So this now led us into pancreatic cancer, apparently. In the foetal stage pancreatic tissue expresses gastrin receptors, then in the mature animal it doesn’t. But when the cancer phenotype develops it goes back to the more primitive stage and makes gastrin receptors, and so every time you eat, you’re stimulating this tumour with your elevated gastrin levels. And so, I remember we had a meeting in this room here with- At Kings College, we had one of the best liver units in the country, and a very common presentation to that liver unit are people with jaundice, they had no other symptoms, they just started to go yellow, and when they investigate them they find that they have a tumour in the head of the pancreas which presses on the bile duct and inhibits the release and so they get jaundiced. So, this is a subgroup of patients with pancreatic cancer who present with jaundice. Now, these tumours are all in the head of the pancreas, and usually that’s the first sign, so they haven’t lost their appetite or anything, so they’re, it’s fairly early in the lifecycle. Now, pancreatic cancer is called the dismal disease. Your life expectancy from diagnosis, for whatever reason, to death was a median survival of about 100 days, about three months. Now that meant that we got this, these characters down there from the liver unit and they said, well, you know, these tumours will double in size in about four weeks; we had four weeks’ toxicology. So, we set up a study and it was a study set up under something which no longer exists called the DDX Scheme, the Doctors and Dentists Exemption Scheme, which allowed a doctor to prescribe anything he wished for his patients, so we, he could do this study on his own recognisance. And, so we did that for four weeks, and after five patients it was plain that these tumours were not doubling in size in four weeks, but some of these patients had felt better. Their appetite had, one of the earliest signs is they lose appetite, and they put on weight in that, even in that four-week period. So, he, clinically, decided just to keep them on. So the net result is we had a group of patients who had a line in this subclavian vein and a pump round their waist and who were coming into Kings College twice a week to have the syringes changed, and they formed a little support group, chatting to each other. And, there were two research nurses that befriended them and looked after their ingrown toenail and every thing, so tremendous tender, loving care going on in this environment.
