Improving Outcomes For Cancer Patients

Levels of oesophageal cancer in the UK are amongst the highest in Europe, with over six thousand people a year dying from the disease. This is why Rebecca Fitzgerald, a Group Leader at the MRC Cancer Cell Unit in the Hutchison/MRC Research Centre, is committed to finding ways of detecting this cancer as early as possible, and to prevent it occurring. Oesophageal cancer is characterised by having a pre-cancerous stage known as ‘Barrett’s oesophagus’. This condition is caused, over time, by the recurrent acid reflux of heartburn.

Heartburn is estimated to affect 10% of the general population, with 10% of this group going on to develop Barrett’s oesophagus. Of this Barrett’s group, between 5-10% will progress to full blown oesophageal cancer.

Rebecca’s talk for SCI’s Cambridge and Great Eastern Regional Group on Thursday, 19 February 2009, focussed on the ways in which these precancerous stages can be detected, monitored and if necessary treated. Currently, endoscopy is the ‘gold standard’ for diagnosing Barrett’s oesophagus. However, the costs involved in this, limit its use as a screening tool. Rebecca described a new device developed by her research group that is simpler and cheaper than endoscopy, and also a much less unpleasant experience for the patient. Using ‘Norman’, a model with transparent and removable organs, and assisted by clinical fellow Chris Peters, Rebecca demonstrated how her new device of a string with a sponge contained within a small gelatine capsule, was used to collect cells from the oesophagus. Once the capsule has been swallowed, it dissolves in the stomach, releasing the sponge, which can then be pulled back up through the oesophagus using the string, collecting cells on the way. This device has been patented and was approved for use by the Medicines and Healthcare products Regulatory Agency last year. The Fitzgerald group has also investigated cellular biomarkers, whose presence indicates that a cell is cancerous. Building on the work of Ron Laskey, a joint director of the MRC Cancer Cell Unit, the group have used the protein MCM2 to differentiate cancerous cells from normal cells.

A lively Q&A session followed Rebecca’s presentation, which covered various topics, from the reasons for the recent rapid rise in the number of cases of oesophageal cancer to the issues surrounding string strength and knotting in the development of the capsule sponge device.

Rebecca’s ultimate research goals are to move the diagnosis of Barrett’s oesophagus into the primary care environment (such as GP practices) and to stratify the risk of oesophageal cancer, using samples collected by the capsule-sponge device to find, and treat, Barrett’s patients with the highest risk of developing cancer. The work of her group has moved these goals significantly closer to becoming a reality.

Dr Ireena Dutta, Hutchison/MRC Research Centre

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