Doctors have been amazed at how a drug developed to treat a form of cancer appears to help early stage multiple sclerosis.
Health Editor Barry Nelson meets one patient who’s had remarkable results.
PETER Straker was doing what he always wanted to do. The bright North-East student had opted to study medicine and then started working as a junior doctor in London.
One of the reasons he chose medicine was a period of work experience he spent with consultant neurologist Professor David Bates at the Royal Victoria Infirmary in Newcastle. Fate would bring them together again within a few years.
Dr Straker was doing a shift at a London teaching hospital in 2002 when he first began having odd symptoms.
At first he shrugged them off, but when they came back he started worrying. “I started to see flickering lights and had vertigo. I tried to ignore them, but they kept coming back,” he says.
In his mid-20s, Dr Straker decided to go and see Prof Bates the next time he was back in the North-East. He thought the neurologist might be able to put his mind at resk.
At the back of Dr Straker’s mind was a fear that this might just be the first signs of MS, a much-feared, incurable disease which had affected his grandmother and his father. “I just hoped it wasn’t going to happen to me,” recalls Dr Straker, who is now 33 and lives in London.
After tests, Prof Bates broke the bad news. There was no doubt, it was definitely MS. Dr Straker was devastated at the diagnosis but determined to live his life to the full.
When he had finished his first training post he decided to defy his illness and fly to South Africa, where he worked as a volunteer medical student in the slums of Soweto. “At least I knew something about MS because I had my father to look to. Dad had a bad type of MS and was very brave. He can’t walk now and needs full-time care,” he says.
When Dr Straker came back from South Africa he began training as a surgeon in London. “I was still able to operate, but I was getting numbness in my hands and a little double vision.”
But as the pace and intensity of attacks increased he realised he had to give up his surgical training. A few months later, he developed a limp which got worse and worse. “I went to America with my girlfriend for a holiday but by the time I got back my vision was awful, it had really deteriorated,” he says.
At first, Dr Straker was able to stay with his sister, Vicky, in London, but as his condition deteriorated, he realised he needed to go back home to the North-East.
Once he was back in Corbridge with his parents, his condition steadily worsened. “I started using a wheelchair regularly and I was worried I was going to fall downstairs,” he says.
Eventually, the young doctor was forced to be in a wheelchair most of the time. “Then my speech started to slur, which is so hard to take,” he says.
“It is the real centre of who you are. I became angry with everyone because they couldn’t understand what I was saying. You become a tyrant.”
In October, as Dr Straker’s condition continued to deteriorate, Prof Bates tried to refer his young patient to Addenbrooke’s Hospital, where he was aware that a drug was being trialled that was causing a stir in the MS world. At that stage, the Cambridge doctors were the only ones in the country to be treating MS patients with a compound originally developed as a leukaemia drug.
While there were worries about sideeffects – the American authorities halted one trial after a patient bled to death – there was some evidence that it could benefit early stage MS patients. Unfortunately, Dr Straker could not take part in the Cambridge trial and was left facing a bleak future.
Christmas 2005 was approaching and Dr Straker was at his lowest ebb – bed-bound, coughing and finding it increasingly difficult to swallow.
“People were singing carols but I didn’t have the breath to sing,” he recalls.
As a last resort, Prof Bates took the unusual step of asking his hospital drug and therapeutic committee to agree to his request to prescribe alemtuzumab. They agreed.
Dr Straker was lying in a hospital bed, close to St James’ Park, while he was slowly infused with the drug and distinctly remembers hearing the roar of the Gallowgate crowd as the Magpies equalised against Arsenal.
“I was quite annoyed because I was flat on my back in my hospital when I wanted to be at the match,” said Dr Straker, a fervent Newcastle supporter.
Before agreeing to the infusion, he asked Prof Bates how the drug worked.
“It kills your T cells and hopefully replaces them with T cells that won’t attack your brain,” he says. “That is how it is supposed to work but that is not a guarantee.”
Incredibly, Prof Bates was proved right. “When I was lying in bed in January my big toe on my left foot moved for the first time in six weeks. It responded to my command… I was so excited,” says Dr Straker.
Gradually, there were more signs of recovery. “I was suddenly able to sit up without falling over, then I could turn over in bed, then I could pee again.”
As the improvements continued, Dr Straker was referred to Hexham hospital where intensive physiotherapy soon got him up on his feet again for the first time since his illness.
Before long he was so improved that he was able to move back to London and resume his medical training, working as an accident and emergency junior doctor, relying on a wheelchair to get around but spending most of his time on his feet.
Recently, because of long-term concerns about his vision being affected in future if MS symptoms come back, Dr Straker started training as a psychiatrist.
“It’s the one thing you can do as a doctor if you lose your vision,” he says.
But his most satisfying achievement is to propose to and marry his long-standing girlfriend, Daisy. “She stuck with me all the way, which is a huge feat. ”
At the wedding ceremony in London on September 19, Dr Straker did something he never thought he would do – ask his new bride for the first dance.
Looking back, Dr Straker admits he has been very lucky and just hopes that the drug will realise its promise.
“It is just a shame that it doesn’t seem to work with more progressive MS,” he says.
More than anything else, he feels indebted to Prof Bates. “He is a very brave doctor. I owe him a great deal.”
MULTIPLE sclerosis (MS) is the most common disabling neurological condition affecting young adults. Around 85,000 people in the UK have MS.
■ MS is the result of damage to myelin – a protective sheath surrounding nerve fibres of the central nervous system.
■ When myelin is damaged, this interferes with messages between the brain and other parts of the body.
■ For some people, MS is characterised by periods of relapse and remission while for others it has a progressive pattern.
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