The President of International Society of Paediatric Oncology (SIOP) and long-standing CCLG member, talks to us about her work.
Q: Tell us a little about your career...
A: My interest in childhood cancer was kindled as a junior doctor in Newcastle, working with Professors Alan Craft and Andy Pearson. Moving to Edinburgh, I undertook a PhD on Wilms tumour genes. This combined my interests in paediatrics and molecular biology and cemented my lifelong commitment to understanding why children develop cancers and how to treat them more effectively. I established a research group at The Institute of Cancer Research, finishing my clinical training in paediatric oncology at the Royal Marsden with Professor Ross Pinkerton.
In 2010, I moved to a new role to provide clinical leadership for transformation of cancer services for patients of all ages, uniting 11 Trusts in north London. My experience of international collaborative networking came in very useful, keeping the focus on improving whole pathways of care and outcomes that matter most to patients and families.
Q: How far have things come for childhood cancer treatment and care, and where do you see things going?
A: Survival rates have improved hugely over the last 20 years from 70% to nearly 85%. This is driven by more sophisticated use of existing treatments based on a child’s individual risk and stronger multi-disciplinary team working and international collaboration. The introduction of molecular biology into diagnosis, choice of treatment (type and strength) and the assessment of how well a child responds to their treatment have all had a big impact.
The identification of specific molecular drivers that enable the discovery of drugs with clearly defined targets has had - and will continue to have - a major impact on treatment options for different sub-types of childhood cancers. This should result in safer, kinder and more effective therapies for all cancers.
Early diagnosis is key to improving outcomes. Raising public and healthcare professional awareness and providing clear and quick routes for assessment of potential cancer cases are key to this. I expect that even prevention of certain childhood cancers may become possible in the next decade, with increasing knowledge of molecular drivers and their control pathways.
Q: What area of your work excites you most?
A: Measuring outcomes that matter to patients and understanding the reasons for variation. Data might not sound exciting but it underpins all the evidence on which we base our decisions. My current focus is on maximising what can be learned from reusing the existing information gathered from clinical trial databases for international benchmarking, and on collaborative work between population-based cancer registries (which collect information from people diagnosed with cancer who live within a defined geographic location). Around the world there are large differences in survival chances – some reasons are well understood while other variations are more subtle which need evaluating further.
I’m also excited by the potential to bring together data and information collected from cancer registries in the UK, Europe and beyond. It should become possible to evaluate children’s outcomes across their whole life, to discover if the treatment choices we recommend on their behalf today are the best ones for their adult life.
“Early diagnosis is key to improving outcomes. Raising public and healthcare professional awareness and providing clear routes for timely confirmation or exclusion of cancer are key to this”
Q: What is the proudest moment of your career?
A: I was incredibly humbled to be elected President of the International Society of Paediatric Oncology (SIOP) in October 2019, enabling me to represent the global paediatric haematologyoncology community in dialogue with the World Health Organisation (WHO) and many others, especially in response to the COVID-19 pandemic.
From Contact magazine issue 94 - Spring 2022
