Busting the myths of medical research
By Associate Professor Daniel Thomas
Daniel Thomas is a clinical haematologist at the Royal Adelaide Hospital and cancer scientist who develops new drugs for the treatment of rare and hard-to-treat cancers. As Program Director of Blood Cancers at SAHMRI, he leads a creative and innovative cancer research laboratory.
Myth: People are used as ‘guinea pigs’
Probably the biggest myth to bust is that medical research treats people as guinea pigs, or that science ‘experiments on people’. I work as a blood cancer specialist and patients on our medical research trials live a lot longer than other patients. That’s been shown repeatedly in oncology and haematology. There is incredible trial activity taking place because of medical research, and patients can move from one life-saving treatment to another. So, the majority of cancer patients do not feel like they’re ‘guinea pigs’ – they’ve had access to something life-changing when there were no other options.
In addition, many people don’t realise how complex human ethics approvals are in order for research to continue. I’m very busy, but a big chunk of my time is spent carefully writing and amending human ethics protocols to make sure everything is done properly.
Myth: Medical research is all science – there’s nothing creative about it
Medical research is a lot more creative than people realise. It’s not just rote-learning facts in a scientific textbook, it can involve believing in your gut that something might be real before you can completely prove it. You have an idea, but you also need to be open to being wrong.
Most of our discoveries in the last 15 years have been serendipitous. They came about when we were working on something, then we noticed something unusual. So yes, you do need experience to tell that something is unusual – but most of it is completely out of your control.
The cell and the human body is still infinitely more complex than any computer. My personal worldview helps to enjoy rather than be terrified by that! Interestingly, so far AI is not going to come up with amazing research outcomes, because large language models are mostly based on what has been done before and probability. It’s not trained to creatively do something really different and does not have intrinsic understanding of why something worked.
Myth: Big breakthroughs can only come from big laboratories
Many of the great breakthroughs have come from small labs that were not always grant funded for long periods. A good example is CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) discovered by Jennifer Doudna at Berkeley. She told me it was tough for many years to get her bacterial research funded – and yet now her technology is curing genetic diseases in babies.
Another example is the team who discovered Helicobacter pylori, which causes stomach ulcers and stomach cancer. They received a Nobel Prize for their work, but funding had been tough in the years prior.
So I guess what I’m saying is that it’s important in Australia that we fund a range of both big labs and small labs, and both basic and translational research projects. The best future for Australia is lots of little startups working on diverse but overlapping projects. You just don’t know where the next incredible thing will come from.
AusHealth has been wonderful in seeing value in lots of different spaces. They help scientists and doctors get their discoveries through the tough scale-up that’s needed to bring new therapies to patients. Since returning from Silicon Valley five years ago, I couldn’t have achieved the breakthroughs we’ve achieved without incredible support from AusHealth.
Myth: 90 percent of medical research fails, so why bother?
It’s true that 90 percent of everything we do fails. But the 10 percent is a game changer. It changes the world forever. If we knew exactly what to do it wouldn’t be research!
When my patient benefits from something we discovered in our lab it’s an amazing feeling. And they benefited before anyone else in the world.
My time in Silicon Valley taught me the value of looking at the data – and even negative data can lead to the biggest breakthroughs. If people don’t see what they think should happen or don’t see what they’re looking for, they’ll put it in the trash can – and they could be throwing away the answer to another problem.
The hardest thing I’ve found in my career is that you have to humble yourself under the data – only the data is congruent with truth.
Myth: Basic medical research has less value than translational research
Translational research is really trendy at the moment because everyone wants outcomes, but people often don’t realise how important basic research is to helping patients in the long term. In other words, there’s nothing to translate unless someone discovers the ‘basics’, like CRISPR or immunotherapy or CAR-T cell therapy. If we only fund translational research, then there will be nothing to build on in ten years’ time. We need to have a balance.
Myth: Big publications and glossy journals lead to breakthroughs
That’s not true. In fact, the pressure to continually publish can sometimes hinder the true research work that needs to be done to help patients.
In Australia it’s not easy to get funding, it’s very competitive. This means the only way researchers can remain doing research they enjoy and believe in is by publishing in high impact journals relatively quickly. It’s called ‘publish or perish’ and a lot of that time could have been spent doing what’s really needed to help patients.
Other funding models, such as the National Institutes of Health in America are very effective. This is where researchers are funded regardless of whether they publish or not, as long as they continue to work on a particular disease and translate when the time is right.
Myth: Australia is too far from the action and too slow to translate treatments into real world therapies
Australia is a long way from the rest of the world, and for a long time many of the life-saving treatments were not available here. Historically, the Pharmaceutical Benefits Scheme (PBS) in Australia took longer to approve things than the Food and Drug Administration (FDA) in America.
This has changed since Covid: many biotech companies both large and small are now coming to Australia because we’re perceived as safe from virus and war. We’re now home to a multi-million-dollar industry that is increasing. Some of the best clinical trial centres in the world are in South Australia (CMAX, AVANCE). We’re also good at recruiting so, although our population is not as high as Asia or the US, we have tertiary hospitals with dedicated physician scientists who care about recruiting patients to potentially life-saving trials.
Some patients get frustrated that things aren’t available tomorrow when they read about a medical breakthrough. But whereas it used to be 10 to 12 years from discovery to clinical trial, it’s now taking less than six or seven years – and can be as short as three years.
We’re getting much faster, but things still need to be done properly.