The Purvis Society was delighted to welcome Dr Julia Chisholm, Consultant Paediatric Oncologist at the Royal Marsden and Trustee of CLIC Sargent, to speak at the fourth of this term’s Sixth Form Purvis Society meetings.

Speaking to a large audience, Dr Chisholm began by giving an overview of her talk by projecting a series of though-provoking questions: “What is cancer?”; “How common is teenage cancer?”; “What kinds of cancer do teenagers get?”; “What are the risk factors?”; “How is cancer treated?”; “Trends in survival”; “How can we support young people with cancer?” and finishing with “The challenges of working with teenagers with cancer”.

Acknowledging that relatively few of her audience had more than a vague grasp of the principles at stake, sheJulia Chisholm defined this condition as “a malignant tumour or growth of body tissue that tends to spread and may recur if removed”. Illustrating the point with some photographs of young patients, she expanded on the definition by talking briefly about her own area of specialism, rhabdomyosarcoma: a cancer derived from skeletal muscle, and amongst the commonest of teenage cancers. The genetic basis of some sorts of cancer was examined before she invited the audience to tell her of the four most common cancers occurring in the UK, with the depressing suggestion that over 330,000 new cases are diagnosed each year. Reassuringly to our young audience, teenage cancer is relatively rare, although it is the commonest disease-related cause of death with a cumulative risk of contracting some sort of cancer being as high (or low…) as 1 in 285. Risk factors were discussed: age and gender (older males are more susceptible); previous history of cancer; family history; UV radiation and infections (the HPV and associated immunization programme was mentioned here). On the basis of Dr Chisholm’s experience, a sincere appeal to everyone not to forget their sunblock could hardly be ignored! Reassuring us once again, she told us that the five-year survival rate from the approximately 2,000 cases of various cancers diagnosed in this age group per year is nearly 85%, so it is not all doom and gloom. Expanding on her theme of age-related illness, and using some brilliant schematics, she clearly illustrated the shift in disease types from those of very young children through the teenage years and on into adulthood, showing us, for instance that leukaemia and lymphomas declined in frequency whilst carcinomas massively increased.

Treatment, Dr Chishom told us, was now extremely varied and immensely complex and had moved a long way from the old idea of “cut it out”! Radiotherapy, chemotherapy and targeted therapies (precision medicine) have been brought in with conspicuous success. Clinical trials were discussed (an area of particular interest to her) with the clear statement that these were vital in the development of new therapies, and clearly she felt these should be available to all, although there are a few stumbling blocks.

Bringing her fascinating talk to a close, Dr Chisholm expanded on the national Teenage and Young Adult Agenda, emphasising and illustrating the holistic approach which she feels is so vital, and illustrating her point with some age-specific aspects of cancer sufferers’ support (including pictures of hospital rooms whose colour schemes were designed by the patients themselves). She gave us some feedback gleaned from young people undergoing treatment, amongst which, and amusing to me, was the suggestion that cleaners did not surface on the ward before 10.00 am and that “staff talking about personal stuff is very annoying”! Leaving us to reflect on this, she concluded by acknowledging the crucial role that cancer charities have played in the past and which they must continue to play in the future.

Dr Christopher Mann