January 2010 podcast transcript

Welcome to the Cancer Research UK podcast. This month new trial offers hope for children with an aggressive form of cancer, groundbreaking research uncovers the genetic damage caused by smoking, new research reveals the importance of diagnosing cancer early, and government statistics show a postcode lottery for cancer survival. I’m Paul Thorne from Cancer Research UK.

Children with a high risk form of the childhood cancer neuroblastoma are set to benefit from a new international clinical trial.

The trial, funded by Cancer Research UK, uses immunotherapy to help prevent the disease from coming back.

It opens in the UK this month, building on early promising results from a US study which found that treatment with immunotherapy – boosting the immune system to fight the disease – improved the chances of survival from the disease.

Cancer Research UK’s science information officer Laura Bell says that the new trial could be a significant step forward in treating neuroblastoma.

"More than half of all children with neuroblastoma are successfully treated, but we need to do more to help the children with more aggressive forms of the disease. This new treatment is highly targeted to cancer cells, and it should be more effective than existing treatments. This is a world-class clinical trial which we hope will change the outlook for many children with neuroblastoma in the future."

Scientists have mapped the entire genetic makeup of a lung and a skin cancer tumour for the first time. The study revealed a catalogue of mutations that can be traced back to their causes – smoking an sunburn. It showed that moderate smokers could be inflicting a new mutation on their DNA each day. Henry Scowcroft, our science blogger, described the research as groundbreaking, and explains why it’s so important.

"This was a fantastic piece of research by scientists at the Wellcome Trust Sanger Institute in Cambridge and it really takes things forward a step in our understanding of cancer overall. What scientists have done previously is try to home in on the particular individual genes that are mutated in cancer cells, and then work back from that to design drugs to target those genes.

"What this gives us is a picture of the whole genome of a cancer cell, and how all the different bits of damage around the cells are all linked to each other. The amount of data this generates allows scientists to really understand how the environmental carcinogens interact with the DNA to cause cancer, and gives us a whole new set of data to start understanding what’s going on here."

And you can find out more about that story on our Science Update blog – that’s scienceblog.cancerresearchuk.org

Twenty one research papers published in the British Journal of Cancer, reveal that up to 10,000 deaths each year could be prevented if cancer was diagnosed earlier.

By looking at survival rates in other countries, the researchers concluded that British people tend to go to their doctor with symptoms later. They also suggest that there may de delays in GPs referring people who may have cancer to specialists.

Health information manager Dr Jodie Moffat tells us what Cancer Research UK is doing to rectify the situation.

"We’re working with the Department of Health on an initiative to promote the earlier diagnosis of cancer, and we’ve got a lot of projects going on to help spot cancer early. One of the things we’ll be doing is working in Derby to raise bowel cancer awareness in men over fifty, and we’re working with GPs across the country to help them know the symptoms of cancer and when to refer patients on."

Cancer Research UK is calling on the government and primary care trusts across the country to act urgently after shocking new figures revealed that a cancer patient’s chances of surviving for at least a year vary hugely depending on where they live.

The variation among trusts was biggest for lung cancer survival, with patients in Herefordshire three times more likely to die within a year of diagnosis compared with patients in Kensington & Chelsea. And almost all of them failed to match the best survival rates in Europe.

Our Head of Policy, Sarah Woolnough, says this is largely due to cancer being diagnosed at a later stage.

"We think this is completely unacceptable. There’s no reason why there’s such a stark variation in one-year survival rates across the country. One-year survival is a marker for later diagnosis of cancer, so we think there needs to be a huge effort by the government to ensure that cancer is being diagnosed at the earliest stage possible."

Now, January is a time for new beginnings and New Year’s resolutions. For many people, giving up smoking is at the top of their list. Dr Kat Arney from our Science Information team spoke to Cancer Research UK’s Professor Robert West, to find out about their latest research on the best ways to break the addiction.

Research shows that at any time, around seven out of ten smokers want to kick the habit. And as the calendar flips over to the 1st of January 2010, many smokers will be deciding that this is the year they want to quit for good. But what’s the best way to go about it? If anyone can tell us, it’s Professor Robert West, Director of Tobacco Studies at the Cancer Research UK Health Behaviour Centre.

"Well actually it is an important time, and about one in ten smokers tries to quite around the new year period. So it’s a good time to make sure you get a really good shot at it. The evidence is very clear – what you should do, if you’re really serious about stopping smoking, is contact your local NHS Stop Smoking Service. It’s very simple, practical evidence-based advice and support based on the evidence of large studies and many millions of smokers who’ve been through it.

"What you get in addition to that is medications, of which there are three main types. There’s nicotine replacement therapy (NRT), and there’s [two different] prescription pills that you can get from the service or from your doctor. One of them is called Zyban, which is effective, and there’s a relatively new one called Champix. This has been found to be particularly effective in helping people to stop smoking and deal with the cravings.

"So between the medicines and the support and practical advice you’re getting from the Stop Smoking specialist, you’re about four times more likely to succeed in the quit attempt than you would have been otherwise, and that really makes a difference and could save your life.

"I wish we could say that there were some methods that worked for some kinds of smoker, and other methods that work for other kinds of smoker, but I can’t because we don’t really have very good evidence to back that up.

"What I would say is that it’s whatever works for you. You don’t get one shot at stopping smoking – you can keep trying, and if one method doesn’t work, then you try something else. So if you’ve tried nicotine gum or a nicotine patch or NRT and you absolutely didn’t get anything from it – and you made sure that you used it properly (a lot of people don’t use it properly, they don’t use enough and they don’t use it for long enough). But if you did all those things and it wasn’t doing anything for you, then try one of the other medicines.

"If you tried throwing the fags away and you found that was too scary for you, then don’t! Try something different next time. If you’ve been successful at something then you stick at it, and if it hasn’t then you try something else. But the really important thing is to keep trying. The reason for that is once you’ve passed the age of thirty five, which a lot of people listening to this probably have, then every year that you put of stopping smoking, you’re going to lose an average of three months of your life, and that’s really scary. So it’s very urgent to stop as soon as possible. And the way to do that is to keep trying.

"One of the things that is quite novel with the Department of Health’s campaign this year is that they’re going to be handing out these things called Quit Kits. They’re quite an interesting idea. They’ve done some research that has told them about the kinds of things that smokers want when they’re trying to stop smoking – something to deal with the cravings, and that sort of thing. And they recognise that despite the fact that the Stop Smoking services are really world-beating, not everyone wants to go to them – they haven’t got the time or whatever it might be.

"These Quit Kits are going to be sent out to people who apply for them on a first-come-first-served basis – so if you want your Quit Kit get in early! – and they have a whole range of different things that are designed to beat the cravings. It’s an interesting idea and I would recommend anyone, whether or not you go to the Stop Smoking service, to give it a go."

That was Dr Kat Arney speaking to Cancer Research UK’s Professor Robert West.

We’ll be back next month with all the latest news. In the meantime, you can keep up to date by following us on Twitter, at Twitter/CR_UK