Introducing On Cancer
Robert Bristow, Director of the MCRC
Every two minutes, someone in the UK is diagnosed with cancer, with one in two people receiving a cancer diagnosis in their lifetime. With these statistics, it is important to step-change our approach to diagnosis and treatment paradigms. Thankfully, there is an increasing emphasis towards the biology and technologies that uplift the early detection of cancers and increase the chance of cure. When combined with precise and biology-driven treatments, patients will live longer and lead better lives following a cancer diagnosis. We are now in the era to realise the promise of personalised detection and medicine to choose the ‘right early detection protocol and/or treatment, for the right patient, at the right time.’
At the Manchester Cancer Research Centre, we are setting in motion precision cancer risk assessment and treatment programmes to benefit all cancer patients. Through our extensive networks, interdisciplinary collaborations, and state-of-the-art facilities, we continue to influence clinical practice and policy in national and international settings. Our teams act as beacons, rallying people towards common goals to demonstrate that collective action and scientific co-creation between researchers and patients can effectively drive healthcare innovations.
In this On Cancer publication, we provide cancer team science exemplars and spotlight future policy implementations to drive a ‘Cancer Precision Medicine for All’ approach in decreasing the mortality and morbidity of cancer. We outline innovative research programmes in: digital cancer transformation and data machine learning, novel approaches to early detection and diagnosis, embracing advanced radiotherapy technologies and biology to drive uncomplicated cures and providing new clinical trials using the precision medicine areas of targeted agents, immunotherapy and cell therapies. These approaches will be better tailored to the individual by focusing on additional factors such as comorbidity, polypharmacy, ethnicity and increased participation from socially deprived communities.
Digital transformation in healthcare and our digital Experimental Cancer Medicines Team (digital ECMT) are collaborating with the Digital Cancer Centre team at The Christie NHS Foundation Trust to gain novel clinical insights around therapy resistance and improve patient outcomes with rapid assessment of early phase clinical trials. The concept is to use Artificial Intelligence (AI) Assistants to calculate the best treatment approach to drive the best outcomes in terms of increased survival and decreased side effects. Using technologies such as bio-wearables and “hospital in home” devices, trial patients can interact with clinical teams to input side-effects and blood tests using their personal smart phone. Detailed information about a patient’s other diseases and medicines allows us to understand interactions with cell therapies, immunotherapies and targeted treatments, including decreasing or increasing resistance to therapy.
Our advanced technologies using proton and photon beams, with adaptive imaging, are redefining precision medicine with decreased long-term side effects in adults and children. Manchester is home to the first NHS high energy Proton Beam Therapy (PBT) clinical unit and a separate national proton research centre. Using precise radiotherapy beams that act as “depth charges” within the tumour, PBT optimally spares the surrounding normal tissues. We can perform complex radiotherapy planning and targeting tumours which are dangerously close to critical organs. Further, its use in treating children is invaluable, as it causes less damage to healthy tissues surrounding the tumour and there is a reduced chance of secondary malignancies. In addition, our development of the MR-LINAC technology which combines Magnetic Resonance (MR) imaging with a photon Linear Accelerator (LINAC), performing MRI scans during treatment offers us the potential of real-time monitoring of a patient’s tumour during their treatment, enabling clinicians to adapt treatments in accordance. We are rapidly assessing these new technologies for outcome and heath economic endpoints to pivot these findings at a policy level to overcome national policy constraints on best implementation within the NHS clinical setting.
Precision prevention and early detection
Our vision to improve the lives of all people living with cancer means we must develop precision prevention and early detection strategies that encompass diverse groups across the entirety of our population. Researchers here in Manchester have been working to tackle inequalities in cancer through incentives such as community screening, community engagement and home-based testing. This includes mobile early detection units that are placed in carparks in areas of social deprivation to increase screening engagement. We have already demonstrated the increased rates of detection and survival from said incentives in lung cancer with a subsequent national roll-out across the NHS. It is imperative that we work together to pioneer the move towards healthcare models that are inclusive and community focused.
Cancer is a global challenge, and it requires us all to make a difference. We strongly believe that our internationalisation programmes that reach into low and middle-income countries increases our knowledge regarding the diversity of cancer genomics in different ethnic populations and the potential impact on bespoke personalisation of treatment based on this information. The co-creation of the early detection work between Manchester-Christie NHS Trust and Kenyatta University Teaching, Referral and Research Hospital in Nairobi is an example of active listening to our scientific partners and in this case designing a cancer research and healthcare strategy ‘by Kenya and for Kenya’.
For our research to reach its greatest potential, we require the engagement from everyone, from policy makers to nurses, funders, academics, and industry to dynamically shift the way we treat cancer, overcome barriers in screening, enable our researchers to utilise patient data and address funding shortfalls. On Cancer not only provides detailed and real-world evidence but also outlines clear policy recommendations that, if implemented, will improve the lives of those living with cancer.
I encourage everyone to read On Cancer to discover more about our unique research and technologies here in Manchester as it relates to the gravitas and impact of implementing policies for the benefit of our patients and UK healthcare.