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The second leading cause of cancer-related deaths is colorectal cancer, a disease which affects men and women at similar rates, and which is more likely to occur in people living with obesity, suffering from a poor diet, living a predominantly sedentary life or those who smoke. Today the burden of colorectal cancer is increasing, despite our understanding of the lifestyle factors which contributes to increasing the risks.

In many cases, colorectal cancer is difficult to correctly stage before patients begin undergoing therapy, and this means that some patients are treated with more radical therapies than they might require. Cancer surgeon Henry Smith is focused on improving the outcomes for patients diagnosed with colorectal cancer, by enabling more precise definitions of cancer staging before patients undergo major surgical procedures such as a hemicolectomy. This is an ambitious research project, which fundamentally aims at understanding which patients fall into which category of illness before they are treated.

“There’s a growing awareness of the need to personalise treatment for colorectal cancer. Historically, the attitude has been that cancer treatment should always be radical, but sparing treatments can be effective on a proportion of the population without worse outcomes.”

By studying genetic profiles, using biopsy samples, Henry Smith and his team of researchers will investigate how to improve the process for identifying patients with early colorectal cancer without localised spread of the disease, and who would benefit from a less aggressive surgical procedure such as ‘local excisions’. They also aim to more accurately identify the regions that advanced stages of disease have spread to, so that surgery to remove the affected lymph nodes can be personalised to target the diseased tissue without sacrificing healthy regions. For patients with the most advanced stages of cancer at diagnosis, it is known that treatment with chemotherapy before surgery can improve outcomes, so it is also important to be able to identify this population before surgery.

“Complex and invasive surgeries are a big undertaking, and patients deserve to know the facts while they weigh up their options. Being able to accurately explain the risks and potential impacts of each treatment to patients is something that is very difficult to do at the moment, but which we hope to get better at so that people can decide what is the right course of treatment for them and their lives.”

Henry Smith is enthusiastic about the opportunities that this fellowship can provide to his team, and for the potential this brings to patients suffering from colorectal cancer.

“I have always wanted to be an academic cancer surgeon, having patients who I can help and a translational research team working alongside, to develop new or better ways of treating people. Being able to bring those new practices back into my clinic is what I find so motivating.”