Podcasts about Hammersmith Hospital

DMT and Ayahuasca? What's the difference? What are they? Jim couldn't even fake his way through these questions. Good thing our podcast shaman Professor David Nutt was here to guide Jim his Ayahuasca journey. IDKAT Live Show on May 21 @ 8pm in Los Angeles: https://www.flapperscomedy.com/shows/jim-jefferies-live-podcast-taping/69867/ BIO: Prof. David Nutt is the Founder of Drug Science and the Edmund J Safra Professor of Neuropsychopharmacology. He serves as the Head of the Neuropsychopharmacology Unit in the Centre for Academic Psychiatry within the Division of Brain Sciences, Department of Medicine, at Hammersmith Hospital, Imperial College London. He has also chaired the UK Advisory Council on the Misuse of Drugs. For over twenty-five years, Prof Nutt has served as the editor of the Journal of Psychopharmacology, and he acts as a psychiatry drugs advisor to the British National Formulary. He has written over 500 original research papers and 31 books. Notably, his book for the general public, 'Drugs Without the Hot Air' , earned him the Transmission book prize in 2014 for Communication of Ideas. Twitter: @ProfDavidNutt The Drug Science Podcast - https://www.drugscience.org.uk/podcast ADS: LITTER ROBOT: As a special offer to listeners of the show, go to http://stopscooping.com/IDKAT and enter promocode IDKAT to save an EXTRA $50 on any Litter-Robot bundle.  LECTRIC eBIKES: Get your adventure started at http:/www.LectricEbikes.com. And please mention that I Don't Know About That With Jim Jefferies sent you in the post-checkout survey! BETTERHELP: Visit http://www.BetterHelp.com/IDK today to get 10% off your first month. CHAPTERS: 0:00 — Ads 2:20 — Theme Song 12:27 — Judging a Book by It's Cover 14:37 — David Nutt Introduction 18:35 — Questions 24:08 — Jim's Ayahuasca Diet 26:55 — Ads 38:47 — Grading 39:43 — Answers 44:28 — The Great Tradition 50:30 — How Old Is Too Old? 1:13:25 — Australian Ayahuasca Guide 1:14:33 — Dinner Party Fact

La hematóloga y doctora Estella Matutes Juan es entrevistada por el periodista Íñigo Alfonso en una nueva sesión de Memorias de la Fundación, cuyos protagonistas son destacadas personalidades provenientes de diferentes ámbitos de la cultura que fueron destinatarios de becas o ayudas de la Fundación Juan March. Fue merecedora de una beca en el Extranjero de la Fundación Juan March en 1979 para estudiar la leucemia en el Hammersmith Hospital de Londres. Trabajó como hematóloga en el Royal Marsden Hospital de Londres durante veinticinco años y ha sido profesora en el Instituto de Investigación del Cáncer de la Universidad de Londres. Es asociada de la Unidad de Hematopatología del Hospital Clínic de Barcelona y es miembro de la OMS. Es artífice del "Matutes score", un análisis de antígenos utilizado para el diagnóstico de la leucemia más frecuente.Más información de este acto

In January we saw experts from across the genomics ecosystem, including patients and those with an interest in genomics, gather at the Festival of Genomics - the UK's largest annual life sciences event. In this episode, our host, Vivienne Parry, Head of Engagement at Genomics England, speaks to Louise Fish, CEO of Genetic Alliance UK, and Professor Matt Brown, Chief Scientific Officer at Genomics England, to discuss the event and emerging future trends in genomics.  In this episode you'll also hear some exciting future advances in genomics research from some eminent speakers at the Festival: Harold Sneider, Professor of Genetic Epidemiology, University Medical Center Groningen sheds light on the "Identification of methylation markers for Type 2 diabetes up to 10 years before disease onset." Nagy Habib, Professor of Surgery, Imperial College London, delves into "The future of saRNA therapeutics and its potential for treatment".  Lennard Lee, National Clinical Advisor on innovation and cancer vaccines, presents his perspectives on "The Future of Cancer Vaccines," offering a glimpse into the promising advancements in this critical field. "The scientific breakthroughs that are being made are absolutely incredible and they're really exciting, but from the point of someone living with a genetic condition, what they want to see is those scientific breakthroughs making a real difference in the clinics...For some conditions, it's about treatments, but it's also about being able to get a diagnosis faster, to be able to understand what condition is impacting on you, how it might affect you over your lifetime and your wider family, and to be able to work with NHS services to understand and plan for the care and treatment that you'll need throughout your lifetime."   You can read the transcript below or download it here: https://files.genomicsengland.co.uk/documents/Podcast-transcripts/Insights-from-the-Festival-of-Genomics.docx   Vivienne Parry: Hello and welcome to the G Word. Vivienne Parry: The Festival of Genomics is the UK's biggest genomics event, and it's become an essential part of our year. It's free for 90% of its delegates, it's in person, and with more than 5,000 people expected, it's now so big that it's had to move to ExCel's cavernous Dockland Halls. It's the place to hear top science and to spot new trends, but actually for me the joy of the festival is the people you meet. Of course, it's great to catch up with old friends, but it's the new collaborations sparked by random encounters at the festival which I think are the lifeblood of the genomics ecosystem, and everyone with an interest in genomics is here, patients, clinicians from the NHS, researchers, industry, policymakers, and the G Word. What we thought we'd do is bring you a flavour of this great event from the floor of the ExCel halls, and give you a quick soundbite from three of the speakers that we felt best exemplify the future of genomics. With me to discuss the event and future trends in genomics, Professor Matt Brown, Genomic England's chief scientific officer, and Louise Fish, CEO of the Genetic Alliance UK, which as its name suggests, is an alliance of over 200 organisations reflecting the needs and concerns of those affected by genetic conditions. My name's Vivienne Parry, I'm head of public engagement at Genomics England, and I'm delighted to be your host for today's pod from the Festival of Genomics. Welcome to you both. So, let's start with you, Matt. How important is the Festival of Genomics for genomics in the UK? Matt Brown: Well, the Festival of Genomics has become a really key meeting for the genomics community in the UK, and I think increasingly in Europe as well. It's a really large, high quality event that brings together commercial and academic and biotech companies in the one forum, and I think it's a really exciting programme. Vivienne Parry: And of course, Louise, it's open to patients as well, which makes it an unusual event. Louise Fish: Absolutely, and it's brilliant to have patients and families here. So, people living with genetic conditions clearly need to be part of the debate when we're talking about developing new services, and developing new treatments and diagnostics, so it's absolutely fantastic to be able to come together in one room with people from the NHS and the broader sector. Vivienne Parry: And it's grown enormously, and I guess that reflects, as much as anything else, just how exciting genomics is. Matt, I'm going to pin you to the ground [laughter] and say, why is it so exciting in genomics at the moment? Matt Brown: Look, the field's really hitting its tracks. We're seeing advances in technology, analytics, application in the clinical space, and of course booming commercial activity associated with that. But from a situation ten years ago, where we had research capability for using genomics to assist in diagnosis and cancer profiling, now we're in a situation where we have multiple different approaches to assist with both of those things, transcriptomics, proteomics, spatial, single cell methods, optical mapping, a whole monopoly of different technologies that have developed out of the research world but are pretty close to being ready for clinical application. Of course, in analytics, the rise of AI and the potential that has for improving interpretation of genomes and improving personalised medicine prediction in cancers and in multivariant data, those are absolutely massive things. But aligned to that, there's also, you know, the growing worldwide application of genomics in clinical spaces, of course led through the UK and the NHS Genomic Medical Service, which has really shown the way for the world about how this might make a difference. Vivienne Parry: And Louise, that's the really exciting thing is we're now seeing not just talk about therapies, we are seeing the therapies for rare disease actually going into clinical trials and into services even. Louise Fish: Yeah, absolutely, and that's why people living with genetic conditions and their families want to see the change. The scientific breakthroughs that are being made are absolutely incredible and they're really exciting, but from the point of someone living with a genetic condition, what they want to see is those scientific breakthroughs making a real difference in the clinics. And that's sometimes about treatments, you know. For some conditions, it's about treatments, but it's also about being able to get a diagnosis faster, to be able to understand what condition is impacting on you, how it might affect you over your lifetime and your wider family, and to be able to work with NHS services to understand and plan for the care and treatment that you'll need throughout your lifetime. So, treatment's one part of it, but actually that ability to better understand what the future will hold for you, and to plan ahead for the care and support that you will need to live your life to the full is what really excites people living with genetic conditions and their families. Vivienne Parry: Now, let's hear the first of our three clips. The programme is absolutely vast, but these were three presentations that we just thought were terrific. Let's hear the first one. Nagy Habib: My name is Professor Nagy Habib. I'm a consultant surgeon at Hammersmith Hospital, Imperial College, London. We are going through a very exciting time, where we know what is the problem with the diseases, and so far we couldn't do anything about it, but suddenly the door is opening and it all came with the RNA vaccine, because we had to go very fast to get a vaccine for covid, to protect the population, and that pushed the science to go very fast, and now we can apply it to other areas apart from covid, like cancer and rare genetic diseases. And these therapeutics are what you and I and everybody else have received during vaccination. There has been six billion injections around the world, so you can imagine that everybody had an RNA injection. And RNA is that molecule between our genome, the DNA, and the protein. For anything to happen in our body, it requires the protein, but there must be an RNA in between. In the past, it was all about DNA, but now it is RNA. Why can't we get a vaccine against cancer? And so now the field is growing very fast for a vaccine for cancer. Now, the way we think about it is that we can have an injection so that we don't develop cancer of the prostate or cancer of the breast and so on, but in actual fact today what we can say is that if we take out a tumour with surgery, and we can take the RNA from the tumour and inject it in the patient, the early clinical trials tell us that this might work, and to stop the tumour coming back. It is very important to make sure that, once the tumour is out, it doesn't come back. And I think there is hope that we can have RNA vaccines in cancer. Now, to treat cancer without surgery, still we have some way to go, but again, now we know that the problem with cancer is that some of our immune cells that are there to defend us from cancer, they change their mind and suddenly they collaborate with the enemy. So instead of helping us, they are destroying our immune system, and we are developing drugs that can stop that from happening to our immune systems. Now, when you really think about what are the diseases that kill people, cancer is definitely very high up. The second one, not in a particular order, but cardiovascular system, we get heart attacks and we die from heart failure, or we get stroke and we die from stroke, and that's because we eat too much. The food is very tasty [laughter]. So, now we have injections, and the injection can make us lose weight, and we lose weight very fast. The problem is again it's very expensive. Who can afford £600 a week? And when you stop the injection, you put on weight again. So, now we are working again with RNA, and we have found a way where you inject only once every six months. And then the final thing, which is really the dream of everybody, is to stop Alzheimer's disease. So, Alzheimer's disease, as we get old, there are toxic materials that are accumulating in our brain cells, and only this year we've got two drugs coming along that can help stopping Alzheimer's disease at an early stage. Now, what we need to do is to bring that it works on all types, even the advance type of Alzheimer's disease, and now there are [inaudible 0:09:26] where we can take it from the nose. So, you inhale it from the nose and it goes straight to the brain, because there is sort of a motorway that connects the roof of the nose with the base of the brain, which is very simple. It doesn't even need an injection in the arm vein. So, it's all very, very exciting. Vivienne Parry: That is so fascinating. It's real future casting. Matt, I mean, I say it's future casting, but tell me a bit about the Rare Therapies Launchpad, because, you know, that picks up some of what Nagy has outlined. Matt Brown: Yeah, so DNA and RNA therapeutics are absolutely booming, and that's one of the big excitements is that we're not only being able to diagnose people, but we're coming up with new ways of actually providing treatments for patients with rare diseases and cancers through nucleic acid therapeutics. For rare diseases, the type of clinical trials that are involved are really quite different, and you can't just basically translate what was used for common diseases into the rare disease space. It just doesn't work, and that's really held back the field a lot. So, to try and enable rare therapies to actually make that leap from a research setting into actual clinical practice, Genomics England, in partnership with the Medical Health Regulatory Authority and others, have set up a Rare Therapies Launchpad, to provide an end to end solution for people to be able to run clinical trials for rare and ultra rare diseases, particularly focusing on nucleic acid therapies, and linking that with both the regulatory authorities and health funding authorities so that we can get these ultimately into clinical practice. I think we need these sorts of initiatives so that we don't continue to see rare therapies falling over because they're being assessed and made to go through the hurdles that common therapies do nowadays. Vivienne Parry: So Louise, we really are in the area of what people call N of 1 medicines. Louise Fish: Yeah, absolutely. So, these are medicines that are made specifically for one person and will help that one person, and obviously that brings a whole heap of possibilities for people living with genetic conditions, but also a load of challenges that we understand for decision makers within the MHRA and NICE and the NHS. And so I think there are some real challenges that we're really aware of from the decisions that are already being made by those decision making authorities about treatment. Obviously, putting it at the most basic level, you don't have the same evidence base for treatment that's just available for one person that you do from a clinical trial, where thousands of people will have taken part in a trial to understand how it affects a whole host of people. So, we know that the decision making bodies are going to need to take a different approach to evidence, so are going to need to be willing to look at evidence that is just from a trial involving one person. They're going to need to be able to extrapolate the benefits of that treatment across someone's lifetime, and that can be challenging, and we've seen that before in rare disease medicines and the new treatments that have come along in recent years. So, there are definitely some challenges, and we're really glad to see those challenges being acknowledged upfront by Genomics England, the MHRA and others, and being debated and discussed, and trying to find solution now rather than waiting for those treatments to come along later, and then trying to retrofit and decide how to manage them. So, it's great to see this debate taking place early, and we're really keen to make sure that the voices of people living with rare conditions and their families are part of that discussion. Vivienne Parry: And the really cheering thing that we're hearing from Professor Habib is that he thinks that the cost is going to be much less, because some of these things, you know, have million pound price tickets, so to have something that will be cheap is really going to be I think the gamechanger.   Louise Fish: One of the challenges with that is understanding the lifetime costs of someone living with a genetic condition and all of the complexities that are involved, and not just the medical care that they need, but the social care and the wraparound care that they'll need, the extra support from schools and colleges, the extra support from employers if they're able to go in employment. So, I think we're constantly trying to help the government and decision makers have a better understanding that those lifetime costs of living with a genetic condition are the things that should be taken into account when they're making decisions about a new treatment that could be totally game changing for someone's health and their future. Vivienne Parry: Cheaper treatments on the way, Matt? Matt Brown: So, I think we absolutely need to work on reducing the costs of these treatments, because at the moment the costs are so high that, were we to extrapolate that out to try and treat the thousands to tens of thousands of different rare diseases that there are out there, we couldn't possibly afford it. I think it's very promising that we will get cheaper treatments. This might come about through reducing the development costs, in particular reducing the clinical trial programmes, and the level of safety and efficacy evidence that you require before you can actually make these treatments available. I think that will make a massive difference, if we can simplify that. And another thing is, by better collaboration between the different rare disease communities and genetic medical services around the world, to make sure that what might be an N equals 1 condition in the United Kingdom, when you consider it around the world, might actually be an N equals 100 people, and then basically the cost per patient drops substantially. To achieve that, we need much better coordination between the national genomic medical services. Vivienne Parry: At the end there, you heard talk of using RNA therapies for obesity and Alzheimer's, and we principally talk, particularly in Genomics England, not just about cancer and rare disease. But I wanted to present to you another presentation, which I just thought was extraordinary, which comes from the Netherlands, and it's about picking up signs of diabetes using genomics ten years in advance. Just listen to this. Harold Sneider: Hi, I'm Harold Sneider, I'm a genetic epidemiologist working at the University Medical Centre in Groningen in the Netherlands, and my focus is on cardiometabolic disease, and I have a great interest in hypertension, for example, obesity, but also type two diabetes. So, one of my major interests is to try and identify genes for common complex, mostly cardiometabolic diseases, so our approach is to do genome-wide association studies using genetics, but also epigenetics. And epigenetics can be screened for so-called methylation markers, and those methylation markers have an effect on expression of the genes, and we can look at this all over the genome. Then a very interesting question came up, whether these types of epigenetic signals or methylation markers could actually be used to predict disease in people that are still healthy. So, the goal of this type of work always consists of two parts. First, it's that we try to find out which genes are highlighted by these DNA methylation markers, because they are located at certain positions on the genome, so we know which genes are involved in those regions and we can learn more about the underlying biological mechanisms that play a role in the development of the disease. Because we found those signals up to ten years before the disease occurred, so that tells us something about changes that already happen at an early stage. It's like an early detection mechanism. At the same time, a combination of these markers together lets you calculate what's called a methylation score that can be used for the prediction of the disease, and the ultimate goal here is that even in healthy individuals, when you have those measurements, you can calculate such a score to improve the prediction and identify people with a higher probability to develop such a disease. I definitely think we can apply this general approach also to other – for example, cardiometabolic diseases, such as coronary artery disease or also hypertension. Vivienne Parry: Harold Sneider there from Groningen. And extraordinary, the idea that you might be able to pick up not just diabetes perhaps ten years in advance, but also he was talking about potential for other lifestyle diseases, like cardiovascular disease, for instance. What are your thoughts about that, Matt? Matt Brown: Look, I think it's always been an aspiration of the clinical community to move treatments from treating patients with established disease to actually working in really early or preclinical spaces, where you've got a much better chance of preventing end organ damage, and secondly you've got a much better chance of actually inducing remissions or potentially actually curing diseases. And I think not just in diabetes, but also in a range of immune mediated diseases, there's pretty good evidence now that you can, by intervening early, really make a massive difference to the natural history of diseases, and new methods are coming about to identify those patients, be it polygenic risk scores or other biomarkers, to enable us to sort of flip the approach of medicine from being reactive to pre-emptive. Vivienne Parry: And rare conditions, as they do so often, Louise, are leading the way in understanding the issues, which will then spill out into a much wider area of the population. Louise Fish: Yeah, absolutely, and rare conditions obviously is the space that we work in. So, Genetic Alliance UK, as you say, is an alliance of around 230 charities that support people largely with rare genetic conditions, and many of those charities are condition specific or look after groups of conditions, like metabolic rare diseases. So, that's the kind of space that we come from, and obviously in our space, the excitement is around the work that we're doing with Genomics England around the Generation Study, and trying to use that to understand whether it's possible to screen babies to understand whether they have a rare genetic condition, and if so to identify that condition and intervene early. And again, excitingly, that's not just about treatment, it's about whether there's a way of helping that child and their family, if you can identify very early to help really improve their lifestyle choices. And one of the best examples we have is identifying children with brittle bone disease, where if you pick them up through screening, you'd be able to teach their parents to handle them safely, so they didn't have breaks in their bones as babies, which is what we see now. So from our perspective, it's obviously different to the polygenic risk scoring, but again it's that idea of using genomics as a way of identifying conditions very early, and intervening before signs and symptoms start, to try and improve the life chances of the person living with that condition, and help their wider family to help them, which is really exciting from our perspective. Vivienne Parry: But the experience and knowledge that you've gained as rare disease organisations actually is enormously valuable to other people. I mean, rare has always been at the forefront. I mean, in cancer, for example, it was chronic myeloid leukaemia, which was a rare cancer, that kind of unlocked cancer targeted treatments for everybody else. And it always seems to me that rare is at the forefront. Although it's often seen to be behind, it actually is the key to unlocking so many other things, and the experiences that you have all had are so valuable for much wider populations. Louise Fish: Yeah, absolutely, and one of the reasons we run Genetic Alliance UK is so our member organisations can learn from one another, ‘cos there's always one of the rare patient organisations which is surging ahead in a particular space, doing something really exciting, doing something really new, and we try and make sure that our members can learn from one another and don't have to kind of reinvent that wheel. But I know that spills out into the wider cancer space and beyond, which is fantastic. Vivienne Parry: And Louise, do you think there are particular conditions which, if I can put it like this, are on a roll at the moment, where genomics is really advancing fast for them? Louise Fish: Oh goodness, that's a really good question. There are lots of conditions where genomics is making a significant difference really quickly. For us, I think we go back to the Generation Study, and at the moment we only screen in this country for nine conditions, soon to be ten with the addition of a new condition, but the Generation Study's looking at 200 conditions and whether it's possible to screen for them. And for all of those 200 conditions, it's a really exciting opportunity to see if we can learn more, both about the potential to understand and develop treatments early, but also just about the chance to understand the natural history of that condition so much earlier than we do at the moment. And I think that's it, it's that understanding of the natural history of the condition really early, and understanding how a family can be helped through all the aspects of the condition, which is giving people most excitement, I think, alongside the potential to develop treatments. And I know we talk about treatments a lot, but at the moment only five percent of rare diseases have a condition specific treatment available, so we really try and balance, within Genetic Alliance UK, that hope for the small number of conditions that do have treatments, which is really exciting, or have treatments in development, and actually making sure that the scientific breakthroughs in genomics are something that all conditions can benefit from, whether there's a treatment or not. The potential for early identification of people with a condition, understanding the natural history better, and wrapping a package of support and care around people that is not just about a drug itself, is really important to us and to all of our members. Vivienne Parry: Matt, are you seeing any particular areas where there's a really rapid success? Matt Brown: Look, I think there have been some absolute standout successes in nucleic acid therapies in recent years. So, one is the treatment of familial hypercholesterolemia, with siRNAs for PCSK9, so the Inclisiran type approach, which has absolutely revolutionised management of that disease. In recent times, I'd highlight, for example, the treatment of sickle cell disease, an absolutely massive global problem, and now we've got a therapy which can really control sickling crisis and make a big difference to a disease which isn't just a disease of developed countries, in fact it's particularly a disease of Africa, of course. On a global level, that's just going to have a huge effect. But I think, yeah, I just would like to come back to that comment you made about things starting with rare diseases. So, in genomics, rare disease genomics has taught us a heck of a lot about what drives common diseases as well, and to my mind, gold dust for drug development companies is where you have genes that are associated with both rare and common forms of the same type of disease. And that tells you that basically you're very likely, through your treatment, to be able to actually influence the disease, and that it will influence a large proportion of patients with the disease. So, I'm really enjoying seeing this division between rare diseases and common diseases broken down a little bit, and a lot more learning in therapies going from one to the other. Vivienne Parry: Let's move to a completely different area, one that's very important to Genomics England and less important, Louise, at the Genetic Alliance UK, which is cancer. We're going to hear from Lennard Lee about cancer vaccine. Lennard Lee: I'm Dr Lennard Lee, I'm a medical oncologist, so I practice as an NHS doctor, treating cancer, and I'm an associate professor at the University of Oxford. We've come to a position whereby vaccines can be developed quicker than anyone thought. In the last few years, we've realised that the technology has moved on rapidly, MRNA technology, and you can make vaccines and update them really, really quickly. We've now come to a situation where vaccines can be made against cancer, and this is where genomics is really starting to supercharge this technology. If you can sequence a cancer then what we're finding now is that the technology now exists for you to print off an MRNA vaccine for that patient, a truly personalised product. And it's amazing because the genetic basis of the cancer, what the genomics sequencing shows then becomes a vaccine itself. The vaccine is designed based on that sequence, and that's why genomics has really supercharged this field of vaccinations for cancer. One of the possible things we just need to clarify and be aware of is that when people talk about cancer vaccines, they mean a number of things. Ultimately, what it involves is getting a new treatment for people with cancer, because it's based on their genetic sequence, so it's used to treat people with cancer. The future's an exciting one, truly personalised medicine based on genomics. Genomics is going through so many different phases in the field of cancer. Firstly, we were starting to understand why cancer happened and what patients outcomes were. The second phase started to kick off where genomics would help patients select the right drugs at the right time for them, which is amazing. And now we've entered the final evolution of genomics, where it now becomes the actual drugs that we treat people with. And cancer vaccine is one of the first potential areas where genomics will start to form the basis of the treatments going ahead. In five years' time, we're going to know if it works or not, where an individual vaccine based on the genomic abnormality seen in that cancer is going to give better outcomes for patients than an off the shelf product. We know that every cancer's different, so genomics has showed us this, but all of a sudden that sequence could become that vaccine, which then primes that immune system, truly personalised therapy. And it is so exciting that we're going to be talking about this in this festival, and it's being driven as from the UK, which has got so much strength in terms of genomic capabilities as we're developing vaccines. Vivienne Parry: So Lennard Lee there, absolutely confident of the importance of cancer vaccines. Matt, what are your thoughts on that?  Matt Brown: I think it's a tremendously exciting field. The early data on cancer vaccines with melanoma, for example, showed that for a cancer which previously had been resistant to virtually all of our approaches, is actually quite responsive to novel cancer vaccine approaches. We are yet to see across what diversity of cancers this is actually going to work, so there's clearly a huge clinical trial programme that's going to be required to drive this, and the UK is playing a really central role through the Cancer Vaccines Launchpad that Lennard's involved with running, in creating the evidence base about whether these are going to achieve the promise that they hold. I also think that they've got a lot of possibility for inherited cancer types. For example, I think the programme's looking at cancer vaccines for Lynch syndrome, to try and prevent colorectal cancer in that group of patients. So, I think they've got lots and lots of opportunities, and it's nice to see something positive actually coming out of the pandemic like this, for what was a pretty bleak episode worldwide otherwise. Vivienne Parry: They are a small part, I know, of your organisation, Louise, but in some ways, those people with inherited cancers in their families are seeing the benefits of genomics on both sides, both in that earlier diagnosis, picking up right from the very beginning, and of course in the promise of these new treatments. Louise Fish: Yeah, absolutely, and you're right, it's a small part of our remit. We do have some organisations in our membership who specifically support people with rare inherited cancers, and we work very closely with an organisation called Cancer 52, who also represent organisations with rare cancers. I'll just give them a quick shoutout in case anyone listening is not aware of them and their amazing work. But you're right, I think there are a couple of things going on that are really exciting in the cancer space. It's that ability to better understand why some people are likely to inherit cancers, how that pattern works within families, and to support those families and help them understand like the risk that they have, and to make informed decisions about their own treatment and care in the future. And also about whether they want to have children, and if they do want to have children, kind of how they want to approach that to try and reduce the risk of passing on that heritability. So, that's a really important part for everybody. I think there's also potential to develop new treatments, which is absolutely amazing and really exciting, and it is really exciting to hear about the potential for cancer vaccines. The other area where I think people living with inherited cancers are interested to find out more is what impact it might have on better understanding which treatments will work for which people. And we know, for example, that there are some cancer treatments that only work for one in four people with that particular kind of cancer, but it's been really hard to understand why that's the case. And I think the potential for genomics to identify which people could benefit from a particular cancer treatment would have two huge benefits. A, cancer treatments, many of them are really horrible, you know. They're horrible things to go through, and if you had a better confidence that a particular treatment was going to work for you because of your genetic makeup, that would make you a lot more confident about deciding to try that treatment, and taking on board the side effects of the treatment and how it's going to impact on you. That would also obviously massively impact on the cost effectiveness of that treatment. At the moment, we might give it to four people and only one of them would benefit, but you're paying for the cost of giving it to all four people. If you could identify in advance which people were more likely to benefit then you'd give it to fewer people, they'd be more likely to benefit, and the cost would come down. So, I think that there is real potential in this field of genetics and genomics to help in all kinds of ways that people living with these conditions are really excited to see and explore. Vivienne Parry: So Matt there, it's not of course simply about identifying, you know, what the cancer is like and its genomic makeup, but actually it's that wider field of pharmacogenomics, which is a big feature of the programme at the Festival of Genomics this year. And we're very much involved in that, aren't we? Matt Brown: Yeah, we are. So, pharmacogenomics is one of those areas where genomics is about to make a big difference in clinical practice. What we're hoping to get to is the point where we have people who are not yet treated with a medication actually already have the genetic profiling done, so that when they go to a general practitioner or a physician and be prescribed a medication, the data will already be there to say what the appropriate dose should be, and whether they're at risk of getting adverse reactions to those medications, so we could avoid them or use alternate medications. So, that sort of pre-emptive pharmacogenomics is just over the horizon, and if we can achieve that, we're going to significantly improve patient care and reduce the risk of adverse drug reactions, which are a major cause of morbidity and hospital admissions not just in the UK but worldwide. Vivienne Parry: So Matt, perfect segue into our next question, which was, you've already identified one area which you think is going to be big in the next few years. You're both absolutely in the centre of the genomics ecosystem. What do you think we're going to be seeing at next year's Festival of Genomics? What do you think is going to be the big thing that's coming up on the inside rail? Matt Brown: So look, I'd like to say what I think's going to be in next year and what I think's going to be in ten years. Next year, I think the big things are going to be advances in AI and genomic analytics. That's really ramping up fast, and I think we're going to see it in clinical implementation a lot more next year. I think the cancer therapy vaccines are going to be really big next year, as are nucleic acid therapies. Multiomics for rare disease diagnosis and cancer personalised medicine, I think is also ramping up very fast. In ten years' time, the two areas that we've not discussed so far where I think genomics is going to make a big difference are going to be in infectious diseases and in pathology services. In infectious diseases, genomics I think has a fair chance of replacing to a large extent culture based practice, or serology based diagnosis of infectious diseases, which will be done by sequencing instead. And that will be a massive change to the practice there, because you'll be able to rapidly work out, even if people have been treated with antibiotics already, what the infections are and what the likely treatment responses are going to be. Louise Fish: So from my perspective, next year what I hope to see is people getting just as excited about the differences that some of the technology we hear about this year are actually making when they're being applied in clinical practice. So I think from my perspective, it's all about that move from being excited about the science to seeing people just as excited about the difference that science is actually making when it's benefiting people living with rare conditions and their families through clinics across the UK and the NHS. Next year, I'd like to hear that excitement when people are talking about how it's actually affecting real lives. In ten years' time, I hope we'll be talking about the massive difference that some of the amazing techniques we've heard about here this year have made to the lives of people living with genetic and rare conditions. So, you know, in ten years' time, I hope that some of the treatments and the opportunities and the tests we hear about today, we can see how they've affected the natural history of the condition across ten years of lives, and that we can really see that people are living their lives to the full as a result of the fantastic technological breakthroughs that we're hearing about today. Vivienne Parry: Fantastic. It's been great to talk to you both, and it has been a fantastic festival. Vivienne Parry: So, thank you to you again, and also thank you to Frontline Genomics, who organised the Festival of Genomics, because it really has been a wonderful, wonderful event. And if you're interested in things genomic, you can subscribe to the G Word on your favourite podcast app, and if you're new to our podcast, and we always welcome our new listeners, do check out our back catalogue. You'll find it's really extensive. There's a wonderful set of genomic listening available to you, in which even spatial transcriptomics gets explained. I've been your host, Vivienne Parry. This podcast was edited by Mark Kendrick at Ventoux Digital, and produced by Naimah Callachand, and it's very good to have had you with us. Bye for now, and hope to see you at the Festival of Genomics next year.

Public Service Announcement: Would you like to support us ? We are raising money for our NFP and podcast to obtain an office space and podcast recording studio for 2024. Our goal is $10, 000 AUD and any donation big or small is helpful ! If you're interested in supporting us, please email us at hello@pbbmedia.org for more information. If you're not familiar, Check out our work at pbbmedia.org In this interview, Oni Blecher interviews Dr. Howard Chilton has been a neonatologist (a baby's physician) for over 45 years. He was born in York, England and studied at St Mary's Hospital Medical School in London. After wonderful years in London in the swinging sixties he graduated then interned at Addington Hospital on the beach in Durban, South Africa. Following this, he was accepted for a Senior House Physician appointment in Neonatal Medicine at Harari Hospital in then, Salisbury Rhodesia, now, Harare, Zimbabwe). After more training, Howard eventually obtained paediatric appointments at the Hammersmith Hospital and the Westminster Children's Hospital, then, after obtaining his MRCP (UK) degree, the John Radcliffe Hospital, Oxford where he also did a short fellowship. He then became a SHO at the Hospital for Sick Children, Great Ormond Street, London in the Department of Respiratory Medicine. He did a mandatory Neonatal Fellowship in the US at Denver Children's Hospital which included two years in a centre of excellence in high tech neonatology including doing neonatal ground and air retrievals, really taught him how to look after the sickest, smallest babies.Before starting this fellowship though, he had a long stopover in Sydney doing locum Respiratory and Paediatric jobs, to check out job prospects. During one job at Prince Henry Hospital he met a beautiful nursing sister called Tamara.At the end of the fellowship, Howard was appointed as the Director of Newborn Services at the Royal Hospital for Women in Sydney, where he held this position for over twenty years, resigning in 1999 to concentrate on clinical work and parent education. Apart from looking after babies and their parents, Howard now spends a lot of his time talking: to parent groups, or to conferences in Australia and overseas, and to media outlets about ‘responsive parenting' and the myriad issues which arise for parents when they take their new baby home. He believes knowledge of the biology of the baby can help parents understand and meet their baby's needs and enables them to relax and enjoy the wonderful experience of parenting.He married Tamara soon after arriving back in Sydney from the USA and she remains the light of his life. They have two daughters, Georgina and Isabella and five grandchildren ! all under 5 years of age. Find out more about Dr. Chilton, including his well renowned books at babydoc.com.au

It's 131 Episodes of the human library audio podcast “U n' I with Rashmi Shetty”& I feel completely grateful. All the storytellers willingly shared their story & today are good friends. One thing we all have in common is we are all connected to the “#voiceinme” Today is the 25th episode in Season 2. These are the video extracts of the 131 episodes: https://coachrashmishetty.com/podcast/ https://coachrashmishetty.com/podcast-2022/ https://coachrashmishetty.com/podcast-2023/  Our guest today is Dr. Arti Datta the founding Artistic Director of Mudra Dance Studio, Muttontown, NY, and the President of The Mudra Foundation: Art for a Cause. Dr. Arti Datta is the founding Artistic Director of Mudra Dance Studio, Muttontown, NY, and the President of The Mudra Foundation: Art for a Cause. Dr. Arti Datta was initiated into Bharatanatyam early in her childhood in India. An alumnus of Kalasadan, one of the premier cultural institutes in Mumbai, India, was the disciple of the late Guru Shri Mani who trained her in the rigorous Vazhuvoor tradition. Dr. Datta continued her education in dance at the Bhartiya Vidya Bhavan, London, UK. She has performed extensively in India, the U.K., and the United States. Dr. Arti Datta is a clinical scientist by profession and has conducted her post-doctoral cancer research at the Hammersmith Hospital in London, U.K., and at the NYU Langone Medical Center in New York. Dr. Arti Datta has successfully choreographed and directed several multi-media productions including Shiv-O-Hum, Leela – The Play of Krishna, Yatra – A Journey of Indian Dance, part of the Joseph G Astman International Concert series at the Hofstra University, NY, Devi: An Ode to Mother Goddess, Arpan – An Offering, a benefit for the victims of the Japan tsunami disaster, WATER: The Flow of the Divine, a fundraiser for the Sankara Eye Foundation, and AANGIKAM - a tribute to the victims of the Nepal earthquake. NAVARASA: The Essence of the Nine Emotions as a benefit for the Guide Dog Foundation, JEEVAN TARANG: The Rhythms of Life benefitting CRY America, MARGAM: The Path for Hewlett House, and most recently PREKSHA: A Meditation in Dance supporting Long Island Crisis Center was staged in May this year. On the 10th Anniversary of the dance school, as a way of integrating her passion for dance with a desire to give back, she founded the nonprofit The Mudra Foundation: Art for a Cause. (www.TheMudraFoundation.org) Dr. Datta was recognized by the India Association of Long Island (IALI) as one of the most influential people in the Indian American Community in NY and has been felicitated on numerous occasions for her contribution to the arts in the US. Dr. Arti Datta serves on the board of the Long Island Arts Alliance and volunteers her time at New York Cares. She continues to teach dance at the Mudra Dance Studio, Muttontown.  Listen in as Dr. Arti shares her journey from the logical world of Science to the creative world of Dance. --- Send in a voice message: https://podcasters.spotify.com/pod/show/the-third-eye1/message

Edwina Brown, Consultant Nephrologist at Imperial College Renal and Transplant Centre at Hammersmith Hospital, London, UK, and Honorary Professor of Renal Medicine at Imperial College London, UK, joins Jonathan to discuss how nephrologists can take a more person-centred approach to medical care and decision-making. Brown also details her goals as President of the International Society for Peritoneal Dialysis (ISPD), and how she wants it to become more inclusive. Use the following timestamps to navigate the topics discussed in this episode: (00:00)-Introduction (02:06)-A patient-centric approach in nephrology (03:51)-Brown's goals as President of the ISPD (07:27)-A 30,000-foot view of peritoneal dialysis (10:18)-Peritoneal dialysis from a global perspective (18:02)-Kidney failure in an aging population (23:07)-Controversies in nephrology and how they are being addressed (27:04)-End-of-life renal care and bereavement support (29:38)-The changing landscape of women in nephrology (33:12)-Brown's three wishes for the future of healthcare

On today's episode, meet Dr. Sanjay Popat. Dr. Popat has both a private and an NHS practice at The Royal Marsden. He is a Consultant Medical Oncologist at The Royal Marsden, Professor of Thoracic Oncology at the Institute of Cancer Research and is an internationally recognized expert in the treatment of lung cancer. Sanjay qualified from Guy's and St Thomas' Hospitals in 1994, completed general medical training at the Royal Brompton, and the Hammersmith Hospital, and medical oncology training at the Royal Marsden Hospital. He was awarded a PhD in Molecular Genetics in 2002. He's a strong advocate for patient education and support and is passionate about precision medicine.

Standing on the podium to give a presentation can be a daunting task. Sharing your knowledge and research with a room of strangers is often not easy. Virtual audiences, while perhaps less fear-inspiring, can be even harder to engage. Dr. Glastonbury shared tips on how to conceive and prepare your next presentation and then present so that you can connect with your audience, share your expertise, and enjoy the experience. Learning Objectives: Upon completion of this activity, participants were able to: Understand the elements of a presentation that make it meaningful and memorable for an audience. Recognize basic slide techniques that ease the cognitive load of your audience. Develop a clear process & also inspiration, for planning their next presentation. Presenter: Christine M. Glastonbury, MBBS, is a Professor of Radiology & Biomedical Imaging, Otolaryngology-Head & Neck Surgery, and Radiation Oncology at the University of California, San Francisco. Dr. Glastonbury is a Neuroradiologist with a particular academic and clinical interest Head & Neck (HN) Imaging, and specifically HN cancer. She works closely with the Radiation Oncologists and HN surgeons on a weekly basis to optimize the care of HN cancer patients at UCSF. She has written and published multiple books, more than 130 articles and received multiple awards for teaching, mentoring and for education exhibits at scientific meetings. Dr. Glastonbury completed her medical degree and Radiology training at the University of Adelaide and the Royal Adelaide Hospital in South Australia before completing a fellowship at the Hammersmith Hospital in London. She then completed two years of Neuroradiology Fellowship and a year of Body Fellowship at the University of Utah, Salt Lake City before moving to San Francisco in 2001. At UCSF Dr. Glastonbury is the Vice-Chair for Academic Affairs and served as interim Chief of Neuroradiology for nearly 4 years until August 2021. She is the director of Mentoring in Radiology, a member of the Radiology Diversity Committee, and a co-founder and strong advocate for UCSF Women in Radiology. Dr. Glastonbury serves on the Executive Council of the American Roentgen Ray Society and on the Executive Committee for the American Society of Head and Neck Radiology where she is also the Treasurer. She is the Program President for the Symposium Neuroradiologicum XXII of the World Federation of Neuroradiological Sciences in May 2022. Click here for webinar.

Nephrology/Urology: 2. Harry and Yvonne talk through the common causes of AKI as well as how to classify, investigate and treat it. aThis episode was vetted by Dr Peter Hill, Consultant Nephrologist and clinical lead for Interventional Nephrology at Hammersmith Hospital, London. Links: https://www.thinkkidneys.nhs.uk/

David Pinato (Imperial College London, Hammersmith Hospital, London, UK) discusses his Article on prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection.Read the full paper: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00573-8/fulltext

Derek Hockaday interviews Derek Jewell, Emeritus Professor of Gastroenterology, 14 Feb 2013. Topics discussed include: (00:00:00) coming to Pembroke College, Oxford, time as an undergraduate, including memories of Percy O'Brien; (00:02:27) year of studying animal physiology; (00:05:47) Oxford for clinical years; (00:07:40) entrance procedure to Oxford Medical School; (00:12:40) clinical years; (00:15:27) interest in the blood laboratories during senior house surgeon job; iron, vitamin b12 and Dphil in gastroenterology area; (00:18:46) John Badenoch and Sidney Truelove; (00:19:52) house jobs; (00:21:25) Oxford hospitals compared to Hammersmith Hospital; (00:23:36) Paul Beeson; (00:25:46) more on DPhil research; (00:28:09) senior registrar role, Radcliffe Travelling Fellowship to Stanford; (00:34:03) experience of working with inpatients; (00:37:37) work at the Royal Free Hospital, returning to Oxford; (00:40:46) Sidney Truelove, Oxford school and inflammatory bowel disease, editing the textbook of gastroenterology; (00:50:56) advances in gastroenterology; (00:54:58) interaction between gastroenterologists and surgeons; (00:58:54) pathogenesis of ulcerative colitis and Crohn's disease; (01:02:36) changes in treatment of Chrohn's disease; (01:07:57) Oxford compared to other places in relation to inflammatory bowel disease; 01:11.40 miniature sabbatical trips; 01:12:46 stopping general medicine; (01:17:57) National Health Service trajectory since the 1970s; (01:23:12) final thoughts. Note the following sections of audio are redacted: 00:45:05-00:45:19; 01:25:56-01:26:07; 01:26:28-01:26:39.

This week I'm speaking to Dr Gill Hart about food allergies and food intolerances, whom I consider to be the most informed scientist on food intolerance as well as an expert biochemist with over thirty years' experience in the development and validation of hospital standard diagnostic tests and testing services. She has had her finger on the pulse of food intolerance tests for decades, so if you have ever suspected certain foods don't suit you, do listen to this podcast. Gill completed her PhD in 1987 and started her career as Senior Biochemist at the Hammersmith Hospital in London. Gill joined the food intolerance lab YorkTest in 2005 as Scientific Director and has reviewed, designed and led many research studies delving into the world of how to testing for food intolerances. She is an expert in food intolerance testing, and also consumer health testing in general. She says that “it's an exciting time for food intolerance and home heath testing as more than ever before, people feel empowered to make a positive difference to their health and wellbeing and prevent future health issues”. Find out about allergies and intolerance here.

David Sellu (https://www.davidsellu.com) was a respected colorectal surgeon with a record of over 40 years of outstanding medical service. He saved countless lives over 4 decades of practice, but then one patient encounter changed his life forever when a patient died under his care in February 2010. He was investigated by the GMC and then tried at the Old Bailey, where he was charged and convicted of gross negligence manslaughter in 2013.Many of the complexities of the case were not adequately explained or explored to the jury, and he was convicted by a jury with a majority of 10-2. He was jailed in a maximum security prison at the age of 66 and served 15 months of a two-and-a-half year prison sentence. His conviction was later quashed on appeal after major failings were discovered regarding his first trial.His story is one that sent shockwaves throughout medicine and has implications for every doctor.This conversation uncovers his early years in Sierra Leone where he received no formal education and taught himself how to read and write, often studying under street-lamps for illumination. He went on to win a scholarship to Manchester Medical School, become a Senior Lecturer in Surgery at Hammersmith Hospital and a Consultant General and Colorectal Surgeon in Oman and London.It is a story that encompasses a stellar career, medical error and blame culture, injustice, the brutality of life in prison, the battle to overturn his conviction and clear his name, and the ongoing fight to make sure this never happens again.

In this episode we talk to Ralph Berry, the Delivery Network Manager for ‘Live Well Leeds' and Sha-aib-ali a junior doctor in Hammersmith Hospital about how we can all protect our mental health locked down in these dark months. We this episode is reassuring and provides you with some top tips for mental wellbeing. We are in this together. Samaritans Tel: 116 123 Text SHOUT to 85258. It is a free, confidential, and anonymous mental health text support service. For more information: https://giveusashout.org/ YoungMinds is a mental health support service for young people. Tel: 0808 802 5544. For more information: youngminds.org.uk Find us on Twitter: twitter.com/Left_Whingers Find us on Facebook: Left Whingers Podcast Email us: info@leftwhingers.co.uk Credit to Leyton for our brilliant theme music, you can find more of his work here: https://open.spotify.com/artist/5EoEk5ulYJgi3F56orFFWb?si=78tQvMSHTIWOStzMQET7uQ

The UK is in the midst of an unprecedented health crisis.

Vasovagal syncope might be a diagnosis on your list of differentials that seems relatively benign, as there are many more sinister causes for a sudden loss of consciousness. But no one wants a sudden loss of consciousness to happen in front of the whole staff of an operating theatre, or in front of all your peers in the dissection lab. In this episode of Sharp Scratch, we broke down some of the reasons why we might feel faint, strategies we can use to prevent faints, and why there’s no shame in being a frequent fainter - all with the help of expert guest Boon Lim, award winning consultant cardiologist based at Hammersmith Hospital, where he runs one of the busiest syncope service in London.

Joyce is Professor of Reproductive Science at the Institute for Women's Health, University College London. She has been a leader in the field of fertility, genetics and reproductive health since 1987. As well as being an established scientist with over 200 scientific publications, Joyce is a passionate educator of the public and students at all levels, from school children to PhD level. Joyce studied a BSc in Biochemistry, has a PhD in Pharmacology and started her career as a clinical embryologist at the London Fertility Centre. In 1992 she joined the much loved and respected “in vitro” pioneer Lord Robert Winston to work on preimplantation genetic diagnosis at the Hammersmith Hospital. She is the mother of three sons born through IVF and she shares her own journey with us. KEY TAKEAWAYS· Women are born with 1-2 million eggs but by puberty most have died!· Quantity and quality of eggs declines as we age – if you compare one from a 28 year old to 38 years old · Data is showing 20% of women in the UK of post-reproductive age are childless – some by choice but many more not. · Experiencing infertility is traumatic and that trauma stays with you· At 35 the chance of miscarriage and infertility drops dramatically · Prof Harper does not recommend a blood test for fertility/menopause · We discuss solo-motherhood · People stop fertility treatments because of emotional issues, rather than financial ones. BEST MOMENTS · EARLY thirties is the time to look to starting a family · The majority of miscarriages are due to chromosome abnormalities. · We look at who is most to blame if a couple is infertile and how long to leave it to get some help · Having an informed choice is the most important thing· Our ovaries haven't kept up with feminism · I never wanted to be an IVF patient· Very powerful messages for the midlife woman· Joyce was a bit of a lad! RESOURCEShttps://www.instagram.com/ProfJoyceHarper https://twitter.com/ProfJoyceHarper https://joyceharper.com www.globalwomenconnected.com click the image to pre-order Professor Harper's book These interviews are also available on APPLE PODCASTS Spotify and StitcherTheme music by Ray Duffy ABOUT THE HOSTDr. Gill Barham is an international award-winning author, speaker, speaker trainer, broadcast presenter, Elite Holistic Health Coach and advocate for self–care.Her Podcast “Radiant Menopause” is designed to debunk myths, inform and educate women, (and men) on what to expect of the transition into midlife. Her goal is to empower women to make the most of their “wisdom” years.Dr Gill Barham uses her experience and expertise to run UK and International Public Speaking and Wellbeing events and retreats.Dr. Gill studied music as her first degree before qualifying as a Registered General Nurse (RGN) in the UK. She has been studying functional medicine for the past 8 years and her transformational work has been recognised with a Doctorate Honoris Causa from the AUGP (Academy of Universal Global Peace) A Peace Award from the UPF (Universal Peace Federation) and she is a member of WAoFP (Worldwide Association of Female Professionals) Europe and the ATL (Association of Transformational Leaders) with which she became a No 1 best-selling co-author in the UK and USA of the book Transformation Lessons.Her humanitarian work currently involves running a domestic abuse awareness campaign called SPOT THE SIGNS - during lockdown and beyond. This is supported by her other podcast “The Life you Deserve” where she interviews experts and survivors highlighting ways in which we can recognise violence in the home and support potential victims.Connect with her here: www.radiantmenopause.com www.drgillbarham.comTwitter Facebook Linkedin InstagramKEY TAKEAWAYS

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by interventional cardiologist Dr Sukh Nijjer from Hammersmith Hospital, London. They discuss his paper in Heart concerned with the optimal management of ACS in the COVID-19 era. If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2 Link to published paper: https://heart.bmj.com/content/106/20/1609

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by interventional cardiologist Dr Sukh Nijjer from Hammersmith Hospital, London. They discuss his paper in Heart concerned with the optimal management of ACS in the COVID-19 era. If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2 Link to published paper: https://heart.bmj.com/content/106/20/1609

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Vishal Luther from Hammersmith Hospital, London. They discuss how cardiology can be taught effectively online and then move on to discussing the pros and cons of electrophysiology as a sub-speciality in cardiology. If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2 Links: http://webinar.cardiologists.london/ https://bjca.tv/video-gallery/ EP decoded book - https://www.amazon.co.uk/Decoding-Cardiac-Electrophysiology-Understanding-Techniques/dp/3030286711

Dr. Hayes interviews Dr. Trevor Powles his involvement with translational medicine in the UK and early bisphosphonate. Conflict of Interest: Dr. Powles has not reported any conflicts of interest to ASCO.   TRANSCRIPT The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Welcome to JCO's Cancer Stories-- The Art of Oncology brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the role of cancer care. You can find all the shows, including this one, at podcast.asco.org. Welcome to Cancer Stories. I'm Dr. Daniel Hayes. I'm a medical oncologist, and I'm a translational researcher at the University of Michigan Rogel Cancer Center in Ann Arbor. And I'm also the past president of the American Society of Clinical Oncology. Today I am privileged to be your host for a series of podcast interviews with the founders of our field-- today in particular Dr. Trevor Powles. Over the last 40 years, I've been fortunate to have been trained, mentored, and inspired by many of these pioneers. It's my hope that through these conversations all of us can be equally inspired by gaining an appreciation of the courage, the vision, and frankly the scientific understanding that these men and women who established the field of clinical cancer care over the last seven decades. By understanding how we got to the present and what we now consider, quote, "normal," end of quote. I hate using quotes, but in oncology I think we can also imagine our work together towards a better future for our patients and their families during and after cancer treatment. As I've noted today, I'm really honored to have as my guest on this podcast Professor Trevor Powles. He's really generally considered one of the true pioneers in breast oncology. Dr. Powles was raised in London, where he went to medical school. He trained in medicine and surgery at St. Bartholomew's Hospital and associated affiliates, graduating from medical school in 1964. He went on to obtain a PhD at the Institute of Cancer Research. He directed his thesis towards hypoglycemia and bone metastasis. Following his PhD, he then completed specialist training in medical oncology at the Royal Marsden and further pursued training in endocrinology with Professor Philip Bundy, [? who was ?] then Chief of endocrinology at Yale before moving to the UK. Dr. Powles remained at the Royal Marsden hospital during the bulk of his distinguished medical career, first as head of the Marsden breast cancer unit, and ultimately is the founding chairman of the Committee for Clinical Research for the entire Royal Marsden. After he retired-- which again requires [INAUDIBLE]-- at the age of 65, Doctor Powles has served on staff at the Cancer Center at London Parkside. Dr. Powles has authored hundreds of peer reviewed papers. He's mentor of many of the leaders in breast college around the world, which we will discuss in a second. And he's really won too many awards and honors from me to list here, but they include the coveted William McGuire Award presented annually at the San Antonio Breast Cancer Symposium-- and by the way, so have two of his mentees, Professors Mitch Dowsett and Ian Smith. And he's also won the Nancy Brinker Award. Many of you know Miss Brinker founded the Komen for the Cure Foundation. And perhaps what is perplexing to those of us in the colonies, in 2002 he and his twin brother Ray were named Commanders of the Most Excellent Order of the British Empire, or CBE for short-- which of course is one of the highest honors one can obtain in the UK-- for their work in breast in Trevor's case, and haematologic cancers in Ray's case. Trevor, I know that a lot of your work also was done with a variety of other contributors, including Dr. John Kanis, Dr. Eugene McCloskey, and of course Sandy Patterson [? period. ?] You've always been quite generous in pointing out that they had a lot to do with your own contributions, and we appreciate that as well. Dr. Powles, welcome to our program. Thank you very much, and thank you for those kind words. Yeah. Actually, I interviewed someone a few weeks ago, and he said, "Geez, that sounded like my mother wrote that." [LAUGHTER] I have a number of questions for you, and I want to start out-- your research and your background was really in endocrinology of the 1960s. And that was a particularly exciting time for endocrinology with the discovery of the hormones not more than 20 years before that, and then the increasing knowledge of understanding of [? the ?] peptides steroid hormone receptors. What made you veer off from that field into oncology in general and breast cancer specifically? When I was working at the Hammersmith Hospital doing my endocrinology [INAUDIBLE] endocrinology there. And one of the conditions we would be looking at would be hypercalcemia with hyperparathyroidism. And hypercalcemia was occurring very commonly in the breast cancer patients in the oncology and the radiotherapy department. [? And ?] to begin with, we thought this would just be another paraendocrine-type syndrome, and that was the thing that really fired my interest. From there, I then wanted to do my PhD to look more into what was causing the hypercalcemia with breast cancer, and that started the whole path of finding out about bone metastases, what they were doing, how they were causing the hypercalcemia, and the path just continued and continued. Most of your work-- I'm going to get to some of the other things you've done-- has been endocrine therapy, endocrine processes, and the bone metastasis, which is really endocrinology. In the United States about that time, most of the excitement in the 60s was around chemotherapy. Was it difficult for you to stick with the endocrine approach? No, it wasn't really. When I first started, all of in the endocrine treatment was ablative treatment. And I knew that from when I was doing my endocrinology is that the hypophysectomy, adrenalectomy, oophorectomy, those were the early days for chemotherapy at using combination chemotherapy and metastatic disease. [INAUDIBLE] and endocrine therapies were far better treatments from the chemotherapy. And although I was doing chemotherapy because we started with single agents then combination treatments-- and there was a lot of chemotherapy going on at that time at the milestone for haematological cancers, lymphoma, teratomas, et cetera-- I was able to do that, but I really focused on the endocrine side. And coming back to the hypercalcemia, the one thing that really impressed me was when I was originally doing my endocrinology was that rapid response you could get to the hypercalcemia by ablative endocrine therapy for oophorectomy, or adrenalectomy, or hypophysectomy. And that was really the thing that started all of the research I did in bone. It started on my PhD with in vitro work. We set up bone assays, I went to Cambridge to [INAUDIBLE] very famous scientist Cambridge to teach us how to do the bone assays for in vitro bone assays. We also set up the animal model with breast cancer. We were able to show that breast cancers could cause bone breakdown and osteolysis in vitro. We could find that we could block that by using drugs like aspirin, and that got us very interested in cross [? demandings. ?] We could then go into the animal experiments. And when we had a rat model using breast cancer that we knew from our assays caused bone breakdown in vitro, and when we did that in the animals by injecting into the aorta we could get bone metastases [? and ?] soft tissue tumor. When we gave aspirin, we could completely prevent the bone metastases-- quite dramatic experiments. And that was what really fired me into getting into the oncology, getting into the endocrine treatment in oncology because of my background in endocrinology. And that has stayed ever since. So what was the timing there? This is the late 60s? My PhD was 1970 to '73. I was at the Hammersmith from '67 to '69, and then I went to [? Barts ?] to endocrinology, and then I came back and then with Bondy in the Marsden, and then I got on the staff of the Marsden as a senior lecturer in 1975. So what you just described to me sounds like translational science. That word wasn't coined until probably 20 years later. Was it unique where you were to be taking things from the lab straight out to the clinic? And where there obstacles to doing that? No, there weren't. The thing that was good about that was we were doing the laboratory work based on what we'd seen, what I'd seen in the endocrinology with the hypercalcemia and the bone metastases, and responding to endocrine therapy. I then was in the PhD, doing the PhD, and then I was able to translate that into the clinic once I then became a consultant. So the main work I was doing when I was first a consultant, the research work, was actually looking at hypercalcemia bone metastases in patients. We had a surprise because when we took the aspirin into patients, we could see no effect at all even though we'd had very dramatic effects in vitro and in vivo. And it was only when the bisphosphonates came through that we were able to then use those, because at this stage we knew it was working on osteoclasts. And it was only when we started to get the bisphosphonates that we really got into the dimension of first of all, being able to treat the hypercalcemia, then being able to switch off the bone metastases, bone pain, and bone fractures with bisphosphonates. And then take it into the adjuvant, I was then able to take it into the adjuvant scene and set up the first adjuvant bisphosphonate trial. So I'd gone right from in vitro, I continued the path right the way through to clinical work. And then what happened was that if we did the bisphosphonate trial and we got the result of just like that had happened in the rats-- it stopped the development of bone metastases and it stopped the hypercalcemia in the rats, but didn't affect the soft tissue. So in the humans, we had exactly the same result where we were able to reduce bone metastases, not have an impact on soft tissue or other disease, and improve mortality. And so we've gone right the way through. It's a story that's extraordinary from my point of view, because I was able to follow the whole path all the way through. And you're absolutely right. That is a really good example of translational research where you hang in there until you get the answer. What's the history behind transferring the bisphosphonates from prevention of osteoporosis in cancer? Now they're widely used as well as denosumab. In fact, it's malpractice not to use them in a patient with bone metastasis. How did you make that leap where you're standing next to somebody who was treating osteoporosis, and you said, "I wonder if that should work?" And how did you get hold of the drug? There's got to be a history behind it. Well, we were looking. We were looking for [? anti-osteodiscitis ?] agents [INAUDIBLE] the aspirin didn't work but [INAUDIBLE] worked so we knew for no reasons at all that it would prevent, stop hypercalcemia. And so we were going down that path, and two really important people in the way the path was going. One was Herbie Fleisch, and Herbie Fleisch [? had ?] suddenly produced bisphosphonates. It was a terrific story if anybody was interested in bone, because it was an agent that clearly was working on osteoclasts, and that was the target we were after. We knew at that stage that the cancer cells had to activate osteoclasts in order to cause the bone breakdown and develop in bone. And the second person who was key was Craig Mundie, who again I met. And I went over to the Boston Dental Hospital several times, and I met Craig and the others there, and that was linking up with being able to see the story that they were developing where tumor cells were activating osteoclasts that were then causing bone breakdown that was then producing growth factors to activate the cancer. So it became a really preferential site for bone metastases to develop because of the interaction between the cancer cells and the osteoclasts. So then there's Herbie Fleisch in Switzerland. I had a few skis with him. He was a very good skiier. But the spin off was that bisphosphonates were going to be the thing that we really [INAUDIBLE] to be looking at. And then we tried four different bisphosphonates. Five foot was a guy in Amsterdam who had APD that was actually the forerunner for [INAUDIBLE]. And the one that worked best for us was clodronate, which we got originally from Finland. And we set up the bone trials. We had to go through three stages. We had to-- first of all, before we could use adjuvant, we had to show that it worked in metastatic bone disease. And it did. It reduced what's called skeletal related events-- that's fracture, hypercalcemia, pain-- requirements of radiotherapy. We then did a trial for phase 3 trial of using clodronate for patients who had metastatic disease but who didn't have bone metastases. And we could reduce the risk of them getting bone metastases. And then we had the justification for doing the-- So let me interrupt you for a minute. Now you're about 1983 or '4 I think when that was probably? Is that right? It was-- yes, it would be. With the adjuvant trial, we would have started in '86. I think. That's the window of time. And then in that trial, we didn't get the results from that until I think it was 1997 when we did the first analysis, and that we were able to then show in that randomized-- it was placebo controlled as well-- we were able to show a reduction in bone metastases and improved survival. And then we did a subsequent analysis in 2006. So we've got longer term data. Back then where other bisphosphonate trials were going on, adjuvant bisphosphonate trails going on, and then we had the meta analysis in 2015, Oxford meta analysis, which I was involved with Rob Coleman. And we did the analysis there, which confirmed that we could reduce bone metastases and improve survival with adjuvant bisphosphonates. So the story that starts from a test tube, so to speak. Oh, there's one other very interesting experiment we [INAUDIBLE] that's never been repeated. Right at the beginning, we were able to show that doing co-cultures-- you're reminding me of things now-- doing co-cultures of the bone assay with human breast tumors I'd get from the Marsden while I was at the institute. We'd have fresh human tumors, and we would do a co-culture and some of them could cause the complete breakdown of the bone assay, and others would not have osteoporosis. And we did a follow up of those patients-- it was only about 30 patients, I think-- and we did a follow up of those patients, and those who had the most bone breakdown in vitro [? with ?] [? those ?] patients who were then going to get the bone metastases. That was a real incentive to show that link that we were getting. So we knew something was going on there. And that experiment was going on in 1971. And in 2015 with the meta analysis of bone mets and mortality. So that's a long story. That's the story. Let me say that this entire story reiterates the phrase that, "On the shoulders of giants we all stand." You look at the number of people you've laid out who led to this story, which is still ongoing. It's actually fascinating. I want to return just a minute to your work with endocrine therapy of breast cancer and your work with tamoxifen. But first of all, a lot of young people listen to this. 'Cause I came in the field just as surgical ablation of many of the origins of estrogen was going away. Can you talk about what it was like to take care of the patients who were having hypophysectomies and adrenalectomies and oopherectomies? I recall thinking, "I'm an endocrinologist here. I'm not a medical oncologist," as a first year fellow taking care of Addison's disease and other things. There are two things about ablative endocrine therapy. The first was that the responses could be very dramatic, and it was quite a high response rate. There was something [INAUDIBLE]-- don't forget we weren't basing it on ER. ER came later, and then [INAUDIBLE]. Even not based on ER, we were getting 30% to 40% response rates, particularly in bone. The second thing is the management of the patients. The hypophysectomies were relatively easy, because I'd already got experience of patients who got pituitary failure from my endocrinology, and that's much it easier to manage. But the adrenalectomies are much more difficult because you can get very acute glucocorticoid symptoms if you're not getting cortisol, whereas in hypophysectomies it's a relatively slow process. And they were much more difficult to look after. But the thing that was important about it was the fact that although we were doing it, these patients were getting hypercalcemia [INAUDIBLE]. You could have a patient who was hypercalcemia, you do ablative surgery, within 48 hours the calcium is back to normal. In fact, it will go hypoglycemic sometimes on bone hungry [INAUDIBLE] thing. And from a clinical point of view, it was some of the best responses we ever saw even up to this time. Now one of the things that came out of that was that we had one patient-- I can say a name because he's long since dead and [INAUDIBLE] anyway-- her name was Mrs. Pottinger. It's engraved in my mind forever. And she had bone metastases, and she was not particularly well and also had some heart problem. And she was due to have adrenalectomy, and she wasn't well enough for adrenalectomy. And so what I did is I'd used [INAUDIBLE] when I was at the Hammersmith as part of treating Cushing's disease. And so I'd already knew about medical treatment for-- so I then decided that we would do-- and I think it must have been the first patient. I had to get permission from [INAUDIBLE], and I still got the letter I wrote to the medical director of [INAUDIBLE] then saying could we use [INAUDIBLE]. So what we do is the basis was in order to get her well enough to have her adrenalectomy, and she did exactly the same as she would have done if we'd done adrenalectomy. Within 24 to 48 hours, she's getting better, the pain's going, the calcium's down. So she then refused to have an adrenalectomy. There's no way she is going to have it. She said, "No I'll continue with the [INAUDIBLE]." And she continued on [INAUDIBLE] for over a year before she died. And that started a whole new thing. [? Ian ?] [? Smith ?] was my registrar at the time. And so we decided we'd do a phase 2 trial. We did a Phase 2 trial of [INAUDIBLE] on the understanding we were doing a medical adrenalectomy. And that started the whole story that we were doing using [INAUDIBLE], because a [INAUDIBLE] came over, I had various other people come, and what we found was the story was. It wasn't the medical adrenalectomy by blocking postmenopausal estrogen. And then we went down the pathway of doing various, about three or four different aromatase inhibitors with Mitch doing all of endocrinology. It's a wonderful time. We had Adrian Harris, Charlie [INAUDIBLE]-- [COUGHING]. [INAUDIBLE]. [INTERPOSING VOICES] That's a parade of stars. Were you talking across the Atlantic a lot during that time with Dick [? Stanton, ?] and Angela Brody, and the other two who were also-- Yes. Angela Brody was the one who got us a source for [INAUDIBLE]. That was the phase 2. Charlie led on that on the phase 2. That was Angela getting us to do that and linked him with Mitch. And Dick Stanton, yes it was a lot of collaborative work with Donald MacDonald. And a lot of the endocrinologists I knew. So that was how that whole story rolled. That's an amazing library. Let me take you back now to your childhood. I know you and your identical twin, Ray-- by the way for the listeners, if you Google either Trevor or Ray Powles, you'll see pictures of the two of them standing together. And I challenge you to tell who's who. [LAUGHTER] Anyway-- Well I could. I could tell the difference. Yeah I know you can tell the difference. I know that you were both young boys in London during World War II. Tell me about the experience then, and how your mother moved you. Obviously, we were very young. My father was in the Navy abroad, so my mother was alone and was looking after my older brother David, who was four or five years older than us. And I can remember the bombing. I can remember quite a lot about it, surprisingly. We were evacuated up into the north of England 1943, 1944, something like that. And we were there for I think something like six months. And it was an incredible story. I went back to see-- I hadn't been back-- I went back to see-- I was up in the north of England, and I suddenly thought I'll go over. We were at a place called Stockton. And so I was five when we left-- four, four years old when we left. And I had no idea. I knew it was Stockton, and I knew the name of the house was the Priory, and I had a faint recollection of the door. And then I went up to Stockton, and I found the house we were in. And I knocked on the door, and it was a major-- a colonel-- Colonel Brown and his sister who lived there. And the sister was still alive, and she must have been about 90. [INAUDIBLE]. And she looked at me and she said, "You're one of the twins." [LAUGHTER] So we had a chat. [INTERPOSING VOICES] At the time, did you think of this as being frightening, or was it just a great adventure for a young boy? Yeah, I wasn't unaware of danger. My house was bombed down the road flattened and presumably a lot of people died, but I was unaware of danger as such. We had a shelter-- it's something called a [INAUDIBLE] shelter, I think it was called-- that was half buried with corrugated iron as the top thing. And if the siren went, I can remember that we would have to go out and get into the shelter. And we could hear the V-1s very, very-- I can still remember. You can hear the V-1s coming over. It made a hum-- [HUMMING] --like that. And it's gradually getting louder and louder, and then it would stop, and then it would just fall out of the sky at an angle. It would go down at about 45 degrees. So if you could hear the [? stop ?] overhead, you weren't going to be hit. But if you could hear the [? stop ?] coming towards you, there was a chance you were going to get hit. I can remember that. Everybody was sitting listening to where these bombs were cutting out their engine. So that's one of the things I can remember. And I can remember the V-2. It was a huge bang if one went off. I know that you and Ray both also developed tuberculosis as young boys. What was the background behind that, and how were you treated? Yeah, Ray-- we'd just finished school. And we weren't sure what we were going to do, and Ray had developed [INAUDIBLE], which again didn't mean anything to me. He coughed up a couple of times or [INAUDIBLE] of blood. And the next thing he's carted off and he's got tuberculosis, and he's been taken down to a sanatorium down near the Thames out along the marshes sort of thing. And he's there for six months. And during that six months, I can't see him and everything, and I thought, "Well, you know I'd like to do medicine. I think this is rather a good thing." So what I did, I then applied for medical school and got a place. And then Ray gets better, and he then applies to medical school, and he gets a place as well. The dean said to Ray when he saw it, he said, "Haven't we seen you here before?" And Ray said, "No, it's my twin brother." And he then says, "Did we accept him?" And Ray said, "Yes." And then he said, "Pity." [LAUGHTER] And it was the end of the interview. The next thing, he's in as well. [LAUGHTER] And then I get TB, because it's about an 80% chance you get it if an identical twin's had it. And I was in the hospital for three months. So we were both back a year. I would have been a year ahead of Ray, but in fact then suddenly we're both back a year. And it was quite an interesting year for me, because I only had one subject to do. So I was able to do some reading, things like Darwin and that sort of stuff. And then we just carried on. And you were treated with streptomycin in those days? [INAUDIBLE]. You had 50 grams of strep. Yeah, yeah. Sounds like you used that as a springboard to change the practice of medicine. So in every cloud there's a silver lining. The one thing I want to bring up-- I remember several years ago at one of the San Antonio meetings, and you and Dr. [? Bernie ?] Fisher were the bait. And he did all but call for you to be arrested and locked up because your study was negative, and of course the [? PL1 ?] one was positive. And you very graciously responded to that, "You know, Dr. Fisher, I didn't start this trial up to be negative." [LAUGHTER] That was a great response. My goodness did I not admire him. The reason I did the trial is-- again, this is a funny story. I did a lot of horse riding, as you know. And what I did is after the 1985 first meta analysis, Oxford meta analysis, that was the first one to show that chemotherapy worked for the [INAUDIBLE] and other trials that chemotherapies show the reduction. And it showed that tamoxifen worked. That was the first meeting where I was really convinced that both those were positive effects. Up till then, it was one trial and you couldn't be sure if it was going to be reproduced all the like. And that was the 1985 meta analysis meeting in Oxford. And then I came back home, and I got on my horse, and I rode for a week. I took the horse down to the South Downs. The South Downs is a long, expansive country, and it took me five days, I think it was, of riding to get across from one side to the other where I'd stop in a pub. I had to go down the week before and plan out exactly what I was going to do. So I've got five days on a horseback thinking, and that was where I thought, "Well, where do we go from here?" You might say, well, let's do bigger and better chemo or the like, right? And you might say endocrine therapy, let's do more tamoxifen, or different doses, or [INAUDIBLE] down those paths. So I said, "But if you really want to do something different, the two things you could do would be for chemotherapy is why not give it before surgery?" That was the time when I really thought neoadjuvant chemotherapy was where we ought to be going, because then we could see that they're responding or not et cetera. But tamoxifen, if it weren't for adjuvant therapy, then it should work for prevention. We had a clinic at the Marsden that I took over because somebody was leaving-- which was a family history clinic, and they all had very strong family histories three or four relatives, et cetera, et cetera. And I took over this clinic, and I thought to myself we could do a prevention trial here with tamoxifen. We'll do a pilot. What happened at the Marsden they just had a ethics committee set up, one of the first in the world. This is in 1985. And it had never met, it had only passed the trials to be done. And so the first meeting of the ethics committee at the Marsden was to discuss the prevention, because it was such a awful thing to do. Do you know what I mean? And but after two or three goes, I got it through the ethics committee mainly because a colleague of mine who was the head of medicine then was Tim McIlwain. He pushed it through because he said "Look, it makes so much sense." And we did a [INAUDIBLE] and we had an agreement that we could do 250 patients randomized, then go to 500. And then we had a national meeting to discuss setting up the national program. And so it was a feasibility trial actually looking to see what the toxicity was or whether it was acceptable to do it. And we had such a spin off from that, because tamoxifen at that stage was supposed to be a pure anti estrogen. And we were screening all the tissues, we were doing bones that [INAUDIBLE] from the clotting factors. Everything. Cholesterol. We were doing, measuring everything in pre and post menopausal women. And everywhere we looked, tamoxifen wasn't acting as an anti estrogen. It was acting as an estrogen effect, so much so that at the Think Tank-- I presented it at the Think Tank, and I said, "Look these aren't [INAUDIBLE] tamoxifen and anti estrogen at all." And I thought Mark, dear old Mark Lippert, was going to have an epilepsy, which 'cause it's correct because it is an anti estrogen breast cancer effect. But that was the first time. So then in the paper I wrote, I called it a selective anti estrogen. But I didn't coin [INAUDIBLE], but I did coin the expression, the first published thing of a selective anti estrogen. I remember that paper. [INAUDIBLE]. I remember that. So I want to finish up with just-- Let me just finish up one thing. Can I just finish up one thing? [INTERPOSING VOICES] Because it links into [INAUDIBLE]. So after Think Tank presented it possibly as an estrogen. And what was happening is we've got a bell shaped curve that was very narrow. So we were on the estrogen side as opposed to the anti estrogen side, right? And that was what was happening in the normal tissues. So I had a slides that said, "Tamoxifen is not an anti estrogen." You probably remember if you were there. You were there. We go out on the boat, and we get stranded out of the boat in the mist-- the one you've mentioned about where you and I and Mark, et cetera-- when we're approaching the time after about four hours when we're thinking about meeting our maker, Mark says to me, "I've really got to have a word with you about this anti estrogen." Well one other thing-- and this is going to be more my talking than yours. I really just touched on the surface of your contributions to the field, but I think probably the greatest is your mentoring history. And you've already hit on a few of these, but I travel extensively and I'm struck by the number of times I've been in some remote area-- or at least remote to me-- and corner of the world, and somebody-- it's usually my host-- volunteers that he or she trained at the Royal Marsden with Trevor Powles. And I think it's one of the things you should be most proud of all the many things you've done. And I want to know that you set up a system that was opening and inviting and also somehow funded to support people to come from all over the world. What made you do that? How did you do that in the first place? It's hard to do. Certain people came to me, which was very nice. We did have funds. I would be able to get funding even at that stage. There are many more hurdles for getting funding now than there were then. And the other thing about it was the fact that I find that people-- many times we've [INAUDIBLE] [? mentioning ?] things-- but one of the things I really did [? let ?] is let people have the run of doing things as opposed to me doing it maybe with the assistant. And that was very rewarding for me in terms of results and [INAUDIBLE], 'cause people were very motivated to do it, people like you, and Charlie, and the others. So in some senses, I think it was the fact I was looking for the results we wanted to get rather than anything else. That's probably the basis of it, and therefore people came who ere good. And I'm very lucky I had very, very good people come. So just to go through the list briefly-- Ian Smith, Mitch Dowsett, Troy [? Kohns, ?] Adrian Harris, Paul Goss, who am I leaving out? Anyway, it's a who's who of breast cancer, especially endocrinology and breast cancer. And they all came out of your brilliance. So we owe you not just for what you've done, but who you've trained to do even more. Very kind of you to say that, but in fact they get the credit because if you look through my publication lists you can see.     Actually, I left out Steven Johnston, of course, who is-- Steve. Yeah, Steve. Yeah. OK, we've run out of time. I very much appreciate the fact that you've taken time to come on and do that for us. I'm sure our listeners will be thrilled by the stories you've told-- at least I always am-- and it's great to hear most of them again. And I hope sometime we can even do this again. So thank you for all you've done, thank you for all the people you've trained, and thank you for taking time to do this today. Well, thank you so much for asking me.   Until next time, thank you for listening to this JCO's Cancer Story-- The Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or review on Apple Podcasts or wherever you listen. While you're there, be sure to subscribe so you never miss an episode. JCO's Cancer Stories-- The Art of Oncology podcast is just one of ASCO's many podcasts. You can find all the shows at podcast.asco.org.

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Zachary Whinnett from The Hammersmith Hospital in London. They discuss the His bundle pacing and the HOPE HF study. If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2 Link to published paper: https://heart.bmj.com/content/105/2/137

Wendy Gin-Sing RN, MSc, MRes, is an advanced nurse practitioner with the Pulmonary Hypertension Service at the Hammersmith Hospital in London. In this episode, she discusses the first ever PAH Patient Charter that was launched on November 12, 2019 to coincide with PH Awareness Month. The Charter was facilitated and sponsored by Actelion, a Janssen Pharmaceutical Company of Johnson & Johnson and a PAH-expert Steering Committee made up of patients, patient advocates and healthcare professionals. #PAHPatientCharter #phawarenessmonth  Read the PAH Patient Charter here: bit.ly/36K0Hoz My name's Wendy Gin-Sing. I'm a Pulmonary Hypertension Nurse Specialist. I work at the Hammersmith Hospital in London. I've been looking after pulmonary hypertension patients for about 24 years, and the last 20 years as a Nurse Specialist. I've seen quite a few changes over the time. Today, I want to talk to you about the new PAH Patient Charter that's just been released. But first, let me give you a brief explanation about what pulmonary hypertension is. To understand pulmonary hypertension, you need to know what the normal circulation in the body is. You have two circulations, one which pumps blood all the way around the body, and that's the blood pressure that can be measured on your arm. And then there's a second circulation where the heart pumps the blood through the lungs so that it picks up oxygen ready to start off again. In pulmonary hypertension, the pressure in the blood vessels in the lungs goes up. Normally, this is just very low pressure, because you don't need the blood to go very far. It just goes from one side of the heart to the other by the lungs, and the oxygen moves over from the lungs into the blood vessels at low pressure. In pulmonary hypertension, blood vessels in the lungs change. The walls become thicker. They become less elastic, and the pressure goes up in the blood vessels. This then places more demand on the right side of the heart, which, over time, becomes tired and can sometimes fail. The PAH Patient Charter came about through Actelion, a Janssen Pharmaceutical Company of Johnson & Johnson. They got a group of us together: patients, patient associations, doctors, nurses. We sat down together and discussed about what we felt was really important when looking after patients with pulmonary hypertension. Both from the medical side and the patient side. We came together and we agreed on many points, and have produced the Charter. This Charter is going to be important for patients, caregivers, and clinicians looking after pulmonary hypertension. It sets out what patients with pulmonary hypertension should expect. Some of the very simple things like an earlier and accurate diagnosis, being involved in decision making, access to the therapies that are available in their country, and also, and probably the most important, the holistic care for patients so that they can actually live life well and have a better quality of life. When this is released, I think patients can use it in a variety of ways to speak to their health care professionals, and to try and ensure that they are getting the standard of care that's set out in the Charter, but also to be able to use it for lobbying politically and through the health care organizations in the countries they're in to improve the care of all patients with pulmonary hypertension. In the UK, we're very lucky that we have designated centers and access to all the pulmonary hypertension medications. But I am aware that there's many places in the world that don't have specialist centers. They have health care that they can't access all the drugs. For some patients, it takes a very long time to get a diagnosis. The optimal patient journey really starts in the very beginning, getting an early and accurate diagnosis. It still takes around two years in countries with developed health care to achieve a diagnosis of pulmonary hypertension. Whilst the first year, maybe, patients perhaps [are] not seeking medical attention, they have often seen four or five different physicians over the next year before they get an accurate diagnosis. Once patients have their diagnosis, they should have access to all available pulmonary hypertension therapies within their country. They should also have their care from a most disciplinary team so that they can look after their holistic needs. Not only their physical needs, such as rehabilitation and doing more exercise and managing their symptoms, but also the psychological care that patients, and not only patients, but their carers as well really need as they're going through the journey with pulmonary hypertension. For some patients who pulmonary hypertension therapy doesn't control all their symptoms, they need supportive care to help manage those symptoms. As the disease progresses, they should then have input from the palliative care teams, so that they have a really good quality of life throughout their pulmonary hypertension journey. I was honored to be asked to take part in the Patient Charter group. It was really good to meet up with patients, physicians, patients, advocacy groups from around the world: PHA Europe, PHA (US), phaware global association®, the PH Association for Latin America, Singapore, Greece, and Germany. It was really important that advocacy groups were involved in the PAH Patient Charter. As health care professionals, we see pulmonary hypertension very much from our point of view, and the associations have many members, all of which who live with the disease or care for somebody who does. It's so important to get their views so that this PAH Patient Charter is really a whole global initiative. The PAH Patient Charter is really important, because it will help patients be more empowered so that they can be part of making the decisions about their care. Not only because they're better educated, but also they have more confidence in being able to talk to you, [the health care professionals,] but making decisions about the care that really affects them. Pulmonary hypertension can affect anybody, from little children up to people who are very old. It affects people in every country, and that's why it's important to have a global PAH Patient Charter that we use to improve quality and quantity of life with patients with pulmonary hypertension. We're excited that the PAH Patient Charter's been launched during Pulmonary Hypertension Awareness Month. To learn more, search the hashtag #PAHPatientCharter. My name's Wendy Gin-Sing, and I'm aware that I'm rare. Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Never miss an episode with the phaware® podcast app. Follow us @phaware on Facebook, Twitter, Instagram, YouTube & Linkedin Engage for a cure: www.phaware.global/donate #phaware #ClinicalTrials #phawareMD  @actelion_com @EuropePHA @PHAssociation @wginsing @PhDeutschland @LatinosConHP @Hellenic_PH @phsingapore

Wendy Gin-Sing RN, MSc, MRes, is an advanced nurse practitioner with the Pulmonary Hypertension Service at the Hammersmith Hospital in London. In this episode, she discusses the first ever PAH Patient Charter that was launched on November 12, 2019 to coincide with PH Awareness Month. The Charter was facilitated and sponsored by Actelion, a Janssen Pharmaceutical Company of Johnson & Johnson and a PAH-expert Steering Committee made up of patients, patient advocates and healthcare professionals. #PAHPatientCharter #phawarenessmonth  Learn more about pulmonary hypertension trials at www.phaware.global/clinicaltrials. Never miss an episode with the phaware® podcast app. Follow us @phaware on Facebook, Twitter, Instagram, YouTube & Linkedin Engage for a cure: www.phaware.global/donate #phaware #ClinicalTrials #phawareMD  @actelion_com @EuropePHA @PHAssociation @wginsing @PhDeutschland @LatinosConHP @Hellenic_PH @phsingapore

This episode features Ken Spearpoint. Ken is Consultant Nurse, Resuscitation, Hammersmith Hospital & Principal Lecturer, Medical Simulation, University of Hertfordshire. Ken is very experienced in the area of resuscitation, having been working in this field since the 1990’s. He has seen the service develop a lot in that time and that is discussed in the podcast. […] The post CCP Podcast 005 : Chat with Ken Spearpoint. appeared first on Critical Care Practitioner.

Episode 3 of ‘Open Your Palm, Feel the Dust Settling There’ - a new three-part audio work by artist and Savage Messiah author Laura Grace Ford, generated by psychogeographic walks – drifts – through the Latimer Road, Hammersmith and White City areas of West London. Ford lives in a social housing block where concerns persist about the safety of cladding. Post-Grenfell, narratives were imposed and voices were excluded. Drifts through living rooms, abandoned buildings, and back rooms of pubs allow stories to proliferate from a network of hidden interiors; walking becomes a political strategy, a way of engaging with the collective intensities held in the fabric of a place. From this process of tuning into these collective channels, Grenfell Tower emerges as a dominant thread in the spatial narratives uncovered on these walks. This series is a mapping of the repercussions and tremors radiating from this moment; most audible in the nomadic and transient zones, Wormwood Scrubs, Hammersmith Hospital, the spaces underneath the Westway. Laura will present a live audio visual performance of the work on 27 June at Somerset House Studios.  https://www.somersethouse.org.uk/whats-on/open-your-palm-feel-dust-settling-there

People with a brain age older than their bodies could be at greater risk of dying early, according to a recent study. Dr. James Cole, a neuroscientist at Imperial College London, led a research project using MRI scans and a computer program to predict a person’s brain age. The system, which is still in development, could help spot people whose lifestyles put them at greater risk of poor health and early death. LLAMA host Peter Bowes visited Hammersmith Hospital in London for this in-depth interview with Dr. Cole, who explains how data for the study was collected and how the findings could be used to help people live longer lives. He also discusses what some people call “the mosaic of aging”, the idea that different tissues and systems in the body can age at a different pace.

I think that this is Thameside's first stereo test transmission. While the show is  still mono  the opening and closing "do you ever have difficulty" jingles are remixed and in stereo. I wonder how they did that? Paul James has a brand new Beatles spot. It's very hot in the studio and he assures us that Sarah is reading the dedications with her clothes off. (In our dreams!) Sarah mentions (amongst others) Thameside listeners at Hammersmith Hospital, Windy Miller, snoopy, cupcake, the copycats club, Robin Holbert. As well as more ILR outtakes Dave has CB dedications for Red Rooster, Blue Wheeler and Orange Club in the Rayners Lane area. He also talks about Steve Walsh from Radio Invicta (another fine London pirate) who is advertising Svenson hair weaving in the local press.

Host: Jason Birnholz, MD This program features Dr. David Cosgrove, professor of clinical ultrasound, Imperial College School of Medicine, and honorary consultant in radiology at the Hammersmith Hospital in London. He is an expert in ultrasound, known around the world, and is the author of numerous publications. He speaks with host Dr. Jason Birnholz about a new form of ultrasound imaging— elastography, or sheer wave imaging — for detecting breast cancer. Next, Dr. Birhnolz sits down with Dr. Michelle Brown, associate professor of radiology at the University of California, San Diego. She is presenting research on detection of placenta accreta using MRI. The incidence of placenta accreta has increased ten-fold since 1950, as the incidence of the primary risk factor, cesarian section, has also increased. These interviews were recorded at the Radiological Society of North America's 95th Scientific Assembly and Annual Meeting, which took place November 29th through December 4th in Chicago.

Prof Giuseppe Saglio of the University of Turin and San Luigi Gonzaga Hospital in Italy on nilotinib as a new standard of care for chronic myeloid leukaemia. ASH President Nancy Berliner of Brigham & Women's Hospital adds her thoughts. Jorge Cortes of M. D. Anderson Cancer Center on three different ASH papers by his group looking at alternatives to standard imatinib in CML. Jane Apperley of Hammersmith Hospital and Imperial College London, reflects on these, and discusses strategies for dealing with imatinib resistance. OT Broadcast News Scientific Editor George Canellos of Dana-Farber Cancer Institute on what some were jokingly calling a re-run of World War II that took place in the Non-Hodgkin’s Lymphoma session: R-CHOP 14 vs R-CHOP 21 in elderly patients with diffuse large B-cell lymphoma. Andrzej Jakubowiak of the University of Michigan discusses a 4-drug regimen to treat newly diagnosed multiple myeloma....Ruben Niesvizky of Weill Cornell Medical College in New York City on the novel proteasome inhibitor carfilzomib, used in combination with lenalidomide and dexamethasone to treat relapsed or refractory multiple myeloma. OT interviewers: Peter Goodwin and Sarah Maxwell.

On Desert Island Discs today the castaway is Robert Winston. As Professor of Fertility Studies at Hammersmith Hospital in London, he has been at the forefront of medical developments in his field. He pioneered the screening of embryos for genetic defects and has frequently made the headlines with his views that all women, including widows, lesbians and those who are HIV positive, should be considered for treatment. [Taken from the original programme material for this archive edition of Desert Island Discs] Favourite track: Goldberg Varations - Aria And Reprise From Variation by Johann Sebastian Bach Book: The Koran (in Arabic and English) Luxury: Glass And Tools To Make A Telescope

On Desert Island Discs today the castaway is Robert Winston.As Professor of Fertility Studies at Hammersmith Hospital in London, he has been at the forefront of medical developments in his field. He pioneered the screening of embryos for genetic defects and has frequently made the headlines with his views that all women, including widows, lesbians and those who are HIV positive, should be considered for treatment. [Taken from the original programme material for this archive edition of Desert Island Discs] Favourite track: Goldberg Varations - Aria And Reprise From Variation by Johann Sebastian Bach Book: The Koran (in Arabic and English) Luxury: Glass And Tools To Make A Telescope