Cancer breakthrough

Survival rates from large cancers of the breast could improve because of a new technique that may enable doctors to tailor chemotherapy to individual patients, a meeting heard this week, writes Aisling Irwin.

Scientists at the Institute of Cancer Research have developed a technique which allows them for the first time to watch living cancer cells self-destruct in response to chemotherapy. Paul Ellis, research fellow at the ICR and the Royal Marsden NHS Trust, said that he and colleagues had managed to withdraw with a fine needle some cancerous tissue from breasts just a day after they received chemotherapy for their cancers.

This has not been done before, mainly because, until recently, such cancers were treated by masectomy. Now doctors are trying chemotherapy followed by surgery to remove just the tumour. A major trial at the Royal Marsden run by Ian Smith and Mitch Dowsett is experimenting with this method.

Dr Ellis said, at the launch of the two institutions' 1995 annual research report, that he was able to see under the microscope the difference between cells before and after chemotherapy. In many women cancer cells were in varying stages of apoptosis - the self-destruct mechanism the chemotherapy triggers. Dr Ellis believes he will be able to predict from such studies which women will respond well to chemotherapy in the longer term. About a quarter of women with breast cancer are resistant to chemotherapy.