How your support is beating cancer

I didn’t win the Transcontinental Race 2016 (not even close) but, through the incredible efforts and generosity of my friends, family and supporters, Cancer Research UK did. Together we raised almost £12,000 and in November I had the privilege of the visiting the Barts Cancer Institute to see first-hand just how those funds are being put to use.

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To begin, Professor John Marshall gave an introduction to his particular field of research and a basic overview of the metastasis process which would be necessary in order to appreciate the nature of his work. I found it fascinating so I’m going to attempt to share the basic gist of it with you too.

“Dear Science, please accept my apologies for what comes next.”

Cancers are formed when a cell mutates. Cancerous cells multiply rapidly and form tumours. Sometimes these mutated cells break away, force themselves into the blood stream and then out again somewhere else. If those cells manage to find a new home they can also begin to multiply and form secondary tumours. That process of metastasis is what makes cancer so deadly. A single tumour can be surgically removed relatively easily, but chasing cancer around the body is significantly harder. If we can prevent metastasis we can dramatically improve survival rates.

Those cancerous cells have proteins called integrins, which can be crudely thought of as legs. They are the mechanism by which the cells move, invade and then survive. One particular integrin is αvβ6 which is overexpressed in many cancerous cells – notably including breast cancer and pancreatic cancer – and it’s this integrin that attracts the focus of Professor Marshall and his team.

An antibody known as 264RAD has been developed and will begin phase I human trials in 2018. It’s a radioactive treatment which targets the peptides that bind only to αvβ6 and then makes them fluorescent. Using conventional imaging technologies a tumour needs to be ~1cm in diameter before it can be identified. This radiotracer can help to identify much smaller cancerous cells due to the radioactive flare effect. A 5mm tumour is 1/8th the size of a 1cm tumour and anything we can do to speed up intervention has a substantial effect on treatment success. The next phase is the development of a toxin that can be delivered in the same way and used to target and kill the αvβ6 expressing cells.

“I felt a momentary chill when Professor Marshall produced a vial of destructive, cancerous cells.”

With our minds suitably blown, the other fund-raisers and I made our way across the facility to the research labs to see the science in action. Lab coats on. We first looked at cells under the microscope to see the difference between normal and cancerous cells. I had a strange sensation when Professor Marshall opened the refrigerator storage and retrieved a collection of cancerous cells. I felt a momentary chill to be in the presence of something so destructive.

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The next room was filled with enormous machines that all looked deceptively basic – like Doctor Who props – but disguised the incredible technology hidden underneath their simple bodies. Flow cytometry and mass cytometry machines run complex analyses of samples and deliver enormous volumes of data (1-2GB per run, we’re told). I’m about to butcher more of the science but I believe the process involves stringing the sample out into a single line of cells and then exposing them one at a time to a laser to detect, measure and sort them. They can test for multiple parameters with a single pass. Some of the machines have three lasers which means even more data per second. You can never have too many lasers, right?

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The final area of the lab tour was the histology department, which is concerned with the microscopic anatomy of tissue samples. When a tumour is removed it can be sent here for processing and George at Barts is recognised as an authority in the area. External research teams pay to use George’s expertise, which generates more funds and keeps the research going.

The lump is first placed into a fixative solution to preserve it. The water content needs to be removed and this is done by slowly exposing it to ever-increasing concentrations of alcohol. At 100% alcohol the water is gone and the alcohol can then be replaced with xylene which, unlike alcohol, will mix with the wax that comes next. The sample is encased in a cube of wax so that it can then be sliced on what the team affectionally call the ‘bacon slicer’. This precision machine can slice the sample as thin as 4 microns. That’s 4 millionths of a metre or 1/250th of a mm. It’s about the thickness of a blonde human hair.

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A sample (mouse embryo) sliced 1/250th of a mm thick

Talking with George made quite an impact on me. He had been honing his skills for over 40 years. Two years previously he had lost his wife to breast cancer and had returned to the lab to help make a difference. He will retire next year and I hope there are talented, enthusiastic young scientists coming through to follow in his footsteps.

During my race I was given so many words of encouragement but the words that affected me the most were those of my friend Adam, who has been fighting cancer this past year. He said “It’s thanks to people like you that I will survive this”. I feel embarrassed to repeat it because all I did was give other people a channel to demonstrate their own generosity, but the concept struck a chord. Thanks to the work of scientists funded by Cancer Research UK survival rates have dramatically improved. A few years ago the 5-year survival rates for breast cancer was around 60%. Today it is in the 90s. That’s many thousands of women each year whose lives are saved by this research.

“During the race I was given so many word of encouragement but the words that affected me the most were those of my friend Adam, who has been fighting cancer this past year.”

Research like Professor Marshall’s is 90% funded by public donations. His work is incredibly promising and, encouragingly, is only one of many parallel avenues being explored by researchers around the world. Fund-raising like ours is making a tangible and significant difference and is saving the lives of our families and friends.

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Cancerous breast tissue, ready for slicing.

There is still a phenomenal amount of work yet to accomplish though. Cancer remains the leading cause of death and, with increasing lifespans, cancer is set to affect 1 in 2 of us in our lifetimes. The statistics are sobering. That’s you or your partner. It’s one of your parents. It’s half your children and half of your friends.

To my fellow adventurers, I’d encourage you to take the opportunity to raise funds and awareness for any cause. I’m not the type to sponsor people – or request sponsorship – for jollies or relatively minor exertions, but if you are doing something notable then it can be an opportunity to benefit everybody involved. As well as fund-raising for the charities you represent, knowing your efforts are directly linked to positive change for other people can help you find extra strength when you need it most.

“To all the many friends, family and followers who made donations, I want to offer a heartfelt thank you from myself, the team at CRUK and all the many people whose lives will be improved by your generosity.”

By the way, the Just Giving page is still open. If you’ve found the blog entertaining or useful in your own preparations do please consider a donation to CRUK or another charity.

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