Rakesh Chopra, MD, former Chairman and Head of the Oncology Department of Artemis Hospitals, was born in New Delhi, the capital of modern India. As a child, he attended the Lawrence School, Sanawar, a private boarding school in Himachal Pradesh, among beautiful sylvan surroundings.
“Sanawar was established in 1847, and its history, influence, and wealth have made it one of the most prestigious and oldest schools in Asia,” related Dr. Chopra. “We were regimented into the rough coexistence of communal hostel life where Never Give In was the motto we lived by. Rudyard Kipling famously said: ‘Send your son to Sanawar and make a man of him.’ The school is celebrating its 175th anniversary this year.”
Dr. Chopra continued: “My father was a dermatologist of international standing; given that I was reared in the fourth generation of doctors in our family, I was expected to follow suit and pursue a career in medicine. In 1963, my father, who was in the armed services, got posted in the United Kingdom, and he took the family along, largely to widen our horizons and world view. Having qualified for the All England age 9-plus exam, I studied at the Thames Valley Grammar school at Twickenham, London, which was a terrific learning experience. During that time, I played rugby, which definitely toughened me up mentally as well as physically. I also remember that period in my life vividly: it was a time of bonding that brought us closer as a family and taught us to work as a cohesive unit. It also showed my father’s wisdom about how living and studying abroad would deepen our understanding of how the world operated.”
On returning home, Dr. Chopra entered the Bombay International School, where several teachers had an early influence on his academic career. “I remember the teachers were fully engaged in the process of expanding our intellectual curiosity. For one, in the 10th grade, Ms. D.P. Panthaki had unique and innovative teaching aids that sparked my interest in science, laying the foundation for taking the medical stream in the 11th grade. During the Indian School Certificate graduating exam, we were asked, what would you like to be when you grow up? I wrote an essay titled ‘I Want to be a Cancer Doctor and Serve the Rural Poor.’ During the premedical course work at Delhi University, we had a chemistry teacher, Dr. P.L Soni, who religiously gave us 50 pages of homework and the next day dutifully corrected each page for all 52 students. Getting a full score saw us into medical school with a terrific underpinning of knowledge, God bless his soul,” shared Dr. Chopra.
TITLE: Former Chairman and Head of the Oncology Department of Artemis Hospitals, India
MEDICAL DEGREE: MD, Armed Forces Medical College, Pune
WORDS OF WISDOM FOR YOUNGER ONCOLOGISTS: “For budding young oncologists, there are three magic words: Work, Work, Work. Oncology is a careful blend of art and science, so it is important to think out of the box and keep an open mind for new research and innovative management strategies. That said, follow protocols judiciously, treat all patients equally (with no biases), and pursue the highest standards of academics.”
New School, New Opportunities
In 1971, Dr. Chopra began his medical journey when he entered the first class of the University College of Medical Sciences in Delhi, which had been newly founded by the Ministry of Health to increase opportunities for aspiring doctors. “The medical school had just opened and had, what was to be expected, some initial growing pains. As a student body executive, I fought the challenges faced by a new professional institution. For instance, the cancer unit at the Safdarjung Hospital housed an active surgical referral center and a rudimentary cobalt radiation facility, with little or no medical oncology backup system. The day-to-day struggle to treat patients with cancer in such a challenging environment filled me with a passionate desire to make things better. One of my mentors, Prof. Rehman, would operate for hours, dedicating his life to his work as a cancer clinician. It was a difficult setting, in which we cared for many patients with late-stage cancer, most of whom succumbed to their disease,” said Dr. Chopra.
Although his nascent career in oncology was beginning to take shape, Dr. Chopra faced family pressure to pursue dermatology as a career and help realize his father’s dream of establishing the first dermatology/cosmetic center in the capital city. “It was not to be, as I wanted to take up the challenge of pioneering oncology, a new specialty in the northern part of India. As a prelude, I completed my postgraduate residency in internal medicine at the Armed Forces Medical College in Pune. I did rotations through the Command Referral Cancer Center, which was sadly lacking in medical oncology expertise, having limited drugs and supportive care and virtually no multidisciplinary approach. Cancer became my obsession, and I was determined to be part of the emerging advances in detection and treatment that were on the horizon,” he explained.
Valued Mentors in the States
Dr. Chopra’s oncology dreams became a reality when he joined the faculty of the Sir Ganga Ram Hospital, which initiated the first medical oncology program in North India as part of the broad umbrella of the Department of Internal Medicine. “As time went on, our patients with cancer were offered superior care, newer diagnostic and therapeutic aids were added to the armamentarium, and collaborative clinical trial results were added to the literature; options and outcomes became more meaningful. But, most important, the confidence level among patients grew. A disease that was once considered a death sentence was now becoming highly treatable. For instance, a multidrug protocol from Memorial Sloan Kettering [MSK] was the order of the day for advanced multiple myeloma, so I went to the United States to get first-hand information from leading oncologists, to follow up and treat our patients in India. It was truly remarkable,” he remembered.
Dr. Chopra continued: “I was fortunate to be offered an oncology fellowship at the Long Island Jewish Hillside Medical Center under the mentorship of Dr. Kanti Rai. He became my friend, philosopher, and guide from those early days. He has held my hand and is largely responsible for my success in my oncology career. One could not ask for a better gentleman clinician and down-to-earth human educationist as Dr. Rai. He also orchestrated my rotating fellowship at the MSK, which was an eye-opener for a young oncologist from India. I am truly blessed to have had such incredible leadership role models, such as Dr. Jim Armitage, who has also been a guiding force in my career growth, and Dr. Morton Coleman, who over the past 30 years has been nothing less than my true oncology guru,” said Dr. Chopra.
Dr. Chopra became a member of ASCO in 1982. According to him, it’s a landmark of longevity for the oncologist from India who pioneered medical oncology in the northern region of his country. “Becoming an ASCO member was a pivotal step in my career, a moving venue of collaboration and innovative action. I was a member of the first ASCO International Affairs Committee and did the international symposium for breast cancer on diversity in health care across the globe,” said Dr. Chopra. This year he has completed 40 years as an ASCO member.
Optimism in the Face of Challenges
Asked about the main challenges faced by the oncology delivery system in India, Dr. Chopra responded: “First is the immense population. We are a highly heterogeneous country with a population of about 1.4 billion, of which about 65% to 70% live in rural areas, creating several access barriers for patients with cancer living in those areas. Moreover, most of the large cancer centers are situated in cities, and community clinics in rural places are few and far between. So, we need to use outreach programs to identify patients with cancer and treat them.
Dr. Chopra also mentioned the challenge of the cost of cancer care. “Compared to Western countries, currently, we have few of our people who are covered by private health insurance; the government is working actively to increase that number. It’s an uphill battle, but I remain optimistic. The way forward in India is to focus on cancer awareness, with a priority on education and lifestyle modifications, especially as they relate to tobacco and alcohol use, which is needed to decrease the incidence of cancer.”
Dr. Chopra was the monitor for India’s first phase I clinical trial, an experience that was rife with challenges. “From the start, we had regulatory issues,” he stated. “In fact, the regulatory mechanism required a long gestation period, so the research processes were conducted in a neighboring country. That said, we have a vibrant population of some of the best young drug researchers in the world, so it is just a matter of time before we can reconfigure our system in a way that gives our bright young researchers the opportunities that their counterparts in the States have,” continued Dr. Chopra. “To that end, the present government has taken positive steps in the direction of equitable health-care access and has launched the most widespread health assurance program worldwide, called the Pradhan Mantri Jan Arogya Yojana program.”
Advice for Aspiring Oncologists
Asked to share some hard-won advice for the best and brightest just joining the oncology community, Dr. Chopra replied: “For budding young oncologists, there are three magic words: Work, Work, Work. Oncology is a careful blend of art and science, so it is important to think out of the box and keep an open mind for new research and innovative management strategies. That said, follow protocols judiciously, treat all patients equally (with no biases), and pursue the highest standards of academics. Although the halls of academia are rich with knowledge, clinical wards are the greatest training grounds; there are no shortcuts to good old-fashioned clinical medicine. And, as an academic oncologist, you are made visible by your writings, so do that repeatedly and with confidence. Always remember that building an oncology career is a long journey; the burnout rate among us is high, and it is vitally important to keep a balance between work and your outside life—a well-balanced researcher/clinician performs at a higher level. Therefore, healthy extracurricular activities should be a part of your life.”
Dr. Chopra continued: “Looking back over my 40 years in oncology, I’ve witnessed a sea change in the clinical and philosophical approach to cancer care. I’ve seen incredible advances from genomics to molecular biology, all of which have enhanced the tools in our armamentarium. Caring for patients with cancer is an honor, and every young ambitious oncologist coming up the career ladder should understand that. It is a principle that will guide you throughout your career. I vividly recall many of my patients, such as a young man with a metastatic testicular tumor, treated and cured, who went on to become a Mr. Universe in body building. And a young lady with a lower limb osteosarcoma who had limb-conservation therapy and just graduated with a medical degree from an Ivy League school.”
A Global Oncologist’s Downtime
Asked how he decompresses from the rigors of his busy career, Dr. Chopra said: “I took to religious teachings at the age of 9, and that has been my pillar of strength throughout life. And, believe me, as an oncologist who has been in the trenches and cared for the sickest among us, my religion has served me well. I also have been practicing sports medicine and was privileged to be the official doctor for the Indian Women’s Hockey team. And I love to do nature walks and appreciate the natural beauty of my country.”
Dr. Chopra also mentioned his love of traveling, painting, and music. “Traveling and savoring local cuisine is also a passion, which is now thankfully becoming more available as we see the end in sight of the COVID-19 pandemic. I’ve dabbled with some painting; in fact, I’m fascinated and influenced by the Hudson River School of Art, which was a mid-19th century American art movement. I also find Sufi music, and other forms of music, relaxing.”
So, Dr. Chopra has plenty of avocations to help him decompress. “But I love my work,” he added, “and in that regard, I’m very fortunate. Oncology is a unique profession, and I have never for one moment regretted my career choice.”