May 2008 transcript
00:00
Kat: Welcome to the Cancer Research UK podcast, with me, Dr Kat Arney. This month we discover the risks of sunbeds, find out how cancer drugs get approved for patients, and take a trip to the Chelsea Flower Show.
Coming up later, we hear how sunbeds led to skin cancer for one woman, but first, here's the news with Julie Sharp.
00:53
Julie: Cancer Research UK scientists at the University of Dundee have uncovered the biological explanation for the use of arsenic as a treatment for a certain type of leukaemia.
The poisonous chemical has been used to successfully treat acute promyelocytic leukaemia for many years, but until now it wasn't known why it worked.
Professor Ronald Hay and his team found that arsenic helps to stick molecular tags, called SUMO proteins, onto the faulty proteins in the cancer cells that cause the disease. An enzyme, called RNF4, then hunts down SUMO, and destroys the faulty proteins.
Dr Mike Tatham explains more about what this research might mean for people with this type of cancer in the future.
"Obviously most people have heard of arsenic as a poison and that's for good reasons – it's very toxic. So it's quite surprising to find that arsenic can be used as a treatment for cancer.
If you're treating people with a poison you've obviously got a risk of having toxic side effects for extended periods of time or for higher levels, so ideally because we now know the sequence of events from treatment with arsenic to degradation of the cancer-causing proteins in the cell we can look more specifically at the proteins involved – in this case RNF4 – and say "well, let's see if we can design a drug that specifically deals with RNF 4, or specifically inhibits a point in the pathway." So instead of having to treat patients with a poison like arsenic, we could maybe have a different drug that specifically acts at a more focused point in the pathway, that won't have the side effects that arsenic has."
And finally, Cancer Research UK-funded scientists at the Institute of Cancer Research have pinpointed part of our genetic code that contains genes that may put smokers at even more risk of developing lung cancer.
The team scanned through the DNA of thousands of men and women in the UK and the US. All of the people involved in the study were current or former smokers and around half were lung cancer patients, while the other half were healthy.
The researchers think that current or former smokers with certain versions of these gene regions may increase their risk by up to 80 per cent, although the gene variations don't seem to affect people who have never smoked.
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.
04:05
Kat: The summer is on its way, and many Brits will be looking forward to the "bronzing season" and thinking about topping up their tans with a trip to their local sunbed salon.
Thanks to our annual SunSmart campaign, many people now know about the risks of excessive sun exposure and burning outside. But many are still unaware of the serious health risks posed by sunbeds. Over exposure to UV rays in the tanning salon can prove as dangerous as getting burnt on the beach.
In fact, using a sunbed once a month or more, can increase your risk of skin cancer by more than half. Short periods of intense, irregular exposure to UV rays, as you would get from a sunbed, are also the fastest way to damage and age the skin.
I asked SunSmart manager Rebecca Russell why sunbeds are so dangerous.
"Well we know that there are no health benefits from using sunbeds, but there are a number of health risks. The main one and the most serious one is an increase in skin cancer risk. We know from a recent report from the International Agency for Research into Cancer (IARC) that not only does that risk increase significantly from using sunbeds but if you use a sunbed at a young age, that increase is up to 75%, which is a staggering increase.
Some people may say that sunbeds are healthier or safer than going out in the sun, but unfortunately the marketing tactics of the industry do reinforce that misconception – the myth that a sunbed is safer than suntanning. However, that is incorrect. The UV rays from a sunbed are the same as the UV rays from the sun, but they can be equal to, if not greater in intensity. We know that the UV rays from a sunbed have been shown to be 10-15 times stronger, or more intense, than that of the midday summer sun.
There is a perception that a tan is desirable, but a tan – whether you get it from the sun or from a sunbed – is actually causing permanent, irreversible damage and accelerating the signs of ageing, so people will experience premature ageing, wrinkles, leathery skin etc.
Currently in the UK there is no legal framework so the industry is essentially unregulated. Cancer Research UK are calling on the government to introduce a piece of legislation such as a licensing scheme. Ideally the components of that licensing scheme would prevent under 18s from accessing sunbeds. It would also mandate the provision of health information to all customers, and make sure that sunbed use is supervised by trained staff that are trained to advise on skin type and to turn away people that are unsuitable.
We all need to enjoy the sun safely. We all need to make sure we cover up, that we avoid sunburn, and spend some time in the shade when the sun’s at its hottest, around the middle of the day."
06:37
Kat: Justine Sheils from Liverpool used to be a sunbed fan, but has now been treated for skin cancer. I asked her to share her story.
"I was initially diagnosed in 2006, but I'd had a spot on my chest 18 months previous to that. Because I’m a keen runner I thought it was caused by the friction from my running bra. I went to Thailand for two months, came home and noticed that it had started to go a bit black and "urgh", and still left it for a couple of weeks.
One day I went to pick a prescription up at the doctors and saw a Cancer Research UK sign in the surgery about skin cancer. I walked out and walked back in, and asked the doctor for an appointment. I went back the next day and the GP didn’t tell me there and then that it was skin cancer, but that she needed to refer me on.
That was on the Tuesday, and on the following Monday I went to Ormskirk Hospital to see a dermatologist who asked me how often I'd used sunbeds. I told him that I'd used them for many years, and was he going to tell me that I had skin cancer? And yes, it was skin cancer. So by December 2006 I was finally free and I'd just be on three-monthly and then six-monthly checkups.
But then I found a lesion on my head in the February. It was just like a little wart. I went to the doctors and had it removed, and it came back as cancer. Because it was a lot deeper than they'd initially suspected I needed to have my stomach cut open and three layers of muscle taken to be built up into my scalp.
I started using sunbeds when I was fifteen, I could go so far as to say that I had maybe gone on every day up until my mid-twenties. Then as you get older you become more aware of the lines that are coming up on your face and around your eyes so maybe just go on once a week. But I used sunbeds right up until I was diagnosed with skin cancer, I probably used them at least once a week.
I never ever thought it would happen to me – I never thought I would get skin cancer, but I did. I always liked to look nice with a tan until I've been poorly. I look at myself now and I look younger without a tan. Even a suntan from the sun gives you damage, but damage from the sunbeds is even worse. And the younger you are using them, the more risk you put on yourself."
Kat: You can find out more about how to take care of your skin and stay SunSmart this summer at www.sunsmart.org.uk
10:17
Kat: Now it's time for the final part in our series on drug development. Here's Anna Lacey to investigate the final step in the process – how drugs actually get to cancer patients, and the hurdles they have to pass along the way.
Drug licensing package
Although cancer drugs start their development in laboratories, there comes a time when they need to be made on a larger scale. This is usually done by pharmaceutical companies, but before they take on a new drug and invest large amounts of money, they have to be fairly confident that it will work.
To make the decision easier, Cancer Research UK set up a company called Cancer Research Technology – or CRT. And to find out what they do, I went to speak to Hamish Ryder, the Director of Drug Discovery.
"Industry in general tends to be fairly reticent to work on highly novel targets so our role really is to take things on which might be seen by industry as too early stage and too risky, and to move them forward faster. We’ll take projects from academia – both from Cancer Research UK and from other cancer research organisations worldwide – and we’ll look for the best way of moving them forward.
Now it could be that the best way of moving them forward is to suggest further experiments that they could do to add value to the project, or we may feel that there’s a need to add value ourselves to the project. In that case, we would bring the project in house, demonstrate activity in caner models, and thereby having de-risked the target, seek to find a commercial partner. "
So by spotting promising drugs and performing the necessary experiments, CRT introduces exciting new drugs discoveries to the pharmaceutical companies. But this isn't a one-way relationship.
"Cancer Research UK owns CRT, CRT receives income from products which industry has taken from CRT and commercialised. This money is sued first of all to run CRT, but any profit that CRT makes is gift-aided back to Cancer Research UK, so that it can be reinvested in basic research into cancer. "
Once the drug has been through all the stages of development and made it through clinical trials, it has to be licensed. This is a seal of approval that lets everyone know that a drug is safe to use. But to access a new cancer drug on the NHS, it has to be approved by another organisation – the National Institute of Health and Clinical Excellence, or NICE. Andrew Dillon is the Chief Executive.
"What we want to do is to find out just ho well a drug performs in terms of the benefits it gives to patients compared to what we have at the moment. So what we need to do is to look at all the clinical studies that have been performed to assess just how good it is compared to what we’ve got, and is it worth what the NHS is being asked to pay for it."
There are more drugs approved for cancer than there are for many other diseases. But with limited NHS money, it's inevitable that some cancer drugs won't make the list - even if they improve quality of life. The job of NICE is not only to see if a new cancer drug is better than the current version, but if it is worth approving at the expense of drugs for other diseases.
"We know there's a difference between living with cancer and living with a chronic disease that isn’t going to prove life-threatening. What we try to do is to remember that people with chronic conditions that aren’t life-threatening are just as deserving of the support of the National Health Service and the care it can give as people who are living with conditions that are life-threatening. We think that the measurements that we use and the judgements that we make about improving quality of life are appropriate for treatments that are introduced for cancer and for the other diseases and conditions that we’re looking at. One of the key things we can improve on is the point at which we actually start work. New drugs get introduced but here is a long development time in advance of that. So there's an opportunity for us to put a "flag" on those new treatments coming through that we ought to be looking at, and we can make sure that we can get advice out to the NHS within a few months of a drug being licensed."
As the drug reaches the patient, so we conclude our story of drug development. We started by looking at the molecular science of cancer, and then discovered chemicals that stop it from forming. These chemicals were then trialled in test tubes and animal models before being given to people in clinical trials.
If a drug is safe and effective then it's given a licence, and with the approval of NICE, the drug can be given to patients through the NHS. The journey from lab to patient is long but each step is crucial – because together they lead us towards better treatments for cancer.
15:46
Kat: And finally, every year Cancer Research UK has a themed garden at the Chelsea Flower Show, generously paid for by an anonymous benefactor at no cost to the charity. Last year our garden won a gold medal, and we've got high hopes this year.
I spoke to garden designer Andy Sturgeon about this year's entry.
"The whole concept of the garden is progress, and this is really something which has come out of all the work that Cancer Research UK does, and I wanted the garden to represent this. The style of the garden is best described as a contemporary woodland garden. Planting-wise, the dominant features are seven trees called Southern Beech (Nothofagus), which is from Chile. These start to create the mood of a woodland. But to really create that atmosphere I've got 27 tree ferns, and they're really going to give the woodland garden this contemporary feel.
Progress is mainly represented by these pools of water that we have in the garden. There are four pools and they start small at the back of the garden, just two and a half metres wide, and they get progressively larger towards the front of the garden. And also within these pools we have ripple of water that are computer-generated from underneath. They're meant to look like raindrops landing on the water, and you can imagine these concentric ripples spread out through the pool and progress out. There's a sequence of ripples in these pools, so they will dance backwards and forwards through the pools, but there will be a general trend forwards – the idea of progress from the back to the front.
You have to aim high at Chelsea, or there's no point turning up. You have to aim for a gold medal, whether you're going to get it or not. You do it partly for yourself – you put a lot of pressure on yourself – but of course you do it for the sponsor as well, because it means a lot to them. They're investing a lot in this and it’s important to get the results. I think this will be the sixth year that Cancer Research UK have had a garden, and the track record has been pretty good. so far I've had two golds for Cancer Research UK and I'm aiming for my third, so the pressure's on."
18:06
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, including finding out how people with cancer can share their experiences, plus a quick jog round the park with thousands of women – yes it's Race for Life time again!
- Credits:
- Presented and produced by Kat Arney
- News by Julie Sharp and Kat Arney
- Drug licensing package by Anna Lacey
- Original music written and performed by Kat Arney and Henry Scowcroft
- With special thanks to all the participants
