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