Big data for small patients
Building “child-size” individual predictive models for life after childhood cancer
Side-effects are an unfortunate consequence of many cancer treatments. While novel therapies and techniques have improved the side-effects experienced by patients, there are still advances that will provide precision treatments that are better adapted to each patient. In radiotherapy (the use of radiation to kill cancer cells), new “big data” methods can establish which parts of organs are most susceptible to damage, so future treatment plans can avoid such regions to reduce side-effects.
Dr Marianne Aznar talks radiotherapy research and her Engineering and Physical Sciences Research Council (EPSRC) fellowship.
Radiotherapy is a powerful and very effective cancer treatment. However, side-effects can occur sometimes even decades after treatment. The job of a physicist in radiotherapy is to target radiation to the tumour, making sure that the right dose goes to the right place.
Dr Marianne Aznar
Background
With a comprehensive clinical background as an accredited Medical Physics Expert, and now a Senior Lecturer in Radiotherapy Physics at The University of Manchester and The Christie NHS Foundation Trust, Marianne has been granted an EPSRC fellowship*.
Her goal: To focus on the long-term side-effects of modern radiotherapy
“I’m French – like all young female scientists we grow in the shade of Marie Slodowska-Curie. I read lots of [her] biographies as a kid and suddenly I thought ‘Oh you can do Physics and Cancer!’ That led me to training as a medical physicist and working in a cancer centre.”
Through her clinical practice and early research career, Marianne noticed that there was a lot of effort in minimising the risk of side-effects and improving treatments, especially in vulnerable groups like children. However, she found those efforts were limited by a lack of understanding of exactly how radiation causes side-effects.
Marianne’s research
In the UK it is estimated that 80% of childhood cancer survivors have one or more chronic health conditions as a result of treatment-related toxicities.
With many children receiving radiation treatment as part of their cancer care, there is an associated risk of lasting side-effects such as learning problems and reduced growth that affect patient quality of life.
“The job of a physicist in radiotherapy is to target radiation to the tumour making sure that the right dose goes to the right place.”
Marianne stressed that modern radiation is an advanced, safe and effective treatment but even when using equipment such as the new Proton Beam Therapy machine in Manchester, which opened in 2018, there is associated risk of radiation hitting surrounding healthy organs, especially when they are in close proximity of the tumour.
“My first research project consisted of developing different ways of delivering radiotherapy and estimating through published models which way would lead to the lowest risk of side effects.
“Today, I’m trying to better understand and prevent the late effects of radiotherapy in children treated with radiation.”
Through vast data analysis of historical radiotherapy treatment data gathered at St Jude Children’s Research Hospital, Memphis, Tennessee and here in Manchester, Marianne will create a knowledge base that will inform the future planning of radiation treatments.
“One of the things that really attracted me to this fellowship is that for five years I can dedicate myself to it. That gives me a chance to focus and create some very strong links with St Jude Children’s research hospital who are world leaders for following their patients.”
Dr Marianne Aznar
The EPSRC Fellowship
When asked about her senior fellowship, Marianne replied: “It’s life changing – It’s difficult to convey how happy I am. This [research] has been living at the back of my head for ten years and now I can finally do it!”
Marianne’s five-year fellowship, ‘Big data for small patients – Building “child-size” individual predictive models for life after childhood cancer’, will ascertain which part of healthy organs are particularly damaged by radiation; namely, ‘the important regions’.
“One of the things that really attracted me to this fellowship is that for five years I can dedicate myself to it. That gives me a chance to focus and create some very strong links with St Jude Children’s research hospital who are world leaders for following their patients.”
“There’s been a lot of work on the late effects of radiotherapy, but it usually happens at a very macroscopic level. What I want to do with this fellowship is to bring it to a level of detail that we have never had before.”
It is hoped that in identifying ‘important regions’ radiotherapy professionals will be able to provide “smarter” radiotherapy plans, hence minimising side-effects in children.
“Another aspect of this research to find out how and when patients wish to be informed about side-effects so they can really be empowered and more informed and be in charge of their own health.”
Advice to EPSRC Fellowship applicants
“If I try to think back to when I was younger, the advice that I would give is: don’t wait around for the big idea.”
“I encourage more senior researchers to also apply for fellowships if they have a piece of work that has been sitting at the back of their mind for ages, but they never really had the chance to focus on it.”
*EPSRC fellowships support talented researchers to deliver research excellence, providing them with the flexibility and freedom to design a package that fits their research needs and career ambitions.
