From Branch to Bedside – standing up to inherited bowel cancer

In 2012 our first Stand Up To Cancer campaign raised a staggering £8 million. The money went to help fund clinical trials across the country.

Three years later, we take a closer look at one of them, and find out how it’s all going.

We’ve just celebrated Mother’s Day – burnt toast, glitter-splattered cards and lots of family time. And a time when we take a moment to let our mums know just how much they mean to us.

But there is another special day in March that also demonstrates how important family is to us. Exactly one week after Mother’s Day, on March 22^nd is Lynch Syndrome Awareness Day.

Lynch Syndrome, also called ‘hereditary non-polyposis colorectal cancer’ is a genetic condition, where an increased risk of cancer is passed from generation to generation. People with Lynch Syndrome have around an 80 per cent chance of developing early onset bowel cancer, as well as a number of other cancers – including stomach, pancreatic, prostate, liver, kidney, breast and womb cancers.

This means people with Lynch Syndrome will usually have seen a parent, a sibling or another family member go through the trauma of a cancer diagnosis. Some will have lost many members of their family to cancer.

They also face a near certain cancer diagnosis themselves. Some describe living under a ‘black cloud’, always present, always threatening, their family tree peppered with cases of cancer.

But hope may lie in a different kind of tree – the willow tree. You may not realise it but this beautiful tree harbours a wonderful secret.

Tree-mazing properties

The story of the willow tree’s surprising qualities begins many centuries ago in the fifth century BC, when Hippocrates, one of the first and most influential physicians, wrote that willow leaf tea could help relieve the pain of childbirth.

Centuries of scientific detective work has enabled scientists to identify the chemical in willow bark which gives it its pain easing properties.

Chemists have also spent decades refining and improving this chemical to enhance its power and decrease its side effects. But it wasn’t until the 1970s that a British pharmacologist – John Robert Vane – showed how this drug worked. For this discovery he was awarded the 1982 Nobel Prize in Physiology or Medicine.

Could aspirin prevent cancer?

This drug is now the most widely used medicine in the world – the go-to pill for any sufferer of hangovers, headaches and minor illnesses.

It’s called aspirin.

But just as the willow tree flexes and bends in the wind, the role of aspirin is constantly changing. In recent years scientists have increasingly been interested in aspirin as a life-saving preventative medicine. Evidence has now emerged that it can prevent – and perhaps even slow the spread of – certain types of cancer, including bowel cancer – something we’ve blogged about extensively in recent years.

Researchers are still unsure exactly how aspirin prevents cancer – some suspect it’s to do with the fact it reduces inflammation (a ‘normal’ process in our bodies that is also involved in the development of cancer). Others think it might have something to do with its effects on our blood.

But regardless of how it works, aspirin can have serious side effects – so it’s crucial that we know who should take it and at what dose. And for most of us, it’s far from clear cut whether the benefits outweigh the harms (as this infographic shows):

But for people at high risk of cancer – such as those with Lynch Syndrome – the balance of risks is completely different.

A feather in our CAPP

Over the last decade, Professor Sir John Burn – a leading medical genetics researcher based at the Institute of Genetic Medicine in Newcastle, has run a series of clinical trials – known as the CAPP programme – looking at whether aspirin can reduce the number of cases of bowel cancer diagnosed in people with Lynch Syndrome.

And in 2011, these trials showed that aspirin almost halved the incidence of bowel cancer in people with the condition.

But there’s still one outstanding question: what is the correct dose?

And this is where we come in. With funding from Stand Up to Cancer, Professor Burn’s team is running a trial called CAPP3, to determine the most effective aspirin dose to prevent the disease – giving the hope to families that the black cloud can be lifted.

Three thousand people who have Lynch Syndrome are being invited to take part in the trial. They are being asked to have blood tests and to take a daily dose of aspirin for two years.

The researchers are testing three different doses of aspirin but no-one will know which dose they are taking – crucial for the study to be accurate. The blood samples will help Professor Burn and his team investigate which is the most effective dose, and whether some people react differently to aspirin (something that recent research suggests is likely).

The team will also use the information to test whether certain markers in the blood could be used to predict who will develop cancer in the future.

Since 2012, Professor Burn and his colleagues have been busy setting up the trial in centres across the country. The trial is now open in nine locations, giving people with Lynch Syndrome the chance to participate around the UK.

It’s only though research like this that we can offer hope to families affected by cancer. So on behalf of all those affected – thank you to everyone who supported Stand Up To Cancer. The funds you raised could help to keep families with Lynch Syndrome together – and ensure they celebrate many more Mother’s Days.

Hayley Frend is a science communications manager at Cancer Research UK

• The UK SU2C campaign, a partnership between Cancer Research UK and Channel 4, has generated more than £23.8 million to accelerate ground-breaking cancer research since its launch in 2012.For more information, or to make a donation, visit standuptocancer.org.uk 

Image

• Willow tree from Flickr, under CC BY-NC-ND 2.0