Kirsty Smitten harbours fantasies of one day collecting a Nobel Prize for her scientific work – and rightly so, given that it could save millions of lives and avert a medical catastrophe.
At just 28, she has achieved something that hasn’t been done for nearly 40 years: created a new class of antibiotics.
In doing so she is leading the fight against anti-microbial resistance – what the World Health Organisation calls one of the biggest threats to global health – which has seen bacteria, viruses, fungi and parasites evolve over time and no longer respond to medicines.
However, in a devastating twist of fate, this exceptional biochemist is now having to face up to the fact she may not be around to receive any accolades. Kirsty has been given just months to live after being diagnosed with heart cancer – a terminal disease so rare it affects only two people a year in the UK.
‘How? I mean, really, how has this happened?’ asks Kirsty when we meet at the Cornish bolthole where she is spending a week recuperating between rounds of chemotherapy with her fox-red labrador, Bailey.
‘I eat healthily. I don’t drink much, I don’t smoke. And, until my diagnosis, I played sport every day.
‘There aren’t words to express how sad I feel that I might not be around to see how our potentially Nobel Prize-winning work might unfold. My only hope is that the work carries on without me. I’m sure it will.’
At just 28, scientist Kirsty Smitten (pictured) has achieved something that hasn’t been done for nearly 40 years: created a new class of antibiotics
AWARD-WINNING: Kirsty at Sheffield University, where she gained her PhD and set up her research company
Drug-resistant bacteria, such as MRSA, are already blamed for more than a million deaths each year, and it is predicted that by 2050 this could rise to ten million.
With her team at Metallo Bio, a company she set up with the support of her doctorate supervisor at Sheffield University, Kirsty has developed two antibiotic compounds to treat bacterial infections, including strands of pneumonia and meningitis that have become resistant to the drugs usually used to treat them, as well as infections that develop in wounds and after surgery.
After proving successful in laboratory and animal testing, the next stage in development will be human trials, beginning with hospital-acquired pneumonia. If, as expected, it proves effective, Kirsty hopes the treatment will be licensed by 2030.
This brilliant scientist, who has a PhD in chemistry and, in 2020, was named in Forbes magazine’s prestigious 30 Under 30 list for science and healthcare, also raises money for food banks in her spare time.
She has so much more to offer the world, but as a scientist – despite understandable moments of ‘Why me?’ rage – Kirsty is a pragmatist. She knows her cancer was caused by a rare genetic mutation, not her lifestyle. But it is that anger that propels her to pore over research and try to buy whatever additional time she can with the same doggedness that may, eventually, help save the world from anti-microbial resistance.
‘I feel angry towards friends if they say, “I feel unwell today,” ‘ says Kirsty, examining the cannula that’s now a permanent fixture in the vein in her right arm, ‘because I’ll think, “Can you moan about that to someone else?”
‘It’s a bit unfair, because I’ve asked them to be normal with me.
‘Sometimes the anger overwhelms me. I was watching a TV news report about a convicted rapist the other night and got upset, wanting to know why I’ve been given only months to live when there are people like him committing terrible atrocities in the world.
‘It seems so unfair. But, even so, I wouldn’t wish this on the worst person in the world.’
Kirsty has cardiac angiosarcoma – a tumour in her heart. If she opted for the surgery needed to remove it, there is a significant risk she would bleed to death. And if she survived the operation, she would, at most, gain only a few more years. This type of tumour will grow back and is likely to spread or burst, causing her heart to fail.
While Kirsty’s legacy could save millions of lives, she will not now get the chance to realise her other ambitions: falling in love, settling down and having a family.
‘I’m infertile, thanks to the treatment. There wasn’t time to do an egg extraction,’ she says.
‘I’m also single. It wouldn’t be fair to be in a relationship not knowing how little time I have left.
‘And, anyway, who wants to date someone with terminal cancer?’
The first inkling that something was seriously wrong came last November, when Kirsty woke in the night with agonising chest pains.
At the time, her family was mourning the sudden death of her seemingly healthy father, Kevin, 61, a retired businessman who had suffered a heart attack while playing football in Portugal three weeks earlier.
Taking no risks, Kirsty’s mother, Sharon, 60, whisked her to A&E at Birmingham Heartlands Hospital near their Solihull home.
Kirsty played football and hockey every day, and was a regular at her gym, so the doctor said he thought her pains were probably a pulled muscle in her chest, and planned to send her home with painkillers. But Kirsty, who perhaps has more understanding of the human body than most, refused to leave, insisting the pain was too intense and that it warranted an X-ray, which was duly performed. The doctor also ran blood tests.
Several hours later, two consultants took her into a room where they explained that the clotting factor in her blood was raised, which could signify a pulmonary embolism – a potentially fatal clot in the lung. They also said the right atrium in her heart was three times the size it should be.
Heparin, an anticoagulant used to decrease the blood’s clotting ability, was administered and an emergency CT scan ordered for the following day.
Illustration of antibiotic resistant Pseudomonas aeruginosa bacteria
Kirsty recalls: ‘After the scan, I saw a consultant and he said, “Good news, you don’t have a pulmonary embolism, but we found a 6cm mass in your mediastinum [the space in the chest that holds the heart].”
‘He said there were many things this could be, other than cancer. But I think, even at that point, I knew the fate that lay ahead.’
An MRI followed. Kirsty was told the mass was irregular and accumulating a lot of the dye used by doctors to make it more visible on the scan – all bad signs.
She understood more about the terrible implications than her mum and older brothers, Matt and Dan.
‘I have a good knowledge of oncology through my work, and realised that meant it was cancerous,’ she says. ‘I warned my family that an irregular-shaped mass accumulating a lot of dye was really not good.’
Due to the delicate positioning of the tumour and the risk of suffering a serious bleed, Kirsty underwent numerous procedures before her terminal diagnosis.
‘It took three months, seven scans, 15 blood tests, a minimally invasive biopsy and major heart surgery to tell me I have angiosarcoma,’ says Kirsty. ‘It’s the most aggressive type of sarcoma or, as I call it, “the death sentence”. They told me I have just seven months to live.’
Since her diagnosis on February 8, Kirsty has undergone six rounds of chemotherapy and takes 48 tablets a day. These include heavy-duty pain relief, anti-nausea medication, antacids, an antihistamine to ease the chemo-induced rashes and iron for her low red blood cell count – all in the knowledge that they cannot save her life.
It is little wonder she also needs the occasional lorazepam – a drug for anxiety and sleeping problems.
Kirsty has never suffered from these mental health conditions before, but they have been a constant unwanted companion since November.
‘I started to have panic attacks in my sleep and before every scan,’ she says. ‘I didn’t know what was happening – I’d never had a panic attack before so thought I was having a heart attack.
‘The worst thing is waking up in the mornings, aching and in pain from the chemo, and wondering if this will be my last day. I have the same fear before I go to sleep, wondering if I might die in the night.
‘Hopefully I’m stable enough for that not to happen at the moment. But when I start to deteriorate, it’s likely to happen very quickly.’
Kirsty is as clued up as anyone could be, having read every academic paper and personal account available on angiosarcoma. She was in contact with another young British woman with the condition, who died in her sleep a few weeks ago.
Kirsty has two main fears as the disease progresses. The first is no longer looking like herself, which is why she wears a cold cap during chemotherapy, in the hope of holding on to her hair. The second is of the cancer spreading to her brain, impairing her acute intelligence.
She is also painfully aware of the impact on her family – who had no opportunity to process their grief for her father before having to confront losing Kirsty, too. ‘Initially, Mum said she couldn’t cope – but my brothers and I explained that I really need her right now and I can’t expend so much energy worrying about whether she’s OK,’ says Kirsty. ‘She’s been so much more supportive since.’
Agonising though it must be, Sharon is with her daughter every step of the way. Kirsty now lives at home with her in Solihull, and while this meant leaving her laboratory and team in Sheffield, she continues to work remotely.
After being told at Birmingham Heartlands that surgery was too risky, Kirsty did her own research and contacted Professor Robin Jones, head of the sarcoma unit at London’s Royal Marsden hospital.
He and his surgical team have agreed to meet with Kirsty at the end of this month, when she finishes her next cycle of chemotherapy, with a view to operating soon.
‘We don’t know how much time that will buy me,’ says Kirsty. ‘Some people have the tumour out and get one or two years before it starts to come back. Other people have days or weeks. They don’t know what makes that difference.
‘I know a woman whose son had angiosarcoma and had it taken out, but in six weeks it came back – the cells can’t be removed completely. Sadly, he died. I’ve also chatted to people on Facebook who have gone two years post-surgery and they’re still in remission, so I have to hold on to hope.
‘Even after surgery I will have to continue with chemo to try keep it at bay – so my life will never be the same.’
Kirsty can’t help holding on to the vague hope that, if her cancer is slow to return, her colleagues in oncology may find a cure in time. But given how rare her cancer is, she knows that’s very unlikely to happen – and it comes down to money.
Securing funding for research into her own work is challenging enough. This is despite anti-microbial resistance already being responsible for an estimated 1.2 million global deaths every year. If unchecked, this is expected to rise to ten million a year by 2050, superseding the deaths from cancer and equating to one every three seconds.
‘I work in medical technology and no one wants to fund something that is going to be used by only one person in 36 million – that’s how rare my cancer is. So there are no new treatment developments,’ she says. ‘But given that investment funding isn’t going to go into rare cancers, I think the Government needs to make a specific allocation towards research into them.
‘Six months ago I had no idea that you could even get heart cancer, and I’m a medical scientist. It’s no wonder diagnosis times are lengthy and there are no treatments – no one knows about it.’
Kirsty would like to spend the time she has left raising awareness about cardiac angiosarcoma, in the style of Dame Deborah James, who campaigned tirelessly to raise awareness of bowel cancer before dying from the disease last year aged 40.
However, there is a significant difference in the numbers affected: some 43,000 people are diagnosed with bowel cancer each year.
‘I’ve faced difficult odds before,’ Kirsty says. ‘The likelihood of finding a successful alternative to antibiotics was certainly not high, and my type of cancer affects just one in 20 million people.
‘In fact, my GP joked that, with my track record, it might be worth buying a Lottery ticket.
‘It’s not in my nature to give up. So I’ll go on working and fighting this for as long as I possibly can.’
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