Determining when limited resection can safely prevent cancer in inflammatory bowel disease
Lead researcher: Dr Annie Baker
Location: Institute of Cancer Research, London
Grant award: £25,000
Dr Annie Baker and her team are looking for ways to predict which inflammatory bowel disease patients can safely have only part of their bowel removed when they show signs of precancerous changes, and which patients should have their whole bowel removed to prevent further risk of bowel cancer.
The challenge
People with inflammatory bowel disease (IBD), chronic inflammation of the bowel, have a higher risk of developing bowel cancer. They are closely monitored for signs of tissue with precancerous changes, and if these are found, they will either have their whole bowel removed (a colectomy) or only have the affected section of the bowel removed (a limited resection).
A colectomy is major and complex surgery, with significant health implications afterwards; a limited resection is less invasive but there is still the risk of developing further areas of irregular tissue or cancer in the parts of the bowel that are left, requiring further treatment.
The science behind the project
When the irregular area of tissue is removed, the surgeon will also take an area of healthy tissue around it (the margin). However, Dr Baker’s research group have shown that even when this tissue looks normal under the microscope, it can be carrying abnormal DNA mutations.
They will be looking at preserved tissue samples from patients who have had limited resections at St Marks Hospital in London, to see what mutations they had in their precancerous growth and if any were also present in their margins. They will then see if the people who had mutations in their “normal” tissue were more likely to develop further precancer or cancer.
The team will also test if particular DNA mutations can predict long term outcomes in patients who have limited resections.
What difference will this project make?
The results of this study will help to predict which people with IBD can safely treat their precancerous changes by having less invasive surgery to only remove part of their bowel, and which people are at higher risk of further changes and so should have their whole bowel removed. This will support more informed decision making by patients and their clinicians about the best treatment option for them, including potential for the development of targeted screening methods for patients with IBD.
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