BBC Horizon Defeating Cancer

There is one disease that touches all of our lives.

A disease whose diagnosis can be devastating.

One of the hardest things was actually telling the family, especially our three children.

More than one in three of us will get it in our lifetime.

Nobody knows if it's going to be the last Christmas,

the last birthday, the last holiday, and it's just that uncertainty.

Cancer is one of the most complex diseases to treat,

because it's a part of us.

Cancer isn't an alien invasion from outside,

it's actually part of the price we pay for being human.

This programme follows three people through

one of the most difficult times of their lives.

I'm just repeating history now.

Dad died of it and it looks like I'm going to.

Horizon has been given unprecedented access behind the doors

of the Royal Marsden Hospital in London,

where they are pioneering some ground-breaking new treatments.

This is new to us, we've not done it before, we've not given

this kind of dose, with this technology.

On the day, it will be nerve-wracking.

For Ray, Phil and Rosemary,

these treatments offer new hope.

And for all of us,

they hold the possibility that we could one day defeat cancer.

It's summer 2011.

And Ray Dean is about to face the biggest challenge of his life.

I used to be a professional footballer,

played against some of the best footballers in the country.

The most famous being Georgie, Georgie Best.

And, er, yeah, played at Liverpool.

On the famous turf at Anfield, in the cup match, yeah.

That was in the, erm, in the younger days.

Seven years ago, Ray was diagnosed with prostate cancer

and underwent an intensive period of radiotherapy treatment.

It was seven weeks, five days a week, I had 35 sessions.

So I started at about five o'clock in the morning so that I could do

a bit of work, earn a bit of money, and then go up there for the treatment.

His treatment held the cancer at bay for nearly five years.

But then Ray received the news he'd been dreading -

the cancer had returned.

You get more and more confident as the years go by that it's not

going to come back, but, unfortunately, it has come back.

This time, Ray's options for treatment are limited.

Now, his best hope lies with radical developments in cancer medicine.

Hopefully, everything's going to be all right.

I don't think the nerves will kick in, I'm too old to have nerves now!

So, erm, yes.

It's just the build-up.

This robot could offer Ray some hope.

It's part of a new generation of advanced radiotherapy machines,

one of only a handful of its type in the UK.

In charge of getting it up and running is Dr Nick Van As.

Radiation remains the most effective way of killing a cancer cell.

We could kill all cancer cells if we could give them enough radiation,

the problem is we'd have to spare the normal tissue around it.

So, the challenge is to get the high dose of radiation to a cancer

and minimise the dose to those surrounding tissues.

The robot is the newest arrival at

the Royal Marsden Hospital in London.

Together with its scientific partner, the Institute of Cancer Research,

the hospital pioneers and researches cutting-edge treatments.

It's nice to be working in a place where we have the ability to invest

in new techniques and be, hopefully, at the forefront of

developing where treatments are going to be in ten years' time.

This robot is the hospital's latest way of using radiation to kill

cancer cells.

It targets the cancer with pin-point accuracy,

even as a patient moves and breathes.

On the ceiling you can see that there's two X-ray units,

one on each side, that's for visualising the tumour, and then

that allows the robot to correct for movement of the tumour in real time.

And then this over here is a light detector.

And for patients who we are treating a lung or a liver cancer or

something that's moving with respiration,

as the chest moves up and down this system detects that

breathing motion, so the two systems then work together.

And then the whole robot moves over and treats the patient

and then this part, that arm will be fixed

and then the head will move with respiration to follow the tumour.

And that's really what makes this technology unique.

And we've got a nice mural on the ceiling for patients to look at.

Known as "CyberKnife", the robot will allow the team to use

far higher doses of radiation per treatment session than they have ever done before.

Lead radiographer Helen Taylor is responsible for delivering

the treatment, but before seeing real patients,

she has to test every element of the machine.

It's a bit tricky in a static patient,

because they don't normally behave quite so well.

But it's all we can do at this stage until we get the real thing.

The team have been preparing for this for two years.

It's been an exciting project,

we've been doing our normal jobs every day for years and years

and can do it in our sleep, but this is new to us, we've not done it before,

we've not given this kind of dose with this technology before.

If we put that dose, for instance, in the wrong place

we could do some serious harm, so it's important we get it right.

The staff at the hospital are pushing at the boundaries

of medicine, because cancer is so notoriously difficult to treat.

The problem is that cancer is a disease created by our own bodies.

Cancer isn't some sort of alien invasion from outside

that has got into us, it's actually our own cells.

And cancer is a consequence of what happens to our own cells

when they go wrong and, in a sense, it's kind of part of the price

we pay for being human and being composed of all these cells.

Our cells are constantly dividing.

They grow, repair and replenish our bodies.

It's an astonishingly accurate process, most of the time.

Of course, not all our cells will function normally all the time,

things will go wrong, and we need to have a mechanism to get rid

of cells that aren't working properly.

When cells go wrong, the body has a particular way of dealing with them.

The cells can kill themselves.

It may sound strange, but this is essential to keeping us healthy.

If cells don't die, and continue to divide without stopping,

they can grow out of control, creating cancer.

What we can see here is actually

cancer cells which are growing in the laboratory.

So this is a film that's been taken over a day or two, obviously with time lapse.

It's chaotic, it's disorganised.

The cells, you get the impression,

are not really paying any heed to what's going on around them.

And it's worth saying that actually to even grow in the laboratory,

to grow in plastic in the first place, is highly abnormal.

Once the cells have become cancerous,

the body can no longer control them.

These are cells that become very difficult to kill

and the way we would describe that is being immortalised,

so the cells have the potential to become immortal

and to grow forever, and that's clearly a highly abnormal behaviour.

The ultimate aim of a cancer treatment is to target

these abnormal cells,

leaving a patient's healthy cells untouched, killing only the cancer.

For much of his adult life,

59-year-old Phil Garrard has lived in the shadow of cancer.

Running is important, it takes your mind off things, it relaxes you.

Once you get the heart pumping,

you always feel good afterwards.

I'm feeling fit and healthy at the moment.

I don't feel any different to when I was 20 years old, to be honest.

Phil has good reason to worry about his health.

17 years ago, he witnessed his father die from prostate cancer.

He was diagnosed, I think, too late

and the cancer had spread to the bones.

And, I have to say, it's a painful way to die.

It really shocked me.

It took him four or five years.

Yes, it wasn't good, it wasn't a pretty sight.

It was so devastating that, in truth, I think I ran away.

I couldn't cope with it.

To add to the pain of his father's death, Phil was told

there was a chance he too would develop the disease.

So, for the last 17 years, he's been going for regular tests,

to pick up any early signs.

Three months ago, Phil and his wife, Marie, received the latest results.

When we went that day to get the results, do you remember?

We sat down and he said it in the nicest possible way,

"Well, we found cancer." Yeah.

And for me, it was, "Wow, cancer, the big C." I know. Total disbelief.

My head just went.

Because I just was obsessed almost with what had happened to my father.

Having gone through the trauma of that, I just said,

"I'm just repeating history now.

"Dad died of it, and it looks like I'm going to."

And I just couldn't get myself out of that thinking.

But now Phil has been given the chance to leave

the shadow of his father's death behind.

By having his prostate removed in an operation at

the very forefront of surgical development.

In the corner of an ordinary operating theatre,

stands another extraordinary robot.

Known as the "da Vinci", it's promising to change the way

prostate cancer surgery is performed.

The robot is the pride and joy of Chris Ogden,

one of the world's most respected prostate surgeons.

He has pioneered this new surgical technique in an attempt to

improve the experience of patients undergoing surgery.

It means he must work in a very different way to other surgeons.

Chris, why are you taking your socks off?

Well, yes, most surgeons operate with their socks on.

In fact, I used to, until I started doing da Vinci surgery.

And it was after about three or four months, when I was getting through so many pairs of socks

with... For mysterious reasons, they kept on getting holes in.

But it turns out that the pads that prevent your feet from slipping

were causing my socks to wear through, so now I operate barefoot.

Using the robot means Chris can eliminate any natural tremor

from his hands.

And the tiny instruments are highly manoeuvrable, allowing

delicate, accurate movements, all without him

even touching the patient.

It was evolved for remote operating, originally through a joint effort

between the American military and NASA,

the theory being that it would offer surgical expertise in space

without having to send up your trained surgeon.

Chris is aiming to increase the accuracy of surgery,

and using this technology, he hopes

to see his patients recover more quickly from their operations.

In October 2010,

unfortunately there was evidence of local recurrence at that site...

As new treatments are developed,

the doctors at the hospital must decide just which treatment