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Your support makes all the difference.Dr Trevor Powles, 57, leads the breast unit at the Royal Marsden Hospital, London. Research by him, published last week, showed that the number of women who have a breast removed could be reduced if they are given chemotherapy before surgery.
Training: About 16 years.
Experience: 20 years.
Hours: About 60 a week.
NHS salary: About £80,000 to £90,000 a year.
The job: "Our unit is probably the largest of its kind in Europe - we see 600 new breast cancer patients every year. The most important thing I do every day is to look after patients who have primary breast cancer or who are at risk of having cancer.
There are many aspects to this job: the patients, the clinical research, teaching, some private work. There's a lot of paperwork: I usually get down to it at the end of the day, when it's quiet.
Today I've got to do a grant application to the Department of Health for research we're doing on examining cancer cells.
More and more women are going to be having drug treatment before surgery - by the year 2000, probably 50 per cent. We have to find out who best responds to this treatment, how much treatment they will need.
We remove just a few cells by fine needle aspiration and look for the presence of certain "markers" or proteins, which tell us about the cancer: whether it will invade other cells, whether it will proliferate rapidly, whether it will respond to treatment. If the marker shows that the cells divide rapidly and the cancer is more likely to come back, for example, it would be more appropriate to give drug treatment before surgery.
That's our research project. It's already been shortlisted, but I have to have the final application in by the end of the week.
Pros: It's very, very interesting, a wonderful mix of looking after patients and academic satisfaction. Breast cancer is at the stage TB was in the 1950s - a disease which is falling apart. We're getting right on top of it. It's a good time to be in breast cancer treatment.
Cons: It's hard work and there are demands from all directions. That can make it very stressful. It could easily take over your life. I try not to bring work home. I do quite a lot of sport to unwind: skiing, windsurfing, riding. My family have been very supportive, especially my wife.
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