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Bowel Screening Breakthrough
JANUARY 29, 2013
Irish team develops a blood test to help identify those who will not benefit from this
important medical intervention…
IRISH doctors have achieved a major breakthrough in the area of bowel screening.
Physicians and scientists in the RCSI and Beaumont Hospital in Dublin have just
developed a new method of predicting which patients with bowel (colorectal) cancer
will respond effectively to chemotherapy. And, more importantly, which patients will
not. Basically speaking, the discovery will help identify people who will not respond
to chemotherapy, therefore pointing them towards a more effective treatment option.
The new tool developed by the Irish team does one vital thing: it measures the
amount of drug required for a cancer cell to die without harming healthy tissue.
In future it may also be used in clinical trials to develop new drugs to treat bowel
cancer. “Our study has enabled us to predict which patients are likely to be resistant
to chemotherapy by examining how certain proteins in their cancer cells interact,”
said Professor Jochen Prehn, pictured, Director of the Centre for Systems Medicine
at RCSI. “We hope that the clinical decision-making tool that we have designed will
enable doctors to develop personalised therapies for patients to ensure the best
outcomes and potentially avoiding unnecessary chemotherapy and the negative side
effects that go with it.”
Programmed Cell Death Okay. Here’s the science bit: chemotherapy destroys
cancer cells by bringing on a process of programmed cell death. This is known as
apoptosis. However, sometimes mutations in cancer cells alter the levels of certain
proteins and prevent this process of cell death happening, which results in
chemotherapy being ineffective in some people with bowel cancer.
“The prediction tool also has the potential to be used in clinical trials so that new
drugs can be developed for bowel cancer patients who are resistant to
chemotherapy,” said Prof Prehn. “The model we developed in this study could
eventually be applied in other cancers.” This is an important piece of work, given the
scale of bowel cancer in this country.
Bowel cancer is the second most common cancer in Ireland: in 2009, 2,271 people
were diagnosed with the disease. It is also the second most common cause of
cancer death in Ireland. In another study – this time coming out of the University of
California in San Francisco – it was found that screening for breast and bowel cancer
may not carry the long-term benefits it was once thought, particularly in relation to
older people. In a report carried in the British Medical Journal and highlighted in our
own Irish Medical Times, it was concluded that breast and bowel screening should
be targeted towards patients with a life-expectancy greater than 10 years. For people
who are expected to live less than that, the harm that could accrue from screening
could well outweigh the benefits.
Put in a more simple way, the guidelines recommend screening healthy older
patients because “complications from screening can harm patients immediately,
while the benefits of screening are not seen for many years”. So, what to do if you
are concerned about anything in this report? Talk to your GP; your own doctor is
always best-placed to advice you on these important medical matters.