June 2008 transcript

00:00

Kat: Welcome to the Cancer Research UK podcast. In this month's show we hear about a groundbreaking deal between the charity and the pharmaceutical industry, discover the online support available for people with cancer, and pound the park with Race for Life.

Coming up later, we hear one man's story about being on a clinical trial for a new cancer treatment for people with a certain gene fault. But first, here's the news with Alison Ross.

01:13

Alison: Scientists at the Cancer Research UK London Research Institute have made an important discovery which could be used to produce highly focused vaccine therapies for cancer.

The research centres on dendritic cells - cells in the immune system that "teach" other immune cells how to recognise bacteria or viruses. Many scientists are developing vaccines that can train these cells to recognise cancer within the body and destroy it.

Led by Dr Caetano Reis e Sousa, the researchers discovered a new protein on the surface of dendritic cells, which could potentially be targeted by cancer vaccines. Here he explains why this work is important for people with cancer.

"It is important because in the long run it may allow us to design better immunotherapies for cancer. For example, if we want to induce a T-cell response against proteins expressed in [produced by] cancer cells, we now have the ability to deliver those cancer proteins directly to dendritic cells, and thereby have a very efficient means of telling T cells who to attack.

In this latest research we've shown in proof-of-principle experiments that this can be done, however we are a long way from making that into an effective immunotherapy."

Cancer Research UK has struck a groundbreaking deal with pharmaceutical company Astra Zeneca to develop a previously shelved drug for cancer patients. Known as AZD0424, the drug blocks the function of important signalling molecules that tell cancer cells to multiply.

This is the first drug to be taken into the Clinical Development Partnerships programme, which aims to get more potential treatments into early stage clinical trials.

Cancer Research UK have launched an exciting new blog, aiming to reveal the science behind the latest cancer stories in the media, as well as highlighting progress by the charity's scientists. As with all blogs, comments are welcome so please let us know what you think.

Written by science and health information specialists, including the podcast's Dr Kat, you can read the team's posts and join in the discussion at scienceblog.cancerresearchuk.org

And finally, if you heard Andy Sturgeon talking in last month's podcast about the Cancer Research UK garden at the Chelsea Flower Show, you’ll be pleased to hear that the garden won a gold medal.

Paid for by an anonymous benefactor, and based around the theme of progress, the garden has generated huge amounts of publicity and awareness about the charity and our work.

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.

04:11

Kat: Dr Julian Lewis heads up his lab at Cancer Research UK's London Research Institute. But as well as being one of our prominent research scientists, he is also a cancer patient on an early stage clinical trial.

I spoke to Julian in his lab and asked him to share his story and tell us more about the trial.

"My story is that I have had an interest in cancer research for a long time - I work for Cancer research UK - but I've got a personal interest because of some family members who got cancer, my sister in particular. And it turned out that her cancer, which was ovarian and breast cancer, arose because she had a mutation in a gene called BRCA 2, or Breast Cancer 2.

I had myself tested and it turned out I also was a carrier of a mutation in that gene, and then a bit later I was diagnosed with prostate cancer. It turned out it was already rather advanced and it there were bone metastases - bone offshoots of the original cancer.

I had standard treatment which eventually failed, and so I enrolled in a Phase 1 trial - a trial of a brand new drug that was rationally designed to deal with cancers in people who had BRCA mutations. The BRCA gene is important in repairing DNA. The DNA in your cells is getting damaged all the time - having little accidents as a result of the hurly-burly of chemical reactions in every cell. Those accidents have to be repaired, and BRCA gene products are important for this repair. If you don't have them, repair doesn’t work properly.

The treatment is based on that fact, but it takes a bit more explaining! There are different kinds of damage and different kinds of repair mechanism that cope with that damage. To some extent those repair mechanisms act as a backup for each other. So there is a mechanism of repair that depends on the BRCA genes, and another (called the single-strand break repair mechanism) that depends on another component - an enzyme molecule called PARP.

This is a bit like a "belt and braces". The tumour cells in your body have no BRCA working. They depend entirely for their survival, and the repair of their DNA, on PARP. So if you block that, which you can do with this drug, then those cells die because they can't cope with all the damage that happens to their DNA.

I've been on the trial for around a year and a quarter, and I'm doing well. I'm still fine, and the drug worked well for me. My tumour marker, which indicates the extent of my cancer, was rising before I started the treatment, and it's now been going down steadily.

This treatment works only for the small minority of patients who carry mutations in one of their BRCA genes, but of those patients who are appropriate for the drug, about 50% have shown a good response.

This treatment could never have been developed without basic research into these fundamental mechanisms by which DNA repairs itself, gets replicated, deals with different kinds of damage. All that basic molecular biology was absolutely essential - without it we wouldn't have this treatment, and the same goes for many other treatments that are now on the horizon for cancer."

Kat: That was Dr Julian Lewis, from the London Research Institute talking about his experience of being on a clinical trial of a PARP inhibitor. In fact, Cancer Research UK played an important role in the development of the drug, through our fundamental research into the biology of cancer.

08:58

Kat: Cancer isn't just about the physical illness - it can have a strong emotional impact as well. People living with cancer and their family and friends can sometimes find it useful to share their experiences and ask for advice, and the internet is a great way to do this.

Our reporter Anna Lacey went to find out about some of the resources available, and started by talking to Martin Ledwick - the Head of Cancer Information Nurses at Cancer Research UK - about the potential issues people can face.

Patient Support package

"There are a great variety of reactions that people have to a diagnosis of cancer, and of course as they're going through treatment and recovery from the different sort of treatments they'll have, all sorts of different things can arise for them. So there are a huge variety of emotional impacts, there can be communication issues within the family.

Often people can feel extremely isolated when they're going through a cancer experience, particularly with more unusual types of cancer, or perhaps if they're being treated in a smaller town, or if it's difficult for them to get to a support group.

Often there may be practical solution that they've found for themselves about how to deal with specific problems that they've got. Also from an emotional support view, there's a huge advantage to being able to see and hear from other people that have been in the same position, and realise that they're not alone, that other people have been through these things as well."

One way for people to share their experiences is through a website known as DIPEx, which stands for the Database of Individual Patient Experience. It's run by researchers at the University of Oxford, and Sue Ziebland is the project's director.

"DIPEx is a website that is based on people's experiences of different health issues. The first modules that we launched on the DIPEx site were prostate cancer and hypertension, and since then we've added 39 conditions to the site, to provide people with an avenue to access a broad range of other people’s experiences of that condition. Cancer Research UK directly funded the ovarian cancer project and also the lymphomas project.

When you come to the DIPEx website you'll be greeted by the homepage that lists all the different conditions that we do, and all of the cancers and cancer screening projects are collected under one heading, so it’s quite easy to find. In this case we’re looking at the lung cancer module.

For each module the DIPEx team interviewed a range of people from different backgrounds, age, sex and ethnic group to try and gather as many experiences as possible.

For example, under "Financial Help" you’ll find that we've written a summary of all of the issues around financial help that people talked about in our interviews. So as you scroll down you can click on their photograph and a strapline telling you what that bit of the interview is about. Then you have the choice of playing the video of the clip, playing the audio, or you can read that section of the transcript.

The response from patients, families and friends has been fantastically positive. Regardless of the health condition, other people who have lived through it are seen as having a particular type of expertise, and it's very much part of the information that people want now. People don't just want facts and figures. Obviously they want support from professionals who have a certain type of information about the illness, but they also want to know what it's like."

To help people share their expertise and experiences further, Cancer Research UK have set up Cancer Chat - an online patient information forum. Katy Scammell is one of the people behind the initiative.

"The forum's going to be split into a number of topics covering ever area of cancer - for example treatment, or diagnosis. And people can go on there, post a question and others can reply with a response. The current support that we offer is our nurses help-line, where people can talk to a nurse, or CancerHelp UK, where it's written by healthcare professionals.

Outside of that, other places where you could traditionally get peer-to-peer support would be support groups, but they don't suit everybody. You'd have to be able to travel to that group, and be available at the time that group meets. Whereas with a forum, you can go on there when it's suitable for you, and also meet people from across the UK and not just in your area.

People can discuss any aspect of cancer that they might have questions about. That could be on risk and prevention of cancer, treatments, diagnosis, also living with cancer. But there is also a category called "other" because we don't want to close down what people want to talk about, so if there is an area they’d like to talk about that isn't already covered on the site, there's a place for them to put those questions. Our website address will be cancerchat.org.uk and people can also find us through our website CancerHelp UK by following the links."

Kat: That was Katy Scammell talking to Anna Lacey about Cancer Research UK's new Patient Information Forum - Cancer Chat. And if you'd like to look at the interviews on the DIPEx website, then you can find it at www.DIPEx.org.

15:03

Kat: Race for Life is now in its fifteenth year, and last year 665,000 women raised a fantastic £40 million for our lifesaving work. This year the series kicked off with more than 5,500 women running in Battersea Park. I went along to ask the all-important question - why are you here?

[Selection of Vox Pops from Race for Life]

Kat: If you'd like to find out more about Race for Life, or enter yourself, then visit www.raceforlife.org. And if you're a chap, then you can always go along and volunteer to help out at an event near you. Or how about entering our men-only 5k event, Run for Moore, raising money for bowel cancer research? And for the keener runners out there, there's also our series of 10K races for both men and women. Find out more at www.cancerresearchuk.org/running .

18:10

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 Alison Ross and Kat Arney
• DPatient support package by Anna Lacey
• Original music written and performed by Kat Arney and Henry Scowcroft
• With special thanks to all the participants