Biography

I am a Professor of Surgical Oncology and Consultant Surgeon based at the University Hospital of South Manchester NHS Foundation Trust and the Christie Hospital in Manchester where I have a large clinical commitment to the Manchester Breast Service, which is the largest in the country. I graduated from Newcastle University in 1980 and was awarded my medical degree in 1990. After completing my training in Edinburgh, Leicester, Cardiff and Birmingham I joined the University of Manchester as a Senior Lecturer in Surgical Oncology in 1991, and was appointed as Professor of Surgical Oncology in 1999.

I have research interests in preinvasive cancer (ductal carcinoma in situ), breast cancer chemoprevention, endocrine therapy and bone metastases and I have developed xenograft models of human DCIS, primary culture and stem cell cultures of human DCIS. My research in Manchester was recognised by the Royal College of Surgeons of England when I was appointed a Hunterian Professorship in 1995 for my work on parathyroid hormone related peptide and its role in bone metastases. I am a member of numerous medical societies and have been the recipient of numerous honours and awards, including the Patey Prize from the Society of Academic & Research Surgery (SARS) and the Ronald Raven Prize from the British Association of Surgical Oncology (BASO).

I have authored or co-authored more than 160 peer-reviewed articles and my work has appeared in many journals, including the Journal of the National Cancer Institute, The Lancet, Cancer Research and Cancer. I am also the chief investigator on several preoperative DCIS trials and an international trial (DCIS II) funded by Cancer UK.

Memberships of committees and professional bodies

I am a member of the following societies/organisations:

  • Association of Surgeons of Great Britain and Ireland
  • British Association for Cancer Research
  • British Association of Surgical Oncology (BASO), Elected National Committee Member
  • British Breast Group
  • Clinical Trials Advisory Awards Committee, Cancer UK
  • European School of Surgical Oncology
  • National Cancer Research Network (NCRN), Trials Adoption Committee
  • National Institute for Health Research Senior Faculty Member
  • Society of Academic & Research Surgery (SARS), Elected National Committee Member

Methodological knowledge

  • "In Vivo" Models
  • Clinical Trials
  • Translational Science

Overview

My role as Professor of Surgical Oncology is principally based at the University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital and involves management of all types of breast disease as well as thyroid problems. I work 3 PAs in the Christie Hospital and have active laboratory research in the Paterson Institute for Cancer Research.

In September 2007 I was appointed as Clinical Lead for Research for the Greater Manchester and Cheshire Cancer Research Network and Clinical Director for the recently awarded Breakthrough Breast Cancer Unit.

Qualifications

1990 MD Thesis, Newcastle University Medical School
1986 FRCS (England), Royal College of Surgeons
1985 FRCS (Edinburgh and Glasgow), Royal College of Surgeons
1975-1980 MB BS, Newcastle University Medical School

Research interests

My current research programme is concentrated on two main areas; breast cancer and parathyroid hormone related protein/hypercalcaemia of malignancy. I currently have a team of 2 research registrars, 2 postdoctoral assistants and 2 technicians working on various laboratory research areas. In addition 3 ½ research nurses and 1 graduate research worker are working on various clinical trials and studies for which I have obtained funding. In total nine MD theses and one PhD have been awarded under my supervision.

Active research areas encompass breast cancer prevention, mechanisms of bone metastasis, angiogenesis, stem cell (non-adherent) culture of DCIS and invasive breast cancer. Other areas of interest include endocrine therapy of breast cancer and tumour tissue analysis (microarray).

Ductal Carcinoma in Situ (DCIS)

DCIS constitutes 30% of all screen detected breast cancer. I have developed an athymic nude mouse model in which human DCIS is implanted as xenografts and survives up to two months, in collaboration with Professor Chris Potten in the Paterson Institute for Cancer Research.

More recently I have identified stem cells from DCIS lesions and demonstrated growth inhibition of non-adherent stem like cells by NOTCH and epidermal growth factor receptor inhibition.

Working with Dr Rob Clarke and Dr Gill Farnie in the Breast Biology Group, we have developed cancer stem cell culture from primary human DCIS and shown that DCIS stem cells are controlled by NOTCH and epidermal growth factor receptor. In addition, we have shown that inhibiting HER2 oncogene overexpressing DCIS cells leads to inhibition of proliferation, leading to development of clinical trials in this condition with anti-HER2 inhibitors.

 

Control of Apoptosis in the Normal Breast in Breast Cancer

We have developed studies on apoptosis in both normal breast, DCIS and invasive cancer (in collaboration with Professor Charles Streuli) where we investigated mechanisms of inducing or preventing apoptosis in the breast. We initially developed new measures of apoptosis (activated caspase3 immunohistochemistry) and more latterly we have investigated the role of inhibitors of apoptosis intracellular proteins which block apoptosis and are elevated in breast cancer.

More recently we have obtained a grant from Breast Cancer Campaign to study inhibitors of apoptosis proteins (IAPs). These proteins prevent the final execution of the cell and we are analysing which of the 8 proteins are over expressed in breast cancer and whether inhibiting individual IAPs will induce tumour response and an increase in apoptosis.

Stromal Influences on Breast Cancer Growth

Working with Prof. Goran Landberg, we have shown that the use of aromatase inhibitors switches off activated stroma in breast cancers in a randomised controlled trial and we are exploring ways of switching off both the stroma and epithelial cells simulataneously to augment response to therapy.

Prevention of Lymphoedema

A large, £1.5m, National Institute for Health Research Programme Grant has been obtained to study whether early detection of arm swelling by measurement or bioimpedance will allow prevention of progression to lymphoedema through the use of external compression garments. These latter studies are taking place at the Nightingale Breast Centre, a £14m new building concentrating on the prevention and detection of breast cancer.  

 

Teaching

I have an undergraduate surgical firm (3rd year) and run Speciality Study Modules (SSM) for final year students and have been involved in teaching undergraduates and postgraduates since 1980.

I taught anatomy in Newcastle to medical, dental and physiotherapy students and in all the academic centres in which I have worked I have been involved in bedside and formal teaching of medical students.

I undertake regular ward and outpatient clinic teaching and act as an internal examiner for the University of Manchester. I am a Lecturer on the third year medical students Basic Integrated Science Course for Breast Disease and I also lecture on the introductory course teaching medical students Basic Clinical Skills.

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