Ally is an academic psychiatry trainee, nearly a Consultant psychiatrist, currently funded by The Charity to study non-drug treatments for fatigue in people living with a brain tumour
“I was honoured and equally scared to be asked to write a chapter on psychiatric complications of a brain tumour, to go in the biggest psychiatric textbook in the world.
Why? Because it was a once-in-a-lifetime chance to speak directly to other psychiatrists and make my play to motivate them to work with brain tumour patients. We need it.
I’m not alone in thinking so. Our team once called up all the brain tumour teams we could find in the UK and asked them whether they wanted more psychiatry input. Nearly all of them said yes.
A few years ago, I gave a talk to the Society for Neuro-Oncology in America. I laid out the different kinds of research studies on a spectrum showing that nearly all studies relating to quality of life after a brain tumour were (and still are) of a kind of design called ‘observational’. Observational studies describe current reality.
They mainly tell us which symptoms or problems happen at the same time as everything else that’s going on. These studies are important because they highlight issues that matter to people living with a brain tumour.
But while there are exceptions, the general weakness of observational studies is that they don’t take us much closer to discovering new treatments.
I started my academic career doing observational studies, and will continue to do them. But I have come to think that what we need now is to discover new treatments, for things that make living with a brain tumour difficult, like fatigue, depression, personality change, memory problems, and epilepsy.
I would argue that on this quest, psychiatrists have skills that other doctors just don’t. The reason for this is that psychiatrists deal with those specific issues day-in, day-out. We understand the impact that they have in the real world. We know what questions matter because we see it every day, whether or not a brain tumour is involved.
How do we get more psychiatrists involved with brain tumours? I would be lying if I said I knew. The old adage about experience – that she is a hard teacher, because she gives the test first and the lesson afterwards – is equally true for discovery science.
But first, I think we need more psychiatrically-led laboratory research.
Lab research tells us about biology, and understanding biology is the best way to discover new treatments for the symptoms that affect quality of life.
Second, we need more psychiatrists running randomised controlled trials. Trials are the only way to discover which treatments work in the real world.
These two designs, lab research and clinical trials, need champions of investment, like The Brain Tumour Charity.
I am always mindful of how lucky I am to be training in both lab research and, thanks to the Research Involvement Network (RIN) and The Brain Tumour Charity, clinical trials too.
I am extremely grateful to you for giving up your time. I hope to be able to repay that generosity by making, in my professional career, a small contribution to the monumental task of discovering better treatments for people living with a brain tumour.”
Ally graduated MBChB from The University of Dundee in 2003. He is currently finishing both his PhD within the MRC/MRF-funded PsySTAR (Psychiatric Scottish Training in Academic Research) programme, and his psychiatry training within NHS Lothian.
In 2017, after accessing the RIN, he successfully applied for The Brain Tumour Charity’s Quality of Life grant. His study (BT-LIFE) starts recruiting in spring 2018 and aims to assess the feasibility of non-drug treatments for fatigue.