It's news time

• We launched a clinical trial (press release) to test whether curcumin – an extract from the curry spice turmeric – could improve treatment for advanced bowel cancer. This doesn’t mean curry cures cancer (as we pointed out here), or that people with bowel cancer should take curcumin supplements. But this early-stage trial could help us find out whether curcumin’s promise in the lab could be translated into patient benefit.

• Around one in six worldwide cancers – two million new cases every year – are caused by infections, according to a French study published on Wednesday and covered on our news feed and the BBC. Eighty per cent of these cases occur in less developed parts of the world, where measures to prevent and treat infections are not always widely available. (On a related note, it’s worth reading Olly’s post on the ‘blame game’, and this post by Ed Yong, on why we need to be careful about how such stats are explained).

• Measuring a type of genetic variation in the blood of men with prostate cancer could help predict how their disease will develop, according to US research published on Tuesday (covered here). If confirmed, the work might help towards the development of a test to distinguish slow growing prostate cancers from more aggressive ones – something we urgently need to improve to help men diagnosed with the disease.

• Wednesday brought news from the US, where researchers have discovered that a gene called PREX2 is faulty in some people with malignant melanoma, the most deadly form of skin cancer. The discovery of the mutated BRAF gene by our scientists led to the development of a new melanoma drug that targets these faults, so this work could be a step towards more new drugs for people with this hard-to-treat disease.

• We were pleased to find out on Thursday that a new drug for non-small cell lung cancer (NSCLC) is to be made available on the NHS. Erlotinib (Tarceva) is suitable for a small but significant proportion of NSCLC patients whose cancer is caused by mutations in a gene called EFGR (which our scientists first linked to cancer in 1984). While it’s neither a cure nor the only option for these patients, it’s great that there’s now another potentially life-extending treatment option.

• US scientists have developed a new way to help patients with a type of brain tumour called glioblastoma better tolerate the effects of chemotherapy. The “stem cell shielding” (BBC) technique involves using genetically modified stem cells to protect healthy bone marrow from the cell-killing effects of treatment. A lot more work is needed, but these are interesting and encouraging results that could boost the effectiveness of temozolomide, a drug Cancer Research UK discovered and developed.

• Last week we reached 100,000 people with our hard-hitting plain packaging video, and this week we doubled that figure. This is an important video behind an important campaign. Will you help us make it 300k or more next week? Please share it with your friends and family.

• And in related news, we published this post in response to several media stories about plain packaging, that weren’t as balanced as they could have been.

And finally… there were a couple ‘scare’ stories in the media this week, which on closer look, shouldn’t be a cause for concern:

• This Daily Mail headline about “new breast cancer fears” is unfounded. The story is about research on a chemical called bisphenol A, which is present in some food packaging, and its effects on breast tissue in monkeys. But the study didn’t gather enough data to be certain its findings weren’t down to chance. Even if bisphenol A affects the development of breast tissue in other primates, that’s a long way from showing that it might be responsible for cases of breast cancer in humans.
• Along with our other SunSmart advice, our recommendation is to stick to the sunscreen, despite some dodgy headlines this week claiming that a key ingredient in such products causes skin damage. The researchers themselves say their work isn’t confirmed and is at a very early stage, so shouldn’t inspire anyone to sideline the sun cream. And, a crucial point, the full research hasn’t even been published yet.

Could a spice extract help to treat bowel cancer? (image by Sanjay Acharya)

Headline writers take note: curry doesn’t cure cancer.

But over the years, several studies have given researchers a tantalising glimpse of the cancer-fighting potential of a chemical called curcumin, an extract of the yellow curry spice turmeric. This is the chemical that gives some drinks, sweets and foods – notably curries and Jaffa cakes – their bright colouring.

But it seems that as well as its culinary properties, curcumin can slow the growth of cancer cells in the lab.

Our scientists are now building on this early work by starting a clinical trial to find out if curcumin could help to treat people with advanced bowel cancer.

This doesn’t mean that a curry or Jaffa cake a day will keep the doctor away. In fact, taken to extremes, such a diet could increase your chances of being overweight, which ups the risk of developing cancer.

And the evidence just isn’t there yet to recommend anyone starts taking curcumin-containing supplements to ward off cancer.

But this small trial will answer some important questions about whether curcumin’s promise in the lab can be translated into an effective, standardised treatment for bowel cancer.

Treatments from nature

Tumeric is a member of the ginger family, and has been used for hundreds of years in many Indian, Persian and Thai dishes.

The idea that a plant extract could help fight disease isn’t a new one. Indeed, some of today’s cancer drugs came from the natural world. For example, the cancer drug paclitaxel (Taxol) originally came from the Pacific yew tree, while eribulin was discovered in sea sponges.

Even ‘head and heart’ tablet aspirin, which is based on old remedies extracted from plants, has shown promise in preventing the disease.

Evidence, not anecdotes

But using the power of plants to beat cancer isn’t about brewing up herbal tea or collecting leaves from the wild. Scientists and doctors are a scrupulously accurate bunch, so when they notice that a particular plant extract might be helpful in treating disease they aim to find out exactly which molecule, at what dose, can actually help patients.

This process of testing and standardisation is absolutely vital – not only to make sure patients are protected from harmful side effects, but also to prove that the potential treatment really does offer clear benefits. Modern medicine is built on evidence – and anecdotes aren’t enough to go on.

Testing curcumin

So how can we investigate whether turmeric could help to treat bowel cancer? The scientific approach is to find the key ingredient – in this case curcumin – and test its effects against bowel cancer in the lab, and then in patients.

Professor Will Steward has been investigating curcumin, and in this latest trial (known as CUFOX) he’ll be finding out if it’s safe and acceptable to patients when taken alongside chemotherapy.

The researchers suspect that the curcumin may make bowel cancer cells more sensitive to the effects of the standard chemotherapy treatment offered to bowel cancer patients – a combination of drugs called FOLFOX. This could be extremely useful. At the moment, six in every 10 patients have to either be given a reduced dose or, in some cases, stop chemotherapy altogether because of serious side effects like nerve pain.

Anything that allows them to continue treatment for longer, or increases the effectiveness of lower doses, could mean treatment is more successful. And because we already know that curcumin is generally safe for consumption, it should be able to be taken long-term without causing severe side effects.

The CUFOX trial will involve around 40 patients with advanced bowel cancer. The first phase will help researchers to work out the best dose of curcumin, as higher levels can sometimes cause side effects like diarrhoea and nausea.

The next phase will involve two groups of patients – one group will receive the standard chemotherapy treatment, while the other group will be given chemotherapy and curcumin capsules. They will then be monitored for two years.

The results initially aim to show that adding curcumin to the standard FOLFOX treatment doesn’t have any negative effects, but the researchers will also be looking for any sign of beneficial effects. This is a small, early-stage trial, so by itself it can’t tell us if curcumin could help people with bowel cancer.

But if the results are promising, the research will ramp up to larger trials that will help to answer this question.

Curry doesn’t cure cancer

A few years ago, early reports of research into turmeric spawned a range of ‘curry cures cancer’ headlines – claims like this are misleading and not helpful for people coping with the disease.

We said it earlier, but it’s worth repeating, the evidence doesn’t justify eating more curry or taking turmeric supplements.

Curries aren’t always the healthiest of meals, and in general there isn’t any evidence that supplements can help to reduce the risk of cancer. And worryingly, there have been reports of contamination in certain turmeric supplements in the past.

Step by step towards better treatments

Our excitement at this new trial has to be tempered with patience. Better treatments for cancer can’t be developed overnight. Research advances our knowledge step by step, not through single breakthroughs.

But we’re making progress – bowel cancer survival rates have doubled in the last 40 years, and research like this will help to save more lives in the future. Researchers will be monitoring participants in this for years to come – and we’ll be awaiting the results.

Nell

Find out more

• 2008 post about Professor Will Steward’s work
• UK clinical trial investigating whether curcumin can help treat Barrett’s oesophagus (please note – this trial is no longer recruiting)
• The American Cancer Society’s page about turmeric and curcumin

Click on the logo to download the podcast

This month, we hear how a landmark study could revolutionise breast cancer treatment, and take a look at the growing evidence on aspirin and cancer.

We also hear how obesity may be driving rises in kidney and womb cancer rates, while smoking patterns of the past mean that lung cancer continue to rise in women.

Plus, scientists develop the first snap-shot of tiny brain tumours, and we talk to Stephanie Moore MBE about how treatment for bowel cancer has changed since her husband, footballer Bobby Moore, died from the disease.

Listen now through the player below:

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Also, the podcast is available on iTunes to subscribe and download for free.

Alternatively, go to the podcast page on our website, where you can hear the show directly through our own Flash player and explore previous shows in the archive. And there’s also a full transcript of the podcast available here.

We hope you enjoy it – please do let us know what you think of the podcast in the comments below, or email us at podcast@cancer.org.uk.

Kat

The campaign ended over the weekend, but keeping the focus on the disease, today marks the start of Bowel Cancer Awareness Month.

So we thought it would be a good idea to look at how things have changed for bowel cancer patients over the years, and how continued research has lead to a falling mortality rate.

In the graphic below, you can see how this improvement has been driven by research on bowel cancer, both by our own researchers and by scientists around the world. And you can scroll down to read about this research in more detail.

• Download a high-resolution PDF version of this graphic

Setting the scene

About 40 years ago, people with bowel cancer were typically operated on to remove their tumour, and surgery is still the mainstay of treatment today. But back then, little was known about how best to use chemotherapy (nor, for that matter, radiotherapy).

During the the 1960s and 70s, research began to suggest that a chemotherapy drug called 5-fluorouracil, or 5-FU (first discovered in 1957), had significant potential to improve things. As we’ll see below, refining how best to use this drug, and who to give it to, has been one of the key things that’s improved bowel cancer mortality rates.

1980s

In 1982, researchers first described how to carry out a new surgery technique called ‘total mesenteric excision’, or TME, for rectal cancer. This became more widely used over the years, and a follow-up study showed that it was better at preventing the disease from coming back, and improved survival rates.

In 1986, a US trial showed that patients with rectal cancer benefited from having radiotherapy alongside chemotherapy.

In 1987 Cancer Research UK scientists pinpointed the APC bowel cancer gene. Kat’s post about this is well worth a read, as this was a landmark in understanding the disease’s inner workings, and ultimately allowed affected families to be offered genetic testing and preventative screening.

Another significant step forward in the 80s was the confirmation that a drug called folinic acid improved the effectiveness of 5-FU.

1990s

Several more steps forward were taken in the 1990s. Firstly, keyhole surgery began to emerge as a better way to treat cancer. It took a while for this to become standard practice (NICE recommended it in 2006), and the NHS is currently rolling out a training programme to make sure this is widely available. Research in 2009 confirmed that availability was on the up.

Also in the 1990s, researchers really began to nail down how best to use 5-FU. For example, giving people with incurable bowel cancer 5-FU after surgery was shown to improve long-term survival rates, and other studies showed that it could cure people with less advanced cancer that was at high risk of spreading.

Two large studies began – the EPIC study of diet and cancer started recruiting in 1992, and a large bowel screening study in 1994 began to investigate a technique called flexible sigmoidoscopy (flexi-sig). Cancer Research UK helped fund both studies.

More progress was made in understanding bowel cancer’s genetics. For example, in 1995 our researchers in Cambridge published a paper on an inherited bowel cancer syndrome called Hereditary Non-Polyposis Colon Cancer, or HNPCC (also known as Lynch Syndrome). This led to more people being offered genetic testing and screening.

In 1998 he Committee on Medical Aspects of Food and Nutrition Policy (COMA) published a landmark report. It ruled that the evidence linking red and processed meat to a higher risk of bowel cancer was strong enough to recommend people limit their consumption.

And two significant policy changes were brought in by the UK government. Firstly, in 1997 the Department of Health recommended that patients should be treated by teams of medics from different areas of expertise – so-called multidisciplinary teams.  And in 1999, the Government introduced the ‘Two week wait’ for suspected cancer patients  which undoubtedly helped people be seen more quickly and likely saved lives.

2000s

In 2003, the EPIC study showed that a high-fibre diet could reduce the risk of developing the disease, giving people more information about choices they could make to stack the odds in their favour.

And by 2005, surgery to remove liver and lung metastases had become standard for suitable patients. This led to even more people being cured.

After intense pressure from Cancer Research UK and our colleagues in other organisations, a national bowel screening programme began rolling out in 2006, based on the fecal occult blood test (which detects blood in your stools).

And the landmark Cancer Research UK-funded QUASAR trial proved in 2007 that 5-FU chemotherapy could benefit many more bowel cancer patients. Previously the drug had only been offered to people whose cancer seemed likely to spread after surgery. QUASAR showed that its benefits extended to ‘medium risk’ disease.

2010s

In March 2010, we were delighted to hear that the Flexi-sig screening trial had shown that this technique could save more lives. We pushed the Government to include it in the screening programme, and they agreed later that same year. We now need to make sure this is implemented across the UK as soon as possible.

And last year, the Cancer Research UK-funded CAPP2 trial showed that people with HNPCC (Lynch Syndrome)  would benefit from taking aspirin to reduce their risk.

What’s in the pipeline?

Looking to the future, several things give us reason to believe that the downward trend in bowel cancer deaths will continue.

Firstly, new generation ‘targeted’ treatments, notably cetuximab and bevacizumab, are now licensed in Europe and are the most requested drugs in England’s Cancer Drugs Fund.

There’s still some debate over how best to use these drugs (which are expensive) but some of them are now available for use under certain circumstances. We’re running trials like FOCUS2, PICCOLO and COIN to try to find out how to get the most bang for their considerable buck, and to assess whether they’re suitable for wider use.

But many of these drugs work best in people whose cancer has certain gene changes. Another big thing on the horizon is routine genetic testing on the NHS, as part of ‘stratifying’ patients into groups. We’re leading the charge on this with our Stratified Medicines programme.

Finally, we’re just starting to see the effects of the bowel screening programme, and this will continue over the next decade, particularly as flexi-sig starts to impact on the programme. Screening can be controversial, so we need to keep an eye on the programme to make sure it’s as effective as it can be.

Get checked out

More and more people are surviving bowel cancer, as researchers translate their findings into better treatment.

So here’s our key message: if you notice any of the disease’s symptoms, PLEASE get yourself checked out by a GP.

The key symptoms include blood in your stools, looser stools or bleeding from your bottom, for longer than 3 weeks.

But they also include other, vaguer things like bloating, abdominal pain and unexplained weight loss. The chances are it won’t be cancer, but if it is, getting an earlier diagnosis can make a real difference – and it’s better to find out than ignore the warning signs.

If more bowel cancers are diagnosed at an early stage, thousands of lives in this country could be saved. Better treatments are on the way, but – as we never tire of saying – they’re almost always more effective when we spot cancer early.

Henry

• More about bowel cancer symptoms
• Help raise money to beat bowel cancer – visit the Bobby Moore Fund website

All the news in one place

Another week has flown by, and yet more interesting cancer research was in the news, both from our own scientists and from research groups around the world.

We’ve summarised the big stories of the week below.

Click on the links for full coverage.

There were a few big stats stories out this week:

• On Monday, new analysis showed that nearly 10 per cent of bowel cancer patients die within a month of diagnosis. And of these, over half are over 80 years old, and six in 10 are diagnosed following an emergency admission to hospital. This suggests that the public, especially the elderly, may not be aware of bowel cancer’s warning signs.
• Then yesterday, we released new figures showing that the number of kidney cancers diagnosed each year in Great Britain has risen over 9,000 for the first time. Experts think that obesity is one of the key factors behind this staggering 135 per cent rise over the past 35 years.

• Macmillan Cancer Support released a report showing that cancer mortality rates among older people are failing to match the improvements seen in younger patients. This is worrying, and implies that there’s ageism at work in the health service.

• Rare side-effects of new cancer drugs, particularly heart damage, are being under-reported in medical literature, according to academics in the US. They’ve called for ‘urgent reform‘ and standardisation of the measurements of possible side effects during clinical trials.

• Our scientists have developed a technique that could be used to detect tiny secondary tumours in the brain, a process that is currently impossible. The next step will be clinical trials of this imaging technique.

• Two new ‘drug sensitivity encyclopaedias’ released this week could be invaluable research tools to help scientists search for new cancer drugs.

• And on the subject of valuable research tools, we were very interested to read about the UK Biobank, an enormous online database of medical and lifestyle records from half a million middle-aged Britons, which was published yesterday. This could be a powerful resource to study diseases like cancer.

• Our commercial arm – Cancer Research Technology – unveiled an innovative £50 million investment fund to bridge the funding gap in the UK between cancer drug discovery and early development. As we say on the blog, this joint venture with the European Investment Fund should result in drugs getting to cancer patients faster.

• Our scientists at the Paterson Institute for Cancer Research in Manchester discovered a promising new approach to treat a type of myeloid leukaemia with relatively poor survival. The work is still only in the lab, where the researchers have designed a molecule to block a key enzyme involved in an aggressive form of leukaemia called mixed lineage leukaemia.

• To tie in with brain tumour awareness month, we looked at two recent bits of European research into brain and central nervous system tumours.

• German scientists came one step closer to solving one of cancer research’s biggest problems – they found a potential way to target cancer cells containing a faulty cancer gene called Myc.

• And finally, hot on the heels of the Government’s high-profile announcement over minimum alcohol pricing (see our analysis here), a new study about alcohol and breast cancer hit the headlines. We looked at why this is news, and what the stats actually mean.

The UK population has traditionally had a close relationship with alcohol

Alcohol has been a well-loved but problematic part of British life for centuries, as immortalised in 18^th century artist Hogarth’s depictions of “Gin Lane” and “Beer Street”.

In its latest steps to try to tackle England’s long-standing and complex relationship with booze, the Government has just announced its alcohol strategy.

As you probably spotted last Friday, one of its headline-grabbing – and welcome – measures will be the introduction of a minimum price of 40p per unit of alcohol sold.

While the strategy’s main aim is to reduce binge drinking, its impact will be seen far beyond our city centres after closing time.

Because it would be a mistake to look at modern-day footage of drunken young people falling over in the streets and assume that alcohol is a purely social problem – the hidden damage to the nation’s health from excessive alcohol consumption is just as serious.

But while most people know that drinking excessively over time can cause liver damage, fewer know that it also increases the risk of cancer.

Alcohol and cancer – the facts

Drinking alcohol is associated with increased risks of mouth, food pipe, breast, bowel and liver cancers. The evidence shows the more you drink, the greater your risk. And as far as we know, it doesn’t seem to matter whether you have a couple of drinks every night, or save it up for one night a week.

Overall, research shows that over 12,500 cases of cancer are caused by drinking – that’s one in every 25 cancers in the UK. The only way to address the problem is to reassess our relationship with alcohol, and consider ways to reduce consumption.

But that doesn’t mean you have to be teetotal. You can minimise your risk by drinking less than 3 units a day if you’re a man, or less than two units a day if you’re a woman.

Minimum pricing – our view

We believe that minimum pricing for alcohol is a positive step in addressing our consumption as a nation. A recent paper by researchers from the University of Sheffield shows that the proposed minimum price of 40p per unit, together with a ban on discount sales, will lead to a nationwide reduction in consumption of 4.6 per cent.

This may not sound like much, but the authors think it would reduce the number of alcohol-related hospital admissions by 5,100 a year. And an overall reduction in consumption would also reduce the number of alcohol-related cancers in England.

Naturally, most people wonder what minimum pricing will mean for them. The simple answer is ‘not much’. According to the Sheffield study, the impact of minimum pricing on moderate drinkers (defined as no more than 14 units per week for women and 21 units for men) will be £5-6 per year, equivalent to a couple pints down the pub.

But for harmful drinkers, the estimated cost is an estimated additional £100-135 a year.

The reason for the difference lies in how minimum pricing works: it increases the price of cheap, high-strength drinks, like white ciders, that are typically consumed by harmful drinkers. Minimum pricing could also be a lifeline for the local pub, by stopping the use of alcohol as a loss leader by supermarkets and helping to even the playing field between the two.

Added benefits

While the spotlight is on minimum pricing, there are other positive measures in the Government’s strategy. For example, the Government recognises that a lot people still don’t understand the health risks of excessive drinking, so they’re expanding the Change4Life programme to include alcohol. We’ve worked recently with Change4Life on their recent adverts which highlighted how one drink can easily turn into a few.

In addition, we’re optimistic about the plans to include tools for health professionals to spot hazardous drinkers and help them reassess their drinking patterns. The development of a new approach to help under-18s who arrive at A&E with alcohol-related problems is also an encouraging step.

But despite these positive steps, we think the Government needs to balance these health messages with greater restrictions on alcohol marketing, particularly when it comes to protecting children. It is worrying that recent research has shown that more children recognise major alcohol brands than popular cake and sweet brands.

Overall, this strategy represents a big step forward in Government action on alcohol. It’s needed because the harms of excessive alcohol consumption extend much further than drunken chaos on a Saturday night.

Helping people to make healthy choices about alcohol consumption will help to reduce the toll of cancer on our nation.

Chit Selvarajah is a policy adviser at Cancer Research UK

Aspirin has been around for over a century

“Should I be taking aspirin to reduce the risk of dying from cancer?”

This is likely to be the question on many people’s minds today, which sees the publication of three reports on the effects of aspirin on cancer risk, and cancer spread – two in the Lancet, and one in sister journal Lancet Oncology.

But before we look at today’s studies, we need to set the scene. Over the last few years, the evidence has been building that regularly taking the simple, cheap drug aspirin could reduce the risk of dying from cancer.

For example, a large study from December 2010 showed that people who took 75 milligrams of aspirin (the same dose as in a ‘junior’ aspirin) every day had a reduced risk of dying from cancer.

But these results didn’t answer all the questions, and we felt it was too early to start recommending that people take low-dose aspirin every day. This is because aspirin’s not a harmless drug. In some people it can cause serious side effects, like internal bleeding.

On top of this, it wasn’t clear what the best dose is, or at what age it’s best to start taking aspirin.

Today’s studies clarify the picture a little, but because of the uncertainties we’re still recommending that people discuss things with their doctor before taking aspirin.

Here’s our Chief Medical Officer, Professor Peter Johnson, on the subject:

What do the latest studies add?

The three studies published today were all led by Professor Peter Rothwell at Oxford University, who’s one of the world’s top aspirin researchers.

The studies looked at data from several large trials of taking daily, low-dose aspirin that aimed to find out aspirin’s effect on heart disease, and also measured how many people were diagnosed with cancer.

Preventing cancer

Taken together, the studies provided more information about how aspirin affects the risk of cancer developing in the first place.

Earlier studies had shown that aspirin probably reduces the risk of developing bowel cancer, and some other cancers in the digestive system. But this study showed that, after three years of daily low-dose aspirin, the risk of developing cancer at all dropped significantly in both men and women.

In fact, there were nine cases of cancer in every 1,000 people taking aspirin, compared with twelve cases per 1,000 people not taking it – an absolute reduction of three cases per 1,000 people.

The cancers most strongly prevented were oesophageal, stomach, bowel and lung cancers.

Preventing cancer spreading

But a new – and somewhat unexpected – finding from this research is that cancer patients taking aspirin every day appeared to have a reduced risk of their cancers spreading.

In fact, not only were regular aspirin-takers less likely to be diagnosed with a cancer that’d already spread, but (compared to non-aspirin takers) patients on aspirin diagnosed with early localised cancers had a lower chance that their cancer would spread later on.

This is important, because when a cancer spreads it is much more difficult to treat, and nine out of ten cancer deaths are due to the disease spreading.

And it also hints that aspirin could be useful for people who’ve already been diagnosed with cancer – though, importantly, this will depend on the individual case.

This is because some cancer patients will also have a higher than normal risk of bleeding, because of their cancer or treatment. So it’s important that people with cancer talk to their doctors rather than deciding to take aspirin by themselves.

Because of these two effects (the reduced risk of getting cancer, and the prevention of it spreading) , the research also suggested that regularly taking aspirin reduced the risk of dying from cancer by nearly 40 per cent after people had been taking it for 5 years.

Balance of risks and benefits

Finally, and importantly, the studies looked into the balance of benefits and harms of taking aspirin in a healthy population. This is critical, because if people are considering taking aspirin for preventing cancer, we’ve got to be very sure about whether it does good or harm overall.

As the graph below shows, over time, the benefit – lowering cancer risk – increased, while the risk of serious side effects, like internal bleeding, got smaller. Crucially, in the first three years of taking aspirin, the risk of serious internal bleeding was much higher in aspirin-takers than those who weren’t on the drug:

This risk went down over time, and after 5 years of taking the drug, the risk of internal bleeding was back at the same level as people who weren’t on the drug.

Overall, the risk of all the outcomes combined – cancer, serious internal bleeding and major heart and circulatory problems – was lower in the aspirin group. That seems to show the balance could be tipping to the benefit side. Here are the raw numbers:

But that’s not the only consideration – if people stop taking aspirin daily, their risk of a stroke goes up.

And certain people definitely shouldn’t take aspirin, because they’re at higher risk of serious complications. That includes people with asthma, stomach ulcers, haemophilia, or anyone taking other drugs that might interact badly with aspirin.

So what should I do?

The first and most important thing is that if you’re considering starting to take aspirin daily, discuss it with your GP first, or your cancer specialist if you’ve been diagnosed with cancer.

In particular, there might be a reason why taking aspirin every day would be a bad idea for you personally – despite what the overall evidence says. And it’s worth discussing the benefits and harms, taking into account your own and your family’s medical history.

And if you do get the go ahead from your own doctor, you should make sure you don’t take aspirin on an empty stomach.

Today’s results are encouraging, and add to our understanding of the effects of taking aspirin daily. But there are still questions to answer. For example:

• What is the optimal period of time to be taking aspirin for?
• At what age does the biggest benefit and smallest risk occur?
• Who is most likely to benefit, and who is most likely to get side effects?
• And how can we minimise the risk of a stroke when people stop taking the drug?

Cancer Research UK scientists are running trials at the moment that aim to answer some of these questions.

And we’d also like to see some analysis and advice from the Governement about whether aspirin should be recommended more widely.

Until this is the case, taking aspirin should still be a decision you take in consultation with your doctor.

Jess

Reference:

• Rothwell, P et al, Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time  course of risks and benefits in 51 randomised controlled trials, Lancet (2012) DOI:10.1016/S0140-6736(11)61720-0
• Rothwell P et al, Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trial, Lancet (2012) DOI:10.1016/S0140-6736(12)60209-8
• Algra A & Rothwell P, Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials, Lancet Oncology (2012)   DOI:10.1016/S1470-2045(12)70112-2

Diagnosing cancer early saves lives

If cancer is diagnosed early, it’s nearly always easier to treat successfully. But too many cancers are still diagnosed at a late stage – thousands of lives could be saved in the UK if more cancers were spotted early.

We’re working hard to solve this problem, and we’re excited to announce a major new partnership with Tesco. By working together we will find ways to close the gap between survival rates in the UK and the best countries in Europe so that thousands more will survive cancer in the future.

Tesco will raise £10 million to fund 32 early diagnosis research projects across the UK, as well as displaying our leaflets on the signs and symptoms of cancer to the millions of customers who go through their stores’ checkouts each week.

But what exactly will this research involve? Read on for just a few highlights of the work that this valuable partnership is supporting.

Testing for prostate cancer

Men who inherit faults in their BRCA genes (which are normally thought of as ‘breast cancer’ genes) have a higher risk of prostate cancer. But could they benefit from regular tests to help diagnose the disease early? Professor Ros Eeles at The Institute of Cancer Research in Sutton is investigating targeted PSA testing for men with faulty BRCA1 and BRCA2 genes. Men are taking part in towns across the UK including Liverpool, Aberdeen and Newcastle.

Faster chest X-rays to detect lung cancer early

Could more lives be saved if all patients with possible lung cancer symptoms were sent for an urgent chest X-ray? Professor Richard Neal in Bangor is investigating. Initially, he’s running a small trial, with the aim of planning a larger study testing this approach. The disease is one of the most common cancers in the UK and it’s often diagnosed late, so in the long-term, this research could make a real difference to thousands of people.

Improving cervical screening

Based in London, Professor Peter Sasieni is investigating whether testing women aged 25-65 for the human papillomavirus (HPV) as part of the cervical screening programme could save even more lives than the smear test alone. All cervical cancers are linked to HPV, and it’s hoped that HPV testing could make the screening programme more accurate and more effective at preventing the disease and diagnosing it early.

A new test to help diagnose oesophageal cancer

In Cambridge, Dr Rebecca Fitzgerald is trialling a simple new screening test to detect changes in the oesophagus (foodpipe) that can develop into cancer. The test could identify people who need early treatment, helping to prevent the disease from developing. If successful, Dr Fitzgerald’s study could save more people from this hard-to-treat cancer.

Recognising skin cancer symptoms

Researchers in Edinburgh are finding out whether people can learn how to recognise the signs of melanoma skin cancer by looking at images online. Melanoma is becoming more common and it’s important that people are aware of the symptoms so they can visit their doctor as early as possible.

Improving bowel cancer screening

In London, Professor Wendy Atkin is finding better ways to prevent bowel cancer and detect the disease early through her research testing new screening and diagnosis techniques. Her work has already proved the benefits of a new test called flexible sigmoidoscopy, which can detect and remove bowel polyps before they develop into cancer. This test will soon become part of the national screening programme in England.

Better tools for diagnosing breast cancer

In Guildford, Professor Kenneth Young is finding out if new digital X-ray technology could improve breast screening. He believes this technology could be more efficient than the current method, particularly in women who are younger or have denser breast tissue.

These are just a handful of the potentially life-saving projects Tesco is supporting across the UK. To find out more about the many other projects that are part of this exciting partnership, explore our interactive map and find out about research happening near you.

You can find out more about our work into early diagnosis on our website, and there is information about how to spot cancer early, including signs and symptoms to look out for, on our Healthy Living pages.

Nell

It's time for our weekly news digest

It was a yet another big week for cancer-related news, and not all of it good. To save you from the task of rummaging through the papers, we’ve summarised all the important stories of the week.

If you want to know more about any of the stories, click on the links for further information.

• The biggest story of the week was a disappointing one – the National Institute for Health and Clinical Excellence (NICE) provisionally decided not to recommend abiraterone for advanced prostate cancer, an announcement we found hugely frustrating. The decision is now open for consultation, with a final ruling expected in May. Patients and doctors value the extra months of life abiraterone can give if prostate cancer has come back after chemotherapy. You can read our official response to this preliminary decision, and our discussion on the blog about why we want to see a solution to the impasse between NICE and the manufacturer.

• On a related note, we also spotted this great, if slightly technical, summary of some other exciting prostate cancer drugs currently in trials

• In better news, on Monday, the Department of Health launched a potentially life-saving campaign to help people spot the warning signs of bowel cancer. We’ve said it before, and we’ll say it again: early diagnosis is crucial in the fight against cancer, so we’re pleased to see this campaign to improve diagnosis of the UK’s third most common cancer. You can watch the TV ad and read more in our news story.

• Staying with bowel cancer, research published on Tuesday also gave us reason to be hopeful. A US study has confirmed that a test called flexible sigmoidoscopy, which is being introduced by the NHS here, is good at at detecting bowel cancer. It also showed that repeated testing increases how many cancers are detected. But it’s too early to say if this translates to further lives saved.

• Across the pond, Canadian and US scientists found crucial genes linked to two types of aggressive childhood brain tumour called glioblastoma and diffuse intrinsic pontine glioma. These are hugely significant findings that could be a big step towards new ways to treat these notoriously hard-to-treat tumours.

• An interesting study in the BMJ confirmed that – at least for some patients – exercise can improve health and quality of life. While encouraging news, our head information nurse, Martin Ledwick, was keen to stress that this wasn’t a one-size-fits-all recommendation. “Each patient’s individual condition, state of health and needs should be taken into account before prescribing exercise”, he told our news team.

• We couldn’t help but make a small splash about Cancer Research UK’s 10th anniversary, which happens to be today! Read our blog post for a whistle-stop tour of some of the progress made in the past 10 years, and also over preceding decades by the Cancer Research Campaign and the Imperial Cancer Research Fund which merged to form Cancer Research UK. We’re certainly not patting ourselves on the back – there’s so much more to do – but it’s encouraging to see that significant, steady progress is being made against the disease.

• And finally, the media’s obsession with different foods and their potential effects on the risks of different cancers continued, with this story about research on ‘slowly cooked tomatoes’ and prostate cancer. As is usually the case, and as we’ve pointed out before, the underlying science was carried out in a lab, not in people – so it’s impossible to draw conclusions about what happens when we actually eat tomatoes.

Olly

Colin Barnard shares his story

You may have seen the news today that Tesco has chosen Cancer Research UK as its Charity of the Year 2012 and is aiming to raise £10million. The money will be spent on research and awareness to improve early diagnosis and detection of the disease, supporting the funding of up to 100 research projects about early diagnosis across the UK.

Tesco will also be continuing its sponsorship of Race for Life for the next three years and is aiming to raise a further £3million to support the event series.

Spotting cancer early is crucial, as we know that people are more likely to survive cancer if it’s found at an early stage. Colin Barnard, 68, knows first-hand how important early diagnosis is and what a difference Tesco’s support will make to people’s lives. He had his bowel cancer detected through routine bowel screening in early December 2011.

You can read more about his incredible story in this special guest article.

A buff envelope landed on my doormat in October last year. At first glance it could have been anything.

Little did I know this letter really would change my life. It was an invitation to take part in the NHS Bowel Cancer Screening Programme. It was actually the second time that I’d been invited to take part. Last time was in 2009, when my brother-in-law was in the late stages of prostate cancer and my wife and I were fully engaged in trying to support him and his wife and children through his final months, so I did not complete and return the screening test kit.

The test – simple, potentially life saving

This time was different, thankfully. I carried out the test myself at home and sent it back. Let’s not beat around the bush here – I had to take six small samples of faeces, but actually this wasn’t difficult and took very little time to do, though it had to be done on three different days.

A few weeks later in mid-November I received a letter – the one everyone dreads – telling me that my test had produced an ‘abnormal’ result. I was invited to attend Hemel Hempstead Hospital to have a test to look at the inside of my bowel, called a colonoscopy.

So on 2nd December I went to the Endoscopy Unit at the hospital for my colonoscopy. It was done under sedation and I was not aware of anything while the examination was being done. At the end of the examination the Consultant Gastroenterologist who’d done the procedure invited my wife and I to join him in a room. Calmly, he told me that he’d been unable get the tube past a large tumour that was almost completely blocking my lower bowel. He’d taken samples of the tumour for analysis, but told us that the tumour was almost certainly cancerous and that surgery was necessary.

I was shaken by the news and pleased my wife was with me to hear what the consultant said as my brain went into overdrive and it was hard to concentrate on what was being said. I was not upset or devastated, but very relieved to know that such a potentially serious condition had been discovered and could be dealt with.

A week later I met my Consultant Surgeon, who pencilled in my operation for 21st of December at Watford General Hospital, his last surgery day before he was off on holiday.

The surgery

As you can imagine, the day came around quickly. I turned up bright and early at 7am and saw on the admissions board that I was the third patient to be dealt with that day. But out of the blue I was told I would be in first, so – thankfully in hindsight – there was no opportunity for any anxiety beforehand.

I’m happy to say that the surgery went well, and just 4 days later I was well enough to be discharged. I arrived home in time to join my family for Christmas lunch, which was a truly unexpected and wonderful feeling!

Whilst at the time of writing it’s only a couple weeks after my operation, I am recovering quickly and able to do one and even two mile long walks daily. Today I had my wound staples removed – another milestone has been reached.

Thankful

What has generated a feeling of wonderment in me is the speed of this whole process. I know I have probably been amazingly lucky, but from only knowing that I had a possible problem when I attended for the colonoscopy on 2nd December to find out that day that I had bowel cancer and being successfully operated on less than three weeks later is astonishing and miraculous.

I have a huge amount to be thankful for, and lots of people in the NHS to whom I am immensely grateful, especially all the medical and support teams involved.

But one thing to which I almost certainly owe my life is the NHS bowel cancer screening programme, without which my problem would almost certainly not have come to light until either the tumour had blocked my bowel or the cancer had spread elsewhere, at which point treatment would have been much more difficult.

I hope everyone reading this will take heart from my good luck story and if the time comes that you get the chance to complete any screening test, do not spurn the opportunity – it really could save your life.

 Colin Barnard

Further reading

• What is bowel cancer screening?
• Cancer signs and symptoms
• Our research into screening and early diagnosis