A recent study we funded sparked headlines on how a new imaging approach could help guide radiotherapy treatment. Aside from the fascinating science, there was another interesting story behind these headlines: how the role of the clinician scientist brings life in the lab together with practicing hospital medicine. Here, Dr James O’Connor, from The University of Manchester and The Christie Hospital, describes what it means to be a clinician scientist, and how important the role is for making sure new treatments and technology reach the clinic as soon as possible.
“So what exactly do you do?” That’s a question I get asked a lot. Colleagues at work, as well as family and friends, all want to know what a clinician scientist actually is.
In short, my job is a mixture of being a researcher and being a medic. And the two parts of the job go hand in hand.
I spend most of my time in the lab as a researcher, developing new ways of imaging cancer.
But one day a week I work as a consultant radiologist at The Christie NHS Foundation Trust in Manchester. As a doctor, I use my experience and judgement to diagnose cancer, see where it has spread to and decide if tumours are responding to therapy. And keeping an eye on both these areas is really important.
Being a medic helps me to identify limitations in the scans used to diagnose and monitor patients with cancer. Being a scientist lets me take those limitations and develop and test new ideas in my lab that could solve these problems.
And if we find something that could work then, I’m in the perfect position to help make sure these new approaches can be tested in the clinic and potentially benefit patients quickly.
One great thing about being a clinician scientist is variety – no two days are ever the same. Some days are spent in the lab; others in meetings; others writing funding proposals or turning data into papers.
In some ways it is a bit like being self-employed.
Although I have several staff funded by my grants, I need to attract more funding to build a cutting-edge research group. So I am always looking out for new ideas, new studies and new collaborators.
This aspect is really different from clinical work. Thinking outside the box is crucial.
It’s never nine to five, but I like that! I organise my day to fit in around home life. This is busy – we have four young children – but it can work well. I (nearly) never miss school assemblies or plays. I often do the school run. But it does mean that evenings and weekends are often filled by working from home.
Making a difference
The scans and technology used to diagnose cancer can seem a bit removed from having contact with patients. And when you’re looking at new versions of this technology in the lab it can seem even more distant.
But I’ve had some wonderful encounters with patients during my research. They have generously given their time to take part in my studies, which has not only shaped my research, but has also given me a crucial understanding of what it’s like to live with cancer.
And that’s why we do the work that we do.
The Christie is one of the largest single centre cancer sites in Europe. Every year, around 2,000 of our patients take part in trials of new therapies. These drugs may alter how a tumour behaves, but not necessarily shrink it. Sometimes it can be difficult to work out why that’s happening and this is where my research comes in.
Current scanning methods often can’t match the best treatment for each individual, or detect which patients are responding to a new therapy. My research group is developing new scanning methods that try to address these problems. We use advanced MRI scans to map different biological properties within different regions of tumours.
And we’re beginning to see some promising results.
We recently developed a new way of measuring oxygen levels inside tumours, which is something that has been difficult to do before. Being able to see areas of low oxygen – called hypoxia – is really important. These regions can suggest whether a tumour might be more aggressive and likely to spread, and spotting them could signal where to target new treatments.
These encouraging early results have allowed us to move this technique into two trials in patients with lung and rectal cancers.
It’s early days, but this method looks really promising. One day this technique could help doctors select the best therapy for each patient and monitor how tumours respond to new drugs and radiotherapy.
And it’s great to be in a position to see that discovery move from the lab and into the clinic.
Imaging scientists must show that scans are affordable and can improve patient care. “We have no shortage of people developing clever ideas,” says my colleague, Professor Tony Ng, from King’s College London. “But these ideas must produce techniques that directly benefit patients within the next few years.”
It’s critical that our best imaging scientists work together to keep the UK at the forefront of cancer imaging. Cancer Research UK and the Engineering and Physical Sciences Research Council (EPSRC) have invested a substantial amount of money to help make this happen. This initiative has helped me build collaborations with colleagues across the country, combining our strengths.
Research is all about communication and building relationships with other academics. As well as collaborating with UK colleagues, I also work closely with many other scientists in the USA and Europe. This is one of the most enjoyable aspects of my work.
Only by sharing ideas and working together will we truly crack the big challenges in research.
The value of fellowships
Thanks to two Cancer Research UK fellowships I’ve been able to launch my academic medical career.
These grants are fantastic. They allow people like me to try out research and then, if they want to become academic leaders, they can develop their interests and skills further.
I am very lucky to have had this opportunity from Cancer Research UK. My job is challenging, but it’s great fun and is never boring!
I love the balance of seeing patients and also having the opportunity to take an idea and hopefully turn it into something that improves people’s lives.