At 86, Dr Wang Zhenyi still makes weekly rounds of the hematology ward at Shanghai's Ruijin Hospital, chatting with patients and discussing cases with doctors.

Wang's caring, dedication and energy are legendary, but so is his research that led to a leukemia treatment breakthrough in the mid-1980s. The treatment Wang developed dramatically increases the remission and survival rate of patients with acute promyelocytic leukemia (APL) that was formerly considered highly fatal. It uses all-trans retinoic acid (ATRA), a vitamin A derivative, alone or in conjunction with chemotherapy.

The treatment has been used successfully for many years around the world and has been called the Shanghai Protocol when combined with arsenic trioxide, a traditional Chinese medicine.

Last month, Wang and Shi Changxu, age 90, received China's top science and technology award for 2010 from President Hu Jintao at a ceremony People's Great Hall. Shi, an engineer and metals specialist, pioneered the use of super-alloys.

Bombarded by news coverage and requests for interviews, Wang recently spoke with Shanghai Daily about his life's work. Despite the accolades, just the latest of many over the years, Wang is modest and calm.

"I only found an effective treatment for one kind of leukemia, it's just one of around 20 types of the disease," Wang said.

Wang is also noted for nurturing many of China's top researchers and doctors, including Health Minister Chen Zhu who, along with his wife Chen Saijuan, were Wang's students. Both are noted hematologists.

"I only played a small role while they succeeded mostly through their own intelligence and opportunities," said Wang.

Wang's ground-breaking work in leukemia research and treatment has been recognized worldwide since the 1990s (he first published his findings in 1988).

In 1994, he received the Kettering Prize from the GM Foundation for Cancer Research in the United States for his achievements in treating APL; the Brupbacher prize for cancer research from Switzerland in 1997; and del Duca World Prize from France in 1998. He was, and still is, the only Chinese recipient of these prestigious awards.

His ATRA therapy with vitamin A derivative made APL the first highly treatable adult acute leukemia. The ATRA treatment renders malignant cells benign.

ATRA cannot eliminate cancer genes or be a complete cure, but it can greatly reduce dangerous bleeding. Use of chemotherapy alone has severe toxic side effects, but ATRA and chemo together produce better results and better quality of life. Long-term surveys show a remission rate of 85 to 95 percent with a five-year survival rate if using ATRA combined with chemotherapy and arsenic trioxide.

The therapy has been proven by molecular medicine by Wang's students and colleagues at the Shanghai Institute of Hematology and published in last year's Science, a world-leading scientific journal.

Wang, who was born in Shanghai, said that instead of taking part in celebrations of his award, he would prefer to share his experiences with medical students and young doctors who are the future of medicine in China.

Wang is a professor emeritus at Ruijin Hospital affiliated to Shanghai Jiao Tong University's School of Medicine where he tours the hematology ward once a week and engages with colleagues.

In order to keep up with the latest medical knowledge and practice, Wang holds a weekly session and answers doctors' questions about blood diseases.

"It is a test for me to collect useful information for them and receive their challenges," he said. "The information can help them in their clinical practice. And I, as a doctor, should never stop learning. In my 70s, I started to learn computer skills from my granddaughter because it is necessary in the current information age."

Medicine's perks

Wang, whose family comes from Jiangsu Province, said he took up medicine as a career because as a child he thought it was honorable and paid well.

"A friend from a doctor's family always gave me food and gifts that patients had given to his family," Wang said. "From that time on, I decided to become a doctor to enjoy similar wealth and prestige."

Wang's grandmother died of typhoid when he was seven. Though his family hired the best doctor in the city, she died of a disease that is curable today.

Her death increased Wang's determination to treat disease, especially difficult cases.

Wang, inquisitive and a straight-A student, was recruited by Aurora University in Shanghai (now the Jiao Tong University's School of Medicine) in 1942.

He graduated with a doctorate in 1948 and then practiced at Hospital Sainte-Marie (now Ruijin Hospital). Since he attended Aurora, where instruction was in French, Wang is fluent in French and learned English when he was in his 60s.

Over the years, he worked in various departments, including the traditional Chinese medicine department. During the "cultural revolution" (1966-76) he swept the floors in a suburban health school and then was sent to a rural clinic in Anhui Province for several years.

Wang used every opportunity to learn while in the countryside. Since medical facilities were primitive and there was little medication available, he treated patients as best as he could. He taught himself acupuncture and herbal medicine.

When Wang returned to Shanghai, he broadened his focus beyond Western medicine to encompass traditional Chinese medicine.

"My different situations offered me different challenges and opportunities, but treating and curing patients is always the core," he said.

In the 1980s, there wasn't a lot of advanced equipment and Wang had to scrounge and borrow to set up a hematology laboratory and then the Shanghai Institute of Hematology.

"Conditions were very hard in the 1980s and a lot of lab equipment and materials were borrowed from other hospitals and institutes," Wang said.

"My students even had to catch rats for our experiments."

Today, the perks of medical practice that he once envisioned are not important and he has been known to turn them down. Wang says making useful discoveries and helping patients are his greatest rewards.

Concern for his patients as people, not as medical cases, is at the heart of Wang's work.

One day, a young doctor reported to Wang that a patient had a good appetite. Wang was curious and asked why but the young doctor had no idea.

Wang decided to investigate and talked to family members who were feeding the patient. He learned the family was vegetarian, and thus the patient might be lacking vitamin B12 in his diet. That was crucial to diagnosis and cure.

Wang especially treasures some gifts from his patients, even pairs of socks. At home he has socks that were given by a former patient treated 30 years ago. Wang's correct diagnosis saved the man's life.

"The family found me recently through the media and gave me the socks as a present because the former patient is working in a socks factory," Wang said. "They are precious to me."

In the interview Wang said he recently received a letter from a former patient with APL leukemia, now 82-years-old, who had survived and thrived for 14 years after treatment with ATRA.

"He is still very stable and healthy," said Wang. "Only a doctor can receive this kind of gratitude and satisfaction."

All Wang's students and colleagues are awed by Wang's approach to medicine.

"Love and care for patients are what we should learn from Dr Wang," said Shen Zhixiang, director of Ruijin Hospital's hematology department.

"We may have better knowledge and more advanced equipments than Wang did, but our concern for patients and devotion to work cannot compare with Wang's."

Medical family

Medicine runs in Wang's family. His three sons and three granddaughters are involved in medicine.

His wife, Xie Jingxiong, was Wang's classmate and a specialist in pediatric hematology. She passed away in December after suffering from Alzheimer's disease for 16 years. During that time Wang nursed her at home, bathing her and feeding her himself instead of turning to an ayi.

The first APL patient who was successfully treated by all-trans retinoic acid was a five-year-old girl first treated by his wife and doctors in Shanghai Children's Hospital. The girl was critically ill in 1985 and was in Xie's care at the time.

The couple discussed the case and Wang said he and his colleagues had found in long-term studies that ATRA could be helpful.

At the time ATRA was a skin medication, used for acne and other conditions. Wang's group found it also lowered the level of leukemia cells, but it was in an experimental stage.

With approval of the girl's family, Wang treated her with ATRA and her condition improved dramatically in a month.

"Today that girl is 30 years old. She and her family visited me recently and said she is healthy and will marry soon," Wang said.

After that case, Wang and his team treated 24 APL patients in the following year, 1986, and all recovered (the disease went into remission).

Then Wang started to promote ATRA therapy worldwide and set up a workshop at Ruijin Hospital to produce medication for APL patients.

"I never thought of seeking fame or applying for a patent at that time," he said. "The only thing in my mind was to promote it as quickly as possible to help more patients."

Hospitals and cancer centers in United States, Europe and Japan all sent representatives to Ruijin Hospital to learn about the treatment and purchase medication. They overwhelmingly reported successful treatment.

In 1988 Wang and his students wrote a report on ATRA therapy, which was published that year in Blood, an authoritative international hematology journal. By 2010, the report was cited more than 1,700 times.

What makes a good doctor? Wang was asked.

"Dedication, innovation and love."

Cai Wenjun