Birmingham has been a leader in medical research since the granting of our Royal Charter in 1900, from the development in the use of aspirin to the invention of the pacemaker and IVF treatment. Now, in our 125th year, our researchers are using emerging approaches including personalised medicine and neutron therapy to drive forward the next advances in cancer treatment. Here we outline three areas of research at the University that academics hope could improve patient outcomes and save thousands of lives every year.
Personalising treatment of pancreatic cancer
Dr Shivan Sivakumar, Consultant Medical Oncologist and Associate Professor in Oncology, is investigating how new techniques could encourage the immune system to attack pancreatic cancer cells and prevent the development of tumours.
Pancreatic cancer is one of the deadliest cancers in the world, with a survival rate beyond ten years of just 5% in England. It is typically diagnosed at a late stage when curative surgery is no longer an option. Even for the one in ten people who are eligible for surgery, the recurrence rate of pancreatic cancer after this treatment is over 80%. Shivan’s team at Birmingham is taking samples of a patient’s cancer cells following surgery to use as the basis for personalised treatments for the individual, which would encourage the patient’s immune system to produce antibodies to the cancer, preventing its recurrence. This could potentially save thousands of lives every year around the world.
He says: ‘The University has a strong clinical expertise in pancreatic cancer, a robust academic immunology programme and excellent access to patient samples. With over 150 pancreatic cancer operations happening each year in Birmingham, it’s the place to do translational research that will ultimately impact on patient care and outcomes.’
Using next generation radiotherapies
Radiotherapy is used to treat 50% of all cancer patients. While the majority of those patients receive conventional X-ray radiotherapy, Jason Parsons (BSc Medical Biochemical Studies, 1996; PhD Biochemistry, 2001), Professor of Radiobiology in the Department of Cancer and Genomic Sciences and his team are focusing on research into more targeted radiotherapies, using technology that is uniquely available at the University.
Currently, X-ray radiotherapy delivers high doses of radiation to the tumour, damaging its cell DNA and causing them to die. However, healthy cells and critical organs in the area can suffer collateral damage and significant side-effects to patients.
In Birmingham, researchers are using two different pieces of equipment (accelerators) to develop new treatments that can offer far more targeted radiation delivery to cancer cells that are also more effective in killing the cancer.
The first is the MC40 cyclotron, which can produce both proton beam therapy but also helium ion therapy. Proton beam therapy can deliver the majority of the radiation dose to the tumour, reducing damage to the surrounding normal tissue, while helium ion therapy is additionally more effective at killing tumour cells.
The second – and the only machine of its type in the UK – is a neutron source. This enables an alternative type of radiotherapy known as boron neutron capture therapy (BNCT), which is a significantly more effective treatment than X-rays. BNCT has been clinically approved in Japan to treat recurrent head and neck cancers, with great interest in this treatment in the UK and the rest of the world.
With Birmingham recently being awarded a RadNet (Radiation Research Network) Centre of Excellence by Cancer Research UK, Jason’s team are using 2D and 3D models of cancers, particularly those of the head and neck plus adult brain (glioblastoma), to investigate the interaction of the different radiotherapies with tumour cells and their DNA to establish new treatments for clinical testing.
Increasing earlier diagnosis of ovarian cancer
Professor of Gynaecological Cancer Sudha Sundar’s work is focused on developing better tests for ovarian cancer, with one strand of her research highlighting the potential to improve detection in primary care by better analysis of ultrasound scans. Ovarian cancer is an uncommon cancer, affecting about 7,500 women in the UK, and can be difficult to diagnose in its early stages. In Birmingham, nearly 50% of women with ovarian cancer are only diagnosed within four weeks of an emergency admission to hospital. For those patients, the chance of living for another 12 months is only 50%.
However, if a GP is able to diagnose the patient while the cancer is in its early stages, that life expectancy increases to 80%. Sudha explains: ‘The major challenge for successful diagnosis via primary care with your GP is the lack of a successful screening programme. Symptoms for ovarian cancer are vague and nonspecific: bloating, feeling full very quickly, general abdominal discomfort and needing to use the toilet frequently. National data shows that women often need repeat visits to their GP before being referred to hospital.’
Sudha’s team demonstrated that with proper training, sonographers could use a scoring system following an ultrasound that could pick up almost every patient with ovarian cancer, eliminating the need for assessment by specialists and reducing unnecessary surgery. NICE (National Institute for Health and Care Excellence) guidance in the UK is now set to change as a result of this research.