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SUMMARY:IMPROVING OUTCOMES FOR CANCER PATIENTS - Dr Rebecca Fitzgerald\, H
 utchison-MRC Cancer Cell Unit\, Research Centre\, Cambridge
DTSTART:20090219T190000Z
DTEND:20090219T200000Z
UID:TALK16623@talks.cam.ac.uk
CONTACT:John Wilkins
DESCRIPTION:The majority of cancers that arise from solid organs have a pr
 e-cancerous stage sometimes called pre-invasive disease or intraepithelial
  neoplasia. This pre-invasive stage generally persists over many years bef
 ore it acquires the necessary molecular (genetic and epigenetic) abnormali
 ties for invasion. Since invasive disease is rapidly disseminated through 
 the lymphovascular system most patients with clinically apparent cancer ha
 ve a poor prognosis. The diagnosis of disease at a pre-invasive stage affo
 rds the opportunity for cure. However\, the detection of such lesions thro
 ugh screening and surveillance programmes also raises questions regarding 
 the psychosocial and economic burden of diagnosing disease which is asympt
 omatic and may never progress to cancer in the lifetime of the individual.
  \n\n \n\nIn this lecture I will use one disease example which exemplifies
  many of the controversies and opportunities associated with the early det
 ection of cancer. Barrett’s oesophagus is the precursor lesion to cancer
  of the lower oesophagus and gastro-oesophageal junction (called adenocarc
 inoma). Barrett’s oesophagus is estimated to affect 1.6% of the populati
 on and 2.3% of those with heartburn symptoms\, however the majority of pat
 ients are undiagnosed. The cancer conversion rate is 0.5-1% per annum and 
 once a cancer has progressed to a symptomatic stage the five year survival
  is an abysmal 13%. Since the oesophagus is easily accessible by endoscopy
  and since patients are followed up longitudinally there is an ideal oppor
 tunity to study the molecular changes in the metaplasia-dysplasia-carcinom
 a sequence. This has led to intense interest in developing clinically rele
 vant biomarkers in order to risk stratify individuals. Furthermore\, rapid
  advances in endoscopic technologies mean that it may be possible to ablat
 e Barrett’s oesophagus without recourse to oesophagectomy. Screening mig
 ht therefore be a worthwhile proposition. This lecture will discuss the cu
 rrent state of the Barrett’s oesophagus field and the lessons that are g
 ermane to making clinical progress in other pre-invasive lesions.\n\n
LOCATION:Department of Chemistry\, Lensfield Road\, Cambridge
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