Spotlight on the Experts

Dr Pippa Corrie

Dr Corrie qualified in medicine at Oxford in 1989, having previously obtained a PhD studying the mechanism of action of platinum anticancer drugs. On completing general medicine training in Birmingham, the challenges faced in treating and researching cancer proved irresistible and she became CRC Research fellow in the newly established CRC Institute for Cancer Studies there. She was well trained in the conduct of clinical trials, while developing a basic research interest in the regulation of tumour invasion. In 1996, she took up a consultant appointment at Addenbrooke's hospital, Cambridge. Then a rather dormant department, it has since been transformed into a major UK Cancer Centre and her contribution has been to set up a highly active cancer trials office, with staff supporting 20 consultant oncologists in running over 40 phase I-III trials in all tumour types. She is now an Associate Lecturer in the University of Cambridge and Lead Clinician for the West Anglia Cancer Research Network. Her clinical interests are GI, hepatobiliary and pancreatic cancers and melanoma. She is part of a local research collaboration developing novel therapeutics targeting regulators of tumour invasion. Work is combined with family life involving husband, cat and 2 delightful children!

Question and Answer Session

I took an opportunity to undertake some scientific study which involved a module of cancer lectures at the Royal Marsden and a period of laboratory-based research. I became involved in a project to identify how the then new platinum-based anticancer drugs worked and was fascinated by the field of drug discovery.

I returned to complete my clinical medicine training and was constantly drawn to patients with terminal illness, most of whom had one or other form of cancer. I enjoyed the depth of relationship that was built between patients, their families and the clinicians, based, I guess, on such vulnerability and the need to trust implicitly. As I learned more about the field of medical oncology, the potential to work with people and families dealing with such serious, life changing illnesses while also being intimately involved in active research to understand the causes of cancer in order to discover effective treatments for as yet incurable conditions was irrisistable. I have not been disappointed by my choice of career over the years.

Why did you specialise in pancreatic disease?
I have always had a soft spot for the underdog in all aspects of life. Equally, I enjoy a challenge. Most of the tumour types I manage have extremely poor prognosis and few active treatments available for them: excellent fodder for new research and potential for change. I am also concerned that pancreatic cancer patients don't shout very loudly about their illnesses and in a time where public pressure influences political and funding decisions (take for example, the breast cancer lobby, led largely by middle class, articulate women), I want to help this group shout a bit more loudly for help and resources.

What motivated you to develop an active trials office?
I understood early on in my training the ethical imperative to evaluate new treatments in a rigorous scientific manner if they are to be at all meaningful to society. Anecdotes and optimism won't do. I was very grateful to be well schooled in the Birmingham CRC Clinical Trials Unit regarding the formal conduct of clinical trials. When I took up a consultant post at Cambridge, I was amazed to find that an equivalent clinical trials office did not exist. Somebody had to put the matter right!

What has given you most satisfaction in your career?
In honesty, finding a wonderful man to marry since moving to Cambridge, now 7 years ago, having children and being able to combine a very happy family life with such a challenging profession.

What has caused most frustration?
Oh golly - too many things! Probably the time it takes to do anything, due to so many hindrances such as lack of money, narrow-mindedness of individuals and ever-increasing administrative hoops.

Where do you see the advances coming in the field of pancreatic cancer oncology?
I think we need to better understand the mechanisms which cause this devastating disease to occur. Prevention is always better than cure and early detection and identification of those at risk will be far more powerful than anything I can do as an oncologist. I think we are a way off achieving this goal though.

Where do you see the advances coming in the treatment of the disease in general?
There are a bunch of new biological agents which are now being introduced into clinical practice. These are targeted treatments based upon our scientific knowledge of why the cancer has occurred and hence far more likely to impact on disease than conventional cytotoxic chemotherapy drugs. My hope is that the selectivity of these new biologicals will allow them to be safely used in patients with earlier stages of disease, to control cancer much in the same way that insulin controls diabetes. They may yet prove to be effective preventative agents too.

What changes would you make to current management of pancreatic cancer that would have most impact on outcomes for patients?
Drug treatment is icing-on-the-cake stuff, really. The key problem with this cancer is late stage of presentation. We need to do everything we can to raise awareness with the public, GPs and general physicians to be thinking of this disease early on and refer patients to specialist centres while the tumour is still in its infancy and potentially operable. I mentioned earlier that prevention is better than cure. There are 2 well established 'life style' risk factors for this disease: smoking and excess alcohol consumption. Though many cancer patients will develop their condition out of sheer chance, I cannot stress enough the importance of getting the message over to the public that their lives are in their own hands, to an extent.

Why are you keen to help Pancreatic Cancer UK?
For all the reasons already alluded to above - to help raise awareness of the 5th commonest cause of cancer death in this country, to encourage active research in this disease. I believe that public pressure today is probably far more influential than the medical profession in determining resource allocation at least at government level. I am also very keen to learn more about the lay public's view of cancer and medicine. Perhaps I might be a more compassionate, more helpful and useful doctor by understanding better the viewpoints of patients and their families and what is most important to them in their time of need.

last updated 8th March 2004