Every year at the Symposium and Awards Luncheon, BCRF recognizes one researcher’s groundbreaking contributions in their field with the Jill Rose Award for Scientific Excellence. At this year’s event on October 14, we are proud to honor Professor Dame Lesley Fallowfield.
Dame Lesley has been a BCRF Investigator since 2016 and is one of the world’s foremost experts in psycho-oncology, quality of life, and survivorship.
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Here is a shortened excerpt from her recent interview on BCRF’s podcast, Investigating Breast Cancer:
I use to be a visual scientist. I was developing ways to measure the integrity of the optic nerve in patients who’d got demyelinating diseases like multiple sclerosis when they started having all sorts of strange visual problems that clinicians couldn’t measure with standard clinical tests. So, I developed some new methods to measure the things that patients were complaining about.
During this time, a very close friend developed acute myeloid leukemia at 34-years old. She had one of the first bone marrow transplants and sadly died of graft-versus-host disease. When she was in hospital suffering the appalling sort of problems that you experience with that, she looked up at me and she said, “You’re meant to be so clever. Why don’t you measure something important?”
I said, “What do you mean?” And she said, “Well, why do people do things like this to you without really telling you what could happen? Why can’t you measure the many serious side effects of these treatments?” She died about two weeks later.
I thought very long and hard about that conversation and coincidentally read an article by a breast cancer surgeon saying that he thought the psychological aspects of breast cancer were poorly understood. So, I just phoned him up and said, “Give me a job.” He replied, “Well, you don’t know anything about cancer.” I responded saying, “So teach me. I know how to measure difficult things that people think you can’t measure, and I’ll find someone in the world who’ll give me a job doing just that because I promised my friend.”
Essentially, psycho-oncology looks at the social, behavioral, and psychological aspects of cancer care. It can encompass anything from support for patients and educational training of healthcare professionals who deal with cancer patients, to looking at ways to measure quality of life in big clinical cancer trials.
In 1984, if you performed a literature search, you’d probably come up with about two or three papers that actually mentioned phrases like “quality of life.” It’s been a long, hard road to actually get to the stage now where people accept that it is important. We’ve seen some incredible therapeutic advances in new and different treatments since then that means that many patients have a realistic prospect of cure or living much longer with their disease and hopefully living well. But nothing comes without a cost. It’s so important to be absolutely clear about what a therapy’s toxicities and downsides are—not to stop giving it to people, but so that we can work out ameliorative interventions upfront to help patients cope with side effects. We’re very focused on survival benefits, but we’ve got to do even more about the quality of that precious extra time.
BCRF have funded some of our research on education around discussing de-escalating treatment. Which means not giving patients treatments that really have little prospect of adding anything to their cure or long-term survival. We know from many different studies for example that not all women with early breast cancer need or should indeed even have chemotherapy. There are certain types of breast cancer that are treated well enough by surgery, radiotherapy, and endocrine treatment (hormone treatments). But, of course, it’s quite difficult to explain to a patient that we don’t always need to give them all the things that they might be expecting to perhaps give them a better outcome. And so, there are these wonderful new tests called gene expression profiling tests, which help determine whether a patient is at low, intermediate, or high risk of the cancer recurring. So if the patient is at high risk they should be offered chemo, but there’s a bigger question about the intermediate and low-risk patients who probably are happier, and better off not having the chemotherapy for little or no benefit.
I am deeply honored to be receiving this truly prestigious award in memory of Jill Rose. It is especially humbling when I look at the list of previous awardees. I hope that she would have appreciated the multidisciplinary research contributions that we have all made.
BCRF frees myself and other grantees from the many bureaucratic hurdles that surround most grant applications. It enables us to fulfill Evelyn Lauder and Larry Norton’s vision of creating a group of scientists who could think big and initiate novel research that genuinely moves things forward. My team and I are so grateful to the donors and supporters for providing us with this seed-corn funding which would be difficult to obtain elsewhere. Thanks to some of our recent BCRF grants, we have been able to develop, run and evaluate some novel educational programs that help healthcare professionals to explain the complexity of modern breast cancer tests and treatments, permitting patients to make more informed choices. These materials are then made freely available to facilitators throughout the world.
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