Children with the most common malignant form of brain cancer could see diagnostic wait times dramatically reduced thanks to new research that trialled a quicker and less invasive way of determining which type of tumour they have. 

The study, published in eBioMedicine, was conducted by a team of researchers led by the University of Birmingham (UoB) and Newcastle University, with Birmingham Children’s Hospital as the lead clinical centre, and funded by Children with Cancer UK and Cancer Research UK. UoB and Birmingham Women’s and Children’s NHS Foundation Trusts are both founding members of BHP.

The collaborative team identified how the four different groups of medulloblastoma, a malignant children’s brain tumour, had a specific profile based on their individual metabolism. Taking cell samples from 86 tumours, a laboratory test was used to accurately identify metabolic markers including chemicals specific to the different tumour groups.  

The study also validated previous research that found that glutamate, a metabolite present across all of the tumour cells, is linked closely with tumour prognosis. 

Significantly, the research could pave the way for using MRI scanning combined with machine learning to assess medulloblastomas for their ‘signature’ metabolic profiles without the need for invasive biopsy and could rapidly reduce the current 3-4 week wait from presentation to full diagnosis. 

Andrew Peet, Emeritus Professor of Clinical Paediatric Oncology at the University of Birmingham and an Honorary Consultant at Birmingham Women’s and Children’s NHS Foundation Trust, who is lead author of the study said: “Time is so important in cancer diagnosis so our findings on different types of medulloblastoma having a detectable signature metabolism could be game changing for quickly diagnosing, and then offering the best possible treatment for children.”

Professor Steve Clifford, Chair of Molecular Paediatric Oncology at the Newcastle University Centre for Cancer, who jointly led the study said: “Providing a rapid diagnosis using innovative scanning and AI (artificial intelligence) techniques, has the potential to revolutionise patient management, allowing early non-invasive diagnosis, tailoring of treatment decisions and reducing the period of uncertainty for patients and parents while awaiting a full diagnosis. Further, our biological findings provide critical new insights into the metabolism underpinning these tumours, and the potential to exploit these therapeutically.”

The latest findings could be game changing for children like Jack Bourne, aged six, from Birmingham who was diagnosed with medulloblastoma in March 2023.

Jack’s dad Tom said: “We’ve been through 13 months of treatment but six weeks of that was just waiting to find out what type of tumour he had. We were so scared.”

Within weeks of starting school, Jack had started experiencing sickness and headaches which doctors put down to possible separation anxiety or vertigo. But when parents Tom and Tom and Suzanna noticed that he was struggling to walk, they sought a second opinion and Jack was referred to Birmingham Children’s Hospital the same day.

“When they told me the results of the MRI scan, I didn’t know what to feel,” said Tom. “As we were trying to digest everything, they were asking us to sign consent forms because they wanted to operate first thing the next morning. You’re reading these forms and all you see is – he might not make it out alive. It’s heartbreaking, it really is.”

Jack pulled through the ten-hour operation to remove the tumour, but it would take more than four weeks for doctors to figure out what specific type of medulloblastoma he had in order to effectively treat it.

“The research that’s going into diagnosing tumours is really important,” said Tom. “In Jack’s case there was quite a delay while they sent his tumour to Great Ormond Street to be analysed. During that time Jack was given some chemo just to start things off because they just wanted to do something rather than just wait. But all you want is for your child to be given the best possible treatment right from the start.” 

Christiana Ogunbote, Head of Research at Children with Cancer UK said: “We are incredibly proud to help fund this innovative medulloblastoma research and are excited to see how it could change the experiences of children diagnosed with this disease and their families. Discovering new ways to improve outcomes for children with cancer is at the heart of what we are trying to achieve. Through continued and sustained investments in research we look forward to a day where every child can survive their cancer diagnosis.” 

Dr Laura Danielson, Children’s and Young People’s Research Lead at Cancer Research UK, said:  “Developing quicker, less invasive ways to accurately diagnose the different types of medulloblastoma, the most common malignant brain tumour in children, is a crucial step in improving outcomes for young patients. 

“This important study has identified a new way to distinguish between the four subgroups of medulloblastoma. This discovery paves the way for the development of simple imaging tests that could quickly and accurately diagnose the different types of medulloblastoma. 

“This kind of discovery research is important to drive new and improved ways to better detect and treat cancers affecting children and young people.”

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A ‘lollipop’ that can diagnose mouth cancer early could become a reality, thanks to a pioneering project funded by Cancer Research UK and the Engineering and Physical Sciences Research Council (EPSRC).

Scientists at BHP founder-member the University of Birmingham have been awarded £350,000 over the next three years to develop a prototype flavoured ‘lollipop’ from a material called a smart hydrogel.

Smart hydrogels – previously developed by the University’s Dr Ruchi Gupta and her team – work a bit like a fishing net: they absorb large quantities of water while ‘catching’ larger molecules, such as proteins. The ‘net’ can then be cut open to release the larger molecules for analysis in the lab. The idea is that patients suck on the lollipop, transferring a saliva sample into the hydrogel. Scientists can then release the ‘caught’ proteins by blasting the hydrogel with UV light and then analyse the liquid for saliva proteins which indicate the early stages of mouth cancer.

Around 12,400 people are diagnosed with cancers of the head and neck in the UK every year*. Currently, diagnosing mouth cancer can involve putting a flexible camera on the end of a tube through the nose or mouth and taking a biopsy for testing. This procedure is invasive, time-consuming and requires an endoscopist.

Mum of five, Rachel Parsons, needed a biopsy after being referred to Coventry University Hospital with a lump on her cheek in 2008. She admits she was unprepared for the procedure which, in her case, turned out to be painful.

“I had no idea what a biopsy really was,” said Rachel, from Coventry. “I had the kind of injection you get at the dentists and, when it wore off, it was really sore because I’d needed stitches.”

That was just the beginning of a 12-month nightmare for Rachel who ended up needing a nine-and-a-half-hour operation to remove a cancerous tumour from her cheek and replace the skin with tissue and veins from her forearm.

“The thought of putting a lollipop round your mouth instead of having a biopsy in the first instance is amazing,” said Rachel who has spent years as a patient ambassador, campaigning for more awareness of mouth cancer. “I wish something like that had existed when I was diagnosed.”

Dr Ruchi Gupta, Associate Professor of Biosensors at the University of Birmingham, said she was thrilled to receive funding to begin the next phase of the project: “Smart hydrogels have really exciting potential for diagnosing mouth cancer,” she said. “They can be easily moulded into shapes as a solid to ‘catch’ proteins in saliva.

“We’re really excited to start the next phase of this project. We’re hoping that we can be the first to make a device which is much kinder for diagnosing mouth cancer for patients and easier for GPs to use.”

Rachel, who still has numbness around her face and can’t open her mouth wide enough to eat a burger, added: “I’m so grateful for the research and treatment that saved my life. Things have improved immensely since then but what’s happening now could be absolutely brilliant for people diagnosed in future.”

Executive Director of Research and Innovation at Cancer Research UK, Dr Iain Foulkes, said: “Biopsies and nasoendoscopy are the gold standard for diagnosing mouth cancer, but it requires great skill to carry out and can feel unpleasant for patients. We want an accurate, faster and kinder alternative test which can help us diagnose cases of mouth cancer sooner.

“This project is an exciting first step towards an entirely new way to identify mouth cancers earlier. Research like this is guiding us towards a future where people can live longer, better lives, free from the fear of cancer.”

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• Early detection and diagnosis research at BHP
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The musculoskeletal radiology department at BHP member the Royal Orthopaedic Hospital (ROH) has developed a new website designed to enhance the diagnosis and management of cartilage tumours.

bactip.co.uk is a platform that equips healthcare professionals with the tools and knowledge to navigate the complexities of central cartilage tumours. By offering drawings and real case examples, it serves as a valuable resource for interpreting musculoskeletal radiology imaging findings related to these tumours, ensuring their accurate and consistent reporting. Developed collaboratively by experts in the field, bactip.co.uk offers an approach for assessing, diagnosing and monitoring these lesions.

A standout feature of bactip.co.uk is its integrated calculator, which streamlines the grading process based on tumour characteristics, like size and aggressiveness. This innovative tool aims to simplify decision making processes for healthcare professionals dealing with cartilage tumours. This advanced tool also standardises the reporting of central cartilage tumours, reducing subjective differences and improving patient care.

bactip.co.uk enables radiologists and clinicians to make informed decisions by offering an imaging follow up plan. Whether it involves suggesting a referral to an oncology specialist or safely discharging a patient from surveillance monitoring, the protocol provides a detailed framework customised for each unique case.

As a leading authority in orthopaedic excellence, the ROH musculoskeletal radiology department is proud to share its expertise through bactip.co.uk, an open-source free resource.

Dr A. Mark Davies, consultant radiologist at the ROH commented: “This initiative reflects our commitment to openness making sure that healthcare professionals worldwide can access our cutting-edge knowledge and best practices without any barriers. Our dedication to spreading knowledge and best practices aligns with our shared goal of enhancing patient outcomes on a global scale.”

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• Early detection and diagnosis research at BHP
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A new programme, funded by Cancer Research UK and led by BHP founder-member the University of Birmingham, has set out to attempt to eradicate a major and incurable bone marrow cancer.

An interdisciplinary team of researchers will investigate the underpinning biology of the very early stages myeloma, a cancer that develops from plasma cells – a type of white blood cell – made in the bone marrow. This is game changing research because the early stage, called MGUS, is common and only an unpredictable minority of cases go on to develop the killer disease of myeloma.

MGUS patients have non-cancerous expansion of immune cells in their bone marrow. In most patients this will be stable for many years and will never cause significant harm. The problem is that, in some patients, the cells will become more aggressive and cause full-blown cancer.

For decades it has not been possible to sufficiently tell these two types of patients apart. Until now this challenge has been considered insurmountable resulting in all cases of myeloma being diagnosed very late. However, thanks to the funding by Cancer Research UK it is time to make a change. Using biological and bioinformatic research the team aim to devise ways of accurately predicting which patients with MGUS are truly at risk of developing life threatening myeloma and those that will not.

With the help of experts in the economic challenges faced by health providers such as the NHS the team will then will design the best possible screening strategies to detect the disease and the quickest possible route to clinical trials of ways to prevent myeloma occurring.

Lead researcher Chris Bunce is Professor of Translational Cancer Biology, in the School of Biosciences at the University of Birmingham. He said: “Despite decades of academic and pharmaceutical company research, costing eye watering amounts of money and human endeavour, a cure for myeloma remains elusive.

“All myeloma cases, however, arise from an easily diagnosed pre-condition that remains virtually ignored by researchers. This funding from Cancer Research UK reverses that stance and turns the focus onto the very early stages of myeloma with a view to stopping the disease in its tracks.”

The research aims to provide a deeper understanding of how specific chemicals in the blood change as patients transition from MGUS towards developing myeloma. These changes – first identified by researchers at the University of Birmingham – could help distinguish ‘high risk’ MGUS from ‘low risk’ MGUS, as well as helping to identify potential drug targets for treatment.

Mark Drayson, Professor of Clinical Immunodiagnostics in the University’s Institute of Immunology and Immunotherapy, and co-lead research for the project, said: “By bringing together different approaches and expertise we aim to overcome the existing barriers to developing an effective test for stratifying risk of progression from MGUS to myeloma that is recognised as both affordable and effective.”

Dr Marianne Baker, Science Engagement Manager at Cancer Research UK, said: “To beat cancers that are often diagnosed late, like myeloma, we need to understand the earliest stages of its development – the underlying biology of the disease. This is a historically underfunded area, so we’re excited to see what the project brings; the more our researchers discover, the less room cancer has to manoeuvre. It’s vital we translate results into innovations, like tests that can predict risk, and give treatment the best chance of success.”

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• Early detection and diagnosis research at BHP
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