Gynaecological Cancer Awareness Month: How cancer research makes for more special moments
September is Gynaecological Cancer Awareness Month, a time for education on and important conversations around cancers of the cervix, ovaries, vagina, vulva and womb. Professor of ovarian cancer medicine James Brenton is based at the University of Cambridge’s Cancer Research UK Cambridge Institute and co-leads on ovarian cancer research for the Cancer Research UK Cambridge Centre.
Here, he looks at the reasons for optimism around the disease while patients from a dedicated ovarian cancer research programme in the city share special moments they have been able to enjoy thanks to research.
I’ve been an oncologist and consultant in ovarian cancer for over 20 years, and the progress made in preventing, diagnosing and treating the disease wouldn’t have been possible without Cancer Research UK funding.
The charity recently launched its ‘Together We Are Beating Cancer’ campaign, shining a light on the special moments people like Barbara, Lorraine and Margaret have been able to enjoy as a result of research.
For those of us carrying out the research, this is always moving, making it very real, helping us to see progress and think about what we’re trying to achieve.
Ovarian cancer is so complex and we still have a lot more to discover, but compared to when I was training in the late 1990s, we can now talk much more positively about treatment choices for patients.
Advances so far
What has changed between then and now is we’ve uncovered how complex what I call the wiring diagram of ovarian cancer is.
We were in the wilderness on this for a long time and a lot of my work in the last 20 years has been focused on trying to make sense of the complexity. How do we see the wood for the trees?
Another big difference is that – thanks in large part to Professor Sir Stephen Jackson, who recently moved his lab to the Cancer Research UK Cambridge Institute, having benefited from the charity’s grants throughout his career – we have discovered a group of medicines known as PARP inhibitors.
These PARP inhibitors mean we can control ovarian cancer for longer and change the outlook for people with the disease. They’re also now the building blocks for medicine combinations we hope will provide a cure.
Collaboration is key
I think the biggest challenge to advancements is being able to move between doing intensive studies of individual patients and looking at samples from clinical trials and larger scale studies.
The complexity of the analysis required is such that we need to keep moving between different scales of study.
Trying to get enough high-quality data – because ovarian cancer is rarer than some cancers, affecting around 7,400 people in the UK each year – is difficult.
A critical component to coping with this challenge is international collaboration and through Cancer Research UK funding we’ve established a dedicated ovarian cancer research programme here in Cambridge, giving us a vehicle to really engage with patients and understand what they want, and what’s important to them, then design our own studies and better engage in the all-important global relationships.
Continuing to improve
These kinds of infrastructures we’re able to put in place enhance the research environments of Cancer Research UK’s Cambridge Institute and Centre, and that enables us to bring in more money from other sources.
For example, we’re part of a big machine-learning project with GE HealthCare, creating a visualisation platform for patients to be better informed and in control of choices relating to their treatment.
At the moment, there are limitations in data sets and trying to bring everything together in real time.
My vision for ovarian cancer is that, through advanced imaging methods and genomics, we’ll pinpoint exactly when in their journey a patient will really benefit from certain types of treatment. Importantly, this will mean some patients won’t require chemotherapy as they’ll instead be able to receive combinations of tablet-based treatments based on PARP inhibitor medicines. In addition, we want to reduce the uncertainty when choosing some chemotherapy treatments and help patients find clinical trials that might better match their cancer’s wiring diagram.
An exciting future
I’m also a co-lead of the Mark Foundation Institute for Integrated Cancer Medicine at the University of Cambridge.
This is our approach to dealing with very complex diseases like ovarian cancer and what we’re trying to do is bring together all the things we can measure in a patient, from the clinical features to the imaging, molecular tests and so on.
By studying patients in this very detailed way, we think we’re going to do a better job of figuring out the complexity of their disease and understanding patterns as they occur.
It’s exciting the programme will be one of three research institutes housed in the new Cambridge Cancer Research Hospital once that’s open. Embedding researchers in an NHS setting, with staff from Addenbrooke’s Hospital, can only lead to huge benefits in patient care.
To help Cancer Research UK continue supporting Prof Brenton and fellow researchers to carry out work that has saved an estimated 114,000 lives from cancer in the East of England since the mid-1980s, you can make a donation at cruk.org/donate
Three patients share their stories
Here are the stories of Barbara, Lorraine and Margaret, who are showing their support for Cancer Research UK’s Together We Are Beating Cancer campaign
My name’s Barbara James. I retired from nursing in 2016, having spent 45 years working for the NHS. The final four of those were as a specialist community palliative care nurse, so I was well acquainted with cancer. Nonetheless, it came as a shock when I was diagnosed with stage four ovarian cancer in January 2021 – I’d only gone to my GP as I’d found a lump in my groin.
Between then and July 2022, I had chemotherapy, debulking surgery and 18 months of bevacizumab, a targeted cancer drug I know Cancer Research UK helped with when it was going through clinical trials. The cancer appeared to have gone, but reappeared during a routine scan in January. I had more chemotherapy until July, when the decision was made to start me on a PARP inhibitor.
In my mind, this could give me many more years with my family. My husband and I have two sons and four wonderful grandchildren, and it was a momentous occasion to see the eldest turn 18 in July, the same month he finished his A-levels. In August, I reached a milestone I wasn’t sure I’d see – my 70th birthday. I had an afternoon tea with family and friends, and instead of presents asked for donations to support two causes very close to my heart. Thanks to everyone’s generosity, I was able to donate £350 towards ovarian cancer research.
I was diagnosed with stage three ovarian cancer in September 2019, when I was 57. To be honest, I’d never heard of it and didn’t understand the seriousness of it for a long time.
I’d been feeling poorly, bloated, full after eating small amounts, pain in my abdomen and lethargic. I went for tests and received a diagnosis of gallstones. It was only when the consultant asked for a CT scan that I was advised to have a biopsy.
After further assessments, I underwent a debulking operation, at which point my cancer diagnosis was confirmed. From that day, I can’t fault the treatment I’ve had. I was offered a chance at life by going on a two-year trial known as ATHENA.
This involved a PARP inhibitor being used in combination with another type of targeted treatment and I’m convinced if I’d not taken part in the trial I wouldn’t be here today – I’m so grateful for research. After this experience, to celebrate life, I did something every month for a year after turning 60! There was a time I didn’t think I’d see this milestone age and the first of my celebrations was at the Ritz.
In September 2020, when I was 64, I had vague abdominal symptoms and clinical tests deemed everything was normal. Three months later, I had significant groin pain and further tests at Addenbrooke’s Hospital led to the devastating diagnosis of ovarian cancer, with probable spread. This came about five years after having kidney cancer.
In January 2021, I had surgery to remove organs such as my womb and ovaries. Unfortunately, I relapsed not so long after. More tests have indicated I might benefit from an inhibitor that’s in the pipeline, so obviously continued trials and research is imperative to me. Through being part of the ovarian cancer research programme in Cambridge, I’ve seen the dedication of the research and medical teams who are extremely committed and hard-working in their attempts to make breakthroughs.
Battling on with chemotherapy – another treatment type I know Cancer Research UK scientists have pioneered – I continue to look and feel relatively well. This has enabled me to form a close relationship with my grandson, Theo, and I’m so glad he’ll likely remember our time together rather than blankly observing granny’s candle on the table, unable to relate to it. I’ve also been able to attend my daughter’s wedding and celebrate my husband’s 70th birthday. I’m currently looking forward to the birth of another grandchild and my 50th wedding anniversary next year.
New videos to help ensure ovarian cancer patients get best treatment
Ovarian cancer researchers and patients from the Cancer Research UK Cambridge Centre, along with fellow ovarian cancer experts and patients from Birmingham, have developed videos in multiple languages in an effort to increase uptake of genetic testing among people with the disease.
An additional molecular test offered after diagnosis can help doctors and patients choose the best personalised treatment. It can also identify if a patient was born with a high chance of developing cancer, meaning they can take steps to reduce their chance of getting cancer again and share the information with family.
However, the uptake of this test is low in some groups of women, especially in black, Asian and mixed ethnic groups, and this is mainly thought to be due to a lack of informed decision-making resources for those whose first language is not English.
With funding from Ovarian Cancer Action, the Demonstration of Improvement for Molecular Ovarian Cancer Testing (DEMO) team undertook research to identify any barriers and misconceptions around genetic testing.
The short animated videos and accompanying written content produced as a result are available in the Bengali, Polish, Punjabi, Romanian and Urdu languages.
DEMO project co-lead Dr Gabriel Funingana, a clinical research fellow at the Cancer Research UK Cambridge Institute, said: “Every person diagnosed with ovarian cancer, no matter their background, should have access to cutting-edge genomic tests like whole-genome sequencing. They have the power to personalise treatment and drastically improve survival outcomes.
“The DEMO project is a step towards a healthcare future where every person with ovarian cancer benefits from the incredible advances in genomics. Together, we’re making this future a reality.”
To view the videos go to youtube.com/@CRUKCamCentre