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Alan Craft: a trailblazer in paediatric oncology
It was quite by accident that Alan Craft ended up being
such a key figure in paediatric oncology. When a colleague
at Newcastle’s Royal Victoria Infirmary went on maternity
leave in the 1970s, he stood in to look after children with
leukaemia. This became Craft’s chosen field, and over four
subsequent decades his reward has been the pleasure of
seeing huge increases in survival rates for childhood cancer.
Craft has spent most of his life in Newcastle, the largest city
in the UK’s northeast, attending school and university there.
Like many great doctors and researchers, an inspiring science
teacher—in his case a biology teacher—steered him towards
medicine and a place at Newcastle University Medical School.
That turned out to be the right decision: “It was during my
final year of medicine working with a wonderful physician
in Carlisle that all I had learned came together, and I realised
what medicine was all about”, Craft told The Lancet.
So he took a position at Newcastle’s Royal Victoria
Infirmary as a paediatrician. It was the early 1970s, and
treatments for leukaemia were just becoming available
but most children were still dying. While caring for children
with the disease, Craft discovered a passion for oncology
and trained as a paediatric oncologist. After a year at
London’s Royal Marsden Hospital, he returned to Newcastle
to set up the hospital’s first ever paediatric oncology unit.
“Back then, our motto was cure at any cost”, recalls Craft,
“But today it’s cure at least cost—and modern drugs and
better supportive care mean that children are better able to
cope with the side effects of treatment.” He has also seen
a striking increase in survival for many childhood cancers:
“for leukaemia survival rates have increased from some
30% to around 85% during my working lifetime”, he says.
Throughout that working life, Craft has developed an
interest in epidemiology, which has been as much about
finding out what causes cancer as curing it. “One of the
important insights Alan had, which certainly had a great
impact on my career, was to recognise the importance of
epidemiology in identifying the antecedents of childhood
cancer”, says Louise Parker, who began working for Craft’s
research team in 1987 and went on to become a leading
scientist in this field. Craft and Parker’s base in Newcastle
proved to be important. “Children came to our unit from
most of northern England, including nearby Cumbria, home
to the Sellafield nuclear reprocessing plant and the site of a
major cluster of leukaemia”, explains Craft. Parker and Craft
set about trying to understand these patients. They were
joined by Mark Pearce, who completed a PhD on a study of
the workers at Sellafield, which showed an increased risk of
leukaemia and stillbirth with a dose dependent relation.
Previous work on radiation and guidance on radiation
protection had come from studies of the atomic bomb
www.thelancet.com Vol 380 August 4, 2012
survivors in Japan, but these were based on rather
imprecise measurements. Craft, Pearce, and Parker, along
with colleagues from the US National Cancer Institute,
decided to investigate whether radiation exposure from CT
scans might be associated with the development of cancer.
The study they publish in The Lancet is the culmination of
many years’ work checking through hospital data from
70% of the UK’s hospitals and some 175 000 patients.
“We can now confirm the Japanese data and put radiation
protection on a much firmer basis. While CT scans can be
hugely beneficial, for diagnosing serious brain injury and
other problems, there is a risk-benefit ratio. Use of this
technology to diagnose more minor ailments or conditions
such as appendicitis, as described in recent research, could
be exposing patients to an unacceptable increased risk of
leukaemia or brain cancer”, Craft says.
In a sense, this study marks the conclusion of a remarkable
career; Craft retired in 2010 and retains an emeritus chair
at Newcastle University. His services to paediatric oncology
saw him receive a knighthood in 2004—an honour that
Parker, who now works at Dalhousie University and for the
Canadian Cancer Society, thinks is richly deserved: “Alan has
been my colleague and great friend for 25 years. Through
each of those 25 years his commitment to bettering
the health of children everywhere has been unwavering
through his clinical practice and leadership in research and
clinical medicine.” William Woods, of Emory University and
the Aflac Cancer and Blood Disorders Center, concurs. “He
helped to organise the UK Children’s Cancer Study Group
over 30 years ago, leading studies in bone tumours for the
Group as well as in the International Society of Paediatric
Oncology; and later becoming its President. In the process
Alan directed the childhood cancer programme at the
Royal Victoria Infirmary in Newcastle, building one of the
pre-eminent programmes in the UK.”
In retirement, Craft retains an active interest in research.
But he now has time for other interests: Craft is Chairman of
the UK Scout Association and has been selected to carry the
Olympic Torch ahead of London’s summer Olympic Games.
Yet there are still many questions Craft would like to see
answered. “The work we have done on CT scans needs to be
extended, and there are advanced plans to expand our study
into Europe”, he says. “The effects of CT scans in older people
should also be investigated, although they could be expected
to be less sensitive to radiation.” However, Craft’s passion for
his retirement pursuits mean that these questions will be
answered by the next generation of researchers.
Published Online
June 7, 2012
http://dx.doi.org/10.1016/
S0140-6736(12)60915-5
See Articles page 499
Tony Kirby
tony@tonykirby.com
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