Does chemotherapy affect patients' concentration and coping ability? How can we tailor cancer treatments to suit each individual's unique metabolism? And can we develop early means to tell us which drugs will be effective for the cancer in a particular patient? These are among the practical questions to be tackled by medical scientists at the University of Dundee in a major £900,000 cancer study led by Imperial Cancer Research Fund Professor of Cancer Medicine Elaine Rankin.
Funded by the ICRF, the study capitalises on the University's international research reputation, drawing together experts from a range of related disciplines including psychiatry and biomedicine, to tackle different aspects of the disease and its treatment, and to translate laboratory discoveries into practical benefits for patients.
From her base at Ninewells Hospital and Medical School, Professor Elaine Rankin said: "We view each patient as an individual who has a unique cancer. We want to develop ways of predicting which could be the most effective drugs for treating that particular cancer. We want to know more about why some patients experience side effects, looking in particular at two less well recognised but nevertheless common side effects - changes in concentration and changes in taste.
"Dundee is the ideal place for research of this nature, because of its abundance of world-class specialists keen to cross the divide between laboratory and the patient in hospital. It also has an interested and supportive population of patients who see the value of taking part in studies such as these." The three year, multi-pronged initiative will look at:
"The effects of chemotherapy on concentration, memory and the ability to cope with daily life. Working with Professor Ian Reid of the Department of Psychiatry, the team will be investigating how patients manage routine tasks such as shopping, coping with housework and the children, and normal daily work, before, during and after sessions of chemotherapy.
Professor Rankin: "This is a neglected area. Very few studies have been done but anecdotally patients do report changes in concentration. If we knew more we would be able to advise patients and their families accordingly and to help them develop strategies to cope."
Tailoring drug treatments to the individual. The team will be developing in the clinic the findings of Professor Roland Wolf at the University's Biomedical Research Centre, that different people react in different ways to the same drug and how treatments can be personally tailored to suit them.
Professor Rankin: "The interaction between drugs and an individual's metabolism can be quite idiosyncratic. Some drugs are effective on certain people and tumours but not on others. Some people have side effects, some don't. At present cancer specialists use a blunderbuss approach to drug treatment using the same drugs for all patients with breast cancer for instance but we will be working towards a position where we hope to be able to say for a particular individual and a particular tumour this is the cocktail of drugs which will be most effective."
Examining changes in taste experienced by cancer patients. Collaborating with Professor Graham Ogden from the Dental Hospital and School, the team will investigate how chemotherapy causes the sense of taste to change and what means can be used to prevent this.
Professor Rankin: "Very little work has been done in this area but it can be a major source of stress between patients and their families. Patients may experience changes in taste which severe affect their enjoyment of food so they no longer look forward to mealtimes. As a consequence they eat less and may lose weight which can distress their carers who regard weight loss as an issue in cancer."
Investigating changes in tumour cells within the first hours of treatment and whether these can be used to predict how effective a particular drug is likely to be. Collaborating with Professor Sir David Lane of the University's Department of Surgery and Molecular Oncology, the team will be looking for measurable changes within the first 24 hours of treatment.
Professor Rankin: "If we could predict at that early stage that, for example, a tumour was unlikely to respond to that particular drug, we could then substitute another before exposing the patient to further doses of the ineffective treatment."
Several hundred patients from the Tayside area are expected to be involved in the study over the coming three years. /ends