News regarding Oslo Cancer Cluster

The panel at the breakfast meeting on the future of cancer treatments in Oslo.

Giving patients a stronger voice

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How can the voices of cancer patients be heard when evaluating new methods of treatment?

A breakfast seminar was held yesterday in the series called The Cancer Treatments of the Future. Over 150 people attended at Litteraturhuset in Oslo, among them were relevant key players from the healthcare sector, governmental agencies, patient organisations and the public. The aim was to identify new opportunities to improve patient involvement when evaluating new methods of treatment.

The seminar was jointly arranged by Oslo Cancer Cluster, Legemiddelindustrin (LMI) and The Norwegian Cancer Society. The sponsors of the event were Astra Zeneca, Janssen and MSD.

 

Anne Grethe Erlandsen

Anne Grethe Erlandsen, the State Secretary of the Norwegian Ministry of Health and Care Services.

Anne Grethe Erlandsen, the State Secretary of the Norwegian Ministry of Health and Care Services, first talked about creating a healthcare service with the patient as the starting point. She said that it is important to involve the patient in the decision-making processes to bring in new perspectives, ask questions and challenge the healthcare service.

“The patient is the most radical agent of change in the healthcare sector.”
Anne Grethe Erlandsen

 

Ellen Nilsen

Ellen Nilsen, Special Adviser at Nye Metoder.

Next, Ellen Nilsen, Special Adviser at Nye Metoder, which is the national system for managed introduction of new health technologies within the specialist health service in Norway. Nilsen gave a presentation of Nye Metoder and its processes.

 “Anyone, including patients, their relatives or patient organisations, can submit a proposal for a new method of treatment.” Ellen Nilsen

The proposal is then managed by the regional health authorities in The Commissioning Forum, which commissions a full Health Technology Assessment (HTA) from The Norwegian Medicines Agency. Anyone can submit input to The Commissioning Forum by e-mail or in a form on the website.

Decisions are then made by the regional health authorities in The Decision Forum, based upon the HTA. Patient organisations are also represented in a reference group that meets every six months. The patient representatives are only observers, but have the right to make verbal contributions.

  • Learn more about Nye Metoder by reading this presentation in English from their official website.

 

Health Technology Assessment (HTA) is the evaluation of a new method of treatment, often in comparison to existing treatments. The treatments are assessed according to a set of criteria: the severity of the disease, the utility of the treatment and its cost effectiveness.

 

Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency.

Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency.

Then, Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency, presented how they are developing a pilot project to involve patients in their HTAs. They have sporadically received input from patients and patient organisations in the past, but they wish to implement a better system for it now.

“Satisfied patients are important to us. Everyone should have a voice, regardless of their diagnosis or disease.” Anette Grøvan

They believe the patients can contribute with their experiences of living with the disease, the quality of existing treatments and their expectations on new treatments.

 

 

A panel discussion, moderated by Markus Moe, the Editor-in-Chief of Dagens Medisin, was then held with the following participants:

  • Tove Nakken, Head of brukerutvalget* at Oslo University Hospital and Deputy Head in Lymfekreftforeningen (The Norwegian Lymphoma Society)
  • Heidi Brorson, member of brukerutvalget* at the South-Eastern Norway Regional Health Authority and Special Adviser in the Norwegian Cancer Society
  • Anette Grøvan, Senior Adviser at The Norwegian Medicines Agency
  • Jan Frich, Chief Medical Officer at the South-Eastern Norway Regional Health Authority and Senior Adviser in the Commissioning Forum
  • Odd Terje Brustugun, oncologist at Drammen Hospital

*”brukerutvalget” is a selected group of patient representatives that exists in each regional health authority

 

Panel discussion at the breakfast meeting about the future of cancer treatments.

The topic of the panel discussion was how to improve patient involvement when evaluating and approving new methods of treatment.

 

Nakken first highlighted the lengthy processes in Norway: “Patients want to take part of the treatments that have been approved in our neighbouring countries. But the bureaucracy in Norway takes too long.”

Brustugun agreed that there is a gap between the treatments available in Norway and abroad, and that this is affecting an ever-growing patient population: “The patient’s perspective is important, because there is a large group of patients that can potentially become long-term survivors if given the new treatments.”

Frich said the overall cost of pharmaceuticals in Norway has actually increased over the years, mostly due to new and expensive cancer therapies. He explained they are legally obliged by Stortinget to evaluate new methods according to a specific set of criteria. The reason that a treatment isn’t approved may be that the effect of it has not been documented well enough.

Brorson called for greater transparency in the decision-making processes: “If there was more openness about the decision-making, the patients would have a greater understanding for it and become better informed.”

Grøvan added: “We are not finished developing the system for patient involvement and there are a lot of considerations to make sure that it becomes structured and fair.”

 

The audience at the breakfast meeting on the future of cancer treatments.

The engaging panel discussion inspired the audience to make their own comments and reflections.

 

The fruitful discussion led to many constructive ideas on how to improve patient involvement. Hopefully, these kinds of collaborative discussions can inform politicians to take the necessary steps forward to improve cancer patients’ lives.

Oslo Cancer Cluster wants to thank the speakers, the sponsors, the organisers and everyone who attended! This discussion will continue at Arendalsuken 2019, at our event August 15. We hope to see you there!

 

  • Here is a summary of the event, written in Norwegian, from LMI’s official website.
Arctic Pharma, a member of Oslo Cancer Cluster, gave students a lecture on the chemistry behind cancer treatments.

Chemistry with mutual benefits

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Students were taught about the chemistry behind developing cancer treatments in the Oslo Cancer Cluster Incubator.

In February, forty chemistry students were given a memorable specialisation day on the subject of the chemistry behind developing cancer treatments. The company Arctic Pharma in Oslo Cancer Cluster Incubator invited them to the lab and gave a long and detailed lecture on the chemistry behind the medication they are developing to treat cancer.

Karl J. Bonney, who is a researcher in the company, started the day with an interactive lecture in English about the chemistry of the substance Arctic Pharma hopes will be effective against cancer.

Bonney emphasised to the students that the company is in the early stages of the development, and that it will take approximately three to four years before they are potentially able to start clinical trials on humans to see whether the substance is effective.

The pupils who are studying chemistry as their specialisation in the last year of upper secondary school were obviously fascinated by what they heard. They asked many important questions both to the lecturer, Bonney, and the chemistry teacher, Karsten, who participated to explain the most difficult terms in Norwegian.

 

Sugar-hungry cancer cells

Arctic Pharma is exploiting a well-known biological fact regarding cancer cells, namely that they like sugar, which means they have a sweet tooth. This is called the Warburg effect, and, so far, nobody has used it in the treatment of cancer. Since this is such a characteristic aspect of cancer cells, it would make sense to think that this could be a viable starting point for treatment.

Arctic Pharma is one of the smaller companies in Oslo Cancer Cluster Incubator and is co-located with Ullern Upper Secondary School. Bonney has been permitted to use the school’s chemistry lab to test the chemical substance being developed to attack the Warburg effect.

The chemistry day at the company was organised to return the favour and to inspire the young chemistry students to keep studying chemistry at a university or university college.

 

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Ullern student Jørgen on his work placement in the hospital.

Transporting patients

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Student Jørgen Amdim got to experience life as an orderly on his one-week placement at the Norwegian Radium Hospital.

 

Transporting patients in Norway’s biggest cancer hospital is strenuous both physically and psychologically. “But it’s really good,” said Jørgen Amdim, who is studying the program Healthcare, childhood and youth development at Ullern Upper Secondary School. His one-week placement was at the Transport Section at the Norwegian Radium Hospital. The work experience certainly gave him a taste for more.

Jørgen has previously worked in a nursing home, but he found the work a little tedious. He enjoyed being an orderly though and asked the school if there were any available placements.

An orderly is an attendant in a hospital who is responsible for, among other things, transporting patients, medical equipment and other essential materials. Jørgen spent one week as an orderly at the Radium Hospital and he loved it. He enjoyed it so much that he wants to work there again during the summer of 2019.

Knut Arve Kristiansen, the Head of the Transport Section, has worked at the Radium Hospital for 30 years and praised Jørgen:

“He was a perfect addition to our team, and we are very happy with him.”

 

80 km per week

Jørgen enjoys manual labour, which is great if you want to become an orderly. Wheeling around heavy medical equipment or patients in beds and wheel chairs is hard work. Knut Arve explained:

”As orderlies, we’re constantly on the go, and we could end up walking around 80 kilometres on hard floors during a week of work.

“It can be strenuous for the body, so we have to regularly do strength exercises to keep fit,” Knut Arve continued.

Knut Arve only had positive things to say about Jørgen and he hopes that Jørgen will want to return to the Transport Section for a summer job as an orderly.

“Jørgen is a social person and very well liked. This is important for patients when they are transported between examinations and the rooms they are staying in,” said Knut Arve.

Jørgen praises the work environment and especially the warm welcome he received from the other staff.

Jørgen has constantly been accompanied by a colleague from the section during his stay, because he is not allowed to do much on his own when on a placement. If he returns for a summer job, things will be different. Then he will have to work more independently and take responsibility if an emergency should occur while he is transporting a patient.

The orderlies are also responsible for transporting food and medication. To newcomers, the Radium Hospital can appear to be a huge labyrinth, especially outside the wards. The hospital is also currently being renovated, because a new hospital is being built. A sense of direction is therefore essential for anyone finding their way through the building.

 

A future in health

Jørgen does not necessarily want to become an orderly, but sees himself working in healthcare:

“I would really like to work in an emergency room – receiving ill and injured people at the hospital when they arrive in an ambulance. But I think working as an orderly is very exciting too, so I don’t want to exclude it as an option.”

Knut Arve says that a trade certificate is required to work as an orderly and that they currently offer placements for several apprentices in the section. Students need to study Healthcare, childhood and youth development during upper secondary school and then finish a two-year apprenticeship to obtain their trade certificate as an orderly.

”Workdays here are very varied and you meet many different people. It is really fun to talk to people and no two days are the same. I have really enjoyed it.” said Jørgen.

 

Attracting and developing the life science talents of the future is an essential goal for Oslo Cancer Cluster. One way to do that is to take students outside the traditional classroom setting and invite them to work placements and educational lectures. These collaborations between industry and academia give the students a unique insight into the specialist skills needed to become tomorrow’s researchers and entrepreneurs.

  • Find out more about Oslo Cancer Cluster’s school collaboration with Ullern Upper Secondary School.

 

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Three students experimenting with fruit flies in a lab.

Operation fruit flies

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Fruit flies are not only annoying little insects that appear when bananas are overripe. They are also popular research tools for cancer researchers.

The four pupils Kalina Topalova Casadiego, Ida Hustad Andresen, Andreas Bernhus and Dina Düring got to experience how cancer researchers look at fruit flies during their work placement in January.

“Let’s turn on the gas, and then I’ll put some fruit flies on the pad under your microscope.” Speaking is cancer researcher Lene Malrød who, together with her colleague Nina Marie Pedersen, is responsible for four pupils from Ullern Secondary School on work placements.

“Gosh! They’re moving,” proclaims one of the pupils.

But not for long. Soon, all the fruit flies are anaesthetised and, eventually, dead; then the pupils are tasked with surgically removing the ovaries of the female flies. It is easier said than done, even with the help of microscopes to enhance the tiny flies. Especially when the operating tools are two tweezers.

Fruit flies are kept in two test tubes

The fruit flies are kept in test tubes.

 

An exciting placement

It is the third day of the pupils’ work placement at the Institute for Cancer Research, located next to the school. For four days at the end of January, they have learnt about cancer research and which methods researchers use in their daily work.

“The work placement is not like we imagined,” says Kalina and Ida.

“There’s a lot more manual work than I would have thought, and then you realise how important research is through what we do,” says Ida.

She is the only one who is specialising in biology in combination with with other science subjects, and she finds this very useful when working in the lab together with researchers. The other three have had to catch up on the reading, but they all agree that it is very exciting.

“Yesterday, we learnt a lot about CRISPR, which is a new method for cutting and splicing genes. Media gives you the impression that this is a highly precise tool, but the researchers here say that a lot can go wrong, and that it’s not at all as precise as you might think,” says Ida.

A student looks at fruit flies under a microscope

The students look at the fruit flies under a microscope.

 

From Western Blot to flies

A total of twelve pupils were picked out for this work placement. They have been chosen based on motivation and grades, and they all have a wish to study something related to medicine or science after they finish upper secondary school.

The twelve students are divided into three groups with completely different activities and get to learn a number of different research methods. The group consisting of Ida, Kalina, Andreas, and Dina, for instance, is the only group which will have a go in the fly lab.

“Am I really supposed to remove the ovaries? I don’t see how,” one of the pupils say, equally discouraged and excited.

Andreas, on the other hand, is in complete control. First, he has separated the males and the females with a paint brush. He has then used the tweezers to remove the heads from the females, punctured the bottom to remove the intestines, and finally found the ovaries in the abdomen.

Lene gathers all the different body parts for the pupils to look at through a different microscope. These fruit flies are in fact genetically manipulated to glow in the dark – they are fluorescent.

If you are wondering why researchers use fruit flies as part of their research, you can read more about it in this article from Forskning.no (the article is written in Norwegian).

“It is so much fun to be here, and we are really lucky to get this opportunity,” says Dina on her way from the fly lab to another lab to carry out another experiment.

 

The pupils on the work placement have uploaded many nice photos and videos on Ullern Secondary School’s Instagram account – visit their account to see more from the placement.