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EBI Clinical Primer helps to improve diagnosis of bowel cancer

Adam Chambers

2 April 2015

Adam Chambers, a surgical trainee in the East Midlands Deanery, is used to applying research evidence in his day-to-day surgical care of patients. Adam believes that basic scientific research is the vital initial step that ultimately leads to a change in clinical practice, and that’s why he welcomed an opportunity to develop his academic interests through an EBI Clinical Primer scheme alongside continuing his surgical training.

Adam is aiming to specialise in bowel (colorectal) surgery with the goal of practising as a Consultant Colorectal Surgeon. A large proportion of Adam’s clinical work involves patients with bowel cancer. As a result he has developed an intense interest in what drives the development and progression of colorectal cancer. Having already gained basic research experience while completing an MSc in Wound Healing and Tissue Repair, he wanted to build on the knowledge and skills he had acquired by undertaking a formal laboratory based period of research.

During his EBI Clinical Primer fellowship, with the Colorectal Tumour Biology Group run by Professor Ann Williams and Professor Chris Paraskeva (School of Cellular and Molecular Medicine, University of Bristol), Adam examined the role of inflammation and the response of bowel cancer to radiation.

Bowel cancer is the second most common cause of cancer-related deaths in the UK. In a particular type of bowel cancer called rectal cancer some patients are treated with combined chemotherapy and radiotherapy before they have surgery, to shrink their tumour. However the chemo-radiotherapy is not always successful meaning that for some patients they receive an ineffective, unpleasant treatment delaying surgery unnecessarily.  Therefore there is an urgent need to be able to identify those patients that will most benefit from pre-operative chemo-radiotherapy (CRT).  Adam’s research aimed to understand why some patients do not respond to the CRT. His research project showed that a protein called BCL-3 plays a role in promoting cancer cell survival after radiotherapy in the laboratory. When the function of this protein is inhibited, the rate at which the tumour cells are killed by irradiation is significantly increased. These exciting results suggest that targeting BCL-3 function may sensitize tumour cells to RCT and importantly that the level of BCL-3 expressed by a tumour could be used to predict which patients will most benefit from pre-operative CRT.

This may lead to fundamental changes in the treatment of bowel cancer in the future, with stratification of patients to which therapy they receive, the effectiveness of therapy and possibly new chemotherapies.

‘Being awarded the EBI Clinical Primer scheme has been extremely beneficial to the early stages of my research career’, says Adam, ‘The Primer has allowed me to gain the necessary research knowledge and technical skills for subsequent funding applications. These skills such as tissue culture, protein and RNA analysis and in vitro irradiation, has enabled me to ‘hit the ground running’ as I start my PhD. This experience was critical for my success in gaining a University of Bristol Scholarship as it meant I could discuss at interview the preliminary data I have collected. The Primer has also led to successfully gaining funding from the David Telling Charitable Trust. The preliminary data has meant I have submitted an abstract to the Association of Coloproctology conference in May 2015. The work will build towards further abstracts/publications and critically future clinical studies.

Personally I have been inspired by being in a highly ambitious and competitive laboratory setting that has developed skills such as critical appraisal of the scientific literature, scientific knowledge and communication skills, through discussion with experienced members of the Paraskeva/Williams lab. As well as learning from the group the Primer has given me the opportunity to explore my own ideas, which has helped me to develop my PhD project going forward.'

To learn more about the Colorectal Tumour Biology group at the University of Bristol, visit here: 

Further information

Please visit the EBI Website to learn more about the funding available from the Elizabeth Blackwell Institute, including Clinical Primers.

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