0:00:02 > 0:00:04Cancer is a condition we all know about.
0:00:04 > 0:00:07Here in the UK, a third of a million people
0:00:07 > 0:00:10are diagnosed with it every single year.
0:00:11 > 0:00:16And as we live longer, that number is set to rise.
0:00:16 > 0:00:19Currently, cancer is the country's second-biggest killer.
0:00:21 > 0:00:24Tonight on Bang, we reveal it's not all bad news
0:00:24 > 0:00:28as serious progress has been made in our fight against it.
0:00:30 > 0:00:34Over the last 40 years, our chances of surviving some cancers
0:00:34 > 0:00:39have more than doubled and we're much better at preventing them too.
0:00:39 > 0:00:41From the latest approach to screening...
0:00:41 > 0:00:44It saved Chris's life. I am convinced of it.
0:00:44 > 0:00:47..to cutting-edge technology being used in theatre...
0:00:47 > 0:00:50For brain surgery, I think it's going to be revolutionary.
0:00:50 > 0:00:52..and the new wave of designer drugs
0:00:52 > 0:00:55that aim to cure some cancers altogether.
0:00:57 > 0:01:00Tonight on Bang, we confront cancer
0:01:00 > 0:01:02and explore how we're planning to defeat it.
0:01:06 > 0:01:08According to this nationwide survey,
0:01:08 > 0:01:11more doctors smoke Camels than any other cigarette.
0:01:13 > 0:01:17This ad from 1949 shows how we used to view smoking.
0:01:19 > 0:01:22A year later, British scientists discovered the link
0:01:22 > 0:01:24between tobacco and cancer
0:01:24 > 0:01:28and it was a finding that would save millions of lives.
0:01:28 > 0:01:31It's still responsible for a quarter of our cancer deaths
0:01:31 > 0:01:34and we've since found other things that pose a risk.
0:01:35 > 0:01:40In fact, it's been estimated that two out of every five cancer cases
0:01:40 > 0:01:43are caused by our own lifestyle choices.
0:01:44 > 0:01:50Too much exposure to the sun's UV rays has been linked to skin cancer.
0:01:50 > 0:01:53Poor diet, inactivity and excessive boozing,
0:01:53 > 0:01:57they've all repeatedly been shown to significantly increase
0:01:57 > 0:01:58your risk of cancer.
0:01:58 > 0:02:01But if you listen to the press, you might think
0:02:01 > 0:02:03lots of other things were a risk too,
0:02:03 > 0:02:06things like deodorant,
0:02:06 > 0:02:08grapefruit
0:02:08 > 0:02:11and even wearing your belt too tight.
0:02:11 > 0:02:14These are just a few of the things the press have linked to cancer
0:02:14 > 0:02:16in recent years.
0:02:16 > 0:02:19So, is every story in the paper worth worrying about?
0:02:19 > 0:02:24Sir Richard Peto has spent decades studying the causes of cancer.
0:02:25 > 0:02:28It's easy to say that anything might be dangerous.
0:02:28 > 0:02:31Biscuits might be dangerous. Coffee might be dangerous.
0:02:31 > 0:02:33Sitting in chairs all day might be dangerous.
0:02:33 > 0:02:37But I think we shouldn't let worrying about possible hazards
0:02:37 > 0:02:40divert attention from dealing with the main things.
0:02:40 > 0:02:44And the main things in this country would be, number one, tobacco,
0:02:44 > 0:02:48and number two would be having too much fat around your tummy.
0:02:48 > 0:02:53So, some things are worth worrying about, others are not.
0:02:53 > 0:02:55But unfortunately, when it comes to cancer,
0:02:55 > 0:02:58some things are out of your control.
0:02:58 > 0:03:01And what makes all this a game of chance comes down
0:03:01 > 0:03:05to how cancer occurs in the body and why.
0:03:05 > 0:03:07Here's Liz to explain.
0:03:08 > 0:03:10Cancer isn't just one disease,
0:03:10 > 0:03:13it's a whole range of different diseases,
0:03:13 > 0:03:15but they all share some common features.
0:03:17 > 0:03:21Cancer starts in our bodies, within our own cells,
0:03:21 > 0:03:25and it happens when our very biology malfunctions.
0:03:26 > 0:03:30Our bodies are made up of cells programmed to do specific jobs,
0:03:30 > 0:03:32from carrying oxygen around your blood
0:03:32 > 0:03:35to transmitting signals in your brain.
0:03:36 > 0:03:41The instructions that tell a cell how to behave are held in its DNA,
0:03:41 > 0:03:44in sections of chemical code known as genes.
0:03:44 > 0:03:47This is just one gene and a fairly small one at that.
0:03:47 > 0:03:52Now, each cell follows its own set of instructions that dictate
0:03:52 > 0:03:56how it must function to stay healthy and act normally within the body.
0:03:59 > 0:04:03Imagine this bubble is behaving like most cells.
0:04:03 > 0:04:07If it's healthy, it's programmed to grow and divide and so multiply.
0:04:07 > 0:04:11But this multiplication needs to be done in a controlled way.
0:04:11 > 0:04:15This cell division is known as mitosis.
0:04:15 > 0:04:18And of course, each of these cells may go on to divide further.
0:04:18 > 0:04:21But there is a predetermined limit to how many times
0:04:21 > 0:04:24division will occur from that first cell.
0:04:25 > 0:04:30Another set of instructions control when a cell should die.
0:04:30 > 0:04:34This is important for cells in a number of different circumstances.
0:04:34 > 0:04:36They can stop being useful to the body
0:04:36 > 0:04:38or they can start behaving abnormally,
0:04:38 > 0:04:42so it's vital that a cell is able to self-destruct.
0:04:44 > 0:04:48Cell death is essential for maintaining order within the body.
0:04:48 > 0:04:53It happens up to 70 billion times every day in a healthy adult.
0:04:55 > 0:04:59But it's possible for our biological instructions to go wrong.
0:04:59 > 0:05:03The chemical coding within the DNA can be changed or damaged
0:05:03 > 0:05:07by outside influences, altering how the cell behaves.
0:05:07 > 0:05:11As a result of these chemical changes,
0:05:11 > 0:05:13cells start to behave in ways they shouldn't.
0:05:15 > 0:05:18They may grow too fast and multiply too often
0:05:18 > 0:05:22and they may no longer listen to the body's signals to stop
0:05:22 > 0:05:25or refuse to die when they're instructed to.
0:05:25 > 0:05:27When cells become cancerous,
0:05:27 > 0:05:31they no longer obey the normal rules of cell life and cell death.
0:05:32 > 0:05:36All cancers start out as a growing population of too many cells
0:05:36 > 0:05:39in the wrong place, doing the wrong job.
0:05:39 > 0:05:43And in most cases, they start growing as a mass, a tumour.
0:05:45 > 0:05:48Now, not all tumours are cancerous, in which case,
0:05:48 > 0:05:49they're called benign.
0:05:49 > 0:05:52But if a tumour invades surrounding tissue or spreads
0:05:52 > 0:05:57to other parts of the body, it is cancerous or malignant.
0:05:58 > 0:06:02Between 5% and 10% of cancers are caused by genetic errors
0:06:02 > 0:06:04inherited at birth.
0:06:04 > 0:06:07And some dangerous mutations and damage to DNA
0:06:07 > 0:06:09are caused by substances like cigarette smoke,
0:06:09 > 0:06:13radiation from the sun, viruses like HPV
0:06:13 > 0:06:18and also by a number of other unavoidable environmental factors.
0:06:18 > 0:06:21And the longer we live, the more chance we have
0:06:21 > 0:06:25of collecting a bad combination of mutations.
0:06:25 > 0:06:28It's the fact that we're all living longer that means that
0:06:28 > 0:06:31an increasing number of people will get cancer.
0:06:31 > 0:06:34We're much, much less likely to die from heart disease and stroke
0:06:34 > 0:06:37and infection than we were 40 years ago
0:06:37 > 0:06:39and so an increasing proportion
0:06:39 > 0:06:42of the deaths that are left are due to cancer.
0:06:44 > 0:06:47Cancer only became a serious problem in the modern world
0:06:47 > 0:06:50as people started to live longer.
0:06:50 > 0:06:52But our understanding of cancer has grown too
0:06:52 > 0:06:55and we've applied science and technology
0:06:55 > 0:06:57to find ways to overcome it.
0:06:57 > 0:07:00One of the biggest success stories is radiotherapy.
0:07:00 > 0:07:05Back in 1895, a German scientist, Wilhelm Rontgen,
0:07:05 > 0:07:08discovered a new type of light, invisible to the human eye,
0:07:08 > 0:07:11yet of an energy and nature that allowed it
0:07:11 > 0:07:13to pass straight through the human body,
0:07:13 > 0:07:17only being preferentially blocked by the denser parts like bone.
0:07:17 > 0:07:19Shone into a photographic plate,
0:07:19 > 0:07:23it gave extraordinary images like these.
0:07:23 > 0:07:26These mysterious rays that could pass through our flesh
0:07:26 > 0:07:30like light through glass became known as X-rays.
0:07:30 > 0:07:33Quite soon after their discovery, it was noted that just because
0:07:33 > 0:07:36most of the X-rays passed through living tissue,
0:07:36 > 0:07:39they didn't necessarily leave it unaffected.
0:07:39 > 0:07:42And within weeks, Victorian doctors were using X-rays
0:07:42 > 0:07:46to try and cure all sorts of ailments, including cancer.
0:07:49 > 0:07:54Taking photos like these uses a very small dose of X-rays.
0:07:54 > 0:07:58But it was found that if the dosage was thousands of times bigger,
0:07:58 > 0:08:02it could damage living tissue inside the body.
0:08:02 > 0:08:06Now, in here I've got some real, live cancer cells,
0:08:06 > 0:08:08growing and dividing as I speak.
0:08:08 > 0:08:12Placed under a microscope, the cells themselves are clearly visible.
0:08:16 > 0:08:17At the other end of this lab,
0:08:17 > 0:08:21they've got a source of high-energy radiation like X-rays.
0:08:21 > 0:08:23Let's see what happens to our cancer cells
0:08:23 > 0:08:25when they get a quick blast of that.
0:08:30 > 0:08:33The energy from the beams of radiation damages the DNA,
0:08:33 > 0:08:35shown here in red.
0:08:35 > 0:08:39This stops cells replicating or kills them outright.
0:08:41 > 0:08:44The use of high-energy radiation to attack cancerous growths
0:08:44 > 0:08:48is known as radiotherapy. But as with most things in medicine,
0:08:48 > 0:08:52there's a lot more to take into account as you leave the lab
0:08:52 > 0:08:55with the intention of trying the process on real people.
0:08:57 > 0:09:01X-rays aren't the only sort of radiation used to treat cancer,
0:09:01 > 0:09:05but they are the most common, and different types of radiotherapy
0:09:05 > 0:09:09can be administered from outside or inside the human body.
0:09:09 > 0:09:13But whatever method is used, the big problem is that healthy cells
0:09:13 > 0:09:16are made from the same stuff as cancerous growths,
0:09:16 > 0:09:20so they can also suffer from intense radiation exposure.
0:09:21 > 0:09:26Now, imagine this is a section through a patient.
0:09:26 > 0:09:30These bits here represent all the healthy tissue that should be there,
0:09:30 > 0:09:34and this, that's been discovered through careful scanning,
0:09:34 > 0:09:35is a cancerous tumour.
0:09:35 > 0:09:40Now, with a further leap of the imagination, this is my X-ray gun,
0:09:40 > 0:09:44capable of firing a stream of highly energetic photons into the body.
0:09:48 > 0:09:51Firing a beam straight on like this
0:09:51 > 0:09:54not only heavily damages the cancerous tissue
0:09:54 > 0:09:58but also the healthy areas in front of and behind it.
0:09:58 > 0:10:00But if we set the gun firing
0:10:00 > 0:10:05whilst it moves on a circular path centred around the cancer,
0:10:05 > 0:10:06let's see what happens.
0:10:09 > 0:10:14With this setup, any damage to the healthy tissue is spread out,
0:10:14 > 0:10:18whilst the cancer receives a concentrated dose.
0:10:18 > 0:10:23With actual radiotherapy, the doses are carefully split up over time.
0:10:23 > 0:10:26By giving smaller doses on different days,
0:10:26 > 0:10:29the body has a chance to repair the limited damage it's received.
0:10:29 > 0:10:33The tumour can't repair itself nearly so well.
0:10:33 > 0:10:36Now it's time to give the cancer another blast.
0:10:39 > 0:10:42Obviously, with real treatment,
0:10:42 > 0:10:46programmes of radiotherapy and recovery are uniquely planned
0:10:46 > 0:10:50to maximise damage to the cancer, avoid vital organs
0:10:50 > 0:10:52and keep the patient as safe as possible.
0:10:52 > 0:10:55Now, obviously, this isn't real radiotherapy,
0:10:55 > 0:10:58but it's this ever-increasing planning
0:10:58 > 0:10:59and precision of the doses
0:10:59 > 0:11:03and building in the correct recovery time that's making
0:11:03 > 0:11:06what's always been a very powerful treatment for some cancers
0:11:06 > 0:11:09increasingly safe and effective.
0:11:09 > 0:11:12The real technology and the way we use it
0:11:12 > 0:11:14is getting more sophisticated all the time.
0:11:15 > 0:11:18Every tumour is a unique, complex shape,
0:11:18 > 0:11:22and one of the most advanced new treatments follows it in 3D
0:11:22 > 0:11:25and then changes the shape of the X-ray beam
0:11:25 > 0:11:27to concentrate the dose on the cancer.
0:11:29 > 0:11:31By increasing our precision,
0:11:31 > 0:11:35we've made major breakthroughs in fighting tumours with radiotherapy.
0:11:36 > 0:11:41And it's not the only kind of treatment where this is the case.
0:11:41 > 0:11:44When it comes to cancer surgery,
0:11:44 > 0:11:46pioneering technology is also helping to increase
0:11:46 > 0:11:48our chance of survival,
0:11:48 > 0:11:51especially with operations to remove brain tumours.
0:11:53 > 0:11:57Operations like this one are incredibly delicate procedures.
0:11:57 > 0:12:00Removing cancerous cells from healthy tissue
0:12:00 > 0:12:02in the most complex organ of the body
0:12:02 > 0:12:06requires extreme precision down to a microscopic level.
0:12:07 > 0:12:09Here at Charing Cross Hospital,
0:12:09 > 0:12:13Mr O'Neill carries out operations like this one every week.
0:12:13 > 0:12:17And while every case poses its own individual problems,
0:12:17 > 0:12:19the goals are always the same.
0:12:19 > 0:12:21The thing that we do know here and now
0:12:21 > 0:12:24is that we can give the patient a much better outlook
0:12:24 > 0:12:26if we can get as much of this tumour out as accurately as possible.
0:12:28 > 0:12:31- We have to be very, very precise.- Right.
0:12:31 > 0:12:34And we use as much technology as we can.
0:12:34 > 0:12:37We take pre-operative MRI scans and we convert them into a 3D volume
0:12:37 > 0:12:39so when we point to the head
0:12:39 > 0:12:41we can point to the exact point on the image
0:12:41 > 0:12:45so we can see exactly where we're heading and where the tumour is.
0:12:45 > 0:12:48We use ultrasound to update that volume.
0:12:50 > 0:12:53And of course then you have your experience, your naked eye
0:12:53 > 0:12:57or using the microscope to identify what looks abnormal.
0:12:57 > 0:12:59But even with all the current technology,
0:12:59 > 0:13:01surgeons often have to send a sample
0:13:01 > 0:13:04from what they believe to be the edge of the tumour
0:13:04 > 0:13:05to the biopsy lab.
0:13:05 > 0:13:09There they run tests to see if the job is complete.
0:13:09 > 0:13:11But this can take up to half an hour,
0:13:11 > 0:13:14and the patient has to remain under anaesthetic.
0:13:14 > 0:13:18The more cells that can be removed while keeping healthy tissue intact,
0:13:18 > 0:13:21the smaller the chance of the cancer coming back.
0:13:21 > 0:13:25But even with biopsies, the process isn't 100% accurate.
0:13:25 > 0:13:28If we can improve our accuracy even more,
0:13:28 > 0:13:31I think we can improve these patients' outlook incredibly.
0:13:32 > 0:13:35Surgeons here are working with Imperial College
0:13:35 > 0:13:39on a new device that will bring the biopsy into the theatre.
0:13:39 > 0:13:42They're enhancing a tool that's already commonly used,
0:13:42 > 0:13:48a knife that cauterises the tissue with electricity as it cuts.
0:13:48 > 0:13:49It's a very precise tool,
0:13:49 > 0:13:54and what's really good about this is it stops bleeding immediately.
0:13:54 > 0:13:58Dr Takats and his team have taken a workhorse of the operating theatre
0:13:58 > 0:14:02and combined it with a common piece of equipment from the chemistry lab,
0:14:02 > 0:14:04a mass spectrometer.
0:14:04 > 0:14:08Electrosurgery, as it works, produces smoke.
0:14:08 > 0:14:13Using this tubing, we can introduce this smoke into the instrument
0:14:13 > 0:14:17and we can perform almost real-time chemical analysis.
0:14:20 > 0:14:23And as an example of how this technology works,
0:14:23 > 0:14:28I'm using it to analyse two very different samples of animal tissue.
0:14:30 > 0:14:35- Oh, wow, look at that. Lamb liver chemical signature.- Exactly.
0:14:35 > 0:14:36That is pretty impressive.
0:14:36 > 0:14:39And not only are we getting a good old whiff of that,
0:14:39 > 0:14:42but some of that smoke, of course, has been filtered through this tube,
0:14:42 > 0:14:44but it's letting you know in real time
0:14:44 > 0:14:50the chemical signature of the cells or the tissue you're cutting through.
0:14:50 > 0:14:51Exactly.
0:14:51 > 0:14:54Cancer has a unique metabolism,
0:14:54 > 0:14:58quite different from any other tissues,
0:14:58 > 0:15:00which means that just by looking at
0:15:00 > 0:15:06those molecules which electrosurgery liberates from the tissue,
0:15:06 > 0:15:10we can easily differentiate between healthy and cancerous tissues.
0:15:10 > 0:15:12And it can give a warning signal
0:15:12 > 0:15:14whenever the wrong type of tissue is hit.
0:15:16 > 0:15:20This technology could help surgeons define more precisely
0:15:20 > 0:15:22where the tumour boundaries are
0:15:22 > 0:15:26and ultimately help to safely remove more of the cancer.
0:15:27 > 0:15:30This intelligent knife could be used in the removal of tumours
0:15:30 > 0:15:32from any part of the body.
0:15:32 > 0:15:36The surgeons here will be starting to test it in the next few months.
0:15:36 > 0:15:39For brain surgery, I think it's going to be revolutionary,
0:15:39 > 0:15:43because the whole point is to try and avoid removing normal brain
0:15:43 > 0:15:45and get to a point where you can
0:15:45 > 0:15:48very accurately identify tumour versus normal brain,
0:15:48 > 0:15:51and how more accurate could you get
0:15:51 > 0:15:54than a molecular fingerprint of the tissue you're looking at?
0:15:54 > 0:15:58Improving the precision of tumour removal is especially important,
0:15:58 > 0:16:02as it helps to limit one of cancer's deadliest characteristics,
0:16:02 > 0:16:04its ability to spread.
0:16:08 > 0:16:13As a malignant tumour grows, cancer cells can invade surrounding tissue,
0:16:13 > 0:16:16like a weed spreading through a garden.
0:16:16 > 0:16:21But they also have the potential to take root in other parts of the body
0:16:21 > 0:16:23in a process known as "metastasis".
0:16:23 > 0:16:27With metastasis, individual cancer cells break off from a growth
0:16:27 > 0:16:31and travel in the body's vessels to other organs.
0:16:31 > 0:16:36Only about one in 10,000 cancer cells take hold in other tissues,
0:16:36 > 0:16:39but once there they can lie dormant for months or even years
0:16:39 > 0:16:42before conditions are right for them to start multiplying again.
0:16:44 > 0:16:48What metastasis means is that cancer can spread,
0:16:48 > 0:16:52so you could get a breast cancer that moves to the brain
0:16:52 > 0:16:55or a lung cancer appearing in the liver.
0:16:55 > 0:16:58But even if a cancer has metastasised,
0:16:58 > 0:17:01there are ways of fighting back.
0:17:01 > 0:17:04One of the most commonly used techniques uses medicines,
0:17:04 > 0:17:06and it's known as chemotherapy.
0:17:14 > 0:17:16Chemotherapy drugs are a bit like the selective weedkillers
0:17:16 > 0:17:18you might use in your garden
0:17:18 > 0:17:23so you can rid your lawn of weeds but leave the grass untouched.
0:17:23 > 0:17:26Chemo agents target fast-growing cells in the body,
0:17:26 > 0:17:28like cancer cells, killing them,
0:17:28 > 0:17:31leaving the slower-growing, healthy cells unharmed.
0:17:33 > 0:17:36But cancer cells aren't the only ones that multiply fast.
0:17:36 > 0:17:38Our blood cells, made in our bone marrow,
0:17:38 > 0:17:41and cells in our gut do, too.
0:17:41 > 0:17:43So chemo can also affect these.
0:17:43 > 0:17:45And this is what leads to side effects,
0:17:45 > 0:17:50like tiredness, susceptibility to illness, and hair loss.
0:17:50 > 0:17:53Nevertheless, chemotherapy has helped to save millions of lives
0:17:53 > 0:17:56and remains a very effective treatment for cancer.
0:17:58 > 0:18:02Unfortunately, if any diseased cells are left behind,
0:18:02 > 0:18:06they can mutate further or undergo other chemical changes.
0:18:06 > 0:18:09So they can evolve to become resistant to chemotherapy,
0:18:09 > 0:18:12like some weeds are resistant to weedkiller.
0:18:13 > 0:18:14The Institute of Cancer Research
0:18:14 > 0:18:17are working with the Royal Marsden hospital
0:18:17 > 0:18:20to develop new drugs that target specific cancers.
0:18:20 > 0:18:25We might refer to them by body part - brain, lung, breast etc -
0:18:25 > 0:18:30but it would be more accurate to refer to them by genetic coding.
0:18:30 > 0:18:35And so far, we've identified over 200 different types of cancer,
0:18:35 > 0:18:39each one of them capable of changing or mutating within the body.
0:18:39 > 0:18:42A lot of work is currently being done to develop medicines
0:18:42 > 0:18:46based on the specific genetic make-up and character
0:18:46 > 0:18:48of particular diseases.
0:18:48 > 0:18:53Dr Udai Banerji is currently overseeing 31 trials of new drugs.
0:18:53 > 0:18:55The cancer is very smart,
0:18:55 > 0:18:58and it actually evolves with every treatment that you get.
0:18:58 > 0:19:02What we have to do is almost play chess with the cancer
0:19:02 > 0:19:05and try and predict what it's going to do next.
0:19:07 > 0:19:10- Good morning, Karen.- Good morning, Maria.- How are you?- I'm fine.
0:19:10 > 0:19:13- And you?- Yeah, very well, thank you.
0:19:13 > 0:19:15Once a drug is found to be effective in the lab,
0:19:15 > 0:19:16it has to be tested
0:19:16 > 0:19:20with real patients already undergoing treatment.
0:19:20 > 0:19:24Karen is on one of Dr Banerji's phase one trials.
0:19:24 > 0:19:27She was diagnosed with cancer three years ago.
0:19:27 > 0:19:30- Looks all right, doesn't it? - Everything OK. I'll turn it off.
0:19:30 > 0:19:34When I was actually told, the first thing I said to my consultant was,
0:19:34 > 0:19:35"Am I going to die?"
0:19:35 > 0:19:38And she said to me, "I don't know".
0:19:38 > 0:19:42So that was like, "Oh, OK, then," and so it was a shock,
0:19:42 > 0:19:45but I took it much better than I thought I would.
0:19:45 > 0:19:47I thought if you got cancer you'd be laying in bed
0:19:47 > 0:19:50and you'd never get up. That's how I imagined cancer to be!
0:19:50 > 0:19:53But, you know, you just get on with it, and it's made me feel
0:19:53 > 0:19:57a lot better about myself, and here I am, three years later.
0:19:58 > 0:20:01By the time Karen had been diagnosed,
0:20:01 > 0:20:03her cancer had already spread.
0:20:03 > 0:20:06She responded to traditional chemotherapy at first,
0:20:06 > 0:20:09but it stopped working soon after.
0:20:09 > 0:20:12My consultant at St Richard's said, "The Marsden are really fantastic
0:20:12 > 0:20:15"and they have trials and you can be a guinea pig and you can see..."
0:20:15 > 0:20:18And I just said, "Yep, bring it on. Anything.
0:20:18 > 0:20:22"Anything to get me better so I can have time with my grandson."
0:20:22 > 0:20:23In the last few months,
0:20:23 > 0:20:26Karen's become one of the first six people in the world
0:20:26 > 0:20:28to try out a new treatment
0:20:28 > 0:20:33as part of a trial which combines chemotherapy with a targeted drug.
0:20:33 > 0:20:35We are so eternally grateful
0:20:35 > 0:20:38to patients who volunteer for these studies.
0:20:38 > 0:20:41There are no guarantees the drug will work.
0:20:41 > 0:20:43There is a possibility that you'll have side effects
0:20:43 > 0:20:45which have never been seen before.
0:20:45 > 0:20:50I think they are the true heroes of drug development that we have.
0:20:50 > 0:20:54Only about 10% of drugs used on these kind of trials
0:20:54 > 0:20:56make it to market.
0:20:56 > 0:20:59But for Karen, the results so far have been promising.
0:20:59 > 0:21:01How did the last week go in itself?
0:21:01 > 0:21:04I'm back at work full time Thursdays and Fridays.
0:21:04 > 0:21:06Had a little grandchild this weekend,
0:21:06 > 0:21:08- so that's been very exciting. - Excellent news!- Yes!
0:21:08 > 0:21:13But, no, healthwise I've felt really well, so, yes, long may it continue.
0:21:13 > 0:21:16At the moment, Karen's tumours have stopped growing,
0:21:16 > 0:21:19and she plans to continue to take part in the trial
0:21:19 > 0:21:21as long as the drugs keep working.
0:21:21 > 0:21:23I think the final goal would be
0:21:23 > 0:21:27to predict exactly where the cancer cell is going to evolve to
0:21:27 > 0:21:31and so almost back it into a corner with different treatments
0:21:31 > 0:21:34to be able to then deliver the final blow
0:21:34 > 0:21:37to try and kill all the cancer cells.
0:21:37 > 0:21:41Not everyone having this treatment has responded as well as Karen,
0:21:41 > 0:21:42and it's impossible to know
0:21:42 > 0:21:46if it will be found safe and effective long term.
0:21:46 > 0:21:50But these kind of trials play a key part in overcoming cancer.
0:21:50 > 0:21:53The work being done here is really exciting,
0:21:53 > 0:21:56but it only underlines how much more there is to know
0:21:56 > 0:21:59about this complex set of diseases.
0:21:59 > 0:22:02It's vital that we completely understand the enemy,
0:22:02 > 0:22:05because then we can better predict what it will do next,
0:22:05 > 0:22:08because that will give us the best possible chance
0:22:08 > 0:22:09of developing the drugs to defeat it.
0:22:11 > 0:22:15New treatments offer up hope where previously there was none.
0:22:15 > 0:22:19And if you catch them early, certain cancers are a lot easier to treat.
0:22:19 > 0:22:23TV presenter Tommy Walsh knows this all too well,
0:22:23 > 0:22:28and he believes screening for some cancers is very important.
0:22:28 > 0:22:31Both my mum and my sister had breast-cancer operations,
0:22:31 > 0:22:34and I had a few scares meself,
0:22:34 > 0:22:39the first of which, unusually for a man, was a lump in my breast.
0:22:39 > 0:22:42And most recently, I was screened for bowel cancer.
0:22:42 > 0:22:45But thankfully it turned out to be negative.
0:22:45 > 0:22:49But my experience has shown me that cancer really is a game of chance.
0:22:49 > 0:22:52Even though it seems unlikely, it can happen to anyone.
0:22:53 > 0:22:54The NHS has introduced
0:22:54 > 0:22:57several national screening programmes over the years
0:22:57 > 0:23:00to try and catch cancer in its early stages.
0:23:00 > 0:23:03The latest involves bowel cancer testing kits,
0:23:03 > 0:23:06which have been hitting the doormats of everyone over 60
0:23:06 > 0:23:08in the last few years.
0:23:08 > 0:23:13Sandy Gallagher's husband Chris received one just six months ago.
0:23:13 > 0:23:15This came through the post, and I thought,
0:23:15 > 0:23:18"Nah, I don't feel unwell
0:23:18 > 0:23:22"and I don't fancy the idea of anything wrong".
0:23:22 > 0:23:25And when I read the instructions of what you had to do,
0:23:25 > 0:23:28I thought, "No, this isn't my ball game at all".
0:23:28 > 0:23:30Did you have to pressure him?
0:23:30 > 0:23:34Gently persuade him, Tommy, and I just said to him, "Look, just do it.
0:23:34 > 0:23:40"It's not a problem. It only takes minutes. And you never know."
0:23:40 > 0:23:45The kits can be completed discreetly and hygienically in your loo at home.
0:23:45 > 0:23:47Using the cardboard spatulas provided,
0:23:47 > 0:23:52you take six tiny samples of poo and seal them away under these flaps
0:23:52 > 0:23:55and send the kit back in the envelope provided.
0:23:56 > 0:23:59Chris's kit was analysed at this screening hub
0:23:59 > 0:24:01run by Professor Stephen Halloran.
0:24:01 > 0:24:04So, what we now need to do is to see
0:24:04 > 0:24:07if we can identify the presence of blood
0:24:07 > 0:24:09in any of those six samples.
0:24:09 > 0:24:11Why blood? Why is that important?
0:24:11 > 0:24:16We've known for many years that if people have colon cancer,
0:24:16 > 0:24:20those lesions inside the colon bleed.
0:24:20 > 0:24:24So if you see blood in your poo, then you need to act on it,
0:24:24 > 0:24:27you need to go and see the doctor, see your GP,
0:24:27 > 0:24:29and they will take appropriate action.
0:24:29 > 0:24:32But the blood doesn't always show up in the toilet bowl,
0:24:32 > 0:24:34and the kits contain a special ingredient
0:24:34 > 0:24:38that helps indicate if there's any hidden in the samples.
0:24:38 > 0:24:40Extracted from a South American tree,
0:24:40 > 0:24:43guaiac resin reacts in the presence of oxygen.
0:24:43 > 0:24:46If there's blood in a sample, it will release the oxygen
0:24:46 > 0:24:50from a few drops of hydrogen peroxide added to the mixture.
0:24:50 > 0:24:53So what we're going to do is just add it...
0:24:53 > 0:24:58and what we'll see is that it changes colour to blue.
0:24:58 > 0:25:02Oh, look at it! Yeah! That's a really rich blue, isn't it?
0:25:02 > 0:25:06And what's happening is the oxygen is reacting with the guaiac.
0:25:06 > 0:25:08- So that tells us there's blood in it.- Absolutely.
0:25:09 > 0:25:13In the kits, the guaiac is already absorbed into the sample panels,
0:25:13 > 0:25:17so all the team here have to do is open up the back of the kit,
0:25:17 > 0:25:18add some drops of hydrogen peroxide,
0:25:18 > 0:25:21and if there's any blood there to release the oxygen,
0:25:21 > 0:25:23the window turns blue.
0:25:23 > 0:25:25If we find blood in one, two, three or four,
0:25:25 > 0:25:30then we refer you to have a second and potentially a third kit.
0:25:30 > 0:25:33If we have five or six spots that are positive,
0:25:33 > 0:25:36that's sufficient evidence for us to refer directly for colonoscopy.
0:25:37 > 0:25:39A colonoscopy is a minor procedure
0:25:39 > 0:25:44where doctors use a camera to examine the bowel in more detail.
0:25:44 > 0:25:47Finding blood in your poo doesn't necessarily mean cancer,
0:25:47 > 0:25:49but after Chris got a positive result
0:25:49 > 0:25:52the doctors found a six-centimetre tumour,
0:25:52 > 0:25:55which they were able to remove in surgery.
0:25:55 > 0:25:57The thing that they told Chris
0:25:57 > 0:26:01was apparently you've got four walls to your bowel
0:26:01 > 0:26:06and the size of the tumour had gone through three of the walls,
0:26:06 > 0:26:08so if this hadn't been found when it was,
0:26:08 > 0:26:11it would have grown through the bowel wall completely,
0:26:11 > 0:26:13through the fourth wall,
0:26:13 > 0:26:14and then the likelihood is
0:26:14 > 0:26:17it would have spread to other organs of the body.
0:26:17 > 0:26:20How lucky were you that you actually managed to persuade him
0:26:20 > 0:26:23to actually take that test?
0:26:23 > 0:26:28Getting that test unsolicited through the post was a miracle.
0:26:28 > 0:26:31Frankly, it saved Chris's life. I am convinced of it.
0:26:34 > 0:26:37Most kits come back negative, but in England alone
0:26:37 > 0:26:42over 70,000 cancers and pre-cancers have been detected so far.
0:26:42 > 0:26:44In cases where it's caught early,
0:26:44 > 0:26:47around 90% of people diagnosed with bowel cancer
0:26:47 > 0:26:49live for at least five years.
0:26:49 > 0:26:54Of those who find out late, it's under 10%.
0:26:54 > 0:26:58Another stage of bowel screening is in the process of being rolled out
0:26:58 > 0:27:00for all 55-year-olds in England
0:27:00 > 0:27:04that could reduce your chance of getting bowel cancer by a third.
0:27:04 > 0:27:06It involves a minor inspection with a camera
0:27:06 > 0:27:10with added potential to painlessly lasso out any small growths
0:27:10 > 0:27:13before they even become cancerous.
0:27:13 > 0:27:17By making bowel screening available for anyone of a given age,
0:27:17 > 0:27:20these programmes have the potential
0:27:20 > 0:27:22to save thousands of lives every year.
0:27:22 > 0:27:27Let's face it, cancer screening isn't a particularly glamorous activity.
0:27:27 > 0:27:29But for me, it's a no-brainer.
0:27:29 > 0:27:34It may be worrying, but remember, early diagnosis could save your life.
0:27:34 > 0:27:36Smarter knives...
0:27:36 > 0:27:39more precise radiotherapy...
0:27:39 > 0:27:42specifically targeted drugs...
0:27:42 > 0:27:45and improved screening...
0:27:45 > 0:27:47we've come a long way since a link was first made
0:27:47 > 0:27:49between cancer and smoking,
0:27:49 > 0:27:54and today, we're better positioned to deal with it than ever before.
0:27:55 > 0:27:59But in fact, most major breakthroughs in cancer research
0:27:59 > 0:28:02happen because patients are willing to volunteer
0:28:02 > 0:28:04to take part in trials and programmes
0:28:04 > 0:28:06whilst dealing with their own illness
0:28:06 > 0:28:09alongside the doctors and medical researchers
0:28:09 > 0:28:12who have dedicated their lives to medical science -
0:28:12 > 0:28:17they, too, are helping us to detect, prevent, treat and cure cancer.
0:28:19 > 0:28:20Next week on Bang,
0:28:20 > 0:28:23we find out how big data is going to change our lives
0:28:23 > 0:28:25in ways we could never imagine.
0:28:25 > 0:28:28Join us to find out exactly what big data is
0:28:28 > 0:28:32and the good and the not-so-good of this brave new world.
0:28:32 > 0:28:36In the meantime, if you're interested in a career in biomedical research,
0:28:36 > 0:28:41check out our website, /bang, for our very own careers guide.
0:28:41 > 0:28:43And if you'd like to learn more about cancer,
0:28:43 > 0:28:45follow the links to the Open University.