Right now, more children than ever are surviving cancer. In late 1970s, just 2 in 5 children in the UK survived their disease for at least 5 years. Now, more than 8 in 10 children will survive cancer for at least 5 years after their diagnosis. And that’s thanks to research.
But while progress has been made, too many children still die from cancer every year; something I am all too familiar with.
Back in my second year of medical school, I saw a child dying of medulloblastoma, which is the most common malignant brain tumour in children. I asked her doctor what treatments were available for her and he said there weren’t any. He said that they had done everything they can, and that all they could do was let her die in peace.
That made me so angry. A child shouldn’t have to die in peace – they should be able to enjoy the rest of their life. And that’s what motivated me as a medical student to start working on medulloblastoma.
It was an evening at my local pub that changed the course of my career forever. I was there with my friend and fellow medic Nigel, who told me that at the end of our careers, no matter which field of medicine we chose, we should have been responsible for a 15% reduction in deaths from a disease that we worked on. A strong goal!
But I’ve never forgotten that. And I made it my ambition to be able to say that when I retire, 15% fewer children with brain tumours will die because of the work I’m part of. Giving up my stethoscope wasn’t easy as I loved working with kids and doing medicine, but I knew that to achieve my goal, I’d have to do research. Around the same time I became a father for the first time myself. I am so grateful that my kids enjoyed a healthy childhood. Being a parent made me even more determined to ensure that children’s cancers effects as few families as possible.
So that meant opening the door on the lab and closing the door on the clinic forever – a decision I haven’t regretted.
There have been significant improvements in survival of medulloblastoma, but they have been achieved through increasingly intense treatments, which are associated with serious long-term side effects.
Through my research, I hope to spare children unnecessary treatment. My lab is interested in the origins of cancers, particularly children’s brain tumours. I want to answer the burning question which has stumped our profession for decades: why, when treated the same way, do some children with brain tumours survive while others sadly don’t?
Through answering this, I hope to be able to improve treatments so that children are given the minimum amount needed to cure their disease, while sparing their developing bodies lasting damage.
And over the past 15 years, my team and I have made significant progress towards this goal.
Largely thanks to our research, we now know that medulloblastoma brain tumours are not one single disease, but rather a collection of diseases born from different brain cells and involving different genetic flaws. Perhaps most importantly, earlier this year we shed first light on why some types of medulloblastoma are curable, and, why others aren’t.
We found that brain tumours that are curable are more treatable because they produce lots of proteins that prevents them making proper blood vessels. Instead, they makes ‘leaky’ blood vessels that are easier for drugs to get through. So for these children the door is always ‘open’ to chemotherapy, which is why these tumours respond well to the treatment.
We could switch this effect on and off in cells in the lab. So we think that if we could make harder-to-treat forms of the disease produce these proteins and ‘leaky’ blood vessels in patients, then perhaps we could allow more chemotherapy drugs to flood in and make the tumours curable.
This knowledge will help us along the path to more personalised treatments. Understanding the biology of tumour cells provides doctors with rules and directions that they can follow to tread that fine line between cure and harm. That’s my research.
It can take years, even decades, for research to be translated into something that benefits patients. But the more scientists work together, exchanging ideas, resources and expertise, the faster our discoveries can make their way into the clinic.
I firmly believe we’ll cure brain tumours and I’m absolutely committed to that. It’s not going to be easy – I’ve been working on it for 20-30 years. But I wouldn’t be doing it if I didn’t believe it were possible.
Richard is supporting Cancer Research UK’s ‘Right Now’ campaign to beat cancer sooner. Visit cruk.org
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