A Maltese doctor pioneering longevity medicine in the UK and Malta estimates life expectancy can easily go up to 120 years old from an average 84 if patients focus on prevention.

The advice of Philip Borg, a consultant cancer interventional radiologist at Manchester’s Christie Hospital, is to screen for diseases that are likely to kill before any symptoms are even felt.

This, together with healthy lifestyle choices on exercise, diet and sleep – simple but not necessarily easy – can mean living up to 120, according to Borg, who has now specialised in longevity medicine.

While his cancer specialty is “traditional sickness medicine”, which means waiting until something goes wrong to visit a doctor, he is also certified in what is termed “wellness medicine”.

Borg believes the current medical model of treating illnesses when they emerge means trying to extend life at the very end.

“This usually translates into a very low-quality extension, which is also extremely expensive.

“It has always struck me how silly it is to have a medical model that is based on waiting until something happens,” Borg admits, adding it is the way doctors are trained to look at medicine.

As a medical student some 20 years ago, Borg says he was never told about prevention and believes this should be a fundamental part of the curriculum.

“It is all about reactive medicine, not preventive. Doctors are not taught how they can advise patients on what they can do to avoid illness.”

Borg is on a mission to educate patients and even other doctors to understand that chronic illnesses do not just happen and can be “10, 20 and 30 years in the making”.

Eighty per cent of deaths among those over 50 who do not smoke are caused by four illnesses: cancer, Alzheimer’s, heart and metabolic diseases, such as diabetes and obesity.

Take heart disease. A significant proportion presents as death, Borg states. But really, it would have been in the making for a while, although completely asymptomatic.

“So, when do you want a stent in your heart? When you are in pain and cannot move and have long-term damage, or do you do a calcium score to find out what is what?

“Who wants to wait until they are bleeding or unable to swallow? I certainly would not!”

And it is not just about death, says Borg. These diseases cause a decline in quality of life; 20 years of slow deterioration when they can be detected and tackled.

Wellness medicine

Borg’s leap into “wellness medicine” – as opposed to “sickness medicine” – started off as a personal journey during the pandemic and has been a learning experience for him too.

New to Malta and even to the UK, he says they are 20 years behind the US, where it is common practice. In the US, he completed a fellowship in anti-ageing, metabolic and functional medicine to be certified in longevity medicine too.

He knows a culture change is required, not only by patients but also by doctors.

“I work with very experienced world-class doctors in cancer, professors in surgery, and I have regular conversations about this subject, which may have never dawned on them but which they find interesting.

“Changing mindsets is all about education,” he insists. He is out to kill the common misconception that diseases just happen and wants to encourage their detection even before any symptoms are felt.

It sounds logical, but some patients are already hesitant to visit a doctor when they are unwell, let alone when they feel fine.

“A good analogy would be the car,” Borg says. “Do you drive it until you are out of fuel or the oil runs out? No, you take it for a regular check-up and make sure these things do not happen.”

Acknowledging that preventive medicine and screening could create an element of anxiety too, he underlines that 38 per cent of cancers are preventable and caused mostly by lifestyle factors like obesity and smoking – both big in Malta – and that the chance of survival for cancers caught at stage one is 90 per cent.

This drops all the way down to 10 per cent at stage four, meaning catching illnesses early is a no-brainer.

“I would certainly want to be in a position where I have found something and I have done whatever I can to treat it.”

As a specialist at Europe’s largest cancer hospital, Borg has daily encounters with patients who ask themselves, when they get diagnosed, what they could have done to prevent their disease.

“I look at it from the point of view of seeing patients at the stage four cancer daily, and it is a pretty bad situation to be in.”

This is not just about living almost 40 years more than the average, says Borg. “It is about living longer and better.”

What is important is not how long you live, your lifespan, but how well you live – health span.

“No one wants to live to 120 if they are bedridden and cannot do the things they love. They want to be able to lift their grandchildren and greatgrandchildren and play golf if that is what they enjoy.”

Longevity medicine aims to maintain health span and limit its decline to the last five years of life, as opposed to a long-drawn-out curve.

Branded Longevitydoctor, Borg is offering “the gold standard” of what a patient can get, with a cancer-screening programme and a way forward.

“Of course, this private healthcare service costs money and could be considered exclusive,” he acknowledges.

However, when compared with what people spend on other areas and, more importantly, how much it would cost them if they were unwell, apart from the loss in quality of life, it makes sense, even financially, to act early and prevent.

“Cost is a barrier at the moment but as with most things, they become cheaper as they are introduced,” Borg says, referring to new technology known as a liquid biopsy.

This test for cancer cells in the blood before symptoms occur will be on offer this summer, he announces in the firm belief that catching things early is more cost-effective.

In 30 years, he maintains, this blood test will become widespread and available to everyone as part of annual health checks.

Two types of patients opt for wellness medicine: either those who have lost a relative to cancer and want to know if they have the same risk factors; or those who want to learn how to live longer and better and are interested in preventing diseases that can kill.

Borg’s focus, apart from screening, is on lifestyle factors, and he also offers a guide to healthy living.

“It is never too late to improve, and you are never too young either to start thinking of how you will live later on in life,” Borg says.

“Any suggested interventions are, after all, also about living well now. You feel better and fitter and sleep well.”

It is that simple, he maintains. But it is not that easy, and the answer lies in education.

“I love my job, even though most people ask me how I do it. It puts my focus on what is important and how quickly all that can be taken away.

“This is about improving quality of life; of living a long life doing what we enjoy until the end.”