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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.
02:21Cancer has been evolving with us throughout the history of humanity.
02:25It's a notorious killer.
02:30And very good at growing.
02:33But 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.
02:58Mutations are happening in your body right now.
03:00But your immune system is very good at removing them.
03:04Your body has lots of mechanisms to deal with interlopers and problem cells.
03:10What cancer is very good at is evading those natural mechanisms.
03:14Mutations cause cells to grow when they should have stopped.
03:19And that can cause major problems for your body.
03:32Try 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.
03:45Glyoblastoma, a type of brain cancer.
03:49While 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.
03:58Richard is determined to change that.
04:00I think there is something brilliant about everyone saying you can't do it.
04:06And saying, well, sod you, I can.
04:09So there's a little bit of the defiant spirit.
04:12You have to think outside the box.
04:15You're making good progress.
04:17Brain cancer is a very difficult disease to treat.
04:22The treatment at the moment revolves around three distinct steps.
04:27First is surgery.
04:29Second is radiotherapy.
04:32And then chemotherapy.
04:34Which works reasonably well in about a third of patients.
04:39And in two thirds of patients less well.
04:41And that's been the standard of care now for 30 years.
04:45And we haven't seen any changes in standard of care over that time.
04:50And so, from our perspective, that seems like a long time.
04:54Especially when average survival is a little over a year.
04:58You've done really well.
05:00Richard plans to revolutionise brain cancer treatment.
05:05But he's up against a formidable enemy.
05:07Brain cancer is often fast growing.
05:13And symptoms can appear out of the blue.
05:19What did you have for lunch?
05:21I had a jacket the same time.
05:23Have they got the good cheese again?
05:24Yeah.
05:29Come on then, give us a hug.
05:31Yeah.
05:34My name's David.
05:35I'm going to sit down and have a drink.
05:38Take him in.
05:40I 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,
06:12upper respiratory infection.
06:14And then they settled on sinusitis.
06:17And I had all sorts of medications.
06:20And then a month ago, I had a seizure
06:22where I actually passed out and collapsed.
06:26At first, I thought maybe he was having a stroke
06:27or a heart attack.
06:28He clutched his chest.
06:29His face dropped.
06:31But then his whole body, you know, he just collapsed.
06:33He was shaking all over.
06:35Struggling for breath.
06:38You know, everything was clenched up.
06:39And then I realised it was a full seizure.
06:42David underwent a scan.
06:45It showed a large tumour on his brain.
06:52Within a week, he's sent to Richard at Attenbrookes Hospital in Cambridge.
07:01So, David, not uncommonly for one of my patients, has had a seizure.
07:06Which means he's had a fit.
07:08And 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.
07:19And that's what we're going to talk about today.
07:28Come through.
07:29Nice to meet you.
07:30Nice to meet you.
07:31I'm Richard. Come through.
07:37My name's Richard Mayer, one of the Consultant Neurosurgeons.
07:40So, what we can quite clearly see is asymmetry with an area of abnormality here.
07:46Okay.
07:48My concern is that this represents some form of tumour.
07:52Okay.
07:53And that may be a malignant form of tumour.
07:54So, a type of cancer.
07:56So, there are three options in neurosurgery.
07:59One, we do nothing. We watch it.
08:01But, I think, if we were to do that with serial MRI scans, say, every couple of months,
08:06my worry would be that this would increase in size quite quickly.
08:09Second option would be to do a biopsy, which would tell us what this is, but it wouldn't remove any of it.
08:18The third option would be to try and do what's called a debulking operation.
08:22We take out as much of the bulk of the tumour as we can, and we send some of that off for analysis.
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.
08:39Yes.
08:40Is that right?
08:41Yes.
08:42Okay.
08:43Any questions about that at all?
08:44We're happy to follow your recommendations.
08:47Okay.
08:48All right.
08:49Fair enough.
08:50So, there seems to be a sort of well-demarcated region on the brain, on the scan, for where this tumour exists.
08:58We will not be able to get out absolutely everything, and it is just debulking.
09:02It's taking out the bulk of it.
09:04Okay.
09:05So, the results are normally a week, and then after that, we can make plans for anything we need to do subsequently.
09:10Okay.
09:11Good.
09:12All right.
09:13Nice to meet you both.
09:15Yeah.
09:16And I'll see you tomorrow.
09:17Yes.
09:19My concern is that this is some form of malignant brain tumour, the most common being a glioblastoma,
09:24but until we've actually done the operation and got the results back, we try not to predict too much.
09:35Glioblastoma is Richard's greatest nemesis, as it's almost always fatal.
09:42When you see these patients week in, week out, telling them, I'm very sorry, but there's nothing 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 what will.
09:59Richard's frustration has inspired him and a colleague to pioneer a revolutionary new approach to treating brain cancer.
10:06A clinical trial using personalised treatment.
10:13I think this could absolutely change medicine for good, because what we're trying to do is understand really the molecular level of what's going on in these tumours.
10:21Richard's plan is to pinpoint the specific genetic mutation causing each patient's cancer from hundreds of possibilities.
10:31Then, as quickly as possible, to match the patient with a drug thought to work against that precise mutation.
10:37The whole process used to take months, months 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 we've identified in real time using whole genome sequencing.
10:59And we think by bringing all of that together, it gives us a much better chance of finding a genuine treatment that's going to work for these patients.
11:08Just a day after his appointment, David is going under the knife.
11:13Obviously it's very, very real now, but basically I just want to get it over and done with.
11:23Just get this part out of the way, get the first step out of the way.
11:27Just wake up, basically.
11:32Then go from there.
11:34Good 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.
11:43Hmm.
11:44OK.
11:45Someone 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. Absolutely.
11:52All right. Well, I'll see you upstairs.
11:53Yes.
11:54OK.
12:03What's your favourite place in the world?
12:07With my family.
12:08With your family, yeah?
12:09Yeah.
12:10Yeah.
12:12For David, family life came late.
12:18Wait for us, playtime.
12:22I was very nervous about becoming a father at 50, but I was there at the birth.
12:29And when she came out, that's when it changed.
12:34You know, there was instant love there.
12:38And it's just been an enjoyable experience from then to now.
12:44She's always coming up with something new and, yeah, it's just a pleasure to be around.
12:55Yeah.
12:56He makes her laugh all the time, and they're 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.
13:07Three.
13:08When you get ill, well, it makes life more precious.
13:13But not just your own.
13:17You start thinking about others, especially the ones close to you.
13:21You 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, sir.
13:37Sorry.
13:57This is just some oxygen.
13:59Nothing else, all right?
14:01Nice big breaths, David.
14:03All right.
14:05That's it.
14:07Oh, yeah, of course.
14:08Oh, lovely.
14:10The sun's shining.
14:12Having the best round.
14:22In my childhood, my parents had a really big bookshelf that 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 that might be interesting.
14:47Probably that's what does drive me, is that there's something under the hood I don't understand, and can we get down to the bare bones of what's going on.
14:56Okay, it's a pin.
14:57Right, roll on three.
14:58One, two, three.
14:59And back.
15:00With David anesthetized, the operation to remove his tumour can start.
15:01If 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.
15:13Well, good.
15:14Okay, can we make sure he has a strap, please?
15:15Yeah.
15:16It's very privileged, you know, to be able to look at someone's brain without wanting to sound strange is a great privilege.
15:20And it's one that no one takes lightly.
15:21Knife back, please.
15:22Brain surgery has been seeing his тобой experience in the past.
15:23It's also the way that she happens to have his tumour at a point where he likes to touch the person.
15:25to have a rapid drop in the past.
15:26And he's very inclined.
15:27Yeah, what he does.
15:28Use the test for him.
15:29And that's what he does.
15:30Every step.
15:31All in the time.
15:32It's out.
15:33The doctor was a little bit more helpful for him to look through this.
15:34David's best hope would be if Richard could match him to a drug on the pioneering trial.
15:35All good, okay, can we make sure he has a strap, please?
15:37Yup.
15:38It's very privileged, you know, to be able to look at someone's brain
15:40without wanting to sound strange, is, is a great privilege.
15:42Knife back, please.
15:48Brain surgery has the risk of a terrible, disastrous outcome not that far away.
15:56Daryl, please.
16:01You can inadvertently damage something that leads to the patient's death or significant
16:09disability relatively easily, and so you have to be concentrating throughout the operation
16:18to 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.
16:38A 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.
16:51With 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, and the way these cells grow and move is like
17:10tendrils leeching out from where they've started, meaning that there are these long trails that
17:17go into the normal brain.
17:18The cells will infiltrate deep into the brain, and you can't cut them out, you can't even
17:24see the edges, because you have cells that are proliferating and cells that can migrate
17:28and invade into tissues.
17:30And that's why it's called cancer, because it's the claws of the crab.
17:32What that means is it's essentially like trying to unpick two tins of paint that have mixed
17:37together, you just can't do it.
17:40Because we all would love to be able to take every last cell of the tumour, but we know
17:45that's impossible.
17:47So this is definitely tumour.
17:51A bit more tumour coming out.
17:58The hope is, there is a drug on the trial which can treat any tumour left behind.
18:05To pinpoint the right drug, samples of David's tumour are collected for genome sequencing
18:10to map its genetic code.
18:12Wonderful, thanks David.
18:18Thanks everyone.
18:20Send to the next.
18:22All right.
18:23Dave, we're just taking you round to recovery ward, OK?
18:27Hi there, it's Richard, the surgeon here, calling from Adam Brooks.
18:34Hiya.
18:35Everything went really well, he's woken up in recovery, and I was very pleased with how
18:40the surgery went, and 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
18:48managed to remove.
18:49Oh, that's fantastic, thank you for calling me.
18:52OK, no problem at all.
18:53That's a really big relief, thank you very much.
18:55All right, you take care now.
18:56OK, thank you.
18:57Bye.
18:58Bye.
18:59Bye.
19:00Bye.
19:01Bye.
19:02Bye.
19:03Bye.
19:04With brain cancer, time is of the essence, so David's tumour is rushed to the lab.
19:09If it is cancer, they then need to find out which specific mutation is the cause, so they
19:15can match it with an existing drug.
19:19That's done through genome sequencing, which once took a very long time.
19:24Whole genome sequencing used to be something that was, you know, otherworldly, that was,
19:30you know, brand new, took forever, was so expensive you had to batch the samples together,
19:36which means you could only run them once every month or two.
19:39And that's not the case anymore.
19:41The costs have come down, our pathways have got better, so actually people can be put
19:46in for whole genome sequencing as they get on and have their treatment.
19:50So 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,
20:02the analysis, the drugs, this is, you know, on point for something that is, is groundbreaking.
20:15It's been a week since David's operation.
20:19Today is results day for David.
20:21So we're going to get him into the clinic and we'll talk him through what his tumour has
20:26come back as, what pathological diagnosis this is, and also how much we managed to remove
20:32that surgery.
20:33It's a big day for him.
20:34Yeah, it's a big day.
20:41One of my first neurosurgical mentors told me that it's important to give people hope
20:48and similarly it's important to be realistic.
20:52And we used to always skirt around cancer in terms of mentioning the word and talking about
21:00diagnosis.
21:01So I think it's important to get a balance of both and that's what I try and do.
21:07Hi.
21:08David, if you want to sit there.
21:13All right.
21:14Oh God.
21:15So you're obviously here for results.
21:20So we have been able to make a diagnosis and it has come back as some form of tumour.
21:27Okay.
21:28And it's a malignant type of tumour.
21:30So a type of cancer.
21:32And it's called glioblastoma.
21:34It's a cancer that's treatable, but it's not curable.
21:38Okay.
21:39Any questions about that diagnosis at all?
21:42No, I think we were pretty much expecting that.
21:45Yeah.
21:46Because we've always trusted your confidence and your ability.
21:54We have read up on these sort of things.
21:56Okay.
21:57What's not clear is just what happens next really.
22:00Sure.
22:01Okay.
22:02Well, let's start with the scan.
22:03So this is the post-operative scan on the left.
22:05This 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.
22:16Because unfortunately we can never remove all of the cancer.
22:21So given that there will still be cancer cells there, the next stage of your treatment
22:26is to go for radio and chemotherapy.
22:29Yeah.
22:30We also sent your tumour off for DNA sequencing, as we mentioned.
22:34The results from that may or may not direct what we do next.
22:38How long will chemo and radiotherapy keep this at bay?
22:42Okay.
22:43So you're talking about prognosis.
22:44Is that something you want to talk about today?
22:47Oh, yeah.
22:48We have discussed this.
22:50Yeah.
22:51So prognosis is an average.
22:52So it's not a specific figure for you personally.
22:55But on average, survival is in the region of about 14 and a half months.
23:04So traditionally students don't like coming to our clinic because it's full of bad news.
23:10And 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,
23:25then you can gain some sort of satisfaction from that.
23:29But it is tough.
23:30It's horrible.
23:31You're telling people the worst news they've ever heard in their whole life.
23:34To go home.
23:40You know, we've got a young daughter.
23:41Sure.
23:42We want to spend any, you know, what time is left is precious.
23:46Sure.
23:47Absolutely.
23:48Extremely precious.
23:49Absolutely.
23:50And we want to make the most of it.
23:51It's all I want now.
23:52Mm.
23:53Spend time with you and Lucy.
23:54Just hoping it would be a bit longer.
23:55Okay.
23:56Yes.
23:57How many people have, like, gone on past the, you know, 12 to 14 months?
24:01Yeah.
24:02I mean, we have a kind of five to 7% five-year survival.
24:05Okay.
24:06It's an average.
24:07Mm.
24:08Okay.
24:09So let's hope you're on the other side.
24:10Let's face it, Laura, I've never been average, have I?
24:12Or lucky.
24:13Oh, of course I've been lucky.
24:15You'd better win on that scratch card.
24:17Of course I've been lucky.
24:18Go start.
24:19Okay.
24:20He doesn't know at the end of the day, you know you've been loved, and you know you
24:31will be loved right up to the end.
24:34But they're going to be happy times when I've got them.
24:38Okay?
24:39Take care.
24:40You too.
24:41Okay.
24:42All right.
24:43I'll see you.
24:44What am I going to do without him?
24:50Let's try and chip up a bit, please, for me.
24:53I don't like seeing Elias that upsets you even more.
24:56Oh, no.
24:57Just give it up.
24:58It's really tough for them, really tough.
25:01David's got a lot of positives despite this overwhelming negative.
25:06He's had a good operation where we've managed to get a large chunk of this tumour out.
25:11He's well, and when we get his whole genome data back, we can look and see whether there
25:17are mutations or alterations in his DNA and regions that we can target with drugs that
25:23we've got on our clinical trial.
25:26What we want to do is transform this idea of cancer as a death sentence into something
25:32that 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.
25:50One of the first patients to join the trial was Amanda, a former finance director.
25:56You put half a pack of butter on this, did you?
25:59Yeah.
26:00Not that I'm complaining.
26:01Almost two years ago, Amanda had surgery and post-operative treatment for a glioblastoma.
26:09You've got a dirty face. You've been digging again.
26:12But a few months ago, Amanda's tumour returned.
26:17Patients with brain cancer will unfortunately recur very quickly. If it takes months to get
26:30the results of the DNA analysis you're going to use to plan their treatment, they may have
26:36already 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
26:50after the grandchildren. She had come back and hit work.
26:54I've looked at these for years, these wedding photographs.
27:03Long time ago, eh, Amanda?
27:05Yeah.
27:06And it seems like yesterday.
27:09Sit down, baby. I'm with her 24-7. I love it.
27:15Push.
27:16Push.
27:17But break your leg.
27:18No, you won't. Go, push.
27:20Push.
27:21I'm gonna get her breakfast, I'll get her tablets first thing in the morning, give it to her,
27:26and it's just, cos she'll forget and I go, you ain't took your tablets. Amanda, just take
27:33your tablets. I look at it, it's me job.
27:35Ready?
27:36Yeah.
27:37Oh!
27:40Come on, then.
27:41Come on.
27:42Gary's very, very kind.
27:45He worries about me and he gives me lots of support, especially now.
27:54Brain cancer robs the person of themselves.
27:59As it grows, it takes away that individual's personality, their ability to function in this world.
28:05And I really hope that our current approach will get some of that back for the patient to try and enable a normal life.
28:14To improve Amanda's future, Richard sought to get her onto his trial.
28:23So, 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.
28:40And that's in a period of weeks, not months and certainly not longer than that.
28:49When Amanda's cancer DNA was examined, a mutation was found that matched a drug on the clinical trial.
28:56I was really surprised to find out that there was still some hope for me.
29:05And my oncologist informed me that Richard would be phoning me to ask me to see if I was interested in joining this trial.
29:16I was really pleased at that. I was thrilled actually. We both were.
29:25How much hope do you think we get from it?
29:28That's all you have to do, man. Hope. Hope, yeah.
29:34That's all you've got. It's hope.
29:37Yeah.
29:39And if that...
29:40But I want more.
29:41Well, it's going the right way at the moment.
29:44Yeah.
29:47Time is everything.
29:49With a new treatment, might just give me a little bit more time.
29:54My cup's always our full.
29:57So they always give you hope that they'll do something else.
30:00And it's hope.
30:02And that's all you can ask for, is hope.
30:04And therefore, if there's a chance of a hope, I'm with Amanda.
30:09You'll be alright.
30:15What we're doing at the moment is trying to help the patients of today.
30:21But that will also help the patients of tomorrow.
30:24It's in there.
30:27Oh, thank goodness.
30:31Amanda's now been on Richard's clinical trial for three months.
30:35I feel so much better than I did when I was on the chemo.
30:38So I'm hoping that these are all good signs.
30:40Oh, yeah.
30:42Come on, do them.
30:44Yeah.
30:46As part of her routine, Amanda has regular MRIs that take detailed images of her brain.
30:50I have to have them frequently in order to plot any changes to my tumour.
31:04And if there are no changes, I'm going to see that.
31:07I feel so much better than I did when I was on the chemo.
31:11So I'm hoping that these are all good signs.
31:15As part of her routine, Amanda has regular MRIs that take detailed images of her brain.
31:19And if there are no changes, yay!
31:22They're not a problem for me at all.
31:25And 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
31:46that we can target with drugs.
31:50A precision drug has to have a target.
31:53What we need to work out is which of those targets
31:57and which of those drugs work in which patient.
32:00A few weeks later, Amanda is back in Cambridge for an appointment with Richard and to collect the drugs she's taking on his trial.
32:13I'll try to look out that door.
32:16So 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.
32:27Once these drugs were absorbed into Amanda's body, they travel to the tumour in her brain and into the cancer cells.
32:41The 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.
32:51The drugs work by blocking these overactive signals to prevent cancer cells from multiplying and to prevent cancer cells invading Amanda's brain.
33:05In theory, that means the tumour should stop growing or even shrink.
33:09Be brave.
33:12I'll be brave, girl.
33:14Oh, yeah, yeah.
33:16Yeah, yeah.
33:21You're a funny lady.
33:23I know.
33:25Come 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.
33:40And that's what you want to do, innit?
33:45Yeah.
33:47We just need to be positive all the time, don't we?
33:50Yeah.
33:54Hi there, come and have a seat.
33:57How are you doing?
33:58Great.
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.
34:06This is you at the beginning of February, and this is the scan from June, and I hope you can sort of appreciate that that sort of distance there is a little bit smaller on that scan.
34:17Oh, definitely.
34:18Yeah?
34:19Yes, I can see that.
34:20I think that's very, very encouraging, really.
34:22Yeah.
34:23There's definitely no increase in size in the lump, which is good, and perhaps it's actually shrunk a little bit, which is really, really encouraging, given the fact that you're on this trial, and that's something that we are looking for.
34:37It's amazing.
34:38OK?
34:39Yeah.
34:40We're astounded, aren't we?
34:41I'm amazed.
34:42And how are you feeling?
34:43How are things?
34:44I feel absolutely fine.
34:45Yeah.
34:46OK.
34:47Any symptoms at all?
34:48No.
34:49She's getting stronger.
34:51OK.
34:52Good.
34:53She's getting more and more back to normal.
34:55OK.
34:56Although she's got a long way to go, but from where she was, she's doing absolutely fantastic.
35:02Well, that's fantastic news, and as I say, from our perspective, you know, we knew that you had these targets within the tumour, these changes in certain genes.
35:12Yes.
35:13That made this new type of treatment, which sort of specifically targets those changes rather than the generic chemotherapy.
35:20Yes.
35:21Right.
35:22As an appropriate thing for you.
35:23Yeah.
35:24So, 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.
35:36But it's in herself.
35:37Yeah.
35:38Indeed.
35:39Yeah.
35:40The fact that she's feeling better as well.
35:41Yeah.
35:42Yeah.
35:43Yeah.
35:44He just wants me to start cooking again.
35:47Yeah.
35:48I don't know about that.
35:50Yeah.
35:54My wife is a nurse, and when we discuss our day at work, it often relates to bad news. And I think it does give you a frame of reference.
36:19Okay, is Dad's home?
36:21Have you had a good day?
36:22Yes.
36:23Oh!
36:24Most 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.
36:41Okay, have you been playing on the trampoline?
36:44Yeah.
36:45Oh, well done, mate. That was excellent.
36:48Excellent.
36:55Family helps people get through difficult times.
37:00I think it's really important.
37:02And I can see how families strengthen each other.
37:09Hello.
37:10Hello.
37:11Did you have a good day at school?
37:12Yeah.
37:13Oh, fish.
37:14It's been two months since my operation. Then I had my chemo and radiotherapy.
37:31A bumper crop this year.
37:32You slowly come to terms with it. I think you have to.
37:48Rosie's just going to eat you up. So now it's just, I just relish my time with my family, really.
37:57So many people inquire now, we have to put five rows of benches instead of four.
38:03You're getting too good, you need to be off key a bit more now, drive people away.
38:08No.
38:10Lucy's the biggest focus.
38:12I spend a lot of time with her, trying to keep things normal.
38:16Right, another day closer to end of time.
38:19Lucy's coping with it very well. I mean, she's just, she just keeps reminding me I've got to get better.
38:29At 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?
38:41Well, 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 when your hospital came, you've got a radiotherapy department on your hospital.
39:00That's where daddy goes a lot.
39:02I really hope it works, and I hope it works for other people as well.
39:07You 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,
39:18and 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?
39:28Can we put them on a 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?
39:42I am.
39:43Are you all right?
39:44Very comfy.
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.
40:02Booking holidays, and picking places to go to.
40:17Yeah.
40:18How much do I love you?
40:19Answer that.
40:20Do you love me enough to buy me a boat?
40:22I don't know about that.
40:23I think if it weren't for the clinical trial, Amanda may well have progressed, and her quality
40:33of life would have been impaired.
40:35Obviously, with the trial drug, it's gone the other way.
40:39It's actually shrunk, and obviously this is brilliant, because she can still, you know,
40:43live her life, and that's exactly what we want.
40:49What 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
41:01work in this field, and now I think there are more, and that's what I want.
41:06I want us to build a village to try and cure this.
41:09That village includes consultant oncologist, Professor Juanita Lopez, who worked with Richard
41:18for three years to get the groundbreaking trial up and running.
41:23They're now finally starting to see the first patients benefit from their work.
41:28I saw Amanda in clinic recently.
41:32The tumour seems to be shrinking.
41:34So from my perspective, this looks really promising, and I'm really excited.
41:39The other thing to say is that if she wasn't on this drug, not only would it not have shrunk,
41:44it would have increased in size.
41:46So actually, you know, seeing it shrink is really quite different to the natural history
41:50of what we'd expect this tumour to do in this scenario.
41:53This is David's scan.
41:54So we've removed all the tumour in his right temporal lobe, which is great.
41:58I think we're still waiting for the sequencing on him.
42:01But I've just checked, and that should be back within the next week or so.
42:04So it'd be good to discuss to see whether he has any targets as well.
42:09You must remember I said, well, this is too big, this is too hard.
42:14It's challenging.
42:15It was too difficult.
42:17It was too hard to do.
42:19Yeah.
42:20But, you know, if someone was brave enough to do it, here it is.
42:22Yeah.
42:23And I think that you had great ambition.
42:25I had ambition.
42:27And 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.
42:39It's been floods of tears and chaos and crisis management.
42:46But if, you know, we're not going to do it, kind of who is?
42:49And they don't have a voice.
42:50And I think that's a really sad, you know, bit of the story that patients, they can't speak for themselves.
42:58So it's really, you know, championing those who, you know, have no voice.
43:03Or can't.
43:04Yeah.
43:07Where do we think this will take us?
43:10I think we want to cure brain cancer.
43:13Yeah.
43:14It's all there.
43:15We just need to link it together and have the ambition.
43:18Sky's the limit.
43:24The trial structure means that we can add new drugs as they come on board.
43:28And 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.
43:39This clinical trial will last for as long as it needs to last.
43:43And we hope it's going to last for as long until we cure this cancer.
43:47The ultimate aim is to cure brain cancer.
43:50I think we have to be that ambitious.
43:52Now, we are a long way away from that.
43:54OK, I'm optimistic, but I'm not stupid.
43:56We have a lot that we need to do, but we are on a trajectory.
44:00We are on the first step and the ladder.
44:02But we have to be ambitious.
44:04We have to be positive.
44:05We don't just want to improve how the cancer looks.
44:10We don't want to get people a few months.
44:12We want to change how we manage this cancer for good.
44:15But you have to start somewhere.
44:17And we're very much at the start of that journey.
44:19Well, you'll find details about support that's available for any of the issues that we have in the world.
44:24featured in the program at Channel 4 dot com slash support.
44:25Well, you'll find details about support that's available
44:48for any of the issues that featured in the program
44:50at channel4.com slash support.
44:53Cancer Detectives returns next week at the later time of 10
44:56and you can stream the whole series now
44:58and join Davina McCall and Adam Hills
45:00when Channel 4 stands up to cancer on Friday the 12th of December.
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