Surgery research

Each year in the UK over 250,000 people get cancer. While surgery remains one of the few treatments capable of curing cancer, surgery is often unpleasant and carries some risk.

We aim to better understand how cancer develops and create tools for its early detection and novel therapies to prevent or control its progression. We hope in the future to reduce the need for surgery and the risk of surgery, and improve patients’ outcomes if they do have surgery. 




Research issue

Building on our successful track record of the last 10 years we aim to develop the following areas of research over the next decade:

  • To better understand the principles underpinning the development and progression of cancer 
  • To develop novel biomarkers useful in the early detection of cancer
  • To explore possible therapeutic targets which may be useful in combating cancers
  • To design training programmes aimed at improving fitness before surgery and reducing mortality after surgery
  • To refine and transfer currently established techniques of patient monitoring for use during operations and into the intensive care unit

What we are doing about...

1. Cancer development

By understanding the human genome (the DNA from which we are all made) and gaining an insight into the role of “junk” DNA, which was previously believed to have no functioning role, we are beginning to recognize the role this DNA plays in the development of certain common cancers.

2. Cancer detection

We are comparing normal and tumour samples to identify repetitive DNA sequences that are unique to tumours. We are interested in whether these repeats can be found in blood of affected individuals and developed into biomarkers for early detection of cancer.

3. Identification of therapeutic targets

We are investigating which factors cause the activation in cancer of particular repetitive DNA sequences and what are the consequences of this activation. In the future novel treatments can be designed which target these factors and individual repeats proven to contribute to cancer.

4. Pre-operative optimisation

Due to the pressing need to undergo surgery in cancer there is little time between diagnosis and operation. In the past this has meant that little could be done to improve a patient’s physical fitness before surgery. However we have designed exercise programmes that can significantly improve physical fitness in as little as 4 weeks. We now need to test if this type of programme can be used in a larger group of patients about to have surgery.

5. Imaging of vital organ function during surgery

It is vitally important during major surgery that the blood supply and health of the patient’s main organs (brain, kidney, liver etc) are well preserved. Traditionally this has been difficult to judge as no direct measure has been available. Recently, using techniques we have refined in healthy volunteers, we have been able to use a new ultrasound scanning technique in surgical patients to do just this. Over the next 5 years we hope to investigate the use of this technique during major surgery and on the intensive care unit. 


We have published in peer reviewed journals on all of the above subjects.

  • Ashish Bhalla, John Williams, Nicholas G Hurst, William J Speake, Gillian M Tierney, Samson Tou, Mr Jonathan N Lund. One-third of patients fail to return to work 1 year after surgery for colorectal cancer. 2014 Techniques in Coloproctology Nov 8. [Epub ahead of print]
  • Mitchell K., Phillips B., Lund J., Williams J., Rankin D., Smith K., Atherton P. A dose, rather than delivery-profile, dependent mechanism regulates the muscle-full effect in response to oral essential amino acid intake in young men. Journal of Nutrition 2014 [In press]
  • Jones K., Bhalla A., Amawi F., Peacock O., Williams J., Lund J. Assessing surgeon stress when operating using Heart Rate Variability (HRV) and the State Trait Anxiety Inventory (STAI): will surgery be the death of us? Colorectal Dis. 2014 [In press]

See our individual profiles for more publications.


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Surgery research group

Division of Medical Sciences and Graduate Entry Medicine
The University of Nottingham, Royal Derby Hospital
Uttoxeter Road, Derby DE22 3DT

telephone: +44 (0) 1332 724622