One of Oxford’s leading breast cancer specialists is stepping down from clinical work, after working in the city for nearly 30 years, but will continue his research activities, which, with the support of NIHR Oxford BRC, have seen big advances in recent years.
Prof Adrian Harris has been the Cancer Research UK Professor of Medical Oncology at the University of Oxford since 1988 and is a Consultant Medical Oncologist at the Oxford University Hospitals NHS Trust, based at the Churchill Hospital.
Although he is retiring from clinical work, Prof Harris will continue to carry out research into breast cancer, and remain the Director of the Molecular Oncology Laboratory at the University.
“It’s been a very happy and productive time,” he says. “One of the things I’ve liked about working in cancer was that you could do state-of-the-art science and state-of-the-art care and look after people long-term.
“I’ve been lucky to have such excellent staff. Oxford is a great environment to work in. Even though the living costs are high, we get top calibre people across the board. People believe in what they are doing.”
When Prof Harris first came to Oxford, the Churchill was a very different place: “The famous Nissen huts were still here, and there was nowhere for me to sit, so we got two second-hand portacabins, which was my workspace for three years as the new cancer unit was built.”
He has received support from Cancer Research UK since 1989. In that time, the charity has provided more than £50 million. He is also grateful for the support he has received over the years from a local cancer charity, Friends of Kennington Cancer Fund, who have raised over £350,000 for his research.
Adrian worked with the Imperial Cancer Research Fund as they helped to establish the Weatherall Institute of Molecular Medicine and create a new clinical oncology unit in 1992. He played a key role in the design of the unit, ensuring that patient were able to have a view of the outside world.
Prof Harris also played a central role in the creation of the Churchill’s new state-of-the-art cancer centre, a place where researchers and clinical staff would work together, where patients could get all their care and treatment under one roof, and now home to the country’s second largest phase one cancer clinical trials unit.
“It was always my ambition that university and NHS employees – consultants, pharmacists, nurses, research fellows – should be together in the same place, so when the new cancer service was built, I made a deal to swap the space I was in for an equal space and Cancer Research strongly supported that,” he explains.
“Because it’s a shared facility, we know each other better, and the NHS works more closely with the University. Obviously it’s easier if you have excellent facilities. And instead of meeting people once a week, we can see each other every day or so, for example if you have any difficult issues.
“So from the patient’s point of view, the information is transmitted much more rapidly, referrals are much quicker.”
A significant aspect of the new cancer centre was the bringing together of medical and clinical oncology teams, he says: “Back then, academic radiation oncology was not really around in the UK, so Cancer Research UK and the Medical Research Council decided to build a radiation institute. In 2010, we decided to join the two teams together and become an integrated department. That’s how the health service works to give the best care and it seems that academic work should follow that pattern.
“It was the first time in the country you had medical and clinical oncology in the same department and I think that’s worked very well.”
Adrian has seen many scientific advances since he began his career, but the most significant, he says has been in “patients’ rights: how you talk to patients, patient privacy, not having hordes of medical students discussing around you. When I was a medical student, it was like ‘Doctor in the House’”.
“These improvements to training, culture and organisation have made a big difference.”
Although giving up his clinical work, Adrian is continuing his research.
When he first came to Oxford, he worked on the new endocrine therapy for breast cancer, before switching to working on the growth factors that make cancers grow, in particular that sub-group of cancers that grow more quickly due to an abnormal blood supply and are resistant to therapy.
He says he has witnessed enormous changes in the way cancer is treated – and huge advances in survival rates – in large part due to our improved understanding of the disease: “When I started there was one sort breast cancer; now there are 5 kinds of breast cancer and each has a different treatment and that leads to more personalised treatment.”
“Radiotherapy has changed beyond all recognition; you can give higher and higher amounts to smaller and smaller areas, so it kills more cancer cells with less toxicity. It’s a very effective treatment. And that’s important because, although 80% of patients die from metastasis – that is, when cancer spreads to other areas – 20% die because it comes back in the area it started.
“Then there are the drugs, which have made a massive difference across the board, though particularly in breast and colon cancer, and now with melanoma. Treating cancer after it’s diagnosed and after the surgeons have removed the tumour, and when you know there’s a chance there might be tiny metastasis around – if you give drugs immediately after the surgery, you can actually improve the outcome five, 10, 15 years later.”
Leading the World
He says there have also been great strides in treating cancers using hormone therapy, immunotherapy and anti-blood vessel therapy. “All of these have come out of scientific advances, many made in Oxford, that are then applied in the clinic.
Looking forward to what breakthroughs we can expect in cancer treatments in the coming years, he says that as well as new drug development and radiotherapy, fields in which Oxford is a major centre, there is a “big focus in Oxford on immunotherapy, because we have several research groups leading the world on immunological aspects of disease”.
Adrian has left a legacy, not just in the patients he has treated, but in the people he has taught. Clinicians who did their PhDs under him are now running the clinical service for breast cancer, so he is looking forward to supporting their clinical trials with his research in the labs.
Over the years, Prof Harris has met and treated many interesting and famous patients. One that sticks in his mind is the renowned sculptor Franta Belski, who donated the bust of Churchill which now overlooks the head and neck cancer unit at the Churchill Hospital, because he was a patient when it was the medical oncology unit.
“It’s 50 years since I went to medical school, so I’ve seen a lot. Although people run down the NHS, it has been a fantastic system. Considering how I started in a portakabin and had three consultants at the time and now there are 50 consultants doing cancer work in the city, there’s been a massive investment and it’s been great to see the benefits of that in the UK and here in Oxford. And a lot of that has been done through trials that I’ve participated in over the years.”