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.”
Mask wearing reinstated at Prince Philip Hospital
ALL staff and visitors to Prince Philip Hospital must wear face masks (unless exempt) with immediate effect following the latest review of prevalence of COVID-19 in the community, Hywel Dda University Health Board (UHB) has confirmed.
This follows the decisions made last week to reinstate mask wearing at Glangwili Hospital and both mask wearing and visiting restrictions at Withybush Hospital.
Visiting will continue in general at Glangwili and Prince Philip hospitals following the latest review of case numbers but local ward restrictions are in place so please contact the ward to arrange your visit in advance.
Mandy Rayani, Director of Nursing, Quality and Patient Experience for Hywel Dda UHB, said: “Wearing a surgical mask or face covering and keeping a physical distance when attending a hospital or medical facility will help protect our most vulnerable patients and service users.
We are grateful for the ongoing support and efforts of our communities to stop the spread, particularly around more vulnerable people.
“These measures will be continually reviewed, and as soon as it is safe to do so, we will ease these restrictions.”
The health board is stressing the continued importance of the behaviours known to reduce transmission of COVID-19 and other infectious diseases, and the different requirements in place in health and social care settings.
Mandy, added: “Isolating if we have symptoms of COVID-19, or other infectious diseases, is one of the most important things we can do to prevent the onward spread and break the chain of transmission.
“We strongly encourage anyone in our locality who has the classic symptoms, or who suspects they may have COVID-19 to isolate and take an LFD test. If positive, we urge people to continue with the same isolation guidance that has been in place – this will help you to rest and recover and protect others from risk of transmission.”
The following measures remain in place at Withybush hospital sites (updated 5PM, Tuesday 12 July 2022):
All staff and visitors to Withybush Hospital to wear masks (unless exempt).
Visiting to inpatients/wards is paused, except for end-of-life visits and any visits considered necessary through agreement with the ward sister/charge nurse.
People attending an outpatient appointment are asked to attend alone unless they require the support of a carer/relative.
Testing of all inpatients on admission.
Maternity visiting remains unchanged. A designated birth partner can visit following admission to hospital during pregnancy, throughout labour and following birth. A designated partner can attend antenatal appointments or scans.
The Chief Medical Officer for Wales, Sir Frank Atherton reminded people to follow simple steps to protect themselves from the risk of catching COVID-19 such as getting vaccinated, wearing face coverings in crowded indoor settings, and taking a lateral flow test if you have symptoms.
The Welsh Government has extended the availability of free lateral flow testing for members of the public until the end of July. Visit www.gov.uk and search ‘order rapid lateral flow kit.’
If you, or someone you care for is not online you can telephone 119 between the hours of 7am and 11pm (people with hearing or speech difficulties can call 18001 119).
Later this week, the Welsh Government will update its vaccine strategy with details of the next booster dose in the autumn.
Sir Frank said: “The vaccine is the best way to protect yourself and others from coronavirus. While the vaccine does not completely stop transmission it offers protection against serious illness and reduces the risk of hospitalisation.
“You can still get the vaccine if you haven’t had your full course, or you were too ill to get your spring booster and I would encourage parents to think about getting the vaccine for their children over the summer months to help minimise any disruption to their education during the autumn and winter terms.”
To book a vaccine appointment, call 0300 303 8322 or email COVIDEnquiries.email@example.com and for up-to-date information regarding visiting and mask wearing please visit the health board’s website http://hduhb.nhs.wales
Werndale Hospital recognised for outstanding patient care in national award
STAFF at Werndale Hospital near Carmarthen have been recognised for the quality of their patient care.
The prestigious ‘Private Hospital Group of the Year’ award is presented to an organisation that has shown excellence in its delivery of care, commitment to the community and innovation within healthcare.
Werndale Hospital was also recognised for their initiatives to support staff in their career progression and wellbeing.
The latest statistics show, 98% of patients at Werndale Hospital were satisfied with their overall level of care, 98% of patients would recommend their care to family and friends, and 98% of patients rated the nursing staff as excellent or very good.
In addition, independent analysis of Circle hospitals’ hip and knee procedure outcomes of health improvement shows that Circle scored 8.4 versus an independent sector average of 7.8 in the hip category, and a score of 15.4 versus an independent sector average of 13.9 in the knee category.
The award presented to Circle Health Group, owners of Werndale Hospital, in London in June, also noted the extraordinary contribution the teams at the hospital had made to the community.
In 2021 alone, Werndale Hospital partnered with Air Ambulance Wales and raised £1,205 to support the charity’s work in the community.
In addition to the charitable work, Werndale Hospital was recognised for it’s commitment to support staff through a series of wellbeing initiatives and career development opportunities. The judges were particularly impressed with the launch of the ‘Be Heard’ survey at the hospital.
The survey looks to empower staff to feedback on everything from the working environment at the hospital through to their own career ambitions. Building directly on the feedback from this survey, the ‘Grow Your Own’ campaign was launched which supported staff to work towards specific qualifications from nursing degrees with partnered universities through to bespoke management programmes and MBA qualifications.
As a direct result of this support for staff at what is a challenging time for healthcare workers, Werndale Hospital and Circle Heath Group were recognised as being a Top 20 Best Large Company to work for.
At the heart of Werndale Hospital’s approach to treating patients is a commitment to the community they serve.
Paolo Pieri, CEO of Circle Health Group, said: “The award is a testament to what an amazing year 2021 was for Werndale Hospital with considerable investment into the facilities and services on offer to patients in west Wales. I couldn’t be prouder of what our staff and doctors have achieved.”
Give blood, save lives – Do something memorable this National Blood Donor Week
THE WELSH BLOOD SERVICE is urging people to consider becoming blood donors to help save lives this National Blood Donor Week.
Over 350 blood donations are needed every day across Wales. The donations play a vital role in saving lives by supporting a range of treatments, from helping recovering accident victims and patients with blood cancers to supporting mothers and newborn babies during childbirth.
The Welsh Blood Service supports 20 hospitals across the country and relies on donations from blood, platelet and bone marrow donors to help patients in need.
Supporting the call is 65-year-old Howard Provis, one of Wales’ longest serving donors with nearly 50 years of dedication to the service. Howard has been donating platelets since the age of 18 and has recently made his 1,000 th donation which has helped save the lives of thousands of people across Wales.
Encouraging more people to come forward following his own experience, Howard explains, “With a background in first aid and first responding, I have seen people in many situations that have required blood. For me being able to give blood or platelets has given some of those people a second chance to live or spend precious extra time with their families and friends.
“Tomorrow, it could be me that needs a blood or platelet donation, or my wife, family or a friend. The thought that my donation today could potentially save someone’s life tomorrow has inspired me to keep supporting the Welsh Blood Service.”
Speaking of Howard’s achievement Alan Prosser, Director of the Welsh Blood Service explains, “Howard is one of only a handful of donors to reach this incredible milestone, and his donations will have helped patients in need from hospitals across the whole of Wales.
“His commitment to helping others is truly inspirational, and we hope his story encourages others to start their own lifesaving journey this National Blood Donor Week.”
National Blood Donor Week is an opportunity for blood services across the UK to raise awareness of the lifesaving importance of blood donation and encourage those who have never donated to give it a go.
The week also incorporates World Blood Donor Day (June 14), a day of celebration and thanks to the thousands of people who give up their time freely to donate and help people in need.
Alan continues, “We must say a huge thank you to every single donor who has supported us over the past two years. It has been a challenging period, but the generosity of people across Wales has been unwavering.
“As our Service works towards a post-covid collection service, we hope more people will step forward and join our lifesaving team. Following changes to UK donation guidelines, more people than ever before can safely donate, which means there has never been a better time to give it a go.”
June 14 is also the one-year anniversary of the landmark changes introduced following the recommendations made by the FAIR (For the Assessment of Individualised Risk) steering group.
These pioneering changes to donation rules have meant that all donors, regardless of gender, are now asked a set of questions, meaning that more people than ever before, including those from the LGBTQ+ community are potentially eligible to donate.
You can book your first or next blood donation appointment by visiting www.wbs.wales/nbdw22 and if you are 17-30, you can also consider signing up to the Welsh Bone Marrow Donor Registry.
For those who cannot donate, you can still become a Welsh Blood Service supporter.
Sharing their social media posts, encouraging your friends, family and colleagues to raise awareness of the importance of donating blood, platelets and bone marrow.
To learn more about donating blood, platelets and bone marrow, or to book, visit www.welshblood.org.uk.
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