Blog posts

Enhancing quality of life for head and neck cancer patients

 

Grainne Brady

Did you know that each year, amost 13,000 people in the UK will be given the news that they have head and neck cancer? Unfortunately, these numbers continue to rise. To mark World Head and Neck Cancer Day, we hear from Grainne Brady, PhD Student at Imperial’s Department of Surgery and Cancer, NIHR Clinical Doctoral Research Fellow and Speech Language Therapist at the Royal Marsden NHS Foundation Trust London. She shares her expertise on the link between head and neck cancer and changes to swallowing, communication and the potential impact on quality of life. 

Treatments for HNC include surgery, radiation and chemotherapy(1). Traditional risk factors for HNC include a history of tobacco and alcohol use (2). More recently, human papilloma virus (HPV) has been recognised as a risk factor for the development of oropharyngeal cancer which is a subtype of cancer affecting the back of the throat, tonsils, back of the tongue and soft palate (2). The discovery that a virus can cause this condition has led to the development of a UK-wide HPV vaccination programme available for both boys and girls aged 12-13 years (3). 

There have been huge advances in the treatment of HNC over the past two to – three decades. These include advanced radiation techniques like intensity-modulated radiation therapy and minimally invasive surgeries such as transoral robotic surgery, which are now standard of care techniques (4).   

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Postcards from Kampala: Data and Dashboards in Uganda

Nina Zhu enjoying coffee and a chat with Dr Sanjeev Singh, CAMO-Net India lead
Nina Zhu enjoying coffee and a chat with Dr Sanjeev Singh, CAMO-Net India lead

The Centres for Antimicrobial Optimisation Network (CAMO-Net) recently convened an insightful meeting at Makerere University in Uganda. This international event brought together researchers dedicated to the critical challenge of antimicrobial resistance (AMR). Throughout the week, attendees engaged in a series of informative presentations exploring data-driven approaches to optimising antibiotic use. Hear first-hand from Dr Nina Zhu from the Department of Infectious Disease on what her experience at the event was like. 

I recently returned from Kampala, Uganda, where I spent an incredible week at Makerere University for the Centres for Antimicrobial Optimisation Network (CAMO-Net) event. Colleagues from around the world came together in Kampala to share knowledge, take part in workshops, and learn more about the work our Uganda National Hub does to address antimicrobial resistance (AMR) in Africa and beyond. 

Data and Dashboards for Optimising Antibiotic Use 

The event’s theme was ‘Data and Dashboards’. Harnessing the power of data through strategic and targeted studies to generate new knowledge related to optimising antimicrobial use is a key theme of CAMO-Net. As my work focuses on using data linkage and system dynamics modelling to understand healthcare-associated infections and AMR, it was a perfect week for me!  

I was joined in Kampala by CAMO-Net members from four other countries: Brazil, India, Malawi, and South Africa. We received such a warm welcome from our Ugandan hosts and started the week with a networking session at a local restaurant. At the reception, Dr Andrew Kambugu, CAMO-Net Uganda lead and head of Makerere’s Infectious Diseases Institute (IDI) gave a fascinating showcase of IDI’s history. It was a perfect blend of networking and getting to know more about the impressive strides IDI has made in infectious diseases, data, and AMR. 

Professor Umar Kakumba, the 1st Deputy Vice Chancellor of Makerere University, and Dr Andrew Kambugu, CAMO-Net Uganda lead, welcomed the whole CAMO-Net team

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St Mary’s Medical School: End of a chapter

Professor John Tregonning (front centre) in the early days of his career in the Department of Surgery and Cancer.

As the Faculty of Medicine prepares for the full decant of the St Mary’s Medical School Building, Professor John Tregoning, Professor in Vaccine Immunology in the Department of Infectious Disease, takes a trip down memory lane, reflecting on almost 20 years spent working in the “site steeped with history.”

On the 1st of August 2024, as part of a wider departmental move, I will leave the St Mary’s Hospital campus having worked there for nearly half my life. As such, it felt like time to reflect.

I first crossed the threshold when the St Mary’s medical school had just merged with Imperial in 1999, visiting friends who were studying there. Admittedly, it was not in an academic capacity. I went to the long-closed, but legendary bar in the basement (allegedly it closed because seeing future doctors heavily inebriated was off-putting to those visiting the hospital). I don’t remember much of that night, a fact I am putting down to time passed, rather than beers consumed.

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Spotlighting Air Quality Researchers on Clean Air Day

Group photo of Aerosol Science Team at Imperial’s Environmental Research Group in front of an air quality monitoring site (Ian is fifth from the left)
Group photo of Aerosol Science Team at Imperial’s Environmental Research Group in front of an air quality monitoring site (Dr Ian Chen is fifth from the left)

Air pollution is linked to 43,000  deaths each year in the UK.  The World Health Organization and the UK Government recognise that air pollution is the largest environmental threat to our health. To mark Clean Air Day, we’re spotlighting Dr Ian (Gang) Chen and Dr Kayla Schulte from Imperial’s Environmental Research Group who are leading the charge in the fight against air pollution. 

Dr Ian (Gang) Chen 

As a kid growing up in China, I always thought the haze was just another humid day with fog. Only after watching the Chinese-made documentary, Under the Dome in 2015, did I realise how polluted our air was. I was shocked and determined to do something about it. To begin my research journey in air pollution, I pursued a two-year MPhil program at the University of Toronto. There, I focused on developing a low-cost sensor to detect soot particles in developing countries. After that, I became interested in identifying and quantifying sources of air pollutants for my PhD studies at ETH Zurich, since it’s the most straightforward way to target emission sources and mitigate air pollution. My research has focused on this topic ever since.  

Our team (Aerosol Science) at Imperial’s Environmental Research Group maintain two air quality supersites in London, where we use the latest technology to continuously monitor pollution. One site is located near Baker Street, central London, a traffic station, while the other is an urban background site located in Honor Oak Park in south London. On Clean Air Day 2023, we launched a particulate matter (PM) dashboard which shows the hourly chemical composition of the solid particles and liquid droplets found in our air.  Making this data open-access and interactive is crucial for public understanding of the air we breathe. The organic mass in PM often contains millions of compounds and my research focuses on identifying and quantifying its sources. In the coming years, we aim to provide near real-time source information for PM on this dashboard, so that both the public and policymakers can understand where the pollution is coming from.  

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Early onset Type 2 Diabetes: A growing concern

Dr Shivani Misra

While traditionally seen as a disease of older adults, type 2 diabetes is increasingly affecting younger people. This “early onset” form carries a higher risk of complications and earlier death. To mark Diabetes Awareness Week, Dr Shivani Misra from the Department of Metabolism, Digestion and Reproduction sheds light on her research which aims to tackle early onset type 2 diabetes in individuals from minority ethnic backgrounds.

When I was at medical school, I learned that type 2 diabetes was a condition that affected middle-aged or older adults often living with obesity. However, these days the demographics of who is affected by type 2 diabetes have drastically changed. More and more younger adults and children are affected with type 2 diabetes and we call this early onset type 2 diabetes, typically defined as a diagnosis before the age of 40 years.

What we do know from large analyses across the world, is that when you’re diagnosed with type 2 diabetes at earlier age, your diabetes can progress through to complications very rapidly and also reduce life expectancy. Of even greater concern is the impact on women living with early onset of type 2 diabetes, in whom pregnancy can be complicated because of  type 2 diabetes and there’s a higher risk of foetal death, sadly.

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The importance of annual reviews for COPD care

Man at COPD review

Currently, there are considerable gaps in the care of people with chronic obstructive pulmonary disease (COPD). Parris Williams, PhD student at the National Heart and Lung Institute (NHLI), highlights why improving the access, delivery and quality of annual COPD reviews is crucial to supporting 1.4 million patients in the UK with the condition.

Chronic obstructive pulmonary disease (COPD), a chronic condition causing restricted airflow and breathing problems, is the second most common lung disease in the UK. Currently 1.4 million people in the UK have a COPD diagnosis. Recommended by the British Thoracic Society and NICE guidelines, annual COPD reviews are a key element in COPD care. These reviews are an opportunity for the patient to discuss their condition with their medical team, alongside inhaler/medication revisions and opportunities for onward referrals if needed. When delivered correctly, COPD annual reviews increase the health and reduce exacerbation risk for patients.

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World No Tobacco Day – how to get where we need to be?

Nick HopkinsonThe path to a smokefree generation demands decisive action and innovative strategies. To mark World No Tobacco Day, Professor Nick Hopkinson from the National Heart & Lung Institute (NHLI) offers his insights, drawing on years of dedicated research to suggest ways in which we can achieve this. 

Smoking is the leading preventable cause of premature disability and death; two out of three people who continue to smoke will die from a smoking-related disease. Ending this requires two things: First, ensuring that people don’t start to smoke in the first place; and second, supporting the more than six million people in the UK who still smoke to quit.

‘Stopping the start’ involves making smoking less appealing,less affordable, and less available to children and young people. A key step to creating a smokefree generation will be steadily raising the age of sale, ensuring that tobacco products can never legally be sold to people born on or after 1 January 2009. The General Election has paused the progress of this legislation, but the policy has enjoyed cross-party support, so is almost certain to become law. We can be confident that it will be effective – youth smoking rates fell when the age of sale in the UK was increased from 16 to 18 in 2007, and similarly where it has been increased to 21 in the US. The year-on-year increase will also prevent the tobacco industry from addicting people later in life.

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Stroke survivors’ cognitive health under the spotlight: New research aims to improve diagnosis and treatment

Dr Fatemeh Geranmayeh

Did you know stroke is the largest cause of disability in the UK and the fourth biggest killer? To mark Stroke Awareness Month, Dr Fatemeh Geranmayeh from the Department of Brain Sciences sheds light on her recent research looking at the recovery of cognitive functions after cerebrovascular disease and the ‘prediction problem.’  

Stroke is a leading cause of death and disability worldwide. Given that stroke strikes every five minutes here in the UK, chances are that you personally know someone affected by stroke.  Of the 1.3 million stroke survivors, three quarters have problems with cognition (that is problems with memory, thinking, language, problem solving, numbers or planning actions). A significant proportion (a third) develop dementia within five years. It’s not surprising therefore that vascular brain health is beginning to get the attention that it deserves in the field of dementia research.  

The spectrum of post-stroke cognitive deficits is broad with significant negative impacts on therapy engagement, mental health, employment and societal costs. Consequently, diagnosis and treatment of cognitive impairment following stroke have been highlighted as priority by patients and national guidelines for stroke management. 

From a research perspective, much effort has been put into understanding the ‘prediction problem’; that is which patients are likely to a) recover cognition, b) show cognitive deterioration requiring additional monitoring and care needs, and c) benefit most from personalised therapy.   

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Advancing liver health through microbiome research

Dr Benjamin Mullish

On World Liver Day, Dr Benjamin Mullish from the Department of Metabolism, Digestion and Reproduction, discusses the research being done on the microbiome and faecal (or ‘intestinal’) microbiome transplants (FMT), and how he hopes that can be converted from ‘bench to bedside’ to improve the lives of patients with liver conditions. 

When most of us hear the words ‘gut bacteria’, we think about germs that can cause infection and make people ill.  However, more recently, scientists and doctors have recognised that we also have billions of ‘beneficial’ bacteria (and other microbes) in our gut that play important roles in keeping us healthy.   The specific ‘mix’ of microbes that a person has in their gut, and the environment in which they live – now often called the gut microbiome – is distinct between different people like a fingerprint.  Furthermore, the gut microbiome is influenced by and altered by a number of factors, including our diet, our medications (particularly antibiotics), and how old we are.

Of further interest, we now think that our gut microbiome plays an influence over our vulnerability to developing a range of medical conditions, how the condition progresses if we do develop it, and even how well we might respond to different treatments used for the condition.  This includes a number of different liver diseases; the gut and the liver are very close physically within the body, and the gut microbiome seems to be an important factor that impacts upon how these two organs ‘talk to’ each other in health and disease.  Within the Section of Hepatology and Gastroenterology, one of our major areas of research relates to how an altered gut microbiome may contribute to different liver diseases, and whether we might be able to alter the gut microbiome as a new approach to treating them.

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Von Willebrand disease – hidden in plain sight

Dr Tom McKinnon

Every year on 17 April, World Haemophilia Day is recognised worldwide to raise awareness of haemophilia, von Willebrand Disease, and other inherited bleeding disorders. From his early days in lecture halls to his current work in research labs, Dr. Tom McKinnon, Senior Lecturer in the Department of Immunology and Inflammation, shares his expertise. He unravels the complexities of Von Willebrand factor (VWF), advocating for greater awareness of this commonly misunderstood condition. 

I can vividly recall an early morning undergraduate lecture I attended over 20 years ago now (has it really been that long?!). In a slightly hungover state, I listened to the lecturer describe a protein that helps blood cells stick together (clot) when you bleed called Von Willebrand Factor and Von Willebrand’s disease – a common inherited condition that can make you bleed more easily than normal. At the time, I didn’t think much about it, but two years and a BSc later, I found myself at Imperial undertaking a PhD investigating the structure and function of VWF, beginning my scientific journey into the world of the largest protein found in the blood, and in my humble opinion, the most fascinating.  

Circulating around the body, VWF is like a giant molecular ball of string that responds to the force of blood flow. When we damage our blood vessels, this ball of string sticks to the damage site, and unwinds and begins to capture platelets that are speeding past, thereby limiting blood loss.  

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