Författare: Justin Stebbing Professor of Biomedical Sciences Anglia Rusk

In a groundbreaking medical achievement in the UK, a 32-year-old woman from Manchester has undergone the country’s first liver transplant for advanced bowel cancer.

Bianca Perea was diagnosed with stage four bowel cancer in November 2021, with the disease having spread to all eight segments of her liver. Initially given a bleak prognosis, she responded really well to rounds of drug-based treatment. Yet despite the promising response, the disease still remained in her liver. Because the cancer was so widespread, only a transplant would be able to remove the disease.

Perea’s liver transplant was performed in the summer of 2024. She has remained cancer-free since then.

Although transplantation is more commonplace in treating primary liver cancers, Perea’s case adds to a growing body of research showing the procedure can benefit patients with advanced bowel cancer.

Bowel cancer (also known as colorectal cancer) is the fourth most common cancer in the UK. It accounts for 11% of all new cancer cases.

The disease can be particularly challenging to treat, especially when diagnosed at an advanced stage – even despite recent developments in immunotherapy. This is because bowel cancer often spreads to the liver – which complicates treatment options and can usually mean the disease is no longer curable.

The standard treatment approach for bowel cancer typically involves a combination of surgery to remove any tumours, alongside chemotherapy or radiation therapy. What treatment a patient receives will depend on the stage and location of the cancer.

For patients with advanced bowel cancer that has spread to the liver, treatment becomes even more complex. While cancer drugs and surgery often work, the disease usually comes back. And though liver surgery is possible in these cases, sometimes the disease is in areas of the liver too risky to surgically remove – or the cancer is too widespread, making it impossible to remove all the tumours while leaving enough healthy liver tissue. In such cases, the goal of treatment shifts from cure to managing symptoms and prolonging the person’s life.

If bowel cancer spreads to the liver, it complicates treatment.
ALIOUI MA/ Shutterstock

But a transplant would be able to overcome these limitations. By replacing the entire liver, it effectively removes all cancerous tissue from the organ.

Research also suggests that the immune response triggered by the transplant may even help combat remaining cancer cells in the body – although the mechanism that causes this to happen is not fully understood.

Survival outcomes

It’s important to point out here that Perea’s success was likely due to a combination of treatments – including targeted drug therapy, chemotherapy and surgery to remove the primary bowel tumour before the transplant. She will now need to be monitored closely – including for the possibility of recurrence. It’s always possible that microscopic cancer cells we cannot see have been left behind. Patients such as Perea will need life-long immunosuppression drugs to ensure she doesn’t reject the transplant.

Still, Perea is not the first case of a liver transplant successfully curing bowel cancer in a patient. The body of evidence so far consistently shows liver transplantation, when used alone or with drug treatment (such as chemotherapy), improves five-year survival rates in bowel cancer patients compared to when only standard methods are used.

For example, one study from Norway showed a 60% to 83% five-year survival rate in patients who underwent a liver transplant for advanced bowel cancer that had spread to their liver.

A US study, conducted in similar bowel cancer patients, found that 91% of those who had received a liver transplant had survived when followed up three years later. In comparison, patients who’d opted to use only standard treatment methods had a 73% survival rate at follow-up.

Just as was the case with Perea, these studies all emphasise the importance of using a multi-faceted approach to manage bowel cancer. Most patients received additional anti-cancer drugs (including chemotherapy) before and after transplantation. More trials will now be needed to confirm the benefits of this treatment technique in a larger cohort.

It’s also important to note that this treatment is probably only suitable for a small percentage of patients – about 2% of those whose bowel cancer has spread to their liver. Strict selection criteria will be necessary to ensure the best outcomes.

We also need more data on long-term survival rates and quality of life for patients who undergo liver transplants for bowel cancer. Trials comparing liver transplantation to other advanced treatments are necessary to confirm its benefits.
The ethical implications of using livers for cancer patients also needs to be carefully considered given the scarcity of donor organs.

The five-year survival rate for all stages of bowel cancer in the UK is currently a little over 50%. This highlights the need for more effective treatment options, particularly for advanced cases. Liver transplantation may be one potentially curative option in such instances.

Bianca Perea’s recent success represents a significant breakthrough. This will hopefully prompt much-needed research in the area so the technique can become a more widely adopted treatment strategy in the future for those who will most benefit. Läs mer…

Cancer is a complex disease with many causes – and sometimes none. For some patients, getting cancer is down to plain bad luck.

As an oncology consultant, I see many cases where patients are otherwise perfectly healthy and have followed a healthy lifestyle. Nevertheless, research has shown there are several ways to reduce your risk. Here are five evidence-based strategies to help lower your chances of developing cancer:

1. Quit smoking and avoid tobacco

Tobacco use is the single largest preventable cause of cancer. Smoking not only increases the risk of lung cancer but also contributes to the development of oral, throat, kidney, bladder, pancreatic, stomach and cervical cancers to name a few. The harmful chemicals in cigarette smoke affect the entire body, not just the lungs.

If you currently smoke, quitting is the most important step you can take to reduce your cancer risk. Around 30% of all cancer deaths in the US and Europe are thought to be caused by cigarette smoking. It’s never too late to quit – and the benefits begin immediately after stopping.

Consider joining a tobacco treatment programme or asking your doctor about products that can help you quit smoking, but sometimes the best way to quit is just to “do it”. Even if you don’t smoke, it’s crucial to avoid second-hand smoke, which is also a risk factor for cancer, so-called passive smoking, so keep your home and environment smoke-free to protect yourself and others.

2. Maintain a healthy weight and stay physically active

Maintaining a healthy weight is one of the most important factors in cancer prevention after not smoking. Excess body fat triggers the release of certain hormones that can promote cancer growth and we know that obesity is linked to a higher risk of breast, colorectal, endometrial, esophageal, kidney and pancreatic cancers.

To help with this, everyone should engage in regular physical activity, which not only helps with weight management but also independently lowers cancer risk. The American Cancer Society recommends at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week for cancer prevention.

Regular physical activity has been linked to a reduced risk of so many different cancers like colon and breast cancer. Even if you don’t lose weight, exercise will still help protect you against cancer so some advise trying to incorporate movement throughout your day, such as taking short walking breaks during work or using standing desks while working on a computer.

3. Adopt a healthy diet

While there’s no guaranteed way to prevent cancer through diet alone, certain eating habits can significantly lower your risk. An anti-cancer diet primarily consists of plant-based foods, including a variety of fruits, vegetables, whole grains and beans.

It was recently reported that King Charles is cutting out red meat to keep his cancer at bay. In general, we should all aim to limit processed foods and sugar, reduce intake of saturated fats and consider adopting a Mediterranean-style diet, which has been associated with a lower risk of some cancers. All of this is linked to maintaining a healthy weight.

4. Limit alcohol consumption

Alcohol consumption is tied to several types of cancer, including oral, throat, breast, liver and colorectal cancers, and may explain why so many younger people are developing certain cancers. The risk increases with the amount of alcohol consumed regularly over time and this is called a dose-response, so the more you drink, the greater your risk.

Read more:
The role alcohol plays in new cancer cases – landmark new report

Just like for smoking, quitting alcohol really helps decrease risk, though at this time of year with office parties and going out that’s not always easy – perhaps aim to drink a little less. There’s now lots of research that shows that there’s no safe level of alcohol consumption when it comes to cancer prevention. If you don’t drink, don’t start, and if you do drink, less is better. But, at the same time, it’s important to enjoy life so focus on moderation.

5. Protect against sun exposure and get vaccinated

If you’re going somewhere hot for the winter, sun protection is crucial in preventing skin cancer, including the most dangerous type called melanoma, one of the most common and preventable types of cancer.

The sun’s UV rays can damage the DNA of skin cells, potentially leading to cancerous growths so to protect yourself from harmful sun exposure, use sunscreen in ample quantities with an SPF of 30 or higher, seek shade, especially between ten in the morning and four in the afternoon, when the sun’s rays are strongest. Be sure to wear protective clothing, including wide-brimmed hats and sunglasses.

In addition to sun protection, getting vaccinated against certain viruses can help prevent some types of cancer. Examples include the human papillomavirus (HPV) vaccine recommended for all teenage girls, with new data showing this dramatically reduces the risk of cervical and other genital cancers. The NHS has pledged to eradicate cervical cancer by 2040 due in large part to the vaccine’s success.

While it’s impossible to completely eliminate cancer risk, these five strategies can significantly reduce your chances of developing the disease. By quitting smoking, maintaining a healthy weight, staying physically active, eating a balanced diet, limiting alcohol consumption, protecting yourself from sun exposure and getting vaccinated, you can take control of many modifiable risk factors for cancer.

Remember that small changes can make a big difference over time. Perhaps even start by incorporating one or two of these strategies into your daily routine and gradually build on them. Regular medical check-ups and cancer screenings are also essential for early detection and prevention.

By adopting healthy lifestyle choices, you’re not only reducing your cancer risk but also improving your overall health and wellbeing, and you’ll probably be happier with your new self too. It’s never too late to start making positive changes that can have a lasting impact on your health. Läs mer…

King Charles’s decision to cut red meat from his diet following his cancer treatment has sparked a frenzy of interest in the potential effect of what we eat on cancer outcomes, and how well people do after they’re diagnosed.

While the specific details of the king’s diagnosis and treatment remain private, his dietary adjustments align with growing evidence suggesting that nutrition plays a crucial role in cancer “survivorship”, meaning living with the disease after being diagnosed – and in some cases, hopefully, being cured of it.

While we’re getting so much better at diagnosing and treating cancer, research also indicates that diet can influence cancer prognosis. However, the evidence is stronger for some cancer types than others.

One systematic review of studies found that a higher intake of plant-based foods was associated with improved prognosis in cancer survivors. For colorectal cancer survivors, a better prognosis, including an enhanced quality of life, was seen in those whose diets included lots of whole grains and fibre.

Breast cancer survivors showed improved outcomes with higher consumption of fruits, vegetables and fibre, as well as moderate intake of soy. In prostate cancer survivors, higher vegetable intake was also linked to improved prognosis.

The decision to reduce red meat consumption, in particular, is supported by some scientific evidence.

Red meat, especially when processed, has been associated with an increased risk of certain cancers, most notably colorectal cancer. In fact, the World Health Organization classified red meat as a “probable carcinogen” and processed meat as a “known carcinogen” nearly a decade ago.

Red meat is associated with an increased risk of colorectal cancer.
Brent Hofacker / Alamy Stock Photo

Recent research has shed light on the mechanisms behind this link, suggesting that the iron in red meat may activate an enzyme called telomerase, which might help cancer cells spread.

While much of the research on diet and cancer has understandably focused on prevention, there is now growing evidence that dietary choices after diagnosis can also affect outcomes.

A study from the Nurses’ Health Study cohorts found that breast cancer survivors who decreased their total fruit and vegetable intake by one or more servings per day after diagnosis had a 14% higher risk of dying from any cause. This suggests that maintaining or increasing plant food consumption after a diagnosis of breast cancer could be beneficial, and also seems to apply to other cancers.

As mentioned, the effect of diet on cancer outcomes can vary depending on the type and stage of cancer. For instance, a study from China showed that nut consumption was associated with up to a 50% reduced risk of breast cancer recurrence, metastasis or death, with the association being more evident among people with early-stage breast cancer.

The emphasis on plant-based foods in cancer survivorship is not just about avoiding potential harm from certain animal products. Plant foods are rich in antioxidants, fibre and other beneficial compounds that may help combat cell damage, reduce inflammation and support overall health. It also contributes to a healthy microbiome – the bugs that live inside our bodies that are known to be important for many aspects of our health.

While we are only starting to understand many of these processes and how they work together, the American Institute for Cancer Research recommends that cancer survivors consume a variety of antioxidant-rich foods daily, to decrease the risk of second cancers or their cancer spreading.

However, it’s crucial to understand that diet is just one piece of the puzzle when it comes to cancer survivorship. Physical activity, maintaining a healthy weight, and avoiding tobacco and excessive alcohol consumption are really important factors.

Several studies have reported that physical activity after treatment may provide many health benefits to cancer patients. And research I have led suggests that elevated body fatness is a predictor of poor outcomes in breast cancer survivors, to give one example.

The growing body of evidence supporting the role of diet in cancer survivorship has led to the development of lifestyle interventions combining dietary and physical activity components. And, of course, having a healthy diet also contributes to fitness and waistlines, so all of this is linked. These interventions are seen as a really important strategy to improve prognosis and quality of life among survivors of most types of cancer.

Approach cautiously

While King Charles’s decision to reduce red meat consumption appears to be in line with scientific evidence, it’s important to note that dramatic dietary changes should be approached cautiously and under professional guidance. It’s also important to enjoy life.

Some doctors emphasise that it’s not recommended to remove any core food group or make major changes to your diet without personalised guidance from a treatment team, including an accredited dietitian. This is particularly important for people undergoing cancer treatment, as treatments like chemotherapy can affect appetite, alter taste and cause digestive issues.

For the general public, the takeaway message is that a healthy, balanced diet rich in plant-based foods can be beneficial both for cancer prevention and survivorship. But at the same time, sometimes the effects are very small. This also doesn’t necessarily mean eliminating meat, but rather focusing on increasing the consumption of fruits, vegetables, whole grains, legumes and nuts, while limiting the intake of red and processed meats.

The current guidelines suggest that people in good health and those with cancer should aim for no more than 350 to 455 grams of cooked lean red meat per week.

It’s also worth noting that the benefits of a healthy diet extend beyond cancer outcomes. A diet rich in plant-based foods and low in processed foods is associated with reduced risk of other chronic diseases such as heart disease, diabetes and obesity. This is particularly relevant for cancer survivors, who may be at elevated risk of premature death not only due to their primary cancer but also other chronic diseases they might have – so-called comorbidities.

Overall, while King Charles’s dietary changes appear to be a step in the right direction based on current evidence, it’s important to remember that individual needs vary; everyone is different.

Cancer survivors should work closely with their healthcare team, including registered dietitians, to develop a personalised nutrition plan that takes into account their specific type of cancer, treatment history and overall health status. Läs mer…

In a heartening turn of events, action movie star Dolph Lundgren recently announced that he is “finally cancer free” after a gruelling battle with the disease.

The Rocky IV actor, known for his iconic role as Ivan Drago, shared this news from a hospital bed in Los Angeles, where he was undergoing a final procedure – an ablation – to help remove an apparently dead tumour.

This remarkable recovery comes after Lundgren was initially given a grim prognosis of just two to three years to live.

Lundgren’s cancer journey began in 2015 when doctors discovered a cancerous tumour in his kidney. For the first five years following his diagnosis, the actor’s condition appeared to be under control with regular scans. However, in 2020, things took a turn for the worse. Lundgren began experiencing acid reflux, prompting an MRI that revealed additional tumours in his abdomen. Doctors then found another tumour in his liver.

Despite the bleak outlook, Lundgren’s story took an unexpectedly positive turn. He sought a second opinion and began treatment with a new doctor who reevaluated his cancer and prescribed medications to shrink the tumours. This change in approach allowed Lundgren to continue working, shooting major films like Expendables 4 and Aquaman and the Lost Kingdom while undergoing treatment.

The actor’s recent announcement of being cancer free raises an important question: how likely is it for someone with a terminal cancer diagnosis to be cleared of cancer altogether?

Atypical case

While Lundgren’s case is undoubtedly inspiring, such outcomes are not typical for most patients with advanced cancer – and the accuracy of predicting when terminally ill patients will die can vary considerably. One study found that clinicians tend to over-predict the number of people they think will die within a specified time period.

In fact, the study showed 54% of those predicted to die within a given time frame lived longer than expected. I’ve led research that shows how difficult it is for doctors to estimate how long patients have to live, even when those people are very sick.

The remarkable advances of new cancer drugs, and immunotherapies in particular, have led to many people living with their disease, when previously they would have died rapidly from it. Kidney cancer falls into this category as it’s often very responsive to these drugs.

We do, however, need to be vigilant as cancers can return even decades after people are given the all clear from doctors. While medical professionals strive to provide accurate prognoses, the unpredictable nature of cancer and individual responses to treatment can lead to outcomes that defy initial expectations – and the term “cancer free” can be misleading.

In many cases, it doesn’t mean that every cancer cell has been eliminated from the body but that there is no detectable cancer at the time of assessment. Some cancer cells may remain dormant or undetectable by current imaging technologies so, sometimes, as one of my research groups found, they can be detected using new advanced blood tests.

Changing landscape

Nevertheless, the possibility of misdiagnosis in terminal cancer cases is relatively low, given the advanced diagnostic tools available today. While this is a concern in cancer screening, it’s less likely in advanced cancer cases like Lundgren’s.

More likely, Lundgren’s remarkable recovery can be attributed to advancements in cancer treatment. In recent years, there have been significant strides in targeted therapies and immunotherapies that have dramatically improved outcomes for many cancer patients.

These treatments can be particularly effective for certain types of cancers, those with specific genetic mutations or changes within their cancers. I was part of research team studying next generation immunotherapies in colon cancer. The study found, for the first time, positive effects in heavily pre-treated patients with few treatment options remaining.

We’re now regularly seeing long-lasting remissions in patients treated with immunotherapy but, like all drugs, immunotherapy only works for certain types of cancer. As an oncologist, I use personalised medicine: treating the right person at the right time with the right drugs for the right cancer.

While Lundgren’s case is good news, it’s crucial to approach such stories with a balanced perspective. Not all patients with advanced cancer will experience similar outcomes, and previously effective treatments can stop working.

However, his story highlights the importance of seeking second opinions, exploring all available treatment options and maintaining hope, even in the face of dire prognoses.

For patients living with prolonged incurable cancer, the landscape is changing. Thanks to therapeutic advances, the period between a diagnosis of non-curable cancer and the end of life has rapidly increased for many patients.

Lundgren’s journey from a terminal diagnosis to being cancer free is testament to the progress being made in cancer treatment. While such dramatic turnarounds are not yet the norm, they offer hope and underscore the importance of ongoing research and development in cancer therapies.

As medical science continues to advance, we may see more stories like Lundgren’s, where patients defy the odds and reclaim their health from the grip of this formidable disease. Läs mer…