Predicting whether cancer is likely to return after surgery could improve the survival of patients, according to a study by a leading Cancer Research UK scientist.
Research published in the British Journal of Cancer1 examines a cancer of the digestive system, occurring in the join between the oesophagus and the stomach, and should help doctors predict how the disease recurs.
Surgeons believe that by identifying patients whose cancer has begun to spread at diagnosis, they can personalise therapy, using both surgery and chemotherapy to limit or prevent the cancer’s recurrence.
The study, carried out by Professor Michael Griffin and his team at the Northern Oesophago-Gastric Cancer Unit, University of Newcastle, involved 169 patients with oesophago-gastric junction cancer.
Dr John Wayman, a research fellow in Newcastle, examined patients six weeks after leaving hospital and then again every three-months for six years after surgery. Following examination, all symptoms suggestive of cancer’s return were investigated.
Cancer recurrence was observed in 103 patients and was found mostly in the bones and the blood vessels around the liver.
Scientists found that the presence of cancer cells in the lymph nodes at the time of surgery was a strong indicator of whether cancer would return and believe this could be used to identify patients who would benefit from combined treatment before surgical removal.
The lymph nodes form the transport network for the immune system and are a common route for the spread of cancer. When cancer cells become detached from a tumour they travel along the circulating lymph and get stuck in small channels inside the lymph nodes.
Researchers believe they can detect cancer spread at diagnosis using two scanning techniques that visualise where rogue cancer cells, which have broken away from the initial tumour, end up. By doing this they can pinpoint whether cancer will return in patients and offer a treatment regime prior to surgery to try and keep the cancer at bay.
Professor Griffin says: “The study will allow us to better understand the biology of this cancer and gives us the opportunity to strategically plan treatment.
“Following this research we’ve started paying close attention to scans that detect cancer spread before we operate. The task now is to develop better techniques to identify patients who are at high risk of cancer returning after surgery. We are currently piloting a new scanning technique to detect cancer that returns in the bone, with encouraging results.”
Sir Paul Nurse, Director General of Cancer Research UK, says: “By predicting whether this cancer will recur, we should be able to tailor treatments to individual patients, improving their effectiveness and reducing the possibility of cancer returning.”
- British Journal of Cancer86(8)