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Research solves pancreatic cancer mystery

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A NEW technique to study tissue samples in 3D has revealed that pancreatic cancers can start and grow in two distinct ways, solving a decades-old mystery of how tumours form.

The new method could help researchers to get more information from tissue biopsies and may lead to improved treatments for pancreatic cancers. The technique was developed by scientists at the Francis Crick Institute, and their results are published in Nature. The work was supported by the European Research Council and core funding from the MRC (one of the Crick’s founding partners).

The pancreas is a crucial organ that sits behind our stomach and plays a key role in digestion. It relies on a network of ducts linking it to other digestive organs, and the most common pancreatic cancers are found in the ducts. However, until now it has only been possible to see 2D slices of these ductal cancers, which contained an unexplained variety of abnormal shapes.

“To investigate the origins of pancreatic cancer, we spent six years developing a new method to analyse cancer biopsies in three dimensions,” explains Dr Hendrik Messal from the Francis Crick Institute, co-lead author of the research paper. “This technique revealed that cancers develop in the duct walls and either grow inwards or outwards depending on the size of the duct. This explains the mysterious shape differences that we’ve been seeing in 2D slices for decades.”

By analysing developing cancers in 3D, the team defined two distinct types of cancer formation: ‘endophytic’ tumours which grow inwards and ‘exophytic’ tumours which grow outwards. To find out what makes cancer cells grow in a particular way, they analysed detailed 3D images and worked with biophysicists at the Crick who created sophisticated computer models.

“We made a simulation of the ducts, describing individual cell geometry to understand tissue shape,” explains biophysicist Dr Silvanus Alt, co-lead author of the paper. “The model and experimental results both confirmed that cancer grew outwards when the diameter of the duct was less than approximately 20 micrometres, around a fiftieth of a millimetre.”

The work was made possible by an interdisciplinary collaboration between two research groups at the Crick, led by Dr Axel Behrens and Dr Guillaume Salbreux. Axel’s group works on stem cells and pancreatic cancer, while Guillaume focuses on using physics to understand biological processes.

“I think we first started discussing this when we bumped into each other in the bike shed,” says Axel. “It’s amazing what can come out of a chance encounter, we now have a patented technique to see the three-dimensional shapes of cancers and a biophysical understanding of the emergence of tumours. Now that we know pancreatic cancer can develop in these two different ways, we can start looking at whether one is likely to be more aggressive or spread in a different way. Many years from now, this could lead to improved diagnostic or treatment options.”

The team also applied the technique to other organs and found that cancers in the airways of the lungs and ducts in the liver behave in the same way. This shows that the mechanism the teams discovered is not specific to the pancreas and also applies to other cancers.

“Both the data and our models indicate that the two different mechanisms of tumour growth are purely down to the innate physics of the system,” explains Dr Guillaume Salbreux. “Like most cancers, ductal pancreatic cancer starts with a single defective cell that starts dividing. We found that very quickly, when there are only a few cells, the tumour has already started to grow either inwards or outwards depending on duct diameter. Defining this fundamental process will help us to better understand how cancer grows in many places across the body.”

Dr Mariana Delfino-Machin, Programme Manager for Cancer at the MRC, said: “Pancreatic cancer remains a very difficult disease to treat but understanding that it can grow in different ways will inform the development of more accurate treatments in the future.

“These findings came about thanks to researchers working in very different fields coming together to successfully tackle the same problem.”

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Lack of GP services in Trimsaran raised with First Minister

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PLAID CYMRU MS Helen Mary Jones has raised the lack of GP services in Trimsaran in the Senedd during First Minister questions. 

While she was positive overall about the way the Health Board has handled the Covid crisis, she said she had had some concerns raised with her.

Reacting to a petition started by Trimsaran Plaid County Councillor Kim Broom, Helen Mary Jones MS said:

“During the pandemic health boards across Wales have had to make changes in the provision of primary care. One example is the GP surgery in the village of Trimsaran in the Llanelli constituency that has had to be temporarily closed so space  can be used for treating COVID patients if necessary.

“While, the community has accepted this, they are concerned, both in the immediate situation, because they have to travel now to Kidwelly, and at the same time the bus services have been cut because of COVID—a perfect storm, but perhaps unavoidable. But there is a suspicion that the health board may use the COVID crisis to permanently close that surgery.

“I raised the concerns directly with the First Minister, Mark Drakeford last week to ask for reassurances to my constituents in Trimsaran that the Welsh Government does not expect any changes to primary care services made because of the COVID crisis to be extended beyond the pandemic without proper assessment and consultation.”

The First Minister agreed with Helen Mary Jones MS. Mark Drakeford replied:

“Well, let me just emphasise the last part of what the Member said, because, on that basis, then I could sign up to what she just said, because I was about to say to her before she’d made that final point, that, of course, many of the changes that have happened during the pandemic we will want to see them continue afterwards. But they need to be properly consulted upon, and they need to be properly understood. But, the fact that we have thousands of video consultations happening every day, and people no longer having to travel inconvenient distances, and do things that were difficult for them to do, we’ll want to preserve those things as well. 

“The specific point that Helen Mary Jones makes points to a dilemma. I’ve been asked a number of times on the floor of the Senedd to think about having COVID-only hospitals, and, therefore, other hospitals that deal with all the non-COVID things. But when you do that, it’s inevitable, as you see in Trimsaran, that the things you would normally go to a hospital for will no longer be available to you, and you have to travel an even longer distance to find them. So, dealing with the pandemic and trying to keep people safe, and trying to make sure that people who need the health service for non-COVID reasons don’t run the risk of contracting the disease is genuinely challenging. And it’s been felt in our primary care, as well as in our hospital services.

“As we move beyond the pandemic, I am very keen that we learn the positive lessons, the astonishing rate of change that the health service has managed to accommodate over the last 12 months, but of course, those are things that need to be done in consultation with local populations, and to make sure that patients are taken on that journey.”

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Lockdown still in place but its now “Stay local” not “Stay at home”

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THE MESSAGE is changing from “Stay at home” to “Stay local” but the lock down, although relaxed is still in place, as part of what is being called “a careful, cautious and phased approach to relaxing coronavirus restrictions.”

First Minister Mark Drakeford made the announcement at today’s press conference. (Friday, March 12)

From Saturday 13 March, four people from two households will be able to meet outdoors to socialise, including in gardens. In addition, outdoor sports facilities, including basketball courts, tennis courts and golf courses, can reopen, and indoor care home visits will restart, for single designated visitors.
From Monday, all primary pupils and those in qualifications years will return. Schools will have the flexibility to bring year 10 and 12 learners back and more learners will return to colleges.

There will also be flexibility for in-school check-ins for all other pupils. All learners will return after the Easter break.

Hairdressers and barbers will re-open for appointments from Monday.

From 22 March non-essential retail will start re-opening gradually as the restrictions are lifted on what can be sold in shops which are currently open. Garden centres will also be able to open.

All shops, including all close contact services, will be able to open from 12 April – the same date as in England.

Some shops will be allowed to sell non-essential from next Monday, others will have to wait

The move is being seen as a snub to small businesses. Non-essential items will be for sales in supermarkets before they are for sale in small shops. Its a U-turn for the Welsh Government who previously said they wanted to be fair to everyone in businesses.

The First Minister said at the Friday press conference: “We are taking a phased approach to unlocking each sector – starting with schools.

We will make step-by-step changes each week to gradually restore freedoms. We will monitor each change we make, so we know what impact each change has had on Wales’ public health situation.”

The First Minister also announced an additional £150m to support businesses affected by ongoing restrictions.

The First Minister has announced that an extra £150m available to help businesses which are not yet able to open to help top up the non-domestic rates grants.

He said it means hospitality, tourism, leisure and non-essential retail businesses, which must remain closed will be eligible for a third payment of between £4,000 and £5,000 to help them meet ongoing operating costs while they cannot trade.

“This is in top of the announcement earlier this week extending the business rates holiday for retail, leisure and hospitality businesses for the whole of the next financial year,” Mr Drakeford added.

“We have made well in excess of £2bn available to businesses over the course of the last year to help them through the pandemic, which is over and above the support available from the UK Government’s schemes.

“This is the most generous business support scheme available in the UK. I’m very pleased we’ve been able to safeguard more than 160,000 jobs in these most difficult of times.”

There has been “false hope” for small firms, and insufficient warning given to businesses ahead of re-opening say Plaid Plaid Cymru. Plaid’s Leader Adam Price also urged Welsh Government to put “families first” before tourism re-opens. The Welsh Government has not given businesses that are allowed to open on Monday “sufficient warning” whilst giving false hope to those not allowed to open, Plaid Cymru Leader Adam Price has said.

Mr Price was responding to the announcement today from Welsh Government on lockdown easing.

The Plaid Cymru Leader added that there should be “some limited extended freedoms for families to come together” before tourism re-opens.

He added that there should be a “Wales wide consultation with the tourism sector” to establish whether it is viable for them to open to Welsh domiciled customers only over Easter and that case rates remained “stubbornly high” in many areas “attractive to tourists”.

Mr Price added that whilst “we all want the rules to be relaxed” this should be “the last lockdown, and to avoid another wave and further deaths in a few months.

Plaid Cymru Leader Adam Price MS told The Herald: “We all want the rules to be relaxed but what we want even more is for this to be the last lockdown, and to avoid another wave and further deaths in a few months.

“The Welsh Government has not given those businesses allowed to open on Monday sufficient warning whilst giving false hope to those not allowed to open.

“We now need a Wales wide consultation with the tourism sector to establish whether it is viable for them to open to Welsh domiciled customers only over Easter.

“Case rates remain stubbornly high in many areas attractive to tourists and we must remember the huge pressures already facing local hospitals.

“After the sacrifices of the past year we should be putting families first and granting some limited extended freedoms for families to come together before tourism re-opens.

“With people’s wellbeing suffering during the pandemic allowing gyms to open would be welcomed by many, providing that they can do so safely.

“Clear and consistent communication from Ministers is essential to ensure adherence to the rules. If we all play our part, we look forward to greater freedoms when case rates allow

Ahead of the update on Covid-19 restrictions, Welsh Conservatives renewed calls on the First Minister to provide a roadmap out of lockdown for families, workers and businesses in Wales.

Andrew RT Davies has called for “windows of opportunity” to be provided for businesses in Wales, as well as a relaxing of restrictions on exercise if the data allows.

Speaking ahead of the First Minister’s announcement, Davies also warned Labour ministers not to reimpose the “five-mile rule” with an easing of travel restrictions expected.

Welsh Conservative Senedd leader, Andrew RT Davies MS said: “Labour should use this review to provide some hope and above all a detailed plan for families, workers and businesses across Wales.

“As a priority, this should include dates and windows of opportunity for businesses in the retail, hospitality, leisure and tourism sectors. It’s the least those sectors deserve.

“I believe it’s important we see a greater acknowledgement from ministers over the importance of exercise to the mental and physical wellbeing of so many people in Wales, and where data allows, we should look to reopen gyms and ensure our sporting fields are once again occupied, particularly for our children.

“Given the great national effort, it’s also the right time to end the “stay at home” regulation but encourage people to “stay local”, but without reintroducing the arbitrary five-mile rule.

“The great British and Welsh vaccination story has improved the situation considerably and as Welsh Conservatives we are unapologetic about our focus on getting Wales back on track after this gruelling and painful ordeal for our country.

“That should now start with a roadmap out of lockdown. And for the sake of families, workers, and businesses across Wales, I hope Labour ministers listen.”

Responding to the Labour Government’s latest lockdown announcement, Welsh Conservative Senedd leader, Andrew RT Davies MS said: “We await the full details, but it appears Labour have missed another opportunity to provide clarity and a detailed roadmap out of lockdown for people across Wales.

“Labour’s U-turn on the opening of non-essential retail at such short notice will be a hammer blow for many businesses, and the decision to now align with England in that area shows we could’ve adopted a similar roadmap weeks ago.

“The ongoing refusal by Labour ministers to do so will only increase frustration in the sectors worst hit by the pandemic and will put more Welsh jobs at risk.

“Sadly, the scant details are reflective of a Labour government that doesn’t trust the people of Wales and which we found out this week believes that Welsh people…“if you give them an inch they’ll take a mile.”

“People in Wales fully understand the pandemic can change course and Labour ministers need to start treating us like adults, cut out the political games, and provide a clear path and roadmap forward.”

The “stay at home” rule will become “stay local” and the Labour have said people should stick to a five-mile rule. Commenting on that aspect, Davies said: “I welcome the end of the “stay at home” regulation, which is possible due to the collective hard work of people across Wales.

“People are fully capable of understanding the “stay local” message and as such the arbitrary five-mile rule is unnecessary.”

Reacting to the announcement from the First Minister for Wales that garden centres can reopen from 22 March, the Chairman of the Horticultural Trades Association, James Barnes, said: “This is the news the industry has been waiting for. We are delighted the Welsh Government recognised that garden centres provide enhanced safe retailing with light, airy and outdoor spaces.

“The many benefits of plants, gardening and nature are well documented, and this decision means that people in Wales can once again easily access everything they need to maximise those benefits as we can all start to look to a happier Spring”.

HTA Council representative for Wales, and owner of Pugh’s Garden Village in South Wales, Nicola Pugh, said: “We are delighted by the news we can reopen our doors on 22 March. We are ready and waiting and have been working hard to ensure safe shopping for all our wonderful customers and growing a selection of beautiful plants locally at our nurseries to ensure that our benches are full to welcome gardeners back to our centres.”

Travel restrictions should be eased with “caution” with the “stay local” messaged introduced for as long as is “necessary” Plaid Cymru Leader Adam Price has said.
The Plaid Cymru Leader was speaking ahead of the announcement.

Mr Price said that relaxation of restrictions should be done “slowly and steadily” and stressed the need for the “clearest plan possible” out of lockdown for businesses.

Adam Price MS said: “Travel restrictions should be eased with caution and the sensible approach is to reintroduce the “stay local” message for as long as is necessary – ensuring that guidance is tailored depending on where people live. Stay Local can mean different things in different parts of Wales – particularly rural Wales.

“Any relaxation of restrictions need to be done slowly and steadily. After all, we all want this lockdown to be the very last lockdown that we face.

“But above all, we support measures that aim to keep people safe, based on evidence, but people and businesses need the clearest plan possible about the road ahead of us.

“However, loneliness and isolation remain also a real challenge for many people, and we hope that the government will put a sharp focus on when and how it will be safe to return to extended household bubbles. We also cannot ignore the mental health crisis which has been brought about because of the pandemic. It is vital that everything possible is done to enable gyms to be among the first facilities to reopen.

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First Minister to set out first steps out of lockdown

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THE WELSH GOVERNMENT will lift the “stay at home” requirement in Wales from tomorrow, and replace it with “stay local”, as part of a careful, cautious and phased approach to relaxing coronavirus restrictions, First Minister Mark Drakeford will announce today (Friday, Mar 12).

From tomorrow (Saturday, Mar 13), four people from two households will be able to meet outdoors to socialise, including in gardens. In addition, outdoor sports facilities, including basketball courts, tennis courts and golf courses, can reopen, and indoor care home visits will restart, for single designated visitors.

From Monday, all primary pupils and those in qualifications years will return. Schools will have the flexibility to bring year 10 and 12 learners back and more learners will return to colleges.

There will also be flexibility for in-school check-ins for all other pupils. All learners will return after the Easter break.

Hairdressers and barbers will re-open for appointments from Monday.

From 22 March non-essential retail will start re-opening gradually as the restrictions are lifted on what can be sold in shops which are currently open. Garden centres will also be able to open. All shops, including all close contact services, will be able to open from 12 April – the same date as in England.

The First Minister will say: “We are taking a phased approach to unlocking each sector – starting with schools. We will make step-by-step changes each week to gradually restore freedoms. We will monitor each change we make, so we know what impact each change has had on Wales’ public health situation.”

The First Minister will also announce an additional £150m to support businesses affected by ongoing restrictions.

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