Cancer Imaging - Zooming in on Cancers

Kat - Joining me here in our little booth overlooking the lecture theatre at the NCRI conference is Herbie Newell and he's Professor of Cancer Therapeutics at the Northern Institute for Cancer Research. Hi Herbie.

Herbie - Hi, Kat.

Kat - We're going to talk about some very exciting new initiatives that have been announced in terms of cancer imaging. Let's take a little step back and look at what we mean when we talk about imaging. Why do we need to do it, why's it important?

Herbie - Ok, so most people are familiar with imaging in the form of x-rays or maybe MR scans and a lot of people would have had those. What we're talking about here is taking it to the next stage where you're not just looking at what's inside the body but you're looking also at the genes and the molecules inside the body. In the case of cancer the genes that have gone wrong.

Kat - This new initiative, what's all that about? What's Cancer Research UK and its partners up to?

Herbie - It's a fantastic example of partnership between Cancer Research UK, the Engineering and Physical Sciences Research Council and also supported by the Medical Research Council and the departments of Health in England. What we're doing is we're putting fifty million pounds into cancer imaging reflecting how important this is going to be to attack the cancer problem.

Kat - What sort of things are we hoping to look at? What sort of avenues are we going to be exploring with these very large sums of money?

Herbie - Well, we're going to be using lots of different techniques. First of all, as you say earlier, to try and find cancer earlier. We're expecting to have tests that will tell us when someone might have the cancer but the critical question is where is that cancer in the body? You can send the surgeons in to the right place. Then as we develop new treatments we need to demonstrate that they're working much earlier than we have to do at the moment where we do big clinical trials costing millions of pounds before we can really find out whether a drug's working. We want imaging techniques to find that out earlier.

Kat - What sort of techniques are we actually looking into? We hear about things like CT scanning, MRI scanning, PET scanning. What sort of techniques will our scientists be investigating?

Herbie - So as part of this CRUK and EPSRC initiative we're going to be using any kind of imaging that might work so for example it may be like CT where there's ionising radiation outside the body. It might like a technique called positron emission tomography where you give radioactivity to a patient. It may not involve radioactivity at all like magnetic resonance imaging. We're also looking at some optical techniques as well to try and make microscopy work but in a whole living person.

Kat - So you could actually use light to see inside someone?

Herbie - That's absolutely right. And see right down to the level of the cell, which of course is the thing we're looking for in cancer.

Kat - What sort of areas of research are the development of these techniques going to help? We talked about diagnosis earlier but are there other areas of research and cancer treatment that would benefit from this?

Herbie - Absolutely. These could play a really important part in every stage of the cancer journey. Not only catching it earlier but getting the diagnosis right. Working out for each patient what their prognosis is, how their tumour might go on, whether it's a high-risk or a low-risk tumour. Then when it comes to treatment, making sure that each patient gets the treatment that's most likely to work and also knowng much sooner whether it is working or not.

Kat - A lot of these imaging techniques are based around radioactivity so for example tracers that are put into the body. What areas are being investigated in that aspect because I think this is quite an exciting area of science?

Herbie - Absolutely so one of the big new techniques  that has come on recently and the government are rolling this out across the country is a technique called positron emission tomography. It's at the other scale to electrons - they're positive electrons. You give these radioactive materials to people and they're already important for getting the diagnosis and prognosis of lung cancer right, helping with managing patients with some kind of haematological malignancy, some types of lymphoma. At the moment we've really only got one type of tracer that we use. What we'll do in this initiative is develop a whole new family of tracers that will tell us about all aspects of cancer cell biology.

Kat - For the area that you, yourself, work in: the development of new cancer drugs, cancer therapeutics - how do you think these techniques are going to help you?

Herbie - These are going to be absolutely critical because what we'll be able to do is the current experiments that we can do in cell lines in test tubes but we'll be able to do them in the only model that really matters - the patient. We'll be able to look at biochemical reactions when we put in new drugs to see whether we're affecting them in the way we want to. That will help us pick out the winners, get the drugs that are going to be the blockbusters and really help cancer patients much sooner than we do at the moment.

Kat - Sounds like exciting times ahead. In terms of the actual initiative, how's that going to work? £50 million is a bit pot of money to spend. How are you going to divvy it up?

Herbie - As ever in science we've looked at all of the centres who've worked in this area. We've looked at their proposals and decided to fund big-time 9 of the best. This is serious amounts of money that CRU, EPSRC, MRC and the Department of Health, England are putting in. With these centres of excellence we'll be able to set up a network that will get people moving together to get this exciting technology through into patients much faster.

Kat - One of the things that people get concerned about is, for example, the cost of some of these techniques. We hear that CT scanners are very expensive, MRI scanners are very expensive. I can imagine that PET scanners cost a bomb. How do you think if we do develop these techniques do you think it's going to be feasible to roll them out as widely as possible?

Herbie - It's a really important question. Our role first and foremost is to provide hard evidence that says this technique might work, this one unfortunately doesn't look so promising. Having got through that stage it then becomes a social issue that we have to recognise the value that will be brought to the individual patient and also to the whole healthcare economy by personalised medicine. That's what this initiative is all about. It's about focussing the right treatments on the right patients so we don't waste time and money with ineffective and sometimes expensive treatments being given to patients and it's not going to work.

Kat - So you can see straight away of something's not working?

Herbie - Indeed, we've got examples already where you can tell within 24 hours whether a patient is like to respond because the drug has or has not produced the effect you want in tumour cell biology. We need more of those examples.