When I worked at Doctor newspaper, I started a series called Research That Matters, which I was rather proud of. It looked at research papers that scored highly for reliability, relevance and practicality to GPs. It assessed them using a points system, awarding points for size of study, reliability of method, relevance of study group and so on. Often, the research that mattered wasn’t headline-grabbing stuff. But the Holy Grail was a paper that might actually change how people practice medicine.
One example was a paper showing that most children with itchy red eyes don’t need antibiotic drops. Simple conjunctivitis clears up just as fast without treatment, and antibiotics can cause irritation and side effects. It wasn’t exciting to most people, but it was a practical way of changing practice for the better.
This week for The Guardian, I wrote about a study that wouldn’t have made it past my self-imposed standards for Research That Matters. It’s not a randomised controlled trial, for one thing. It hasn’t even been published in a medical journal. It’s basically a cohort study, presented at a medical conference. But I have a hunch that it might just change practice rather a lot.
The study looked at the drugs already being taken by a group of women, at the time they were diagnosed with breast cancer. Specifically, researchers looked at beta-blockers, a decades-old treatment for high blood pressure that have been falling out of fashion as newer drugs have been shown to work better to prevent heart attacks and strokes.
Women already taking beta-blockers were much less likely to die of their cancer, to have their cancer return, or to see cancer cells spread around their body. There’s a plausible theory why: beta-blockers act on the stress hormones adrenaline and noradrenaline, which may affect the growth of breast cancer cells. It works in the lab (not always a reliable guide) and this study shows it might work in people, too.
To stress: this is very early research. We need big, properly-done RCTs to reproduce the results. We need to know if beta-blockers have any effect in women not being treated for high blood pressure. And supposing there are positive answers to all those questions, we need to establish the optimum dose, timing and combination of beta-blockers with other breast cancer drugs.
It’s an exciting study. We may never hear of it again. But I think it might turn out to be research that matters.