August 2008 transcript
00:00
Kat: Welcome to the August Cancer Research UK podcast. In this month’s podcast we’ll be revealing the winners of our podcasting competition, finding out about cancer stem cells, and celebrating twenty years of working together with one of the UK’s biggest banks.
Coming up later, we find out how Cancer Research UK’s new campaign is aiming to put pressure on the government to keep tobacco out of sight and out of mind. But first, here’s the news with Liz Baker.
00:57
Liz: A new drug for prostate cancer, originally developed and tested by Cancer Research UK scientists, has shown promise in early stage clinical trials. The drug, called abiraterone, hit the headlines in July after results were released showing that it could treat up to 80% of men with aggressive prostate cancer that is resistant to hormone treatment.
However, the clinical trial only involved 21 men, so we need to wait for the results of a much larger scale trial, currently being funded by Cougar Biotechnology, before we know for sure whether abiraterone is a safe and effective treatment for prostate cancer.
Cancer Research UK is working together with celebrities Sir Trevor McDonald and Konnie Huq, as well as politicians and doctors, to raise awareness of cancer in the UK’s black and ethnic minority communities. July saw the launch of Ethic Minority Cancer Awareness Weak at the House of Commons, highlighting some of the specific risks involved.
For example, research has shown that black women being more likely to get breast cancer at a younger age and have a more aggressive form of the disease. Here’s Yvonne Brown from Birmingham, a black woman who developed breast cancer when she was 44.
"It would be nice to see more black or Asian people as a picture for Cancer Research UK. Because when you got to the cancer centres it’s an equal amount of people there who are Asian, Indian, Afro-Caribbean… It’s across the board. It’s about having more faces out there that people feel they can identify with, so you don’t feel you’re in the minority. Until I had it, I never thought that many black people did get breast cancer."
And finally, we’re pleased to announce the winners of our SciencePod podcasting competition for 14 to 16 year olds. First prize goes to Natalie Jones, Alex Rigby, Matty Burton and Blaithin Settle from Neston High in Cheshire. Their podcast was on the controversial and very topical issue of whether under 18s should be allowed to use sunbeds. Here’s a clip.[Clip from winning podcast]
You can hear the winning podcasts in full by visiting the Youth and Schools section of our News and Resources website.
Kat: And if you want find out more about these stories, or get the latest from the charity's scientists, and researchers around the world, then have a look at our News & Resources website.
04:21
Kat: Smoking causes around a quarter of all cancer deaths in the UK, and is the single biggest preventable cause of cancer in the world. Cancer Research UK lobbied the government to bring in smoke-free legislation, banning smoking in enclosed public places. But we believe this doesn’t go far enough, so we’re now running a new political campaign called “out of sight, out of mind”.
I asked Elaine Londesborough, CancerCampaigns officer, to explain more about it.
"We’re particularly concerned about the impact tobacco has on children and young people. 450 under-18s start smoking every day across the UK. The advertising and promotion of tobacco including its packaging, deliberately builds relationships with potential new young smokers.
So although tobacco advertising has been banned on television, in print and on billboards children are still regularly exposed to attractive tobacco displays in shops, newsagents and supermarkets.
We know that many young people, particularly underage smokers, buy cigarettes from vending machines. We also know that on-pack branding, including logos and colour schemes, makes cigarettes more appealing to young people and dilutes the impact of health warnings. This is a huge problem because smoking has a massive impact on people’s health.
Smokefree legislation has come into force across the UK over the last few years, and this is already proving beneficial to the health of the nation. This is really great but just one piece of the puzzle. The World Health Organisation recommends that all nations implement a comprehensive tobacco control strategy to combat the tobacco epidemic.
It’s a great time to get active on this politically – Scotland have recently announced an action plan called Scotlands’ future is smokefree – we need to make sure they act on their promises. Also the Department of Health are currently consulting on tobacco control affecting people in England, Wales and Northern Ireland – these opportunities make this a great time to affect government policy on tobacco.
We want to see tobacco put out of sight and out of mind. There are three specific measures we’re calling on Ministers to implement.
Firstly – to close the loophole which allows tobacco to be displayed at the point of sale. By removing tobacco from public view, we can reduce the pull towards a potentially deadly addiction. We can also help the majority of adult smokers who are trying to stop smoking – and who wish they'd never started. In Iceland, where point of sale (POS) displays were removed in 2001, the proportion of 16-17 year olds who reported that they had ever smoked fell from 61% in 1995 to 46% in 2003.
Secondly - to prohibit the sale of cigarettes from vending machines. 17% of 11-15 year old smokers routinely buy cigarettes from vending machines. Removing these machines altogether is the only effective means of preventing underage smokers obtaining cigarettes from these sources.
Thirdly - make plain packaging for tobacco products compulsory. Studies show that plain packaging – removing these attractive, promotional aspects – could result in fewer teenagers starting smoking.
People can help in two different ways – If you live in England, Wales or Northern Ireland please use the quick and easy tool on our website to submit your own response to the Department of Health’s consultation. Scotland are ahead of the rest of the UK and have already published an action plan on tobacco. We need to keep up the pressure though so if you live in Scotland you can sign the petition on our website.
Showing public support for these measures will make a huge difference. Please take action now at www.cancercampaigns.org.uk.
Someone who starts smoking before the age of 15 is four to five times more likely to get lung cancer than someone who starts in their mid-20s or later. It’s therefore really important that the government of the UK do everything they possibly can to protect children and young people from a product that kills – tobacco. "
09:18
Kat: Stem cells are a hot topic in science, and this is especially true of cancer research. But we’re not talking about the sort of stem cells are found in embryos. In recent years, scientists have discovered that cancers may harbour stem cells, and that these may help tumours to resist treatment, or start growing again after treatment.
Our reporter Anna Lacey went to speak to Fiona Watt, the deputy director of the Cancer Research UK Cambridge Research Institute, to get to the bottom of the cancer stem cell mystery.
Cancer stem cells package
"The concept of cancer stem cells really arises from pathologists recognising many years ago that if you look under the microscope at a section through a tumour, not all the cells are the same. You will see some areas where the cells can’t divide any more – and in that situation you could say that those cells won’t give you a tumour, it’s more likely to be the cells that are more like stem cells."
So the idea is that tumour cells can be broadly split into two types – those that can go on to make a new tumour – like cancer stem cells, and those that can't make a new tumour – known as bulk or non-stem cells. These bulk cells are rather like weeds in a garden. You can get rid of them with herbicide or chemicals , but unless you kill the roots, they'll eventually grow back again.
If we think about the roots as being like cancer stem cells, we can go some way to explaining why some tumours come back. John Stingl is a group leader at the Cambridge Research Institute.
"“When we have a tumour, 1% of those cells may be stemc ells, and the other 99% are non-stem cells. And what we think is happening is that we’re giving a treatment that kills off all the non-stem cells. And of course, the tumour shrinks because you’re killing of 99% of the cells. But unfortunately the stem cells are resistant to radiation or to drugs, and over time they’ll start to grow again and a couple of years down the line they’ve picked up ever more mutations and they’re even more resistant to therapy.
What we think is happening is that you have a primary tumour where you have a stem cells that is sitting there and dividing, producing new stem cells that go off in the bloodstream and start new tumours. So there’s a lot of interest now in the cancer biology field to identify the pathways that cause a stem cell to divide and form a new stem cell. Because if we could alter that pathway, and get a stem cell to divide to make two non-stem cells, those non-stem cells have a finite growth capacity. They can grow all they want, but eventually they’ll burn out."
But research suggests that not all cancers are caused by stem cells and that the traditional idea of mutations in cancer genes is still relevant. So how can you tell if a tumour is from a stem cell or not, and how would that affect treatment?
"“I think the concept of cancer stem cells, although it is an old one, is only now being thought about systematically for all tumour types. Rather than saying “the way my treatment will work depends on whether there are cancer stem cells or not”, I think the answer is really that you have different types of treatment for different types of cancer.
But for tumours of the blood – the leukaemias – squamous cell carcinomas, where we know there are stem cells, maybe we need to devise a different treatment which specifically targets those cells. but it would be wrong to assume that a tumour where stem cells have been defined is necessarily a worse tumour than one where stem cells haven’t be defined, because the evidence is just not there at the moment."
Although there's talk of future treatments, it's still early days for cancer stem cells, and lot more basic research is needed. Right now Cancer Research UK is supporting John Stingl in answering fundamental questions about both normal and abnormal stem cells in the mammary gland.
"“We’re trying to figure out what actually are the cells in the mammary gland? What do the stem cells look like, how many of them are there, how can we purify them, what genes do they express? When a stem cell divides and produces a daughter progenitor cell, what types of progenitor are there?
We’ve now identified several different types of breast cells. So one experiment we want to do is take 5 different types of normal breast cells , mutate each the same way and then ask “do all the different types of breast cells form a tumour?” or do some form tumours more easily than others. We’re basically trying to reverse-engineer tumours in different types of breast cells, trying to understand why breast cancers are so heterogeneous [different]."
And the more we know about the various types of breast cancer, the more chance we have of diagnosing and treating people more effectively.
"There’s been a big interest in looking for a “stem cell signature” in breast tumours, to hopefully identify women who present with a not-very-aggressive tumour, but may have stem cells in their cancer. That would raise a little “flag” to warn that her cancer might become more aggressive in the future, so maybe she should receive anti-stem cell cancer therapy. The tricky thing is that when we’re looking for a stem cell signature, we don’t know if all cancer stem cells are the same between tumours, or if different types of tumours have different stem cells –that’s what we’re trying to figure out. We don’t know the answers to those questions yet."
15:20
Kat: We normally think of vaccines as something you get to prevent an illness. But Cancer Research UK scientists in Southampton are working on a different kind of vaccine for cancer – one designed to treat the disease rather than prevent it.
I spoke to Professor Christian Ottensmeier, one of our Senior Clinical Research Fellows, to find out more about his research into DNA vaccines for treating cancer.
"They’re really quite clever. DNA is a molecule that gives us the recipes for the cells in our body to do their work, and it turns out that the chemical – the DNA itself – is really quite straightforward to manipulate. You can take little pieces of DNA and, like with a sewing machine, put them together into the right context. The laboratory tools allow us work with DNA and modify it in such a way that we can use this material to stimulate the immune system to recognise cancer. The work that I’m doing stems out of long and very highly published work by Professor Freda Stevenson in Southampton who pioneered this in the pre-clinical setting, showing that DNA holds great promise for the induction of immunity against cancer. My contribution has been to take this into the clinic, but we have so far struggled to make DNA vaccines work well in patients. We are just on the brink of seeing a way in which we can do this better by delivering the vaccine not just as an injection under the skin or into the muscle, but using new ways of delivering these vaccines which appears to be the crucial step in making vaccines that didn’t work very well in people become very effective. We are undertaking a number of clinical trials in which we are asking if we can, by using these DNA vaccines in patients, make the immune system of the patient awaken to the presence of the cancer. We’re just collecting the first data that this is actually working, and it’s very exciting. And although we have no information yet as to whether this means that we can control the cancer, it certainly means that it is doing what it says on the box. We need to make different vaccines for different types of cancer. We have just completed a study for patients with follicular lymphoma, and are just about to report the data. We’re doing a similar study in patients with multiple myeloma – bone marrow cancer. We have just completed recruitment to a study for prostate cancer, and with the Cancer Research UK Drug Development Office, we’re doing a study in patients who have cancers that could be of different origins but all have one shared commonality – a molecule called CEA. So that’s cancers of the bowel, lung and breast and maybe more than that. I think the data that we now have suggests that this [approach] is going to deliver. The key issue is going to be to tweak the system in such a way that what we see in the laboratory, measuring it in the blood of the patients, can translate into real benefit for making cancer better. Because otherwise it’s just another experiment that you do. It feels as though we’re making real progress along that road, so we’re very excited about it. When you talk about the more common cancers we’re dealing with at the moment, we would continue to needs to use the tools that we currently have available - surgery, radiotherapy and chemotherapy – and then when the cancer has been reduced in the amount in the patient, then use vaccines to suppress or eliminate cancer cells that haven’t been removed. It’s a fourth way, along with the standard treatments we have. I think we will see [DNA vaccines] in combination with chemotherapy, perhaps with radiotherapy. At the moment this remains to be proven. Ultimately the test is in the doing, so we need the data from our studies to show that we can do what we think we can do, to exploit and explore, and to ultimately hopefully reduce the side effects of treatment, but that’s a long way off. I see this very much as an iterative process from the lab to the clinic, learning what you can from the study, and then going back to the lab to make things work better, and then taking that back to the clinic. That’s the way I see my programme developing."
20:39
Kat: We’re lucky enough to be supported by many companies in the UK, including the high street bank Halifax Bank of Scotland, who have been working together with us for an amazing 20 years. I spoke to Jas Singh to find out more about the partnership.
"Well, it’s a really simple relationship as Halifax is the financial provider of Cancer Research UK’s credit card. It’s been a very successful partnership for both organisations and since 1988 Halifax is delighted to have donated over £12.2m to your ground breaking research.
It’s a simple idea as the Cancer Research UK credit card works just like any other but raises money every time you use your card – so through your everyday spending like meals out, holidays and your weekly shopping you really can make a difference to saving lives. It’s been a great success and clearly appealed to hundreds of thousands of Cancer Research UK’s supporters over the years that have seen it as a simple way of supporting their favourite charity.
We’re encouraging people to take out a Cancer Research UK credit card as a really easy way of making a difference and to help beat cancer. Listeners will be able to see it being promoted during August and September in a variety of ways including on Cancer Research UK’s website and in your high street charity shops. This is also a really nice opportunity to thank the hundreds of thousands of people who’ve regularly used their Cancer Research UK credit card over the years and played a part in so much money being raised for such an important cause.
Halifax donates money to your ground breaking research in three ways, and without it costing the cardholder a penny. When you first use your new card we’ll donate £50 to Cancer Research UK, and then we also donate 25p for every £100 you spend. For every year you hold your card we’ll also donate £1. So you can see the donations really add up by people regularly using it.
To apply for a card or find out more information just call 0800 032 0409 quoting CRUK20 apply online through our website or alternatively visit a Halifax branch or a Cancer Research UK shop."
Kat: Over the past 20 years, Halifax bank of Scotland have raised more than £12 million for our lifesaving work. In that time, we’ve seen massive improvements in cancer survival, and now half of people now survive cancer for more than five years, compared to just over a third of people 20 years ago.
If you’d like to find out more about how we work together with companies, or if you’d like to get your company involved with fundraising for our vital work, please visit www.cancerresearchuk.org/corporatepartnerships/
24:00
We've reached the end once more so we hope you've enjoyed the podcast. Don't forget that your feedback is vital in helping us improve the show, so please send us your comments and suggestions by email to podcast@cancer.org.uk.
We'll be back next month with all the latest news from Cancer Research UK, so until then, goodbye!
- Credits:
- Presented and produced by Kat Arney
- News by Kat Arney and Liz Baker
- Cancer stem cells package by Anna Lacey
- Original music written and performed by Kat Arney and Henry Scowcroft
- With special thanks to all the participants
