NCRI Cancer Conference 2015

Pritchard-Jones talks to ecancertv at NCRI 2015 about her work looking at why so many people in the UK are not diagnosed with cancer until they are admitted to A & E departments. Her study comprised of a one year follow up of nearly 1000 patients diagnosed with cancer in 2013, and was motivated in particular by the levels of late diagnosis in North-East London. She wants to see people with worrying symptoms being seen by their GPs and referred for tests much sooner. Their current strategy for NHS England is that patients should be seen, tested, and diagnosed within four weeks.

Prof Swanton talks to ecancertv at NCRI 2015 about the discovery by Prof Nicola Sibson of a protein that helps map the edge of brain tumours more clearly so they show up on magnetic resonance imaging (MRI) scans. "It's extremely exciting", he says.

Dr Barker talks to ecancertv at NCRI 2015 about her work looking at cancer as a complex system. She explains the importance of integrating molecular level information with a three dimensional understanding of the disease. The genome, she says, is "digital information, no different from a computer program" and we have never had such a grasp on genomic sequencing. Dr Barker describes this as a "data tsunami" and explains how the creation of models based on a complex systems understanding is the practical application of this information.

Dr Fojo talks to ecancertv at NCRI 2015 about how the value of clinical trials and treatments can be assessed. Since the rising cost of anticancer drugs appears inevitable, the focus has moved towards assessing the real value of a clinical trial and its outcomes, he explains. He argues that negative data should be published by law so that unnecessary trials are not undertaken in vain. Although his expertise are within the American system, he applauds UK body NICE on their ability to assess the scientific and financial worth of different drugs.

Prof Swanton talks to ecancertv at NCRI 2015 about what he regards as the highlights of the conference. In particular, he comments on the work being done to improve targeted approaches and find better drug combinations. It is important, he says, to predict resistance mechanisms and block them to improve progression-free survival (PFS) outcomes. We need to battle the evolution of cancer and grasp it head on, he says. He notes the important work looking at the problem of late diagnosis, arguing that investing in early diagnosis measures (such as earlier referral by GPs following 'red flag' symptoms) is an "extremely cost-effective approach" when compared with the amount of money required for palliative care. He also touches upon other developments being made in CAR T-cells and immune checkpoint blockades.

Dr Chang talks to ecancertv at NCRI 2015 about his work doing whole genome sequencing of pancreatic cancer. He and his team have identified four molecular subtypes of pancreatic cancer which will enable more personalised treatment approaches.

Prof Rubin talks to ecancertv at NCRI 2015 about the upcoming national cancer audit in the UK. He talks about the importance of its role as an annual audit which will integrate NGOs and professional organisations and influence policy.

Prof Kaner talks to ecancertv at NCRI 2015 about how lifestyle behaviours can impact people's chances of developing cancer. Evidence based investigations into diet and exercise and the influence on both getting cancer and surviving it have shown that being physically active, not smoking, and reducing alcohol intake all make a significant difference. Prof Kaner explains how we need to raise awareness and encourage exercise in a clear and non-judgemental way.

Prof Rubin talks to ecancertv at NCRI 2015 about the role of primary care in cancer control. As more people are diagnosed with cancer and surviving it, there is an increased demand for cancer care. Prof Rubin talks about the need for more involvement of GPs in screening and in end-of-life care, with reference to a recent commission published in Lancet Oncology. He argues that we need to encourage further integration between GPs and palliative care professionals.

Dr Kennedy talks to ecancertv at NCRI 2015 about the highlights of the conference and the work of the NCRI (the National Cancer Research Institute). She mentions the work in genomics, immunotherapy, policy (such as E-cigarette policy) and treatment economics as being of particular interest, as well as the importance of the conference in establishing networks and collaborations. She also touches upon the work of the NCRI in facilitating more research on radiotherapy and on survivorship issues effecting patients.

Dr Lewis talks to ecancertv at NCRI 2015 about the work of cancer charity Tenovus and the ways in which their research agenda is decided. He argues that the best ideas will come from patients and carers who have been affected by the disease themselves. He explains how a panel of patients have been asked to choose which researchers' ideas should be taken forward. Likewise, patients' ideas have been put forward and selected by researchers. Most of the issues raised by patients are the simple day-to-day quality of life issues, he says. For example, spending time travelling back and fourth to the hospital or sitting in waiting rooms because of late appointments is a big concern for cancer patients, especially those with a bleak prognosis. He describes a new movement in which real value is being put on patients' feedback which is helping to shape the research agenda.

Prof Bauld talks to ecancertv at NCRI 2015 about the impact of E-cigarettes on cancer. She argues that whilst there is a lot of fear mongering, evidence shows they are significantly less harmful than regular cigarettes. Furthermore, there is no risk posed by second-hand vapour as there is with second-hand smoke. We should be encouraging people to use E-cigarettes rather than equating them with tobacco use, she argues. Legislation such as banning the use of E-cigarettes in public places in Wales is dangerous, she says, as it sends out the message that they present the same danger. However, she does note that further research needs to be done on the long-term effects of using E-cigarettes as well as their potential use by children.

Prof Johnson talks to ecancertv at NCRI 2015 about how a more systematic approach to assessing patients' health and wellbeing is extremely effective. When patients are asked open questions such as "how are you?" they may withhold a lot of information, not realising what the doctor regards as useful and valid. When patients were asked in a rigorous and systematic way about their mental state, financial situation, physical ailments, care and carers, sexual concerns etc, people would report on average ten issues instead of only one. She argues that this approach is valuable as a monitoring tool to chart improvements and as a great way of addressing unmet needs and providing the crucial support needed for people to live "as long as they can, as best as they can".

Dr Nitzan Rosenfeld talks to ecancertv at NCRI 2015 about his work looking at circulating tumour DNA as a quantitative measure of cancer burden and a way of monitoring a cancer's response to therapy.

Prof Selby discusses the development of the Association of Cancer Physicians (ACP) Strategy paper which has just been updated. This comprehensive document includes the aims of the organisation and recommendations for the development of the specialty and cancer services in the UK. It should be of interest to all oncologists in the UK, as well as those involved in the development and commissioning of cancer services.

Dr Fitzgerald talks to ecancertv at NCRI 2015 about the development of less invasive, easier and cheaper molecular tests for the early diagnosis of cancer. In her work she has focussed on developing such a test for oesophageal cancer. The test uses a sponge (incased within a swallowable capsule) on a string, in place of an endoscopy or biopsy to detect atypical cells which may suggest a risk of oesophageal cancer. She also discusses the concept of risk stratification based on biomarkers to reduce unnecessary tests, as well as the steps that can be taken to reduce the prevalence of Barrett's oesophagus in the first place.

Dr Lawrence talks to ecancertv at NCRI 2015 about his work looking at future directions of radiation therapy in pancreatic and liver cancer. In particular, he talks about how advances in radiation mean that it can now be used in a more precise way that minimises damage to healthy tissue. He also discusses the ways in which treatment can be personalised, such as by measuring liver function to see which patient subset can take a heavier dose of radiation.

Prof Oelfke talks to ecancertv at NCRI 2015 about new proton facilities which are opening soon in the UK. This technology is especially important in paediatric cancers as it reduces the harm done by the protons to healthy tissue by better controlling their penetration, he explains. He also discusses the benefits of MRI-guided radiation therapy. Since the technology is expensive, we need to really demonstrate the value of the therapy, he argues.

Prof Thomas talks to ecancertv at NCRI 2015 about how physical activity can benefit a cancer patient's health and wellbeing. Three to four hours of exercise a week is enough, he says, to make a significant difference to individuals and health systems. He explains how a lot of people think they shouldn't exercise because it will increase the problems associated with their cancer, such as joint pain or fatigue. Actually, he says, exercise can relieve these symptoms. This is a point that needs more emphasis and understanding from healthcare professionals and patients. Prof Thomas is also a visiting professor of Applied Biology and Exercise Science at the Coventry University.