£1m dream comes true

Oct 5 2006 By David Whetstone, The Journal

Dedication which pays off for us all

There are no miracle cures, just hard work and commitment. David Whetstone talks to Prof Stephen Proctor whose research is the biggest beneficiary of the North-East Last Night of the Proms.

The cymbals will crash, trumpets will sound and 2,000 voices will unite in declaring that Britons "never, never, never will be slaves". Meanwhile everyone will be singing or playing happy in the knowledge that they are doing their little bit to combat cancer.

All this is in marked contrast to the atmosphere in one of the places where the combating of cancer is a daily preoccupation.

It is a squat building nestling on what used to be an unused patch of gravel at the heart of the labyrinthine Royal Victoria Infirmary Medical School, Newcastle.

I have been led here by Prof Stephen Proctor, tracking him along seemingly never-ending corridors, watching him exchange friendly words with a tall young man whose patchy hair speaks of a relatively recent dose of chemotherapy.

He is the experienced medic, accustomed to the realities and practicalities of illness. But I swallow hard. There but for the grace of God... cancer is a curse that can strike any one of us, directly or indirectly.

The sign at the entrance door says Academic Haematology, haematology defined in my dictionary as "the branch of medicine concerned with the study and treatment of the blood".

Cancer is a hydra, a many-headed beast. To combat it, you need more than just one weapon. This building, so quiet and unassuming, is one of them: a state-of-the-art, frontline weapon aimed at the insidious cancers of the blood. In some particular cases, these are on the rise and no one knows why. People talk about essential work and it certainly goes on here.

It is largely due to Prof Proctor that this dedicated building, within the confines of the Medical School and RVI but part of Newcastle University's department of medicine, exists. He pushed hard for it. "I thought: we've got a research team of 30-odd. We need clinical research space, laboratories, storage facilities for bone marrow. Ideally we'd like to be in the Medical School. They came up with various things but I suggested building in one of the quads. We had to do it without blocking out anyone else's light.

"I wanted two floors, laboratories on the bottom, so people could mingle and interact. And I'm the gardener. No one touches the plants except for me."

The plants are the first thing you notice once you go through that door. Visible through glass, their great leaves and fronds soften the hard corners of the quadrangle. They probably make all the people who work here feel good but they are also representative of health and conducive to positive thinking.

Prof Proctor is eager to explain what goes on in this building and to communicate the realities of the cancer-combating game. On a swift tour, he points out the hardware, big stainless steel drums for the storage of bone marrow and the rich, untainted blood from umbilical cords. All are indicative of the strides taken in technology and medical practice since he first came to study and work in Newcastle in the early 1970s.

To the untrained eye, it looks impressive, reassuring, shiny and new. But he is at pains to point out that all this is secondary to the people who work here, some of them bent over computer keyboards, one or two chatting softly but animatedly. He talks about them with a mixture of pride and affection, rather in the manner of a successful Premiership football manager - which is an analogy he likes to deploy himself.

"There's Ann Dickinson: she was the first person who came to work for me, in 1978, and she's a professor in her own right now (of marrow transplant biology).

"Steve O'Brien: I head-hunted him seven years ago, a major expert in chronic myloid leukaemia. And that's Peter Middleton, a molecular scientist. He's paid for by Catherine Cookson. You see, I'll do anything for money! In that office there is Colin McGuskin, professor of regenerative medicine, who wanted to come here because we'd created the cord blood bank.

"And we've got lots of talented young researchers - two Greeks, a Chinese, a German. It is a bit like putting together a football team. If you want people who are prepared to spend time doing full-time research you've got to look them out. My view is that you find the person and then make the job - and then create the optimum space for them to work in."

This is that space. Officially the Haematological Sciences and Leukaemia Research Unit, it was opened in 2004 by Prof Sir David Weatherall. It was paid for by the Tyneside Leukaemia Research Association (TLRA), the Newcastle Health Care Charity, the Newcastle upon Tyne Hospitals Trust and Prof Proctor's Marrow Transplant 2000 campaign (where people donate a small sum each month to sustain the research in the building).

Prof Proctor, whom I last interviewed - pre-2004 - in something akin to a broom cupboard, believes it cost about £2m, a lot of money but still low enough to have had counterparts in other parts of the country raising an eyebrow in envy and disbelief.

The unit is dedicated to research into adult blood cancers, for which it has become well known internationally. It will be some comfort to anyone newly diagnosed in the northern region that nowhere is better equipped to treat this particular type of illness effectively.

Prof Proctor, a Yorkshireman but a Newcastle University graduate, started work in the city in 1973 and spent the next five years developing an interest and expertise in the field of haematology. He moved into research and became a consultant in 1982, by which time he had determined to marshal the forces to tackle adult leukaemia and lymph gland cancer in the Northern region.

He was well equipped to do it, as he recalls. "I'd spent the 1970s seeing just about everybody in the region with difficult leukaemias myself, whether in Northumberland, Durham or Cumbria."

In 1983, when bone marrow transplantation was in its relative infancy, he returned from the United States determined to carry out the first such operation in the region. The chosen patient was a young man from Cumbria with "a very difficult, acute leukaemia".

"I was terrified at the time, going through it," he says candidly. But the patient made a full recovery and, Prof Proctor believes, has since emigrated to Australia.

Already he had initiated one of the most significant advances in treating adult blood cancers. It came out of a simple desire to go regional, to pool information from a wide area about patients and treatments. "In order that we didn't miss anybody we had to start a regional registry for leukaemia and lymph gland cancer.

"So I put in place from 1982 onwards what became a unique thing, a definitive register of all the cases of adult leukaemia and lymph gland cancer that existed in the region - funded by local charities."

The Scotland and Newcastle Lymphoma Group, a lymph gland cancer registry involving hospitals north of the border, had been set up three years earlier.

For 10 years information was collated and studied until Prof Proctor and his team were able to create a prognostic index, identifying patients most likely to respond to established treatments and those who needed more urgent attention.

A patient with a 50% chance of dying of Hodgkin's disease, he explains, would be more likely to accept the 5% risk of future susceptibility to leukaemia inherent in a more intensive form of treatment involving a greater number of different drugs.

Backed up by the data, he can demonstrate that the recovery rate from Hodgkin's disease in the Northern region is now 87%, up from 50-60% in 1980.

Hodgkin's disease accounts for 25% of lymph gland cancers but, thanks to the work done in Newcastle over a couple of decades, this is demonstrably the best region in the country in which to contract it - unthinkable though that prospect might be. "These days we've got Hodgkin's disease recovery rates about as good as I can get them in my career, so that's nice," says Prof Proctor.

But the fight goes on. Whereas in adolescents the recovery rate is over 90%, in the 60-plus age group it is not so good. Hence the establishment of the Shield Study (Shield: Study of Hodgkin's disease In the Elderly Lymphoma Database). Again, it might not have the glamour of a new treatment but Prof Proctor has demonstrated that in combating cancer you have to play the long game - and to win that game you have to gain the procedural upper hand. The internet has already proved an invaluable tool (check out www.shieldstudy.co.uk ).

Non-Hodgkin's lymphoma, which George Walker (founder of the North Proms) contracted and eventually succumbed to, is generally contracted by people over 65 and 60% of those with the severe forms will die. In this area Prof Proctor's team is also striving to draw up a prognostic index, "doing what I did for Hodgkin's disease in the 1980s".

Meanwhile new treatments come on the market, some of which will work for some people. Shortly Prof Proctor is going to Italy to talk about an agent called anti CD 30 which the Newcastle team has been involved in testing in clinical trials. Not a magic bullet, he stresses, but quite possibly another valuable option in the treatment armoury.

All this work, in the labs and on the wards, costs money. Prof Proctor needs to generate many thousands of pounds to sustain the work of his unit where only 25% of his staff have permanent funding.

It helps that he is well-known and well liked and is prepared to stand on the stage at Newcastle City Hall on Proms night and tell a funny story.

His commitment to his work is matched only by his commitment to the region. His whole career has been spent here and we have all benefited from that.

Continuity is essential, he argues, in sustaining the battle against any form of cancer. A current preoccupation is ensuring that the good work will be sustained after he has called it a day, though there's no sign that this is imminent (even if he does confess to being the proud owner of a bus pass).

The hard-won victories over 30 years have helped to attract the brightest brains to Newcastle and that is likely to be his finest legacy.

Prof Proctor's team receives £50,000 from each Proms concert for bone marrow and non-Hodgkin's lymphoma research.

His unit is an international leader in researching into the blood cancers Hodgkin's disease and non-Hodgkin's lymphoma and plans new research initiatives.

A new international research programme has been initiated in Newcastle using internet technology to tackle Hodgkin's disease in the elderly.

• The Marrow and Stem Cell Transplant Fund 2000: The Millennium Fund was set up to support research in these areas in the northern region. It invites individuals to donate £4 a month. Contact c.f.waugh@ncl.ac.uk

Prof Proctor's team in Newcastle will shortly publish data relating to Hodgkin's disease in adolescents and children which shows recovery rates equal to the best results published from North America and Germany.

Page 3: The stars of the show