Our new cancer sciences centre, opening in 2019, will be bringing together new and existing researchers in many cancers including: breast, colon, esophageal, bile duct, blood, prostate, lung, and children's brain cancers. Our research focuses on how cancers interact with their host environment including the immune system, blood vessels, stroma, radiation, hypoxia, carcinogens (including cigarette smoke) and things that change cancer cells' DNA. Our new course will teach students to understand how cancers form, how we respond to them, and how new treatments, diagnosis and imaging are developed. We will train them in laboratory biomedical sciences, clinical trials, public policy, and the other aspects that go into understanding how new better treatments for cancer are brought about. If you have any questions about the course, our research or anything else related to cancer science, ask us anything!

Course

Centre for Cancer Sciences

Proof

EDIT: Wow - that was a fantastic session. Keep your questions coming in, I'll try and address what I can over the bank holiday. Thanks everyone Dave

Comments: 694 • Responses: 76  • Date: 

JimmyJimmsen168 karma

Is cancer actually curable or is the best possible outcome of a treatment a chronification? I'm wondering because it seems that cancer always comes back once "successfully" treated. Thanks!

couloirjunkie268 karma

Cancer can be cured and always has been able to be. Surgery for many cancers is a cure. However, for many, many others cure is a very long way away. Earlier this year a group described the first true cure of a patient with metastatic breast cancer through use of immunotherapy, and we have certainly seen patients who would most certainly have died of their cancer responding so well to treatment with immunotherapy drugs that their cancer is in remission for long enough for them to live a full and happy life before dying of a different disease (is that a cure?).

shaokim119 karma

What happened to the Cancer Stem Cell hypothesis craze from a few years back?

couloirjunkie157 karma

Good question. There's still a lot of interest in the principle that some cancer cells are able to divide and form cells that can either go on to differentiate or continue to divide, and that there is a small population of these cells that drive both cancer progression and resistance to therapy. The evidence that it is these cells alone that drive resistance, or that they are pluripotent is generally lacking in my view (although some researchers will disagree). Understanding how cancers can mimic or evolve aspects of stem cell physiology I think will help drive new approaches in cancer though.

JimmiRustle77 karma

What's the craziest (wrong) claim about cancer you've heard?

couloirjunkie189 karma

"Smoking cigarettes doesn't cause cancer" is probably the one that used to be the craziest.

NeotericLeaf74 karma

My mother has a rare site of origin for melonoma, her urethra. Does that put me at increased risk of developing non-skin melanoma?

What are the best options for someone with stage 4 melenoma, NRAS Q61R / SF3B1?

In the last weeks, what can be done to make the patient as comfortable as possible?

Thank you for your time, and I certainly won't consider any of your opinions as "treatment". I'm just looking for a greater perspective.

couloirjunkie97 karma

I'm sorry to hear that. For your specific questions your oncologist would be best placed to answer that. I can give you my view (and your question has got me thinking!). I don't think it does significantly increase your risk. The treatment options will be patient and tumour specific - immunotherapies are useful in many patients (e.g. pembrolizomab, ipilumimab), and specific targeted therapies against mutations in RAF have helped (e.g. dabrafanib), but her oncologist will need to tailor her treatment for the specific cancer traits if targeted therapies are used. Many people find being at home and surrounded by family is more comfortable than being in hospital, but again, talking to her, and listening to her is probably the best way to go.

scamperthecat68 karma

A friend of mine is sure he has cancer and has thrown a lot of money into tests. All (lots of them) have come back negative apart from one test from a place called RGCC which say they have detected floating Tumor cells in his blood. He is now taking insane high dosage vit C intravenously and is talking about going for chemo despite no real diagnosis by the multitude of tests he's had. Are these RGCC tests bona fide? Is the high level vit C clinically proven? How can we help him?

couloirjunkie136 karma

There is no good evidence that vitamin C will treat any form of cancer. RGCC is a private provider of tests to detect circulating tumour cells. The cells are detected because they have markers of epithelial cells, which are not normally found in the blood. There are a number of reasons why this can happen, and false positives are common - it is not generally used as a primary screen for cancer. Cancer is usually confirmed by a CT scan, or other imaging of the tumour in the more developed nations, followed by biopsy and pathology. I'm not sure how you can help him, apart from being his friend, and being there for him when he sees doctors. Maybe a counsellor or therapist?

That_one_Pizza54 karma

What is your opinion about pineapple on pizza?

couloirjunkie91 karma

Love it

Sixersleeham44 karma

Hi, I'm actually starting at the University of Nottingham in september although I'm doing computer science. Any advice you can give me for my first year?

couloirjunkie77 karma

Welcome and congratulations! My advice - join clubs at freshers fair, go to all your lectures/workshops (and read your notes afterwards), make the most of the facilities and enjoy the environment - the Park is beautiful in the autumn. The more you put into your course the more you'll get out of it. You'll make lots of friends, some of them for life.

aarthurn1333 karma

Do you enjoy teaching and what do you think about this generation of students?

couloirjunkie99 karma

Yes. Teaching University students at all levels (undergrad, masters, PhD) is incredibly rewarding. It also makes me have to think harder on what we know about cancer, as many of the students ask really interesting questions.

This generation of students are dynamic, interested, challenging and hard working. They may provide different challenges from when I was a student, but they are just as questioning, generally better able to find sources for their material and more passionate about engaging the public about science.

Shimmyshanka27 karma

In the vegan community we constantly here of wild claims of people completely reversing and curing their cancer through a change to a plant based diet.

Im yet to come across a single person to have done this though.

So as an expert do you believe a vegan lifestyle can reverse and cure certain types of cancer with no medical intervention at all?

couloirjunkie67 karma

This is a personal one, as my mother, who died last year from cardiovascular disease was a vegan for my entire adult life. However, neither she nor I believed that a vegan lifestyle can cure any type of cancer, and my belief is based on evidence and a fundamental understanding of the processes of cancer. Hers came from her own down to earth common sense! Plant based diets are not going to cure cancer. Surgery, chemotherapy, immunotherapy and radiotherapy might help treat cancers, and sometimes cure them, but no known diet is going to have that effect.

Everline3 karma

What about a ketogenic diet? There are some claims which say some cancers feed off glucose so reversing to a ketogenic diet may help to starve them or limit growth. Is there some truth there?

couloirjunkie8 karma

Nope

beereydee27 karma

What is a "bespoke" degree and how does it differ from a normal degree?

couloirjunkie63 karma

The degree is designed from scratch as a cancer course, rather than a series of existing modules that seem to be relevant to cancer cobbled together and called a cancer degree. Everything we do in this degree is relevant to (but not exclusive to) cancer. The difference between this and say Biomedical Sciences with some cancer modules, is we put everything in the context of cancer, so yes you're going to understand how cells grow, how blood vessels are formed, how the immune system works and so on, but it will be how that relates to cancer, taught by cancer researchers.

eddietwoo24 karma

Why is pancreatic cancer so deadly? My mother died of it 10 months after diagnosis. Are people with pancreatic cancer able to be cured? Thank you for your time and efforts.

couloirjunkie67 karma

I'm sorry to hear that. Pancreatic cancer and bile duct cancer both have a very poor prognosis for a number of reasons. 1. It is often diagnosed late because it has few definitive symptoms early on (you cant feel a lump, you don't get blood in your urine, or cough up blood). That means it's often progressed far before it is caught. 2. The mutations that cause pancreatic adenocarcinoma are often particularly aggressive ones for them to be able to migrate across the ducts, meaning that the cancers are invasive early on. 3. They often don't have a lot of mutations that stimulate the immune system, so they can evade it quite well. A small proportion have microsatellite instability, and there is interest in whether these will be susceptible to immune therapies. 4. They have often metastasised (spread) before they are detected, and even if no spread has been detected it is often there.

In terms of treatment, new therapies are being tries all the time, so we need to keep working. That's why we are running the course, to train more researchers.

Occams_ElectricRazor21 karma

How do you try to frame a logical discussion with people who truly believe that cancer has been cured, and it's simple greed that is driving current treatments and research? As a physician, I usually just avoid any significant discussion with those people, because trying to explain the variance in cancer pathology and natural history to a layperson who has already made their mind up seems to be a fools task.

couloirjunkie24 karma

Keep talking, keep pointing them in the right direction, and remember, most people are kind, even if you don't (and can't) agree with them.

jsepeta20 karma

How do dogs smell cancer?

couloirjunkie82 karma

Interesting question. Short answer is that no one really nose (sorry!) either if they can or how they can. There has been a significant amount of research, particularly for detecting prostate cancers, into detection from urine, but there have been no really large, substantive well controlled studies as yet. It's possible that metabolic products from tumour tissues can be detected by well trained dogs, but its also possible that the digs can pick up on other subtle hints from their trainers. Blinded studies have shown some evidence that they can, but positive small studies are more likely to be published than small negative ones. There has been some interesting work on this with a small number of highly trained dogs, but the mechanisms are still unknown, and until we know how these results work, it will be hard to take it forward. But interesting nonetheless.

dontstopmenow196618 karma

Question:who are the intended students and what use do you expect them to make of their knowledge from the course?

couloirjunkie27 karma

The intended students are people who want to make a difference to cancer research and treatment in the future, whether it is through making scientific breakthroughs, helping to discover and develop new treatments, or help us to understand the causes and consequences of cancer. This includes jobs in scientific research, both in the public and private sector, in policy and not-for profit areas, as well as helping people make investment decisions, science communication and running clinical trials. Most of us have been touched by cancer in our own lives and we need better policies, prevention, diagnostics, therapeutics and ways of caring for people with cancer and their families.

hyperclaw2717 karma

Is anything not carcinogenic? These days almost everything seems to be labelled as carcinogenic.

couloirjunkie60 karma

Broccoli. Definitely not.

Balanced diet. Healthy lifestyle.

submat8715 karma

Is consumption of meat, eggs, dairy, fish related to cancer?

couloirjunkie44 karma

It's highly unlikely you will die from what you love doing on the basis of this question. Consumption of smoked, cured or salted meat, and a large amount of red meat is associated with a small increase in risk of bowel cancer. Personally I don't eat smoked bacon, maybe partly as a consequence of this, but also because I prefer unsmoked. However, a balanced diet, including fish, dairy, eggs and meat, but plenty of fresh vegetables, is likely to offset that risk and reduce your risk of cardiovascular disease too.

Galileo__Humpkins13 karma

Why does it seem like so many seemingly promising treatments for specific or broad spectrums of cancer fade into oblivion? It feels like for every 50 articles you see about some breakthrough, maybe 1 of the approaches talked about gets mentioned again.

couloirjunkie31 karma

Great question. Lots of answers. For one thing, it takes between 10 and 30 years for a breakthrough to become a reality. Secondly, many articles contribute to each new treatment. In fact it will be much more than 50:1 for those that are successful, let alone those that don't work out. Development of a new treatment will require testing validation, further development through multiple stages. Discovering the target is newsworthy. Finding a chemical that might help is newsworthy - but that's not a drug. And so on. Thirdly, we are in fact in the middle of an unprecendented breakthrough in cancer treatments - there have been almost as many new cancer drugs in the last five years than in the previous 15! And of course, sometimes initial results aren't as widely applicable as people originally thought. And some are downright wrong.

goalposthead452512 karma

The main issue is money; A lot of the articles you’re reading are basic research and funded by government agencies. The average grant that a lab receives is in the hundreds of thousands of dollars, which sounds like a lot until you look into how much developing a drug costs, which is in the billions of dollars. There are orders of magnitude between a science grant and how much it costs to develop a drug, and a research labs aren’t equipped to deal with that difference. However, scientists still do manage to bring compounds to the market! Which is good, that’s the reason we’re doing this research.

So say you’ve developed a compound and you want to bring it to the market. The most common path (based off my understanding) is to partner with a drug company because they do have the billions of dollars to develop drugs. You’ll need to do a lot more animal studies to reallly make sure your drug is doing what you think it is (which is more money). One issue with a lot of basic research is that it doesn’t get replicated enough by a single paper. So when you read “researchers at university x discovered compound y” there hasn’t been enough replication for a drug company to jump on board because, again, it costs billions of dollars to bring a drug to market, and they don’t want spend a lot of money on something that doesn’t work.

But, your compound is really promising, the mechanism of action is confirmed by multiple lines of evidence and now you can start trials in humans. You’ve spent a few million at this point. The application for the FDA is really complicated, and now you’re going to need a legal team (which is money, see the common theme here?). The most common animal model is mice, so while your compound may have worked in mice, there’s no promise it’ll work in humans (as mice and humans are differently), so you need to do multiple rounds of testing. This is the really expensive part, which I don’t know a lot about besides it costs a lot of money, and mice and humans are different so lots of compounds drop out. You also need a lot of people in these trials, which is a lot of money. The reason compounds are so expensive to develop is that we really want to make sure we aren’t killing people when we try and help them, so drug companies need to be very thorough.

Hopefully this was somewhat informative. The tl;dr is that compounds are really expensive to develop because we don’t want to kill people

couloirjunkie2 karma

Great reply. Thanks!

theonlypenguinf13 karma

Hi! I'm starting the MSc in Cancer Immunology at Nottingham next month and I'm very excited! I have two questions; what are your views on how cancer therapy research will develop in the future (eg 'bench to bedside' fully integrated academic, industrial, and clinical research) and do you have any advice for early career scientists like me with regard to career development?

couloirjunkie18 karma

Great to have you on the Masters course. I do indeed have lots of views - I'm sure we can share them next year when you're on the course. Best advice is to do what you're doing - get trained, work hard, think hard and keep your passion.

Doc75710 karma

How long does it take to go from theory to human trial ? How come more things don't make it to human trial despite showing promise in lab and animal testing?

couloirjunkie9 karma

Good question. The shortest I've come across for a successful treatment is about 6 years from someone identifying a potential target to getting a therapeutic into trial. But really it depends on money. It's possible to do it in three, given the amount of time it takes to put a drug candidate through all the battery of safety tests, manufacture enough compound at high enough quality, and getting the regulatory approvals. However, you would need a lot of money and everyone to be convinced by the theory straightaway. For a diagnostic it could be quicker into trial.

The second part of your question is even more intriguing, and we hope to answer that on the course! Short answer is that cells in dishes aren't cancer, and even animal models have their problems. We need both of course, but eventually you have to try it in humans.

h3llknight2210 karma

In the future, could cancer be a way for humans to achieve immortality? Our cells can only divide a finite number of times, governed by something called telomeres. Cancer cells seem to be able to prevent the shortening of telomeres, which allows them to divide almost indefinitely. If humans were able to tap into this power, could we achieve immortality?

couloirjunkie46 karma

Only if you can prevent mutation, and control the effects. Actually most cancer cells have shortened telomeres too. They are able to extend them, but this often results in dysfunction too. Perhaps more importantly - individual immortality would be a really bad thing for humanity. I'm already getting in the way of my teenagers ideas, better to grow old gracefully and let the next generation innovate. Immortality is through your children.

TheFarvio9 karma

What's your favourite movie and genre?

Also I'm gonna have to say thank you on behalf of all the people here who are actually knowledgeable enough to ask serious questions, they're definitely going to appreciate this. :)

couloirjunkie19 karma

Crappy disaster movies! Think Volcano, Dante's Peak, San Andreas, Day After Tomorrow. Sad but true.

JulianaLores7 karma

Do you need any MDs interested in genetics? I would love to be involved in this!

couloirjunkie6 karma

Quite possibly, drop me an email

speech_freedom7 karma

[deleted]

couloirjunkie15 karma

In my view and succinctly: prevention, early diagnosis, and clinical trials of stratified medicines.

Artificial-Brain7 karma

Theres a lot of (mis?) information on cannabis oil being an effective treatment for some forms of cancer, is there any truth to this?

couloirjunkie20 karma

It can probably help the pain, but there is no evidence yet that it can treat the cancer.

amoodymermaid6 karma

What is your view on commercially available nutritional supplements that claim to help us defend cancer? Also, thank you for doing such important work to help us and our loved ones.

couloirjunkie11 karma

See above - a balanced diet and a healthy lifestyle. If you eat a balanced diet you shoudln't need nutritional supplements unless you have a specific genetic deficiency.

winter___6 karma

What is the most incorrect thing about cancer that the students you teach think when they start there classes?

couloirjunkie19 karma

That cancer is independent of the body - what I mean by that is people think of a cancer cell as being a mutation driven cell that is proliferating independently of its environment. There is a storng two way link between the cancer and its environment, and that is critical.

BdmRt6 karma

I‘ve read somewhere that regardless of what you do or what you consume, getting cancer is mainly bad luck. Some stuff may increase the risk like smoking, but even the healthiest living humans can get cancer like everybody else and it depends on coincidences at mitosis. What do you think about that statement?

couloirjunkie15 karma

I think that's a good way of looking at it. Cancer is, in many ways, a natural consequence of being alive. Some people are unlucky, some take risks and are lucky. Risk is a hard thing to get your head around. I'm writing this with a glass of red wine, so its a calculated one I guess.

HectorMoriarty445 karma

What is your stance on Brexit? Do you think it is the best thing to happen to the UK in regards to research?

couloirjunkie20 karma

Collaborations across Europe are critical for cancer researchers, particularly for rarer cancers, or for rarer subtypes of cancer. If Brexit makes that harder it will not help. We won't know the impact until after March 2019 for sure, but it has been harder to build collaborations inside Europe. I do a lot of work outside Europe too (Thailand South Africa, Malaysia), and being part of Europe also helped there, not hindered it, so Im not seeing what benefit there would be to not being in Europe.

tjbassoon5 karma

How do you feel about issues regarding cancer funding being so driven towards breast cancer research, seemingly at the expense of researching other cancers, especially those that affect predominantly men?

Context: I was diagnosed with esophageal cancer a little over a year ago and was floored by the statistics regarding the poor survivability of this cancer, and that it affects mostly men. Funding towards this cancer seems woefully inadequate considering how aggressive it is compared to other cancers, and how high the morbidity rate is of this one compared to breast cancer is. (At the risk of sounding insensitive, my sister died of breast cancer at age 30, so I'm no stranger to this awful disease). Funding to help men get through cancer diagnosis in terms of charity organizations is also seriously inadequate compared to women, but that's for another thread.

couloirjunkie5 karma

I'm sorry to hear of your diagnosis. I have a friend diagnosed with that last year too.

More women still die of breast cancer than most other cancers, so research is still needed there too. Our Breast Cancer Research Centre here has made major contributions to understanding and treatment of cancer, so I do think it's important (and I have personal experience of this in my family too). I also agree that there is nowhere near enough funding into oesophageal cancer (or bile duct cancer, and many others), but it shouldn't be a zero sum game. Research into breast cancer in my lab has helped us work on blood cancers for instance. There needs to be more research into all forms of cancers, and support for charities such as AMMF (bile duct cancer charity), Breast Cancer Now, or the Brain Tumur Charity here in the UK helps that. In terms of mens cancer charities, Prostate Cancer UK does a great job, as do others, so there is support there too.

ober0n985 karma

Are you capable of a 30hr lecture?

couloirjunkie16 karma

I wouldn't want to wish on anyone the experience of me talking for 30 hours straight!

sodium_dodecyl5 karma

Given how incredibly multi-disciplinary cancer research tends to be, what do you think are the primary advantages to teaching students general "cancer science" over teaching specialized researchers and setting them up to collaborate extensively?

couloirjunkie6 karma

Actually that's exactly one of the reasons why we think it's important. Almost every new PhD student I've had, and most graduates going to work in the field, have to be taught about areas of cancer they know nothing about. If you are Cancer Research UK, or the Department of Health, or a company making new antibodies for cancer, you literally cannot hire graduates with a good grounding in what is cancer and what happens to people when they get it. The only courses are Masters courses. You may be great at physiology, or biochemistry, or cell biology, but its unilkely you'll have the breadth of knowledge about cancer that these employers need. The Cancer Research industry is huge, but there are no degrees in it. So we set one up.

cherise6054 karma

Thank you for training our next generation of cancer researchers. As a Biostatistician working on cancer immunotherapy trials, I'm curious if your program(s) cover basic Biostatistics for clinical trials including relevant terminology (e.g. alpha spending function, hazard ratios, Kaplan-Meier plots, etc.)?

couloirjunkie2 karma

Yes, mainly in second year, but we are looking to expand it in third year as the course grows.

Markr19574 karma

What, if any, advances are being made in the treatment of multiple myeloma? My hematologist tells me it's treatable but incurable.

couloirjunkie7 karma

This is a hard one. My father in law died of MM four years ago. Targeted therapies are coming through - three new drugs were approved the year after he died - but they probably wouldn't have saved him because it was so far advanced when he was diagnosed. Check out clinicaltrials.gov for new trials for multiple myeloma.

Mukkore4 karma

Why make a dedicated course on cancer instead of having people with solid training in the base disciplines (chemistry, biology, medicine) specialize?

How much cancer is behavioral/environmental and up to control by the individual?

couloirjunkie3 karma

Great question. Great Universities offer multiple courses, because different people have different interests. At Nottingham we have great programs in Biochemistry, Physics, Chemistry, Pharmaceutical Sciences, Biomedical Sciences and so on. But some students want to a clearer picture of how their studies impact on the world. So what we do is give people a solid training in experimental design, biochemistry, cell biology, physiology, and all the other aspects needed to become a high quality scientist, but the application is to cancer - how cancer cells grow, cause blood to provide oxygen, metabolise, move around, interact with the immune system and so on. We also look at how physics is used to detect cancers, how chemistry can develop new drugs, and statistics be used to find causes of cancers. It may not be for everyone, but we think some students will love the focus, and feel the value. At the end of it they'll have a great training in science first, that will be relevant for whatever they do. But they will also have an understanding of cancer which may fuel their passion, or be helpful to them throughout life independent of their career. And they may become part of the next treatment for cancer....

Slutmonger4 karma

Thank you for taking the time to answer questions professor. I don't know if it's been mentioned in this thread before, but I've heard from less knowledgeable sources before that e-cigarettes are less nocuous than normal garden variety cigarettes. Now I presume that the liquids used in e-cigarettes contain some form of organic solvents in some concentration to help dilute organic aromatic molecules along with other substances of questionable nature with respect to their impact on human health. Could you be so kind as to proffer your opinion on the matter given your expertise with regard to carcinogenic substances ?

couloirjunkie2 karma

It's an interesting question and one that will hopefully have more answers over the next few years. In my opinion (and it is just that, based on my understanding of the basic biology of cancer), e-cigarettes are much, much less likely to cause cancer than cigarettes. The vast majority of carcinogens in tobacco smoke are not in e-cigarettes. If you are asking are e-cigarettes safe, then that's a harder question. My guess is that they are much less dangerous than cigarettes, but nicotine itself has detrimental effects on cardiovascular health. However, they haven't either been around long enough, or been tested extensively enough for us to know. There is evidence that they can help people give up smoking, which in itself could be the best thing about them, but even this is still being verified.

Scurvy824 karma

Are you involved with isotope therapy? If so, which isotopes?

couloirjunkie5 karma

Not personally, but others at the University and in the Hospital use isotopes in radiology, clinical oncology and scientific research.

pplcs4 karma

Does computer science in the form of computer tools or bioinformatician researchers play a role in finding cures for cancer?

couloirjunkie7 karma

Hugely. Use of computer modelling, and the use of bioinformatics has a long and glorious history in cancer research. In fact there is a desperate shortage of good bio-informaticians in caner research just now.

Sir_Bantersaurus4 karma

Newbie question.

For many risk factors for cancer they ask if you have a parent who had that particular cancer but usually before a certain age. Is this because that in old age developing cancer is simply as much about your age than any generic risk?

couloirjunkie2 karma

Sort of, the older you get the more likely you are to get cancer. Developing cancer at an earlier age can sometimes be linked to sequence anomaly, but statistically is harder to do so when you're older.

volantiss3 karma

Do you think that if a cure is found, it would be too expensive for the poorer people? If yes, what can be done to help them?

couloirjunkie8 karma

Interesting question. Most treatments are already too expensive for most people with cancer (2/3 of cancers are in the developing world). Developing health care systems that can deliver cancer treatments is just as important as discovering new drugs. This global health focus is also the topic of some of our researchers in Nottingham

froghat2k3 karma

What percentage of cancer is caused by alcohol abuse?

couloirjunkie13 karma

A small percentage, because most people who get cancer don't drink. Now before everyone says "whoah we know drinking causes cancer" yes it does. Alcohol does cause some cancers in the western world. But 2/3 of all cancer deaths are in the developing world, and alcohol intake is much lower there. The vast majority of cancer sufferers do not and have never abused alcohol.

hooraloora3 karma

How much time, if any, does your centre spend synthesising and testing novel compounds? Do the treatments you assay come from both outside and within your facilities?

couloirjunkie7 karma

We have multiple research groups developing multiple new compounds to try as anti-cancer agents. The University has at least six major research groups working in drug development, and we have worked with small, medium and large companies to try and develop cancer treatments. The drug Temozolomide, currently used as treatment for brain cancer was developed by Malcolm Stevens group over a number of years when he was here at Nottingham and at Aston University, and Prof Lindy Durrant's Group at the University is currently carrying out clinical trials through her spin out company ScanCell. My own group is working on new treatments too, but we are still in pre-clinical phase - before human trials. So in summary - a lot!!

alfabetaom3 karma

I would be very interested in a place on the course. Bsc Microbiology & currently working in cancer clinical trials. Can I join you?

couloirjunkie9 karma

If you already have a BSc then the Masters in Oncology might be more appropriate. If you are currently doing a BSc then you would probably have to talk to the course organiser. We have an open day on 14th/15th September.

cyfarian2 karma

Are you incorporating more holistic methods into your training?

Any focus on certain mushrooms, like cordyceps and turkey tail? How about cannabis?

couloirjunkie6 karma

Actually we have a group here working on cordycepins! By more holistic, we certainly look at the whole aspect of cancer - including what it does to patients families, survivorship and longer term side effects. Also effect of healthy living on cancer incidence and treatment (we have an excellent group looking at smoking and cancer)

ButtsexEurope2 karma

Do you guys know Professor Poliakoff?

couloirjunkie2 karma

Yes, Martiyn is a fantastic educator and scientist here in Nottingham, in the School of Chemistry

AnoniMiner2 karma

Are you concerned Brexit might lead to terminate the program?

couloirjunkie2 karma

Not the Cancer Sciences course, Centre or program, no. I have no worries about that - plenty of others, but not that.

Ali-the-bee2 karma

Hi and thank you for your work. I lost both of my parents to cancer in their 60s. Both were caused by lifestyle. My dad was morbidly obese (bowel) and my mum was a smoker (lung). What percentage of cancers do you think are preventable by improving lifestyle and making changes such as maintaining a healthy weight and not smoking? I am forever hopeful for a cure but at the same time I hope more awareness of prevention will persuade future generations to wear sunscreen etc. Again, thank you. I hope my children won’t have to go through what I went through.

couloirjunkie7 karma

I think early cancer deaths are often (maybe >50%) down to environment, but later cancer deaths probably less controlably so. Reducing smoking rates is the most effective way to stop early cancer rates, and obesity and alcohol use are probably the next two, but I think the future is bright, and covered in sunscreen.

all3f0r12 karma

Please excuse my naivety if I've been misled, but I heard many times here and there that a plant-based diet can cure cancer. I heard the same about green juices (typically vegetables). And fasting as well...

Are one of these true? And if so, under which conditions?

couloirjunkie4 karma

Nope. Not true

kmdani2 karma

Do yo think all cancer is going to be treatable one day? How many kind of rare cancertypes are there which research are just never be financially feasable? (Type of illnes only 200-300 people get it in a year, and it would cost millions to research.)

couloirjunkie4 karma

I am an optimist, and I think that all cancers will be treatable. With good healthcare systems, we can afford to spend more on a minority of people, and many of their treatments will be available from the many other treatments (drug repurposing often works). The story of Imatinib is a good one here.

-0r4cl3-2 karma

Is there any progress on finding treatments with the use of viruses?

couloirjunkie2 karma

Yes. For instance a recent phase III clinical trial of an oncolytic virus showed good efficacy in (cutaneous) melanoma of the head and neck (Andtbacka et al J Clin Oncol 2015). This was probably one of the first and more will becoming through.

Androxian2 karma

How well do you know Mr James Daubney? It's just that I'm sat with him now so no pressure!

couloirjunkie3 karma

Is his beard trimmed properly?

lowearthorbit2 karma

Hello, and thanks for the AMA!

Is there opportunity for approaches utilizing polypharmacology, multiple target modulation, and phenotype driven drug development in the current drug discovery environment? The convention of hit-to-lead small molecule inhibitor development seems to screech to a halt in the clinic and may be on the way out conceptually, and immuno-oncology is a life saver in the literal sense, but isn't positioned to solve every cancer-related health concern.

I'm in the process of submitting a whole stack of proposals for development of a novel drug platform, and the only approach I seem to have for funding in a PI role as an under-30 with only a B.S. (granted, with a team of experienced academic collaborators) is through small business applications through the NIH. Any advice for someone in my situation, or similar "outsiders" with potential and ambition, on how to break into the drug development field?

Any comments you have are greatly appreciated.

couloirjunkie4 karma

Biotech. Start-up. Convince some reputable high quality scientists that what you'll do will work, then go pitch it to investors. NIH isn't the only way to go, particualrly without a PhD.

Mr-Mister2 karma

What’s the most metaphorically cancerous opinion/view you”ve ever heard/found? And literally (e.g. that business way back when selling irradiated water as good for your health).

couloirjunkie12 karma

In terms of malignant view, I'll be controversial here. The concept that individual brilliant scientists act independently to solve scientific problems is a very malignant view. Almost all breakthroughs in science come about because people talk to each other about their ideas. Yes you can come up with a brilliant thought, but its in context of everyone else's too. We put far too much emphasis on the individual and we need to open up a more diverse way of supporting science. Too many privileged middle class old white men (like me) who were trained at a small number of well supported labs at well funded Universities run by middle class old white men are favoured for research funding because people think they are "the best" people. The next generation of researchers will hopefully be more reflective of society, because diversity, and ingenuity, of ideas comes with diversity of people.

the_twilight_bard2 karma

It seems like innovations in cancer treatment has happened steadily over the last 30 years, and we have some drugs or immunotherapies that are quite effective for certain types of cancer. I have two questions regarding this. The first is, if a particular drug does work on a particular cancer, how likely is it that the cancer mutates and that drug stops working in a particular case? Are there people whose cancer does not mutate? If the cancers can mutate, does this suggest that we will simply never find a sure-proof solution for cancer spreading in general?

The second question is what do you believe your field of study will look like in terms of changes in the next 5-10 years. Are we on any major precipices?

couloirjunkie5 karma

Wow, great question. Many many cancers acquire resistance to drug treatments. In fact I would say most cancers can develop resistance to drugs, often by mutation. In the case of some leukemias patients may be on their fourth or fifth drug, and I know of one patient who was reaching the end of their life when a new drug became available. After 3 years they developed a resistance to it, but by then a second one had come out. 15 years later they are still alive but now on their fifth drug, which has only just been approved. They were 50 when they were first diagnosed. They've now seen their children married and become a grandparent. You can;t call that a cure, but you can call it a good result.

The major changes will be widespread sequencing and personalised medicine, early diagnosis by good quality blood tests, and the continued development of new experimental, personalised immunotherapy. I also think we'll have some setbacks with CRISPR technologies, and some breakthroughs with new drug delivery methods.

EileanBharraigh2 karma

What do you think of cancer charities who claim to raise money for cancer research? Do you know if it actually ends up in labs?

couloirjunkie5 karma

I can assure you that it does. I have been fortunate enough to receive funding for my work from many cancer charities including Cancer Research UK, Prostate Cancer UK, Skin Cancer Research Fund, AMMF (the cholangiocarcinoma charity) and Worldwide Cancer Research, and many of my colleagues here are funded by charities. We could not make the breakthroughs that we do without them.

I will say that it is extraordinarily competitive to get funding from these charities. About one in ten to one in five applications are funded, and many really good grants are judged high enough quality to be funded by independent experts in the field, but do not receive funding because of a lack of money.

PyrrhicVictory72 karma

Bit of a crazy question, might not have a straightforward answer. Instead of just a select few, what if every single cell in your body never experienced apoptosis?

couloirjunkie3 karma

You'd look like a blob :-)

Musiclover42002 karma

What are your thoughts on some of the medicinal plants/fungi with anti cancer properties? Some of them like Syrian Rue/harmalas were used traditionally to treat forms of cancer, and the research is available shows some do have anti cancer/tumor effects. Seems like they should be studied/tested more.

Here are some examples.

Syrian Rue/Harmala alkaloids:

The beta-carboline alkaloids present in medicinal plants, such as Peganum harmala and Eurycoma longifolia, have recently drawn attention due to their antitumor activities. Further mechanistic studies indicate that beta-carboline derivatives inhibit DNA topoisomerases and interfere with DNA synthesis."[29]

Peganum harmala has antioxidant and antimutagenic properties.[30] Both the plant and the extract harmine exhibit cytotoxicity with regards to HL60 and K562 leukemia cell lines.

Medicinal/edible fungi:

https://www.ncbi.nlm.nih.gov/pubmed/24083788

numerous studies were conducted on bioactive compounds isolated from mushrooms reporting the heteropolysaccharides, β-glucans, α-glucans, proteins, complexes of polysaccharides with proteins, fatty acids, nucleoside antagonists, terpenoids, sesquiterpenes, lanostanoids, sterols and phenolic acids as promising antitumor agents. Also, molecular mechanisms of cytotoxicity against different cancer cell lines are discussed in this review. Findings with Antrodia camphorata and Ganoderma lucidium extracts and isolated compounds are presented, as being the most deeply studied previously.

https://www.ncbi.nlm.nih.gov/pubmed/23293888

the immune-stimulating effect of beta-glucans has been well studied, and several beta-glucan receptors have been identified on the surface of immune cells. In addition, mushroom extracts with high levels of beta-glucans have also been shown to have direct cytotoxic effects on cancer cells, and beta-glucans are used for the treatment of cancer. This review summarizes the use of beta-glucans in colon cancer. Evidence has supported the idea that beta-glucans can decrease the size of xenografted colon cancer tumors via the stimulation of the immune system and direct cytotoxicity. Beta-glucans can also have synergistic effects with chemotherapeutic agents and other immune stimulators,

Rhazya stricta and Zingiber officinale:

https://www.ncbi.nlm.nih.gov/pubmed/25136570

In the present study, we investigated the effects of crude alkaloid (CAERS) and flavonoid (CFEZO) extracts prepared from medicinal herbs, Rhazya stricta and Zingiber officinale, respectively, on the growth of human GBM cell line, U251. R. stricta and Z. officinale are traditionally used in folkloric medicine and have antioxidant, anticarcinogenic, and free radical scavenging properties. Combination of CAERS and CFEZO treatments synergistically suppressed proliferation and colony formation and effectively induced morphological and biochemical features of apoptosis in U251 cells. Apoptosis induction was mediated by release of mitochondrial cytochrome c, increased Bax : Bcl-2 ratio, enhanced activities of caspase-3 and -9, and PARP-1 cleavage. CAERS and CFEZO treatments decreased expression levels of nuclear NF-κBp65, survivin, XIAP, and cyclin D1 and increased expression level of p53, p21, and Noxa. These results suggest that combination of CAERS and CFEZO provides a useful foundation for studying and developing novel chemotherapeutic agents for the treatment of GBM.

There are a lot of other various examples that show potential to fight different forms of cancer/tumors. Obviously that doesn't mean medicinal herbs/fungi will be cures for cancer necessarily, but especially combined with other forms of treatment they could at least raise the chances of success.

couloirjunkie10 karma

There are many examples of medicinal plants contributing to cancer treatments, and some where good drugs have been developed from them. One aspect of my own research is working with South African and Thai researchers investigating effects of plant extracts used by traditional healers. Applying a scientific approach to the problem is fascinating both biologically and socially. However, it still needs rigorous testing, well designed clinical trials, good quality synthetic chemistry and people passionate about getting the science right. There is a lot of work going on in this area, but the same scientific principles need to be applied.

submat872 karma

Can a plant based diet reverse cancer? Can a plant based ensure a person to never get the disease altogether?

couloirjunkie19 karma

Nope

ravioliraviolii1 karma

Hi Prof. Bates. How hard is it to get hold of relevant control and disease state patient samples and what do you think about the development of spheroid models? How usable are fixed biopsies as they get stored for longer and longer? Thanks!

couloirjunkie2 karma

Easier for cancer as a whole than for many other diseases, and biobanks are now more extensive than ever before. We have a great Biobank here, and work with them closely, but the problem with cancer is that everyone's disease is different, so it's really important that people feel comfortable donating tissues for research. Spheroid models are useful for some things, and we have used them, and still do use them for screening, but patient derived models are still the closest thing to recreating someone's disease in the lab.

couloirjunkie2 karma

I'm a David Bates, but there are a few, and some of them are famous. I'm definitely the one at the University of Nottingham Centre for Cancer Sciences.

ara24_81 karma

Do you think big pharmaceutical companies will try to hamper cancer research so they can keep people sick and their profits too? Do you think such things can happen?

couloirjunkie2 karma

No I don't, for the vast, vast majority of cases. In 25 years of working in the field I have only ever once come across a situation where a Pharmaceutical company did not want me to do the research because it could affect their profits. They made no effort to stop me doing it, but they weren't prepared to fund it because it was not in their interests. In contrast I have had many times when pharmaceutical companies have agreed to do experiments or help me do experiments that I wanted to do when it wouldn't help them at all, or it could even have hurt their program if the results I got had gone the wrong way. I'm not saying that it never happens that companies try to hamper research, but it is very rare.

agggile1 karma

How do you feel about the sigma-2 receptor as a target?

couloirjunkie6 karma

Meh!

BioMae1 karma

I’m staring BSc in Medicinal and Biological Chemistry this October at Nottingham. Are there any possibilities to find out more about your research and participate in the lab work while at university, i.e., summer research placements?

couloirjunkie6 karma

Yes, come and see me when you get here. Welcome to Nottingham, it's a fantastic place.

clarkcol761 karma

What are the chances of an experimental drug to cure early stage cancer being open for testing in the next 10 to 20 years?

couloirjunkie4 karma

Depends on what you call a cure. If you take breast cancer, many women on tamoxifen, or anastrazole have been 'cured' because their cancer hasn't come back at early stages. Drugs tend to be tested on later stages of cancer first and then move back in the pipeline, and we are seeing that with immunotherapies too. However, its hard to do a long term study of a drug in early stage cancers because you need very high numbers of patients and long terms studies, which makes it very expensive. There may be ways round that and I'm hoping biomarker discovery will be one route there. A good example would be EBV positive patients with early stage nasopharyngeal carcinoma, which as one area we're hoping to make progress in.

brazilianutlord1 karma

What is the most amusing thing about cancer in your opinion?

couloirjunkie8 karma

I'm not sure I'd call it amusing, but the ability of cancer cells to die in my culture dishes when they're supposed to survive is often irritating!

trumptrain694201 karma

Fellow Bates here. How does it feel having the best last name in the world?

couloirjunkie2 karma

Never gave it a thought!

argiesg1 karma

Is Phage Treatment a possible option for cancer treatment in the future?

couloirjunkie2 karma

Potentially. Its at a very early stage, but new ideas need to be tested properly.

lorpoppy1 karma

How important will nutrition be at in your research? And specifically gut bacteria?

couloirjunkie2 karma

Great question. It's an area we cover - there is a lot of recent research demonstrating the importance of gut bacteria in immune responses. One of our Oncology Professors covers this during his lectures.

ifydav1 karma

Does eating out of plastic plates cause cancer?

couloirjunkie3 karma

Nope. Not as far as anyone knows.

SexyCeramicsGuy1 karma

Hi! Thanks for answering questions, this has been an interesting read. I was wondering if there is any actual research on links between cellphone/laptop use and cancer. Could you point me in a good direction?

couloirjunkie3 karma

While there have been some studies showing that mobile phone signals can affect cancer cells in dishes, there is very little evidence that cellphone use or laptop use can cause cancer. There is good evidence on the safety of the use of these devices, so I'd worry more about alcohol and smoked bacon than my phone. There are other reasons why prolonged exposure to my phone is not good (antisocial behaviour and my kids getting cross at me), but not the risk of cancer.

Tribalwarrior_1 karma

Hi, are there any non-dividing cell lines that have not been know to develop cancer in humans or other model organisms or are they possible and just so rare that they haven't been recorded yet? I ask as I thought heart muscle couldn't develop cancer as it is non dividing for the majority of human life but as I found out it can.

couloirjunkie2 karma

Almost all cell types can become cancerous, because they can all be induced to divide by various signals, including mutation. Some are much rarer than others (nerve cells rarely form cancers, most brain cancers are from glial cells), they all have the potential.

soap_is_cheap0 karma

Do you think that with a diet restricted in carb intakes could be beneficial in addition to current cancer treatments?

couloirjunkie11 karma

No. The one thing we are sure of is that a balanced diet and fitness is really important for those who do have cancer. Your chances of surviving cancer are hugely improved if you are fit and otherwise healthy. Restricting any one type of food is not recommended.

aRTie02150-1 karma

Is it true that cancer researchers don't want to find a cure? Wouldn't you lose a bunch of funding?

couloirjunkie8 karma

No it's not true. Actually finding a "cure" brings lots of funding - if you find a cure for one cancer, then maybe you can find a cure for another. The most successful labs often get the most money after their biggest breakthrough not before.