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Belfast oncologist reveals how immunotherapy can successfully tackle pancreatic and oesophageal cancers

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Pioneering work: Dr Richard Turkington’s research could lead to new treatments for pancreatic and oesophageal cancers

Pioneering work: Dr Richard Turkington’s research could lead to new treatments for pancreatic and oesophageal cancers

Pioneering work: Dr Richard Turkington’s research could lead to new treatments for pancreatic and oesophageal cancers

If you were diagnosed with cancer in the Seventies, the outlook was bleak, with less than a quarter of patients surviving. But with advances in early diagnosis, tests, surgery, medication and radiotherapy techniques, those odds have been turned around, with half of cancer patients now surviving at least 10 years.

However, some types of cancer haven't experienced these great strides forward in survival rates - and Cancer Focus Northern Ireland has just announced a massive £300,000 investment in pioneering research that will help scientists at Queen's University, Belfast to find out why.

The new research project will study pancreatic and oesophageal cancers, which at present have extremely low survival rates. The five-year survival rate for pancreatic cancer in Northern Ireland is 4.9% and for oesophageal cancer it's 18.6%.

This week, Dr Richard Turkington, oncologist and cancer researcher at Queen's, opened up the doors of his lab to reveal how this new research will offer hope to future oesophageal and pancreatic patients.

An experimental cancer treatment is providing an alternative to chemotherapy in Northern Ireland. It is an alternative to chemotherapy, which attacks all rapidly-dividing cells even if they're healthy.

He is both a clinical senior lecturer carrying out research into oesophageal cancer and also treats patients with oesophageal and pancreatic cancer in his role as a doctor at the Cancer Centre - so he is well aware at first hand of how his research could impact families.

"This pioneering new project aims to determine how immunotherapy can successfully treat pancreatic and oesophageal cancers, two cancers which at present are hard to treat and have very low survival rates," he explains. "Unfortunately, when we look at oesophageal and pancreatic cancer combined, they are the second highest cause of lives lost to cancer in Northern Ireland and are responsible for twice as many lives lost in a year as prostate cancer.

"There's been little improvement in the last 40 years in terms of survival rate for oesophageal and pancreatic cancer. We hear a lot about other cancers, but not so much about these cancers, so we need to raise awareness and try to carry out more research into these cancers."

The research being carried out at Queen's focuses on immunotherapy, a treatment which has revolutionised outcomes in a number of cancers over the last 10 years, such as lung and melanoma skin cancers.

"Immunotherapy overcomes cancer cells' ability to hide from the body's immune system," Dr Turkington explains.

The drug strips away the shielding that the cancer cells use to hide from the body's defence system, exposing them so that the body's immune cells attack and destroy them. And while it has been hugely successful in treating other cancers, it hasn't been as effective in treating oesophageal and pancreatic cancer as expected, Dr Turkington says.

"We're trying to work out why they aren't as effective and what we can do about it," he adds.

"This project is really in the early stages of trying to find out how the immune system interacts with these cancers.

"Pancreatic cancer, for example, would be quite a fibrous cancer, with a protective capsule, and it's difficult for chemotherapy drugs to get into the cancer part to penetrate it in the first place. It's a highly adaptable cancer and can develop a resistance mechanism.

"So we are asking, 'What are these resistance mechanisms and how can we switch them off in these cancers?'

"Oesophageal cancer is less fibrous but is also highly adaptable and can quickly work out ways around these drugs. They're both cancers that can grow rapidly and spread rapidly."

Another issue is early detection and early diagnosis. With both cancers, it can take a while to recognise the symptoms - for example, with oesophageal cancer, the symptoms to watch out for are food sticking in the throat and heartburn which lasts for more than three weeks.

"Pancreatic cancer can be even harder to diagnose and it can often just be apparent when jaundice or yellowing of the skin takes place," Dr Turkington says.

"You might have vague tummy pains or be losing a lot of weight, but it's only when the jaundice happens that people realise what is happening - that's why we need a better way to pick up these cancers sooner."

If successful, it has the potential to save lives both here and across the world. Dr Richard Turkington

Some tumours containing a lot of immune cells are described as 'immune hot' and they are primed and ready for immunotherapy treatments, Dr Turkington says, but the vast majority of tumour are immune cold, containing very few immune cells, making them harder to treat. The key will be figuring out how to change tumours from immune cold to immune hot status.

Within the lab itself, the scientists are carrying out two main kinds of research. One is growing cancer cells in flasks to analyse how they fight against the immunotherapy drugs and what can be done to overcome that fighting ability.

The scientists are also working with tumour samples taken from patients to identify how their immune systems are interacting with the cancers.

"We need to understand and see how the immune system works with these cancers and use that to make the immunotherapy better," Dr Turkington says.

"Immunotherapy has transformed the outlook for specific cancers, such as lung cancer and malignant melanoma, previously thought to be relatively untreatable. We believe the same revolution can occur for oesophageal and pancreatic cancers.

"This new work will enable us to drive forward a new era of treatment.

"If successful, it has the potential to save lives both here and across the world."

The cash injection was revealed as Cancer Focus NI launched its new Legacy campaign, urging people to leave a gift in their will to fund local vital research, offering hope to cancer patients in the future.

Roisin Foster, chief executive of the charity, says immunotherapy has really changed things for other cancer patients and offers the potential to be effective against pancreatic and oesophageal cancers.

"This pioneering research offers hope for patients in an area where there has been little real progress for years," she says.

"We're funding Dr Turkington's research with legacy money that has come in over the last few years and we're asking people if they would think about remembering Cancer Focus in their will or making a donation now, and we guarantee that any money raised will be in Northern Ireland.

"We know that as people live longer, the incidence of cancer is rising, and one in two of us can expect to get a diagnosis in our lifetime. By leaving a gift in your will for research, you'll know that you are leaving an important and meaningful legacy for the generations to come."

To be a part of pioneering local research like this project, consider making a gift in your Will to Cancer Focus NI. For advice on how to do this or for more information visit www.cancerfocusni.org/gift or contact the Legacy Officer on 028 9068 0740

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