Making Scotland a Beacon of Hope for Cancer Sufferers

By ANNE SIMPSON

OUR wretched state of health is paraded so often as the worst in western Europe that, quite frankly, it seems a bit of a miracle that the nation has managed to survive at all. But bleak statistics for cancers and heart disease can obscure the fact that Scotland is up there with the best when it comes to scientific research, world- class medical advances and nursing personnel.

Tessa Holyoake is among those who embody such distinction. Professor of experimental haematology at Glasgow University, she is also director of the ground-breaking leukaemia research laboratory that will shortly occupy the third floor of the long-awaited GBP100m New Beatson West of Scotland Cancer Centre at the city’s Gartnavel Hospital.

Holyoake’s custom-built lab will be called the Paul O’Gorman Leukaemia Research Centre in memory of the 14-year-old who died of the disease in 1987 and whose national charity – established by his parents with the Leukaemia Research Fund – has contributed GBP500,000 towards the GBP3m project.

One of the few scientists who is also a hospital consultant, Holyoake, with her research team, is currently located in antiquated labs dating from the 1970s at the city’s Royal Infirmary. Even so, that hasn’t hindered herwork from gaining international recognition. A colleague remarks: "If you talk to specialists in chronic myloid leukaemia (CML) anywhere in the world they will knowTessa’s name."

Five years ago, when fundraising for the new lab began in earnest, Holyoake’s imperative could not have been clearer. "When people think of leukaemia research we want them to think Glasgow, " she said.

In fact, she has been committed to this goal for 15 years and the new lab would have been up and running before now but for what she describes as "various political delays."

Today, though, her ambition is as strong as ever. "We don’t want to be following others. We want Glasgow to be the drivers in the development of new treatments." Such a compelling goal, she says, is already attracting medical interest from all over the UK and abroad. At present, haematology is scattered over six different sites in Glasgow, making professional and patient collaboration difficult.

"But people are now applying to do specialist registrar training with us because the chance to work with our team in a centre where everything is on one site will be a fantastic experience. And obviously its advantage and importance for patients will be enormous."

Haematology is now recognised as one of the most dynamic areas of medical study, but 30 years ago most blood cancers were terminal afflictions. Today, however, drug advances mean the prognosis for the 25,000 UK sufferers of various forms of leukaemia and lymphoma has improved dramatically, even if mystery still surrounds the cause of such pernicious diseases.

For Holyoake and her colleagues, the opportunity to unlock this secret and outwit a stealthy, resistant army of malignant cells is both intellectually and emotionally taxing and exciting. "The moment that Glivec [a cancer treatment] came along it was a miracle drug, and patients have benefited massively from it." Prior to that the average survival rate for CML was five years. "Some patients made it to 10 years, and others survived for only a fewweeks.

"But patients who are not responding to Glivec any more have what we call resistance mutations: the leukaemia protein in cells changes, which means the drug can’t bind. As a result, that population of cells takes off, causing a different leukaemia." She notes that a similar situation happened with antibiotics in cases of HIV and tuberculosis. "But medicine managed to overcome that by patients being placed on a regime of multiple different drugs to prevent resistance."

From next month, Holyoake’s outpatient clinics will move from Glasgow Royal Infirmary to a dedicated suite at the New Beatson, but running parallel to this doctor/patient aspect of her career will be her continuing scientific pursuit to establish clinical drug trials in Scotland.

"You’ve heard about patients f lying to America to get treatment. Well, we want that availability to be on the doorstep here. By advancing stem-cell technology and exploring the potential of combining new wonder-drugs with mini transplants, we’re hoping to produce longer remission, and yes, possibly a cure."

In this respect Holyoake’s team is already widely respected. But she is also keen to acknowledge Edinburgh’s impressive contribution to the subject. Stem-cell technology, she says, is the runner for the future of regenerative medicine, and those involved in it globally not only know of her group but also of the work being done in the capital where plans are progressing for a GBP59m stem-cell research complex on the campus at Edinburgh Royal Infirmary.

Of course, medicine always needs the challenge of difficult territory and Glasgow’s legacy of life-threatening illnesses as a consequence of heavy industry and deprivation has, paradoxically, given the city a rich history of medical pioneers. Among them are the late nineteenth-century figures of William Macewan, founder of modern brain surgery, and Joseph Lister, whose antiseptic discovery led to modern surgical procedures. Much closer to our time, the late Iain Boyle won distinction through advancing the treatment of kidney and bone disease with his research into vitamin D metabolism.

And today there is something hopefully regenerative in the fact that the work of Holyoake and her colleagues will be synonymous with the Beatson in its new incarnation. In recent years its reputation has been blighted by woeful publicity about its lack of resources at the Western Infirmary, a situation which was guaranteed to exacerbate patient anxiety as well as stress among doctors and nurses alike. But now, in its handsome surroundings and aspiration to be "the best cancer unit in Britain", the New Beatson has the opportunity to lead in innovative patient care; a chance, also, to reaffirm medicine’s shining role in the annals of civic pride.

Holyoake’s husband, Andrew Malloch, is a GP in Greenock, where the couple met as senior and junior hospital house officers. "I was actually Andrew’s boss at the time, " she says. A graduate of Glasgow University, Holyoake was awarded a fellowship from the Leukaemia Research Fund and spent its first two years in Vancouver, at the Terry Fox Laboratory which is at the cutting-edge of cancer research. For the remaining three years of the fellowship she was back in Glasgow, applying the expertise she’d acquired in Canada to building her own home team.

As it happened, Vancouver worked well forAndrew also. While there he trained in sports medicine and ended up with an MSc. "When we returned he rejoined his original practice and occasionally he works with rugby and football teams here. But I think there are very fewwest of Scotland men would give up their career for two years on behalf of their partners."

HOLYOAKE’S earlier reference to America brings our conversation round to another significant breakthrough, courtesy of information technology. In the US in 2002, a certain Maine physician hit on Holyoake’s work published on a medical website. He was so impressed by its contribution to the treatment of CML , his own condition, that he contacted her by e-mail to tell her so. That doctor, now in remission, is Richard Rockefeller, great-grandson of America’s first billionaire, and his admiration for Holyoake’s work was such that he helped to kickstart her fundraising with a cheque for dollars- 100,000.

Yet, just as valuable as that contribution, was Rockefeller’s personal endorsement. "Having surveyed the field, " he wrote publicly, "it is clear to me that Dr Holyoake and her colleagues are doing the best work around. I have chosen to support her and am encouraging all who will listen to do so as well." True to his word, Rockefeller has continued to help.

"After that first donation, he gave us dollars-30,000, and since then he and his dad have donated a further three lots of dollars- 50,000."

Recently, he and Holyoake met in America where she was attending a conference, and, still in good health, he expressed a wish to visit Scotland for the official opening of the Paul O’Gorman lab at the New Beatson next year. But given how often politics can stymie the best medical intentions, was there ever a moment when Holyoake felt like giving up? She had planned the new lab down to the finest detail and suddenly the original go-ahead was overtaken when all such projects were swept into a laboratory review.

"That meant I couldn’t get any answer about our future for at least a year. So, yes, that was a low point. I thought, ‘I’ve set this whole thing up for when the Beatson moves to Gartnavel. Now, if that doesn’t happen and I’m left at the Royal’s out-dated labs, well, there’s really no way forward.’" Did that prompt job-seeking letters to elsewhere? "Not really. I’m head-hunted regularly and usually I say no. But in those days I found myself saying, ‘OK, I’ll come and have a look.’" So what might tempt her away now?

"Nothing. Our time in Vancouver was fantastic: super city, great outdoor facilities which Andrew and I loved. But it didn’t have the heart that Glasgow has. It didn’t have that party attitude, that appealing daftness and drivel. It just didn’t have the humour."

Also Holyoake has learned from her patients and their families that nowhere quite matches the Scottish spirit for fundraising. She cites the case of John McGuigan, a former CML sufferer now in remission, who, with his extended clan, has raised GBP20,000 for the campaign. And Holyoake’s Aberdeen grandmother, Mary Cumming, knits wonderful socks for the fund’s charity auctions, her needles still clicking at the tenacious age of 106.

There have been money-making bike-a-thons, abseils down university towers, and on May 26 volunteers are invited to bag a Munro with a sponsored trek up Scheihallion in Perthshire. "Those wishing to take part should gather in the car park for Scheihallion at 11.30am. And bring some food and wine or beer for a barbecue afterwards." It’s a fair bet, too, that Tessa Holyoake won’t be the only one sporting a pair of her granny’s good luck socks.

The Scheihallion fundraiser takes place on May 26. Call 0141 330 2132 or e-mail Susanne Hill at s. hill@admin. gla. ac. uk.

Tessa Holyoake: the CV *Age: 43 *Born: Aberdeen *Education: Graduate in medicine from Glasgow University; five-year fellowship from the UK Leukaemia Research Fund into stem cell research.

*Marriage: to Dr Andrew Malloch, a Greenock GP with a special interest in sports medicine.

*Career: Professor of experimental haematology; director of the Paul O’Gorman Leukaemia Research Centre at the New Beatson; honorary consultant, Glasgow Royal Infirmary; leading figure on the advisory board of the Scottish Stem Cell Network to improve the pace with which lab research translates into therapeutic benefits for patients.

*Distinctions: Has published many papers internationally; recently elected as a Fellow of the Royal Society of Edinburgh.

(c) 2007 Herald, The; Glasgow (UK). Provided by ProQuest Information and Learning. All rights Reserved.