strawberry birthmark

Outlining how his research into strawberry birthmarks could lead to a new way of treating cancer, he asks: "Would that be a good thing?" Suggest he could be making big money in cosmetic surgery overseas, and he asks, 'Would I be a happy man?" Hutt Hospital's director of surgery should be happy enough – because what began as his research into disfiguring strawberry birthmarks has just won his four-strong research team a major international science prize. That Tan and his team have done their breakthrough research without such facilities and with little funding is testimony to their dedication – and their willingness to spend huge amounts of time working for free. In 30% of cases the birthmark shrinks dramatically, and in 40% it stops growing – but in 30% it just keeps growing. Treating a birthmark with chemotherapy – you have to be pretty desperate." That moment in April when Tan's team won the John Mulliken Prize for the best science paper at the conference of the International Society for the study of vascular anomalies amazed their international colleagues. They sent Tan to a Chinese school – "which means you can't go anywhere, not even to the local university. You can feel sorry for yourself and do nothing or get up and do something useful – and look beyond what you've got." Australia was offering free tuition to a limited number of students from developing countries, and having gained a place Tan started at the University of Melbourne's Medical School in 1980. In their fifth year students could do an elective anywhere in the world, "so I came to New Zealand – and fell in love with this country. People here are so friendly, just so accepting, interested in you, not pretentious – and they are colour-blind." In 1987, having worked for a year in Melbourne Hospital, where he met Sanchia, then training as a nurse, he had to leave Australia under the terms of his scholarship. I was fascinated by the life-transforming nature of plastic surgery – and the creativity. There's no doubt people who want to do plastic surgery are naturally quite creative people, but no doubt that plastic surgery gives people the opportunity to be creative. So, give it a go – and again people gave me a hand," says Tan. He won a fellowship to Oxford to do further training in craniofacial surgery – "you cut out eye sockets and move them, basically" – and to Harvard Medical School to do research. It was his boss there – John Mulliken, the man for whom the prize is named – who got him interested in strawberry birthmarks, or haemangioma. It's a matter of recognising them, because opportunities will keep coming and going – and they can just bypass you." When he arrived back in New Zealand in 1996 looking for a medical school post so he could get on with his strawberry-birthmark research, the only job on offer was one for just over half time in the Wellington Regional Plastic, Maxillofacial and Burns Unit. "It was clear to me where I should be investing my time – and that was going into the lab and understanding the mechanisms regulating the growth and remission of strawberry birthmarks." To fund this research he also set up a private practice – doing cosmetic as well as reconstructive surgery. But Tan's most significant discovery was the origin of strawberry birthmarks – stem cells – and the way these cells are controlled. Now we've found you can use a beta blocker, Propranalol, which is usually used for treating high blood pressure, to treat strawberry birthmarks by blocking renin to stop cell multiplication – which causes them to commit suicide. So just think about this concept of fighting a tumour with an anti-hypertensive drug – to manipulate the Renin-Angiotensin system – instead of using chemotherapy. We are talking about treating the tumour without trying to kill the cells – you just make them commit suicide." The discovery has an obvious implication for treating cancer, but there are others. "The wider implication comes from knowing the roadmap to the mechanisms that control embryonic development – and therefore tissue regeneration and cancer growth. We could replace a piece of missing bone, in situ." It was the research on the Renin-Angiotensin system and strawberry birthmarks that won the international science prize for Tan and his team – Darren Day and PhD student Tinte Itinteang from Victoria University's School of Biomedical Sciences, where the lab work is done, and Hutt Hospital pathologist Helen Brasch. Itinteang – from Kiribati via scholarships to St Patrick's College, Silverstream and the University of Melbourne Medical School – was supposed to present that paper in Belgium. The first significant move towards putting the institute on the drawing board came in 1998 when Tan's old boss at Oxford asked if his top student could help with the research – and Tan had to turn him down because it was unpaid. After some wine they got really happy and I said, 'I've got this idea – a charitable trust to raise money and invest it, and then we can carry on the research.'" Those guests and their host formed the Reconstructive Plastic Surgery Research Foundation to fund a research fellow position. But what was actually launched was a fundraising effort – $3.5 million to set up six laboratories in the empty ward above the plastic surgery unit at Hutt Hospital, and then $10 million for an endowment fund to keep them running. But it has supported the research and is happy to host the institute – a most uncommon feature for a New Zealand public hospital. I believe everyone should be equal as long as the level is high, not low – as long as everyone is able to drive a Mercedes-Benz." His professorship is from the University of Otago's Wellington School of Medicine, which has set up a chair of plastic surgery at the Gillies McIndoe Research Institute – and appointed him to it. He makes it sound spiritual – and good fun at the same time. And it's not just me, it's a whole bunch of people – who do the work for free. He's really the total package in terms of what you want as a surgeon – and he's a lovely guy." Tan, a surgeon first and foremost, says it's a privilege. And I think a lot are better people – much better people. strawberry birthmark