Molecular Research in The Department of Surgery
Molecular cancer research is best carried out by a critical mass of high quality biomolecular and biomedical researchers closely affiliated to clinical centres of excellence. This structure has been employed at the Institute of Molecular Medicine at St. James’s Hospital, where a molecular research team has been established under the Dept. Surgery in Cancer translational research laboratories.
The group have a strong interest in the molecular processes regulating the progression to oesophageal cancer. Other cancer types are also being investigated, including lung, colon and breast cancer. There is a particular focus on mechanisms regulating tumour growth in relation to obesity, metabolic syndrome and bioactive lipids. In addition, genomic and proteomic profiling studies are underway, to determine molecular signatures associated with response to treatment of patients undergoing multimodal chemo-radiation therapy.
Gastro-intestinal Function Unit (GIFU) at St James’s Hospital
The GIFU at St James’s provides a GI Physiology testing service locally and nationally.
Patients are referred with symptoms of heartburn and/or dysphagia. Research in this area concentrates on patients with benign disease; Barrett’s Oesophagus is an example of mucosal injury due to prolonged exposure to gastric juices and if untreated, one in two hundred patients with this condition will go on to develop a cancer. Other benign diseases include Achalasia and Diffuse Spasm. Tests include oesophageal manometry, 24 hour acid and bile monitoring, gastric motility testing and bowel testing. Studies have shown that ambulatory monitoring of the oesophagus helps to confirm gastroesophageal reflux in patients with persistent symptoms (both typical and atypical) without evidence of mucosal damage, especially when medication is ineffective. It is also often used to monitor the control of reflux in patients with continued symptoms on therapy. Oesophageal manometry is used to diagnose motility problems and may be helpful prior to antireflux surgery.
Registry planned for those at high risk of oesophageal cancer
A REGISTRY of individuals at risk of oesophageal can cer is currently being de veloped with the support of the family of a former Medicine Weekly columnist to promote prevention and earlier diagnosis of this potentially devastating cancer.
Medicine Weekly's regular e-Doctor columnist Mr David Stewart sadly died of oesophageal cancer in October 2006.
A well-known and well- respected technology journalist, David first started writing his column for this publication in January 2002.