Cancer surgery and anaesthesia:

Perioperative and pain medicine research

 

Cancer Surgery Research 

Led by Professor Alexander Heriot, covers a broad spectrum of surgical management of cancer. This includes a significant integrated translational program. This program bridges 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 can 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. 

Surgery and Anaesthesia, Perioperative Medicine, and Pain Medicine research at Peter Mac is conducted across several cancer types: 

Research focus 

Academic Cancer Robotic Surgery Program  

Led by Professor Declan Murphy. Research focusing on reviewing and refining robotic-assisted surgical practice in the delivery of anterior resection for: 

  • Rectal cancer 
  • Hysterectomy 
  • Partial nephrectomy 
  • Radical cystectomy for bladder cancer 
  • Trans-oral robotic surgery (selected head and neck cancers)

Breast cancer surgery research 

Research focus on: 

  • Prospective database evaluating treatment outcomes   
  • Other themes include micro-metastases in breast cancer 
  • Tumour biology  
  • Genomic studies 

Colorectal cancer surgery research  

A translational program exploring immunotherapy in anal and rectal cancer through use of patient derived xenografts and tumour organoids, with Professor Rob Ramsey and Professor Wayne Phillips. Other research focus includes:   

  • 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

Gastro-oesophageal cancer surgery research 

Molecular understanding of: 

  • Barrett’s mucosa and family history in Barrett’s mucosa 
  • Oesophageal mucosa stem cell model 
  • Microarray studies in oesophageal cancer 
  • Evaluation of PET (Positron Emission Tomography) in oesophageal cancer 
  • Prospective database evaluating treatment outcomes

Melanoma surgery research  

Research focus on: 

  • Maintaining a prospective database evaluating treatment outcomes  
  • Randomised trial of radiation therapy in patients at high risk of recurrent regional failure 
  • Patient recruitment 
  • Sample management through Melanoma Research Victoria (Formerly Melbourne Melanoma Project) 
  • Translational program developing Adoptive T cell therapy

Surgical clinical trials 

This includes trials run through the American College of Surgeons Oncology Group (ACOSOG), and NHMRC (National Health and Medical Research Council). 

Surgical oncology laboratory research 

Led by Professor Wayne Phillips. Research focus on PI3-kinase mutations in solid tumours, cellular and molecular biology of Barrett’s oesophagus, research into Oesophageal stem cells. 

Research programs 

Contact 

Professor Alexander (Sandy) Heriot 

Division of Cancer Surgery 

Email: This email address is being protected from spambots. You need JavaScript enabled to view it. 

Department of Anaesthesia, Perioperative Medicine, and Pain Medicine Research 

Led by Professor Bernhard Riedel, the team seeks strategies that ensure optimal patient outcomes following cancer surgery. This collaborative research program mentors several PhD candidates. 

The research profile includes pre-surgical risk stratification using cardiopulmonary exercise testing, pharmacogenomic testing, and machine learning, and the implementation of multimodal prehabilitation programs to get high-risk patients fit for major surgery, anaesthetic strategies to offset the surgical stress response, enhanced care unit and telemedicine for optimising postoperative care, and strategies for effective postoperative pain control and prevention of persistent pain. These strategies aim to reduce postoperative complication rates and thereby allow patients to return to their cancer journey, including adjuvant therapies for improved cancer outcomes. 

Research is focused on active participation in international and multicentre studies through the Australia and New Zealand College of Anaesthetists Clinical Trials Network. Our investigator-initiated research that is funded through federal (NHMRC and MRFF) and foundation grants focuses on:  

  • Pre-operative risk assessment using cardiopulmonary exercise testing, pharmacogenomic testing (Dr Michelle Gerstman) and artificial intelligence/machine learning (Dr Hilmy Ismail) with prehabilitation strategies that include patient education (surgery school), exercise, haematinic, and nutritional intervention to help patients prepare for surgery (Dr Hilmy Ismail, Dr Emily Traer)

  • Modifying anaesthetic technique to improve cancer outcomes in lung and colorectal surgery: Comparing volatile anaesthesia to total-intravenous anaesthesia with and without intravenous lidocaine infusion – The VAPOR-C Trial (Professor Bernhard Riedel)

  • Strategies to minimise perioperative immune suppression to reduce the risk of cancer recurrence, e.g., flu-vaccine and immunonutrition (Dr Julia Dubowitz)

  • Individualised anaesthetic technique using pharmacogenomic guidance (Dr Michelle Gerstman) 

  • Optimised pain strategies (Dr Jamie Young)

  • Quality improvement strategies: e.g., enhanced recovery after surgery (ERAS – Dr Georgina Christelis), optimal thromboprophylaxis practice (Dr Rani Chahal), and enhanced care unit with remote monitoring (Dr Ian Richardson)

  • Digital health strategies (Dr Tom Poulton) for optimal patient pathways (Dr Christelle Botha)

  • Shared decision making to ensure goal congruency between surgical objectives and patient values (Dr Debra Leung)

Professor Bernhard Riedel

Department of Anaesthesia, Perioperative Medicine, and Pain Medicine 

Email: This email address is being protected from spambots. You need JavaScript enabled to view it. (Director) or This email address is being protected from spambots. You need JavaScript enabled to view it. (Research Lead) 

Resources 

Links