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The University of Southampton

Oesophageal Cancer. What is it? Where is it? How is it treated?

Published: 23 November 2018
Tim Underwood
Professor Tim Underwood gave his inaugural lecture this week

Professor Tim Underwood, the new Head of Cancer Sciences, gave his Inaugural Lecture this week in which he discussed his early years of surgery for oesophageal cancer through to the current experimental and potential treatments of the future.

He talked about how the provision of surgery has changed leading to dramatic improvements in outcomes and address the key scientific discoveries driving new approaches to treatment.

Using examples from his own research, Tim explained how technological advances are enabling us to understand cancer biology in ever increasing detail, including at the level of the individual cell.  With these advances come the challenges of understanding and interpreting complexity to benefit real people in time to make a difference.  Tim explored the challenge of traditional models of cancer research with examples of how “team science” is changing the research landscape.

Name: Tim Underwood
Position: Professor of GI Surgery, CRUK & RCS Advanced Clinician Scientist Fellow, Head of Cancer Sciences
Research field: Oesophageal cancer and tumour ecosystems

What is your current research focus?
I lead a programme of research studying the role of the tumour microenvironment in oesophageal cancer.  My team develop and apply advanced technologies to understand tumour complexity with a view to developing new treatments.

Why did you decide to focus your career on that particular area of research?
Because the five-year survival for oesophageal cancer is less than 15 per cent and only a third of patients are suitable for treatment with curative intent.  New treatments are desperately needed.

You also work clinically, how do you balance your clinical and research commitments?
I have great teams in both areas, without whom this would be impossible.  Even with this it is sometimes a real struggle.

You’ve recently become the Head of Cancer Sciences – what is your vision for the department?
Fortunately, when I took over as Head of the Cancer Sciences Academic Unit (CSU) in August this year I was following significant success.  I inherited an Academic Unit full of great people who understand medicine in Southampton in a way that I will only ever aspire to.  The CSU has grown into a world-leading cancer research department, with peaks of excellence that span haematological and solid tumour sub-types underpinned by basic biological and translational science. The opening of the Centre for Cancer Immunology, a product of the hard work and dedication of all members of the CSU team, signifies a new era of cancer research in Southampton. 

The first task I set myself is to listen.  I have met over 30 colleagues in one-to-ones to find out about what really goes on and we have discussed the good, the not-so-good and their views on how CSU could improve.  These meetings will continue until I have heard from every team.

Clear themes are emerging, and I will devise proposals about how we can move forward together so we can be more collaborative and collegial.  Cancer Sciences punches well above its weight, but to continue to do this we need to actively work together between groups and between buildings to maximise our performance and our outputs. 

I want to encourage early career researchers to feel more empowered about their work and know that they have a voice and can contribute to the CSU. I also aim to be open and honest about our finances and be the link between the Unit and the Faculty executive.

I have been enthused and amazed by the fantastic work that is going on.  I can tell how engaged and energised people are by their science. We have lots to be proud of, but most importantly we have fabulous people who work hard together to make CSU excellent.  I am excited about the journey ahead.

What have been your biggest ‘eureka’ moments in your research field or clinical work?
Within my research areas, defining the genomic landscape of oesophageal adenocarcinoma has been a standout moment and being able to understand the complexity of this cancer type at single cell resolution for the first time.

Clinically it has been enabling enhanced recovery after oesophageal surgery.  We recently set and internal record with a patient discharged only 5 days after surgery.

How would you describe the rate of progress in your research field and clinical work that you’ve witnessed?
Too slow…….but we are catching up quickly.

What would you say is your proudest career achievement?
Enabling talented researchers and clinicians to fulfil their potential.

What excites you most about the future of your research field and clinical work?
We are on the cusp of something really exciting.  Computational and biological improvements are driving exponential growth in our understanding of disease.  This will lead to better and more durable treatments for cancer.


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