A Future of Precision?
The 2nd National Undergraduate BONUS Conference
EVENT HIGHLIGHT • review by Ryan Devlin
Edinburgh University Oncology Society was thrilled to host the British Oncology Network of Undergraduate Societies’ 2nd Annual Conference. Delegates from across the country attended the day at the Chancellor’s Building of the Royal Infirmary to hear talks on immunology, medical oncology, surgery, radiology, public policy and many more.
The day began with keynote speaker Dr Helen Mackie talking about ‘Realistic Medicine’, an approach to health that the Scottish government hopes that by 2025 all healthcare providers will use. This means that if you are a medical student now, you will be part of the workforce who is giving realistic medicine. A comprehensive outline of what the approach is – Practising Realistic Medicine, is available online.
​
Next, Professor Jeff Evans from the CRUK Beatson Institute in Glasgow talked about “Developing Novel Cancer Therapies: From Bench to Bedside”. We learned about the complexities of biomarkers, an immune system with cells that both fight and protect the cancer, and various studies into the personalisation of treatment. This included CRUK’s PRIMUS which looked into the precision treatment of pancreatic cancer.
Dr Debashis Sarker furthered the discussion on “Precision Medicine in Oncology”, asking the question of whether providing individually tailored cancer care to the masses is possible. Whilst studies have shown that overall survival is better with a personalised medicine approach, some believe, including prominent oncologists such as Ian Tannock and Vinay Prassad, that personal technology is being forced without the infrastructure to implement it. It has not been shown to work, and perhaps it never will, because whilst responses to precision medicine are spectacular, they do not help the majority.
Adding to the complexities of precision medicine, Professor Colin Watts spoke about “Brain Cancer: Novel Surgical Interventions” and how we need to look at cancer as an ever evolving ecosystem with selective pressures. Like natural selection in evolution, certain clones of cancer cells become dominant. The tumour that one begins with is not the same as the one months or years in the future. Tumours can evolve. This has profound implications for the treatment of cancer – both adding to the argument that precision medicine is necessary, but also to how difficult that may be. Questions in glioma surgery are changing: Should surgery be more aggressive if there is a poor prognosis? Should it be more aggressive with a good prognosis?
​
Dr Ed Smith shared “Advances in Radiation Treatment: Proton Therapy”, talking about how protons distribute energy, meaning cancer treatment can be more targeted and decrease damage to surrounding tissue. Dr Smith is from the Christie, a new proton therapy centre opening in Manchester in November, the
first high energy proton therapy centre in the UK. Able to provide treatment for 650-750 patients a year, particularly for paediatric and teenage patients to reduce the risk of treatment causing issues decades later, patients will no longer have to travel abroad for proton treatment.
After talks, lunch and some excellent poster presentations, delegates attended two successive workshops. One led by BONUS President Dr Lila Kastora gave advice on getting an academic paper published – key among the many invaluable messages was that whilst you may hear nothing from journals for a few months, persevere. Know the journal’s audience and the style of papers that get published. Secondly, radiologist Luke Boden and BONUS secretary Aida Nourbakhsh conducted a workshop on how to systematically assess radiographs, specifically ABCDE.
The day ended with a fascinating panel discussion on “Cancer Care – Which Way Forward?” During this Dr Sarker gave a key concluding remark: if you want to go into oncology, make sure to speak to patients with cancer on the wards. Learn from them about their needs, about their experiences. You may learn in lectures and tutorials of the advances of today, however if you want to truly learn of the future in oncology, specifically a future that you can help to shape, then speak to the people receiving care.
More from the Autumn '18 Issue