Margaret Grayson is passionate about research. But Margaret is not a scientist, doctor or nurse. She is a survivor of breast cancer.
Since being diagnosed more than a decade ago, Margaret has experienced first-hand how research saves lives. And the life-saving research that we do wouldn’t be possible without your support.
In this blog post we highlight the progress that we have made for breast cancer patients through research, helping people like Margaret beat cancer, and look towards the future.
“Research is real and it’s now”
The year is 2016, Breast Cancer Awareness Month is upon us, and right now, 8 in 10 women diagnosed with breast cancer will survive their disease for 10 years or more.
But it hasn’t always been that way.
Rewind to the seventies and a rather different picture is painted for patients. Back then, just 4 in 10 women survived breast cancer for a decade, meaning survival has doubled over the past 40 years in the UK.
That boost is thanks to research, and we’ve had a big part to play in it. Our world-leading scientists have been working across the board, from hunting down faulty genes linked with breast cancer to finding new ways to tackle the disease.
It’s important for the public – for our whole community – that research happens.
But for patients and survivors, the incremental progress made through research can sometimes feel a little distant, something Margaret recognises.
“People don’t always realise how important research is until something happens to them,” she says. “But research is real and it’s now. And it’s important for the public – for our whole community – that research happens.”
Margaret was diagnosed with breast cancer in May 2004, and it’s here that research became a big part of her life.
Following her diagnosis, Margaret had surgery, chemotherapy and radiotherapy. And it’s research that has helped make this journey through treatment possible.
But this journey has not yet concluded. Today, Margaret continues to take hormonal treatment aimed at stopping the disease from returning.
Pioneering research in the 80s
Many breast cancers grow in response to certain hormones in the body, like oestrogen. Hormonal treatments target this characteristic by preventing the cancer cells from receiving the hormone’s growth-promoting signals.
Our scientists played a key role in progressing this type of therapy for breast cancer, and made some game-changing discoveries in the 1980s.
In 1983, a collection of our researchers began analysing clinical trials that looked at the effectiveness of one type of hormone treatment called tamoxifen. This drug is used to treat breast cancer patients whose tumour cells have many copies of a molecule on their surface that sticks to oestrogen – so called ‘ER positive’ breast cancers.
Five years on, their landmark study showed that women over the age of 50 who were treated with tamoxifen fared much better than those who were given standard chemotherapy. The study also suggested that tamoxifen was just as good when used alone as in combination with other drugs, reducing treatment costs and sparing women side effects.
More recently, we funded a large clinical trial that found tamoxifen can also prevent breast cancers in some women who have a high risk of developing the disease.
Collectively, these studies have had a huge impact on clinical practice. Not only did they show that tamoxifen is effective at both treating and preventing breast cancer in these women, but they helped doctors work out the best way to use the drug, which helps guide treatment.
This type of research, says Margaret, is the “way to change the outcomes for people in the future”.
“Not just in terms of diagnosis, but through continually improving treatments.”
“The drug I took this morning – that was all determined by research”
This progress continued in the 1980s as our scientists laid the foundations for another targeted therapy: anastrozole (Arimidex). Like tamoxifen, anastrozole cuts off the tumour cells’ oestrogen supply. But it does this by blocking how cells produce the hormone in the first place.
We set up a clinical trial to look at whether anastrozole was better than tamoxifen for some women. And in 2002, our scientists showed that to be the case, with the added bonus of discovering that anastrozole had fewer side effects than tamoxifen.
Now, this drug – among other similar drugs – are the gold standard of care for postmenopausal women with ER positive breast cancer, helping thousands of women, including Margaret, survive their disease.
If I could thank all the patients who have taken part in clinical trials over the years, I would.
“I’ve never been a patient in a clinical trial,” she says.
“But since I was diagnosed in 2004 I’ve come to realise that the type of surgery I had, the combination of chemotherapy drugs, the techniques and radiotherapy, and the drug I took this morning – that was all determined by research.
“If I could thank all the patients who have taken part in clinical trials over the years, I would.
“I have a lot to thank them for.”
“People are working together”
In 1991, our researchers showed that patients whose breast cancer cells had lots of copies of a molecule called HER2 on their surface tended to have a poorer outlook. HER2 tells cells to start growing, so having more copies can make a cell more sensitive to these signals. This knowledge was the starting point that led to trastuzumab, a drug that interferes with these HER2 signals.
After a trial we helped fund showed that Herceptin improves survival in these ‘HER2 positive’ breast cancer patients, the drug was made available on the NHS for these women in 1998.
But it’s not all down to developing new drugs. We’ve also worked to develop and improve other types of treatment too.
We funded some of the earliest studies on radiotherapy as a treatment for cancer, and our research has helped establish the best doses to use, how to reduce side effects, and how to plan this type of treatment effectively.
And more recently, one of our clinical trials showed that fewer but larger doses of radiotherapy are just as effective as standard radiotherapy doses for some breast cancer patients, which could mean fewer hospital trips for women.
This type of research, says Margaret, is vital as it helps form a ‘partnership’ between the patient and the researchers.
“People are working together,” she says, “keeping the patient in mind, and keeping the patient voice central.”
And this is particularly true in research looking to help diagnose breast cancers earlier.
Spotting cancer earlier
Diagnosing cancer earlier means that more treatment options are usually available, and that treatment is more likely to be successful. That’s why we’ve played a key part in the development of the national breast screening programme.
After being the first to test out mammograms, our researcher Sir Patrick Forrest chaired a committee that examined the potential value of routine breast screening, using the best available evidence at the time. The resulting report was the tipping point that led to the programme’s introduction in 1988. But the story doesn’t stop there, and we’ve continued to fund research and work with government to help improve the breast screening programme.
Today, screening remains an effective way to diagnose breast cancer at an early stage, and it’s estimated to save up to 1,300 lives each year in the UK. But research has also shown that screening leads to some cancers being diagnosed that would never have gone on to cause any symptoms or harm – so-called ‘overdiagnosis’.
The Independent Breast Screening Review, which took place in 2012 at the request of both us and the Government, estimated that for every life saved by breast screening three breast cancers were overdiagnosed.
And that’s why it’s vital that women have balanced information about breast screening to help them decide whether to attend or not.
“Research is the way of beating cancer sooner”
With breast cancer still claiming thousands of lives each year in the UK, we need to make sure that progress continues.
Looking to the future, there are lots of promising areas of research that have the potential to make a real impact on the way that breast cancer is diagnosed and treated.
And we remain at the forefront.
Our researchers are trialling exciting new drugs called PARP inhibitors, which we were the first to bring into the clinic. These drugs target a genetic weakness that our scientists led the way in discovering: the BRCA1 and BRCA2 genes, which raise the risk for breast cancer.
And recently we showed that breast cancer is not one but ten different diseases. This knowledge will guide future research and clinical trials into new targeted therapies, helping to make treatment kinder and more personal.
I’m passionate about research
Our research journey for breast cancer is far from concluding. But with your generous support, we can continue making a difference to patients’ lives.
And that’s why Margaret is backing research.
“I knew seven people diagnosed with breast cancer at the time I was,” she says.
“Over the next five years I went to the other six funerals of those people who’d become friends. That’s another very personal reason I’m passionate about research. I didn’t want another seven friends to have the experience.
“For me, research is the way of beating cancer sooner. That’s my passion for it.”