I’m a professor of cancer and here’s how the millions Dame Deborah James has raised will help save lives
LADY Deborah James lived by the mantra of rebel hope – and she had every right to.
When she set up her cancer research fund in May, she hoped to raise £250,000 – a goal she smashed within hours, raising £6.5million within days.
Since the 40-year-old’s death on Tuesday, donations to her fund have skyrocketed and celebrity friends have issued a rallying cry to help make Debs’ £10million dream come true.
So where will the money go? It will be split between three charities close to the heart of Debs – Cancer Research UK, Bowel Cancer UK and The Royal Marsden Cancer Charity.
Bowel cancer expert Professor Simon Leedham told The Sun: ‘Deborah is an incredibly sad and tragic loss, but there is hope when it comes to bowel cancer treatment.
“There are advancements, trials and studies going on all the time and we are about to take a big leap forward.”
Here he reveals what the future of bowel cancer treatment will look like, thanks to Debs.
Over the past decade we have learned that there are four types of bowel cancer. Not everyone has the same type and there are different degrees of aggression.
We call them CMS (Consensus Molecular Subtypes) – think of bowel cancer as a beast with many heads, not just one.
Our understanding of bowel cancer biology is progressing very rapidly.
This classification is how we have derived new therapies that will target one type rather than another, making the treatment more specific.
IN one of the subtypes of bowel cancer patients, we can use immunotherapy, which harnesses the power of the body to fight cancer.
Cancer cells can hide from the body’s immune cells, which is why they are not always attacked when they should.
But immunotherapy destroys this shield and encourages our immune cells to enter the tumor and kill these cancer cells.
Dostarlimab is a new immunotherapeutic drug that is performing well in studies. One, recently published in the New England Journal of Medicine in the US, gave the new drug to 12 rectal cancer patients and made their cancer disappear without surgery.
The drug harnessed the body’s own defense mechanisms. The study was very small, but all participants were cancer-free after the trial.
We are still in the early stages, but the results are very promising, and we hope this trial will serve as a scout for wider use of these drugs in this patient group.
ATTACKING THE CANCER ECOSYSTEM
FOR 20 years we have focused on targeting the cancer cells themselves and trying to stop them from dividing.
We now understand that bowel cancer cells are part of a complex ecosystem and we are also working on targeting additional cells that also support the tumor.
We try to attack the whole infrastructure of cancer.
NEW ANTIBODY DRUG GREMLIN 1
A trial in the UK is in phase one – this is where it is being given to humans after showing success in animal models.
The drug is an antibody that neutralizes a protein in the support cells that feed and sustain cancer cells. The antibody prevents cancer cells from dividing and facilitates their elimination.
To donate or help fundraise, visit bowelbabe.org
SEQUENCING cancers and discovering how they work used to cost thousands of dollars, but thanks to new genomic tools, sequencing costs have dropped dramatically.
Advances in technology mean that we can divide tumors in single cell resolution and then look at the complexity of the tumor.
Space biology is a bit of a buzzword for bowel cancer right now because it’s very new and allows us to understand and see how cells interact with each other within the tumor. .
These tools allow us to take a section of the tumor so we can see what is coming from where. Understanding how cells interact with each other allows us to better target treatments. These developments mean that we now know that cancer cells build an ecosystem to help them survive, so we can now develop treatments to target this ecosystem.
WHEN people are diagnosed with bowel cancer, treatment usually involves removing the tumor first and then giving chemotherapy afterwards.
But it didn’t tell us how the tumor reacted to the chemotherapy because it was no longer in the body.
The UK’s FOxTROT study shows that if you give chemotherapy before surgery, it’s just as safe as doing it the other way around.
It allows us to monitor tumor behavior and the hope is that it will lead to new treatments because we will learn a lot more about tumors and we can create drugs based on what we learn.
EARLY detection is vital from both a research and clinical perspective.
If you can get bowel cancer at stage one, you have 90-95% five-year survival – you get it at stage four, like Deborah had, and that’s between 10 and 15 %.
The government has pledged to lower the age limit for bowel cancer screening from 60 to 50, which is great (largely thanks to The Sun’s No Time 2 Lose campaign, led by Debs , the test is currently available for people aged 56 and over).
It used to be that we only stained poo for blood, but now there is a much more sensitive immunohistochemical test that is also much better at detecting advanced polyps.
It is not just an active treatment once bowel cancer is identified. Reviewing family history and targeting surveillance measures for patients and their relatives are also important.
Three to five percent of bowel cancer cases have a family genetic link, and we have family genetic tests that cost the same as a blood test to detect those at risk.
We know that there are specific ‘irrefutable’ genes that contribute to increased risk, and when we find them, we can ensure that the patients and family members involved are well monitored.
We also know that there are dozens of other genes that contribute to bowel cancer to a lesser extent, and if you have a lot of these genes together, that can also increase your risk.
In the future, we may be able to test this low-level genetic risk in the population and ensure that affected patients have access to good monitoring programs.