‘As a cancer survivor you’re expected to feel grateful’: Laura Fulcher’s campaign for better care

The Guardian | April 2022 | ‘As a cancer survivor you’re expected to feel grateful’: Laura Fulcher’s campaign for better care

News article in today’s (29 April 2022) Guardian explaiing former English teacher Laura Fulcher’s patient experience and life as a cancer survivor. Fulcher had agonising symptoms for 15 months before she was finally diagnosed with bowel cancer, then received little support after her treatment. So Fulcher set up a charity- Mission Remission- to help cancer survivors and to campaign for faster diagnoses.

Read Fulcher’s experience as a patient in The Guardian

Substitution mutational signatures in whole-genome–sequenced cancers in the UK population

Nik-Zainal Abidin, S. (2022). Substitution mutational signatures in whole-genome–sequenced cancers in the UK population. American Association for the Advancement of Science.

Structured Abstract

Introduction

Mutational signatures—imprints of DNA damage and repair processes that have been operative during tumorigenesis—provide insights into environmental and endogenous causes of each patient’s cancer. Cancer genome sequencing studies permit exploration of mutational signatures. We investigated a very large number of whole-genome–sequenced cancers of many tumor types, substantially more than in previous efforts, to comprehensively reinforce our understanding of mutational signatures.

Rationale

We present mutational signature analyses of 12,222 whole-genome–sequenced cancers collected prospectively via the UK National Health Service (NHS) for the 100,000 Genomes Project. We identified single-base substitution (SBS) and double-base substitution (DBS) signatures independently in each organ. Exploiting this unusually large cohort, we developed a method to enhance discrimination of common mutational processes from rare, lower-frequency mutagenic processes. We validated our findings by independently performing analyses with data from two publicly available cohorts: 3001 primary cancers from the International Cancer Genome Consortium (ICGC) and 3417 metastatic cancers from the Hartwig Medical Foundation. We produced a set of reference signatures by comparing and contrasting the independently derived tissue-specific signatures and performing clustering analysis to unite mutational signatures from different tissues that could be due to similar processes. We included additional quality control measures such as dimensionality reduction of mixed signatures and gathered evidence that could help elucidate mechanisms and etiologies such as transcriptional and replication strand bias, associations with somatic drivers, and germline predisposition mutations. We also investigated additional mutation context and examined past clinical and treatment histories when possible, to explore potential etiologies.

Results

Each organ contained a limited number of common SBS signatures (typically between 5 and 10). The number of common signatures was independent of cohort size. By contrast, the number of rare signatures was dependent on sample size, as the likelihood of detecting a rare signature is a function of its population prevalence. The same biological process produced slightly different signatures in diverse tissues, reinforcing that mutational signatures are tissue specific.

Across organs, we clustered all tissue-specific signatures to ascertain mutational processes that were equivalent but occurring in different tissues (i.e., reference signatures). We obtained 82 high-confidence SBS reference signatures and 27 high-confidence DBS reference signatures. We compared these with previously reported mutational signatures, revealing 40 and 18 previously unidentified SBS and DBS signatures, respectively.

Because we are cognizant of increasing complexity in mutational signatures and want to enable general users, we developed an algorithm called Signature Fit Multi-Step (FitMS) that seeks signatures in new samples while taking advantage of our recent findings. In a first step, FitMS detects common, organ-specific signatures; in a second step, it determines whether an additional rare signature is also present.

Conclusion

Mutational signature analysis of 18,640 cancers, the largest cohort of whole-genome–sequenced samples to date, has required methodological advances, permitting knowledge expansion. We have identified many previously unreported signatures and established the concept of common and rare signatures. The FitMS algorithm has been designed to exploit these advances to aid users in accurately identifying mutational processes in new samples.

The full paper is available from Science

In the news:

Guardian ‘Like fingerprints at a crime scene’: study finds new clues about causes of cancer

Cancer Services [report]

House of Commons Library | April 2022 | Cancer Services

Cancer survival has improved significantly over the past half century: it is a story of progress which is a testament to both the progress of science and the efforts of the NHS under successive governments. Despite such progress, cancer outcomes in England remain behind other comparable countries.

The Committee’s inquiry was focused on asking how these differences have arisen and how the Government should resolve them. Therefore, the chapters of this Report focus on the different issues which the Committee have heard contribute to lower cancer survival in England, they include the importance of early diagnosis; access to the best cancer treatments; variation between cancer services, and different cancer types; and, the importance of research and innovation in catching up with the best countries in the world.

Cancer services Twelfth Report of Session 2021–22 [report]

In the news:

BBC News NHS not making progress on early cancer diagnosis

Leeds Cancer Research Centre is officially launched

University of Leeds | February 2022 | Leeds Cancer Research Centre is officially launched

An ambitious vision placing Leeds at the global forefront of cancer research has been set out by the University.

The University is partnering with Leeds Teaching Hospitals NHS Trust to create the Leeds Cancer Research Centre, a new venture bringing together experts from across a range of disciplines including biological, physical, engineering and clinical sciences; clinical practice and innovative health interventions, to tackle some of the greatest challenges facing cancer research today. 

The Centre’s goal is to transform the prevention, diagnosis, and treatment of cancer; tackle cancer-related health inequalities, and improve patient outcomes in Leeds, Yorkshire and across the globe. 

In Yorkshire, more than 31,000 new cases are diagnosed every year, with the third-worst outcomes in England. Nearly a fifth of the Leeds City Region’s population lives in areas of severe social deprivation where cancer is the leading cause of death, with lung cancer accounting for over half of the cases. 

Some 40 per cent of people from these communities who develop cancer are diagnosed at a late stage – and have a 50 per cent greater chance of dying from the disease than those who live in Leeds’s least deprived areas. 

The problems are predicted to worsen due to the impact of the COVID-19 pandemic, with more cases diagnosed at a late stage due to limitations on cancer screening and fewer patients visiting their GP during lockdown. 

Full details from the University of Leeds

Women under 35 face higher risk of breast cancer spreading – study

via The Guardian | 3 November 2021 | Women under 35 face higher risk of breast cancer spreading – study

Women diagnosed with breast cancer under the age of 35 face a higher risk of it spreading, according to the first global study of its kind.

Breast cancer is the most common form of cancer, with 2.3 million people diagnosed every year. Survival rates are generally good, which is largely because of screening, early diagnosis and improved treatment.

However, until now, little has been known about the risk of secondary breast cancer, where the disease spreads to other parts of the body and becomes incurable.

A meta analysis of more than 400 studies has found the risk of breast cancer spreading to another part of the body ranges from 6 per cent to 22 per cent. The results of the study are being presented at the sixth International Consensus Conference for Advanced Breast Cancer.

Full story from The Guardian

New cancer hospital opens in Carlisle


Department of Health and Social Care & The Rt Hon Sajid Javid MP | August 2021 | New cancer hospital opens in Carlisle

Thousands of patients in Cumbria will benefit from state-of-the-art cancer diagnosis and treatment at the Northern Centre for Cancer Care in Carlisle.

  • On Thursday 19 August 2021 Health and Social Care Secretary Sajid Javid has officially opened a cancer hospital in Carlisle to make one of the biggest combined cancer treatment services in the country
  • The £35 million Northern Centre for Cancer Care, North Cumbria, integrates cancer diagnosis and treatment across Cumbria, with a chemotherapy day unit, plus radiotherapy and CT scanners
  • The centre is the first hospital to open as part of the government’s commitment to deliver 48 hospitals by 2030, backed by an initial £3.7 billion

This new £35 million facility visited by the Secretary of State for Health and Social Care today will be used by patients from across north, west and east Cumbria, making it one of the biggest combined cancer treatment services in the country.

The hospital brings new, cutting-edge services under one roof in north Cumbria for the first time including a chemotherapy day unit, radiotherapy machines and a CT scanner as well as outpatients, consultation and examination rooms. The new facilities means most adult cancer patients in Cumbria will be able to receive care close to home, rather than having to travel (Source: Department of Health and Social Care).

Health Secretary opens new cancer hospital

Cancer Research: Skin cancer diagnoses rise by 45% in a decade

Cancer Research UK| July 2019 | Skin cancer rates rocket by 45% in 10 years 

Figures analysed by Cancer Research UK (CRUK) demonstrate that in the 10 years since 2004 skin cancer rates rose by  more than a third (35%) for women and by almost three-fifths (55%) for men.

The figures have been released to mark the launch of the charity’s Own Your Tone campaign which encourages people to embrace their natural skin tone and protect their skin from too much sun.

sun
Image source: cancerresearchuk.org

Melanoma skin cancer is the fifth most common cancer in the UK and the second most common cancer in people aged 25-49, but almost 90% of melanoma cases could be prevented if people took better care of their skin in the sun both at home and abroad. Getting sunburnt, just once every two years, can triple the risk of melanoma skin cancer.

Karis Betts, health information manager at Cancer Research UK, said: “Sun safety is not just for when you’re going abroad, the sun can be strong enough to burn in the UK from the start of April to the end of September, so it’s important that people are protecting themselves properly both at home and further afield when the sun is strong. We want to encourage people to embrace their natural look and protect their skin from UV damage by seeking shade, covering up and regularly applying sunscreen with at least SPF 15 and 4 or 5 stars.” (Source: Cancer Research UK)

Read the full press release from Cancer Research UK 

In the news:

Independent Cheap flights blamed as skin cancer rates soar by 45 per cent in a decade

BBC News Skin cancer risk ‘not just from holiday sun’

How NHS investment in proton beam therapy is coming to fruition

Limb, M. | 2019| How NHS investment in proton beam therapy is coming to fruition | BMJ|364|l313 | https://doi.org/10.1136/bmj.l313

Winter 2019 will be a landmark for the National Health Service, as it will mark the opening of the NHS’s first high energy proton beam therapy unit, at the Christie NHS Foundation Trust in Manchester. Adrian Crellin, NHS England clinical lead for proton beam therapy says: “It is a confirmation that radiation oncology is absolutely a key part of modern cancer treatment.” 

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The two new £125m (€140m; $160m) centres will each treat up to 750 patients a year. “Many of the patients we’ll be treating will be children, young people, and those with what could loosely be termed as rarer tumours,” says Ed Smith, who heads the Christie unit.

Research has advanced since the NHS announced investment in the two national proton beam centres in 2012. Smith, a consultant clinical oncologist, says protons now have “an increasingly proved role in the indications we will treat” and suggests the evidence is “beginning to firm up” for the reduction of long term toxicities.

Conventional radiotherapy uses x rays from multiple directions; a modern variant is high precision, intensity modulated radiotherapy (IMRT), which aims to maximise the dose to the tumour while minimising the dose to the surrounding tissue (Source: The BMJ).

Read the full story at the BMJ 

The full article is available to staff via NHS Athens, alternatively contact the Library for a copy

A solution to less toxicity in chemotherapy treatment?

Oh, H. J., Aboian, et al |2019| 3D Printed Absorber for Capturing Chemotherapy Drugs before They Spread through the Body|  ACS Central Science| 

A study that describes  the development of 3D printed porous absorbers for capturing excess chemotherapy drugs that are not taken up by the targeted tumor to prevent toxic side effects is published in the journal ACS Central Science.  So far the research has not been conducted in human subjects but the early work could potentially offer a way to make chemotherapy less harmful to the body. 

Abstract

Despite efforts to develop increasingly targeted and personalized cancer therapeutics, dosing of drugs in cancer chemotherapy is limited by systemic toxic side effects. We have designed, built, and deployed porous absorbers for capturing chemotherapy drugs from the bloodstream after these drugs have had their effect on a tumor, but before they are released into the body where they can cause hazardous side effects. The support structure of the absorbers was built using 3D printing technology. This structure was coated with a nanostructured block copolymer with outer blocks that anchor the polymer chains to the 3D printed support structure and a middle block that has an affinity for the drug. The middle block is polystyrenesulfonate which binds to doxorubicin, a widely used and effective chemotherapy drug with significant toxic side effects. The absorbers are designed for deployment during chemotherapy using minimally invasive image-guided endovascular surgical procedures. We show that the introduction of the absorbers into the blood of swine models enables the capture of 64 ± 6% of the administered drug (doxorubicin) without any immediate adverse effects. Problems related to blood clots, vein wall dissection, and other biocompatibility issues were not observed. This development represents a significant step forward in minimizing toxic side effects of chemotherapy.

The full article is available to download from ACS Central Science

In the news:

BBC News ‘Less toxic’ chemotherapy hope

From eyedrops to potential leukaemia treatment

University of Nottingham | December 2018 | From eye drops to potential leukaemia treatment

Scientists at the University of Nottingham have found eye drops  have the potential to be used in treatment for an aggressive form of  blood cancer: acute myeloid leukaemia (AML).  Nottingham staff collaborated on research led by experts at the Wellcome Sanger Institute, University of Cambridge, and other scientists which led to the discovery that a compound identified in eye drops, being developed  to treat a form of eye disease, has shown promise for treating AML.The active ingredient in eye drops has the potential to treat AML, as it targets leukaemic blood cells without harming non-leukemic  blood cells. 

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Full details of the research are available from:

University of Nottingham [press release]

Wellcome Sanger Institute [press release]

Abstract 

We recently identified the splicing kinase gene SRPK1 as a genetic vulnerability of acute myeloid leukemia (AML). Here, we show that genetic or pharmacological inhibition of SRPK1 leads to cell cycle arrest, leukemic cell differentiation and prolonged survival of mice transplanted with MLL-rearranged AML. RNA-seq analysis demonstrates that SRPK1 inhibition leads to altered isoform levels of many genes including several with established roles in leukemogenesis such as MYBBRD4 and MED24. We focus on BRD4 as its main isoforms have distinct molecular properties and find that SRPK1 inhibition produces a significant switch from the short to the long isoform at the mRNA and protein levels. This was associated with BRD4 eviction from genomic loci involved in leukemogenesis including BCL2 and MYC. We go on to show that this switch mediates at least part of the anti-leukemic effects of SRPK1 inhibition. Our findings reveal that SRPK1 represents a plausible new therapeutic target against AML.

The full article is available to read from Nature Communications