Detecting cancer... the earlier the better

Christmas this year has been a very mixed affair. Having battled with cancer for over a decade, my wife's Grandmother, Mary, died as a result of the disease a few weeks back.  There aren't many people that I know that haven't been affected one way or another by cancer.  The same can be said too about dementia and heart disease.  All too often, scientists researching ways to prevent, treat, and cure the disease are reminded just how much more work is needed.

That's not to say that progress is not being made. Thousands of papers describing new drugs that target tumours, along with improved methods to detect cancer in the first place are published each month.  The problem is taking these great ideas and converting them into a product that will improve patient well-being and prolong survival.  This process requires collaboration between industry (pharma companies) and academia (Universities), roughly 10 years of research and development, and many millions of pounds.  High-profile failures have also resulted in Industry being less willing to stump-up the millions of pounds required when there is no guarantee that they will get a return on their money.

Professor Eric Aboagye

Given this environment, I am fortunate enough to be working at Imperial College London's Comprehensive Cancer Imaging Centre.  Here, under the expert guidance of Prof. Eric Aboagye (the smiliest man in Science!), we have the ability to take an idea, test this idea in cancer cells and other models of cancer, before trialing it in humans.  The same regulatory and strict peer review processes are in place, but we are lucky enough to have all the required cogs working under one roof, with funds available to facilitate a faster transition than is normally expected.  

This week we publish work in the Journal Clinical Cancer Research which describes an improved method for detecting cancer.  It has been well established that the earlier cancer is detected, the better.  If left untreated, cancer spreads to other parts of the body.  It's these secondary tumour sites, known as metastases, that normally result in fatality.  If cancer is detected early enough, the primary tumour can be removed by surgery or shrunk by a cocktail of drugs before it has a chance to spread.  The recent debate regarding breast cancer screening (article from the BBC here) has highlighted the need to develop improved ways to detecting cancer.  We want to make sure everyone with the disease has it detected, while others are not falsely diagnosed.  

An example of the type of scanner used for cancer diagnosis

In this article (found here), we describe refinement of an already existing technique used to detect cancer - monitoring how cancer cells use large amounts of choline, an essential nutrient which must be consumed in the diet for the body to remain healthy.  The amount of choline 'consumed' by cancer cells is far higher than the normal surrounding tissue, meaning that by measuring choline consumption, one can assess whether the patient has cancer or not.  The current method has proven particularly useful for detecting prostate cancer, where other more conventional methods have had less luck. 

Choline 'consumption' in tumours can be measured by injecting small amounts of radioactive choline into a vein and monitoring its accumulation into tissues in the body. This is all performed while the patient is in a scanner, an example of which is shown above.  Doctors are then provided with a 3D map of radioactive choline accumulation which is used to make a diagnosis.  In this article, we provide evidence that by slightly modifying the radioactive choline that is injected, a far more accurate 3D map is produced which should better discriminate cancerous tissue from healthy tissue.  Far more validation is required, with preliminary tests in humans scheduled for this year, but if these exciting initial results are shown to be robust, this test may be employed by the NHS and others in the not-too-distant future.