The Happy Pod: Kinder medicine for millions of cancer patients

**Holly Gibbs** (0:00)
This is the HappyPod from the BBC World Service.
I'm Holly Gibbs, and in this edition, two major medical breakthroughs for cancer patients. First...

**Aileen Pritchard** (0:16)
I just said, does that mean no chemo? She said, yes, no chemo. And I almost leapt for joy.
If there had been a bottle of champagne there, I would have opened it. That's how wonderful it was. It was one of the best feelings.

**Holly Gibbs** (0:30)
The new DNA test, which could spare millions of people with breast cancer from having chemotherapy, and the drug which doubles the survival time for patients with advanced pancreatic cancer.

**Rachna Shroff** (0:41)
For us to be able to see a median overall survival of 13.2 months, which is double that that we get with chemotherapy, it's unprecedented in the world of pancreatic cancer.

**Holly Gibbs** (0:52)
Also on this podcast, is there a pianist in the house?

**Sterling Nasa** (0:56)
I got into it, embraced it and just thought, look, you're on stage, it's an hour of music. These are world-class musicians and a two-time Academy Award-winning conductor. Just enjoy it, try your best. And I think it went pretty well.

**Holly Gibbs** (1:08)
Find out how this audience member ended up on stage. Plus, the man trying to become Europe's first physically disabled astronaut to go into orbit.

**John McFall** (1:17)
The dream is to fly to space. I would love that opportunity. I'm in a position where I am assignable to a mission, should a mission become available.

**Holly Gibbs** (1:26)
And we hear about slow food, the opposite of fast food.
We start with a breakthrough that is expected to save millions of people with breast cancer from having to go through chemotherapy. The new DNA test can distinguish between patients who are likely to benefit from the treatment and those who are not. Meaning, those who receive a low score can avoid chemotherapy and be treated in other ways. The study followed more than 4,000 women over the age of 40 in six countries with the most common form of the disease. It found two-thirds could safely skip chemotherapy with no change to their outcomes. Aileen Pritchard was one of them.

**Aileen Pritchard** (2:07)
I know exactly where I was standing. I can remember it like it was yesterday.
The nurse telling me that I was in this low range. And I just said, does that mean no chemo? She said, yes, no chemo. And I almost leapt for joy.
If there had been a bottle of champagne there, I would have opened it. That's how wonderful it was. It was one of the best feelings. The weight lifting off your shoulders, the just your whole life ahead of you back to normal again, instead of worrying constantly. And I knew there were trials going on for various things all the time. So I just, I was very happy to join it. To help everybody else, the only chance I was going to get of not having chemo. So there was personal reasons and bigger reasons. You know, science needs everybody to join in wherever we can. So I'm very proud to have been part of it.

**Holly Gibbs** (2:58)
My colleague Owen Bennett-Jones spoke to Professor David Miles, who was involved in this research.

**David Miles** (3:04)
What this study will allow us to do is to say to patients that they can safely avoid the use of chemotherapy following surgery. And we can have a lot of confidence in that because essentially this test was tested in a very large study.
It means that many, many women with breast cancer, who were previously exposed to chemotherapy, knowing that there'd be a small benefit, we can now confidently predict many patients will get no benefit at all. And therefore, there's no need for them to have the chemotherapy. Either they're not getting a recurrence or their particular sort of cancer is not terribly sensitive to chemotherapy. We know from tests done on cancers, breast cancers, which cancers will respond to hormone treatment, which cancers will respond to herceptin. We have no idea who responds best to chemotherapy, or most importantly, who doesn't really need chemotherapy. And that's the key finding of this study. And I think it's going to change practice UK and worldwide.

**Owen Bennett-Jones** (4:12)
Now the DNA is a very early indicator of a problem ahead, isn't it? That's another point about this.

**David Miles** (4:18)
That's exactly right. And what really this test is doing, the Procigna test, is taking a snapshot of the DNA of the cancer that is removed from the patient. So the patient doesn't need any additional tests. It's simply that the pathology department will send the tissue away for this test, and it looks at various genes expressed in that tumor and helps us figure out who will not benefit from chemotherapy. Those with higher scores on this Procigna test, they will need chemotherapy, but we can now confidently define a large population of women who simply aren't going to benefit and don't need to go through all that unpleasantness for no benefit at all.