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Savior of Breast Cancer– Chang, Chin-Chien
[All-directional cancer caregiver with an extraordinary life]
My life has given me wisdom and practical experience.
—Chang, Chin-Chien

Although Chang, Chin-Chien, the General Counsel of Taiwan Adventist Hospital and Chairman of Taiwan Breast Cancer Foundation grew up in an impoverished family, but he is full of high aspirations. He knows how to effectively use all kinds of arduous resources to maximize their effectiveness, faces adversity optimistically, always maintains a humility attitude in learning, and strives for improvement.

To meet the hope of his sick father, he determined to practice medicine and eventually became a full-time caretaker of cancer friends. He continues to care for and take care of the patients’ lives after they leave the hospital. He became the youngest Director of Department of Surgery, National Taiwan University in 1996. He actively promoted surgical teaching internally, led the doctors to jog every week to maintain their physical strength to face with time-consuming surgeries, and presented 100 surgical core courses. After 20 years, he is still a medical intern to study the introductory course for clinical work in surgery. He is passionate about prevention medicine and educational advocacy, and suggests early detection and early treatment to provide attentive medical services.

Dr. Chang was deeply inspired by his teacher, Professor Chen Kai-Mo. He successively founded the “Taiwan Breast Cancer Foundation,” and “Association of Colorectal Cancer Taiwan” to become the supporters of breast cancer and colorectal cancer patients. In addition to patient groups, Dr. Chang also founded “Taiwan Breast Cancer Medical Association” and “Taiwan Society of Coloprocotology,” served in “Taiwan Surgical Society Of Gastroenterology, “Taiwan Surgical Association,” and “Taiwan Oncology Society,” as well as the Director of several organizations, the Superintendent of Taoyuan General Hospital and Taoyuan Psychiatric Center of Ministry of Health and Welfare, and Taichung Cheng Ching Hospital, etc. To date, he has led the hospitals to obtain various outstanding medical assessments to benefit different kinds of patients.
Dr. Chang has dedicated his entire life to prevention and treatment of breast cancer in the past 50 years. His contributions to cancer medical treatments are known to everybody, and he has successively won “Taiwan Medical Model Award” and “Lifelong Achievement Award for Cancer Medicine.” He deserves to be praised as the “Savior of Breast Cancer” and stood out among 2616 candidates of Loved Life Medal from all walks of life in the world and won the “21st Fervent Global Love of Lives Award” in 2018 from Chou, Ta-Kuan Foundation in Taiwan. The Foundation always welcomes recommendations for life warriors from all walks of life in the world who are hardworking, benevolent, courageous, and have made great accomplishments, etc. (Fervent Global Love of Lives Award recommendation hotline of Chou, Ta-Kuan Cultural and Educational Foundation of Taiwan: 02-29178770, Fax: 02-29178768, Address: 3F, No. 52, Mingde Road, Xindian District, New Taipei City, Website: http://www.ta.org.tw, e-mail: ta88ms17@gmail.com).

Always ambitious despite being poor
The year before Chang, Chin-Chien was born was the time when World War II was just over, so his growing years had coincided with the most difficult postwar economy era. His grandfather lived in poverty, managing an agricultural family near Houlong, Miaoli. Hence, his father Chang Wan-Fa decided to leave his hometown to work hard in Taichung and hoped to find other job opportunities. With the efforts of his father, he got a most basic job in Taiwan Railway Administration working as a stoker and then slowly rose from the furnace section to become a driver, and finally a clerk and then retired.

Being courageous to create, and diligent and pragmatic, the working spirit of his father has deeply rooted in the heart of Chang, Chin-Chien and his brothers and sisters to become their driving force.
Due particularly to his father’s low academic qualification and poor family background, he used to encourage them to study hard as he realized that they must acquire expertise through education before they can face the world independently. The children did not disappoint their father due perhaps to his regrets and expectations, and all of them are fond of studying.

Chang, Chin-Chien, whose academic performance was originally poor, also made rapid progress under his elder brother’s teaching. After graduated from a junior high school in Taichung in 1958, he was admitted to his first choice in “Taichung Municipal Taichung First Senior High School (TCFSH).”

Determined to become a doctor after father was seriously ill
Chang, Chin-Chien’s academic performance was always ranked among the top in his 5th and 6th grades of elementary school. Even in the highly talented TCFSH, his performance was outstanding. His good grades in both junior high school and high school had granted him with scholarships every year. The exemptions in tuition and miscellaneous fees had somehow helped the family to reduce the financial burden.

The worry-free junior high school life began to cast a shadow over him the moment his father became ill. His father started to cough up blood, and was diagnosed with active pulmonary tuberculosis. He was sent to a nursing home in Baguashan, Changhua for mandatory isolation.

During that time, his father’s life was very lonely and said to him with earnest attention: “If you were a doctor, perhaps you could cure my illness.” The look of his father when he said that has deeply imprinted in his mind until now, and has since then planted a seed in his heart to become a doctor.
Because of his father’s words, he always has a sense of mission in his heart, hoping to do his best to complete his father’s expectations on himself. He described the mood then: “Watching father’s illness being tortured by pains and discomfort at that time, accompanied with psychological torture and depression, we were heartbroken and desperate. I thought if I were to major in Medicine, I would have cured him to resolve the pains. So I gradually generated a sense of mission.”

His father illness held on for a year. In September 1965, Chang, Chin-Chien finally became a freshman in College of Medicine, National Taiwan University Hospital (NTUH). The happiest person was, of course, his father. However, his father’s condition was very serious at that time. During the summer holiday of his freshman year, his father passed away. Although his father failed to see Chang, Chin-Chien as a doctor, but at least he had seen him admitted to the College of Medicine. That was his father’s greatest comfort.

The challenges after wearing the white gown
Until the 7th grade as a medical intern, he began to feel that surgery was very practical and efficient. So Chang, Chin-Chien, who determined to be a doctor because of his father’s tuberculosis, slowly became more interested in Surgery from his initial wish to become a Physician.

After graduated in 1972, Dr. Chang took the opportunity to actively compete for the highly qualified NTU resident training quota and was finally accepted. He always reminded himself to cherish that accidental opportunity, and frightfully executed each assigned job without the slightly carelessness and ignorance.

Perhaps because Dr. Chang stressed himself too much, he suffered from physical health problem in his first year as a Resident Physician. He took a chest X-ray and found minor infection of tuberculosis. For a while, he coughed so badly that he once wanted to change to the Department of Pediatrics, Obstetrics and Gynecology, or Otorhinolaryngology. As the workload and stress of Surgical Resident Physician were greater than those of other departments, he worried that he could not bear the load physically. Coupled with the shadow of his father’s death due to tuberculosis, he once thought of backing down and quitting.

At that critical moment, the teacher gave him the persistent strength and encouraged him to stay. The teacher’s affirmative feeling on his previous efforts, and the teacher’s true concerns and retention request had allowed Dr. Chang to re-examine himself, and then made up his mind without hesitation. Dr. Chang listened to the teacher’s advice to rest for two months. When the initial symptoms of tuberculosis went away upon taking the medication, Dr. Chang returned to his surgical post and marched forward without being obstructed by self-doubt.

Constant spiritual support
Dr. Chang had the most hectic year after taking the post as a Chief Physician, and it was the same year where he married his sweetheart, Cai Ai-Zhen, who was six years younger than him then. She was a student of the Department of Pharmacy, Taipei Medical University, and his father-in-law, Cai Shen-Ho, was the Dean of Zhuyuan Internal Medicine Hospital, Beigang of Yunlin, who also won the 4th Medical Dedication Award.
Taiwan Breast Cancer Foundation founded by Dr. Chang took the founding purpose of Zhuyuan Internal Medicine Hospital as the Foundation’s purpose of “The founding of this hospital takes wisdom and mutual trust as the foundation, philosophy as the backbone, science as the skin, and implements compassion and aesthetic art” in order to pass on the practicing spirit and philosophy of his father-in-law. The lifelong teaching of Cai Shen-Ho has a profound influence on Dr. Chang and Cai Ai-Zhen.

With a professional background in Pharmacy, his wife has helped many patients, and also took on the role of Director herself and became the soul of the Foundation to maintain its successful operation over the years.

Starting point of cancer research
In 1977, Dr. Chang finally completed the Chief Physician of Department of Surgery of NTUH and prepared to be promoted to Attending Physician, but at the time there was no vacancy available at NTUH, so he went to serve in the nearby Zhongxing Hospital together with four Chief Physicians, and meanwhile, work as a part-time Attending Physician at NTUH. After serving in Zhongxing Hospital for a year, it just happened that the Medical College of NTUH was establishing the Institute of Clinical Medicine and began recruiting the first batch of doctoral graduate students. As Dr. Chang still hoped to return to NTUH one day, so he decided to apply and take the opportunity to return to NTUH.

His two mentoring professors at the Institute of Clinical Medicine have influenced him to become a starting point for his research on cancer: one was Basic Advisor, Professor Dong Da-Cheng; and the other was Clinical Advisor, Professor Chen Kai-Mo.
In 1980, when Professor Dong Da-Cheng who concerned about cancer issue for a long time and committed to cancer research, initiated the establishment of Taiwan Oncology Society. Dr. Chang helped out with the communication work and engaged in the preparatory work for this Society.

As for the Clinical Advisor, Professor Chen Kai-Mo, he already started to research on small bowel massive resection when Dr. Chang was still a medical student then. After becoming his doctoral student, Dr. Chang naturally followed up his research. Influenced by Professor Chen Kai-Mo, Dr. Chang also chose to inherit the expertise of his teacher in the future to major in breast surgery and colorectal surgery.

Because the two mentoring professors of the doctoral class were all engaged in the study of immunology, it influenced Dr. Chang to be really interested in immunology. During that time, Taiwan was just at the beginning to study immunology and cancer.

Studied in the US with Taiwan-Saudi Arabia Medical Corps
After graduated from the doctoral class in 1983, Dr. Chang immediately faced the problem of unemployment. At that time, the government encouraged NTUH to cooperate with the national policy. For doctors who wish to go to Saudi Arabia, they could be promoted as Attending Physicians at NTHU after one or two years. So a few months after graduation, he joined the Taiwan-Saudi Arabia Corps and took his family along to Saudi Arabia for a year.
After returning from Saudi Arabia, Dr. Chang held the post of Attending Physician at NTUH but there was no teaching post available for him then. At that time, it happened that the National Science Foundation had a subsidy plan to send doctors to study abroad. So Dr. Chang decided to study abroad first. He followed the footsteps of his advisor, Professor Chen Kai-Mo to major in breast cancer and colorectal cancer. He applied to study at the world-renowned “Memorial Sloan-Kettering Cancer Center” in New York, USA to conduct research on tumor immunity.

The practices of Attending Physician
In September 1985, after returning from Memorial Sloan-Kettering Cancer Center, Dr. Chang was successfully promoted to the position of Associate Professor. On the other hand, he also began to apply for the National Science Council Programs. As his previous basic doctoral research was on cancer immunity, he went on using cell lines to strengthen lymphocytes on immune-related research when he was aboard. So he won his plan successfully and began his ongoing research by releasing theses frequently.

In terms of Attending Physician, Dr. Chang was responsible for health checks, such as hemorrhoid outpatient and rectal examinations. As there were not many patients for the young Attending Physician at the beginning and there were many senior physicians above him, Dr. Chang figured out that the solution to increase the number patients and create his own future is, firstly to actively enrich himself, and secondly, invest more time to communicate with patients to make up for his greenhorn disadvantages. He adopted a focal concept to treat patients as his own relatives, thereby establishing a good model of doctor-patient relationship and interaction.
 Dr. Chang later focused on two areas of colorectal cancer and breast cancer. He did not pay much attention on breast cancer at the beginning, but was influenced by his mentor Chen Kai-Mo who is an expert in this area and he was much familiar with the status of domestic breast cancer then even though there were little cases of breast cancer at that time. However, due to unavailability of domestic screening policy then, patients were usually diagnosed as over stage 2 severity when they came to the hospital, as compared to very few cases in stage 1 or stage 0. They faced the tragic experience and psychological blow for total mastectomy, letting him to feel deeply distressed and regretful, and determined that this field should also be a direction to work hard and pioneer with.

While serving as the Director in 1986, Professor Chen Kai-Mo established a breast cancer patient group to allow patients to form a group by themselves. Then, under the planning and guidance of the hospital, he volunteered to consulate the patients to make up for a lack of hospital staff. Such move had inspired Dr. Chang’s subsequent establishment of Taiwan Breast Cancer Foundation.
“Trans-century” leader of the Surgical Department of NTUH
In 1996, Dr. Chang was elected Director of the Department of Surgery of NTUH. He was the first Director for being elected in history, just 50 years old then and was the youngest Director in years. Dr. Chang upholds the spirit of modest and self-possessed rather than arrogant. He knows his shortcomings and advantages and admits that he is not the best. Therefore, he is willing to learn to ask for advice humbly, but he also knows to make use of his advantages to make up for the shortcomings. Perhaps, this is the key factor for him to success. After taking office, Dr. Chang believes that training team spirit and relying on a sound system to implement division of labor and cooperation would enable the NTUH’s Surgery Department to continue to progress. He promised himself: As Director of the Department of Surgery of NTUH, I hope to act like ball team manager to tap the potential of the players and boost the morale of the team. When the players win, I’ll share joy and glory with them; when they fail, we’ll bear the outcomes together and learn lessons and shortcomings, and work harder for the next victory.

The new leadership style and thinking have created a completely different atmosphere for the Surgery Department of NTUH. Dr. Chang takes this attitude and faith to lead the Department to meet the challenge of the new century.
When Dr. Chang was the Director, he treated teaching in top priority. It precisely coincided with the medical school’s policy to slowly transform it into small class teaching method. In this regard, he actively cooperated with the promotion and proposed a reform plan for the clinical education of fifth-grade medical students - “National Taiwan University Hospital Surgical 100.” After 20 years, it is still an introductory course for intern doctors to enter the clinical work of surgery. In 2015, he officially compiled and published the book “Core 100 in Clinical Surgery” under the expectations from all walks of life.

Dr. Chang respects his teachers and predecessors, and attaches great importance to good interactions between teachers and students, and historical heritage. On the other hand, he spares no effort in promoting young talents to show his charismatic leadership. Dr. Chang’s concept is that: although younger generation tends to excel the older generation, we must not forget the valuable wisdom and experience passed down from our predecessors. I learned a lot from my teachers and seniors, so I know the importance of inheritance. I also think that when we’ve achieved a certain height of our career, we must also try our best to pass on these experiences and wisdom to the next generation. This’s the reason why I subsequently started to compile textbooks, apply for large-scale programs, promote young talents, and guide the students.
He attaches great importance to and works very hard on inheritance work. He is very pleased of what he has done to train and promote many talents, especially in the field of breast surgery and colorectal surgery.

The sincere caring and considerate attitude of Dr. Chang has allowed him to establish a tight bond between “teachers and friends,” and break the barriers of age and status with the younger generation, thus forming a new atmosphere in the Surgery Department of NTUH. The concentrating efforts and actively nurturing young people to bear new responsibilities have “rejuvenated” the Surgical Department of NTUH and injected it with new vitality, his contributions of which are recognized by everybody.

Stepping out of the ivory tower to serve more people
Dr. Chang has always been enthusiastic about public health education. He uses his professional field to publish public health books in cooperation with publishing houses. He hopes to use his doctoral identity and expertise to convey common diseases and correct knowledge to the general public through easy-to-understand words, and helps people to lead a healthier life through more complete health education and health information.
 When he sees patients suffering from the disease in his actual clinical work, he hopes to help patients to prevent problems before they occur. If patients can be detected with the disease earlier and made earlier treatments, most of them can get good results. No matter how the disease progresses, if they follow the doctor’s advice to accept proper treatments, follow the examinations regularly, and have correct perceptions and attitudes, they can actually not to worry too much. To uphold this spirit and belief, Dr. Chang established “Taiwan Breast Cancer Foundation” and “Association of Colorectal Cancer Taiwan” when he was acting as the Director of Surgery Department of NTUH, making them the guardian centers and shelters for cancer patients with breast cancer and colorectal cancer after they leave the hospital.

Dr. Chang followed the footsteps of his teacher, Professor Chen Kai-Mo and devoted himself to breast surgery and colorectal surgery in the general surgical field. For decades, he has seen too many tragic cases.
In view of the incomplete guidance, education, and follow-up of breast cancer patients at that time, the hospital had no extra time and resources to do these things. Therefore, Dr. Chang decided to leave the clinic and walk out of the hospital to create a reliance and trust support group. The reason why he established and developed this non-governmental and non-profit organization is that he was inspired by his teacher Chen Kai-Mo. The successful founding of “Truth, Goodness and Beauty Club” for breast cancer patient group by Professor Chen Kai-Mo has prompted him to inherit this model.

Lifetime devotion to breast cancer prevention
The purpose and direction of the founding of Taiwan Breast Cancer Foundation are threefold: (1) to advocate the correct concept of breast cancer prevention and treatment; (2) to help breast cancer patients to adjust their body and mind; and (3) to strengthen breast cancer related academic research.

The first priority of the advocacy is to strengthen teaching and publicity to allow healthy people to understand how to prevent the disease and achieve “early detection and early treatment.” The second priority is to provide support, companionship, and counseling to patients who have already been diagnosed, assist them in completing the difficult treatment process, and perform complete tracking and rehabilitation.
The souls of Taiwan Breast Cancer Foundation are Chairman Chang, Chin-Chien and his wife Cai Ai-Zhen, the Director of the Foundation who is also a Pharmacist. Therefore, she can use her expertise to solve doubts about medication of breast cancer; such as, how to take medicine, opportunity treatment, side effects, etc. She spent a lot of thinking to convert the complex pharmacological effects into simple color pictures to enhance the patients to understand and accept them easily, and naturally, to receive better coordination and treatment effects. Coupled with the fact that she is a woman, she can emphasize the psychological effects of patients in a timely manner and become the spiritual sustenance and dependence of the patients.

To help the poverty and relapsed breast cancer patients survive their crisis of life, the Foundation began to apply for the “Let Love Flies” patient service program in 2015 under the sponsorship of “Taiwan Joint Anti-Cancer Association,” hoping to provide subsidies for breast cancer patients with financial difficulties during treatment.
Under the tireless efforts of prevention and treatment of breast cancer over the past decades, Dr. Chang was awarded with “Lifelong Achievement Award for Cancer Medicine” by Taiwan Oncology Association at Taiwan Joint Cancer Conference held in May 2016. The award is considered the best 70-year-old birthday gift for him!

Dr. Chang once said that he divides his work into three levels: “professional,” “business,” and “accomplishment.” “Professional is merely to live and earn a living; career must be well planned as everything needs to emphasize efficiency and outcomes, as well as contributions and feedback; while accomplishment is entirely for dedication and charity nature to ask for nothing in return.” For him, breast cancer prevention is his “lifelong career” and he will never retire.