CANCER SURGERY & ANAESTHESIA: PERIOPERATIVE & PAIN MEDICINE RESEARCH

Cancer Surgery Research at Peter Mac

Led by Prof Alexander Heriot, covers a broad spectrum of surgical management of cancer. This includes a significant integrated translational program, bridging basic science ‘bench’ research to the ‘bedside’ of the patient, exploring the molecular biology of specific tumours with prediction and prognosis, and development of novel therapies. Evaluation of outcomes after surgical management and integration with multidisciplinary management is core to the research program, and this supports a strong clinical trials program.

Junior medical staff are encouraged to participate in the research activities of the Division and have the opportunity to undertake their own supervised research using clinical material sourced from the databases.

Cancer surgery researchers facilitate clinical trials, and research is conducted in collaboration with laboratory-based programs in basic oncological science.

The Cancer Anaesthesia, Pain and Perioperative Medicine research team

Led by A/Prof Bernhard Riedel, the team seeks to ensure novel strategies that ensure optimal patient outcomes following cancer surgery. The research profile includes pre-surgical risk stratification, including cardiopulmonary exercise testing, multimodal prehabilitation programs to get patients fit for surgery, novel anaesthetic techniques to offset the surgical stress response, and effective post-operative pain control and prevention of persistent pain. Utilising enhanced recovery techniques and reducing postoperative complication rates will allow patients to return to their cancer journey, including adjuvant therapies.

Surgery and anaesthesia research at Peter Mac is conducted across a number of cancer types:

• Breast
• Colorectal
• Head and neck
• Urological
• Upper gastrointestinal
• Skin (melanoma)

• Gastro-oesophageal cancer surgery research: molecular understanding of Barrett’s mucosa, family history in Barrett’s mucosa, oesophageal mucosa stem cell model, microarray studies in oesophageal cancer, evaluation of PET in oesophageal cancer and prospective database evaluating treatment outcomes.
• Colorectal cancer surgery research: translational program exploring immunotherapy in anal and rectal cancer through use of patient derived xenografts and tumour organoids, with Prof Rob Ramsey and Professor Wayne Phillips; stratification of treatment of metastatic colorectal cancer using tumour derived organoids; evaluation of PET, management of advanced and recurrent rectal cancer; process management of surgical throughput.
• Breast cancer surgery research: prospective database evaluating treatment outcomes etc. Other themes include micro-metastases in breast cancer, tumor biology and genomic studies.
• Melanoma surgery research: maintaining a prospective database evaluating treatment outcomes, randomised trial of radiation therapy in patients at high risk of recurrent regional failure, patient recruitment and sample management through the Melbourne Melanoma Project; translational program developing Adoptive T cell therapy.
• Surgical clinical trials, including trials run through the American College of Surgeons Oncology Group (ACOSOG), and NHMRC.
• Surgical oncology laboratory research (led by A/Prof Wayne Phillips): PI3-kinase mutations in solid tumours, cellular and molecular biology of Barrett’s oesophagus, research into Oesophageal stem cells.
• Academic Cancer Robotic Surgery Program (led by A/Prof Declan Murphy): reviewing and refining robotic-assisted surgical practice in the delivery of anterior resection for rectal cancer, hysterectomy, partial nephrectomy, radical cystectomy for bladder cancer and trans-oral robotic surgery (selected head and neck cancers).
• Anaesthesia, perioperative and pain medicine research (led by A/Prof Bernhard Riedel): research is focused on active participation in international and multicenter studies through the Australia and New Zealand College of Anaesthetists Clinical Trials Network, cancer specific investigator initiated research that focuses on: pre-operative risk assessment and optimisation using cardiopulmonary exercise testing; ‘pre-habilitation’ strategies using exercise, haematinic, and nutritional intervention; fit for surgery; enhanced recovery after surgery (ERAS); impact of anaesthetic strategies on lymphatic flow following surgery; strategies to minimise perioperative immune suppression to reduce the risk of lung cancer recurrence; optimal thromboprophylaxis practice to prevent perioperative venothromboembolism; optimised pain strategies; development and implementation of anaesthesia and pain medicine quality indicators; and collaborative research with PhD students within Dr. Erica Sloan’s laboratory in Drug Discovery Biology Theme at the Monash Institute of Pharmaceutical Sciences.

Coming soon!

• Surgical management of melanoma at all disease stages
• Breast stream: Surgical research

Prof Alexander (Sandy) Heriot

Division of Cancer Surgery

Email: Alexander.Heriot@petermac.org

A/Prof Bernhard Riedel

Cancer Anaesthesia, Perioperative and Pain Medicine

Email: bernhard.riedel@petermac.org