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Cancer affects one out of every two people in the UK during their lifetime. The stage at which cancer is diagnosed has a profound impact on prognosis—those identified at stages 1 and 2 have a better chance of survival than those detected later. Some cancers, however, remain difficult to diagnose early. For example, 62% of oral cancer cases are identified only at stages 3 and 4 as a result of ineffective detection methods or the inability to apply them at scale.

Researchers at the University �鶹��ѡ are pioneering new diagnostic and therapeutic approaches to enhance cancer detection and treatment, providing patients with more precise and less invasive alternatives that improve prognoses while minimising suffering. Cutting-edge facilities are accelerating the translation of novel methods to clinical practice. 

Advancing oral cancer detection with saliva-based testing

Ruchi Gupta, an Associate Professor in Biosensing at the University �鶹��ѡ, has sought more efficient, less invasive techniques to detect oral cancer. Current diagnostic approaches rely on painful and invasive biopsies, often requiring multiple procedures depending. At a time when the NHS is struggling to diagnose and treat cancers quickly enough, there is a pressing need for more effective and efficient technologies.

“We wanted to explore whether saliva proteins could provide an effective means of detecting potential oral cancer, which may be confirmed by biopsies,” Gupta explained. Although saliva contains many proteins, those relevant to cancer detection exist in very low concentrations. To address this, Gupta and her team developed a hydrogel lollipop that patients can suck on, permanently capturing proteins and increasing their concentration over time. “After releasing the proteins from the gel, as part of the release process, they are also labelled with a fluorophore to selectively detect the key biomarkers,” she said.

Having established the proof of principle, Gupta and her team shifted to exploring more biocompatible materials to limit potential negative toxicity or reactions in patients. They have also improved the quality of measurement by eliminating other proteins from entering the gel. “For each molecule of interest, there are ten million other molecules we don’t want to measure. It’s like a soup and we only want to measure something very small.” The team will focus over the coming 18 months on testing the technology using ex-vivo saliva samples with a view to developing prototypes suited to human trials.

The underlying hydrogel technology can potentially measure any protein biomarker in body fluids, including saliva, urine, tears and serum given the large number of protein biomarkers approved by regulators for cancers including prostate, breast, ovarian and bladder. “Potentially, the technology can be used to measure any of these biomarkers,” says Gupta. It could also apply to infectious diseases which may currently require uncomfortable procedures like the nasal swabs used during the Covid-19 pandemic.  

Harnessing radiotherapy for more effective cancer treatment

More than half of all cancer patients undergo radiotherapy, either as a standalone treatment or alongside surgery and/or chemotherapy to shrink tumours and ultimately eliminate residual cancer cells. After surgery, radiotherapy stands as the most effective curative cancer treatment. By improving its precision and effectiveness, researchers can significantly enhance survival rates.

Typically, radiotherapy uses high-powered X-rays to bombard cancer cells, damaging their DNA beyond repair and causing them to die. However, this treatment often lacks specificity, leading to collateral damage in surrounding healthy tissues and organs at risk, causing acute and long-term adverse side effects.

To counter this, researchers at the University �鶹��ѡ are utilising proton beam therapy, a targeted radiation approach that spares healthy tissues. “Protons generally function similarly to X-rays but more specifically target the tumour cells,” explained Professor Jason Parsons, a Professor of Radiobiology in the Department of Cancer and Genomic Sciences. His team is investigating how proton therapy, in combination with specific drugs, can maximise treatment effectiveness.

Collaborating with AstraZeneca, they are testing specific drugs that inhibit DNA repair that can enhance the effects of proton therapy. However, the technique has limitations. “Protons cannot effectively treat deep-seated tumours, like some developed in the lungs. Their primary use has been for paediatric cancers, adult head and neck cancers, and brain tumours,” Parsons noted.

Parsons’ team is also exploring helium ions as a potential alternative to protons. The University �鶹��ѡ’s MC-40 cyclotron, in addition to protons, can generate helium ions to target cancer cells. “Helium ions are more densely ionising, meaning they generate more localised damage to DNA in tumour cells, which improves treatment response,” Parsons said.

Although helium ion therapy is not yet available in clinical practice, it presents a promising alternative to proton therapy by delivering more effective radiation doses directly to tumours while reducing radiation exposure to surrounding healthy tissues and organs at risk. If further research confirms its potential, helium ion therapy could revolutionise cancer treatment by making radiotherapy even more precise and effective.

Innovating with Boron Neutron Capture Therapy (BNCT)

For aggressive cancers such as glioblastomas and some head and neck cancers, treatment options remain limited, and survival rates are poor. Recognising the urgent need for better therapies, Parsons and his team are developing boron neutron capture therapy (BNCT), an advanced radiation technique. BNCT is clinically approved for the treatment of head and neck cancers in Japan, and is gaining traction in other countries such as China and Taiwan.

BNCT involves infusing patients with a tumour-targeted boron compound, which, when exposed to neutrons, breaks down and releases highly reactive particles that destroy the tumour cells. “BNCT causes extensive, localised damage specifically to tumours, and since cancer cells struggle to repair this damage, they ultimately die,” Parsons explained. This method proves significantly more biologically effective than traditional X-ray therapy and holds promise for recurrent and radiation-resistant tumours.

To improve BNCT’s effectiveness, Parsons’ team is analysing strategies to optimise boron uptake by cancer cells. The current clinical strategy involves attaching boron to the amino acid phenylalanine, called BPA, which tumour cells absorb preferentially through the LAT-1 amino acid transporter. “LAT-1 is over-expressed in cancers, such as those of the head, neck, and brain, making this a highly targeted approach,” Parsons said. By further refining boron uptake, BNCT could emerge as a viable option for patients with limited treatment alternatives.

The University �鶹��ѡ houses the UK’s only neutron accelerator, making it uniquely positioned to conduct BNCT research. “We recognise that some patients require more optimal radiotherapy treatments, and we believe BNCT can provide this. However, to establish a clinical BNCT centre in the UK, we need robust scientific evidence,” Parsons said. “Birmingham is a fantastic hub for cancer research, and we are now a . We have state-of-the-art equipment, accelerators, and strong partnerships with fundamental biologists, physicists and clinicians —everything we need to push the boundaries of cancer treatment,” he said.