Joining the dots – how lab research can lead to new approaches for treating cancer

Professor Steve Jackson

Professor Steve Jackson’s research will help to improve cancer treatments in the future

At its heart, cancer is a disease that starts when genes go wrong. This can happen when the DNA in your cells gets damaged, for example by tobacco smoke, UV radiation in sunlight, or just the normal chemical reactions of life within our cells.

And, in some rare cases, specific inherited gene faults can also add to the mix.

To try to prevent cancer developing, our cells have evolved sophisticated ways to prevent this damage – collectively called the DNA repair system.

A number of cancer treatments, such as radiotherapy and some chemotherapy, also aim to damage cancer cells’ DNA, but so badly that they die. This leads to a problem – cancer cells can switch on their DNA repair systems to protect themselves against the damage, making these treatments much less effective.

So understanding exactly how cells repair their damaged DNA, both in health and in cancer, is vital for figuring out how this disease starts, as well as finding more effective ways to treat it.

Cancer Research UK’s scientists have a long and distinguished track record in understanding DNA repair. One of the world leaders in this field is Professor Steve Jackson at the Gurdon Institute in Cambridge, whose work we’ve funded for more than a decade. Together with postdoctoral researcher Abderrahmane Kaidi, he’s now managed to join the dots between three previously separate areas of research related to DNA repair

Their discovery, published in the prestigious journal Nature, sheds light on the fundamental mechanisms that detect and repair genetic damage, and points towards important new approaches for treatment.

Let’s look at their work in more detail.

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News digest – inherited cancer genes, beta-blockers, non-Hodgkin lymphoma and more

UK newspapers

Read our news digest

Here’s a round-up of this week’s cancer news:

  • A new research programme announced this week will lay the foundations for routine testing for inherited cancer genes in patients with the disease. Read more in our news story and on the BBC.
  • Our researchers discovered that cancer survivors are no more likely to stop smoking, cut down on alcohol, or exercise more often than the general population, according to research published on Wednesday. This press release and the Nursing Times have more detail.
  • US scientists have devised a strategy to block a key cancer molecule called NF-kappaB. We covered the preliminary but promising work on our news feed.
  • Widely used blood pressure drugs called beta-blockers could enhance the effectiveness of chemotherapy for the childhood cancer neuroblastoma, according to Australian researchers (press release).
  • Cancer Research UK scientists – led by Nobel-Prize winner Professor Sir Paul Nurse – produced the first map of the genes that coordinate the division and growth of yeast cells. Read our news story to find out what this has to do with cancer.
  • Our new figures showed that non-Hodgkin lymphoma survival has doubled since early 1970s thanks to improved diagnosis and treatment (press release).

The coverage of Angelina Jolie’s decision to have a double mastectomy continued this week, and we spotted three particularly good pieces:

  • This BBC piece about breast cancer risk is well worth reading.
  • The Guardian had a thoughtful article on Ms Jolie’s decision not to have her ovaries removed.
  • And The Atlantic wrote about the looming US Supreme Court decision over BRCA gene patents.
  • Back to cancer research itself, and a small study, reported on Boots WebMD, suggested a link between heartburn and throat cancer but, according to experts we spoke to, the finding wasn’t ‘statistically significant’ and needs confirming. (Long-term, persistent heartburn is, however, linked to oesophageal cancer).
  • Researchers in East Anglia are starting to unravel why high levels of a protein called MMP8 seem to lead to better breast cancer outcomes, according to the BBC. NHS Choices had more detail and added balance to some of the more overblown reporting of this research.
  • The Daily Mail this week asked “are e-cigarettes really as safe as they claim”?
  • Whereas the BBC asked “what kind of NHS can Britain afford?”
  • Happy birthday to our colleagues across the pond – the American Cancer Society, ‘official sponsor of birthdays’, celebrates 100 years itself. The Washington Post has this timeline and slideshow

And finally

Olly

News digest – Angelina Jolie, clinical trial transparency, testicular cancer and more

The latest cancer news

The latest cancer news

  • We spotted several excellent comment pieces in response to Ms Jolie’s news. She’d “done something extraordinary”, according to Hadley Freeman in the Guardian, a sentiment broadly echoed by Lisa Markwell in the Independent, who has had breast cancer herself.
  • The Guardian’s data blog took a look at the bigger picture of breast cancer worldwide.
  • We also published this moving article about a personal experience of being told you have the BRCA1 gene.

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“I remember the appointment so vividly” – carrying the BRCA1 gene

Rebecca Hull

Rebecca Hull, 41, has had a preventative double mastectomy after discovering that she carries a faulty copy of the BRCA1 gene. She works for Cancer Research UK.

Seeing Angelina Jolie talking in the media so prominently this week does have a huge impact on people like me.

I think her announcement will make it easier for me to talk about my experiences, and I feel that I don’t have to justify my decision to people as much – it makes it more acceptable.

I grew up knowing my mum’s mum died in her late 40s of ovarian cancer and I was aware that mum had cousins who died from breast cancer in their 30s.

Then, in the early 1980s, when she was 38, mum had had breast cancer – and a mastectomy.

In 2006, she felt unwell again and, after initially being repeatedly misdiagnosed with IBS and then a chest infection, she was found to have ovarian cancer.

After some confusion, she was finally told she had advanced (stage 4) cancer, and she was given intensive treatment including carboplatin chemotherapy, surgery – and then more chemotherapy. She responded well initially, but the cancer returned, with shadows on the liver and lung.

She had more chemotherapy but the cancer returned again in 2008 – mum knew there was no beating it this time. She was 63 then and was put onto palliative treatment.

Having the gene test

At about the same time, I had been to the doctor for antenatal checks and, in passing, mentioned my family history. My GP took notice and referred me to the clinical genetics department at Guys Hospital in London. In early 2009 we discovered mum had a BRCA 1 gene mutation, so I had a blood test at Guy’s to find out whether I had a genetic risk of the disease too.

I was called back in April to be told I had inherited the BRCA1 mutation and I had a very high chance of developing cancer.  I remember that appointment so vividly, it was a pivotal moment and my life changed forever.

The hospital team at Guy’s were amazing – and I had a multidisciplinary team of specialists who were able to give me advice and support.

Over that summer, I had to tell my mum’s brother, and they had to think about taking the tests too. As it turned out, my uncle tested negative, so I’m the only one currently affected in the family, although I have two daughters and we currently don’t know their status. It was a huge relief that none of my cousins inherited the gene, but it has become a bit of an elephant in the room now that I am the only one.

While all this was happening, I was working and caring for mum, who was deteriorating. She died in October. It was a terrible time.

Rebecca Hull

Rebecca with her children

Having two children, and having seen family members die from breast cancer at the age I was, I decided that I had to have the surgery and, on Valentine’s Day 2010, I had a bilateral mastectomy with reconstruction at the same time.

It was an 11-hour operation and I had to go into intensive care afterwards. I ended up spending 10 days in hospital.

I was off work for three months and it has had a huge impact on my life.  And although the reconstruction didn’t quite go to plan, and I am still having revision surgery to correct this, I have no regrets.

I feel that I have two big challenges ahead of me still:

First, I have to tackle my ovarian cancer risk. This will involve more surgery, as there’s currently no screening programme or understanding as to whether screening would be effective.  In some ways, I am more reticent about this surgery as it comes with significant side-effects as a result of the early menopause that removal of the ovaries brings about.

But the second and probably biggest challenge involves my two daughters. They are both under 10 and there’s a 50/50 chance they will have inherited the BRCA gene. I must plan for how this could impact their lives, so they grow up aware but not scared.

It is going to be difficult but I’m hoping research will improve the situation as they grow up.

Research in the last 30 years has given us so much knowledge, and I hope that this progress will continue so that their future options will be better.

And I’m especially proud to work for an organisation like Cancer Research UK that has such a great track record of research into breast cancer genetics and prevention.

After all, Cancer Research UK scientists helped pinpoint the BRCA1 gene, and this has led to some huge advances in understanding breast cancers. I know that this work was too late for my mum, but it wasn’t too late for me. And I hope they will continue to make progress that will have a huge impact for my daughters too.

It can be hard at times knowing that this defect has caused so much loss in my life, and could create more havoc. But I do feel immensely grateful that I‘ve had options to manage my risk of developing cancer, and I am undoubtedly in a better position than my mum and the generations before her.

Rebecca

Angelina Jolie, inherited breast cancer and the BRCA1 gene

Angelina Jolie

Actress Angelina Jolie has had surgery to prevent breast cancer

The news today is full of reaction to US actress Angelina Jolie’s decision to have surgery to reduce her chances of breast cancer.

She made this difficult decision because, having lost her mother to ovarian cancer, she discovered she carries a faulty copy of the BRCA1 gene – which put her at very high risk of getting both forms of the disease.

If you haven’t read her brave and thoughtful piece in the New York Times, it’s worth doing so.

But in the light of the considerable interest, and the fact that many people will undoubtedly have questions, we wanted to pull together a few quick thoughts and facts on the topic of inherited breast cancer generally, and the BRCA1 gene specifically.

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News digest – tracking tumour evolution, leukaemia in twins, cancer screening and more

Newspapers

This week’s cancer news

  • Our top story of the week comes from Cancer Research UK’s own labs. Our scientists have developed a new way of looking at how tumours evolve in real-time by tracking DNA changes in the patients’ blood. Our press release and this blog post have more detail.
  • Meanwhile, US scientists have found that breast cancer cells that break off from tumours have a biological ‘fingerprint’. This could allow doctors to spot women whose disease is likely to spread to the brain. Here’s our news story.
  • The BBC covered a lot of interesting research this week. First up, scientists at The Institute of Cancer Research (ICR) studied twins to trace the root cause of leukaemia back to the womb. Fascinating work – here’s the story.
  • Cancer Research UK supported scientists at the ICR also found that as well as being more likely to get prostate cancer, men with BRCA2 are also more likely to develop aggressive tumours and have the poorest survival rates. Read the BBC article for more info.
  • Finally from the BBC, could male sex hormones drive breast cancer in women in some cases? While it’s an interesting story, it’s worth noting that this work was presented at the AACR annual cancer conference in Washington and hasn’t yet been published.
  • It’s pretty technical, but this blog post about the challenge of balancing the benefits and risks of cancer screening tests is well worth reading. And we fully agree with the sentiment that basic research – such as looking at genetic variations to gauge individual risk – will be the solution to finding ways to “screen smarter”.
  • This discussion about the language used to describe people undergoing cancer treatment struck a chord with us.

And finally

 

Gene variations and cancer risk – more results, more answers and more questions

Reseacher looking at DNA fingerprint

Scientists have found around eighty new gene variations linked to breast, prostate and ovarian cancers

A thousand scientists from one hundred international research groups working over four years. Thirteen papers spread across five journals. DNA analysis of two hundred thousand people. And eighty new genetic variations, or SNPs (pronounced “snips”) linked to three different types of cancer, doubling the current total known about so far.

These are impressive, big figures from an equally impressive, big piece of science, which Cancer Research UK helped to fund (here’s the press release). But what does it all mean?

To find out, we spoke to Professor Doug Easton from the University of Cambridge, one of the leaders of the project.

Cancer Research UK: What exactly are SNPs?

Prof Easton: SNP stands for “single nucleotide polymorphism”, and it’s a single ‘letter’ difference in the DNA between individuals. Your DNA is made up of around 3 billion of these ‘letters’ – there are four possible letters you can have: A, C, T and G – so a SNP is just a single place in your genome where you might have one particular letter, and someone else has a different one.

To explain a bit more about SNPs and what they do, have a look at this short animation:

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