Aspirin cancer prevention Credit: Flickr/CC BY-NC-ND 2.0
This post was updated on 16th December 2019.
A lot can happen in a year. A famous high-street bakery can launch their first ever meat-free sausage roll and a new royal baby can enter the world.
But when it comes to research, progress is often made in small, gradual steps, not always taking the form of the ‘breakthroughs’ we read about in the news. To round off the year, we caught up with some of the researchers we spoke to in January, to look back on their predictions for 2019. And there has been some impressive progress that has us feeling optimistic for 2020 and beyond.
We asked some of our top researchers to share their personal ambitions for 2019 and the key trends that they hope to see emerge in their field.
Preventing cancer – Professor Jack Cuzick, Queen Mary University of London
Professor Jack Cuzick, from Queen Mary University of London, works in cancer prevention. He has fronted ground-breaking clinical trials showing how certain drugs can reduce some women’s risk of developing breast cancer. In 2019, he hopes to provide the maths that convinces the National Institute for Health and Care and Excellence (NICE) to recommend low-dose aspirin as a way of preventing cancer.
It’s clear that the most important thing to do to avoid cancer is to not smoke. But if you ask people what the second most important thing is, you get a variety of answers. Our calculations indicate that taking low-dose aspirin for 10 years between the ages of 50 and 70 could be among the most important things this age group can do to prevent cancer. Tackling smoking and obesity are clearly important, but we think this is as important as obesity and is much easier to make an impact on. One of my big ambitions of 2019 is to make this much more widely known.
The most important thing we’re trying to do this year is to get NICE to recommend aspirin as a means of preventing cancer. We know taking low-dose aspirin can come with side effects, like stomach bleeding, but I think the benefits outweigh the risks for almost all people. We’re hoping to get a risk analysis study done to make it clear that offering people aspirin will save the NHS money, because I think the costs of having to manage cancer far outweigh the costs of treating occasional bleeds.
One exciting area that I think we’re going to hear more about in 2019 is breast cancer prevention. Side effects of breast cancer drugs, like tamoxifen and aromatase inhibitors (such as anastrozole), have put some people off taking them to prevent cancer coming back. I think we’re going to see some trials looking at the impact of taking these drugs in lower doses. We have reason to believe low dose may be effective and may not cause most of the side effects, but I’m looking forward to seeing this explored more scientifically.
End of year update
Our cancer prevention expert said getting aspirin recommended as a means to preventing cancer on the NHS was a top priority. And thanks to a review of results from a major trial, the National Institute for Health and Care Excellence (NICE) agreed that taking a daily aspirin for more than two years could reduce the risk of bowel cancer in people with Lynch syndrome. These crucial steps mean from January 2020, people in England, Wales and Northern Ireland who have a high risk of bowel cancer will be able to have the conversation with their doctor about taking daily aspirin to help reduce their risk of developing the disease.
Radiotherapy – Professor Corinne Faivre-Finn, The Christie NHS Foundation Trust, Manchester
Professor Corinne Faivre-Finn is a Cancer Research UK-funded radiotherapy expert based at the Christie Hospital in Manchester. Some of the most sophisticated radiotherapy equipment in the world lives at the Christie. And in 2019, Faivre-Finn hopes to start thinking about how it can be used to help lung cancer patients.
We had a very advanced radiotherapy machine called an MR Linac installed in my hospital in 2018. It’s basically an MRI scanner and radiotherapy machine combined. At the moment there isn’t much evidence on how we can apply this technology to lung cancer, so one of my major ambitions this year is to develop a clinical trial using this machine for these patients and to secure funding to run it.
A proton beam therapy machine was also installed last year. It’s wonderful to have technology like this available for us in the UK, but we have to be very careful with it. This year I also plan on visiting centres elsewhere in the world where they have experience of treating lung cancer with proton beam therapy to learn from them. Then I can start planning potential ways in which we could test these machines to make them work best for patients.
For radiotherapy as a whole, the field is very excited about combining radiotherapy and immunotherapy. At the end of last year evidence was published to show that combining the two treatments had a very good impact on the survival of lung cancer patients. I’m sure evidence on this combination will continue to build in 2019.
End of year update
After the successful installation of a super high-tech machine that combines radiotherapy with MRI imaging in 2018, The Christie team got the equipment ready for patients and even managed to treat a number of people this year. Around 10 prostate cancer patients in Manchester have now benefited from this cutting-edge treatment. And they’re likely to be living with fewer side effects as a result. The team hope to treat many more people in 2020 and extend the machine’s use to cervical and lung cancer.
Another radiotherapy milestone this year was the approval of the first immunotherapy treatment that can be used after radiotherapy for certain patients with advanced lung cancer in England, Wales and Northern Ireland. In trials, 6 in 10 patients who received the combo were still alive 3 years after treatment. Faivre-Finn says around 150 patients this year have been able to receive the new treatment combination on the NHS.
And finally, we launched a new radiotherapy network in November, to accelerate radiotherapy research even further and make this cornerstone cancer treatment even more powerful. We’re looking forward to seeing more developments like these soon.
Screening – Professor Jo Waller, King’s College London
Professor Jo Waller, based at UCL, mainly focuses on cervical screening in her research. She talked to us about the exciting prospects in 2019, including the introduction of primary HPV testing, a new national cervical screening campaign and a switch in tests for the bowel screening programme.
I am looking forward to the big improvements in the cervical screening programme in England which will come with the switch to human papillomavirus (HPV) primary testing. This change will flip the order of cervical screening tests, making the programme better at picking up and treating cell changes before they become cancer. Implementing a big change to a national screening programme is not without its challenges, but the plan is to have it rolled out across the country by the end of the year, which is really exciting.
Secondly, I’m interested in the national cervical screening campaign that will be launched in March 2019. The campaign aims to increase the number of women who attend screenings for cervical cancer, hopefully bucking the downward trend we’ve seen in uptake over recent years. It also coincides with the tenth anniversary of Jade Goody’s death from cervical cancer, which we are also hoping will be a moment where we can raise awareness about the disease again. Between the time Goody was diagnosed with cervical cancer in 2008 and her death in 2009, there were around half a million extra cervical screening attendances in England (this became known as ‘the Jade Goody effect’).
Additionally, there’s the switch to the Faecal Immunochemical Test (FIT) in bowel cancer screening. At the moment, the Faecal Occult Blood Test (FOBT) is used. But it’s expected that the switch should have a dramatic impact on uptake because we know that people find it easier to do the FIT as it is just one test, whereas the FOBT involves three different tests. All the evidence from the pilots suggests that it should cause a big uplift in participation. Bowel screening has historically had low levels of participation compared with breast and cervix. If we can see an improvement, it would be really welcome.
End of year update
This year saw big improvements to cervical screening programmes in England and Wales. By the 31st of December 2019, everyone screened for cervical cancer in these 2 nations will now have their sample tested for HPV first. Testing in this way has shown to be much more effective at preventing cancer and will save the NHS money.
Scotland are planning to follow suit by March 2020, but unfortunately Northern Ireland haven’t committed to this change yet.
During the ‘Cervical Screening Saves Lives’ campaign launched in March, that Waller mentions above, more people went to cervical screening. While a positive result, Waller cautions that the full impact of the awareness push may not be seen until the 2020.
Immunotherapy – Professor Karl Peggs, University College London
Professor Karl Peggs is a clinician and researcher specialising in stem cell transplantation and immunotherapy. His research interests include engineered cell therapies and he’s particularly excited about the continuing progress of a personalised immunotherapy treatment called CAR T cell therapy in 2019.
We’ve seen some major advances in CAR T cell therapies in 2018 for certain blood cancers, and hopefully that will continue in 2019. So far, the treatment has been approved for some adults with diffuse large B cell lymphoma and some children with leukaemia, if their cancer has continued to grow or come back after standard treatments.
We’ve now got 8 centres in England that are being approved to deliver this complex treatment, 1 paediatric centre, 6 adult centres and one hospital that will treat both children and adults. These centres have begun to open and will continue to do so over the next few months. Getting this first wave of centres up and running with the treatment is essential to give us the capacity that’s required to treat patients who could benefit. And the next step in my opinion will be to expand the number of sites that offer the treatment, as it will be much better for patients if they are treated locally. We also need to do some work in 2019 to look at the best way to ensure that everyone who could benefit from the treatment is identified and referred to a specialist centre, to make sure they get the treatment at the right time.
We’re also starting to see trials opening that are testing CAR T cell therapies for patients whose disease hasn’t progressed as much. These will really help us to confirm the value of CAR T cell therapies compared to standard treatment for blood cancer. These trials have the potential to be really exciting, because if CAR T cell therapy is found to be better it could become a treatment option for a much larger group of patients. We won’t have any results in 2019, but we’ll start to see trials opening in the UK and across Europe.
End of year update
This year, more people in the UK than ever before were treated with a type of personalised immunotherapy called CAR T cell therapy. This is partly because this innovative treatment has been approved to treat more NHS patients with different types of blood cancer. But Peggs also says that more people have been given these ‘living therapies’ thanks to clinical trials running at our new London Centre, which is working to improve these innovative treatments. In most cases he says these were people who have very few treatment options left.
Professor Karen Vousden – Cancer Research UK’s chief scientist
Professor Karen Vousden has spent the last 30 years in cancer research studying one of the most important molecules in cancer, called p53. She was director of our Beatson Institute in Glasgow from 2003 until two years ago, when she was appointed Cancer Research UK’s chief scientist. In 2019, Vousden is looking forward to understanding more about how altering diet can affect cancer treatment.
One of the areas we’re interested in is whether we can use defined diets to boost the effectiveness of treatments like chemotherapy. This approach depends on a detailed understanding of how cancer cells feed themselves. Research by us and others has shown that cancer cells are highly dependent on a supply of some amino acids, including one called serine. And we’ve found that we can slow tumour growth in mice given a diet that doesn’t contain this amino acid. Now we’re really interested in trying to move this work into people to see if the same thing applies.
Our ultimate aim is to run a clinical trial testing if a special diet that lacks serine can help patients having chemotherapy, but first we need to test the diet in healthy volunteers. This year we hope to find out if it’s possible to reduce the amount of serine circulating in the body by putting someone on a special diet, as it is in mice. We’ll also be running more experiments with mice to see if this restricted diet has any unexpected impact on the rest of the body, particularly the immune system.
Beyond my work I’m really excited about what we’ll learn about immunotherapy in 2019. The idea that we can reactivate the body’s ability to detect and kill cancer cells using these new treatments has been a game changer in recent years. But while it’s had astonishing results for some people, others don’t respond at all. So as well as looking to develop new approaches, I hope the next few years will bring a deeper understanding of why only some patients’ cancers respond to this type of treatment.
Finally, there’s a lot to look forward to at Cancer Research UK. I’m particularly excited by some of the ambitious initiatives that are being set up at the moment. We’re bringing together talented people from around the world and from lots of different areas of science to tackle some of the big questions in cancer research. And that opens up some hugely exciting possibilities.
We’ll catch up with these experts at the end of the year to reflect on the past 12 months of cancer research. We’re also looking forward to hearing about other interesting things that happened in their field in 2019, let’s hope it’s a busy year!
Gabi, Katie & Ethan
Fiona couper January 20, 2019
Really good to read this on the research. I am participating in the “add-aspirin trial” in the breast cancer arm so good to read about the next steps in planning with NICE.
Mel Morriss January 18, 2019
My wife has just undergone chemotherapy for liver cancer at Kings college hospital London we live in hope. Thanks for your Sterling research.
Rachel January 16, 2019
I’m very interested in diet and immunotherapy. I have metastatic breast cancer and am responding well to treatment. Alongside my therapies I have monitored my diet, eating foods high in magnesium and selenium and taking Manuka honey capsules. I am very interested in the new developments concerning serine. The only time my neutrophils dropped during chemotherapy was when I ran out of Manuka capsules. They shot back up again within three days of restarting the capsules. I haven’t had an infection of any kind and I feel extremely well considering. I think my diet has contributed a great deal to my healing.
caroline Meleady January 14, 2019
I did take aromatase for 5 years but would agree that I struggled with side-effects mainly stiff joints .Glad you are doing further research and looking at dose reduction
Chris Candish January 14, 2019
It,s exciting to learn of all the new initiatves which are driving research and starting to yield results. A great newsletter.
Penny Kostick January 14, 2019
Amazing work, thank you all so much. I have uveal melanoma that is responding well to the plaque brachytherapy l had last June. Early days but I remain positive and very inspired by all cancer research. I’m particularly interested in and a fervent believer of research that uses the bodies ability to detect and kill cancer cells. I believe there is a lot more to discover here. To all researchers everywhere; never give up, ALL research is valuable research. Thank you.
Craig Keenan January 13, 2019
I’ve been running marathons for Cancer Research since 2014 and this year I’m embarking on a 60+ mile 16 hour epic Ultra Marathon to continue to raise as much money as I can to help the fight against Cancer.
There’s still a long way to go in the battle, but I read about the good progress that is being made. Keep up the fantastic work…….I hope my efforts can help you to help others that so desparately need our support.
John Hamilton January 13, 2019
Keep up the great work
Cathy finch January 13, 2019
Fantastic, am hoping there will be a breakthrough in treatment for cll too.
nicolae January 12, 2019
There is the chance that the individual may control efficiently the occurrence and development activity of malign cells.
The tumor cells and the disturbances caused by them represent a very complex problem with various unknown elements which make difficult the doctors’ efforts and the patients’ expectancies.
All information held by the human being until now about the tumor cells are insufficient in order to sole efficiently the malign affections. To this effect, we have to enlarge the knowledge horizon by new „key” information and I have not renounced and I have made this with all my passion and power – in the research study named „All about the malign cells and their fighting”. Now, the importance of the new discoveries may have a significant impact on our anti-tumor defense.
I have not created this work in order to impress somebody. The thing in stake might be even our lives. I wanted that the people be fully aware of the mechanism generating the occurrence and development of malign affections, as well as the main liable agent so that the human being may redirect and adapt its efficient, preventive defense strategy against malignity.
It is not easy to carry out such a complex scientific research in an inaccessible field, located beyond the knowledge limits and to succeed revealing some unknown biological mechanism of malign cells and vulnerable „key” points of their behavior which might be selectively attacked.
I am not an English speaker, I have no support and the translation and editing costs are large, especially to support and continue the fundamental applicative scientific activity of tumor cells.
I am sorry that such new information and solutions cannot reach the audience much more quickly in order to improve, to test them legally and to obtain the copyrights license.
While most people is waiting, hoping for years to have something new which may heal them, this new information stays hidden within my papers and documents, having no chance to be known and useful. I am looking for a suggestion and help in order to reveal them to the world, to continue the activity and release one of the four books named „Life beyond all” which includes everything about malign cells and their fighting against (500 pag.).
Thank you for your attention and support.
The author of these works
E-mail: [email protected]
Mandy January 12, 2019
Amazing work !
Norma Foulds January 12, 2019
I agree that men should be tested for prostate and pancreatic cancers
Norma Foulds January 12, 2019
I agree that there should be a programme for men to be tested for cancers such as prostrate and pancreatic
Jean Cruxton January 12, 2019
What about prostate cancer? Why isn’t there a programme for men? Women have breast screening, why can’t men be given the option regular PSA testing ?m
Karen January 12, 2019
Will look forward to the outcomes during 2019. Sounding very positive in a lot of aspects .
sezsunshine January 12, 2019
what about any improvements in stomach or oesophageal cancers – no improvements seen in these cancers in at least 15 years. We need money spent on reasearching these difficult to treat cancers.
Pat Holley January 12, 2019
Great work in getting grips with this awful illness. Here’s hoping we move forward again in 2019 with some exciting new developments in the treatments your investigating. Good [email protected]
terence Pruce January 12, 2019
Absolutely marvelous and exciting.
Annie Butler January 12, 2019
Excellent information & encouraging research. I’m a very healthy, slim 67 yr old who was diagnosed with breast cancer last July. Devastated with the news. Full mastectomy but no chemo or radiotherapy. Prescribed Anastrozole. Have stopped taking it after 4 months due to hot sweats & risk of osteoporosis so extremely interested in that new research.
Ian Fordyce January 12, 2019
I think prevention is better but cure is an absolute must I am still getting over my third operation after the cancer came back as I had 2 lots of chemotherapy-cisplatin and 6 weeks of radiotherapy I think it was 38 shots they kept me in hospital the whole 6 weeks as I lost so much weight it was oral cancer but when it came back they had to remove my tongue and most of my jaw bone but I’m still here I can’t say thank you enough to cancer research,the surgeon’s and the nurses I’ll never eat again or work but I’m alive you people are amazing
suzanne hopper January 12, 2019
Very good news, hope, hope research and tests on cancer are going to keep on moving. There is more people serving it but we need more people to survive it
Brenda January 12, 2019
Amazing progress in combatting some cancers, the future looks promising.
Anne McRoberts January 12, 2019
Thank you for using my contributions so wisely.I am registered disabled myself and being able to help in this very important research,gives me a feeling of well-being.My thanks for further research into this massive illness.
Janine Simpson January 12, 2019
Very interesting read! It’s really exciting to see how progress is being made with testing etc!
Marco Randall January 12, 2019
Please continue the great work! 👍👍