Campaign to raise Norfolk awareness of new cancer treatment

Called photodynamic therapy (PDT), the treatment uses laser or other light sources, combined with a light-sensitive drug (sometimes called a photosensitising agent) to destroy cancer cells.

The use of PDT can cure some cancers in certain circumstances, and in other cases serve as a palliative treatment.

However, the campaign group is keen to stress that it is not suitable for every person or type of cancer and should not be viewed as a 'miracle cure', but rather as another option to be considered when deciding upon a treatment.

The purpose of the campaign is for PDT to be considered on its merits as an option where appropriate for various cancers in Norfolk. It is currently used for some dermatology patients in the county, but it could be used for other types of cancer too.

The Norfolk Campaign Committee for PDT has been working with Dr Craig Martin, oncology consultant at the Norfolk and Norwich University Hospital, to organise a symposium on the role of PDT in cancer manage-ment. This will be in the Gooch Lecture Theatre at the hospital on January 19 and health professionals, commissioners and support groups have been invited.

Steve Wiseman, fundraising consultant working with the com-mittee, said: 'Our vision is for PDT treatment to be considered on its merits as an option where appropriate for various cancers. We want Norfolk patients to have full awareness of, and ready local access to, PDT when and where they need it. With setting up this symposium we hope this vision will soon become a reality.'

A photosensitising agent is a drug that makes cells more sensitive to light. The drug is attracted to cancer cells and it does not become active until it is exposed to a particular type of light.

When the light is directed at the area of the cancer, the drug is activated and it produces a form of oxygen that kills nearby cancer cells.

Some healthy, normal cells in the body will also be affected by PDT, but these cells will usually heal after the treatment, and often more quickly than other methods.

Also on the committee is former Norwich MP and scientist Ian Gibson, who said: 'It has great potential and the more you try these techniques the more you find out. The answer isn't always drugs. This is an alternative and really needs to be supported.'

Lorraine Farebrother, another member of the committee, said the idea behind the symposium was to bring experts in the field to one in place in Norfolk, where health professionals and commissioners can find out more about PDT and decide if it is something that they would like to offer as an option to patients.

She said: 'The clinicians need to know more about PDT and they will know what questions to ask of those around the country who are already offering it. We need clinicians to tell us if it's something they want before we set our sights on any way forward in terms of making it happen.'

Advantages are that PDT can be repeated many times, it can be used after radiotherapy and as it has a photochemical effect rather than a thermal effect there is no heat.

The photosensitising drug can be injected into the body, and the advantage is that it does not do anything unless activated by light.

So the drug can go everywhere in the body, but just selected parts can be activated by shining a light on the affected area. Clinicians using the treatment say it is particularly exciting as the cosmetic and functional results are outstanding and for internal organs, it can be applied by 'remote control' – light delivered under image guidance by laser fibres passed through needles – so there is no need for open surgery.

The University College London's National Medical Laser Centre has been working on laser developments for nearly 30 years and experts there have described PDT as 'a new way of killing diseased tissue that doesn't damage the scaffolding that holds tissue together'.

Anyone interested in finding out more about the symposium on PDT can contact the group on 01603 469047 or by calling 0771 9215350.

Photodynamic Therapy has been used for some dermatology patients by the Norfolk and Norwich University Hospital Trust since around 2002 in Cromer and Norwich. It is now also offered at the James Paget University Hospital.

It is used for some pre-cancerous skin lesions, for thin types of basal cell and squamous cell skin cancers, for example Bowen's disease.

It is particularly useful for areas where a patient cannot reach easily to put on a cream, on the lower leg area which is known for poor healing and for treating sun damage around the eyes, where the alternative of surgery would mean there is a risk of disfiguring the eyelid.

A photosensitising cream is applied to the area and left to soak in for about three hours.

Then a red LED light is shone onto the area for a few minutes, which activates the photosensitising agents applied through the cream and destroys the pre-cancerous cells.

It can be a useful alternative to cryology, which uses liquid nitrogen to freeze the cells and which can also kill pigment and leave some scarring, and to chemotherapy creams.

Consultant dermatologist Anne-Marie Skellett said: 'For some people it works really well and they are very happy with it.

'It does have limitations. Some people do find it painful and you can't treat tumours that are very thick tumours.'

PATIENT CASE STUDY

Grandfather-of-three John Shaw has had basal cell carcinomas for 25 years. Over that time he has had a variety of different treatments, including radiotherapy and cryotherapy, but none have been particularly effective.

Mr Shaw, a retired local government worker from Gimingham in north Norfolk, said: 'From my point of view it's a very manageable treatment. It's far less aggressive than the other treatments I have had.

'Although it doesn't always work for me as my lesions are very aggressive, it's very useful because it just leaves you with a bit of a red mark and it's sore for a few days.

'Other forms of treatment can leave you quite sore for weeks and if you have an excision it means a wound that's stitched up and needs to heal.

'I can feel very hot at some points, but I've found that lesions vary on how they feel when they are being treated.

'It heals up fairly quickly and it's fairly bearable and is a good way of managing my skin.

'It's suitable for surface lesions which don't go too deep, but some of mine go deeper which it isn't ideal for.

'But for new lesions and those on the surface then it's very successful.'