December 2011 podcast transcript

This month our stratified medicine programme starts recruiting patients, researchers target a key cancer protein, we launch nine high tech gene projects, more lung cancer patients need surgery to survive, the biggest report to date on lifestyle and cancer, and we celebrate the bravery of our Little Stars.

Welcome to the Cancer Research UK podcast. I’m Paul Thorne.

Cancer Research UK has started recruiting patients for a pioneering initiative to demonstrate how genetic tests could be used within the NHS to help match cancer patients to the most appropriate treatment. The project also aims to build a database of information for research into new targeted therapies.

James Peach, director of Cancer Research UK’s Stratified Medicine Programme tells us what impact this work could have on cancer treatment in the future.

“Many of the next generation of cancer treatments will only work in people whose cancer is driven by a particular gene or protein.

We need ways to routinely group, or ‘stratify’ patients as part of their treatment. Cancer Research UK’s Stratified Medicine programme aims to help the NHS prepare for this exciting new way of treating cancer, and provide researchers with intelligence about how treatments work."

Researchers in the US have taken the first steps towards designing a drug to target one of the most important proteins in cancer.

Scientists at the company Genentech have created small molecular fragments that can stick to a protein called Ras – which is overactive in about quarter of all cancers.

Our science information manager Dr Kat Arney tells us why targeting this protein is a big step in treating cancer.

"Researchers have been trying to develop drugs that can target Ras for many years and come up with nothing. So this new approach is a small but important step on the way there, as the scientists have developed a molecule that can stick to one particular part of the Ras protein. But unfortunately this isn’t the really important bit involved in cancer, so there needs to be a lot more work done to develop this further into something that might have potential as a drug. But as far as scientific discoveries go, it’s a pretty exciting step forward."

A new initiative from Cancer Research UK aims to unravel the genetic secrets behind a range of cancers, in order to understand how certain genes control cancer and determine how the disease evades treatment.

The Genomics Initiative will use the latest high-tech gene sequencing machines to address specific research questions that until now were impossible to answer.

The latest sequencing technology allows researchers to scan all of the genes in a cancer – like reading an instruction manual for the disease – and identify cancer causing faults a million times faster than the technology used a decade ago.

Dr Charles Swanton tells us how doctors and scientists can use information about faulty genes to change how we diagnose and treat cancer.  

“The Genomics Initiative is run by Cancer Research UK and funded by Cancer Research UK to try to tease apart the complexity of cancer across a wide range of cancer types. It’s become clear over the last five years there is tremendous diversity both within individual tumours and between patients with the same tumour subtype.

So this initiative – it’s a very important initiative from Cancer Research UK – will help scientists to tease apart those complexities in much greater detail, to try to ultimately identify better means of treating cancer, and identify better targets suitable for drug discovery and drug development programmes.”

Many more lung cancer patients would survive for longer if they had surgery to remove the disease, according to new research from the National Cancer Intelligence Network and King’s College London.

Researchers analysed information on more than 77,000 lung cancer patients diagnosed between 2004 and 2006 in England and looked at how many had surgery to treat the disease.They found that in those areas where more lung cancer surgery took place, more people survived the disease.

Dr Lesley Walker describes how many lives could be extended if the levels of surgery across the country were higher.

“The most important thing for patients with the most common type of lung cancer is that we offer surgery if that’s possible, because this is really the only chance of curing somebody with that type of lung cancer.

What we know is that the rates of surgery offered to people with that type of lung cancer do vary quite a lot around the country, and what we know is that if we were able to offer the same amount of surgery in every area as in the best areas of the country, potentially something in the order of 5,400 people’s lives could be significantly extended.

What we also know is that the rates of surgery in the UK are hovering around about the 14 per cent mark for people with the most common type of lung cancer – that’s better than it was, but it’s certainly well below the percentages of people who get surgery for lung cancer in other countries in Europe and in the United States.”

More than 100,000 cancers – equivalent to one third of all those diagnosed in the UK each year – are being caused by smoking, unhealthy diets, alcohol and excess bodyweight, according to the latest analysis by Cancer Research UK scientists.This new review of cancer and lifestyle in the UK is the most comprehensive undertaken to date.

Smoking is far and away the most important lifestyle factor causing nearly a quarter of all cancers in men and nearly one in 6 cancers in women.
Overall the review shows that 45 per cent of all cancers in men, and 40 per cent of cancers in women could be prevented.

Lead researcher Dr Max Parkin, from Queen Mary University of London, describes some of the key findings from this study.

“From a community point of view, if you’re a policy-maker or cancer charity, what are the priorities? What are the most important preventable things out there that we should be trying to do something about?  It’s not particularly relevant to you as an individual – how you can reduce your own personal risk depends on what you’re doing.

For example, if nobody in the UK smoked, there would be twenty per cent fewer cancers. But for you as an individual, if you’re a smoker and you stop, it’s not 20 per cent less, you halve your risk of dying from cancer.  So if you as a person -or how you’re counselling individuals as a doctor – you have to take into account the personal lifestyle.

Whether you’re a smoker or not is the most important thing. What the figures in this book are telling us is that in the UK – for the community as a whole – what are the factors that are important and how does it pan out.”

Sara Hiom, director of health information at Cancer Research UK, tells us about the lifestyle changes we can all make to reduce our risk of cancer.

“Whilst there may be some surprises in the detail of the study – for example the role that perhaps fruit and vegetables might play, we’ve been quite surprised by some of those figures, by the fact that tobacco plays a bigger role in liver cancer prevention than does alcohol – there have been some surprises in that, and I think that’s really interesting when you look into the detail of the study.

Overall, the key message for me – as someone who has to think about the information that we put out as a charity to the public – is the fact that over a hundred thousand cases of cancer are potentially preventable by four lifestyle changes: tobacco is by far an away the most important, and if no-one smoked there’d be 60,000 fewer cases.

It’s quite clear from an individual perspective that there are choices we can make about our lifestyle that will make a significant difference to our own health and wellbeing. I think that’s an important point to make here – a lot of the lifestyle factors we’re discussing here will have impact on our general health and will reduce the risk of a whole host of other diseases as well.”

Improvements in survival from childhood cancer are one of the big success stories in recent years – and Cancer Research UK's work has been at the heart of that progress.

New statistics show that at least 5,600 children have survived the disease for at least five years than would have done if survival rates had remained as they were in the early 1970s.

For example, the new analysis shows that in the early 1970s only around a third of children with leukaemia – the most common childhood cancer – lived five years or more. Today, the chances of surviving are more than 80 per cent.

But despite these successes, going through a cancer journey is still a tough time for kids and their families. So every year Cancer Research UK's Little Star awards recognise the bravery of children with cancer. Our science information manager, Dr Kat Arney, spoke to one family that has been affected by childhood cancer to find out what they had been through, and what a difference their Little Star award made.

I’m Lorna Morgan, I’m mother to Lorna, 10, and Jamie, seven. Georgia had a blood test in March 2007. Her red blood count was so low she needed an emergency blood transfusion. She was taken to Addenbrooke’s Hospital where we were told it was leukaemia and within an hour she started chemotherapy.  

Georgia was on various types of chemotherapy through a Hickman line into her heart. She had steroids as well, which clashed and caused a stroke three weeks into her treatment.

Kat: That sounds like a lot for a little girl to go through. What difference did it make receiving a Little Star award from Cancer Research UK?

For Georgia at age 6 she had no fear for the future – you could have told her she had hayfever!  For us, we knew the seriousness and the fear for the future. Georgia’s teacher found out about the Little Star awards and nominated her.

I was immensely proud – she had smiled through 2 years of chemotherapy, just smiled and laughed her way through everything.

Kat: Would you encourage other families whose children may be affected by cancer to put them forward for a Cancer Research UK Little Star?

Absolutely, and the nice thing is that every child nominated will receive and award. Particularly for my family, little Jamie who was three at the time whose sister and mum had been disappearing for weeks at a time, he was awarded a Little Star award too.

Kat: And how’s Georgia doing now, a few years later.

Georgia is two and a half years free of cancer, which is absolutely fabulous. Her life is back to normal, she’s back at school, attending secondary school next year, and life is just normal.

Kat: What would be your advice to any mums and dads listening?

All mums and dads, doctors and nurses, any children that you know of who are going through treatment now or have been through treatment, do nominate them for an award. It’ll make all the difference to them and it’ll really brighten their day.

Kat: So that’s Mum’s perspective, but what about Georgia? I asked her how she felt about spending so much time in hospital during her treatment.

When I was in hospital I knew because when I was in school at that time I would feel unsure, because I would be the only one like that. But when I was in hospital I knew that I wasn’t alone because there were lots of other people with cancer and no hair. Losing my hair I think was the biggest thing because I’m a girl.

Kat: What other things happened? Anything else you particularly remember about that time?

Before I was going back to school a nurse came to my school and told the assembly what had happened to me, and that I had no hair, because some people might tease me. But then they didn’t.

Kat: How did you feel when you got your Little Star award?

I felt proud that I beat cancer, and that it is possible to do.

Kat: Do you think it would be a good idea for other children with cancer to be put forward for these awards?

I do, because when you have cancer I know how you feel, because I felt unsure, but when I got my Little Star award I felt really proud.

Kat: To find out more about the Little Star awards themselves, I spoke to Martin McGlown, head of Cancer Research UK’s regional press team.

The Little Star awards, now in their ninth year, are an amazing celebration of the courage of all children who are diagnosed with cancer. They’re quite unique in that every single child who’s nominated for an award gets the accolade. There are no winners and loser, there are only winners because Cancer Research UK believes passionately that every child who is diagnosed with cancer is deserving of recognition.

Kat: So how do the awards actually work? How does a child get nominated for an award?

The awards are sponsored by TK Maxx, our partners. They work by encouraging people across the community if they know of a child under 18 who’s been diagnosed with cancer in the last 5 years to put them forward for a Little Star award.

The recipients get a certificate signed by a host of celebrities including England footballer Steven Gerrard, pop sensation Leona Lewis and a host of others. They also get a very special chrome star trophy and some other goodies, so it’s a fantastic celebration of these children – and also their families, because as well as recognising the children themselves, we do award any siblings in the family a certificate. That’s to recognise the important role they play in supporting their brother or sister through a cancer diagnosis.

Kat: If anyone’s listening to this and thinking “I know a Little Star”, how can they nominate them?

It’s very simple. Just log on to www.cancerresearchuk.org/littlestar and there’s a nomination form there. They can fill in the child’s details and we’ll make direct contact with the family. So it’s very simple, and we really would urge people across the community to think if there’s a child who deserves that recognition then to put them forward.

That was Martin McGlown talking to Dr Kat Arney. If you know a Little Star, you can nominate them now at cancerresearchuk.org/littlestar

We’ll be back next month with all the latest news and features. In the meantime, you can keep up to date by checking our Science Update blog.  And from all of us at Cancer Research UK, we wish you a merry Christmas and a happy new year.