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NCRI Cancer Conference – day three

by Henry Scowcroft | Analysis

10 November 2011

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As well as the talks themselves, there’s been a fair amount of media coverage from the 2011 NCRI Cancer Conference.

BT convention centre

The BT convention centre – site of the NCRI conference

Tuesday saw stories about improved waiting times for cancer, covered by the BBC, the Scotsman and by the Daily Mail, and about how doctors could help inform patients about obesity, which appeared on Sky News, and in the Scotsman, the Herald and the Mirror.

Wednesday morning also saw widespread coverage of research showing that bowel cancer screening was reducing deaths from the disease.

These were based on new research presented at the conference, but there were loads of other sessions too – here’s our Tuesday round-up, whch covers cancer biology, the tumour ‘microenvironment’, radiotherapy, and the Chernobyl nuclear disaster…

Cancer biology

The day began with a couple of fascinating talks. The first, from Cancer Research UK’s Dr Simon Boulton, showcased his recent research on understanding how cells repair damage to their DNA – an important process in the development of cancer. Dr Boulton’s lab have been studying the details of how this process works in a tiny worm called Caenorhabditis elegans, and their findings are moving this field forward at a rapid pace.

He was followed by Professor Michael Hall from the University of Basel in Switzerland whose team is studying a protein called TOR that’s found in virtually all organisms from yeast to humans. He explained that TOR plays a key role in controlling how cells grow, multiply, survive and move, and is likely to play a part in the development of many cancers. Professor Hall outlined some of the progress he and his team have made in understanding this complex molecule, which could lay the foundations for cancer treatments in the future.

As with yesterday, the conference then split into a number of different sessions, focusing on different aspects of cancer.

One of these focused metabolism – how cells produce and use energy. It’s becoming increasingly clear that cancer cells don’t make energy in the same way as healthy cells, so exploiting this difference could be an exciting new way to tackle the disease.

Another session looked at something called the “epithelial-mesenchymal transition”. Although this sounds rather technical, it simply means the changes that cells go through as they switch from being well-behaved cells within a tissue, such as the breast or bowel, and become rogue cells, leaving their surroundings to grow and spread where they shouldn’t.

Finding out what causes cells to change in this way and go on the move is essential if we’re to understand how cancer spreads, and how we can stop it.

The ‘microenvironment’

We’re often talking about new ways to target cancer cells on this blog – but one of the morning sessions turned that idea on its head.

Scientists are starting to realise that it’s also possible to target the many other cells that make up a tumour – cells that aren’t cancerous, but can play an important role in the disease by changing the tumour’s ‘microenvironment’, sometimes helping it to grow or spread.

The session was introduced by Dr Thorsten Hagemann from the Barts Cancer Institute in London, who spoke about his team’s work on ‘re-educating’ immune cells so that they can help to fight cancer.

Dr Hagemann was followed by Professor Michael Hemann, from the Koch Institute at MIT. He’s found that the damage caused by chemotherapy drugs can kick-start a protective response from the cells in and around the tumour. This helps damaged cancer cells to survive, allowing the tumour to take advantage of the body’s own protective mechanisms.

Professor Hemann is investigating how this works in mice, with a view to blocking the process with new drugs and helping to tackle the problem of cancers that stop responding to chemotherapy.

Next up was Professor Douglas Fearon, from our Cambridge Research Institute. His talk focused on the layer of cells that surround cancer cells – the stroma. Some of these cells seem to help the tumour by preventing immune cells from finding and destroying cancer cells.

Professor Fearon’s hope is that, by studying them, he can work out how to target these cells to boost the body’s immune response. And in an interesting twist, it also seems these cells could play a role in a condition called cachexia, the muscle wastage and loss of appetite that can affect patients with advanced cancer.

Finally we heard from Professor Vincenzo Bronte from Verona University Hospital in Italy – he began by saying the only thing missing from NCRI was better weather – “you need to work on that!”

He is also working on the delicate balance that determines how the immune system responds to cancer cells, and is developing a new drug that could help immune cells to target a tumour and prevent it from growing and causing problems.

Focus on radiotherapy

Given that the previous day would have been Marie Curie’s 144th birthday, it was apt that her legacy on cancer treatment should be discussed. After lunch, we heard from a panel of experts about the ‘quiet revolution’ in radiotherapy.

We’ll be blogging in more detail about this session at a later date – it was inspiring and encouraging to hear about the steady progress in radiotherapy technology and the new initiatives that are bringing this life-saving treatment to even more patients in the UK.

Chernobyl – 25 years later

Finally, we heard about the ‘dark side’ of radiation, in an excellent session looking at the 25 years of research and monitoring that’s gone on in the wake of the 1986 Chernobyl nuclear disaster – and what we can learn about the likely after-effects of the recent tragedy in Fukushima.

Introduced by Imperial College’s Professor Gerry Thomas, we learned that the huge amount of radiation released when the Chernobyl reactor exploded, resulted in 5,000 more people developing cancer, over and above what would have been anticipated had the explosion not taken place.

All of these extra cases were thyroid cancers, rather than breast, lung cancers or leukaemia as initially feared. And according to the latest analysis, of these people with thyroid cancer, 29 of these people have died – speaking to the fact that thyroid cancer is, usually, eminently treatable.

Given the media coverage of the tragedy, some might find this figure remarkably low, but Professor Thomas elegantly put this into context. Just by living on this planet, she said, we’re constantly exposed to radiation in one form or another, and have evolved a whole series of defence mechanisms to protect ourselves. She highlighted exposure data showing that we were exposed to more radiation from nuclear testing in the 60s and 70s than from Chernobyl – with little apparent impact on cancer rates:

Radioactive fallout

Summing up she explained that, overall, the evidence showed “no scientifically demonstrated effect of Chernobyl radiation on leukaemia or any solid tumour other than thyroid cancer so far”, although there was still a need for follow-up studies. “We’re not out of the woods yet. However,” she continued, pointing to the data, “we get more certain with every passing year.”

If the dark cloud of radioactivity that hung over Europe has a silver lining, it’s that we now understand much more about the effects of radiation on human health, and that it poses less of a cancer risk than many had feared. In fact a report by the World Health Organisation concluded that by far the biggest health effect of the Chernobyl accident was its effect on the nearby population’s psychological wellbeing, showing just how important it is to put cancer risks into context.

So that’s a wrap for Tuesday’s sessions. We’ll be posting our final update from NCRI 2011 shortly.

Henry, Kat, Julie and Nell