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