Current Research

Our fundraising efforts helped to send Dr Mainie to Japan to learn a new surgical technique which is proving successful as a non-surgical cure for oesophageal cancer patients in 94% of cases.
Current surgical techniques for oesophageal cancer are invasive
and life-changing, requiring the sectioning and removal of a
significant portion of the oesophagus around the tumor and ‘pulling up’ the stomach, through the ribcage. Understandably, this is a life-changing and life-threatening operation, resulting in a number of follow-on complications. The new technique, known as ESD (Endoscopic Submucosal Dissection), was developed in
Japan 10 years ago. The new method is to use a suction cap fitted to the end of an endoscope which has a snare at its base. It creates a polyp with the suspected cancerous cells inside and allows for the total removal of pieces of mucosa at least 1cm in diameter down to the level of the deep musosa. It has the ability to eliminate a superficial cancer in about 94% of cases. It is Dr Mainie’s
ambition that this technique will limit the need for invasive surgery and help transform Gastroenterology in Belfast into a Teaching Centre of Excellence.

Dr Helen Coleman, Senior Lecturer and Lead of the Cancer Epidemiology Research Group at Queen’s University Belfast’s Centre for Public Health has recently been awarded a major new grant from Cancer Research UK to conduct further research into Barrett’s oesophagus and oesophageal adenocarcinoma. This research has two key aims that will build on opportunities for earlier detection of, and therefore better survival from, oesophageal cancer.

The first aim will evaluate trends of Barrett’s oesophagus, low and high grade dysplasia, and oesophageal adenocarcinoma diagnoses in the modern treatment era. Data from the Northern Ireland Barrett’s oesophagus register, hosted by the Northern Ireland Cancer Registry, will be analysed. The Northern Ireland Barrett’s oesophagus register is the only population-based register of Barrett’s patients in the UK, and will be updated to 2020, to include information on over 22,000 patients. Data analysis techniques will be applied to evaluate the potential impact of novel therapies such as radiofrequency ablation (RFA) and endoscopic mucosal resection (EMR) on trends in diagnoses by pathologists. Dr Coleman’s team will also analyse this data to investigate long term cancer risk in Barrett’s patients, and survival rates. Evaluation of these up-to-date trends will estimate the impact of new treatments and help to inform guidelines for patients.

The second aim of this research hopes to identify new ways that survival could be improved through lifestyle interventions. There is also a lack of understanding of how modifiable risk factors, such as smoking or nutrition, interact with molecular features of oesophageal cancer, and this new study will provide insight into such relationships. Data and samples from over 3,000 oesophageal adenocarcinoma patients recruited to the the UK-wide ‘OCCAMS’ consortium, will be analysed. Insights from these studies will inform whether personalised lifestyle interventions (for example, smoking cessation, vitamin D supplementation, aspirin, nutrition interventions) should be targeted at individuals according to molecular characteristics of their tumour.

Dr Coleman will be working closely with Dr Richard Turkington, Dr Brian Johnston, Dr Damian McManus and Dr Inder Mainie from the Belfast Health and Social Care Trust on this research, collaborating with Professor Rebecca Fitzgerald at the University of Cambridge and Dr Chris Peters at Imperial College London. This Career Establishment Award represents an investment of over £850,000 from Cancer Research UK into oesophageal cancer research in Northern Ireland over the next six years. Regular updates will be provided to OG Cancer NI and anyone who would like further information is very welcome to contact Helen Coleman (email: h.coleman@qub.ac.uk; tel: 02890978953).

Esophageal cancer patients and carers report significant levels of psychological distress. Despite this, only a small number of patients and carers engage with existing psychological services. This study aims to explore the perception of esophageal cancer patients, carers, and healthcare professionals (HCPs) of psychological distress and current provision of support, the need for and format of tailored support and barriers to patient/carer engagement. 

The full research can be read here: https://doi.org/10.1093/dote/doy076