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Meeting contemporary medical challenges

Meeting contemporary medical challenges

In this issue of BioScience Today, we speak to Professor Phil Blower, Chair in Imaging Chemistry at King’s College London about why a multidisciplinary approach is crucial to meeting the medical challenges of today.

“I work in a branch of imaging that uses nuclear medicine or positron emission tomography (PET) to diagnose a range of diseases, to understand their severity and to treat them too.

“We design molecules that bind to a particular property of a disease so an image can be taken by the PET scanner which shows the pathological chemistry going on in a patient. The images show us where a tumour is, non-invasively, without having to open up a patient or do a biopsy.

“Cancer cells, for example, take up glucose more efficiently than other cells, so by using a radioactive type of glucose we light up the tumour, making it stand out against the background, producing an image.

“The advantage of using radioactivity is that you see deep into the body – you are not just looking at the surface; and unlike other kinds of imaging such as X-rays or CT for example, you are not just looking at the structure – you get a three dimensional map of the chemistry that is happening in the body.

“The great advantage of the technique is that you see chemical changes long before any structural change has happened in the body, meaning you pick up on changes that wouldn’t be detected by an MRI or CT scan.

“Ultimately, this technology enables clinicians to diagnose and treat conditions sooner, and see how that treatment is progressing. You can see whether a tumour is alive or dead and how it is responding to treatment.

“PET technology has been around for a while and is used by most big hospitals dozens of times a week, but we are trying to extend its application to new areas, so it can be used to diagnose and treat a greater range of diseases.

“Recently we’ve been working on a project supported by The National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. We’re developing a radioactive tracer for use in prostate cancer screening, which allows for simple, safe single step labelling with gallium 68 and we are just moving into phase two clinical trials.

“In addition to this, we are looking at the imaging of heart problems, how imaging can be used to gauge brain chemistry in dementia patients and how tracers can be used to kill cancer cells selectively.

“The radioactive tracers we use in PET imaging have a short half-life of just a few minutes and you have to make them on the premises immediately before the scan, it is a complex process.

“We know that patients are frustrated by the lack of nationwide availability of the latest scanning techniques and the fact that the tracer production sometimes doesn’t work as well as they could. This can mean their scan is cancelled and their treatment potentially delayed. At King’s College London and Guy’s and St Thomas’ we’re aiming to make the process simpler and more reliable, so that it takes just five minutes rather than several hours and can be 

used by more hospitals, regardless of whether they have the highly-skilled staff or the expensive equipment on site.

“Producing the tracers, simply and quickly will have real patient benefits, helping to reduce waiting lists and making it easier for the technology to be adopted in developing countries too. We want the tracers to work every time, everywhere.

“I was always curious and wanting to find things out. I started out on the academic side of inorganic chemistry; in my PhD and early postdoctoral years the application of the research was far in the future.

“I then took up a joint University of Kent / NHS academic post, as I wanted my academic interests to have a practical application. Moving to the NHS was a jump out of my comfort zone, but since that moment, I’ve never looked back, it was the turning point in my career.

“Having a foot in both research and teaching is extremely varied and rewarding; and though it can be difficult to strike the right balance, you’ll find that one sphere informs the other. Now a great motivator of mine daily is mentoring my students, who in turn go out into the world and make a difference independently.

“What I would say to young people who are interested in making a difference is that this isn’t only achieved by being a doctor, there are many other ways in which a scientist can help. There are an awful lot of things going on in hospitals behind the scenes, biologists, statisticians and computer scientists, all have a part to play.

“Our approach to meeting medical challenges today is much more multidisciplinary than was once the case and there are lots of different specialists who have something to contribute. We won’t achieve what we need to achieve, by working alone.

“By working in both academia and the NHS you gain a better understanding of what the real problems are that need solving and what the practical solutions are going to be. The NHS is all about solving real world problems and if you bring your scientific knowledge, you can have an impact too.”

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