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Plymouth patients to be offered ‘sponge on a string' pill to test for food pipe cancer at their GP surgery

Dr Tim Bray

Beacon Medical Group is to become the first place in the South West to offer its patients the chance to take part in an innovative clinical trial investigating whether swallowing a special sponge can detect Barrett’s Oesophagus  -a condition that can increase a person’s risk of developing oesophageal (food pipe) cancer.

The Cancer Research UK-funded BEST3 Trial uses a Cytosponge -a cheap and simple test that can be done in a GP surgery instead of a referral to hospital for an endoscopy.

The Cytosponge test was developed by a team in Cambridge and consists of a ‘sponge on a string’ pill and molecular test. When the pill is swallowed it expands into a small rough textured sponge in the stomach. The sponge is pulled back up collecting some of the cells lining the food pipe, which are sent off to the lab for a protein test also developed by the team.

Scientists are looking for signs of a condition called Barrett’s oesophagus which can develop in people who have regular symptoms of heartburn, acid reflux or indigestion. People with Barrett’s oesophagus have a slightly higher risk of developing oesophageal cancer so it is important to identify and monitor this group of patients to catch any early signs of cancer.

The Cytosponge has already been trialled on over 3,000 patients, and is currently being tested in GP surgeries across the country including in Plymouth.

The Beacon Medical Group is home to six GP surgeries; Plympton Health Centre, Chaddlewood Surgery, Ivybridge Health Centre, Wotter Surgery, Glenside Medical Centre and most recently Highlands Health Centre.

Dr Tim Bray, GP and research lead for the Group, said: “We are delighted to be able to offer this innovative new test to our patients and we hope it will stop patients having to endure, often unpleasant, endoscopies. Research is integral to continuing to advance treatments and care for patients and we are proud to be able to offer opportunities such as these to our patients because, put simply, evidence shows that patients cared for in a research-active organisation have better outcomes.”

The nursing team from the National Institute of Health Research Clinical Research Network South West Peninsula (NIHR CRN SWP) have been trained to deliver the test to patients in partnership with the GP practices.

The trial is also being supported locally by Dr Arun Ariyarathenam at University Hospitals Plymouth NHS Trust. Patients will be referred up to Derriford Hospital for an endoscopy as part of the study if the results of the cytosponge test show any abnormalities.

Corinna Mossop, Research and Development Manager at UHPNT, said: “This study is a great example of best practice where collaboration ensures delivery of the study, benefits patients and supports efficient use of NHS resources. The beginning of the beginning, as it were, of the future delivery of research through collaborative working across healthcare providers.

“If the outcome of the study is positive it is not only patients who will benefit from unnecessary endoscopies but University Hospitals Plymouth NHS Trust, along with other acute Trusts, will benefit from a reduction in demand for endoscopy services, in turn meaning reduced waits for other patients.”

The samples from the study are sent to Addenbrooke’s Tissue Bank for testing. Dr Maria O’Donovan, Consultant Histopathologist, and her colleagues examine the samples under the microscope looking for abnormal cells to identify the patients who have Barrett’s oesophagus.

Dr O’Donovan said: “The Cytosponge is a quick and easy test that can be carried out in a GP Practice. Most patients prefer to swallow the Cytosponge rather than have an endoscopy. The Cytosponge, also has the advantage of obtaining cells from the whole length of the oesophagus.

“In this trial we have found abnormal cells indicating the precancerous process called Barrett's oesophagus and referred those patients for monitoring of their condition treatment. We have also found some early cancerous cells and these patients have been treated.”

The trial, funded by Cancer Research UK and led by the MRC Cancer Unit at the University of Cambridge and Cancer Research UK’s Prevention Trials Unit at Queen Mary University of London first opened in Cambridgeshire in April 2017. The trial will finish recruiting next year and the results will be published in early 2020.


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