Scientists have identified a drug which may offer hope to patients with a particularly lethal form of lung cancer.

The drug eliminated small cell lung cancer tumours in 50% of mice, and blocked the cells’ ability to resist standard chemotherapy treatment.

The Imperial College London team now hope to test it in patients with an inoperable form of the disease.

Their study appears in the journal Cancer Research.

Lung cancer is a major killer, and the small cell version of the disease, which makes up 20% of total cases, has a particularly poor prognosis. Only around 3% of patients survive for five years.

The cancer spreads quickly, so surgery is not often an option.

Chemotherapy, sometimes supplemented with radiotherapy, often reduces the size of tumours, but they usually grow back rapidly, and become resistant to further treatment.

A growth hormone called FGF-2 appears to speed division of the cancer cells, and to trigger a survival mechanism which makes them resistant to chemotherapy.

PD173074 blocks FGF-2 from attaching to tumour cells. The researchers say it could potentially be taken as a pill, rather than fed into the body via a drip.

It was originally developed in 1998 to stop blood vessels from forming around tumours.

Further trials needed

Researcher Professor Michael Seckl said: “We urgently need to develop new treatments for this disease.

“We hope to take this drug, or a similar drug that also stops FGF-2 from working, into clinical trials next year to see if it is a successful treatment for lung cancer in humans.”

Initially, the new drug was tested on cells taken from human tumours.

It stopped the cells proliferating, and neutralised their defences, allowing them to be killed off with standard chemotherapy.

Follow-up tests on mice showed the drug was effective against tumour cells, both in isolation, and in combination with the standard chemotherapy agent, cisplatin.

Dr Joanna Owens, of the charity Cancer Research UK, said: “It is encouraging to see potential new drugs for lung cancer in the initial stages of development.

“The early results from this study are impressive but we will need to wait for the results of clinical trials before we will know if the drugs could work for patients.”

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Tissue created in a laboratory has been used to completely replace the erectile tissue of the penis in animals.

The advance raises hopes of being able to restore full function to human penises that have been damaged by injury or disease.

Rabbits given the engineered tissue by the scientists from Wake Forest University in North Carolina had normal sexual function and produced offspring.

The study appears online in Proceedings of the National Academy of Sciences.

Professor Anthony Atala said: “Further studies are required, of course, but our results are encouraging and suggest that the technology has considerable potential for patients who need penile reconstruction.

“Our hope is that patients with congenital abnormalities, penile cancer, traumatic injury and some cases of erectile dysfunction will benefit from this technology in the future.”

Reconstructing damaged or diseased penile erectile tissue is a tough challenge because of the tissue’s complex structure and function.

Different approaches have been tried – including the use of silicone prosthesis – but with limited success.

The Wake Forest team has already achieved considerable success in the field of tissue engineering, developing whole human bladders that have been implanted into patients.

In a previous study, the researchers engineered short segments of rabbit erectile tissue with 50% of full function.

In the latest work, they harvested smooth muscle cells and endothelial cells from the animals’ erectile tissue.

These cells were multiplied in the laboratory and used to seed a three dimensional scaffold, which was implanted into the animals’ penis.

Organised erectile tissue with blood vessel structures began to form as early as a month later.

The researchers believe the key was the fact that the cells were injected into the scaffolds on two separate days, enabling them to hold almost six times as many smooth muscle cells as in previous studies.

During an erection, it is the relaxation of smooth muscle tissue that allows an influx of blood into the penis.

The relaxation is triggered by the release of nitric oxide from endothelial cells.

Tests showed that vessel pressure within the engineered tissue was normal and that blood flowed smoothly through it and drained away from it normally after an erection.

When the animals with the engineered tissue mated with females, vaginal swabs contained sperm in eight out of 12 cases. Four of the 12 females were impregnated.

Tim Terry, honorary secretary of the British Association of Urological Surgeons, described the study as “fascinating”.

He said complex, highly invasive surgery was often the only option for patients with damaged erectile tissue and the latest work offered long-term hope of a better alternative.

However, he said, much work would be required before the technique could be tested on humans, with potential problems including finding a suitable place to embed the new tissue and ensuring it had an appropriate nerve supply.

“Nevertheless, tissue engineering techniques may well lead to clinical advances with time,” he said.

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Most people feel younger and healthier soon after retiring, a study of French workers has found.

Researchers looked at 15,000 employees over the best part of a decade, and found they felt up to 10 years younger within months of retirement.

The greatest improvements in perceived health were among those who came from a poor working environment.

Those who were in high-status, high-satisfaction jobs showed the least change, The Lancet study reports.

The researchers asked employees from the French national gas and electricity company to rate their own health up to seven years before retirement and up to seven years after.

The team, from Stockholm University and University College London, found that the number reporting their health as below par fell from 19% in the year before retirement to 14% in the year after.

This, they calculated, corresponded to a gain in health of eight to 10 years.

Keep on working

The authors suggest that improving people’s working conditions is essential if the burden of perceived ill-health is to be minimised at a time when societies are moving towards keeping people in the workforce for longer.

“Arguably the best option is to redesign working life for older workers to make it healthier and more satisfying than at present,” said lead researcher Dr Hugo Westerlund, of the Stress Research Institute at Stockholm University.

This, he said, would “hopefully achieve improved occupational health and quality of life, increased productivity, and a larger proportion of the population in work”.

Other research has found that the actual health gap between the lowest and highest paid occupation groups widens on retirement.

A study of thousands of British civil service workers found the average physical health of a 70-year-old who had been a high earner was similar to the physical health of a low earner around eight years younger.

But US research has also highlighted health benefits of staying on in work in some capacity, be it on a temporary or part-time basis.

Dr Johannes Siegrist from the University of Dusseldorf wrote in an accompanying editorial that the implications for policy of the French study were convincing.

“If poor quality of work reduces health and wellbeing of aged workers and reduces the participation of this age group in the labour force, efforts need to be directed towards improving healthy work at the level of single organisations and companies, and at the level of national labour and social policies.”

Andrew Harrop of Age Concern and Help the Aged said: “While many people can’t wait to retire, others want to continue working in later life, whether it’s because they enjoy their jobs or to boost their retirement income.

“Working into later life will bring many benefits to our economy and to the individual, but this will only be achieved if employers are willing to adapt to older workers’ changing needs.

“More flexible working, particularly to take account of more chronic health conditions that are suffered in later life would also give employees the confidence to continue working into later years.”

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A father who had been fighting to stop a hospital withdrawing life support from his seriously ill son has dropped his objections.

The one-year-old, known as Baby RB for legal reasons, was born with a rare, genetic muscle condition that makes independent breathing impossible.

The hospital was backed by the baby’s mother.

But the move had been strongly opposed by the child’s father at a High Court hearing.

However, the father changed his mind after hearing medical evidence which suggested it would be in the best interests of the child if medical support was withdrawn.

Lawyers for the health authority caring for the baby in intensive care told Mr Justice McFarlane: “All of the parties in court now agree that it would be in RB’s best interests for the course suggested by the doctors to be followed.”

The judge welcomed the decision, describing it as a “sad, but in my view inevitable outcome”.

He said: “From the moment of the baby’s birth it was apparent he was profoundly unwell.”

Mr Justice McFarlane said it would now be lawful to withdraw life support from the child.

Tribute to parents

He also paid tribute to the parents, who he said had acted in an exemplary manner.

He said: “It is, I suspect, impossible for those of us to whom such an event has not happened to do more than guess at the impact of it upon these two young parents.

“In one moment all of the hopes and dreams that they will have had for their expected baby will have been dashed and replaced with a life characterised by worry, stress, exhaustion, confusion and no doubt great sadness.”

Both parents were in tears as the judge summed up the case, and the mother at one point left the court, but later returned.

A joint statement issued by lawyers representing RB’s parents and the hospital trust said: “Although RB’s parents separated, they have always been united in wanting the best possible care for their son so that he may have the very best possible quality of life.

“They have been at his bedside daily these last 13 months.

“The court has heard that RB is a dear little boy, adored by his parents, family and the hospital staff.

“Every party in this case has reached this agreement after careful, considered thought for what is in RB’s best interests.”

The statement said the decision to withdraw life support from the child had been “agonisingly difficult”.

“RB’s parents would now wish to spend what little time remains with their beloved son.”

Profoundly ill

Baby RB is thought to have a condition called congenital myasthenic syndrome (CMS), which severely limits the ability to breathe independently and limb movement. He has been in hospital since birth.

The hospital’s legal team argued during the hearing that the baby faced a “miserable, sad and pitiful existence” – even if tracheotomy surgery to relieve his breathing difficulties allowed him to return home.

They were particularly concerned that the child could not communicate whether treatment – such as regular suctioning of his airways to remove fluid – caused him pain.

Several experts told the hearing that the child was too profoundly disabled to enjoy any quality of life.

But lawyers for the father argued the baby’s brain was unaffected, and that he could see, hear, feel and recognise his parents.

The hearing also heard evidence that he was able to play with toys.

For legal reasons, none of the parties in the court case can be identified.

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Women treated for breast cancer are at a higher risk of a relapse if they have “dense” breasts, say researchers.

Those with denser breasts are four times more likely to see their cancer return, compared to women with less dense breasts, says the journal Cancer

The Canadian authors advise that women with the densest breasts should have radiotherapy while the women with less dense breasts could be spared.

Experts say further studies are necessary before any treatment change.

The researchers from the Women’s College Hospital in Toronto, Canada, looked at the medical records of 335 women who underwent surgery for invasive breast cancer and for whom a pre-treatment mammogram was available.

Patients’ breasts were categorised as low density, intermediate or high.

The researchers used the Wolfe scale which classifies breast tissue as seen on a mammogram.

Low density means less than 25% dense tissue, intermediate density means 25-50% dense tissue and high density means more than 50% dense tissue.

Greater risk

Breast density was higher in the younger women in the study, which surveyed women with an average age of 63.5 years.

The women in the high density group experienced a much greater risk of breast cancer returning.

Over a 10 year period, they had a 21% risk of cancer recurrence, compared to a 5% risk for women with the least dense breasts.

After 10 years, the difference in the rates of disease recurrence for women who did not receive radiotherapy after surgery was more pronounced, with 40% of women with high density breasts experiencing cancer recurrence compared with none of the women with the lowest density of breasts.

The authors said their findings indicated that women with low breast density, may not need radiotherapy, but that women with high breast density could significantly benefit from the therapy.

‘Breast density modifiable’

The researchers believe the hormonal profile of denser breast tissue makes it more susceptible to cancer.

Dr Steven Narod, of the Women’s College Hospital in Toronto, Canada, said: “The composition of the breast tissue surrounding the breast cancer is important in predicting whether or not a breast cancer will return after surgery.

“Breast density has been found to be modifiable to some extent by physical activity and hormone therapy.”

‘Attractive prospect’

Stephen Duffy, Cancer Research UK’s professor of screening, said: “This is intriguing.

“One reason for this could be that we know breast density increases the risk of a breast cancer in the first place, so it may simply increase the risk of a second one.

“Another possibility is that the dense tissue makes it more likely that other areas of cancer in the breast are not visible at initial diagnosis and so are not removed when surgery takes place.

“The potential to spare women who do not have dense tissue from radiotherapy is a very attractive prospect. But further studies will be necessary to be sure that this is safe practice.”

Maria Leadbetter, clinical nurse specialist at Breast Cancer Care, said: “By being able to determine which women may or may not benefit from radiotherapy it may be possible to offer more tailored treatment.

“It could also reduce the total number of women having radiotherapy, which can have significant long-term side effects.”

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