Lung cancer success and an alcohol-free new year

Cancer Research UK
We discuss exciting results from a lung cancer awareness campaign, important findings from breast cancer prevention trial, and take a trip to an alcohol-free bar.

080-cancer-research-uk-podcast-january-2014

Transcript

Kat: This is the Cancer Research UK podcast for January 2014. This month we’re discussing exciting results from a lung cancer awareness campaign, important findings from a trial to prevent breast cancer, and we take a trip to an alcohol-free bar. Plus our heroes and zeros. 

Hello and welcome. I’m Kat Arney, and with me to discuss the latest news is Jess Kirby, Senior health information manager at Cancer Research UK. So Jess, the first story that I 'd like to talk about is the success of this new be Clear on Cancer lung campaign. What's all this about?

Jess: This campaign is really exciting because it shows some fantastic results that really benefit people with lung cancer. The campaign was to get people who've had a cough for about three weeks or more to go to see their doctor about it with the idea that it would lead people who've got lung cancer to get it diagnosed at an earlier stage. Of course, not everyone who's got a cough for three weeks has got lung cancer, but it could also help people who've got a cough for other reasons to get it diagnosed and treated.

Kat: It's interesting that it's just focused on talking about this one symptom, just having a cough for three weeks or more. Are there other symptoms of lung cancer? And why did they focus on just this one?

Jess: There can be other symptoms of lung cancer, but the reason why we focused on this three week cough is that that's really the most important symptom of lung cancer, and the one which if people get it checked out then it could lead to earlier diagnosis. 

In general though, if people notice any kind of change to their body that sticks around for a while – maybe if you're finding it harder to breathe or you're coughing up blood, for example – then it's a really good idea to get it checked out.

Kat: Who was running this campaign? Where was it running and what did it look like?

Jess: This is a campaign from Public Health England, and it's a national campaign which has a picture of a doctor, and it says “If you've had a cough for three weeks I want to know about it, please tell me about it”. There have been posters, there have been TV adverts and radio adverts too, and that's been rolled out across the whole country. And we've done the analysis of the results of this campaign and we're really, really pleased at what it shows.

Kat: What are the key findings from it?

Jess: the main thing is that more people got diagnosed with lung cancer during the period of this campaign compared to the same period last year. But the really good things about it is that a lot of those people were diagnosed at an early stage. In fact, about 300 more people were able to have surgery, which is fantastic because when lung cancer is diagnosed early enough to be treated by surgery, often that can actually cure the cancer. So it's really, really great news for lung cancer patients. 

I know that Public Health England is running this type of campaign – the Be Clear on Cancer campaign – with other types of cancer as well. I think they're going to re-run the lung cancer campaign again this year. So it's really fantastic to see the great results that this can have, and the hope that it can be replicated with other cancer types as well. We are evaluating all of these campaigns properly. They cost money from the Department of Health to run, so it's really important that we follow that through to know what impact they've actually had. 

Kat: Another really good news story I saw was a genetics story looking at the genetics of lymphoma, and in particular this is our researchers at the Barts Cancer Institute who were looking at a type of lymphoma called follicular lymphoma, which affects around 2,500 people every year in the UK. And they've published this study in the journal Nature Genetics. 

Now what they were doing is trying to understand how follicular lymphoma changes from a chronic condition – so something that people can be treated with for quite a long time – to how it suddenly flips and becomes a really aggressive type of lymphoma that's very difficult to treat and is resistant to drugs. 

What they did was they were using new genetic technology to read the gene sequence of the early stage lymphomas – when they're still manageable – and then look at them and see what's happened when they've become these aggressive cancers, and basically trying to chronicle the chain of genetic events that changes within these tumours as they go from being chronic to very aggressive.

Jess: Why is it important to do this kind of research? 

Kat: This kind of study helps us to understand really what's going on at the molecular level as these cancers change. This is obviously very important because we know that tumours evolve, they change over time, they become resistant to drugs, they become more aggressive. 

By unpicking some of these molecular 'nuts and bolts' of what's going on, we can understand why they make this switch, and then – importantly – how we can target that with new therapies. So this research has actually thrown up a lot of new targets for potential therapies for this type of cancer. It's still early research at this stage but it could be really important.

Jess: Cancer Research UK's investing a lot of money in these kind of genetic studies. What kind of difference could this make to people with cancer?

Kat: The more we learn about the underlying genetic faults that drive cancer, the more we can treat it effectively. It's this idea of personalised, or precision, medicine – you can test someone's tumour, you can monitor it as it evolves and changes and give them the right treatment at the right time.

Cancer Research UK's been funding a lot of this kind of work - the Catalyst Club, one of our big fundraising groups, they've been raising money for these specific types of genetic projects. So hopefully we'll see more of these breakthroughs coming over the next few years.

And finally, the last study I wanted to talk about was one called IBIS2, which is a breast cancer study. This is a very, very large study and it was published in the Lancet just before Christmas. Jess, what's the study about?

Jess: IBIS2 is another really exciting study which has been running for quite a lot of years actually, and it's looking at a drug which is already used to treat breast cancer, to find out whether or not that drug can actually prevent breast cancer in women who are at high risk. Already, this drug - anastrozole – is used to stop breast cancers coming back in women who've had breast cancer, so it makes sense that it might be able to stop breast cancers developing in women who've never had those cancer in the first place.

The exciting thing about this study was that it was shown that anastrozole reduced the risk of breast cancers in these higher risk women by over half, which is just staggering – really, really great results. And the other great thing about anastrozole is that it had fewer side effects than the drugs which we already have for this purpose, drugs like tamoxifen for example. So overall it seems to be that women could get a better benefit with a lower risk. So it's really exciting results. 

The women in the study have been followed up for about five years, so we'd still like to see them followed up over coming years as well to make sure that we've got that long term [information about] what the side effects are. But these results really are very, very encouraging and it seems that they could offer women at higher risk another option to manage that risk. We really hope that NICE, the National Institute for Health and Care Excellence, will be able to approve this drug based on these results. 

Kat: Because at the end of last year they approved tamoxifen for preventing breast cancer in higher risk women, so that's a hope. And to explain a bit more about this study and some of the issues it raises, here's Martin Ledwick. He's head of our Cancer Information Nurses, and he's talking to Greg Jones.

Martin Ledwick: Well we’re looking really at women who are considered to have a higher-than-average risk of developing breast cancer. And these are women with a significant family history of the disease – that means they’ve got close relatives who’ve been diagnosed with breast cancer, and usually diagnosed with it at a younger age.

Greg Jones: In terms of what the drug is actually doing, how is it working? And is this for women who have breast cancer or have not got breast cancer yet?

Martin: Well it’s basically stopping the action of oestrogen on any cells that could potentially develop into breast cancer. That’s in a nutshell how it works. But it is important to realise that this drug, along with other drugs, is also used for women who’ve been diagnosed with breast cancer to stop it from coming back in the future.

What this study’s about is for women who are considered to be at high-risk. We have had a bit of confusion with some people posting stuff on our Facebook page and so forth who’ve got a bit muddled about that and seem to be wondering whether this is something new that we’re telling women who are having treatment after a diagnosis of breast cancer. But in this study that’s not the case.

Greg: So it’s actually talking about preventing the disease, or at least delaying the disease for women who are perhaps at a higher risk than average. It’s also important for us to remember that this is not actually available yet for women who may be at high-risk.

Martin: Yes – we’ve got the results of this study, which suggest that this might be an option for women in this situation. However, it hasn’t gone through NICE approval yet and it is important to remember that there are other alternatives to this for reducing the chances of developing breast cancer if you’re considered to be at high risk. So, if any woman’s got any worries about this, have a chat with your GP. They’ll be able to give you an assessment to see whether you’re likely to be at increased risk or not, and then they can refer you on for further advice and support. And there are a number of options available for women in that situation.

Kat: That was Martin Ledwick talking to Greg Jones, and that's the news for this month. Thanks very much, Jess.

Now, after the excesses of the festive season, many people decide to cut back on booze in the New Year. This year, thousands of brave souls have taken on Dryathlon – a fundraising challenge to give up alcohol for the whole of January, sponsored by their friends and family to raise money for our lifesaving work. 

To find some alternatives to boozy tipples and get the low down on the health risks of alcohol, I took our health information officer Sarah Williams to Redemption – an alcohol-free bar in West London. 

Catherine: Hi, I'm Catherine Salway and I'm the founder of Redemption alcohol-free gastro bar. 

Kat: You're going to make a few cocktails for us. What sort of cocktails do you do here?

Catherine: Our speciality is mocktails made from coconut water, and we also have another one that's made from sparkling water.

Kat: So what have we got here? We've got some mint...

Catherine: We've got some lime, some lemon, some freshly squeezed lime, some freshly squeezed lemon. We've got some pink Himalayan salt here which we're going to use to make the rim. So we've got teo types of drinks based on coconut water. One is a bit like a margarita – coco-rita. That's the lime, it's got a bit of salt in it, and we use agave syrup. And agave syrup comes from the same cactus plant as tequila, so it kind of is related in that way. So that's one of our favourite drinks. 

We put that together and it's kind of got a bitterness, and adult flavour to it. So I might make you one of those first. And then we've got a more fruity selection where we put the coconut water together with organic fruit presses, and we do blueberry, and we do cranberry. I'm going to make you a cranberry one because that's what I've got to hand here now.

Kat: Cool. So while you get on with that, I'll have a quick chat to Sarah. Hi, Sarah.

Sarah: Hello, Kat.

Kat: January is a time of year when lots of people like to cut down on drinking, or maybe give up for a month or maybe do Dryathlon for Cancer Research UK. What are some of the health risks associated with drinking too much alcohol. 

Sarah: So drinking too much alcohol has maybe a lot more health risks than people might realise. I think most people are familiar with the link between alcohol and liver disease. They might be surprised to learn that drinking too much alcohol, specifically drinking too much alcohol on a regular basis, can also increase your risk of heart disease, of having a stroke, and - of course – cancer as well.

Kat: What sort of cancers are we talking about here? Is it just liver cancer?

Sarah: It's not just liver cancer. Alcohol actually increases the risk of seven different types of cancer. As well as liver cancer it also affects the risk of breast and bowel cancer, which are two of the most common cancer types, so it can have a really big impact.

Kat: What's the scale of this problem? How many cases of cancer do we think are associated with alcohol?

Sarah: Research has shown that alcohol could be behind around 12,500 cases of cancer every year in the UK.

Catherine: That's the salt rim going on – ready to start shaking? The whole skill of it is in the shaking, which is what gives you the body of the drink which makes it look and feel and taste like an adult drink rather than just a fruit juice or something. 

Kat: That smells like a grown-up margarita for sure!

Catherine: Yeah, and then we just do a tiny pinch of salt in there, which sets off the salt rim. And then a bit of lime on the side, just because presentation is quite an important part of the drink, and there you go – coco-rita.

Kat: Right, do you want to try a bit of that?

Sarah: Well, I do like margaritas so I'm hoping this is a good salty one... That's amazing! That's so nice.

Kat: Give it here, go on! That is really, really nice. I don't think you'd miss the alcohol in that. So what have you got for us next?

Catherine: Next I'm going to do you a fruity one, and this is a coconut water base with cranberry organic presse. Sometimes people want to mix up the different flavours – we've got cranberry, blueberry, we had beetroot throughout December just as a seasonal thing. It's one of our most popular drinks. 

Kat: In goes the coconut water. 

Catherine: Yep, and again it is all about the shaking. This is what I've learned from my mixologist friends – getting that really good shake downward on the ice to break up the drink. As you can see I'm putting some welly into it, it's quite good for upper arm body-building!

Kat: Ooh, that is a baby pink! I didn't expect it to come out that colour.

Catherine: That's the ice breaking it down into a frothy baby pink. And there you go – that's the coco-tini in cranberry.

Kat: Go on then, let's have a taste. Go on, Sarah.

Sarah: This looks awesome – ooh, that is really nice. It's almost creamy.

Kat: Yeah, it's kind of a bit like a strawberry daiquiri, that kind of thing.

Catherine: You expect it to have sugar, alcohol, all those things that are bad for you, and actually there's nothing bad for you in that drink. It's really unbelievable what you can do with these ingredients. 

Kat: You've shown us some cocktails with things like coconut water, which may be a little bit complicated. What would you recommend for people at home just wanting to whip up a nice non-alcoholic drink?

Catherine: We're big believers in elderflower, because it's sweet but without being sickly sweet, and so this is our elderflower and lemon fizz. The trick of it, actually, is very simple – just don't put too much elderflower cordial in. Because if you do that, it'll come out really sickly. But if you just have a slight touch of it and then some fresh lemon – we use organic – and then we're using here a good quality sparkling water to bring it up to the top of the jam jar. We serve all our drinks in jam jars, just to be different. And that's just a really simple lemon and elderflower fizz, and that doesn't taste that much different to a champagne cocktail actually.

Kat: That's delicious.

Sarah: I can imagine that on a Sunday afternoon with friends, that'll be really great to drink.

Kat: Are you expecting lots of people to come in during January?

Catherine: Yes, we've got a few bookings for the weekend. We've got a dating website coming in doing an event as well, so January's going to hopefully be quite a big month for Redemption, because we're trying to prove that you can have a night off rather than a night in. 

And I suppose for Dryathlon and all those campaigns around having the month off, it's having a month off not a month in. Because you can't stay in for the whole of January, surely? So if you want to come out you can come and see us and you'll not be exposed to any temptation, and that's what it's all about really.

Kat: Sarah, what would be the benefits of cutting down on alcohol? Is it something that is just for January?

Sarah: Cutting down on alcohol for January probably isn't going to do a great deal for your long-term health – that's much more about how much you drink on a regular basis. But even cutting down for a month you might notice a few things, softer benefits like you might save some money, you might find it's a bit easier to stick to your diet if you're trying to lose weight. That can be helpful if you're cutting out alcohol for that time. 

To really see benefits to your health you probably want to think more about cutting down on how much you drink in the long term. That doesn't necessarily mean cutting out alcohol completely and staying on the wagon, it can just mean drinking that little bit less on a day-to-day or week-to-week basis.

Kat: Or maybe swapping in some of these delicious cocktails for a pint or a glass of wine?

Sarah: Exactly, that's a great idea. So one really good trick, as you said, for cutting down on how much you drink is swapping alcoholic drinks for soft drinks, maybe alternating soft drinks if you're having a night out or a night in. You could also try doing things like increasing the number of days where you don't have an alcoholic drink at all. If you live with someone, like your partner or friends, you could maybe make a pact with them that, say, Thursdays are going to be alcohol-free for 2014.

Catherine: We'll drink to that - cheers!

Kat: That was Sarah Williams and Catherine Salway from Redemption bar. Find out more about them at redemptionbar.com
 
And finally, it’s time for our heroes and zeros.  Our heroes this month are all the scientists, doctors and nurses who have worked so hard to bring advances in cancer that have led to death rates falling by more than a fifth over the past 20 years. The news coincides with the launch of our new TV advertising campaign, highlighting the importance of life-saving research in bringing forward cures. We’ve also put together a blog post highlighting some of our biggest achievements this year. But none of it would be possible without the generosity of our supporters, so we want to say a big thank you to each and every one of you too.

And our zero this month is the claim by British American Tobacco that nicotine is good for you. David O'Reilly, group scientific director for British American Tobacco, which makes Benson & Hedges, Dunhill and Lucky Strikes, told the Sunday Times Magazine smoking helps a person's brain work more effectively. But Professor John Britton from the University of Nottingham, chairman of the Royal College of Physicians tobacco advisory group, said that although a single hit of nicotine can have positive effects on the brain, the drug is highly addictive, leaving smokers needing to get more and more just to enable their brains to function normally. 

Our view is that nicotine is a highly addictive drug, and while licensed nicotine-containing products are much safer than smoking cigarettes - and can help people quit the deadly habit of smoking - we don’t fully understand the long term effects of nicotine use. And it’s always worth remembering that smoking causes more than one in four cancer deaths, and public health must be protected from tobacco industry influence.

That’s all for January’s podcast, we’ll see you again next month for a look at all the latest cancer news.

We’d also like to answer your questions in our podcast, so please email them to podcast@cancer.org.uk, post on our Facebook page, or tweet us – that’s @CR_UK. And if you’re listening to this on Soundcloud, please leave us a comment with your feedback. Thanks very much and bye for now.