UPDATE - Issue 14 - April 2003
Bench to bedside and back to bench
The Royal Marsden pioneers a unique clinic in London for people with genes that predispose towards cancer
This is a story about Karen, whom we thank for allowing us to use her name. She is shown here with her husband, son and daughter. All apparently very normal; but she is, in fact, very special. She herself has breast cancer. Her mother and four aunts died of the disease as did one of her cousins. In addition to that, she is one of the patients who are contributing to cutting edge research and at the same time benefiting from it.
The study of how our genetic make up can cause us to be more or less likely to contract certain diseases is still in its infancy. There have however already been some very important discoveries. Two genes linked to breast cancer have been found in recent years and named unsurprisingly BRCA1 and BRCA2. Further research has now revealed that men who have either of these genes in their genetic code are much more likely to develop prostate cancer than the general population. |
How does one carry out such research? Only by finding and working with families like Karen's. She and some of her relatives have given blood samples for the research programme from which it is possible to try to identify the genetic differences they exhibit which predispose them to a higher risk of these cancers than the rest of the population.
The Institute of Cancer Research and Royal Marsden Hospital, which is the centre where the research is carried out, has established a unique multidisciplinary clinic for the management of cancer predisposition gene carriers. The Carrier Clinic set up by the Royal Marsden differs from the NHS model in that it is multidisciplinary containing oncologists as well as geneticists. When the few NHS genetics centres that do exist were established, they mainly worked on genetic diseases that threaten children. |
Clinicians can, of course, learn from the potential carriers whom they see and feed what they learn into multinational research projects (bedside to bench). At the same time, the Carrier Clinic helps patients and their families to deal with the higher risks of cancer that they run and provide them with rapid feedback of relevant research findings (bench to bedside). The Clinic is a place where advice can be given about the patient's lifestyle and help which may be needed by the family in the future. For example, it is already planned that Karen's daughter will be offered breast/ovarian cancer screening from the age of thirty whilst her son will be offered screening for prostate cancer from 45 years. |