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Cancer Detectives: Finding the Cures - Season 1 Episode 2
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00:00I'm creative. I don't see creativity being limited to artistic endeavours.
00:08Actually, it's there to be applied to everything.
00:13And applying it to a tricky scientific question is brilliant.
00:22You've got to think big. You've got to dream the dream.
00:30Cancer is a huge adversary that's trying to hoodwink you.
00:37Well done, Gary. Nice deep breaths for us.
00:41One, two, three.
00:44But now we're at the dawn of a new series of cancer treatments.
00:49We have the opportunity to change medicine forever.
00:53For generations, a cancer diagnosis left almost no hope.
00:59It's a terrifying disease that has stalked us for millennia.
01:04I didn't expect I had cancer because all the tests were coming back negative.
01:08I don't think my body can take any more.
01:11Science has fought hard against it. And now the tide is finally turning.
01:16One of our key goals is to transform this idea of cancer as a death sentence.
01:22A group of trailblazing scientists are making new breakthroughs.
01:29We now need to take those discoveries and make them work for patients.
01:33This is the world's first lung cancer prevention vaccine.
01:38Discovering cures and finding ways to stop cancer before it even starts.
01:44The tumour seems to be shrinking.
01:46Your scan shows no active disease.
01:49Creating a future where cancer doesn't win.
01:53We're getting very close to defeating cancer once and for all.
01:58What's not curable today could be curable tomorrow.
02:05Cancer has been evolving with us throughout the history of humanity.
02:25It's a notorious killer and very good at growing, but very bad at dying.
02:41Cell division is vital to life.
02:44Most of your cells in your body will divide at some point.
02:48A mutation is an error in the code that every cell has within its nucleus, its DNA.
02:57Mutations are happening in your body right now, but your immune system is very good at removing them.
03:03Your body has lots of mechanisms to deal with interlopers and problem cells.
03:10What cancer is very good at is evading those natural mechanisms.
03:15Mutations cause cells to grow when they should have stopped.
03:19And that can cause major problems for your body.
03:24Try not to move your head, Gary.
03:34In the battle against cancer, neurosurgeon and scientist Richard Mayer specialises in fighting one of the disease's deadliest forms.
03:44Glioblastoma, a type of brain cancer.
03:48While there have been advances in treating many cancers, no one has made real progress against brain cancer for decades.
03:55Richard is determined to change that.
03:58I think there is something brilliant about everyone saying you can't do it and saying, well, sod you, I can.
04:10So there's a little bit of the defiant spirit.
04:13You have to think outside the box.
04:16Making good progress.
04:18Brain cancer is a very difficult disease to treat.
04:23The treatment at the moment revolves around three distinct steps.
04:28First is surgery.
04:30Second is radiotherapy.
04:33And then chemotherapy.
04:35Which works reasonably well in about a third of patients.
04:40And in two thirds of patients less well.
04:42And that's been the standard of care now for 30 years.
04:46And we haven't seen any changes in standard of care over that time.
04:51And so, from our perspective, that seems like a long time, especially when average survival is a little over a year.
04:59You've done really well.
05:01Richard plans to revolutionise brain cancer treatment, but he's up against a formidable enemy.
05:08Brain cancer is often fast growing and symptoms can appear out of the blue.
05:20What did you have for lunch?
05:21I had a jacket for dinner, sorry.
05:23Have they got the good cheese again?
05:25Yeah.
05:29Come on then, give us a hug.
05:31Yeah.
05:33My name's David.
05:36I'm going to sit down and have your drink.
05:38Take him in.
05:39I live with my wife, Laura.
05:45And my daughter, Lucy.
05:50We were on a walk and I suddenly had a dizzy spell.
05:55Followed by, at that stage, it was just like a phantom smell.
06:00And I continued to have them sporadically.
06:04So, I started pursuing the doctors.
06:07And I got diagnosed with everything from inner ear infections, upper respiratory infection.
06:14And then they settled on sinusitis.
06:17And I had all sorts of medications.
06:19And then a month ago, I had a seizure where I actually passed out and collapsed.
06:26At first, I thought maybe he was having a stroke or a heart attack.
06:28He clutched his chest.
06:29His face dropped.
06:30But then his whole body, you know, he just collapsed.
06:33He was shaking all over, struggling for breath.
06:36You know, everything was clenched up.
06:39And then I realised it was a full seizure.
06:41David underwent a scan.
06:44It showed a large tumour on his brain.
06:56Within a week, he's sent to Richard at Addenbrooke's Hospital in Cambridge.
07:02So, David, not uncommonly for one of my patients, has had a seizure.
07:06Which means he's had a fit.
07:07And that's likely related to this tumour that we found.
07:11So, obviously, that can generate a lot of anxiety.
07:14And we need to treat those seizures that he's got.
07:17But, obviously, we also need to treat the underlying tumour.
07:20And that's what we're going to talk about today.
07:27Come through.
07:28Nice to meet you.
07:30Nice to meet you.
07:31I'm Richard. Come through.
07:32My name's Richard Mayer, one of the Consultant Neurosurgeons.
07:39So, what we can quite clearly see is asymmetry with an area of abnormality here.
07:47Okay?
07:48My concern is that this represents some form of tumour.
07:51Okay?
07:52And that may be a malignant form of tumour.
07:54So, a type of cancer.
07:55So, there are three options in neurosurgery.
07:58One, we do nothing.
07:59We watch it.
08:00But I think if we were to do that with serial MRI scans, say every couple of months, my worry
08:06would be that this would increase in size quite quickly.
08:10Second option would be to do a biopsy, which would tell us what this is, but it wouldn't
08:16remove any of it.
08:17And the third option would be to try and do what's called a debulking operation.
08:21We take out as much of the bulk of the tumour as we can, and we send some of that off for
08:27analysis.
08:28So, we make a diagnosis, but we also try and remove as much as we can safely.
08:32All right?
08:33So, I think of those three options you discussed with my colleague, the plan was for debulking.
08:38Is that right?
08:39Yes.
08:40Okay.
08:41Any questions about that at all?
08:43We're happy to follow your recommendations.
08:47Okay.
08:48All right.
08:49Fair enough.
08:50Even though there seems to be a sort of well-demarcated region on the brain, on the scan, for where
08:56this tumour exists, we will not be able to get out absolutely everything, and it is just
09:01debulking.
09:02It's taking out the bulk of it.
09:03Okay?
09:04So, the results are normally a week, and then after that we can make plans for anything
09:08we need to do subsequently.
09:09Okay.
09:10Good.
09:11All right.
09:12Nice to meet you both.
09:14Yeah.
09:15And you.
09:16And I'll see you tomorrow.
09:17Yes.
09:19Take care.
09:20See you soon.
09:21Bye now.
09:22My concern is that this is some form of malignant brain tumour, the most common being a glioblastoma,
09:25but until we've actually done the operation and got the results back, we try not to predict
09:31too much.
09:32Glioblastoma is Richard's greatest nemesis, as it's almost always fatal.
09:41When you see these patients week in, week out, telling them, I'm very sorry, but there's
09:46nothing we can do.
09:48Right?
09:49Absolutely nothing.
09:50I think if that doesn't motivate you to try and turn the train around, then I don't know
09:56what will.
09:58Richard's frustration has inspired him and a colleague to pioneer a revolutionary new
10:04approach to treating brain cancer.
10:07A clinical trial using personalised treatment.
10:12I think this could absolutely change medicine for good, because what we're trying to do
10:17is understand really the molecular level of what's going on in these tumours.
10:23Richard's plan is to pinpoint the specific genetic mutation causing each patient's cancer
10:29from hundreds of possibilities.
10:32Then, as quickly as possible, to match the patient with a drug thought to work against
10:36that precise mutation.
10:41The whole process used to take months.
10:44Months that patients didn't have.
10:46Richard found a way to do it in weeks.
10:49So this is a world first because we're putting together precision therapies and targets that
10:56we've identified in real time using whole genome sequencing.
11:00And we think by bringing all of that together, it gives us a much better chance of finding
11:05a genuine treatment that's going to work for these patients.
11:10Just a day after his appointment, David is going under the knife.
11:14Obviously, it's very, very real now.
11:19But basically, I just want to get it over and done with.
11:23Just get this part out of the way.
11:25Get the first step out of the way.
11:27Just wake up, basically.
11:32Then go from there.
11:35Good morning, David.
11:36Hiya.
11:37How are you getting on?
11:38Yeah, all right.
11:39Did you get any sleep?
11:41On and off.
11:42On and off.
11:43OK.
11:44Someone will come and collect you, take you upstairs, and then we'll get on with it.
11:48Yep.
11:49All right.
11:50Keen to get it out of the way.
11:51Yeah, indeed.
11:52Absolutely.
11:53All right.
11:54Well, I'll see you upstairs.
11:55Yes.
11:56OK.
12:03What's your favourite place in the world?
12:07With my family.
12:08With your family, yeah?
12:09Yeah.
12:10That's right.
12:11That's right.
12:12For David, family life came late.
12:18Wait for us.
12:19Playtime.
12:20I was very nervous about becoming a father at 50, but I was there at the birth.
12:30And when she came out, that's when it changed.
12:36You know, there was instant love there.
12:38And it's just been an enjoyable experience from then to now.
12:48She's always coming up with something new.
12:51And, yeah, it's just a pleasure to be around.
12:55He makes her laugh all the time and their little jokes.
12:58I'm doing this for GCSE.
13:00I did an engineering.
13:04He's a big softie.
13:05He lets her get away with a lot.
13:08When you get ill, well, it makes life more precious.
13:12But not just your own.
13:17You start thinking about others, especially the ones close to you.
13:25You know, if the worst happens, I want them secure.
13:30I want to know they're not going to struggle.
13:32Don't know what I'd do without it, so.
13:37Sorry.
13:57This is just some oxygen.
13:59There's nothing else, all right?
14:02Nice big breaths, David.
14:04All right.
14:05That's it.
14:07Yeah, of course.
14:09Oh, lovely.
14:11Sun's shining.
14:13Having the best round.
14:22In my childhood, my parents had a really big bookshelf
14:26that was full of loads of books that were off limits.
14:30And there was a book that looked like it had been well thumbed through.
14:37And it was called Grey's Anatomy, an anatomical textbook.
14:42The book showed that there were other worlds that could be explored
14:46that might be interesting.
14:48Probably that's what does drive me, is that there's something under the hood I don't understand.
14:52And can we get down to the bare bones of what's going on?
15:00Okay, it's a pin.
15:05Right.
15:06Roll on three.
15:07One, two, three.
15:08And back.
15:09Perfect.
15:11With David anaesthetised, the operation to remove his tumour can start.
15:17If the tumour does turn out to be glioblastoma, David's best hope would be if Richard could match him to a drug on the pioneering trial.
15:25All good.
15:26Okay.
15:27Can we make sure he has a strap, please?
15:29Yep.
15:31It's very privileged, you know, to be able to look at someone's brain without wanting to sound strange is a great privilege.
15:39And it's one that no one takes lightly.
15:45Knife back, please.
15:46Brain surgery has the risk of a terrible, disastrous outcome not that far away.
15:57Daryl, please.
15:59Yep.
16:01You can inadvertently damage something that leads to the patient's death or significant disability relatively easily.
16:12And so you have to be concentrating throughout the operation to a very high level.
16:23Bone flat.
16:27Right. Scope in then, please.
16:32Now, that's tumour, isn't it, there?
16:35Yeah, that's obviously tumour.
16:37Yeah.
16:39A lot of cancers, when you come to operate on them, they look like well-demarcated lumps.
16:45And you can be relatively confident that you've got all the tumour out.
16:52With a primary brain cancer, that's not the case.
16:55Glioblastomas are a group of tumours that are related to certain genetic mutations.
17:02What this leads to is an uncontrolled cell growth.
17:06And the way these cells grow and move is like tendrils leaching out from where they've started.
17:15Meaning that there are these long trails that go into the normal brain.
17:19The cells will infiltrate deep into the brain and you can't cut them out.
17:23You can't even see the edges because you have cells that are proliferating and cells that can migrate and invade into tissues.
17:30And that's why it's called cancer because it's the claws of the crab.
17:33What that means is it's essentially like trying to unpick two tins of paint that have mixed together.
17:39You just can't do it because we all would love to be able to take every last cell of the tumour.
17:44But we know that's impossible.
17:47So this is definitely tumour.
17:52A bit more tumour coming out.
17:57The hope is there is a drug on the trial which can treat any tumour left behind.
18:03To pinpoint the right drug, samples of David's tumour are collected for genome sequencing to map its genetic code.
18:11One of four, thanks David. Thanks everyone.
18:19Send to the next.
18:21It's alright.
18:23Dave, we're just taking you around to recovery ward, okay?
18:31Hi there, it's Richard, the surgeon here, calling from Addenbrookes.
18:35Hiya.
18:36Everything went really well.
18:37He's woken up in recovery and I was very pleased with how the surgery went.
18:42I managed to get out everything that I wanted to.
18:45I can't get out everything, obviously, but I was really pleased with the amount that we managed to remove.
18:50Oh, that's fantastic. Thank you for calling me.
18:52Okay, no problem at all.
18:54That's a really big relief. Thank you very much.
18:56Alright, you take care now.
18:57Okay, thank you.
18:58Bye.
18:59Bye.
19:04With brain cancer, time is of the essence, so David's tumour is rushed to the lab.
19:10If it is cancer, they then need to find out which specific mutation is the cause, so they can match it with an existing drug.
19:16That's done through genome sequencing, which once took a very long time.
19:25Whole genome sequencing used to be something that was, you know, otherworldly, that was, you know, brand new, took forever, was so expensive you had to batch the samples together, which means you could only run them once every month or two.
19:39And that's not the case anymore. The costs have come down, our pathways have got better. So actually people can be put in for whole genome sequencing as they get on and have their treatment.
19:51So really getting those results back more quickly is much more possible.
19:55This would have been impossible five years ago, just getting the infrastructure, the sequencing, the analysis, the drugs. This is, you know, on point for something that is, is groundbreaking.
20:16It's been a week since David's operation.
20:18Today is results day for David, so we're going to get him into the clinic and we'll talk him through what his tumour has come back as, what pathological diagnosis this is, and also how much we managed to remove at surgery.
20:34It's a big day for him.
20:35Yeah, it's a big day.
20:36One of my first neurosurgical mentors told me that it's important to give people hope. And similarly, it's important to be realistic. And we used to always skirt around cancer in terms of mentioning the word and talking about prognosis.
21:01So I think it's important to get a balance of both. And that's what I try and do.
21:12David, if you want to sit there.
21:19So obviously here for results.
21:22So we have been able to make a diagnosis and it has come back as some form of tumour.
21:27OK, and it's a malignant type of tumour.
21:31So a type of cancer and it's called glioblastoma.
21:34It's a cancer that's treatable, but it's not curable.
21:39OK, any questions about that diagnosis at all?
21:43No, I think we were pretty much expecting that.
21:46Yeah.
21:47Because we've always trusted your confidence and your ability. We have read up on these sort of things.
21:58What's not clear is just what happens next, really.
22:02OK, well, let's start with the scan. So this is the post-operative scan on the left. This is pre-operative on the right.
22:07And so what we can see is there's a good amount of the lump that's been removed.
22:12But as I mentioned prior to surgery, not all the cancer will have gone because unfortunately we can never remove all of the cancer.
22:22So given that there will still be cancer cells there, the next stage of your treatment is to go for radio and chemotherapy.
22:29Yeah.
22:30All right. We also sent your tumour off for DNA sequencing, as we mentioned.
22:36The results from that may or may not direct what we do next.
22:40How long will chemo and radiotherapy keep this at bay?
22:44OK, so you're talking about prognosis. Is that something you want to talk about today?
22:49Yeah, we have discussed this.
22:52So prognosis is an average, so it's not a specific figure for you personally.
22:56But on average, survival is in the region of about 14 and a half months.
23:05So traditionally, students don't like coming to our clinic because it's full of bad news.
23:11And it is a very difficult environment to work sometimes.
23:16But I do think if you can do something that's difficult and not very nice in a compassionate and empathetic way, then you can gain some sort of satisfaction from that.
23:30But it is tough. It's horrible. You're telling people the worst news they've ever heard in their whole life.
23:34Just go home.
23:41You know, we've got a young daughter.
23:42Sure.
23:43We want to spend any, you know, what time is left is precious.
23:47Sure. Absolutely.
23:48Extremely precious.
23:50Absolutely.
23:51And we want to make the most of it.
23:52It's all I want now.
23:53Mm.
23:54Spend time with you and Lucy.
23:55So can it be a bit longer?
23:56OK.
23:57Yes.
23:58How many people have, like, gone on past the, you know, 12, 14 months?
24:02Yeah.
24:03I mean, we have a kind of 5% to 7% five-year survival.
24:06OK?
24:07It's an average.
24:08Mm.
24:09OK, so let's hope you're on the other side.
24:10Let's face it, Laura, I've never been average, have I?
24:13Or lucky.
24:15Oh, of course I've been lucky.
24:17You'd better win on that scratch card.
24:18Of course I've been lucky.
24:19Don't stop.
24:27OK?
24:28He doesn't know at the end of the day, you know you've been loved.
24:31You know you will be loved right up to the end.
24:34But they're going to be happy times, what I've got in.
24:38OK?
24:40Take care.
24:41You too.
24:42OK.
24:43All right.
24:44I see you.
24:46What am I going to do without him?
24:51It's trying to get up a bit, please, for me.
24:54I don't like seeing you lie.
24:55It upsets you even more.
24:56Oh, no.
24:57Just give it up.
24:58It's really tough for them, really tough.
25:02David's got a lot of positives despite this overwhelming negative.
25:07He's had a good operation where we've managed to get a large chunk of this tumour out.
25:12He's well.
25:14And when we get his whole genome data back, we can look and see whether there are mutations
25:20or alterations in his DNA and regions that we can target with drugs that we've got on our clinical trial.
25:27What we want to do is transform this idea of cancer as a death sentence into something that can not only be treated, but that can be treated to give people a normal quality of life.
25:38Richard's revolutionary trial aims to rewrite the script.
25:51One of the first patients to join the trial was Amanda, a former finance director.
25:57You put half a pack of butter on this, did you?
26:00Yeah.
26:01Not that I'm complaining.
26:02It made me laugh.
26:03Almost two years ago, Amanda had surgery and post-operative treatment for our glioblastoma.
26:10You've got a dirty face.
26:12You've been digging again.
26:13No.
26:14But a few months ago, Amanda's tumour returned.
26:22Patients with brain cancer will, unfortunately, recur very quickly.
26:27If it takes months to get the results of the DNA analysis you're going to use to plan their treatment, they may have already died by the time we get those data.
26:40Amanda, pre-cancer, she worked 15 hours a day, 16 hours a day. She was up London looking after the grandchildren. She had come back and hit work.
26:55I've looked at these for years, these wedding photographs.
27:04Long time ago, eh, Amanda?
27:06Yeah.
27:07And it seems like yesterday.
27:10Sit down, baby.
27:12I'm with her 24-7.
27:15I love it.
27:16Push.
27:17Push, you won't break your leg.
27:19No, you won't.
27:20Go, push.
27:21Like, I'm going to get her breakfast, I'll take her, get her tablets first thing in the morning, give it to her.
27:26And it's just that, because she'll forget and I'll go, you ain't took your tablets. Amanda, just take your tablets.
27:34I look at it, it's me job.
27:36Ready?
27:37Yeah.
27:40Come on then.
27:42Come on.
27:43Gary's very, very kind.
27:46He worries about me and he gives me lots of support, especially now.
27:55Brain cancer robs the person of themselves.
28:01As it grows, it takes away that individual's personality, their ability to function in this world.
28:06And I really hope that our current approach will get some of that back for the patient to try and enable a normal life.
28:19To improve Amanda's future, Richard sought to get her onto his trial.
28:25So, he analysed her tumour's DNA to see if it had a mutation that matched one of the trial drugs.
28:31It's vitally important that we have the results back quickly so that we can plan what treatment and get them in a clinical trial as soon as possible.
28:41And that's in a period of weeks, not months and certainly not longer than that.
28:50When Amanda's cancer DNA was examined, a mutation was found that matched a drug on the clinical trial.
28:57I was really surprised to find out that there was still some hope for me.
29:07And my oncologist informed me that Richard would be phoning me to ask me to see if I was interested in joining this trial.
29:18I was really pleased at that. I was thrilled, actually.
29:23We both were.
29:24How much hope do you think we get from it?
29:31That's all you have to do, man.
29:33Hope. Hope, yeah.
29:35That's all you've got is hope.
29:38Yeah.
29:40And if that...
29:41But I want more.
29:43Well, it's going the right way at the moment.
29:45Yeah.
29:48Time is everything.
29:50But a new treatment might just give me a little bit more time.
29:55My cups always are full.
29:57So they always give you hope that they'll do something else.
30:01And it's hope.
30:03And that's all you can ask for is hope.
30:05And therefore, if there's a chance of a hope, I'm with Amanda.
30:08I'm with Amanda.
30:10You'll be all right.
30:16What we're doing at the moment is trying to help the patients of today, but that will also help the patients of tomorrow.
30:25It's in there.
30:26Oh, thank goodness.
30:27Amanda's now been on Richard's clinical trial for three months.
30:40I feel so much better than I did when I was on the chemo.
30:55So I'm hoping that these are all good signs.
30:59As part of her routine, Amanda has regular MRIs that take detailed images of her brain.
31:11I have to have them frequently in order to plot any changes to my tumour.
31:17And if there are no changes, yay!
31:23They're not a problem for me at all.
31:26And in fact, it's a reassuring confirmation, clarification of your current situation.
31:34So precision therapies are an interesting way of addressing cancer.
31:40We know that in a majority of patients, they have specific mutations that we can target with drugs.
31:51A precision drug has to have a target.
31:54What we need to work out is which of those targets and which of those drugs work in which patient.
32:01A few weeks later, Amanda is back in Cambridge for an appointment with Richard and to collect the drugs she's taking on his trial.
32:15Let's try to look out that door.
32:21So the part of the clinical trial that Amanda is on involves taking drugs that work on the kind of mutations we found in her cancer's DNA.
32:31Once these drugs were absorbed into Amanda's body, they travel to the tumour in her brain and into the cancer cells.
32:43The mutations in the cancer cells' DNA are causing too many out of control signals to be produced, telling the cancer cells to keep growing when they shouldn't.
32:52The drugs work by blocking these overactive signals to prevent cancer cells from multiplying and to prevent cancer cells invading Amanda's brain.
33:06In theory, that means the tumour should stop growing or even shrink.
33:10The tumour should stop growing.
33:11The tumour should stop growing.
33:12I think.
33:13Be brave.
33:14You're a funny lady.
33:15I know.
33:16Come on then.
33:17So, about to see Amanda.
33:18It's great to see how she's getting on.
33:23Oh, no. Come on, then.
33:27So, about to see Amanda.
33:29It's great to, you know, see how she's getting on.
33:33Like most people here, all you do is you just hope that it works.
33:44And that's what you want to do, innit? Yeah.
33:46We've got... We just need to be positive all the time, don't we?
33:50Yeah.
33:53Hi there. Come and have a seat. Thank you.
33:57How are you doing? Great.
33:59Good to see you both.
34:01So, I guess we're here to look at your scan, so we probably should start with that.
34:07This is you at the beginning of February, and this is the scan from June.
34:12And I hope you can sort of appreciate that that sort of distance there is a little bit smaller on that scan.
34:17Oh, definitely. Yes, I can see that.
34:20Yeah. I think that's very, very encouraging.
34:22Yeah.
34:23There's definitely no increase in size in the lump, which is good.
34:28And perhaps it's actually shrunk a little bit, which is really, really encouraging, given the fact that you're on this trial.
34:36And that's something that we are looking for.
34:38It's amazing.
34:39Okay.
34:40Yeah.
34:41We're excited, aren't we?
34:42I'm amazed.
34:43And how are you feeling? How are things?
34:45I feel absolutely fine.
34:46Yeah. Okay. Any symptoms at all?
34:49No.
34:50She's getting stronger.
34:51Okay. Good.
34:52She's getting more and more back to normal.
34:55Okay.
34:56I know she's got a long way to go, but from where she was, she's doing absolutely fantastic.
35:03Well, that's fantastic news. And as I say, from our perspective, we knew that you had these targets within the tumour, these changes in certain genes,
35:13that made this new type of treatment, which sort of specifically targets those changes rather than the generic chemotherapy as an appropriate thing for you.
35:24Yeah.
35:25So that's a really, you know, good thing that we were able to find that and to match that change to a drug, you know, through the clinical trial, obviously, hopefully, and certainly at the moment, is going to have some sort of benefit.
35:37But it's in herself.
35:38Yeah. Indeed. Yeah. The fact that she's feeling better as well.
35:42Yeah. Yeah.
35:43Yeah.
35:44He just wants me to start cooking again.
35:47Yeah.
35:49I don't know about that.
36:05My wife is a nurse.
36:07And when we discuss our day at work, it often relates to bad news.
36:15And I think it does give you a frame of reference.
36:20Here's Dad's home.
36:22Have you had a good day?
36:23Yes.
36:24Ah!
36:26Most of the patients I see had planned for the future and boom, it's gone.
36:32And I think the thing I take home from that is make sure you enjoy what you're doing, you live your life to the full and enjoy it.
36:41OK, have you been playing on the trampoline?
36:42Yeah.
36:43Oh, well done, mate. That was excellent.
36:44Family helps people get through difficult times.
36:58I think it's really important and I can see how families strengthen each other.
37:08Hello.
37:09Did you have a good day at school?
37:11Yeah.
37:12No fish.
37:13It's been two months since my operation. Then I had my chemo and radiotherapy.
37:25Bumper crop this year.
37:26You slowly come to terms with it. I think you have to.
37:27Rose is just going to eat you up.
37:32So now it's just, I just relish my time with my family, really.
37:33So many people in crime now, we can, we have to put fire on it.
37:34And then I had my chemo and radiotherapy.
37:39Bumper crop this year.
37:45You slowly come to terms with it. I think you have to.
37:49Rose is just going to eat you up.
37:52So now it's just, I just relish my time with my family, really.
37:59So many people in crime now, we can, we have to put five rows of benches instead of four.
38:04You're getting too good.
38:05You need to be off key a bit more and that'll drive people away.
38:09Why?
38:11Lucy's the biggest focus.
38:13So spend a lot of time with her.
38:15Try and keep things normal.
38:17Right, another day closer to end of time.
38:20Lucy's coping with it very well.
38:22I mean, she's just, she just keeps reminding me I've got to get better.
38:28At this time, I am waiting to hear from the neuro-oncologist about the trial.
38:38What are you up to, Goose? What are you playing?
38:42Well, I'm hopeful for myself and hopeful for my long-term prognosis, you know, that I will get on to a clinical trial.
38:53Yeah, where you got to on your hospital game, you've got a radiotherapy department on your hospital.
39:00That's where daddy goes a lot.
39:03I really hope it works.
39:05And I hope it works for other people as well.
39:08You know, it's not just about me.
39:12My hopes for David are that we have a target and that with that target we can put him on a trial and that he has a good outcome from that trial.
39:22You know, every patient I see now, in the back of my mind, I'm thinking, do they have a mutation?
39:29Can we put them on the trial and will we see improvement?
39:32Which I think is amazing and that's something that I've never experienced before.
39:37All right, you comfortable?
39:43I am.
39:44OK, all right?
39:45Very comfortable.
39:46Five months into the trial and Amanda is still responding well to treatment.
39:53Ta-da!
39:56Look at Gaz's face.
39:58Look at this beautiful evening.
39:59Yeah, we're lucky.
40:00Now we can plan for our future.
40:01It's lovely to look forward to something like that, booking holidays and picking places to go to.
40:18How much do I love you?
40:20Answer that.
40:21Do you love me enough to buy me a boat?
40:23I don't know about that.
40:25I think if it weren't for the clinical trial, Amanda may well have progressed and her quality of life would have been impaired.
40:36Obviously with the trial drug, it's gone the other way. It's actually shrunk.
40:41And obviously this is brilliant because she can still, you know, live her life and that's exactly what we want.
40:46What I want to achieve is a significant difference for patients with brain cancer.
40:55You know, when I started in Cambridge in 2013, there were very few scientists who were doing work in this field.
41:03And now I think there are more.
41:05And that's what I want.
41:06I want us to build a village to try and cure this.
41:13That village includes consultant oncologist Professor Juanita Lopez, who worked with Richard for three years to get the groundbreaking trial up and running.
41:25We're now finally starting to see the first patients benefit from their work.
41:30I saw Amanda in clinic recently. The tumour seems to be shrinking. So from my perspective, this looks really promising and I'm really excited.
41:40The other thing to say is that if she wasn't on this drug, not only would it not have shrunk, it would have increased in size.
41:47So actually, you know, seeing it shrink is really quite different to the natural history of what we'd expect this tumour to do in this scenario.
41:54This is David's scan. So we've removed all the tumour in his right temporal lobe, which is great.
41:59I think we're still waiting for the sequencing on him, but I've just checked and that should be back within the next week or so.
42:05So it'd be good to discuss to see whether he has any targets as well.
42:11You must remember I said, well, this is too big. This is too hard.
42:15It's challenging.
42:16It was too difficult. It was too hard to do.
42:19Yeah.
42:20But, you know, if someone was brave enough to do it, here it is.
42:23Yeah. And I think that you had great ambition. I had ambition. And I think by putting that together, we were able to be greater than the sum of its parts.
42:33There have been moments along the way where it's been exhausting. It's been floods of tears and chaos and crisis management.
42:48If, you know, we're not going to do it, kind of who is?
42:50And they don't have a voice. And I think that's a really sad, you know, bit of this story that patients, they can't speak for themselves. So it's really, you know, championing those who, you know, have no voice.
43:04You can't. Yeah.
43:05Where do we think this will take us?
43:09I think we want to cure brain cancer.
43:13Yeah.
43:14It's all there. We just need to link it together and have the ambition. Sky's the limit.
43:25The trial structure means that we can add new drugs as they come on board. And that gives us the opportunity to just keep adding to it, keep adding to it until we find a solution for every patient who has this problem.
43:40This clinical trial will last for as long as it needs to last. And we hope it's going to last for as long until we cure this cancer.
43:48The ultimate aim is to cure brain cancer. I think we have to be that ambitious. Now, we are a long way away from that. OK, I'm optimistic, but I'm not stupid.
43:58We have a lot that we need to do, but we are on a trajectory. We are on the first step and the ladder. But we have to be ambitious. We have to be positive.
44:07We don't just want to improve how the cancer looks. We don't want to get people a few months. We want to change how we manage this cancer for good.
44:16But you have to start somewhere. And we're very much at the start of that journey.
44:20And I want to go to the end of that journey to the end of that journey.
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