BLOG: Some of the most valuable players in Men United, our movement for everyone who believes men are worth fighting for, are scientists who bridge the gap between the research lab and patients’ bedsides – the academic clinicians. They are experts who treat men in hospital but also investigate prostate cancer in the lab.
The reason we think they’re so important is that clinicians are in a good position to see what questions need answering – from spending time with patients. And research training puts you in a better position to know which questions are feasible to ask/answer.
But it's a long and difficult road to become an expert in both those areas. That’s why we’ve teamed up with the Academy of Medical Sciences to award Starter Grants for Clinical Lecturers, funded by the Movember Foundation. We want to help young clinicians specialising in prostate cancer to build up their academic reputation, setting them on the road to a career in clinical research.
In this guest blog we speak to Mr Alastair Lamb, a specialist registrar in Urology, working in the Cancer Research UK Cambridge Institute and Addenbrooke’s Hospital Alastair is our first Prostate Cancer UK – Academy of Medical Sciences Starter Grant holder.
Mr Alastair Lamb
Alastair: “Some people fall into scientific research almost by chance, others know right from the start of their medical training that they want to do laboratory based research too. I’d say that I fall somewhere between the two. I did my undergraduate and clinical medical training at the Universities of Oxford and Edinburgh and my surgical training at the University of Cambridge. They’re all very research-focused institutions and it’s hard to ignore the fact that medicine is fundamentally based on the outcomes of research.
“I started as a registrar at Addenbrooke’s Hospital in 2007, when I was also awarded an Academic Clinical Fellowship. The fellowship allowed me to put aside 25 per cent of my time for research. This gave me a chance to learn some laboratory skills and develop a proposal for a PhD alongside my medical training.
“I specialised in urology because urology covers four of the ten most common cancers. And I became especially interested in prostate cancer, in part because it’s the most common cancer in men. But on a more personal level, many of my father’s friends had had, or were undergoing treatment for prostate cancer. It became obvious that this affected many people close to me and, with one of the best prostate cancer research groups in the country here in Cambridge, it seemed the obvious area to apply myself.
“My own interest in basic science was nurtured throughout my clinical career. As NHS clinicians, we’re very much told what to do and when to do it – even at a senior level. Essentially we’re there to provide a service to our patients. That’s really important – I love it, and find it very satisfying. But there’s little time in there to stop and think or to ask questions and find answers. With basic science, you can really drill down into the disease process and find out the details of what’s going on. I really enjoy that contrast.
“I started out by asking some straightforward clinical questions, like ‘How often does superficial bladder cancer actually come back?’ I found it really exciting to ask a question, find the answer in the data, and then see the conclusions influence clinical practice (in other words, the way health professionals actually do things). Moving into basic research was really just a continuation of that. As clinicians, I think our direct interaction with our patients puts us in a really strong position to see exactly what questions need answering, and what will really make a difference to the men we work with within a reasonable timeframe.
“This isn’t without its challenges. You can’t commit 100 per cent of your time to either your scientific or clinical commitments – you have a foot in both camps – neither of which may completely understand what it is you’re trying to achieve. I’ve found that good communication with both sides is the key to overcoming this problem!
"Another challenge is that, as a surgeon, I have to be really, really good at what I do. So the challenge comes in finding the time to develop my surgical expertise, talk to my patients and deal with any concerns or complications and follow up – as well as committing to my research career.
“I finished my PhD in 2011, and then spent a year and a half working full time as a clinical registrar. This was really important for me because after three years in the lab, I wanted to devote some time to building up my competency and expertise in the operating theatre. I did this at Peterborough City Hospital, and found it really useful to get experience of a different hospital environment and a different way of working.
“In 2012, I came back to Addenbrooke’s as a Clinical Lecturer, and now my time is split about 50:50 between the lab and the hospital.
“I’ve recently been awarded a Prostate Cancer UK – Academy of Medical Sciences Starter Grant, which will allow me to complete the research I’ve been doing over the last couple of years in Professor David Neal’s lab.
"I’m aiming to analyse the molecular information in lots of different prostate cancer samples so I can classify them in groups according to how aggressive they are and what treatments they might respond to. This means looking at the DNA sequence that makes up the genes and at the proteins produced by the genes’ instructions. It also means looking at every step in between to see what might have changed between one man’s prostate cancer and the next.
"The overall aim is that one day, men with prostate cancer can be given the most appropriate treatment as soon as possible after they’re diagnosed. And that decision can be based on a solid understanding of the molecular make-up of their cancer.
“At the end of this grant, I plan to spend a year in a world-renowned teaching hospital in Melbourne, Australia developing my technique in robotic prostatectomy. When I return to the UK, I’ll apply for a Consultant position, specialising in prostate cancer surgery.
"At the same time, I’ll be using the work I’ve done during my Prostate Cancer UK – Academy of Medical Sciences Starter Grant as the basis of an application for a Clinician Scientist Fellowship. This would fund me to start my own small research group (hopefully under the umbrella of a larger team) so that I can forge an independent scientific career within the stability of an established research group. I’ll still be splitting my time between the hospital and the lab, but hopefully spending half a week in each.
“I fully expect that the time I spend with my patients and the issues I see them deal with will continue to influence my research. And I hope that, in time, I’ll see the results of my research start to benefit my patients in return. I’m honored to be part of Men United, and am looking forward to doing my bit for the team!”