Chat Ed : Hello everyone and welcome to our live webchat with the pathologist from the Autopsy series, Professor John Lee, who is here to answer your questions on tonight’s subject – cancer.
Professor John Lee : Hello and welcome to the webchat. Obviously this evening's programme only really scratched the surface of the biology of tumours so I'll try to answer any questions that you may have about them or other questions about the series.
Craigo : What do you find the most interesting part of the human anatomy?
Professor John Lee : I think it's all interesting! We need it all to be able to function properly.
Lauraminnie : I‘m interested in pathology. how did you become a Pathologist?
Professor John Lee : I trained as a doctor at medical school and then, after a spell in research, specialised in histopathology, which is the branch of pathology dealing with tissue diagnosis - looking at biopsy specimens from living patients, as well as doing autopsies.
Dideedidi : As a foundation year degree student I have totally gone from being dead set on chemistry to human biology. Do you think that there is a growing need for pathology students or is it a saturated market?
Professor John Lee : To be a medical pathologist you must first train as a doctor and subsequently specialise in pathology. However, there are lots of courses in forensic science which train people in various forensic laboratory-based techniques. But be aware that many times more students graduate from these courses than there are currently jobs available.
Ash : What happens to the bodies used on the programme after it is finished?
Professor John Lee : They are plastinated at von Hagens' institute and the organs and sections are used for further educational purposes, as intended by their donors.
rosered : What is the deadliest form of cancer?
Professor John Lee : A hard question to give a short answer to! One of the deadliest is a skin tumour called malignant melanoma. Patients with this disease have a substantial risk of dying from the tumour if it greater than about 1mm thick when it is removed. This underlines the importance of presenting early - in this case if you have a darkening, changing, irregular or bleeding mole make sure your doctor sees it as soon as possible.
Bruce Lee : Hi, you mentioned haematogenous spread of cancer, could you explain why cancer cells pass through but do not form secondary tumours within the heart itself but do so in the liver and lungs, organs either side of the heart in the circulatory spread? Thanks.
Professor John Lee : Some sites of the body are more favoured for secondary growths than other sites, for example the lymph nodes and lungs tend to sieve cancer cells out of the blood stream while the liver seems to contain many growth factors which help cancer cells to grow. On the other hand secondary tumours can be found almost anywhere in the body, including in the heart, and sometimes secondaries in the heart are directly responsible for causing arrhythmias and death. Tumour cells have to be trapped in the small vessels, the capillaries - in the main chambers of the heart, there is too much flow and turbulence for tumour cells to stick.
Rachael : Hi my father died 2 years ago at the age of 62 from a massive heart attack/stroke. I was wondering if there’s a higher chance that I may be at risk of developing a heart attack/stroke because of this family history? If so what i could do to reduce risks?
Professor John Lee : Well, family history can mean an increased risk - though not necessarily. It depends on which genes you've inherited. In terms of reducing risks, don't smoke, have your cholesterol checked, try to eat a diet without too much staurated fat in it and get your blood pressure checked from time to time.
Tokai : Is it possible to tell the difference between Crohn's disease affecting the colon and ulcerative colitis using radiological investigations only?
Professor John Lee : There are different patterns but in order to be sure of the diagnosis biopsies would usually be performed, especially to establish the diagnosis initially.
ian : Do you think that graphic shows like autopsy should be shown more widely - for example in schools as an aid to making us all more aware of the effect of our lifestyle on the length of our lives.
Professor John Lee : Yes I do think this sort of material can play an important role in public health education. Clearly these programmes were made for a general audience, and there are things that I would do differently if I were designing educational material aimed specifically at school children, for example.
Bandit : I am a massive fan of the autopsy programs myself, but do you ever get people who disagree with the show and how do they react if they see you in the street?
Professor John Lee : There are lots of different opinions about these programmes, though most of the response seems to be very positive. Obviously I do occasionally meet people who disagree with them and we normally have an interesting conversation about the pros and cons.
Gauri : I am a psychology student, and hence I would like to know if you will ever show an autopsy of the brain, I await with great anticipation.
Professor John Lee : Detailed sections of the brain can certainly be demonstrated. A very brief version of this was shown on Anatomy for Beginners last year and you can also see some brain dissection in the 4th programme in this series. But whether Channel 4 wants to do any more detail than this in future, I don't know.
diamondandy : how big are lumps in your testicles when you check for cancer and you might have one
Professor John Lee : Basically the normal testes should be lump-free, in other words the testes should feel smooth. Any lumps in the testes should be checked by a doctor
Pamela : According to recent newspaper reports cancer will be a controlable disease within 10 years. Do you think this is the case? That people will no longer die from it.
Professor John Lee : Actually I find this rather doubtful. The main problem is that many of the more common types of cancer tend to be detected later than we would like and it will be difficult to improve this enough on a population scale to substantially change the natural history of these tumours.
DonThom : If you have smoked will your body/organs ever recover? How long on average would it take?
Professor John Lee : The good news is that stopping smoking does reduce your chances of getting many of the smoking-related diseases, including heart disease and cancer. How quickly your risk factors return to normal depends, to some extent, on how heavily and for how long you have smoked. But they do substantially reduce within a year or two of stopping and continue to fall thereafter. But very quickly you'll feel better and also save enough money for a decent extra holiday each year!
Maria : Can someone live if they remove a tumour from the colon that is as big as the one you showed in the program?
Professor John Lee : What happens in different patients can vary enormously. Sometimes small tumours are fatal, but equally prolonged survival can occur even after very large tumours have been taken out.
Tyrone4SAM : What is the relationship between polyps of the colon and colonic carcinoma? If polyps are present when is removal of the colon considered?
Professor John Lee : Certain types of polyps can, over a substantial period, become malignant. There is a genetic condition in which many hundreds of polyps may be found in the colon and in this condition (familial polyposis) prophylactic removal of the colon may prevent sufferers developing cancer. In people who just have one or two polyps, the individual polyps can be removed at endoscopy.
KatherineP : i am really enjoying this series so far, and the example of the impact of malignant tumours using the doll house was quite amazing. is a malignant tumour treatable and can a person recover completely from it, or will the cancer always return?
Professor John Lee : This very much depends on the type of cancer and how early it is detected. Many malignant tumours are completely cured, but on the other hand other types are still very hard to cure, even with modern treatment.
Chat Ed : Our half hour with Professor Lee is now up everyone. Thank you so much for coming to chat to us Professor…
Professor John Lee : Thank you for your questions everyone. Obviously there are an almost an infinite number that you could ask, and I gather that almost 8000 have come in during this half hour - sorry to those of you I couldn't answer directly . The associated website on Channel 4 and the Anatomy for Beginners website will give you some pointers to the answers and direct you to other places where you can find more information.
Professor John Lee leaves the room
