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'Critical gaps' in cancer research

More than 180,000 women could die from breast cancer by 2030 unless action is taken over critical gaps in research, a new report warns.

The most comprehensive review of breast cancer research ever carried out has identified 10 key areas where more study is needed.

They include understanding how genetic changes lead to the development of breast cancer, targeting breast screening at those who will most benefit and increasing public understanding of how cancer can be prevented through diet and lifestyle.

Experts are also keen to collect tissue samples to understand more about what happens when cancer begins to spread.

Baroness Delyth Morgan, chief executive of Breast Cancer Campaign, which commissioned the research, said the charity hopes breast cancer can be overcome within 40 years.

But she warned: "If we don't act now, by 2030 more than 1.2 million women could be living with or after a breast cancer diagnosis and around 185,000 lives could have been lost to breast cancer.

"We want future mothers, daughters and wives to have their breast cancer prevented, cured or for them to outlive the disease, and hope that together we can achieve this by 2050."

The report - Gap Analysis 2013 - has been developed by more than 100 scientists, clinicians and healthcare workers.

Author Professor Sue Eccles, from the Institute of Cancer Research in London, said more needed to be done to understand changes in cancers that have spread around the body.

"Our biggest problem is knowing what happens when cancers progress and escape from therapy," she said.

"There's no point in looking at the primary tumour, 80% of which are curable. It's the 20% that escape. By only getting material from the primary, we don't know what the problem is. This is why we really need the material from the secondary cancers."

Cancer that has spread often displays changes compared to the initial tumour, she said.

"We're basing our treatments on what the primary tumour looks like, and it's evolved and changed.

"We know from studies that have been done that the cancer can lose targets that you're shooting at but it can gain others.

"You need to know what's going on in that secondary cancer or the one that's relapsed after therapy. It's a different beast."

The new report is published today in the journal Breast Cancer Research.

Other gaps include the need to develop tests to predict how well patients will respond to chemotherapy or radiotherapy and u nderstanding how to use combinations of drugs and other therapies to tailor treatment for patients.

Author Professor Alastair Thompson, from the University of Dundee, said: "The impact of the Gap Analysis could be immediate as it gives us scientific rationale to change clinical practice.

"For example, currently, metastatic (spreading) disease is not biopsied in order to tailor treatment, but this could change the way one in six women are treated and provide hope to women with secondary breast cancer, with limited treatment options."

Prof Thompson said o nly a very small number of women have cancer that has spread tested through biopsy. Just two studies worldwide have examined the changes and there is a "major gap" in understanding.

He also said the UK lags behind other western counties in terms of treatment.

"It may be that we've inherently got more problematic cancers to deal with, it may be that we need to up our game in getting the evidence in the Gap Analysis into every day practice."

Breast Cancer Campaign has now formed an action plan which sets out how scientists, funding organisations, industry, policy makers and Government can join forces to address the gaps.

The charity aims to raise £100 million over the next decade to address the problems.


From Belfast Telegraph