The Manchester upper gastro-intestinal cancer research group

The patient pathway in Manchester

Patients with symptoms that could indicate upper gastro-intestinal cancers (UGI) are referred by their GP to their local hospital for investigations. An endoscope camera is inserted down the throat and samples collected for examination using a microscope (this is how a diagnosis is made). Other tests and scans are performed as appropriate to give information that may be helpful in guiding treatment decisions.

Once a diagnosis of UGI cancer is made, a centralised team of experts (called a multi-disciplinary team) discusses each patient. This team comprises of every kind of specialist needed to treat and support the patients. The team meet weekly to consider all test results and patient circumstances, before recommending options that are then discussed with the patient.

If the cancer has not spread, chemotherapy, radiotherapy and surgery can be combined to radically treat the patient, which may result in cure. The majority of patients have advanced disease (where the cancer had spread) chemotherapy and radiotherapy treatments are likely to be offered.

The survival outcomes for patients with UGI cancers remain modest, however using a multi-disciplinary (team science) approach over the last 5 years, breakthroughs have been made which offer meaningful improvements in survival and quality of life for patients with UGI cancers.

Upper GI Research in Manchester

Manchester is the largest UGI centre in UK with catchment population of >3.2 million; the centralised high-volume approach allows us to provide link excellent clinical services with education, training and research. The cancer experts responsible for treating current Manchester patients with upper GI cancers, also have interests in researching better treatment options for our future patients.

The Manchester UGI cancer research group brings together diverse UGI cancer research enthusiasts and bridges traditional disciplines, taking a ‘team science’ approach. Professors Was Mansoor and Yeng Ang jointly chair the group. Our members come from four hospital foundation trusts (The Christie, Stepping Hill, Manchester University and Salford Royal) and three research centres (Cancer Research UK Manchester Institute, MCRC and The University).

The Medical and Clinical Oncology teams are predominantly based at The Christie NHS Foundation Trust and provide chemotherapy and radiotherapy management of patients with UGI cancers respectively. The surgical teams operate from Salford Royal University Teaching Hospital (Northern Care Alliance), performing cancer resections.

The Manchester UGI cancer research group aims to be a ‘hub’ to gather enthusiastic individuals and teams together to form unique UGI research collaborations. This Manchester-centric and Manchester-led research will improve outcomes for future patients with UGI cancers.

Supported by The Systemic Therapy Research group at The Christie, the main UGI group meets every three months and smaller focus groups meet as required to work on spinout activities.

We have developed a program of work that includes (but is not limited to) the following themes:

• Pre-cancer surveillance for patients with Barratt’s oesophagus
• Living with advanced (stage 4) cancer
• Chromatin landscape in primary UGI tumours and their metastases
• Prehabilitation in patients with UGI cancers
• Defining gastric cancer surgical outcomes
• Cardio-Pulmonary Exercise Testing (CPET) in UGI cancers
• Patient engagement groups which focus on UGI cancers

Banner Image: Haematoxylin and eosin stained gastric cancer under the microscope courtesy of Stephen McGrath, Consultant Histopathologist, Northern Care Alliance NHS Foundation Trust