Discipline Hopping: Colorectal Cancer Therapy

每两个人中就有一个会在一生中患上癌症。癌症几乎影响到每个人，无论是朋友、亲戚还是病人自己。在过去的四十年里，治疗方面的创新通过延长生命、提高生活质量，甚至治愈癌症，改善了许多患者的预后。然而，英国28%的死亡仍然是由癌症造成的。结直肠癌（或肠）癌是英国第四大常见癌症，每天有超过110例确诊病例。最著名的治疗方法是手术切除肿瘤；然而，这一操作也存在挑战。例如，切除整个肿瘤并不总是那么容易，如果不这样做就会导致复发。一个重要的临床需要是提高外科医生识别肿瘤边缘的能力。其他主要治疗方法包括放疗、化疗和免疫疗法。不幸的是，它们并不总是成功的，可能只导致寿命的延长，或者在最坏的情况下没有可衡量的效果。人们普遍认为困难的问题需要多学科的方法。创造新的、更有效的癌症治疗方法是一个巨大的挑战，几乎所有的研究资助者（慈善机构和研究委员会）都认识到多学科团队寻找解决方案的好处。然而，在学科之间，存在知识差距，这可能会减缓进展，并导致解决错误的问题。在这个提议的医疗学科跳跃奖中，我将学习、培训和研究结直肠癌治疗的各个方面。这将使我有能力在学科之间搭建桥梁。为了做到这一点，我将与临床实践相结合，这样我就能理解诊断（筛查、病理和成像）和治疗（手术、放疗和消融）。我将参加每周的临床多学科结直肠癌会议，会议决定每个患者的治疗方案。我将观察对患者进行的所有不同的结直肠癌手术，如开放手术、机器人手术和腹腔镜手术。这将提供一个机会，以充分了解未满足的需求和挑战的手术，如确定肿瘤边缘。我将见证放射治疗的实施，并了解进一步研究的局限性和机会。我还将了解更多关于早期临床试验以及如何转化基础研究的信息，例如需要哪些数据集以及标准是什么。我将学习术中消融治疗以及这些治疗在未来的发展方向。我将有机会接触医疗保健经济和医疗保健技术评估专家，以全面了解开发新治疗方法所面临的挑战，并从早期阶段就认识到潜在的缺陷。我将与正在开发各种策略以研究新疗法的临床合作伙伴一起参与正在进行的CRC研究项目。通过参与项目，我将学习用于体外和体内评估的关键技术。为了进一步拓宽我的知识面，我计划访问英国、加拿大和荷兰的其他医学研究中心。最后，将有四个重点研讨会，将探讨各种结直肠癌和其他癌症治疗的临床需求。这些小组的成员将包括患者、临床医生、科学家、工程师和行业代表。在这个奖项之外，我将维护在这个奖项期间将发展的研究人员网络。

One in two people will have cancer during their lifetime. Cancer affects almost everyone whether it is friends, relatives, or the patient themselves. Over the last four decades, innovation in treatment has improved the outcome of many patients by extending life, improving quality of life, and even curing their cancer. However, 28% of all deaths in the UK are still due to cancer. Colorectal (or Bowel) cancer is the fourth most common cancer in the UK, with over 110 cases diagnosed per day. The best-known treatment is surgical removal of the tumour; however, there are challenges to this operation. For example, it is not always easy to remove the entire tumour and failure to do so leads to recurrence. An important clinical need is to improve the surgeon's ability to identify the tumour margins. The other main treatments include radiotherapy, chemotherapy, and immunotherapy. Unfortunately, they are not always successful and might only result in the extension of life or in the worse case have no measurable effect. It is widely recognised that difficult problems require a multidisciplinary approach. Creating new, more effective, cancer treatments is a big challenge, and almost all research funders (charities and research councils) recognise the benefits of multidisciplinary teams to find solutions. However, between the disciplines, there are knowledge gaps, which can slow down progress and lead to solutions to the wrong problems. In this proposed Healthcare Discipline Hopping Award, I will be learning, training, and researching all aspects of colorectal cancer treatment. This will give me the ability to build bridges between the disciplines. To do this I will be integrating with the clinical practice so that I can understand the diagnosis (screening, pathology, and imaging) and the treatment (surgery, radiotherapy, and ablation). I will attend the weekly clinical multidisciplinary colorectal cancer meetings, which decide the treatment plans for each patient. I will observe all of the different CRC surgical operations performed on patients, such as open, robotic, and laparoscopic. This will provide an opportunity to fully comprehend the unmet needs and challenges to surgery, such as determining the tumour margins. I will witness radiotherapy being performed and learn about the limitations and opportunities for further research. I will also find out more about early-stage clinical trials and how basic research is translated i.e. what data sets are required and what are the standards. I will learn about intraoperative ablation treatments and how these could be advanced in the future. I will have access to healthcare economic and healthcare technology assessment experts to obtain a complete picture of the challenges to not only developing new treatment methods but also recognising potential pitfalls from the early stages. I will be integrating with on-going CRC research projects with clinical partners that are developing various strategies to investigate new treatments. By engaging with projects, I will be learning the key techniques used for in vitro and in vivo evaluation. To broaden my knowledge further, I have planned visits to other medical research centres in the UK, Canada and the Netherlands. Finally, there will be four focussed workshops that will look at the clinical needs of various CRC and other cancer treatments. Members of the groups will include patients, clinicians, scientists, engineers, and industry representatives. Going beyond this award, I will maintain the network of researchers that will be developed during the award.