Dr Gunawardene has recently published his work investigating rates of bowel cancer recurrence at Wellington Hospital in the New Zealand Medical Journal (https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2018/vol-131-no-1469-2-february-2018/7481).
Patients often consider their bowel cancer as cured when surgery to remove the tumour is complete, but clinicians consider a person cured only once there is no evidence of the cancer returning after five years.
This paper describes the pattern of disease recurrence in colorectal cancer experienced by patients in Wellington Hospital and found that the results compared well against International standards. Improvements in cancer care are thought to contribute to this including the multi-disciplinary team model, where healthcare professionals including surgeons, oncologists, pathologists and radiologists regularly meet to discuss cases and their management. Other improvements include advances in imaging techniques and the use of adjuvant therapies such as chemotherapy.
With an overall recurrence rate of approximately 25%, there is still room for improvement and a major challenge remains in predicting which patients are most at risk of recurrence. Accurately predicting high-risk patients would mean they could be offered more aggressive treatment strategies, which low-risk patients could then be safely spared.
Dr Gunawardene is a PhD candidate and general surgical registrar in the Department of Surgery and Anaesthesia who is working as part of the surgical cancer research group. His research strives to address challenges in improving our ability to predict prognosis in colorectal cancer. Dr Gunawardene is interested in how circulating biochemical markers may predict prognosis, particularly inflammatory cytokines.