me.
But the main attraction was that I thought, and I still think, that the Foundation had a very important project. It was the first time in my life in which I could have, in Europe at least, the clinic, which I love, and the opportunity to continue doing research as an individual and as part of a group.
You were described to me as the most prolific doctor around: 5 books, 530 publications – how do you find the time and the motivation?
The motivation is easy; I never struggle to find motivation. I am here, I have made a commitment and I do what I do. No, the motivation is not a problem at all. The time, on the other hand – this is more difficult. Since I have been here, believe it or not, I have reduced my scientific production. I have produced some books, which are easier because they are just a matter of experience, but original papers… I would like to produce more! This is a self-criticism. There are two types of scientific production. One is your original; what you produce for others, showing your theories and research, provided to the scientific community. The other way is to provide reviews and studies, letters and discussions, which is also important. But starting a lab from the ground takes a lot of work.
For my whole career, my scientific production has been done during summers – when the lab is quietest - when everybody else is at the beach! I take a week or ten days with my family, but the rest of the summer I am very systematic about my work. The days are quite long, but it’s something that I like and want to do.
You have received lots of recognition for your work, from international organisations, magazines etc. How do you feel when you receive these accolades?
I don’t care about that, honestly. I care about my book! It’s like a son to me, this book! And this one too: the WHO [World Health Organisation] produces a book of terminology, definitions and classification every, in this case, 14 years. I was in the previous one, and I am in this new one – this is the Nobel Prize for a pathologist!
And the best recognition that you can get as a urologic pathologist is that picture over there [see photograph below] This picture of about 20 people represents the most relevant and respected people in the area of uro-oncology, from over 70,000 specialists in the world - that is fantastic for me, and it is the only recognition I have received that I really care about. But I don’t work for this recognition, I work because I am a scientist and this is just what we do.