And where were you when we were all battling the weather?

Firstly I was here for the chaos of the tube strikes.

Secondly I was here for the first snow chaos.

OK – so I was in Cape Town for two weeks until Tuesday. We were watching the UK news and I really, really felt everyone’s pain but somehow no one believed me.

As with many, our flight home on Sunday night was cancelled. However, the rest of our experience was very different. I received a text from BA at about 10pm on Saturday night to say the flight was cancelled. They, very unhelpfully, then gave a number to call which only operated during office hours Monday to Friday and the website was hardly responding. However I managed to find a local BA employee at Cape Town airport who very wisely advised me to rebook on the Monday night flight then and there which we did. We then had a trouble free journey home unlike thousands who were stranded here. Our friends in Cape Town (and everyone here) thought we were mad to come back but, as glorious as Cape Town is and it is very glorious, home is home.

While I was enjoying the sunshine, everyone at Campaign was working flat out. A lot of work was being done analysing the results of October, Breast Cancer Awareness Month (and for some, recovering from working six weekends on the trot!).

A letter organised by Campaign’s Policy team was published in The Times on 16 December; (you have to pay to access the website so I can’t give you their link) but you can read it here on our website. It was signed by 122 leading cancer scientists and clinicians, and demanded that the Government renew its commitment to the Charity Research Support Fund. (The CRSF is the mechanism via which the Government funds the indirect costs of charity research, such as university libraries, allowing charities such as Campaign to fund only the direct costs of research.)

On December 20 the Business Secretary issued the annual grant letter which sets out Government funding for universities for the next four years. This is the first step in deciding the funding for the CRSF. We are therefore really pleased that for the first time ever in this annual process, the Business Secretary has given a clear Government endorsement for protecting charity funded research. The letter said that the Higher Education Funding Council for England (HEFCE) should plan for “protecting funding leveraged from external sources such as the charitable and business sectors.”

The campaigning that we and others have done on this issue has helped to produce this result.

This is a satisfying way to end the year – lots more to do.

Charity begins at home

And ‘home’ for the working day is Breast Cancer Campaign. Our staff do things personally to support our charity on top of the day jobs, whether it is raising money through our own wear it pink activity, running marathons or other races or doing sponsored walks – we all do our bit.

I am also always impressed by a willingness to help other charities – and this week was an example. A friend has “adopted” two orphanages in Vilnius in Lithuania and asks for gifts of toys and warm clothes and donations. A friendly truck driver takes the donated goods over just before Christmas and she and her husband also go over and buy lots of fresh fruit and other treats (yes fresh fruit is a treat) for the children and ensure that everyone has a new toy and a big hug.

Colleagues here have rallied round with gifts of toys and warm children’s clothes. We also have quite a number of samples that we are sent and which we can’t use. We have filled five black bin liners which will soon be on their way to Vilnius. Really easy to do but we feel good about it.

On the same theme I was impressed with an initiative in London last week – Mitzvah Day. Mitzvah is Hebrew for a good deed. As I went into my local supermarket I was handed a leaflet and asked to add a few items to my trolley from the list and give them to the collector on the way out. This was to support a local shelter for the homeless. It was practical with things like soap and cleaning materials, shampoo, nappies and tissues, non-perishable foods and perhaps some nice biscuits as a treat. It was no effort and the cost was small but I felt good again – practical and effective and of course very dependent on all the volunteers who made it happen.

Getting on with the day job

Post October, Breast Cancer Awareness Month, a sort of writer’s block sets in. Not that the activity is any less – just different and too much to write about so I do nothing! We have been beset by every lurgy doing the rounds – I think that the adrenalin keeps everyone going during October and the moment you relax the bugs strike. This is not backed by any evidence so I should wash my mouth out with soap.

I am trying to generate some Christmas spirit but finding it difficult. What with strikes, student protests, WikiLeaks and England’s miserable performance on the rugby field, only partly offset by their better performance at the Gabba – I feel I want to stop the world and get off for a while. I don’t want to trivialise the serious stuff in there but one does feel beleaguered at times.

Even the nicest part of last week had a cloud over it. I have written before about my involvement with the Worshipful Company of Needlemakers of which I now am Senior Warden. There are a number of very enjoyable events during the year and last Wednesday was one of them – the Festival of St Cecilia at Westminster Abbey. St Cecilia is the Patron Saint of Music and the Worshipful Company of Musicians sponsors this annual service to raise money for their benevolent funds. It rotates between St Pauls, Westminster Abbey and Westminster Cathedral.

It is a beautiful occasion – the Musicians and the Masters and Wardens of the various Livery Companies process down the aisle (soon to be walked by Kate Middleton!) and then listen to wonderful music and some inspiring thoughts. What’s not to like?

I was quite anxious about being caught up in the student protest – I don’t do very well in crowds. So we arrived very early and there were no students to be seen (hardly a surprise – they don’t usually do early mornings). When we left we walked towards Victoria Station to lunch and although there were police cars there were still no students. After lunch we went to Pimlico tube station rather than coming back towards Trafalgar Square to avoid the demonstration.

So my information on the demonstration came from the news - but the most disturbing report was on LBC that evening where a woman phoned in (around 6.30) to say that she had driven into London and had no choice but to go along the Embankment and young men had kicked her car, jumped on the bonnet and threatened her through the window. She sounded shaken, as a woman alone in a car I can understand why. Were they students? Who knows and if not how do the organisers ensure that they are not a catalyst for general thuggery.

And then there is another Tube strike today – we are working around it – some taking a day’s leave, some working from home and most have made it in. How depressing that we take this all in our stride and work around it.

If you were in central London on Friday....

You may well have seen one or more of the 200 Raggies who were collecting for Breast Cancer Campaign at tube and train stations. The Campaign Megaraid is one of the highlights of Breast Cancer Awareness month and Raggies come from far and wide to take part. It is an interesting logistics operation and our conference room becomes the control room for the day with a spreadsheet projected onto the wall with running totals for each collector.

Most of us also down tools and help out – the more robust ones hiking around with backpacks to unload the buckets and bring them back. The control room takes calls from the Raggies when their buckets become too heavy to hold and someone is despatched to go and empty the bucket and bring the load back to base.

I love counting the money and spend most of Friday and some of Monday operating one of the coin machines counting and bagging the money. I can understand that we end up with a bucket full of foreign coins but what really puzzles me is the coins which are no longer legal tender. One bucket I counted had nine old ten pence pieces – they haven’t been legal tender for some time – is someone walking around with these in their pocket so that they can dump them in a collecting tin one day? There were also defunct foreign coins – German marks and French francs. Why are these in your pocket?

But there were notes as well and even a £50 note which was really exciting: it is such a great day and the Raggies and staff work so hard with little sleep on Thursday and Friday nights. I am afraid I wimped out at about 8.30 on Friday night. We count until all the money is counted because they want to know exactly how much has been raised by each collector, each university and in total – over £56,000 this year – a record.

For the uninitiated, universities have their “Raising and Giving” committees and students who take part are Raggies!

Thanks to all the Raggies and other volunteers, especially the team from Barclays (they normally never see real money.......) and also Pret a Manger for donating sandwiches on Thursday night to feed everyone!

If it’s October it must be.....

Let’s knock Breast Cancer Awareness Month. As regularly as the month of pink comes around so does the criticism. Less sexy cancers, a rather sickly pink. As my colleagues are sick of hearing me say “if I had a money tree then we wouldn’t need to raise money”. Until that happens we will do whatever it takes within what is acceptable to raise the money. The research won’t happen otherwise – the government isn’t going to fund it.

We absolutely understand that, for some who are going through treatment or have just been diagnosed or lost someone, all this pink stuff can be hard to deal with. On the other hand there are many women who have said to me that it is an opportunity to do something challenging (check out 500 women in muddy Hyde Park doing Pink Aerobics – many of whom have had breast cancer) or something silly to forget the daily grind of chemotherapy with the side-effects it brings; or to remember Mum or sister or colleague and all the time know that the end result is research which might change that picture in the future.

I have never claimed that the cause I espouse is better than any other – each to his own. The huge popularity of BCAM is that so many have been touched by this disease – whether personally or family, friend or colleague and they all appreciate that the money raised is vital.

We took inspiration from the AIDS campaigners of the eighties. All those women who wouldn’t talk about breasts let alone cancer suddenly realised that if people, and very famous people, could talk about contracting AIDS and therefore coming out about their sexuality or intravenous drug use maybe talking about breast cancer wasn’t such a big deal.

I had lots of opportunities in the early 90s to complain about the very high profile that AIDS had where the incidence in this country was very low compared to breast cancer – I didn’t – just watched and learned.

...as I said to the Prime Minister yesterday....

A very exciting and very early visit to Downing Street Thursday morning. If you didn’t already know it October is Breast Cancer Awareness Month and the Prime Minister very kindly invited us to Number 10 Downing Street to have a photograph taken. One of our Board members came along too and we pinned our pink jigsaw pin on the Prime Minister’s lapel and he put some money in our collecting tin. (Real folding money which he took out of his wallet – the reporter outside asked if it was just a piece of paper or real money so I knew you would be interested!)

I believe in the “photo opportunity” trade this is known as a grip and grin! He gripped we grinned and I managed to deliver all our key messages in five minutes.

Then we were on our way – to be followed later in the morning by the Governator (Arnold Schwarzenegger to the uninitiated) who apparently was accompanied by nine minders. Perhaps being Prime Minister isn’t such fun.....

We were also shown the Cabinet Room which seems surprisingly small – no blood on the carpet which you might think would be the case after the last few years in Downing Street - and the pencils needed sharpening.

Now back to work....

Worse than waiting for exam results

We are all braced for the announcement of the Comprehensive Spending Review at the end of the month but we are still in full consultation mode - most of it is now over but the shouting is still going on. More about that later.

We are now in the midst of Breast Cancer Awareness Month. Last Sunday hundreds of women took part in Pink Aerobics in Hyde Park in torrential rain – they are really amazing – pink and mud is the theme for the month!

We are gearing up for our (16th) Pink Ribbon Ball on Saturday night and then it is all hands to the pump for the London mega-raid on Friday 22 October. Our amazing raggies collect all around central London and most of our staff down tools and help on the day. I pull rank and insist on operating one of the coin counting machines (a coveted job) - not that I don’t like receiving big cheques or folding money – but there is something so satisfying hearing all those coins rattle down the chute of the machine. And then there is wear it pink – more about that later....

The week started at the Conservative Party Conference – where there was a subdued (because of the spending cuts looming) buzz. We wait for the result of the Comprehensive Spending Review on October 20 – worse than waiting for exam results. I know I should have blogged like mad about everything that has been happening on the political front but too much and too tired. Please read Simon Denegri’s blog – I did think that all I needed to do was just post up a link to him every morning if you want to know what is happening in the medical research arena – what affects one affects all.

There is no more heavyweight charity in medical research than the Wellcome Trust. They have a very clear voice in the sector. Read the article in the Guardian this morning We won't fill the gaps say firms and charities where Mark Walport, Director of Wellcome, pointed out the risks the government runs if it withdraws funding from university research. Not only will charities be less effective but industry will as well. Breast Cancer Campaign is committed to funding research in the UK – international companies can go anywhere and where the money goes the talent and the employment follows. Be afraid, be very afraid!

And finally...... The Times (which you can’t read online without paying for it) printed a list of the winners of the election for Shadow Cabinet places. You know that women’s liberation has a long way to go when you read about the person who received the most votes –

"Yvette Cooper (232 votes) wife of Ed Balls. One of Party's most popular figures".

Strangely the entry for Ed Balls (who only came third) did NOT say "husband of.....".

Science is vital

I have just signed the ‘Science is Vital’ petition established by the Campaign for Science and Engineering (CaSE) which grew out of ‘Save British Science’ in the 1980s.

As the Campaign says on its website, “the UK has a proud history of excellence in science, technology, engineering and mathematics. We are world-leaders in many fields of research, producing over 10% of global scientific output with only 1% of the global population, and despite spending less on science per capita than most of our competitors.” This is nowhere more apparent than at the annual breast cancer symposium in San Antonio, Texas, every December where British scientists punch way above their weight in terms of not only the numbers presenting but also the quality of the research. We have been fortunate to see a number of scientists we support each year.

Why should you sign this if you are not a scientist? Science investment in the UK is a crucial driver of our economy and overwhelmingly supports world-class research. We know – our research is peer-reviewed internationally. Cutting investment risks putting all this in jeopardy — especially at a time when our competitors, such as the US, China, Germany, and France, are increasing their science funding. If we do the opposite we will lose not only our science base but also our scientists and discourage inward investment which will have a negative impact on the economy – and on all of us.

Do not think for one moment that charities can pick up the slack. We are already, as you will have seen from earlier blogs, at risk of losing the Charity Research Support Fund thereby reducing the amount of research that we will be able to support.

Please follow the link here.

Thank you.

Thoughts for last week

Our sector has our own trade paper – Third Sector. It runs a column which charts a week in the life of a charity Chief Executive. One tries to sound worthy, hard-working, caring and business-like and possibly even humorous as well. I ticked that box a while ago but I was reminded of it when I thought back about the past week which has been a full one, both professionally and personally.

On the work front, besides planning for a board meeting and October, Breast Cancer Awareness Month, I have been signing off responses to numerous consultations (see CEO AMRC - Simon Denegri's blog) in between preparing for party conference season. I don’t know quite how our small (but perfectly formed) research and policy team have crammed it all in.

As you would expect our fundraising and communications teams are rushed off their feet and there will be no let up until the end of October and wear it pink. There is so much happening over the next few weeks that we have a Monday morning round-up of everything that is happening just for that week so that we can know what our colleagues are doing and how we can help. This coming Friday afternoon sees me at Hyde Park helping with Debenhams’ staff STEP ON IT - raising money with a walk.

Back to last week: it is a thoughtful time of year if you are Jewish. I grew up in an orthodox Jewish home, although we did not stick to all the letters of the law – especially regarding food! However, my father, besides being a surgeon had studied the Talmud and lived the spirit of his religion. I remember as a child when he explained to me that on the first day of the Jewish New Year the book of judgment was opened and you had till the end of the Day of Atonement (last Saturday night) to atone for your sins and ask for forgiveness because when the book was shut everything that was going to happen was written and you had no chance to change it. No, I don’t really believe that but old habits die hard and there was a lot to think about this week.

So Avram Grant did not attend the West Ham game on Saturday because he, the son of a Holocaust survivor, was respecting the Day of Atonement. I was disappointed to learn that a small percentage of the fans thought he should. There are some things more important than football – and West Ham earned their first points of the season – so there.

Nobby Stiles is selling his memorabilia from the time that England had a football team that could and did win a World Cup. Footballers in the 1960s were paid around £25 a week which was very much in line with other salaries. Clearly money doesn’t buy success.

This also coincided with the visit of the Pope and without entering into any discussion about the very real and valid criticisms of the church – there was something impressive about seeing tens of thousands of people coming together to pray rather than in anger. There were protests and that is good too – we all have a voice, which brings me onto my next thought.

My grandfather was in the Royal Flying Corps in WWI and my father served on a British hospital ship in WWII (the AMRA for history fans). This week saw the commemoration of the 70th anniversary of the Battle of Britain: then, as now, it is politicians that cause wars, not soldiers. I am only too aware that I would not be living here, safely, with the right to protest, in London today if it were not for them. If you have a spare couple of hours in London – go to the Air Force Museum in Hendon and have a look at those airplanes – how did they do it?

I was also reminded of when Winston Churchill died and was lying in state in Westminster. It was a freezing January night: we came home from work, grabbed something to eat and went to queue for five hours to walk past and pay our respects.

We all know Churchill’s comment on the Battle of Britain - “Never in the field of human conflict has so much been owed by so many to so few”. Even more poignantly, leading blogger Iain Dale was visiting Commonwealth graves this weekend with his father and mentions the inscription on the grave of Flying Officer D Hopkinson, died aged 22, 17 May 1943 “He died to give us another dawn, for us to live all his tomorrows.”

Science at the top of the media agenda – for all the wrong reasons.

For once science has been near the top of the media agenda this week and for all the wrong reasons. You can read others far more eloquent than I on the subject of Vince Cable’s speech and subsequent interviews and comments on the subject of cutting back on science spending. We have been campaigning for the retention of the Charity Research Support Fund (how could you not know dear reader) so that we could at least continue to fund research at the level we do now.

Now, not only is that under threat but the Government is threatening to cut back on science spending on research and possibly particularly on cancer – almost saying that because the charities have done so well they can opt out. Yes, this is a simplification but it makes the point.

In his speech he said “I want to lay down a challenge to the science and business communities today. That we come together, work together and plan a future together that makes the most of this country’s competitive advantages in financially difficult circumstances for the benefit of us all.” You would not think what would follow from this an announcement that the science budget would be cut – cut academic research and there is no one left with whom to collaborate.

I think that is a mistake, not because it will put scientists out of work but because we as a country have precious few natural resources to exploit: we are hardly a low cost manufacturer like China or India but what we still seem to have are talent and brains and we punch far above our weight in science and innovation. Unsurprisingly that is also what drives industry and ultimately the economy so that more companies/people pay tax. More taxes....... so obviously the sensible thing to do is to choke this at the source – cut the science budget.

But that wasn’t what sent me into full rant mode. What sent me into full rant mode was Vince Cable’s statement that “There was some estimate on the basis of surveys done recently that something in the order of 45 per cent of the research grants that were going through was to research that was not of excellent standard. So the bar will have to be raised”.

We are just finishing the trustees’ report for our accounts. In it we talk about how, in the past year, the percentage of grants funded against applications regrettably has reduced. This is not because the quality has declined but because the number of applications has increased significantly but the number we can afford to fund has not increased alongside this. A panel of international, external experts has judged the research as excellent as has our very eminent scientific advisory board – and yet the bar has been raised – again – so that some of these excellent pieces of research are not being funded. I am not sure how you can be more or less excellent but that is the territory we are in. Other funding bodies, including the research councils are no different.

Oh joy, oh rapture there is someone smarter and better qualified than me who said it for me – please read Dismisses internationally excellent research.

We know that the government is going to make cuts – make them but don’t pretend it is merely to slash the mediocre.

Is that a t-shirt I see flying past my window...

Workers in London’s iconic “Gherkin” building were bemused to see a pink cloud shaped like a t-shirt floating past their window this morning. Just a reminder that Breast Cancer Campaign’s flagship event, wear it pink, supported by Vanish, is on October 29th. Just wear something pink and make a donation to research – couldn’t be simpler. Of course if you just wish to wear pink bubbles that is entirely up to you.

You can register for wear it pink either on the website or through our Facebook Page.

Just because you are paranoid...

...doesn’t mean they aren’t out to get you. OK – they aren’t out to get me – but my feeling that the government’s commitment to medical research may not be as strong as we would like, or that the UK needs, is resonating elsewhere.

Rather than write about it myself – let me direct you to one of the best blogs in the charity medical research sector – Simon Denegri*. In his recent blog he says “I know that I can be prone to policy hypochondria but, in talking with our members, my instinctive sense that the current White Paper proposals do not account for nor incentivise strongly enough medical research, has hardened.” Read more Sunshine, stem cells and policy hypochondria over the NHS.

Simon mentions the following blog in his text from William Cullerne Brown** on what is being billed as Vince Cable’s first major speech on science on the 8 September. As How to read Vince Cable's big speech on science at Queen Mary's University of London. This goes beyond medical research and into science in general and sounds some warning signals. He states, “I think the central question is still what role spending by government on research and technology plays in the government's economic thinking...... Either the coalition believes the state has an important role in securing Britain's hi-tech future, in which case it should have no difficulty in committing to long-term support for science. Or it doesn't, in which case the only thing it can say is, as Margaret Thatcher did, that the government's job is to cut taxes so that firms can make up their own minds about where to spend their money.”

Certain industries may well do that – and do it elsewhere – the pharmaceutical industry certainly has that option. And without good basic research coming out of the universities – well there are plenty of other options for them and not in this country.

* CEO of the Association of Medical Research Charities
** William Cullerne Brown is Chairman and Founder of Research Fortnight and Research Europe

Self help or self harm – do we know?

Whether we live a “healthy” lifestyle or not many of us think about it even if we don’t always succeed. Herbal and other complementary therapies have always been around and while there may be a lack of evidence to how effective they are (no I am not going to enter into the evidence-based discussion here) most of them are not harmful.

I am for the healthy lifestyle and I believe that if you eat a balanced diet you shouldn’t need supplements but have to admit to swallowing vitamin C if I think I am getting a cold and sometimes the cold develops and sometimes it doesn’t...

Just as there are interactions between licensed medicines (and your doctor and/or pharmacist should always make a careful note of what you are already taking before prescribing/dispensing something new), there are interactions between the medicines and the complementary therapies or indeed some foods.

In 2004, a colleague and I went to the American Society of Clinical Oncology (ASCO) conference and there was a very scary presentation from a group including someone from the Memorial Sloan Kettering Cancer Centre – one of the top cancer hospitals in the USA. What was so alarming is that they said that over 70 per cent of cancer patients receiving medical treatment are also using complementary therapies and some of these were actually counteracting the effect of their cancer treatments. What is really worrying is that the vast majority of these patients did not tell their doctor because they thought they would be laughed at or stopped from taking something which they thought “was doing them good”.

Sloan-Kettering has a database About Herbs, Botanicals & Other Products where you can look up the various products and also see if there are known interactions.

This was brought to my attention this week by an article in the Irish Times by Muiris Houston The mixing of treatments can be lethal. This drew from an article in Cancer World by Anna Wagstaff, Grapefruit juice and St Johns Wort are just the tip of the iceberg (July-August 2010 No 37). We know that many cancer drugs are “toxic” which means that as well as killing the cancer cells they have unpleasant or even quite serious side-effects and the two have to be balanced. What happens if some other substance is either preventing the drug from working – or even causing the drug to stay in the body longer than it should, resulting in an overdose.

When treatments fail patients or when the side-effects are so bad the treatment is stopped – is the impact of possible other therapies that the patient is taking explored? As Anna Wagstaff says, “Drug interactions cannot always be avoided but so long as they are identified, they can at least be managed. The danger lies in interactions that are not being identified and by their very nature it is difficult to know how widely this is happening”.

I am neither for nor against complementary therapies – I am for the evidence - and article like this should provoke an acceptance the evidence is needed and a spirit of cooperation between clinician and patient is essential. Sloan Kettering has made a good start.

Good, even better but not best

Now that the flurry of activity surrounding the publication in the British Medical Journal about breast cancer mortality statistics has calmed down, we need to look behind the headlines – “UK breast cancer rates fall faster,” “Breast cancer death rates dive,” and “Not so far behind Europe after all”.

It is all about the context. The research is good and the conclusions are thoughtful, but then the newspapers need a headline and a few punchy paragraphs and that is where the context disappears. In a nutshell, of course it is good news that mortality rates are continuing to fall and they have fallen the most in the UK. It isn’t such good news that our mortality wasn’t that great to start with.

The facts are that breast cancers in the UK are diagnosed earlier and treated more effectively than they were two decades ago and mortality has fallen.

What complicates things is that the quality of data relating to cause of death from the various countries in this study can be variable. As the study says data from, for example, Greece, Poland and Portugal should be considered with caution. Out of 28 countries (counting the devolved countries of the UK as one) there are the three already mentioned where the quality of data is “low” and 14 where it is “medium” (including France, Sweden and Germany) and only 11, including the UK and Ireland, where the quality is “high”.

The researchers have adjusted for all this so we can be confident that the trend is down but comparisons are not always reliable.

To go back to my starting point – we are better but what do we need to be best? Let’s be frank – best would be never to have to deal with breast cancer at all; next best would be cures for all the types of breast cancers – you are treated and then don’t have to think about it again. Is this realistic in the near future? Best for me would be early diagnosis and then effective treatments (without the worst side-effects) which can keep the disease at bay.

If that doesn’t sound very exciting – there are diseases we can’t cure but can treat effectively such as asthma as David Beckham, Ian Botham, Paula Radcliffe and Alice Cooper all know.

An issue of fraud

A headline with the words “charities” and “fraud” in is always unnerving. Reports over the weekend on the conviction of a gang of fraudsters who planned to steal millions of pounds from a wide range of charities such as Children in Need, Comic Relief, Banardos and the Lottery were concerning.

There are various types of fraud – the sorts that beset any organisation. However this case highlights a particular issue. The further the donor is away from the beneficiary the more difficult it is to control. Perhaps if donors (and the media) focused less on “administrative expenses” and more on controls this might be less likely.

All the organisations involved were donating money to charities which purported to be supporting work mainly in developing countries but were fraudulent and had been set up for that purpose. The sums of money for each grant were (relatively) small and the work was being done in areas which it would be expensive or even dangerous to visit.

I know that eyes glaze over when we talk about our processes but this highlights how important they are. The financial controls we have regarding the processing of donations and management of our funds are very tight, as you would expect, but the controls we exercise on the spending of the money on research are equally as tight.

The hurdles our researchers have to jump are high and many: the research first has to pass through a review process with external reviewers; then through our Scientific Advisory Board; then through the Trustee Board at which point a lucky (or should I say a very bright) few are awarded a grant. The next set of controls is put into place with a contract. Scientists have to report to us regularly on progress. We bring all our new grantees to a meeting and brief them on what is expected and how hard it is to raise the money. They need to relate the grant that they have received to someone running a marathon or a school having a wear it pink day. Money is not anonymous.

Pointless headline

In addition to the stream of consultations from Government trawling across the media – there has been no let up in stories on breast cancer – none of them particularly new or revealing. Yesterday morning was no exception. “UK women four times more likely to get breast cancer than Africans” said the Guardian – others narrowed this down to “East Africa”. I am sure that the statistics, such as they are, are probably OK but I refer you to a blog I wrote earlier about the issues facing “Africa” now.

All women in the UK have access to health care. The medical care is there providing they seek it. The earlier they seek it the better their chances for survival. This does not apply to “Africa”. Africa is a continent not a country; there are huge differences in the provision of healthcare in each of the countries and each of the regions in each country and many millions of women have little or no access to healthcare for diagnosis let alone treatment and live and die uncounted.

One of our researchers put this slide together a few years ago and it very neatly encapsulates the risk factors at play. You can work out which are the ones that you have control over and which are outside your control. It may seem irreverent about such a serious subject but a spoonful of sugar makes the medicine go down – but only one spoon please.

Too much news, not enough information

I haven’t written for a while because there is too much news, too much happening albeit without much detail always being provided’. Charities in our sector are struggling to keep up with the avalanche of discussions and consultations around the “refresh” of the Cancer Reform Strategy and the Government White Paper ‘Equity and Excellence: Liberating the NHS’ published in July and then there are the implications of the Cancer Drugs Fund – the list seems endless.

One thing about having very limited resources, as we do, is that it really focuses the mind on where you put your energies for the greatest impact. Tempting as it may be to indulge in rafts of meetings and discussions and briefing documents each led by a different organisation – if you don’t have the people you can’t. Happily this has a very positive result that you focus on what is important to your stakeholders and feed in to whichever you think is the best group.

We took a view before the election that there were many other charities that would focus on health. Therefore we, as readers will know, took on the Charity Research Support Fund as our campaign. If this fund disappears, less research will be supported. This will lead to a reduction in research, a brain drain of our brightest and best scientists and an inexorable slow down in improving cancer treatment. Our arm is strengthened because we are working with the Association of Medical Research Charities.

On everything else we are working with the Cancer Campaigning Group – watch that space!

Controversies in breast cancer

Just back from two days in Edinburgh at a conference titled “Controversies in breast cancer”. An unusual conference organized by scientists and clinicians and by invitation only. Papers are not reviewed and there is no press coverage: just a forum for experts in the field to discuss and debate a wide range of topics in breast cancer research. The proceedings will be published online before the end of the year.

The conference is now in its fifth year and draws from a diverse group both geographically (international) and in terms of discipline and it is a refreshing experience. I don’t claim to understand the more esoteric science but one is left in no doubt that scientists are continually challenging each other, and themselves, to decide which paths to follow to do the best for breast cancer patients.

One topic which was rather less controversial than it sounded was titled the “Emerging breast cancer epidemic”. We have seen breast cancer incidence rise steadily in the UK and in fact in the developed world and this is predicted to continue through the next decades. More and more are surviving so mortality (death) rates are going down but just because we can sometimes cure a disease does not make it less of an epidemic.

That breast cancer is the most common cancer in women knows no geographic boundaries – it is a global burden that has doubled in the last 30 years. We are used to hearing stories about the disease burden in developing countries of, say, HIV/AIDS, malaria and TB but cancer is not a rare disease in Africa.

What was also interesting is if you take a country such as France the at risk population for breast cancer changed from 19.1 million in 1970 to 21 million in 2010. In Nigeria it went from 24.6 million to 42 million. As infectious diseases are being more successfully treated, the impact of AIDS is reducing and therefore women are living longer. This trend is going to continue and of course it is a good thing. However the single most significant risk factor for breast cancer is age and as these populations live longer the incidence of breast cancer will increase rapidly.

At present the number of young women developing breast cancer in Africa appears high – this is not due in the main to some genetic difference but more to do with the fact that the women who are diagnosed are educated, economically active and more likely to seek help. There are women in rural areas who die from advanced breast cancer without diagnosis or treatment.

The problems they are facing are so different from ours - adulterated drugs, very few trained oncologists. Screening programmes are not an option – lack of access to mammography let alone the resources to deal with any false positives and of course a lack of a consistent supply of electricity!

So as the control of infectious diseases improves and the scourge of AIDS is reduced; as life expectancy increases and with economic growth changing lifestyles – the breast cancer epidemic is a reality.

All Party Parliamentary Group on Cancer

On Tuesday I was at the House of Commons for a reception held by the All Party Parliamentary Group on Cancer. The All Party Groups I have been associated with are very effective. They bring together MPs and members of the Lords and the charities and others with an interest in the subject. In this case and the case of the group on breast cancer – this is very much the patients as well.

Paul Burstow MP, who is the Health Minister with responsibility for cancer, announced that the Government will update the Cancer Reform Strategy (CRS). The original strategy was a huge piece of work to which we all contributed and it is really encouraging that the new government is planning to build on that rather than start from scratch.

A White Paper on Health will be published shortly and we understand that the update to the Cancer Reform Strategy will focus on aligning cancer services with the reforms that will be announced in this White Paper. It is really good news for the sector and for patients that the update process will be led by Professor Sir Mike Richards, the National Cancer Director, as he has been a tremendous influence for good in forming policy.

There was talk of making cancer outcomes the best in Europe and dealing with inequalities in care – something which we have been campaigning about for some time. Access to treatments was also mentioned and there was a very moving presentation from an individual who had kidney cancer and had to fight twice for the drugs which have kept him alive – and having a good quality of life.

I won’t say “watch this space” but rather watch out for the White Paper and then for the revision to the Cancer Reform Strategy which will be out sometime in the winter.

Too old to treat?

I remember my late mother-in-law had a routine check-up when she was in her late eighties and they found a shadow on the lung. No one was very sure what it was and the doctor said that they would watch it as they did not want to operate on her because of her age. Before any discussion could be had my mother-in-law said that she wouldn’t contemplate any treatment anyway as she had lived long enough! There was no question of her being manoeuvred into this position – no one manoeuvred her into doing anything! As she then survived until just a few months short of her century this was probably a wise decision.

But when is old? I am sure that you are as shocked as we are to learn about the discrimination faced by older women with breast cancer. NHS doctors believe women are being denied treatments due to age rather than ability to benefit and this was widely reported in the press last week. A national consultation which was published last week revealed that women over the age of 65 are at risk from exclusion from chemotherapy for example. Only 16 per cent of women over 65 received chemotherapy compared with 77 per cent under 50. We also know that older postmenopausal women are less likely to receive surgery than younger ones. The only acceptable criteria for older people not receiving treatment are personal choice and poor health.

There is a deep irony here as the greatest risk factor for breast cancer is age – the risk increases the older you get. As older postmenopausal women (aged 70 or over), make up roughly a third of the 45,700 women diagnosed with breast cancer each year, it is imperative find out the reasons why they may not be receiving potentially beneficial treatments.

This is why Breast Cancer Campaign is currently supporting research in Manchester which aims to find out whether some older women with operable breast cancer are not being given surgical treatment because of their age rather than choice, health or ability to benefit.

The researcher will interview 550 patients aged 70 and over with operable breast cancer about their general health and choice of treatment. She will use the information collected to establish whether decisions about providing surgical treatment are being based on age even when the patient choice and health would make appropriate to operate.

Knowing the extent to which older women are not given surgery as a result of age, patient choice and poor health will help researchers establish whether these women are being discriminated against. This will provide researchers with evidence to encourage a change in practice and ensure all women receive the best treatment possible regardless of their age.

Campaign's House of Lords awards reception

Oakwood School receiving Campaign's 'School of the Year' award from Baroness Fookes

Apologies that it has all gone a bit quiet in this blog. The last few weeks have been very inwardly focused on business planning, budgeting, risk assessments and other vital but not very bloggable stuff.

Last night was our annual reception at the House of Lords very graciously hosted by our very first patron, Baroness Fookes. For once the sun shone and our guests were able to go out onto the terrace and enjoy the wonderful view over the River Thames. The event runs like clockwork: as a charity that made its name with events, we have a well-honed plan and crisp teamwork from all staff. All I have to do is make the speech and walk around and talk to people.

It enables us to bring the people who raise the money together with the scientists whose research they are funding. It is important for the scientists to hear their stories so that they are not too distant from the process, and judging from the many excited comments I had from people who had spoken to the scientist whose research they are supporting – our scientists did us proud.

There are awards for the top research team of the year and a number of fundraising and volunteer awards. It is always very difficult to decide these as everyone there has a story to tell and many have gone to great lengths to raise money. Lots of tears and hugs as well. See the list of award winners here.

There was some anxiety from the scientific community about the Charity Research Support Fund which I have written about in the past. Fundraisers were also concerned that we might be forced to support less research if this support is not sustained.

I was also able to share with everyone our delight in achieving The Sunday Times 100 Best Small Companies to Work For 2010 (number 91) and achieving a 2 Star Status in Best Companies Accreditation 2010. More importantly we were third on the list where staff were asked if they felt they made a difference.

As I said to everyone there, “I am in no doubt that the main reason we all feel that we make a difference is because of all of you. You are our inspiration and our motivation whether it is because we know that we are supporting the best scientists to do the best research or because of all the people who help us raise the money. You can be confident that we are spending the money you have worked so hard to raise most effectively to improve diagnosis, treatment and survival.”

Another day, another ground-breaking discovery!

If you read the papers or watched the news over the weekend you would think that everyone at Breast Cancer Campaign is busy working on how we close down the charity because no more research is needed. We are moments away from a vaccine to prevent breast cancer.

OK – that is an exaggeration – but not much. “Jab ‘to prevent breast cancer’ may be trialled on women in a year: A revolutionary jab that could prevent and treat breast cancer has been developed”.

As with all these things the reality is quite a bit further from what was printed. I won’t attempt to deal with the science of this, and I am sure that our scientists will have a lot to say about it, but while the research itself is interesting we are not facing a vaccine for breast cancer any time soon. For the non-scientific I think that the article by Dr Mark Porter in today’s Times put it very well.

The breast cancer vaccine is great news — for mice genetically prone to the disease.

UK researchers are generally more restrained in their claims but US researchers are less so, possibly for the reasons Porter outlines.

It isn’t that simple – one of the biggest advances in treatment in the past few years – Herceptin – only works for about 25 per cent of breast cancers. As Dennis Slamon, the scientist whose work over 20 years ago led to the development of Herceptin says, “the only thing that breast cancers have in common is the organ of the body in which they occur”. It isn’t one disease, there won’t be one cure or one way of preventing it, and one drug or new breakthrough won’t fit all.

Breast cancer research cash is in danger of drying up

Our third Scientific Conference is taking place today with a packed schedule and over 300 delegates from all over the UK and from as far away as Canada, the USA, Nigeria, Poland and Australia.

I will indulge myself my repeating here some facts about Breast Cancer Campaign -

Our mission is to beat breast cancer by funding innovative world-class research to understand how breast cancer develops, leading to improved diagnosis, treatment, prevention and cure.

We are a serious player in the breast cancer research field, currently supporting 113 research projects, worth over £17.1 million in 40 centres of excellence across the UK and Ireland. Over the past 14 years, the charity has awarded 302 grants with a total value of over £31 million to universities, medical schools and research institutes across the UK, and now also in Ireland.

As I told the delegates – they all know that breast cancer is a high profile disease and as the most common cancer in the UK it should be. The picture is completely different for women today than in the 70’s. Thirty years ago only half of women with breast cancer survived for more than five years. Today that figure is around 80 per cent. Women are living longer after breast cancer but simply surviving is not enough and five years is not a lifetime.

This is the good news. The bad news is that breast cancer research cash is in danger of drying up. Potential new life saving breast cancer treatments may never reach the patient if the new Coalition Government fails to continue supporting charity-funded research.

We know it is a difficult and uncertain financial climate but we need reassurance that support funding will remain consistent. A ‘quick fix’ cut will have long term implications for breast cancer research and ultimately impact on the lives of people with breast cancer.

Currently the Charity Research Support Fund contributes to the cost of the research institutions’ utilities such as heating and lighting, leaving medical research charities like ourselves free to fund research.

This is a conference by scientists for scientists – Campaign needs to ensure that the infrastructure continues to be provided to house their research and we can continue to support it.

I saw in the paper this morning that the departing Chief Secretary of the Treasury, Liam Byrne, left a letter for the new guy – David Laws, “Dear Chief Secretary, I am afraid there is no money, Kind regards and good luck.” Apparently it was a joke – just shows how out of touch with the world those chaps who run the country can be.

The abstracts are published today in Breast Cancer Research as a supplement.

Exciting week for Breast Cancer Campaign

Monday morning will see 30 of the top scientists and clinicians working in the breast cancer field debating on the allocation of research grants. Those that make it through to this meeting of our Scientific Advisory Board (SAB) will have already been reviewed by at least two and up to six or seven independent experts in the field from across the UK and as far afield as Houston and Sydney. Those that make it through to this stage are then debated and discussed.

My research colleagues at Campaign and I stand back from this process – a huge amount of work goes into managing the process (all paperless by the way) but we leave it to the experts to decide what is the best research – what will make the greatest impact on people with breast cancer in the future. They then make their recommendations which go forward to the trustee board.

It is obviously nerve-wracking for the applicants but also for us: it is no secret that money is very tight and, as others have cut back, the number of research grants coming to us is increasing and tough decisions have to be made. I wish I had a money tree!

What I find so extraordinary is that these scientists do not get paid anything for reviewing the research; the SAB are rewarded with a night in Travelodge (no criticism of Travelodge but it ain’t the Dorchester) not to forget the pizza dinner. That doesn’t account for the time spent in doing the reviewing – about two hours per grant and each board member could have up to seven or eight to review.

You may wonder why I am harping on about this – it is because I think that so few people outside the research field realise this – it is altruism but also a passion for research and a commitment to changing lives.

There may be even more pressure on charity funded research which is why our election campaign was about the Charity Research Support Fund – our plea to Government – please commit to maintaining this – see my blog Please read on even if politics isn't really your thing – more about that another day.

Tuesday sees our third Scientific Conference – sold out – more about that tomorrow.

P.S. If you wonder what I have been doing since the last blog - my incandescence of rage (if there is such a thing) about the absence of women from the election campaign and after could not be suppressed so I didn’t trust myself to write anything – just focused on the day job!

A perfect storm

It looks as if I was not alone in thinking what I was thinking in my previous blog post. Where are the women in this election campaign? Within moments of posting the blog I received a letter from a fellow Forum UK member, Kate Jenkins, on the subject which I was more than delighted to sign. You can see it here and then on Saturday there was an article in The Times by Janice Turner.

I am not totally sure where the fault lies – is it the reluctance of the parties to put women forward and is this because the media focus on what they are wearing rather than what they are saying. The press has been awash with interviews and photos of the wives - wonderful that the three party leaders have supportive wives but they are not being elected and their views should not influence us.

I don’t think this discussion will end on Thursday – there are too many of us who feel that this has been a testosterone-fuelled campaign to the detriment of all!

They think it’s all over – it will be on May 7th

Thank goodness the leadership debates are over. I didn’t watch more than a few moments and still think that there is something barking mad about judging who you will vote for on the basis of a few hours performance on television by three people......

Read the manifestos!!

Also – where are the women? I haven’t done the research but my instinct is that the wives of said leaders received more press attention than women PPCs. It is not that there aren’t any women candidates – the serious stories are going to the men. Very disappointing.

Our own campaign has done really well – as predicted there has been much publicity about health, treatment and waiting times amongst other health issues and, despite my predictions that this would not get any coverage – there was some limited publicity about science and medical research. We supported collaborative efforts on health but restricted our efforts to asking our supporters to write to their local prospective parliamentary candidates about something called the Charity Research Support Fund.

This is so that our donations go further in improving treatments and finding a cure for breast cancer.

Thanks to all the 840 supporters who did contact their PPCs and so far we have 574 signed up.

It isn’t too late to help – Click now on: www.breastcancercampaign.org/election

London Marathon 2010

If it’s Monday morning and my voice is croaky it must be the day after the Marathon. It is a slightly surreal experience being on a crowded Northern Line at 8am on a Sunday morning – pretty surreal being anywhere at 8am on a Sunday morning. There was a mixture of runners, family and friends – one runner-to-be was already wrapped in the foil blanket which is given out at the end of the race which only added to the surreal-ness!

We had three groups of staff and volunteers at the race – some were moving between cheering points as the race moved on but I was stationed with colleagues at Mudchute (Mile 17). The moment when the first wheelchair racers come through – you know it is “game on”. It is one thing watching this on TV and another close up – to see how flimsy those wheelchairs look and how much human power is required is very humbling.

The elite runners and club runners come through singly or in small groups and then the mass of the so-called fun runners come through and keep coming through. I don’t know why they are called “fun-runners” as there is nothing fun about it. The weeks and months of training and then so many of them also raise money – lots of money.

The challenge as a supporter is to spot the runner, call their name loudly enough (lots of accompanying noise as well) so that they see you are there and get that little extra bit of encouragement. Mile 17 is a tough place too and some of the pain was evident.

Our runners all did amazingly well, our fastest was Vito who finished in an incredible 02:58:27 and the amazing Diana with her two new hips was still smiling at mile 25 and went on to finish in 07:10:16. I am sure Diana won’t mind my saying - she celebrated her 76th birthday the day before her eighth London Marathon and only took up running after having had breast cancer.

Amazing people doing amazing things!

Make your mind up

The Electoral Commission has reported that there has been a surge of people applying to register to vote since March 15 – more than 460,000 – with around half since the debate last week particularly from that elusive group, the 18–25 year olds.

Coming from a country (South Africa) where people died for the vote and then when they did get the vote stood in queues for many hours to exercise it, I have no patience with those who don’t bother, don’t get around to it and don’t think it makes any difference.

One of the quirkiest vote encouraging efforts is a video produced by Total Politics using “Making your mind up” which was number one in 1981 for Buck’s Fizz (and won Eurovision). It features politicians, political bloggers and three of the original members of Buck’s Fizz. It is quite amusing but of course you would probably have to be over 25 to have a chance of remembering the song......

However, it will amuse anyone old enough to remember it - and all those Eurovisionistas.

Let battle commence!

Will the nation be glued to television tonight to see the three leaders do battle?

I have a plan for coping with the General Election campaign. A short digression – some years ago I met someone who had a plan for Wimbledon. She took two weeks off work; she laid in supplies as for a siege and her family was put on notice that they would have to fend for themselves as her contribution to the running of the household was strictly limited to what could be done in the morning before the tennis started. She spent the two weeks in front of the television, suitably refreshed from time to time.

So I think you need a plan. I will read the party manifestos. This is a bit geeky I know but that way you find out what they say, not what they want you to think they say, nor what the opposing party/ies want you to think they said (still with me?). It is always interesting to go back to them from time to time to see if they have kept their promises.....

I do listen to the news headlines twice a day and read anything my colleagues draw to my attention which might affect our organisation or our cause.

Other than that – I have sufficient recorded to watch on television to avoid the news and all the radio programmes I don’t have time to listen to on my MP3 player. As a readaholic I always have a batch of library books so that I don’t have to read the paper in desperation.

You see – you need a plan. I hope that our politicians have one that works.

Transplants save lives...

That’s the heading on the NHS Organ Donor Register leaflet and of course it is true. Hundreds of people die every year who could have been saved by a transplant. You would think that with 16 million people on the register this would not happen but of course just because you are on the register doesn’t mean that your organs will be used. Many of us die from cancer or other diseases which mean that our organs can’t be used but if, by some awful chance, an accident should take my life I would want to think that it hadn’t been in vain and that some good comes from it.

I am aware that this is my choice and a choice which will not be made by others. It is essential that we respect people’s wishes in this; otherwise we will end up with the mess we were in before the Human Tissue Act came into force.

You may think that I am writing this because of the report over the weekend about errors apparently by NHS Blood and Transplant in recording data which means that a number of people’s organs may have been wrongly removed. Actually this is not the reason - the reason why I am writing this is because last Thursday I filled in my donor form. This wasn’t a big decision I have been agonising over for months but simply that enemy of all good things – inertia.

It is done now and I am furious at this story – obviously because of the distress it will cause those families involved but also because people like me might not come forward because of a concern that something like this might happen. From what I understand, all those involved had agreed to be organ donors but had specified which organs could be used and it was this which was not accurately recorded. How awful for the families left behind to have to deal with this after the event: to have given permission thinking that you were doing what your loved one wanted to find out now that it wasn’t at all.

As I have agreed that any bits of me they can use can be used this does not change my mind but it is a blow for life-saving work.

Two anecdotes is evidence?

I was once at a scientific meeting where someone commented that two anecdotes is evidence – this was said somewhat tongue in cheek but in this case the anecdotes support the evidence!

In January the Academy of Medical Sciences published a report as lead-in to the General Election “Reaping the rewards: a vision for UK medical science”. They are urging the government of whatever political persuasion to make it possible for medical science to become a driver for not only health improvements but also for an economic recovery in the UK. I won’t paraphrase here all the information but suffice to say that the UK has an outstanding record in medical research and drug development but that could be all at risk because of the barriers to research and particularly clinical trials. The publication can be seen here.

What is really shocking is that between 2000 and 2006, the proportion of world clinical trials conducted in the UK fell from 6 per cent to 2 per cent. This not only has implications for research, drug development and patients in the future but for patients who are ill now – and some of them very ill – who cannot benefit from current trials.

The Government has ordered a rapid and independent review to be conducted by the Academy of Medical Sciences to look at this.

For the scientists we support this has longer term but serious implications – what is the point of doing research which will not be moved forward into patient care – and especially not be moved forward into patient care within the UK? There is an interesting summary on the challenges in an article in Bioworld here.

So where does the anecdote come in? Just back from a week visiting the Swiss family in Basel where the pharmaceutical industry is the largest employer in the region drawing talent from all over the world. It is interesting to hear from people in the industry there about the resistance now to doing trials in the UK. Not because we don’t have willing patients; not because we don’t have excellent clinicians and hospitals but because of the cost and the layers of bureaucracy which create delays and add further to the cost.

The result of the review is very important – more important is the action taken – or not!

Blogger's block unblocked....

I have had a bit of blogger’s block. Not that there wasn’t anything to write about – there was so much to write about that I just couldn’t decide. Whether it was the total power failure in our area for a whole day last week when we had to lock up and send people home as there was no heating (let alone computers) or the huge fire not very far away from us which brought the City to a halt – let alone anything that is happening in the office.

The “not the election” campaign is in full swing and apart from our own campaign which I wrote about earlier, my inbox/tray is full of position statements and the like from other charities and organisations.
Two excellent ones which are relevant to us in terms of science and medical research are the Academy of Medical Sciences and The Royal Society - both make interesting if worrying reading if advice is not heeded.

Life outside work has been pretty busy too. As regular readers will know I am a Liveryman of the Worshipful Company of Needlemakers (see Needlemakers Company) – one of the Livery Companies of the City of London. This not only brings me into contact with interesting people but also takes me to interesting places and makes me feel part of the City of London – not the part that makes loadsamoney but the part that is charitable, steeped in tradition and yet at the forefront of technology.

As I wrote last year - it also means that I go to church rather more than you would expect someone with the name of Goldberg to do. But when that church is St Pauls Cathedral – what a wonderful experience! It is such a fabulous building, the music is wonderful and when the Mayor and all the Livery Companies are there in their colourful gowns – as they say, what’s not to like!! Friday was the 68th service of the United Guilds of the City of London. This tradition started during the war as a service to lift the spirits after the Blitz and it was the first occasion on which all the Livery Companies combined to hold a religious service. Excellent sermon by the Bishop of Norwich – you didn’t need to be Christian to appreciate the sentiments or enjoy the service.

Of course the Livery Companies also like to enjoy themselves and we repaired to the Innholders’ Hall (appropriately enough!) with the Innholders, the Cooks and the Tinplate Workers to eat the excellent fish pie which is always provided on this occasion!

Sunday Times 100 Best Small Companies To Work For 2010

Breast Cancer Campaign has made the Sunday Times 100 Best Small Companies to Work for 2010. We were ranked at number 91 in the list, but was singled out for the third highest rating (94 per cent positive) of staff who say that they make a difference. It is the very first time we have entered so it is a great credit to all our staff, trustees and supporters that we have succeeded in making the grade and are in such good company. Our shared vision is to beat breast cancer; this motivation and affinity with the cause gives us all a clear focus and commitment and brings us close to our supporters through our values.

Clearly I am delighted and very grateful to everyone – but I am not entirely surprised at the high score for staff feeling that they make a difference. Strangely it took 9/11 to bring home to me how lucky I am to do what I do. In the days that followed many of my friends and colleagues in the corporate sector found it very difficult to motivate themselves when such devastation can happen almost in a heart-beat. For us, the number of women dying of breast cancer on the 11th of September was the same as on the 10th of September and unless we do something about it will be so on the 11th of September in years to come.

The swan and monopoly

The swan is all calm on the surface and paddling like mad underneath. In my blogosphere it has appeared calm I’ll admit – not much to report because this time of year for me is much behind the scenes planning rather than upfront action. I am sure that there is a better way to do business planning that doesn’t involve sweat and tears if not blood. Planning in the last couple of years has involved art as well as science as we try and divine what is going to happen in the economy around us. Each year we refine the process and each year we can think of things we should have done better. Grit teeth and work through it!

Numbers One and Two Grandsons spend Friday nights with us. This gives us the opportunity to spoil them and their parents a night off (more of a morning not being woken up at 6 a.m.) They are now into Monopoly. Our game started on Friday evening and had to be halted when the players were falling asleep. Number One Grandson and I continued this morning. I was losing money hand over fist and he was winning. He is very competitive – hates losing and likes winning. He had a dilemma: I was losing enough to be in danger of going out altogether – too many visits to gaol and I kept landing on his multi-housed properties - but he very much wanted to continue playing. So he decided to forgo his rentals in order to keep me in the game longer. Therefore the fun of the game outweighed the satisfaction of winning. We called time as we had to go but I am sure that there is a very significant lesson here which could probably form the basis of a three volume management tome but for the life of me I can’t think what it is. All offers of co-authorship gratefully received.

Rugby, rugby and more rugby

A weekend of rugby – and it isn’t over yet. You couldn’t grow up (as a white) in South Africa without having at least a passing interest in rugby. At my all-girls school we tracked the fortunes of South African rugby and cricket very closely – otherwise what would we speak to the boys about? I spent occasional afternoons on the touchline watching male friends being pounded into the ground. (One friend who went to live in America damaged his shoulder so badly playing school rugby that he was subsequently pronounced 4F by the draft board in the US so couldn’t be sent to Vietnam. The things you end up being grateful for.)

If rugby is on you can be sure that the television is on in the Goldberg household. Saturday afternoon saw Wales play Scotland – Scotland being the favourites. I came into the living room about three quarters of the way through when Scotland seemed unassailable and yet the men in red triumphed and Wales won spectacularly. Regrettably the Irish were mauled by the French (note rugby pun!). Tomorrow England v Italy – fingers crossed and yes, I do shout for England as I have lived most of my life here.

From there we went to see the movie Invictus. I was hesitant about going - I have rarely heard convincing South African accents from American actors; further I was somewhat suspicious that it would be “heartwarming” a damning criticism in this household. But of course Number One husband wanted to go and off we went. I started crying about half way through and sobbed till the end. Of course it is idealized, it is sentimental and even heartwarming – and I know how the story ended but it is a superb film and the rugby scenes are incredible – and made by an American! I don’t think anyone who did not live through apartheid can ever understand the symbolism of rugby for the Afrikaner and the hatred of it by the black population. This film captures that.

I remember the final between South Africa and the All Blacks well. We were at the (now defunct) Hanover Square Wine Bar surrounded by New Zealanders, Australians and Brits watching the game. There was a magnum of champagne to the person who guessed the final score. Of course the All Blacks were going to win - they were invincible, with the monumental Jonah Lomu destroying England (and everyone else) almost single-handed, so, to be contrary, I put the Springboks to win – and so they did. I cried when Mandela came onto the field in a Springbok Jersey then and I cried again tonight.

A notch above most research

Monday saw me in Manchester visiting one of our research fellows – in fact the first award we made - who is over half way through his five-year fellowship. My blogs seem to be dominated by transport but I nearly didn’t get there thanks to problems on the Northern Line and then had to come home via Sheffield because of train problems. Rather a lot of travelling for a couple of hours meeting but it was really worth it.

Research has shown that breast cancer can originate from a type of cell called cancer-initiating stem cells (CSCs). Current treatments kill the breast cancer tumour cells but not the CSCs, which then continue to divide and form a new tumour. This spread of breast cancer is the real challenge we face. Rob Clarke has been working on these CSCs for some time and has identified a receptor on the cells which, if destroyed, allow the cell to be destroyed as well. I am not going to go into details here – have a look at the press release on the recent publication but watch out for Notch4!

One of my favourite blogs is Simon Denegri’s. Simon is Chief Executive of the Association of Medical Research Charities. Breast Cancer Campaign has been a member for quite some years and in the early days of the charity AMRC was our guiding light. All our very rigorous research review processes started with their advice and they play a very critical role helping ensure high standards are maintained throughout the medical research sector. I would go so far as to say that I personally would not donate money to a medical research charity that was not a member.

Simon’s blog isn’t about any of that – it is about what makes the medical research sector so successful in the UK – as Mark Walport of the Wellcome Trust said – independent, innovative and creative – but to which Simon adds – trust, passion and quality.

A rant and a rave

Saturday morning started peacefully enough with my usual visit to the Barbican Library – regular readers will remember I am a great fan of libraries and this one in particular.

Things started to deteriorate from there: with books on board I thought I would pop into M&S in the City and buy some flowers – they have beautiful proteas (national flower of South Africa). This entailed parking for a short time. Although M&S is in Moorgate, which is in the City, the roads at the back are in Islington. There were two pay and display meters and neither was working. Simple enough to telephone – except the last time I parked in Islington was before my credit card was used fraudulently and the number has changed. You are required to enter the last four digits of the card or a pin number – neither is still valid and if you can’t do that – tough – you can’t park and there is no way you can actually speak to anyone to register a new card, the person-less voice just says “good-bye” and cuts you off.

I decided to take a chance leaving an angry note to this effect on the dashboard. The traffic warden left me alone – perhaps s/he could hear the “irate of Moorgate” letter to Islington Council I was mentally drafting if there had been a ticket. Looks like I can’t park in Islington again.

Now for the rave: we love opera but the cost of even the cheapest seats in Covent Garden is eye-watering and I have to take 12x binoculars and sit with my elbows pinned to my sides as the seats have no arms. (Yes I know it is about the same as a ticket for a premier league football match but I don’t go to those either). Over the past year or two there have been regular broadcasts to cinemas across the UK (and the US and Europe) “Live from the Metropolitan Opera”. This is world class opera, broadcast as it happens. They are all good but sometimes they are transcendental and Simon Boccanegra on Saturday was the latter. Placido Domingo (one of the three tenors for the non-opera, football fan) sang baritone for the first time – a very rare ability. I don’t know the opera but the power of the acting kept us transfixed and Verdi doesn’t write bad music. I did shed a few tears.

Even if you are not an opera fan it is worth going to one of these performances – there are English sub-titles and the cameras are live all the time – which means you see all the sets being changed and moved and what goes on backstage as well as interviews with the principals – and pleas for donations which always seem to raise a bit of a laugh. When you see the quality of the production and the sheer number of people involved – I am not surprised that the ticket sales only cover half of the costs.

Off to Manchester on Monday to see the work of our Research Fellow there.

Please read on even if politics isn't really your thing

If you are like me you are probably already weary of politicians making their pre-pre-election speeches. It is a bit like those cycle races where they all crawl along because no one wants to be the first one to break into a rush to the finish. But the only thing that is certain is that there will be an election in the next six months!

Breast Cancer Campaign has left the starting blocks with our election campaign. In our sector there will be much lobbying about health, treatments, waiting times – the list will be long and the number of organisations will be many. We will support any collaborative efforts but we are focusing on something which many will not know about but which could have a devastating impact on research in the UK.

We are asking our supporters to write to their local parliamentary candidates (we make it very easy – just a few clicks away) about something called the Charity Research Support Fund. Why should you care? Well this is a government fund which helps pay the infrastructure costs of charity funded research in universities like heating, building repairs, cleaning etc (around 20-30 per cent of the total cost of medical research projects). This means we can focus our funds on the direct costs – the scientists and the laboratory supplies necessary for breast cancer research. As a result our donations go further in improving treatments and finding a cure for breast cancer.

Charities spend over £900 million each year on medical research – if this fund goes it will effectively slash the amount of research provided by charities. We will have to reduce the number of grants we make each year by about a quarter. To give you a real number example – instead of 40 new research projects there will be only 30 – that’s a big difference.

You can be sure that this will not be front page headlines in the papers so we are relying on our supporters to help. It only takes a minute for you to make a difference. Let the people who want to be your next MP know that breast cancer research is an issue you care about.

Click now on: www.breastcancercampaign.org/election

The link will take you to a form that will automatically email your local candidates asking them to back breast cancer research.

The first of my candidates has replied and has agreed to meet to hear more and we have over 200 who have signed up.

It’s all gone a bit quiet...

I am still here but for a couple of weeks I was in the most beautiful city in the world. I thought if I blogged from holiday everyone would hate me so much. We left London just as the snow was coming to an end and woke up next morning to summer.

I have been to Cape Town many times – this was for my mother-in-law’s 100th birthday and we had to book last July as this is peak holiday season in the Cape but did so in the knowledge that her increasing frailty meant that there was a chance she wouldn’t be there and she died in September.

So it was the first time we have ever been to Cape Town without any family responsibilities and it felt really strange. We still have some family and friends but there was no centre to our days which had always revolved around her.

I have always thought Cape Town beautiful but the more I travel elsewhere the better it gets. Enough about that – a few photos (above) including the new world cup stadium from the air. It is situated in the most daft place with inadequate transport etc etc but is a stunning looking building – and it seems to be almost ready. The other is my “happy place” at Saunders Rocks when life gets too stressful this is where my mind goes – yes that is me. Finally – sunset at Mouille Point.

Back to business in tomorrow’s blog!

Happy New Year

Where did the time go? The holiday break seemed so long before it started but flew so swiftly. We had the Swiss family staying with us for most of the holiday and it was great to see the grandchildren. Also managed a sleepover at home with all four grandchildren – perhaps sleep isn’t the operative word here – for anyone. It was nice to see children and in-laws too without the pressures of work and the rule of the instant email on the phone.

One thing we can say for certain about 2010 is that there will be an election. If only we could get the general public engaged with politics as much as The X Factor it might be more representative. I know that the political parties are always keen on the “youth” vote because younger people are even less engaged. Personally I am not that concerned – perhaps as age creeps on I have become grumpy but I feel that I pay taxes, have paid them for a life-time – lucky me to have been willing and able to work for most of my life – they shouldn’t take my vote for granted either.

I gather that the leaders of the political parties are up for debates before the election. I have a better idea – each one of them in a booth which is sound-proofed. The booth has three buttons – A for “yes”, B for “no” and C for “I don’t know or I am not prepared to tell you”. Then they are asked questions and have to answer by pressing a button – they can say whatever they like but we won’t be able to hear them. The one who presses the C button the least wins.

In between babysitting duties we managed a few films – Holmes (great but I am a fan anyway); Nine – slightly surreal, if you liked Moulin Rouge this is your movie and a dire children’s movie which three out of four grandchildren loved and which had nothing for the adults (unlike films like Shrek). The cinema was empty – but an 11.30am show on 27 December was never going to be a sell-out! I also had my second visit to Priscilla, Queen of the Desert for a women’s night out and smiled all the way through again.

So back to eating three meals a day, instead of one continuous graze....