News from Around the Globe

Research is constant.  Every day we are learning more about how to fight cancer in all of its forms.  Here are the latest news articles from some of the leading cancer organizations.  Check back often to stay up to date.

news from around the world

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Stronger Than Cancer has shared these news articles for information purposes only.  It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

 

Viewpoint: A new way of taming the cell cycle with cancer drugs

5 days 18 hours ago

Research Feature

Iain Hagan and Wendy Trotter at the Cancer Research UK (CRUK) Manchester Institute developed a new approach to synchronise the cell division cycle of an entire population of human cells in culture. Iain believes the approach – now published in Open Biology – will be a game changer for cell biologists.

Our new paper is my first publication on human cells since I started working on cell division in yeast 36 years ago. I see it as a bit of a mark of the dawn of a new era for our laboratory.

The method that Wendy and I developed exploits the ability of CDK4/6 inhibitor drugs to arrest cell cycle progression at a natural pause point of the cycle: the restriction point. After synchronisation and re-initiation of the cycle, all the cells in the population go through it at the same time and at the same rate. This makes it possible to do biochemical and functional analyses of the changes that happen in cells at specific points of the cycle.

After synchronisation and re-initiation of the cycle, all the cells in the population go through it at the same time and at the same rate.

With this method, we can also keep the cells out of the cycle for up to 48 hours and they retain their ability to resume synchronous cell cycling. We can use that time to turn on, turn off or replace any molecule we want to investigate. When we let the cells return to the cycle, we can find out what happened to the molecules or the cells we’ve interfered with. 

Many of these molecular manipulations take hours to come into effect. If cells were still dividing, it would be hard to work out whether any changes observed in the cells were a consequence of problems in the previous cycle, or were indeed providing the desired insight into the function of molecules and the behaviour of cells within the actual cycle under study.

Although these types of analyses may sound straightforward, they have been impossible to do with this level of fidelity up to now. The gold standard for cell cycle synchronisation has been the double thymidine block approach, which stops the cell cycle at the phase of DNA replication. This approach was developed in 1962 – the first paper was published five months before I was born – and there has been nothing to rival it since. But this method causes a lot of damage to DNA, and the subsequent cell cycle is far from normal. So it’s very difficult to study the biochemistry of DNA replication or transcription, or chromatin biology, with a double thymidine block.

By contrast, the approach we’ve developed uses CDK4/6 inhibitors, which are clinically approved to treat breast cancer. Cancer is a disease of cell proliferation, so stopping the cell cycle has a profound impact on disease progression. One of these drugs in particular, abemaciclib, has emerged as an effective therapy for patients with the hard-to-treat triple negative breast cancer. We show in our paper that CDK4/6 inhibitors have no impact upon DNA integrity, so our approach will be a game changer for researchers studying DNA biology.

The approach we’ve developed uses CDK4/6 inhibitors, which are clinically approved to treat breast cancer.

I came up with the idea that led to our new approach in 2014 while teaching on the Biological Basis of Cancer Therapy course that is organised by the CRUK Manchester Institute’s postgraduate manager, Julie Edwards. This course is part of the education programme of the Christie NHS Foundation Trust’s School of Oncology and is taught to clinical and medical oncologists and the University of Manchester’s Masters students. I was in the middle of a lecture and telling the students about the power of CDK4/6 inhibitor drugs to stop the cell cycle when I suddenly thought: “This approach is so powerful in yeast. Why is no one using it in human cells?”

I took the idea to colleagues working in human cells. They said it was interesting, but did not pursue it. But in 2016 Wendy joined the lab as a senior scientific officer and brought in expertise in human cell work. I immediately asked her to test the approach – and it worked first time. But then came the fire in 2017 that burned the CRUK Manchester Institute. We spent several months deconstructing our ruined lab and then moved lab twice and this year we had the lockdown. Given that the cell cycle is 24 hours long, these are challenging experiments. But we have now finally published our work.

As the technique is so powerful, however, we have been telling people about it for a while, and Wendy has been sending out detailed instructions to around 20 labs. Some of these labs have already published papers reporting research they did using this approach. For example, Jonathon Pines, who is head of the division of cancer biology at the Institute of Cancer Research (which is part-funded by Cancer Research UK) used it for a paper published in the Journal of Cell Biology. Gislene Pereira of the University of Heidelberg and German Cancer Research Centre has used it for another paper published by the same journal. And Bill Earnshaw of the Wellcome Centre for Cell Biology, University of Edinburgh, says that the method has opened up entirely new avenues in their research programme.

As the technique is so powerful, we have been telling people about it for a while.

We took what would be considered by others as a risky choice: telling everyone about our method so we can help push the field forward, but risk ‘being scooped’. However, the potential impact of the method was too great to worry about this. I do believe it will be very widely adopted. 

A drug that was developed to treat cancer, with great effect, can now advance our understanding of cell division to help identify further routes to cancer therapy.

Read Iain and Wendy's paper

 

About the author: Iain Hagan tracey_crowe_headshot_update.png
Iain Hagan is senior group leader at the CRUK Manchester Institute. Iain did his PhD with Professor Sir Paul Nurse and Professor Jeremy Hyams at the Imperial Cancer Research Fund London Research Institute, and then went to Japan on a 4-year postdoctoral fellowship with Professor Mitsuhiro Yanagida in Kyoto University. In 1993, Iain received a return fellowship from the Cancer Research Campaign to establish a research group at the University of Manchester. He continued to work in what later became the Faculty of Life Sciences at the University of Manchester, with further fellowship support from the Cancer Research Campaign, before moving to the CRUK Manchester Institute in 2001. Iain was awarded the Human Frontier Science Program 10th Anniversary Medal in 1999 and the British Society for Cell Biology Hooke Medal in 2001. In 2009, he was elected as a full member of the European Molecular Biology Organisation.

 

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We’re asking scientists to tackle 9 of the toughest challenges in cancer research

6 days 7 hours ago

Science blog

It started with a challenge.

Or 7 to be exact, 7 challenges we issued to the global research community, challenges that scientists, doctors and people affected by cancer all agreed would help us make the radical process we need to beat cancer. Challenges that launched our most ambitious research initiative ever.

Since we issued this first set of challenges back in 2015, we’ve funded 7 international teams to tackle wide-ranging issues from preventing unnecessary breast cancer treatment to understanding if the bacteria in our gut could help treat cancer.

But we’re not done yet. While our teams have been sinking their teeth into the challenges, we’ve been on a global hunt for the next set of problems, working with researchers and people affected by cancer.

And we’ve been more ambitious than ever.

We’ve partnered with the National Cancer Institute (NCI) – the US federal government’s principal agency for cancer research and training – to build on the success of our Grand Challenge initiative and stimulate even more innovative research collaborations. The new partnership brings the Cancer Grand Challenges investment up to £426 million to date.

Here’s the latest line up of Cancer Grand Challenges that we want the world’s brightest minds to tackle.

How do some cells stay normal despite having cancer-causing mistakes in their DNA?

Cancer develops when mistakes in our DNA – called mutations – cause cells to grow and divide uncontrollably. But the presence of these errors doesn’t guarantee cancer will occur. Surprisingly, some cells continue to behave normally even when they have lots of ‘cancer-causing’ mutations.

Why some cells can resist becoming cancerous but other can’t remains a mystery. Researchers suspect that factors like ageing, the immune system and a cell’s environment could play a part.

If scientists could understand more about what makes our cells ‘normal’ and exactly what tips them into becoming cancerous, they may be able to develop new tools to help catch cancer early and design new drugs to target this transition and stop cancer before it starts.

Can we develop new ways to deliver drugs into any and every cell?

New technology has allowed scientists to engineer smarter cancer drugs that can precisely target and kill tumour cells in the lab. But just doing this in the lab isn’t good enough.

Getting drugs inside the ‘right’ cells is a major hurdle when it comes to designing new treatments. This task is particularly challenging for larger and more complex drugs – known as macromolecules – that are too big to slip into cells without help.

But what if we could find innovative new ways to deliver these drugs to all cells in the body, including hard-to-reach places like the brain, but only kill the cancer cells?

To do this, scientists could exploit innovative delivery methods like nanoparticles – tiny, drug-carrying vessels 1,000 times smaller than a human hair – or mimic the tactics viruses and toxins use to infiltrate cells.

This is potentially one of the biggest hurdles facing researchers, but there’s so much to gain if it works. This research could unlock new ways to treat not only cancer, but many other diseases.

Can we take away cancer cells’ power to divide?

Under certain stressful conditions – like when their DNA is damaged – cells can stop dividing and enter a state called senescence. It’s a safety mechanism to stop faulty cells from multiplying.

Senescence can help protect us against cancer by forcing would-be cancer cells to stop dividing before it’s too late. And research suggests cancer cells can become senescent too, halting their growth.

The big question we want scientists to answer is can we trigger cancer cells to become senescent? And can we find ways to target and eradicate these cells from the body?

What are the potential benefits and risks of e-cigarette use around the world?

E-cigarettes have become increasingly popular over the last decade, with an estimated 3 million people in Great Britain using them in 2019. The majority of these people used to smoke.

While e-cigarettes can help some people to stop smoking and the evidence so far suggests they’re far less harmful than tobacco, it’s still not clear what effects vaping has in the long term. And there are also questions about how the increased use of e-cigarettes might be affecting society as a whole – particularly young people.

We need to shed light on these unknowns and in particular provide an answer to the crucial question: how safe are e-cigarettes and are there long-term health consequences?

How does inflammation cause cancer?

Inflammation is one of the body’s most powerful weapons. It’s our immune system’s first line of defence against infection and injury, involving a cascade of chemicals and immune cells that take down potential threats and help to heal our wounds.

But as well as preventing infections and repairing injuries, inflammation can cause collateral damage and sometimes lead to cancer. It’s estimated that up to 1 in 4 around the world are linked to chronic inflammation.

The link between inflammation and cancer was first made over 150 years ago. But we still don’t fully understand the link between inflammation and cancer, including how many types of inflammation exist, and which can cause the disease.

We’ve already got a team of scientists unravelling the mystery of inflammation and cancer, but we think there’s even more to learn. Because if researchers could untangle the complex web of interactions involved in inflammation and pinpoint which processes cause cancer, they could reveal new ways to prevent cancer from ever starting, potentially saving thousands of lives.

Can we find new ways to treat solid tumours in children?

Despite great progress in understanding the biology of some children’s cancers, the way we treat these diseases – especially solid tumours – has barely changed in over 30 years. And current treatments can have severe, life-long side effects.

We desperately need new, more specific treatments that are gentler and more effective for children living with these diseases.

We’re beginning to understand that solid tumours in children are very different from those in adults. If we could understand more about these differences and find ways of targeting them, we could create new drugs or reuse existing ones to better treat children’s cancer.

How does DNA outside of our chromosomes helps cancer to survive and evolve?

Our DNA is mainly coiled into structures called chromosomes, which keep its long strands neatly organised. But cells can also contain small rings of DNA that exist separately from these chromosomes, called extrachromosomal DNA.

These DNA loops are most commonly found in microbes like bacteria, but new research has revealed that cancer cells contain vast amounts of extrachromosomal DNA, often containing copies of genes that help the cancer grow and survive. These rogue pieces of DNA can also change and multiply rapidly and are believed to help cancer to adapt, evolve and become resistant to treatment.

But the exact role of extrachromosomal DNA in cancer is unclear.

If we can understand how these extrachromosomal loops arise and change in cancer, we could create new therapies to target them.

Why do some cancers come back many years after treatment?

Sometimes, patients who seem to have been successfully treated for cancer can have the disease come back years or even decades later, often without any warning.

It’s thought that cancer cells that weren’t killed by initial treatment can go to sleep, lying dormant until they’re coaxed out of their slumber and begin to dive again, a phenomenon we’ve written about before.

But what causes some cancer cells to go sleep, or where they hide when they’re asleep, is still a bit of a mystery. Scientists also don’t know for sure what wakes these cells up years later.

It’s a challenge that’s cropped up before. And we need answers.

Understanding more about slumbering cancer cells could help scientists find these cells and eliminate them. Or, if we could predict when they’re about to rise from their slumber, we could keep them sleeping permanently.

Can we treat extreme weight loss and weakness in people with late-stage cancer?

In the late stages of cancer, some people experience extreme weight loss and muscle wasting – a condition called cachexia. It can also lead to weakness and fatigue, with every-day activities becoming challenging.

We don’t exactly know what happens in cachexia. But what’s clear is that it’s very different to general weight loss and can’t be completely reversed by eating more or taking nutritional supplements.

Worringly, cancer treatments are often less effective in people who have cachexia and other signs of deteriorating well-being.

If scientists can unpick the complicated pathways involved, they could develop new treatments to improve the quality of life and survival of people with late-stage cancer.

If you’re a researcher and want to build a team to take on this challenge, visit our Cancer Grand Challenges website to find out how you can apply.

With these 9 challenges, we’re pushing researchers to the edge of impossible. We can’t wait to see who will rise to the challenge.

Katie 

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The Food Industry’s “model of systemic dishonesty”

1 week ago
In 1993, the Harvard Nurses’ Health Study found that a high intake of trans fat may increase the risk of heart disease by 50 percent. […]

Researcher voices: How funders can tackle racial bias and inequality in cancer research

1 week ago

Research Feature

As part of our commitment to listen and learn from Black researchers, we co-hosted a virtual discussion panel with the Francis Crick Institute's Race Equity Network, PRISM. Here, panellists Dr Furaha Asani, Dr Lynn Asante-Asare, Prof Dean Fennell and Dr Faith Uwadiae talk about their experiences in academia and summarise the priority actions that funders should take to tackle racial bias and racial inequality in cancer research.

  Furaha Asani: “Increase the talent pool of Black researchers” furaha_photo.png The UK’s research pipeline is not diverse. UK Research and Innovation (UKRI) data analysed in the Broken Pipeline report show that only 1.2% of the studentships awarded between 2016 and 2018 went to Black students. This lack of diversity extends to professorship level. The Staying Power report, published in 2019 by Dr Nicola Rollock, found that there are only 85 Black male and female professors in UK higher education institutions – 0.6% of the UK professoriate. Considering the proportions of white and Black people at all faculty levels, white academics are almost two and a half times more likely to be professors than their Black counterparts.   The data are starker when disaggregated by gender. The report reveals that just 25 of the UK Black professors are women, and that Black female professors experience a messy and convoluted path to professorship that is characterised by a lack of transparency and fairness. A different report by AdvanceHE, also published in 2019, found 35 Black female and 90 Black male professors in the UK. These pieces of research highlight the urgent and critical need for action to increase the talent pool of Black researchers.   Research funders need to create a framework to which they can hold themselves and research institutions accountable. Under this framework, institutions should provide evidence of a diverse and inclusive workforce in funding applications. Then, funders should only allocate funding to institutions that meet the principles of the Race Equality Charter, which encourages higher education institutions to take racial inequality and institutional and covert racism seriously.   This framework should also include ensuring that we establish diversity in research project teams, especially if individuals from particular ethnic minority backgrounds are a focus of the research, so Black people and people of colour aren’t put into a ‘Petri dish’ to be studied from a white perspective.   Mentorship is very important. Those of us who have unfortunately not had mentors at key stages of our research careers know the extra burden we had to experience. I did not have a mentor throughout my PhD, but I now mentor other Black women to give them the opportunity I didn’t have. I have eight mentees and I dedicate a lot of time to helping them.   Mentorship fatigue does happen, as many Black academics mentor several others for the reasons I do. We do this from our hearts and all of this labour is unpaid. I feel it’s time for research institutions and funders to acknowledge this type of work and to step in with support.   Furaha is a health and equalities researcher, mental advocate and writer. She co-signed an open letter to UKRI following the news that no Black academic leads had been allocated UKRI grants for research projects focused on the disproportionate impact of COVID-19 on ethnic minority communities.   Lynn Asante-Asare: “I’ve lacked people who understood my experiences” lynn_photo_headshot.png

I’ve recently completed my PhD in cancer research and I’m now a medical student hoping to continue working in oncology further down the line. I’ve had an amazing time working at a Cancer Research UK (CRUK) institute, but I’ve always lacked mentors who understood my experiences as a Black person and allies who were aware of what I was going through or had the confidence to engage with me on topics surrounding race.  

Funders have a huge role to play in growing the diversity of candidates who apply for PhDs. And they shouldn’t just support schemes with money alone – funders and institutions should proactively go out there and search for diverse talent pools. For example, they should focus on engaging with university societies that have students from various ethnic minority backgrounds and with external organisations that support Black students. 

We also need to celebrate the work of Black researchers more and shine a spotlight on their careers to show Black students that a career in research is possible for them too. I'm passionate about sharing my own experiences and I’ve written a lot of online profiles about my career and background and posted YouTube videos of my research. I’ve also mentored Black sixth-form pupils and undergraduate students. These approaches give more visibility to Black researchers so that younger people can see them as role models. Social media, in particular, can also be an incredibly useful and powerful tool to reach younger people, network and promote a variety of career paths in cancer research.  

An indirect way to support career progression is to make the environment healthier in a way that supports ethnic minority researchers to apply for and succeed in securing certain positions. We need an environment in which our differences, whether cultural or socioeconomic, are celebrated and not used as sources of disadvantage. Throughout my career there might have been funding pots and other academic opportunities I could have gone for, but I was often engaged in outreach activities and my time was limited. There was always some trade-off between the time I could spend supporting my community and pursuing additional research opportunities. 

We should work together to share the effort that will bring change for the better. This is why it’s so encouraging that we’re actively having these conversations in which non-Black people and allies are present.  

Lynn did her PhD at the CRUK Cambridge Institute and is now completing her medical training at the University of Leicester.

  Dean Fennell: “Data could help break down racial inequality” dean_photo_headshot.png

We need a clearer measure of racial bias to deal with it appropriately. We must use data to show what this bias actually looks like. Fewer researchers from ethnic minority backgrounds get research grants, but is this because not enough people apply, because of unconscious bias or because of the quality of the research proposal? Data could help to generate the evidence required to break down racial inequality step by step.

Systemic racism is really hard to call out on an individual level. This is why we need some form of auditing process in which institutions can objectively look at what they're doing and uncover any issues of bias. Funders would benefit tremendously from having an idea of how different research institutions rank and measure in terms of diversity. This ‘diversity index’ could be a mechanism to ensure that funding goes to institutions that promote diversity. It could be similar to the Athena SWAN (Scientific Women’s Academic Network) charter.

We also need to champion transparency, and both funders and research institutions should publish diversity data, including a breakdown by disaggregated ethnic minority groups to help us understand where bias may be present in the system. 

Focusing specifically on research funding decisions, a lot of work can be done to minimise the chance of racial bias. Firstly, a double-blind process in applications would help reduce the possibility of unconscious bias. Secondly, funders need to ensure that funding panels and committees include individuals from a diverse range of ethnic backgrounds. This goes beyond Black scientists – lay committee members can also have an important role.  

We also need to build on initiatives like unconscious bias training, so that they don’t just become a ‘tick box’ exercise. Bias doesn’t change after just 30 minutes of training. Funders and research institutions need to think about how they can develop the training and potentially make it part of a bigger framework.  

Dean is chair of thoracic medical oncology at the University of Leicester and group leader at the Leicester Experimental Cancer Medicine Centre, of which CRUK is a major funder. He is a speaker at Black in Cancer Week (11–17 October 2020). 

  Faith Uwadiae: “We should build support networks and safe spaces” faith_photo.png

When I finished my undergraduate degree, I was very confused about what to do next. It’s important that students have people around them who can give them guidance about where to go. As a Black student, sometimes you don’t have that support network that is going to push you along.  

There were lots of Black students around when I was doing my undergraduate degree. However, as my career progressed and I became a PhD student and then a post-doctoral researcher, I began to notice that Black academics were becoming few and far between. Now, when I look at young Black students and early-career researchers, I can’t help but think about who will support them. Personally, Twitter has been the main tool I’ve used to put myself out there and proactively find like-minded people to build my support network.  

I often find myself in situations in which I’m made to think whether the whole system is rigged to disadvantage me because of my race. And this is very hard to tackle. This is partly why networks that focus on race equality and equity are so important, because they’re safe spaces for discussion and for everyone to learn and educate themselves about these topics. 

It’s important that these spaces are not just for ethnic minority members of staff but also include allies who are interested in hearing about our views and learn from us. It’s wonderful that CRUK and the Francis Crick Institute have these staff networks; we need now to expand them and use them to connect researchers who have similar experiences and to help them find potential mentors.

I’ve been lucky to have a mentor and have had one mentee too. Funders need to encourage mentorship by acknowledging this activity on funding applications as extra work that a researcher is doing, and that this makes them a more well-rounded academic. And mentoring Black students doesn’t have to completely fall on Black academics, as there aren’t many of us. Funders have a responsibility to help create an inclusive environment in which non-Black academics feel empowered to support the next generation of Black researchers.

To increase diversity in cancer research we need to actively fund a pipeline of Black students. Having PhD programmes or grants ringfenced for students who are from ethnic minority communities would be really positive. Funders should also actively engage with more ethnic minority researchers so they can join research funding panels and committees and bring their invaluable perspectives to funding decisions.   

Faith is a postdoctoral researcher at the Francis Crick Institute in London, of which we are a major funder. 

 

We’re very grateful to the brilliant panellists and participants of the virtual discussion event for sharing invaluable insights into how we can do more as a funder to understand and tackle racial bias and inequality. Their useful recommendations will feed into a refreshed action plan we’ll publish later this year. As we implement initiatives to bring about positive change and a more inclusive culture, we’ll continue to engage with our Black and other ethnic minority researchers in ways that recognise the identities and perspectives of different ethnic groups as distinct. 

                                                                           Iain Foulkes, Executive Director Research & Innovation, CRUK 

 

Black in Cancer Week (11–17 October) is an insightful week of events organised by Black in Cancer highlighting cancer disparities and the work of Black cancer researchers. We are delighted to sponsor Black in Cancer Week.

 

 

Follow @BlackinCancer on Twitter to learn more about Black in Cancer Week (11–17 October) and attend the planned events Watch the recording of the virtual discussion panel ‘Addressing racial bias and racial inequalities in cancer research’

 

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Scientists develop new precision medicine approach for pancreatic cancer

1 week 1 day ago

News report

Scientists from the University of Glasgow are developing new ways to predict who will respond to drugs targeting damaged DNA in pancreatic cancer. 

Publishing their findings in Gastroenterology, the team used cells grown in the lab (cell lines) and mini replicas of patients’ tumours (organoids) to identify molecular markers that can predict which tumours will respond to a number of drugs that target damaged DNA.  

Dr David Chang, from the University of Glasgow’s Institute of Cancer Sciences, called the results “a huge breakthrough in terms of what might be possible for future treatments.”

The team are now taking their strategy forward into a clinical trial to help doctors work out who might respond to the drugs, either alone or in combination. The trial – PRIMUS-004 – is part of our Precision Panc platform for pancreatic cancer, which aims to increase opportunities for people with pancreatic cancer to join clinical trials and to develop new treatment strategies. 

“The strategy we’ve developed is extremely promising, and we’re very pleased and proud to see it now be taken into clinical trial.” – Dr David Chang Precision Panc

In 2017, we invested £10 million in Precision Panc to speed up our understanding of pancreatic and work towards more tailored treatment for the disease. It’s our biggest standalone in pancreatic cancer research to date, with the aim of driving progress for pancreatic cancer, where survival has remained stubbornly low.

Precision Panc: the study bringing personalised medicine to people with pancreatic cancer !

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A major barrier to treating pancreatic effectively is that there are very few treatment options. But there are some pancreatic cancers that cannot repair damaged DNA, which make them vulnerable to some new treatments. This is what researchers are aiming to target.

“We urgently need new ways to treatment pancreatic cancer,” says Michelle Mitchell, Cancer Research UK’s chief executive. “The Precision Panc study offers a dynamic way to explore new tailored treatments, and it’s fantastic that we know have new drug candidates to add to the PRIMUS-004 trials.”

A menu of trials

PRIMUS-004 is a mid-stage (phase 2) clinical trial testing the new approach to help match people with pancreatic that’s spread to new targeted treatments.

The trial is due to open this month and will be an option for people who’ve already had platinum chemotherapy and whose cancer has a fault that means it cannot repair damaged DNA. Funded by AstraZeneca and endorsed by Cancer Research UK, it’s the first trial in the UK that will test this precision medicine approach in pancreatic cancer. 

PRIMUS-004 is the fourth trial that Precision Panc will feed into, with 3 studies already linked to the platform – PRIMUS-001 for people with pancreatic cancer that’s spread and PRIMUS-002, which is testing the benefits of 2 different chemotherapy combos before surgery. 

Another trial – PRIMUS-005, involving patients with locally advanced cancer – is also due to open this month. 

As well as helping to give people with pancreatic cancer better trial options, the Precision Panc study is also collecting and analysing tumour samples and looking for new biomarkers to help researchers predict which treatment might work best. 

So far 331 people have entered the Precision Panc platform from 27 sites around the UK. And while COVID-19 paused recruitment earlier this year, most centres have managed to reopen and 14 people joined the study in September 2020, only slightly below pre-COVID levels. 

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NHS staff shortages: What’s needed to build a sustainable cancer workforce?

1 week 1 day ago

Science blog

For a few months this year, Thursday evening in the UK meant just one thing. Not the latest episode of a lockdown favourite or another virtual pub quiz, but a chance for people across the country to clap our carers.

It was a rowdy 5 minutes where people came together to recognise the herculean efforts of healthcare staff across the country. But our love affair with the NHS and the staff who make it began long before COVID-19. And it’s an appreciation that will outlast the pandemic.

Because the NHS needs more than our colourful banners to keep it going, it also needs government support.

In the 2019 General Election, the Conservative party pledged to ‘increase cancer survival rates’ and ‘boost early cancer diagnosis across 78 hospital trusts’. Ambitions that will be impossible without a sustainable, future-proofed workforce.

A ‘make or break’ issue

NHS staff shortages is not a new issue. In 2015, workforce was identified as a ‘make or break’ issue in the Cancer Strategy for England. But nearly 5 years later, it remains unresolved.

And the longer it’s left, the worse the problem will get. Before the COVID-19 pandemic, more than 1 in 10 diagnostic posts were vacant. Earlier this month, Professor Sir Mike Richards published a review of diagnostic services, which described services as approaching a ‘tipping point’ and calls for major expansion to the workforce.

Diagnostic services in all 4 UK nations are struggling to meet waiting times. And while many things contribute to missed waiting time targets, the biggest barrier is staff shortages.

As the vacancies pile up and the demand for cancer services increases, the Government’s ambition to diagnose 3 in 4 cancer early by 2028 is becoming less and less likely.

Whilst training NHS staff to take on new roles and responsibilities and improving ways of working is important, it’s not a replacement for a well-resourced workforce. So the big question is: what would it take to build a vibrant and sustainable cancer workforce? It’s not an easy figure to estimate, but we ran some numbers.

As there is more data available in England, the estimates look at staff numbers in England alone. But many of the findings will apply across all 4 nations.

Growing the cancer workforce

To ensure the NHS has enough staff to diagnose, treat and care for people with cancer over the next decade, they’ll need some new recruits.

Which is where Health Education England (HEE) – the organisation responsible for workforce planning, education and training – comes in. In 2018, they identified 7 professions that are key to diagnosing and treating cancer and estimated that, to deliver world-class cancer services by 2029, staff numbers would need to grow by 45%.

The 7 key professions:
  • Histopathologist: A doctor who examines tumour or blood samples under a microscope to help diagnose cancer.
  • Clinical radiologist: A doctor who interprets scans – like MRI and CT scans – to diagnose, treat and manage cancer.
  • Diagnostic radiographer: A specialist who takes scans – like MRI and CT scans – that can be used to diagnose cancer. They’re the people you see when you go for an ultrasound or MRI appointment.
  • Oncologist: A doctor who treats cancer.
  • Specialist cancer nurse: A nurse who helps to ensure that people with cancer are supported through their treatment and care and have the information they need. They can also play a vital role in delivering cancer treatments.
  • Therapeutic radiographer: A specialist who plans and delivers radiotherapy treatment.
  • Gastroenterologist: A doctor who investigate, diagnose and treat disease related to the stomach, bowel, liver and pancreas.

Thanks to existing investment in education and training from HEE, staff numbers are already on course to increase by 2029 in most of these professions – but not by enough. In fact, we’ve estimated it will cost HEE between £142 million and £260 million more than it already invests to grow the key cancer professions by 45%.

As one-off figures, they sound big. But this investment in the future of cancer workforce can be spread out over the next few years. And with Health Education England spending around £4.3 billion last year, it would be a fairly small annual investment.

To put it in context: if HEE’s budget remains the same, £260 million spread over 3 years would be approximately 2% of their annual budget. Not too big an investment in the grand scheme of things, but one that could help transform cancer services. And not just cancer services – some of the 7 professions identified also diagnose and treat other diseases, so the benefits could extend to those too.

Here’s what it would be paying for.

Seven key professions

Based on our modelling, each of the 7 cancer professions are growing or declining on their own trajectory at the minute depending on how many staff are being trained and recruited, as well as the number of staff retiring, leaving early or rejoining the workforce.

The good news is that numbers of people joining 6 of the 7 professions are on the rise. But only one – gastroenterology – is on track to meet HEE’s ambition of 45% growth by 2029.

And numbers in one key profession – histopathology – look set to decline in the coming years. If nothing is done to change the forecast, the number of histopathologists in England is estimated to drop by 2% by 2029. A far cry from the 45% growth that HEE aspires to.


Copy this link and share our graphic. Credit: Cancer Research UK

There are a number of ways for HEE to increase the cancer workforce – which is why our cost estimates in fact range from £142 million to £260 million.

The lower cost option of £142 million would involve a combination of increasing training opportunities, recruiting more specialists from other countries, encouraging existing NHS staff to move into these specialist areas and encouraging specialists to come back to the NHS – including those who have recently retired.

Growing the cancer workforce solely by increasing training opportunities within the NHS would cost a bit more. £260 million according to our estimates.

And it’s possible that more might be needed. Our modelling did not take into account that several posts in the NHS – more than 1 in 10 – are currently vacant. These need to be filled too.

UK Government must act

As with all estimates, these figures were calculated with several assumptions. But it is the first complete look at what’s needed across the cancer pathway and should form an important part of the conversation about what’s needed to transform cancer services in England.

It’s a conversation that’s been going on for many years. And with the number of people being diagnosed with cancer estimated to increase in the coming years, it’s time to move beyond words. The UK Government must act now.

In a few weeks the UK Government will decide how much money Health Education England will have to spend in the coming years. Which will in turn determine how much money they put aside for the cancer workforce.

Put simply, how the UK Government responds to NHS staff shortages now will determine what the future holds for people with cancer in the decades to come.

And with 1 in 2 of us getting cancer in our lifetime, an additional £260 million seems like a small price to pay for a cancer workforce that’s large enough to give everyone the diagnosis, treatment and care they deserve.

> Take action. Ask your MP to stand shoulder to shoulder with the NHS today

Katie 

Reference

Estimating the cost of growing the NHS cancer workforce in England by 2029 (2020) Cancer Research UK

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