7 Questions: Emma Greenwood on advancing research in cancer

pharmaphorum spoke to the head of policy development at the influential cancer charity about how it is supporting research and increasing the numbers who survive the disease.

What prompted you to join Cancer Research UK?

I joined the Cancer Research UK (CR-UK) policy team in 2008 after working in science publishing. I enjoyed working in publishing but realised I wanted to use my academic background (in genetics and law) to support real change, and CR-UK’s focus on health and research policy were a good fit with my areas of expertise.

At the time, the charity was spearheading campaigns to remove tobacco displays and vending machines from shops, following the landmark ban on smoking in workplaces, as well as to get 3 million more people screened for breast and bowel cancer. CR-UK was clearly ambitious in what it set out to achieve and I wanted to be a part of that. It has been fantastic to work on subsequent efforts to make a huge difference to people’s lives, such as the £23 million Radiotherapy Innovation Fund for England in 2012, which has since helped thousands more patients receive advanced radiotherapy to help cure their cancer.

We get things done because we have a strong focus on how we use evidence, so politicians and policy makers feel comfortable engaging with us, and equally our size means that the public and media take notice when we speak out about something.

The thing that excites me still about working at this organisation is the research that we fund, and the impact that has on people’s lives. Cancer patients in the UK benefit every day from the research that CR-UK has funded over the years, which is only possible because of the generosity of the public.

Your current campaign slogan is: ‘We can beat cancer sooner’ – can we talk of a potential cure for cancer yet?

The first thing to say is that we have made huge advances in understanding the underlying biology of cancer in the last couple of decades, meaning that research for cancer treatments is increasingly focusing on subtypes of cancer rather than a generic cure for all cancer. This means both developing new treatments targeted at genetic mutations, for example, and identifying new combinations of existing treatments that we’re getting better at tailoring use of in specific cancers. Cancer treatments are increasingly becoming more effective as well as kinder to patients.

The huge advances we’ve made in cancer research and treatment in the past 40 years have helped double cancer survival, so that 2 in 4 cancer patients survive for 10 years or more, rather than 1 in 4 in 1970. CR-UK published a bold new research strategy last year with the underpinning ambition that we’ll get this figure to 3 in 4 in 20 years’ time. We know that this is ambitious, but we think it is achievable through growing investment in our world-class research as well as working with others to influence policy and service delivery to optimise cancer care in the UK. This is in addition to our substantial work in prevention policy to help reduce the amount of people who develop cancer in the first place.

What are Cancer Research UK’s priorities for the next five years?

There are a couple of major things that will drive our work – the first is our research strategy. The ten priorities in this include things like dramatically increasing our investment related to cancers of unmet need where survival is persistently poor, producing a step change in early diagnosis and prevention research, quickening the pace of therapeutic innovation and looking closely at how we help develop the global research leaders of the future.

One initiative I’m particularly excited about in terms of research is the CR-UK Grand Challenge, an opportunity for global groups of researchers to pitch for £20 million of funding to tackle some of the biggest challenges in cancer control. We have international thought-leaders, including Nobel prize winners, on the funding panel. It’s our most ambitious programme to date and the funding will be awarded by 2016. Beyond the science, we will be looking closely about how we work with policy makers, patients and the NHS in general to improve cancer survival. A huge proportion of improvements in survival can be made through optimising diagnosis and treatment. We’re working with the Chief Executive of NHS England and the Government to drive forward new ways of working in the NHS.

What is the significance of the new Francis Crick Institute, which opened in London earlier this year?

The Francis Crick Institute provides the UK with one of the biggest intellectual powerhouses in the world for biomedical research. By combining talent across scientific disciplines from our best research organisations as well as harnessing the best management expertise and significant financial investment, it will change the way we approach some of the greatest biomedical research challenges, including cancer control. It will be game changing for the UK research base in general.

We’ve known for years that the research community needed to become more collaborative and work across disciplinary boundaries, for example health research and engineering. The Crick is testament to the extremely hard work of the funders to do something about this and, to date, it represents around £650 million of collective investment.

What are the neglected areas of cancer research and treatment which need more attention?

Our strategy highlighted that survival rates for some cancers, namely brain, oesophageal, lung and pancreatic, are persistently poor despite improvements across all cancers on average. We’ve committed to significantly increasing our investment in these cancers, as well as finding ways to attract more researchers into areas of unmet need.

We’ve also committed to at least doubling the research we fund around radiotherapy and surgery. Both forms of treatment have a major role in curing cancer – 9 in 10 patients whose cancers are cured have radiotherapy or surgery – and in the last decade there have been major advances in both. In radiotherapy in particular, technology has changed at an extreme pace given that 10 years ago it was seen as an outmoded form of treatment. But we know there is a challenge in increasing research activity around radiotherapy and surgery so we will be doing everything we can to support this.

What is your approach to partnering with pharmaceutical companies?

We are very open to working with pharmaceutical companies as it is clear that pooling resources can help improve outcomes for patients. Our sister company, Cancer Research Technology, helps commercialise our research and ensure that the proceeds we make from our intellectual property can flow back to Cancer Research UK and create additional benefit. Additionally, our Centre for Drug Development helps to ‘de-risk’ promising but perhaps not commercially viable research to make this attractive to companies to take forward. Industry can step in where we don’t have the resource and ultimately patients benefit from products of research that otherwise may never have been developed. Another great example of working with industry is our lung ‘Matrix’ trial – this is a multi-arm clinical trial testing several targeted lung cancer drugs across our network of Experimental Cancer Medicine Centres. Our partners AstraZeneca and Pfizer are providing the medicines being used in this trial.

Does the NHS have the potential to equal the best cancer services in the world?

The Independent Cancer Taskforce, chaired by Cancer Research UK CEO Harpal Kumar, has just published a new cancer strategy for England. I truly believe there is an opportunity to create world-class cancer services, and actually part of the job is crystallising a vision that the cancer community is already uniting around. This vision also applies to the other UK nations, though there are separate activities related to their own cancer plans underway.

For example, we know that early diagnosis of cancer is a problem for the UK and there is already a huge effort to improve this, in particular through a large pilot programme to test new approaches to diagnosis supported by CR-UK and Macmillan Cancer Support. Equally, there is consensus across the cancer community that the UK must improve how it adopts new treatments within the NHS. There is a lot of thought going into how, in a cost-constrained NHS, we can be more pragmatic about investing in new innovations and take a more rounded view of cost-effectiveness. And the idea that we need to invest more in prevention to save downstream costs is uncontroversial. So we know what our problems are as a nation – the task now is to think creatively about the solutions.

Fundraising and awareness campaigns are a big part of the charity’s work. What is the secret to your success in this?

Our size is, of course, an advantage – for example there has been a huge amount written about #nomakeupselfie, which we didn’t start but were agile enough to jump on it and help raise nearly £8 million in a matter of days. We are a well-recognised and trusted brand, so when we draw attention to things, the public listens.

But we work hard to maintain this position, so rigour is another important factor in success. All of what we communicate is carefully developed to make sure that it meets the needs of our supporters and partners. Our health marketing, adverts and information are all extensively tested.

We also work hard to maintain relationships with our dedicated supporters who are invaluable in spreading our messages. We have a base of over 200 Campaigns Ambassadors, for example, who are tireless in their ability to lobby their MPs, tweet, send letters, and generally bang the drum for improving cancer outcomes. Our supporter base in general is brilliant at helping communicate for us, hopefully as a result of trust in what we do.

About the interviewee:

Emma Greenwood is head of Policy Development at Cancer Research UK, working across public awareness of signs and symptoms, early diagnosis of cancer, NHS services and cancer strategies, access to effective treatments, and the UK research environment.

During 2010 Emma was seconded to the Academy of Medical Sciences, working on the review of regulation and governance of health research, which resulted in Government commitments in the 2011 Budget and the creation of the Health Research Authority.

Before joining Cancer Research UK in 2008, Emma worked in the editorial team for the EMBO portfolio of journals at Nature Publishing Group. She regularly peer reviews for National Institute for Health Research funding streams.

She holds a degree in Genetics and an MA in Biotechnological Law and Ethics.

Read more:

Taskforce calls for action on England’s lagging cancer survival