‘Existing cancer therapies kill the leaves of the weed; our new model kills the root’

Even when you come up with an idea that shakes up cancer research, the road ahead is still tough, as Professor Norman Maitland tells Sheena Hastings.

BRIAN Hughes hasn’t had prostate cancer but two good friends have had the disease and their stories inspired him to try to play his small part in publicising it as well as helping to fund research into its causes and treatment.

One of the friends had a full and successful prostatectomy after his tumour was diagnosed. He recovered from the treatment and went back to enjoying his running before dying from a cardiac arrest.

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The other friend was found to have prostate cancer when abnormalities were spotted in a blood test done as part of investigations for another condition. He is still alive and well today.

Through his friends’ experience Brian, a hairdresser from York, learned a great deal about prostate cancer and realised how little he’d understood about the disease, which is the most common cancer in men, accounting for a quarter of all cancer diagnoses.

One of the most worrying aspects of the cancer was, he found out, that because of men’s notorious reluctance to talk about their bodies or book an appointment at the doctor even when there are noticeable symptoms, there was a huge awareness-raising job to be done.

Too many of the 40,000 men in the UK who are diagnosed each year don’t recognise the symptoms (urinary problems) as early as they might. This has an obvious effect on outcomes.

That’s why Brian started a men-only 5k run, held in York on Father’s Day – this year it’s on June 17. The first event took place in 2010, and last year 300 runners took part. So far it has raised more than £28,000.

The money raised goes towards the valuable and groundbreaking research into new therapies for prostate cancer being done by scientists at the Yorkshire Cancer Research Unit at York University. The run is also about getting men together to share information and experiences.

Thousands of fundraisers around Yorkshire work, like Brian, to help to improve scientific understanding of the disease.

“I became a fundraising volunteer for YCR and do whatever I can to help,” he says. “It can happen to any one of us.”

This role has brought him into contact with the team of 15 led by Professor Norman Maitland director of the YCR Cancer Research Unit, whose remarkable research into prostate cancer stem cells over the past 10 years has been published in many leading international journals

Last year, after intense scrutiny of its latest funding application to YCR by a panel of eminent scientists from across Europe, its research was judged to be of the highest quality. A grant of £2.15m was approved so that Prof Maitland’s prostate cancer projects were assured for a further five years.

Currently there is no cure for the disease, but if caught early, prostate cancer is highly treatable. While some men will have cancer that is more aggressive or “high risk”, which needs treatment to help prevent or delay it spreading outside the prostate gland, almost 90 per cent of men survive for five years after diagnosis.

The incidence has risen from 14,000 two decades ago to 40,000 after the introduction of a blood test called PSA – although this test is only 70 per cent accurate. In those 20 years, the death rate from prostate cancer has remained steady at about 10,000 a year.

In the UK, about one in nine men will get prostate cancer at some point in their lives. Older men, men with a family history of prostate cancer and men of black African and black Caribbean descent are more at risk.

A national screening programme was mooted for some time but now looks unlikely to happen, says Prof Maitland. But all men over 50 are entitled to a painless PSA test. However, “most GPs won’t offer it”, he says, because it creates more work and because prostate is in many cases a slow-growing cancer which may never become a big problem.

A few years ago, the Yorkshire Cancer Research Unit was recognised internationally as the best research group in its field, after the professor and colleagues found “the root” of prostate cancer and revolutionised research methodology.

Maitland’s gifted colleague Dr Anne Collins faced a feeding frenzy of international attention when their findings were announced.

They had pinpointed the fact that a cancer stem cell within a tumour can, even when the rest of the cells have been blasted by radiotherapy or killed off by hormone or chemotherapy, survive and repair the damage to the tumour. This is when a relapse occurs.

“Current therapies shrink the cancer and the symptoms go,” says the professor. “But if the tumour comes back then life expectancy is around two years.”

Meeting Professor Maitland is to become the privileged recipient of a one-to-one on the science of prostate cancer. A molecular biologist, he’s superb at explaining the mission that he’s been pursuing at York University for 20 years.

His research group’s intensive work with prostate cancer stem cells and experimentation in mice using chemical agents which kill the stem cells themselves will, he’s convinced, bring about a leap in life expectancy for men with high-grade prostate cancer tumours. The problem is now finding a way of getting the research out of the laboratory.

“Big pharmaceutical companies, which sell prostate drugs worth $36bn worldwide each year, judge success by small incremental increases in life expectation – months, not years. This is potentially much bigger than that,” he says.

“The top 20 pharmaceutical companies worldwide are excited about our work, but those companies are also highly risk-averse, so we are left looking around for the funding we need to take our model from mice to clinical trials and safe use in humans. All that can take 10 years and costs around $100m .

“Unlike the US, where there are many philanthropists who will take a risk on this sort of investment, the UK is not over-endowed with the same sort of people.”

In 2002, Prof Maitland and his team set up a spin-off company called Pro-cure Therapeutics, to take out patents on its research methods (attracting income from those who use them elsewhere) and exploit use of models of prostate-specific gene therapies.

The company has now been put on the market to help raise the money needed to develop the stem cell “reagents” into a fully-tested and approved drug for clinical use.

The professor says that without the backing of Yorkshire Cancer Research and its initial willingness to take risks on his ideas, he would have had to take them abroad due to lack of funding to develop the science.

“I think we’ve justified their faith,” he says. Three years ago, the unit won Europe’s top scientific prize for its prostate cancer research.

“We built up the unit from a small entity in 1991 to a world-leading research establishment, but now, without the huge money from a pharmaceutical company to take the model of a new treatment through real treatment, we can’t do anything – although other areas of research continue.”

The clock’s ticking, and meanwhile men are dying – 887 of them in Yorkshire alone in 2010.

“What we’ve found is the closest thing to a cure for advanced prostate cancer... I’m also a gardener, and it’s a handy metaphor to use if I say that existing therapies kill off the leaves of the weed, but the new model we’ve arrived at kills the root.”

Let’s hope the green-fingered professor finds his white knight.

R U Taking the P...? is a men-only 5k run being held in aid of Yorkshire Cancer Research on Sunday, June 17 at Rowntree Park, York. The event starts at 9.30am and entry forms are available from YCR on 01423 877210. You can also enter online at www.ycr.uk/rutakingthep. The closing date for entries is June 6.

Prostate signs and symptoms

Normally the growth of all cells is carefully controlled in the body. As cells die, they are replaced in an orderly fashion.

Cancer can develop when cells start to grow in an uncontrolled way. If this happens in the prostate gland, prostate cancer can develop.

It can grow slowly or very quickly. Most prostate cancer is slow-growing to start with and may never cause any symptoms or problems in a man’s lifetime.

If a man does have symptoms, such as problems passing urine, they can develop over many years.

For some men the first noticeable symptoms are from prostate cancer which has spread to their bones. If this happens, they may notice pain in the back, hips or pelvis that was not there before.

These symptoms could be caused by other problems such as general aches and pains or arthritis, but it is still a good idea to get them checked by a GP if they cause concern.