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PROJECT DETAILS
Project Title
A longitudinal study assessing the degree of insult to autonomic tone resulting from cancer or its treatment, the
potential for recovery of autonomic function after treatment and its implications for the cancer care pathway.
Project Summary
Significant autonomic dysfunction (AD) is associated with a wide range of symptoms such as postural hypotension,
nausea, vomiting, diarrhoea, poorly controlled sweating, bladder emptying problems and erectile dysfunction, all of
which are associated with cancer and its treatment. A high prevalence of AD has been reported in patients with
advanced cancer. Furthermore, AD is also associated with reduced survival times in terminal cancer sufferers.
However, recent research has indicated successfully treated colorectal cancer patients have close to normal
prevalence of AD one year following treatment. No published studies have as yet reported changes in autonomic
function through the cancer treatment pathway to establish at what point AD develops in cancer and to what extent
is that damage is recoverable and if so over what time.
We wish to establish the natural history of AD in cancer to establish at what point it develops and if and when AD
recovers after treatment by assessing autonomic tone prior to treatment and at various points on the treatment and
recovery pathway. If it proves that advanced AD is triggered by cancer and/or its treatment then we would
investigate the following follow-up questions:
1. Is it possible to improve the wellbeing of patients being treated for cancer by aggressive treatment of AD
symptoms such as orthostatic hypotension and nausea using certain medications?
2. Could prediction of the success of treatment be improved based on the patient's autonomic status either before or
during treatment?
3. Could treatment be tailored based on the toxicity of treatment to autonomic tone?
We would initially look at a small set of common cancers e.g. colorectal, breast, prostate.
This project is a collaborative effort including BU, Poole Hospital Medical Physics and Oncology Departments, as
well as the Oncology and Gastroenterology Departments at Royal Bournemouth Hospital. The research student
appointed would attend regular cancer MDT's in order to identify patients, recruit and test them at a pre-treatment
outpatient visit and test them on at least one occasion mid-treatment and at least once post-treatment, wherever
possible when the patients are in hospital for normal care. Assessment of autonomic function measuring heart rate
and breathing can be performed simply and quickly in an outpatient clinical environment.
Academic Impact
No published papers have yet looked at the progression of AD in cancer patients from diagnosis to successful
treatment or death. We would hope to have significant publications on the natural history of AD in cancer and the
implications for patient wellbeing by the end of the PhD studentship.
Societal Impact
If results show significant and reversible AD as a result of cancer or its treatment, then it would be likely that Poole
and Bournemouth Hospitals would adopt the routine measurement of autonomic function as part of the workup for
treatment and monitoring progress at subsequent mid and post-treatment appointments.
The project will be supported by a guidance team including the supervisors and at least 2 patient representatives
who have experienced cancer treatment and have had autonomic assessments as for this project. Furthermore, the
consultants (gastroenterologists) at both Royal Bournemouth Hospital and Poole Hospital have also agreed to
PhD Project Description
April 2015
provide support, sit on the guidance team, and ensure dissemination of the results of the study widely among the
gastroenterology profession.
The results of these studies will be presented to local and national patient support groups, and data will be
published at peer reviewed journals, with high impact factor.
Training Opportunities
The research student chosen to take on this role will become an expert in the nascent field of AD and cancer and
have been expected to have presented at several national and international meetings as well as having published
papers. The student will become very familiar with working in several hospital departments and also be thoroughly
conversant with the academic environment of BU. They would be supported by and be involved with the work of the
Medical Physics Departments at Poole and Bournemouth Hospitals. At the end of this process the student would be
ideally placed to enter a career as a clinical scientist with an interest in physiology, either through the formal STP
training scheme or by an equivalence route.
SUPERVISORY TEAM
First Supervisor
Prof Ahmed Khattab
Additional Supervisors
Dr Steve Perring
Prof Tamas Hickish
Dr Carol Clark
Recent publications by
supervisors relevant to this
project
Perring S, Jones E. Assessment of changes in cardiac autonomic tone resulting
from inflammatory response to the influenza vaccination. Clin Physiol Funct
Imaging. 2012 Nov;32(6):437-44.
INFORMAL ENQUIRIES
To discuss this opportunity further, please contact:
Dr Steve Perring via email: [email protected] or Telephone: 01202 442591
ELIGBILITY CRITERIA
All candidates must satisfy the University’s minimum doctoral entry criteria for studentships of an honours degree at
Upper Second Class (2:1) and/or an appropriate Masters degree. An IELTS (Academic) score of 6.5 minimum (or
equivalent) is essential for candidates for whom English is not their first language.
HOW TO APPLY
Please complete the BU Research Degree Application 2015 and submit it via email to the Postgraduate Research
Administrator for Admissions Suzy Kempinski - [email protected] by Thursday 4 June 2015.
Further information on the application process can be found at www.bournemouth.ac.uk/phd-2015
PhD Project Description
April 2015