The Colorectal Research team at North Bristol NHS Trust offer patients and people at risk of developing Colon cancer excellent patient-centred care and the opportunity to participate in research.
Delivering complex interventional and observational studies, the team is comprised of a multidisciplinary clinical team, supported by our research nurses and a Research Administrator.
Please speak to the person treating you to see if there is a research study that may be able to help you.
Background: Cancer is a global problem. There is significant pre-clinical and epidemiological evidence demonstrating that aspirin has anti-cancer effects. Recently, individual patient data meta-analyses, from trials designed to assess cardiovascular benefits of aspirin, have shown reductions in cancer incidence and mortality associated with regular aspirin use. Additionally, the CAPP2 trial has demonstrated that daily aspirin prevents cancers associated with the Lynch syndrome.
In the meta-analyses, short-term effects on cancer mortality and a decrease in risk of metastases suggest a role for aspirin in the treatment as well as prevention of cancer. This is supported by several large observational datasets. Concerns over toxicity, particularly serious haemorrhage, have limited the use of aspirin in the primary prevention of cancer. In the adjuvant setting the benefit:risk ratio will be different, with higher morbidity and mortality from recurrent cancer potentially outweighing risks associated with regular aspirin use.
Aim: To assess whether regular aspirin use after standard therapy prevents recurrence and prolongs survival in patients with early stage common solid tumours. International recruitment will allow assessment of the intervention in different communities.
Methods: The question will be addressed in four tumour sites (colorectal, breast, gastrooesophageal, prostate) using parallel trials with a common infrastructure. Each trial will be a multicentre, phase III, double-blind, placebo-controlled randomised trial. Participants will be randomised to 100mg aspirin, 300mg aspirin or a matching placebo, to be taken daily for 5 years.
Primary outcomes will depend on tumour site and trials will be separately powered, requiring 2000-3000 patients with each tumour type to demonstrate effects of aspirin on disease recurrence and survival. Secondary outcomes include overall survival, adherence, gastrointestinal complications and cardiovascular events.
Principal Investigator: Ms Ann Lyons
Planned End Date: 02/05/2027
Local Ref: 3589
A common problem in about 40% of patients having bowel surgery is that their bowel takes longer than normal to start working again. In most patients the bowel will start working after surgery in 3- 4 days, but in some it takes a week or more. We call this delayed recovery of gut function. This delayed recovery causes nausea, vomiting, complete constipation, tummy pain and tummy swelling (distension). As a result, patients cannot eat or drink until gut function returns, their recovery is slower, and they have to stay longer in hospital. There is no immediate cure, and although it gets better on its own in most cases, it can take from 3-7 days to do so. During this time patients have to have a continuous intravenous drip and often insertion of a nasogastric tube to empty the stomach to reduce vomiting (most patients find this very unpleasant).
One of the common drugs used in hospitals is the local anaesthetic Lidocaine, used to “freeze” parts of the body, for example for minor skin operations or dental procedures. Recently lidocaine has been used intravenously (through the vein) as part of a general anaesthetic. It reduces pain and inflammation caused by surgery and seems to help other aspects of recovery that may be important for return of gut function, for example reducing nausea and vomiting, and shortening the time from surgery to first bowel movement. However, previous studies were small and the true benefit of Intravenous (IV) lidocaine is uncertain. We hope to find out if giving IV Lidocaine improves recovery of gut function after colorectal surgery for NHS patients.
Principal Investigator: Miss Anne Pullyblank
Planned End Date: 30/11/2023
Local Ref: 4467
The study aims to further medical knowledge and may improve future treatment of melanoma. The study will investigate how much skin should be removed from around the melanoma during wider excision surgery. Currently, doctors do not know how much skin to remove from around a melanoma to reduce the chances of it coming back. Guidelines in different countries vary in their recommendations on this. This study will investigate if reducing the excision margin to 1cm is as good at reducing the risk of melanoma returning as a 2cm excision margin.
Principal Investigator: Mr Ewan Wilson
Planned End Date: 01/07/2029
Recruitment to end 01/07/2025
Local Ref (R&D no): 4755
REINFORCE aims to evaluate surgical services within the NHS, in order to determine the best ways to perform surgery. We will be collecting data on all specified surgeries at participating hospitals for the duration of the study (2 years). We will look at outcomes from patients, surgeons, theatre staff, and the wider organisation (NHS). We hope that when completed, we can advise the NHS on how best to provide their surgical services.
Principal Investigator: Mr Andy Smith
Planned End Date: Recruitment duration 24 months. 10/01/2025
Local Ref (R&D no): 1278
People having short stay surgery (who either go home the same day or who stay overnight but go home shortly afterwards) are at a much lower risk of developing a blood clot than those who stay in hospital for longer. These low-risk people are often given elastic stockings (which squeeze the leg muscles) to reduce the chance of a blood clot. The risks of wearing the stockings are low but they can be uncomfortable. In the UK, there are over a million short stay surgeries performed each year and most of these people are given elastic stockings to wear. Stockings cost the NHS a lot of money and it remains unknown if they benefit these people.
This study will investigate if it is worthwhile to continue using elastic stockings in people having surgery where the risk of developing blood clots is low.
Principal Investigator: Mr James Hopkins
Planned End Date: 31/12/2025
Local Ref (R&D no): 5200
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Research & Development
North Bristol NHS Trust
Level 3, Learning & Research building
Bristol, BS10 5NB
Telephone: 0117 4149330