The Future Fertility Trust teamed up with Applican and offered a Medicine Insight Day to students across the UK as a way to get young people across the UK involved in the programme's scientific research. As a 5th year medical student and founder of Applican, I am really passionate about engaging students in stuff that interests them, gets them buzzing about medical science and inspires them for their applications. We have now uploaded the videos from the Insight Day to YouTube so students who missed out on the day can see them. You can find them here:
And here is some information to accompany the talks:
Talk 1: Expanding on Biology
The biology talk looked at AS Level cell division. Most textbooks will give you some more information but our talk focused on the cell checkpoints which have an essential role in cell division at assessing the integrity of the DNA and whether it is good enough to be passed on to the next stage of cell division. It is worth looking through the cycle of cell division and making sure you understand each aspect of the process with respect to cell division. This links into the checkpoints and understanding the role of cyclins and CDKs in creating downstream pathways: this is a series of reactions (like a domino effect) that result in an effect: in the case of the cell cycle, moving on to the next phase. We then link this to cancer biology and understanding how the cells work. Normal cells require growth factors to stimulate their replication. However, experiments show cancer cells will continue to replicate without growth factors. Similarly, normal cells will be inhibited by contact with other cells but it is shown that this does not occur in cancer cells. In other words, cancer cells are uncontrolled growth. Even so, scientists are understanding that within certain cancers, certain faults are driving the uncontrolled growth. For example, a cell which has a mutation in the receptor to the growth factor means that the series of downstream reactions leading to uncontrolled growth keep occurring even in the absence of the growth factors themselves. This means that with certain cancers, we can target them with drugs that block this from happening by targeting, in this case, the receptor that is problematic. We used Herceptin (Trastuzumab) as an example of this. We then discussed how this could extend to interview discussions and how it is important to understand the issue of funding with monoclonal antibodies, hormonal therapy, immunotherapy: also known as targeted therapies. You can expand on this with the help of a number of online resources found on Youtube, Khan Academy, the Applican blog and more.
Expanding on Chemistry
The chemistry talk looked at the organic chemistry you will cover in AS/IB. We looked at chemotherapy and highlighted that it can be used as adjuvant treatment (to cure cancer) but it can also be used to relieve the symptoms and extend life in cancers that cannot be completely cured. We discussed how chemotherapy can be used before surgery to shrink tumours and can be used in either a mono/combo therapy approach. This looks at how to use different chemotherapy drugs along with our other cancer-treating techniques like surgery, radiotherapy and the targeted therapies we discussed in the last talk to attack cancer cells and preventing them from mutating to become resistant to the form of chemotherapy given. We also looked into where chemotherapy came from. It is always interesting to understand the history behind some of medicine and this can apply to many topics. It is interesting to consider how a lot of successful drugs were found as remedies for certain conditions by accident. Thinking about chemistry, it is important to understand the chemistry regarding alkylating agents and also thinking about stereoisomerism: in particular cis/trans or E/Z stereoisomerism. Cisplatin is an example were the effective from of this molecule for treating cancer is the cis stereoisomerism. Thinking about how alkylating drugs work, there are classical alkylating agents )e.g. cyclophosphamide) which work by binding to the alkyl group of the guanine (G) bases in the DNA and crosslink them. Alkylating agents (e.g. cisplatin) do not have an alkyl group and instead work by affecting DNA repair - linking in to the previous talk. However, it is very important to note how if we target actively dividing cells with chemotherapy we can get a lot of side effects: some of which are well known like hair loss, GI upset (nausea, vomiting, diarrhoea), but some less known such as infertility.
Expanding on Physics
The physics talk focused on radiotherapy as the remaining form of treatment that had not been greatly discussed. Radiotherapy works by damaging the DNA of the cancer cells and destroying their ability to replicate. Radiotherapy will affect both the cancerous cells and the healthy cells; but the healthy cells can repair the damage but because the cancerous cells have faulty checkpoints, the cancer cells are less good at repairing themselves and die. It is important to get the right ‘level’ of radiotherapy to kill cancer cells but only damage healthy cells to a point where they can still repair. This dosage process is called fractionation: and works on the principle of ‘little and often’ in order to allow healthy tissues to repair and regenerate. Radiotherapy can be used to cure cancer, generally not on its own. Often radiotherapy is used after surgery to kill of any residual cells or it can be used in combination with chemotherapy. However, radiotherapy can also be very useful in palliative care for cancer patients as it can receive symptoms greatly - particularly the symptom of bone pain that can occur when cancer spreads to the bone. The order of treatment is also important to discuss. Whether radiotherapy is given before or after surgery is important, for example, in cervical cancer where if a patient is going to need radiotherapy, they do this before/instead of surgery as surgery would weaken healthy tissues and cause the radiotherapy to be less effective. It is important to note that radiotherapy is painless but can cause side effects by damaging healthy cells. The most common side effect is the skin problems people encounter. However, another important side effect from total body irradiation, given before a bone marrow transport, is infertility. In the talk, we also touched on the different types of radiotherapy - this is beyond the knowledge you would be expected but you can read up more by researching online including Youtube, Khan Academy, the Applican blog and many more!
Research spotlight: Ovarian Cryopreservation
The three talks on the science subjects were designed to give you an introduction to Ovarian Cryopreservation - they key topic we wanted to discuss during our Insight Day.
Some deeper information: Scientific Papers
We wanted to provide you with some papers you could have a look at. Be aware that these are ‘high brow’ and you would not be expected to know this level of knowledge at all but we just thought it might be interesting after hearing the talks.
Fertility Preservation: A Key Survivorship Issue for Young Women with Cancer; published in Frontiers in Oncology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843761/
This paper talks about the various methods of fertility preservation in young females with cancer, it also discusses the effects of chemotherapy, radiotherapy and surgery on fertility and the importance of understanding fertility preservation as a key issue in the treatment plan of young females with cancer.
Ovarian tissue cryopreservation and transplantation: scientific implications: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5171890/
This paper talks about the scientific techniques involved and is far higher in detail of the science for those interested in a deeper understanding of the evidence and techniques behind the work
86 successful births and 9 ongoing pregnancies worldwide in women transplanted with frozen-thawed ovarian tissue: https://link.springer.com/article/10.1007/s10815-016-0843-9
This paper demonstrates the success of the techniques in almost 100 pregnancies and deliveries across the world.
Relating this to your application: Our #smash500 fundraising challenge!
Actions always speak louder than words. Thinking about the Applican model for personal statements: think about ‘what did you do about it?’. If you really are ‘passionate’ about something, your actions will show and prove it to the person interviewing you. Fundraising for a cause that means something to you is a great way to become even more passionate about the science and medicine at the heart of the cause. This project is special because it is cutting edge research but you can see how every £500 raised makes a huge difference. It also touches on some of the very real and challenging aspects of healthcare in terms of funding within the NHS. Together, this project would be a brilliant one to discuss at interview and fundraising for the Future Fertility Trust will show how much learning about it meant to you. It would be wonderful to have your support and we are here to support you in any way that we can. Even better, together, schools across the country can make this happen. Check out our campaign https://www.justgiving.com/campaigns/charity/oxfordradcliffe/futurefertility and set up your own JustGiving page for your upcoming event by clicking the orange ‘Start Fundraising’ button!