Metaphors and concepts (6)

This, my final post in the mini-series about the concepts and metaphors that I’ve drawn from my initial research conversations, deals with metaphors at their most metaphorical. These particular examples are not part of the standard scientific way of talking about something. Signalling or pathways, for example, are no longer really seen as particularly metaphorical but are part of the standard scientific language, even though when you stop to look they are clearly metaphorical in origin. The examples here, however, are drawn from more distant ideas to try to express something which otherwise seems out of reach. This can be especially true when trying to convey some concepts to those (like me) who don’t specialise in this area of science.

“Cell graveyard“

In the hypoxic conditions in the middle of a dense tumour, the majority of cancer cells will die, leaving alive only those with TP53 (or similar) mutations which allow them to continue to survive and multiply. The centre of the tumour is therefore akin to a mass grave for those cells which are not destined to become truly intransigent.

“Launchpad / lift off“

The point at which a cell can emerge from the tumour, going through a process called EMT that allows them to move more freely and spread around the body. This launchpad signals the beginnings of metastasis, beyond which most cancers become a very different proposition for treatment.

“Wings“

The metaphorical effect of passing through the bottleneck of hypoxia and the cell graveyard is to gain wings and achieve lift off.

“Black Swan“

A cancer cell that has achieved wings and lift off….

How does all this relate to the London Cancer Hub?

These ideas are incredibly evocative and loaded with emotional as well as conceptual content. As such. they were ideas that i was immediately drawn to explore. and indeed my first thought in the studio was to start creating a winged object. That may have been in part because I have recently discovered a way to make winged object using a new technique and so it’s rat the top of my mind, but also because there is something very poignant about the idea that something gaining wings and lifting off could have such a devastating impact on the prognosis of someone’s disease.

So how does that relate to the LCH? I am drawn to thinking of both a black swan and a white swan. With cancer, the appearance of a black swan is the point at which the disease very likely becomes unstoppable for a particular individual. I like to think, romantically perhaps, that an equivalent white swan can emerge that will make the combined strength of all the players at the London Cancer Hub unstoppable in the future in their effort to prevent and treat cancer. Despite the prevalence of cancer, one of the many things I have learned over the last few months is the level of the selective and adaptive forces required to create the ‘wings’ in a cancer that make it indestructible. I imagine the effort, resources and energy required to create a white swan will be similarly significant.

Metaphors and concepts (5)

I have saved some of the ideas that have proved to be at the heart of my creative research for the latest batch of concepts to emerge from the conversations and research into the cancer ecosystem. And following on from this post I will start to share some of the creative and visual ideas i have been working on – but without posting these concepts first, they would make much less sense. So here goes!

“Hypoxia“

A state of insufficient oxygen. This can happen at the centre of a tumour when the blood vessels do not penetrate to the centre of the tumour, and tends to start happening once the tumour gets to around 1cm. In medical convention, fully oxygenated blood is represented by the colour red, less oxygenated by blue (thinks arteries versus veins). Severely hypoxia tends to be represented by dark blue or black.

In the middle of a tumour the environment for cells is often both hypoxic and toxic – cells that survive these conditions are preselected to be tough, resistent, intransigent.

“Angiogenesis“

The process by which new blood vessels form from existing blood vessels. This is initiated through cells signalling that they are becoming hypoxic. Cells in cancer tumours send lots of these signals and new blood vessels then begin to grow around and into the tumour to try and bring oxygen to the hypoxic cells. The blood vessel growth can be very disordered and excessive as compared with normal vessel growth. The Childhood Leukaemia team shared this image with me of blood vessels from a tumour.

“Mosaic Vessels“

Occasionally blood vessels that grow in cancer tumours as part of angiogenesis include tumour cells as part of the blood vessel structure itself, so that ‘normal’ epithelial cells and abnormal cancer cells form the wall of the blood vessel together. These are mosaic vessels.

“Morisita Index”

The Morisita Index is drawn from statistical study of populations and is a measure within a population of how mixed up or separate the different elements of a population is. In relation to the cancer ecosystem, it measures the degree to which different types of cells – eg epithelial cells, immune cells, tumour cells – are aggregated or segregated. As well as being applied to the nature of different tumours, the index can also be applied to human populations, for example, in a working environment, to express how combined or segregated they are.

“Liquid Tumours“

I have always thought of cancer tumours as something solid. Some hard and unyielding, some softer or floppier, but I had not really considered that tumours could be liquid. Whereas, solid tumours are indeed solid and lumpy, liquid tumours, eg leukaemias and lymphatic tumours, flow.

How all this relates to the London Cancer Hub?

In some ways the easiest concept to apply directly to the LCH is the Morisita Index. In fact, in conversation with one of the researchers who introduced me to the Morisita index, we discussed how he had been drawn to work at the ICR by the multidisciplinary nature of the teams there. I observed that this seemed like a Morisita measure in the workplace…

Other concepts here are less obviously applicable to the LCH directly. Nonetheless I feel that they have relevance to the work i am doing in relation to the LCH as well as the cancer ecosystem. Hypoxia and angiogenesis are to be interpreted literally as part of the cancer ecosystem, but they function rather well as metaphors in the context of the LCH. They are also potentially visually very interesting.

Taking specifically the idea of hypoxia and its relationship to angiogenesis, here is some of my thinking. In the body there are areas that require more oxygen; in organisations there are areas that require more resources or attention. In both cases these call for more connectivity and greater flow though – with the cardiovascular system through the growth of blood vessels, in terms of organisations perhaps one can read stronger relationships, more interaction, greater communication. Where an area of a body is cut or hurt, new blood vessels grow. For new areas of organisation, it is may be necessary to grow new routes of communication, new career paths, new sources of resource. To which you can equate angiogenesis.

These metaphors also work for me in relation to an issue that has troubled me in running the parallel between ideas about the evolution of an ecosystem at the LCH and the study of the cancer ecosystem. Cancer, obviously, is profoundly threatening to the organism. whereas the developing ecosystem at the LCH, one hopes, is going to result in a healthy symbiosis, a mutual thriving. I find the ideas of angiogenesis helpful in relation to this, in that angiogenesis can be a system that functions in a positive, orderly way in a healthy body, bringing oxygen to growing or healing tissue. However, in cancer it can also ‘overgrow’ into a support system for malignancy, playing a role in metastasis as a route through the body. So you can view angiogenesis from both a functional and dysfunctional perspective, as potentially ordered or disordered.

From both the conversations I have been having and my reading, I realise that angiogenesis is no longer the newest focus of research. It was very much at the forefront in the 1990s and 2000s when an active research priority for curing or preventing cancers was developing and deploying angiogenic inhibiting drugs. However, it remains a central part of the cancer ecosystem, and while i was researching at the ICR the Childhood Leukaemias team published several new papers suggesting that new understanding of the role of hypoxia in TP53 mutations could really illuminate what’s going on when cancers metastasise,

Off to school

I was very excited to be able to visit the Harris Academy Sutton (HASU) as part of my residency research. As well as having a really illuminating conversation with some of the incredible teaching staff, it was lovely also to meet and chat with several Year 12 students about their ideas and also to have a look around the amazing purpose-built site, which nestles into the edge of the London Cancer Hub ‘campus’,

Early on in the residency I was quite puzzled by how a school could be integrated into the London Cancer Hub, which seems such a specialist endeavour, so this was one area of discussion I was interested to focus on initially. And whilst the school obviously has a remit in relation to providing a broad education for it’s pupils, i was surprised at the number of different ways that the school either is already, or can become, strongly allied to the London Cancer Hub organisations.

HASU has a specialist science focus, so as such is already tuned in to the subject matter and potential for the relationship with the organisations of the London Cancer Hub. Here is a (not exhaustive) list of some of the ways that HASU is connected with the LCH that emerged from my discussion with the staff:

The relationship with the LCH is a real incentive and attraction to teachers – more than one of the staff I spoke to was really influenced to join HASU because of the LCH.
HASU is the recipient of equipment from the ICR that is no longer useful to them, but very handy for the school
There is an aspiration for every year 10 student to have a mentor scientist – ‘their’ scientist.
There are lots of ideas part way in progress to provide students with mentors from the ICR and RMH (as well as from other industries)
The curriculum is relevant in some areas. Teachers also particularly talk about how those parts of the curriculum might relate to the work of the LCH – eg when teaching mitosis in biology
In time they hope to integrate the LCH organisations into careers events,

I was less expecting some other connections. Some pupils have parents working at the LCH. Not at all surprising when you think about it, but I hadnt previously thought about it. Similarly unexpected for me was the question of whether some of the pupils had relatives being treated at the RMH.

In terms of how conscious the students are about the LCH and its role:

The LCH attracts students to the school as well as teachers, One student who joined in Year 12 said that the science focus and LCH together were a real consideration when she was looking for a school to transfer to.
There isn’t much opportunity or reason to visit the LCH site (they aren’t allowed in to some areas anyway) it is visually part of their landscape, especially now that the old hospital buildings that blocked the view have been demolished,

The view from HASU to the Oak Cancer Centre

From there we got onto a more general conversation about art and science. Several of the students I met were taking art A Level and had thought about the relationship between art and science, to come extent thematically and also from a process point of view. One of their elective courses covers the relationship between art and science in some detail – I am hoping to go back in January as part of that course to talk with the students in some more detail about how art and science can relate in practice….

Metaphors and concepts (4)

Today I am going to dip in to some concepts that aren’t quite as closely related to ecological mechanisms from the cancer ecosystem. They have come up from a variety of conversations with people from a range of settings – from research science to business development discussions for example. Instead of separating these into the cancer ecology concepts and their relationship with the London Cancer Hub as I have done previous posts in this series, for this post where the concepts are less ecological, i am mixing things up a bit.

“Barcoding“

When talking about some of the data that informs the understanding of cancer evolution, it was explained to be how different cells get ‘barcoded’ so that their behaviour and characteristics can be examined, dependent, for example, on where they are located within a tumour. This enables the team to analyse behaviours or outcomes according to the cell location.

The idea of barcoding made me think a lot about how people are positioned and move around the LCH site and the nature of their experience, depending on where on the site they are based. Most of the people I spoke to spend most of their time in a single location for their work, or certainly mainly within one organisation’s buildings. When I asked about using other parts of the site, most of the people I spoke to kept mainly to their own area. However, a few travelled across the site – between the ICR and RMH for example – on a regular basis, and others talked a lot about travel to and fro from other partner organisations such as Imperial, possibly more than within the LCH. I thave oyed with the idea of making an artwork based on tracking people’s movements around the site. I think it would be illuminating – tho i am not sure how keen people would be to take part!

“Securing“

We had a conversation about patient medical data, its sharing, safekeeping and its absolute crucial role in research. The day of this conversation, an article had been published in the Guardian about how UK medical data was – or was not – being protected, and how much research is impossible without access to large data sets that rely on individuals being secure about how their information is shared. (Articles of this nature are being published every week, reflecting major ongoing developments in this sphere).

Security is an obvious concern in relation to different parts of the LCH and movement around the site is not unrestricted, no doubt for some very good reasons. The ICR, for example, is all access controlled, so that only staff or approved visitors can access the buildings. The Royal Marsden obviously needs to be accessible to patients so there are many spaces that can be accessed without restriction. However, I visited several to office spaces where you needed a pass to get in.

All this set me thinking, are there parallels that I can investigate between the security of medical data and the security of the site? Something to think about, though I have no idea yet where that might lead….

“Bridging“, “Stitching” and “Translating“

These ideas came up in particular when talking about the Innovation Gateway and the development of the new multi-use site that could also house larger biotech or pharma-type companies, and the relationships between the research activities and treatment facilities focused in the ICR and Royal Marsden with the commercial ompanies housed at the Innovation Gateway or on the new site. (Confusingly to me, the new development site seems often to be referred to specifically as the London Cancer Hub on its own, without meaning the whole inclusive site covering the ICR, Royal Marsden etc.)

To me the ideas of bridging and translation apply principally to the LCH rather than the cancer ecosystem, and indicate the perceived or actual gap between the focus and/or the operations of the different types of organisations. ‘Translating’ we spoke about literally in relation to facilitating discussions and agreements across disciplines, in particular, for example, between business areas and clinical or research teams. But the idea works not only in relation to the specifics of language, but potentially also translating between priorities and focus as well. ‘Bridging’ fits nicely with all the spatial ideas that have emerged already in the discussions of the cancer ecosystem but works more or less literally on the site too.

Of these three, I think ‘stitching’, for me, has the most creative possibilities – it is literally an interesting way to make artwork. It also seems to me to be an expressive of what might need to happen to create a single site of excellence where the organisations can build effectively on each other’s work rather than operating as separate but physically adjacent entities.

Plenty of food for thought with all this!

Metaphors and concepts (3)

Today’s concepts and metaphors are mainly related to cancer’s evolutionary abilities. These ideas relate directly or indirectly to the ways in which cancer can mutate, grow and evade treatment and the ways that these are talked of. This particular selection of ideas is currently not at the heart of my artwork development, but I feel it is important to note them nonetheless.

“Wild Type“

The wild type (WT) is the phenotype that is the typical form of a species as it occurs in nature

“Convergence“

Where nature comes up with the same solution time and time again though through different paths, eg human and octopus eyes, bat and bird wings.

“Plasticity“

Cell plasticity is the ability of cells to change their phenotypes – without genetic mutations – in response to environmental cues. This is one of the ways that cancers can become resistant or intransigent. The other main way is through genetic mutation.

“Resistance“

Cancers that evolve to be able to survive specific drugs. This may happen either though the plasticity of that particular cell type or through the processes of selection.

“Intransigence“

Cancers that resist treatment or are unlikely or impossible to be successfully treated.

“Evolvability“

How likely a cancer is to be able to evolve into different manifestations through plasticity or selection. This concept arrived with me through reading this article, co-authored by many ICR researchers (some of whom I have spoken with) rather than via interviews

“Adaptive Therapy“

Using a range of treatment options to manage the cancer as a chronic condition to maximise quality of life and longevity rather than trying to blitz the cancer with the strongest treatments and risking it becoming more and more resistant and intransigent.

How all this relates to the London Cancer Hub

The LCH is undoubtedly at an early stage of its evolution as a single entity, so I would expect some of these notions to apply, albeit maybe not in the specific ways that they apply to disease. And if I think about my experiences of organisation development I can certainly draw parallels.

Intransigence, for example, is something that I definitely came across at the BBC – or at least it felt that way to me. It seemed that any number of people could make any amount of effort to change things – to reduce staff numbers, say – and yet the organisation would seem to go its own sweet way and somehow, despite reductions and redundancies, there always seemed to be the same number of people working there from year to year and onwards.

Plasticity too has a resonance in this respect – for me it equates to how far an organisation can adapt its ways of working without fundamentally changing its structure or identity (something that might feel more like a mutation).

However, these specific concepts have not captured my creative imagination for some reason in themselves as a basis for artwork, though they are definitely informing my thinking. My next post in this series will, on the other hand, focus on some of the concepts that i have started to investigate creatively.

Planning a workshop

A few weeks ago when I was over at the Royal Marsden I met up with the Arts Officer there, who is both creating an amazing arts programme for hospital patients and also curating and refreshing all the artwork that is displayed around the hospital. I’ll pop up another post with some images from our tour around the hospital at some point soon, but I wanted to record here the ideas we had about involving some of the clinicians who could give a perspective on the idea of the Ecosystem of the London Cancer Hub. The idea of running a workshop for Research Nurses emerged as they are central to the idea of ‘bench to bedside’, which is the intention to create a smooth transition to and from between research and clinical trials or treatments, an idea that feels to be at the heart of the idea of a London Cancer Hub ecosystem. You can find out more about Research Nurses here and about an example of ‘bench to bedside’ here.

After some drafting and conversation here’s the flyer that resulted. I hope it will be a fun experience for some research nurses as well as an opportunity to find out something of their perspective on the ecosystem. The flyer has gone out, and though as yet there are no bookings I am hopeful there’ll be some interest a bit nearer the time!

The London Cancer Hub – a wilderness or a garden (or something in between)?

As the project evolves(!) it feels like time to reflect on some of the things I’ve learned about the LCH as an entity as well as continuing to update this blog with all the concepts and metaphors I’ve drawn from the conversations about cancer research.

And now that I’ve talked to a variety of folk based at the Sutton site from the ICR, the Royal Marsden and also from the London Borough of Sutton I am both a whole lot clearer and a whole lot less clear on what the London Cancer Hub actually is.

A view across the LCH from the ICR access road to the new Innovation Gateway site

Fundamentally, it seems to me that the ‘London Cancer Hub’ is an idea. It’s not the only example of a ‘hub’ that brings together similar types of organisation in one site with the aim of maximising the potential of the co-sited organisations by placing them together. See for example, this article by UK Research and Innovation outlining collaborations across the UK, several of which include co-location, or this one about the Imperial College White City Life Sciences campus. What makes the London Cancer Hub unique is its tight focus on the science of the prevention and treatment of cancer.

But beyond that simple explanation of a shared goal, I have been struggling a little with what actually binds the London Cancer Hub together, and what differentiates it from other partnerships and collaborations that are aimed at cancer treatment and care. And when I started to delve, I realised that I had arrived with a whole set of assumptions, many of which I am only now becoming aware. And because I am dealing with snapshots, transient impressions and fragments of explanation, which are the nature of the types of conversation I have been having, it’s going to be a little tricky to pin down what I mean, but here’s an attempt.

When I heard about the London Cancer Hub, I assumed that there was some sort of integration effort that was bringing all the disparate elements of the London Cancer Hub into some sort of intertwined relationship. By that I don’t mean at all that I thought there was going to be a single overseeing organisation or that the different parts would become a single body, but I did think there was probably a sort of masterplan that was dedicated to ensuring the different organisations would begin to intermingle more, and to encourage cooperation and cross-fertilisation of ideas and activities.

And now I am not so sure this is the case. (And as ever, i may be mistaken, but if so, that in itself may be indicative of something). Whilst there is clearly significant collaboration going on – in particular I know there are lots of positive and proactive interconnections between the ICR and the Innovation Gateway, and the ICR and the Royal Marsden have a longstanding relationship – I am more unclear about how the LCH as a whole will be becoming actively more than the sum of its parts? And how it will be significantly different or more than the existing partnerships. Here are some questions (in no particular order) that have arisen for me so far from that point of view:

How will people know that this is now – or becoming? – the London Cancer Hub? Several of my interviewees so far have not appeared to know what I meant by ‘London Cancer Hub’ without an explanation from me. Is that timing? Does it matter? How does that change if it does matter?
Who – if anyone – takes the overview of the experience of a member of the public visiting the site, wandering around, and crossing boundaries, visiting different organisations? Does the idea of a visitor experience that crosses between areas matter? Will there be a single map? And/or am I in such a unique position that its unlikely to matter to anyone else?
How is the aesthetic experience of the site managed as a whole? Maybe that’s not important, given that there is always going to be a mish-mash of interesting buildings from different eras, but maybe there are things that might bring a useful coherence? Or maybe different identities as you traverse the site is grounding?
How about the staff experience of being part of a London Cancer Hub? Will there be ways to encourage curiosity or collaboration between the people in different organisations beyond what is structurally necessary?
How will the serendipitous discovery of overlapping interests happen as a result of the Hub’s existence? Who provides space for people from different organisations to intermingle randomly and interestingly – or who will in the future? So far the only place on the site that seems to specifically cater for staff from across the site is the small social club with a once-a-week bar. Is anyone responsible for creating these sorts of spaces? Or is that not how things work? Or maybe just not yet…

More than one of the people I have spoken to so far has looked at me blankly when I’ve asked about what makes the Hub a Hub beyond all being in the same place. I am fully aware that it’s very early days for the London Cancer Hub and maybe it’s too early for these sorts of questions. And maybe ultimately it doesn’t matter. But maybe it does? It would certainly matter if the bonding and binding has an impact on the research, treatment and care of patients and the inspiration, motivation and satisfaction of staff?

A garden run wild between the Innovation Gateway and one of the demolition sites

Thinking about all of this in direct relation to the questions I’ve outlined as my research project, it feels like the underlying question is one of whether the London Cancer Hub equates more closely to a wilderness or a garden. If it’s the former, the assumption would be that everything will grow together organically, creating its own ecosystem like a true, untampered-with, natural habitat, a wild area where species settle into their own relationships as they wander through the uncharted spaces. Or is it more like a garden? In that case, there would be dedicated horticulturalists planting, tending, pruning and nurturing amd mapping our the whole plot.

Given all the effort going in to the creation of the LCH and the high stakes of its success, my guess is that it needs to be a garden. And while there are definitely a lot of gardeners within individual areas, some of whom are also tending the boundaries, it would be interesting to understand the design for the whole landscape.

And finally – i need to think about why i am using landscape metaphors and not bodily ones!

A trip to the library

South Metropolitan School for Girls 1854

I was lucky enough recently to be able to spend a couple of hours steeped in the archive at Sutton Central Library, going through maps of the site where the London Cancer Hub is now based, and talking about the site with a member of the London Borough of Sutton team responsible for shepherding the London Cancer Hub site through the development process. Such a lot of interesting ideas emerged in one afternoon from talking about both the history and the future of the site. Once again I was overwhelmed with the amount that I learned and am full of questions about the implications for the evolution of the London Cancer Hub ecosystem as well as new ideas that may develop into artwork…

Site Plans

So, as I think i have probably already mentioned, the London Cancer Hub is made up of a number of different organisations or groups of organisation. The most significant of these that I have been thinking about are – in no particular order:

The Royal Marsden Hospital (mainly in purpose-built 1950s buildings but with a very new state-of-the-art structure)
The ICR (in brand spanking new purpose built blocks)
The Innovation Gateway (currently inhabiting a small existing mid-century block)
Maggie’s Cancer Centre (in one of their beautiful architecturally designed centres)

The element missing from that list is the major commercial site. The Innovation Gateway is the current incarnation of this, an incubator for small biotech, lifestyle and medical companies whose work fits well with the cancer focus of the Hub. But future plans are larger and more ambiutious, with a vision to house much larger companies (or parts thereof), big players in the medical and/or pharmaceutical world. There is a ‘preferred bidder’ to build this major development , with final contracts potentially being awarded in a few months time, depending on progress. The physical area for all the building to happen is currently essentially the demolition site of a number of old hospital buildings that were no longer useful and would have been complex and expensive, if not impossible, to adapt to this new purpose.

Downs / Sutton Hospital buildings scheduled for demolition

Discussion about this led quickly onto a conversation about land ownership. I had somehow assumed that there was a single site that formed ‘The London Cancer Hub’, owned by a single entity, but this is not the case. As i understand it post that conversation, the ICR owns its own plot; the NHS owns the plot on which the Royal Marsden stands, Maggie’s sits on the Royal Marsden site and the London Borough of Sutton has recently purchased the site for the commercial sector development, which as far as I can tell is referred to as The London Cancer Hub in itself also. This I think may be the root of some of the confusion that I’ve been feeling when talking to different people about the LCH – do we both mean the whole site encompassing everything, or do we mean the new commercial development? This adds to an existing confusion, for example, that I had during one conversation where the person i was talking to interpreted the London Cancer Hub as meaning the focus on the site during the pandemic for treating London-based cancer patients. I will be posting here again about some of this ambiguity, which feels quite important to the ongoing creation of a ‘London Cancer Hub’ ecology. However, ambiguity aside i found the way the sites come together to be fascinating, a real patchwork or mosaic of a site.

Site History

But before I get onto that, once back at the archive I had a chance to focus on the previous and historic uses of the site, which started as the South Metropolitan School for Girls in the mid 1800s.

What follows is a series of images of the site over the years, thanks to the historic maps of the area, and some images of the buildings too from over the years. The building images are the ones that particularly struck me, though there were many more to choose from that might have given a more comprehensive overview of the way the buildings evolved and came together.

The original hospital buildings that were the Downs School, then the Belmont Hospital and then the Sutton Hosplital

Digging the foundations for the Royal Marsden Hospital

I was struck how this image is almost the same angle as the one above with the demolition barriers in place.

I also noticed as I pored through the images that there had been a lot of fires in the old hospital buildings.

I’m not sure how the history of the buildings themselves or, indeed, the fires will feed into my understanding of the ecosystem, or they will feature in my artwork, but both struck me as interesting and worth recording here… The nature of the site as a mosaic of different ownerships, though, I already know is productive food for thought.

In the meantime, thanks so much to the LBS team and the archive for sharing the maps and letting me browse through the photos. Apologies that images are not great – they were my snapshots but maybe at some point I can go back and get better pictures….

Metaphors and concepts (2)

Today’s ideas are all about routes, travelling, and journeying. Some seem to be so commonplace that they are not really thought about as metaphors at all. And I’m also beginning to pick out metaphors that are more clearly ‘metaphorical’ and used deliberately because of their non-scientific connotations.

Concepts in a cancer context

Many of my descriptions about how these relate to cancer are drawn from a fascinating conversation with the Biology of Childhood Leukaemia team in a discussion about the role of gene TP53 in regulating cancer and the effects of hypoxia (lack of oxygen) on cancer evolution.

“Pathways”

Steps in the process that govern a cellular system. For example, the TP53 pathway is the one that a cell goes through in terms of whether it is ‘allowed’ to replicate, is sent to be fixed or if it is earmarked to die.

An example of how a pathway is illustrated – this one centred on the P53 protein generated by the TP53 gene

“Gateway”

On a pathway there can be a gateway, such as the gateway that cells go through on the TP53 pathway, for example, in order to know if they should go forward to replicate or stop and die. This is a gateway that can become very ineffective in cancer – cancer cells do not die in the same way as normal cells – and may be related to changes or mutations of the TP53 gene.

“Bottleneck”

A point at which many cells fail and a few pass through such as in the toxic environment at the centre of a tumour where the majority of cells die but one or two may replicate with mutations that allow them to survive.

“Signalling”

How cancer cells communicate with surrounding cells. Eg, they can signal to the body to grow more blood vessels to a tumour. Signals can be proximal (ie next door with surface proteins) or longer range chemical (eg with hormones etc).

“Rite of Passage”

This is a more specific metaphor drawn from one of the papers of the Childhood Leukemias Team. This metaphor represents the point of no return in cancer. Specifically, the ‘rite of passage’ in the paper refers to the the point at which the TP53 mutation allows cells to transition through EMT and launch themselves into the rest of the body. THis is the point where cancer metastasises, after which the hopes of ‘cure’ are drastically diminished. A rite of passage indeed.

How all this relates to the London Cancer Hub

While talking to ICR researchers the idea of spatial movement came up frequently, both in terms of their research and about their personal movements around the site and around London. While it seemed to me that in terms of the site, they concentrated on the ICR part of the campus, several mentioned how walking past or through hospital buildings either as part of their journey to work, or to collect samples or meet with clinicians, reminded them of the ultimate purposes of their work. This was especially true when they cam into direct contact with patients, even if this was just seeing or passing them on their own pathways,

Movement around the LCH was not the only example of establishing pathways in a very literal sense. Several researchers also told me about their regularly trodden routes around London as part of their work. For example, one scientist talked about how at one stage in her work she was travelling frequently – occasionally daily – on a circuit between the Sutton ICR, the Chelsea ICR and the Imperial College campus at White City. Interestingly, her work was heavily focused on identifying the spatial arrangements of different cell types in tumours, which are ‘barcoded’ to keep track of their position. We chatted about the possibilities of tracking the movements of researchers in a similar way. I would love to track some staff across the site and see what visual mappings came out of the exercise. I’ll be posting more about the site, its history and pathways through it in a forthcoming post…

And the ‘rite of passage’ for the LCH? I could interpret that in so many ways, so I am going to hold back and see what else emerges,

Welcome!

Thanks for coming to visit Glass Bodies, my blog for reflecting on and recording some of my collaborative projects about medicine and the body and how I translate my learning about these into my artworks, usually in glass (hence the name of the blog….)

If you are new to the blog, you’ll see that my most recent post comes first. This is handy for people who are coming back to read my latest updates, but if you have just arrived to read about Evolving the Ecosystem, my research and development residency at the London Cancer Hub as part of Sutton STEAMs Ahead, it will make most sense if you scroll back to September 2023 to my first post about the project and read forward from there. This residency is funded by London Borough of Sutton as part of the Mayor of London’s Cultural Impact Award and The National Lottery Heritage Fund.

Enjoy!