Why Gastric Cancers are so hard to treat –
oncologist Dr Pattison explains
Gastric cancers remain one of the most aggressive, hard-to-treat type of cancers, often with late diagnosis and incredibly poor survival rates. Even with the lengthy and invasive treatment options, only approximately 30 % of the patients make it past the 5-year survival mark. It is one of the top cancer-related killers is the world and has its claws especially deep in the New Zealand population. A study by Otago researchers found a gene for susceptibility to stomach cancers in Maori populations. Prof Parry Guilford with a large research team identified the protein, responsible for cell attachment – E-cadherin to be frequently mutated in families with gastric cancer history.
A very important part of any type of cancer research is to learn more about the underlying pathology and identify sets of changes that allow the disease cases to be described in more specific terms. The widely used term heterogeneity refers to diversity, alterations (mutations) and the defining features of tumours between and within patients. In addition to being variable in their profiles, they react differently to treatments and have varying prognoses of clinical outcomes.
Gastric cancers are currently categorized into two major subtypes when looked at down a microscope – intestinal and diffuse, with the latter one being harder to detect and having poorer survival. The few treatment options available for stomach cancers are not suitable for a large fraction of patients, but the alternatives are scarce, and the knowledge about the development of the disease is limited.
Dr Sharon Pattison, an oncologist at the Department of Medicine Oncology research unit, believes the first step towards improvement is recognizing gastric cancers to be a diverse set of unique diseases, and stresses the importance in further research into this heterogeneity for discovering more specific treatment options. She has done a lot of work investigating how specific cases of gastric cancers differ, going all the way down to tissue pathology to exploring what effects it has on patients’ treatment outcomes.
Dr Pattison’s combined background as a clinician and cancer researcher provides her with a unique and well-rounded understanding of the subject matter. Working on her research projects in parallel to seeing patients, she highlights her clinical work “keeping the questions she is trying to answer in the laboratory – relevant to patients”. She joined the Department of Medicine at the beginning of 2016 after completing her PhD in cancer research in Melbourne, carrying a strong vision for her work and goals.
Here are just a few of Dr Pattison’s insights on the complexity of gastric cancer.
KA: How do you investigate something as heterogeneous and complex as stomach cancer?
SP: Carefully and with an open mind! You must always be prepared for surprises in your results and this is part of the joy of science.
KA: What do you hope to achieve?
SP: To improve survival from cancer, decrease toxicity from treatment and improve people’s quality of life. I’m also involved in teaching, and if I can encourage others to be interested in pursuing a career that involves some research I will consider this a success as well.
KA: What do you find as the biggest challenge in gastric cancer research?
SP: Time. This isn’t just a challenge for research but for most things in life. There are never enough hours in the day to complete all the tasks you would wish too. With regards to gastric cancer research, I find there are so many questions that are begging to be asked it’s unlikely I’ll ever have the time to answer them all. Working in collaboration with patients and other research groups nationally and internationally is the best way I can see over overcoming this hurdle. Many hands make light work!
Can we make it better?
“Capacity to improve is huge,” says Sharon. “We need good model systems to make sure that when we are giving treatments to patients, we have a good rationale behind the treatment to minimize potential harm, and maximize treatment response.”