by Victor Culverwell U6P
Cancer rates are rising. Currently, around 375,000 patients a year are diagnosed with cancer with half of these patients dying of their disease and by 2035 it is predicted to be 500,000 diagnoses a year.¹ Cambridge University in collaboration with Cancer Research and the NHS are set to build a new hospital to take a big step in the fight against cancer to combat the increasingly prevalent disease. They are looking to detect cancer in earlier stages, personalise treatment to be more specific to patients and most importantly save more lives.¹ The concept of a hospital having this big impact seems unprecedented and surely foreseeable however Professor Richard Gilbertson (Head of Oncology, University of Cambridge) says "I believe we have this at our fingertips: the capacity to extend life and eradicate cancer.”¹ But how will they achieve this medical miracle and what makes this hospital so special? Continue reading to find out…
The hospital will be a seven-story medical marvel with an increased number (than typical hospitals) of 77 single inpatient rooms to maximise care for vulnerable patients.³ It will also hold many areas for research “closing the gap between the lab bench and patient bedside”¹ such as specialty day units including Oncology and Haematology units and diagnostic suites for clinical trials.³ Patient flow has been a significant problem for the NHS before with NHS data showing that in September 2023, 14% of patients waited more than one day to be discharged from the hospital after they were ready.⁹ Because of this, the hospital is also planning to have additional beds for the increasing number of patients and is also building a large outpatient area to better manage the patient flow for both in and outpatients. You may be thinking ‘This is a great concept but how will this help them meet their objectives?’
Cambridge University is renowned for its contribution to medical society through research, innovation and production of many world-class doctors, of which many will be working in and around the new hospital within the coming years. Aligning with their goal of earlier diagnosis to prevent terminal cancer, the CCRH are planning to develop an Early Cancer Institute Research Clinic; the idea is to gain a greater understanding of the early stage of cancer and pioneer/develop new ways of testing for cancer.⁵ The clinic will house research facilities for experiments on the first-in-human clinical trials, establishing diagnostics on healthy volunteers as well as an innovation hub for new ideas on detection.⁵ An example of his was Professor Rebecca Fitzgerald’s innovation of the Cytosponge on a string which detects Barrett’s Oesophagus (a common symptom of Oesophagal Cancer); trials suggest this method of detection is ten times more effective than typical GP methods as well as being less invasive and more cost-effective.⁵ Another factor they value is personalising treatment to be bespoke to each patient, their first act in fulfilling this is the Precision Breast Cancer Institute. This institute will combine DNA sequencing and scans to target specific tumour proteins in the patient to find the most appropriate treatment.⁷ Although precision cancer treatment is becoming more and more effective, it varies for each type of cancer and so only works for approximately 10% of overall patients.¹⁰ This figure is still considerably low and thus highlights the importance of developing precision medicine further, which the institute also aims to do with more research.
In combination with these, there are plans to utilise advancing technology by introducing the Integrated Cancer Medicine Institute (ICMI). The ICMI will use multiple datasets such as clinical data, genetic data, imaging data and tumour markers to “integrate” all data or make a holistic treatment plan which is best suited for the patient; this will be done using state-of-the-art AI.⁶ More specifically, the data includes a combination of biopsies, blood tests, genetic testing and medical imaging to better understand the type of treatment that would be most relevant for the individual patient.⁶ Not only does this help achieve their goal of specifying treatment for patients, but it also incorporates the newest technology available, making the most of current resources. The AI has a multitude of tasks, not just suggesting treatment but also predicting the effect of surgery, actively monitoring treatment with live responses to the patient (adapting accordingly to the cancer’s susceptibility to treatment) and even calculating the chance of cancer occurring in close relatives and the chance of relapsing.⁶ This seems to be the way forward in medicine as it removes a level of subjectivity and increases the accuracy of treatment however it does bring up some ethical concerns such as whether this nullifies the need for doctors; I believe this is irrelevant as a significant part of being a doctor is the ability to build trust in a doctor-patient relationship and show empathy, both of which will never be fully replaced by AI - more on this at https://medicalfuturist.com/5-reasons-artificial-intelligence-wont-replace-physicians/ . It also provides particular economic implications because cutting-edge AI technology, the newest research equipment and the building costs of the 26000m² modern hospital will inevitably be expensive.¹¹ So how will it be funded and managed?
In 2019, the government released the New Hospital Programme in a manifesto claiming they would invest £20 billion to build 40 new hospitals by 2030 - CCRH will be the first of these hospitals built.¹² The contribution by the government will be major and so many suggest it is not warranted as the government could be funding other “more relevant” causes such as climate change. Globally, cancer ranks as the second most deadly disease behind some cardiovascular diseases (varying between countries) showing the urgency of the matter.¹⁰ So although I agree that many current issues need funding, cancer is a persistently damaging and destructive disease that separates families so I think it is just to use government money on the new hospital which has the potential to slow down this brute force. As discussed, the government is helping to fund this through NHS funds but they cannot do this alone. Another way the NHS is helping out is by moving their current Teenage Trust Unit, a specialised unit for younger cancer patients, at Addenbrooke’s Hospital (funded by the Teenage Cancer Trust Charity) to the new building, which gives younger patients more of an option in where they stay.⁴ Also, in order to accelerate this process, the CCRH team have done some of their own fundraising in their recent Dragon Boat Race which over doubled their target managing to raise more than £2000.¹³ In light of this, we as a school have decided to do our own event of a 3 km run (24th of September) hoping to also raise money for this charitable cause.
In keeping with the theme of community, the hospital is also working with patients and stakeholders through the Cancer Patient Partnership Group. The CPPG collaborates closely with current and former stakeholders/patients for feedback and input into issues that could be resolved or improved in patient-stay or staff workload etc.⁸ One example of this is patient Fiona Carey who was first diagnosed with cancer 20 years ago and has since had 8 tumours in the kidneys, lungs, gastrointestinal tract and abdomen.² Due to certain abdominal adhesions, she cannot walk long distances but she has not let this stop her and instead chooses to use a wheelchair which makes her feel free. She has undergone countless surgeries and treatment plans but says she is happy with the project as “We’ve had a real voice within the process.”², especially as she has been a patient representative since 2012, now at national level, as part of the co-production ideal of the NHS. Recently, she has become a grandmother and continues to live an active and fulfilling life.² Her inspiring story shows that we can all make a difference regardless of our given circumstances. This is just one of many stories of one of us being affected by cancer.
To conclude, I think that Cambridge Cancer Research Hospital will certainly have an undeniable impact on the world of cancer within medicine. New ideas and principles put in place by the government and NHS reinforce a different perspective on how the hospital will be run, including patients and staff more. Furthermore, increasingly developing technology has also allowed for new methods of diagnosis, treatment and surgery, reinstating this idea of cancer treatment being revolutionised. Additionally, the incorporation of more specialised units, bigger wards and the expertise of staff all contribute to a better standard of care, particularly for cancer patients. But what do you think?