Views from the top
We’ve asked inspirational academic pathology leaders and senior academic pathology trainees to share their thoughts and advice. Here’s what they have to say…
- Professor Adrienne Flanagan
- Professor Mark Arends
- Dr Adrian Bateman
- Dr Nic Orsi
- Professor Val Speirs
- Professor Philip Quirke
- Dr Emyr Benbow
- Dr Kathryn Griffin
- Dr Kathreena M Kurian
1. Professor Adrienne Flanagan
What has been the biggest impact of your research?
Improving the diagnostic accuracy of a number of primary bone tumours through generating their genomic landscapes. The results of the research have led to the identification of diagnostic markers: brachyury (TBXT) in chordoma, IDH1 and 2 mutations in central cartilaginous tumours, Histone 3.3A G34 mutations in > 90% giant cell tumours of bone, histone H3.3BK36M mutations in >90% chondroblastoma, and FOS and FOSB alterations in osteoblastoma and osteoid osteoma.
What is your greatest research achievement?
My research on chordoma which started with the identification of brachyury (TBXT) expression in all chordomas other than the dedifferentiated variants. This not only provided a valuable diagnostic immunohistochemical marker for the disease but led others to identify that a tandem duplication of TBXT accounts for a good number of the germline alterations in familial chordoma.
My research has resettled in the development of chordoma cell lines and a patient-derived chordoma xenograft which have helped in the identification that EGFR inhibitors reduce chordoma cell survival. This represents one of the few tyrosine kinase inhibitors that has an impact on the disease and there is now an European-led EGFR inhibitor clinical trial using Afantinib.
I also now lead a UK-wide NIHR-sponsored study which involves the development of a clinician network which allows research for patient benefit and hopes to develop a network allowing a more standardised approach to the clinical management of this disease. Being such a rare disease, I think that one of my achievements is that I have managed to engage with patients, as without their contribution I would not have been able to deliver the research. In particular, my engagement with the Chordoma Foundation and Chordoma UK has been invaluable.
What do you love most about research?
Looking down a microscope and wondering why cells behave in a certain manner (for example - why does denusomab result in ossification of giant cell tumour of bone?): planning experiments to answer the question and in some cases (which may take years) coming up with an explanation.
As a practicing pathologist, having an academic post provides me with time to undertake research that improves my clinical practice.
What advice would you give to academic pathology trainees?
Work in an academic centre where there are people with vision and who are supportive, a place where there is a greater chance of opportunities to come your way.
Be bold - believe in yourselves - you have lots to offer - you are the future!
2. Professor Mark Arends
What has been the biggest impact of your research?
Lynch Syndrome/DNA mismatch repair research: both developing mismatch repair protein immunohistochemistry for suspected Lynch tumour screening; and identifying the regulation of apoptotic cell death via p53 by mismatch repair, as this is selectable when mismatch repair is deficient.
What is your greatest research achievement?
Modelling DNA repair pathways that cause pathological abnormalities – both Fanconi Anaemia DNA interstrand crosslink repair and DNA mismatch repair – identifying new pathway components (SLX4/FANCP), characterising a new model of Fanconi Anaemia that more accurately phenocopies DNA crosslink repair and using models to delineate aldehydes as key DNA interstrand crosslinking agents; as well as characterising Lynch-Msh2 models to study progression of deficient mismatch repair foci to bowel adenomas and adenocarcinomas.
What do you love most about research?
Problem-solving, working out new mechanisms of pathological processes.
What advice would you give to academic pathology trainees?
Enjoy and persevere – research work goes in cycles and it is important to keep going through the difficult parts of the cycle and take enjoyment from the productive parts of the cycle.
3. Dr Adrian Bateman
What has been the biggest impact of your research?
A greater understanding of the novel fibroinflammatory condition IgG4-related disease. My ‘academic’ output has also comprised the production of reviews and guidelines and among these, being part of the writing committee for the updated guidance on pathology reporting in the NHS Bowel Cancer Screening Programme has been particularly satisfying.
What is your greatest research achievement?
Please see above. As I am a full-time NHS consultant with an honorary academic position, I have limited time nowadays to apply for grants and to lead research myself. So my greatest academic achievements would probably be the IgG4-related disease work and the various guidelines that I have written – or have helped to write. I would also include being Editor-in-Chief of Diagnostic Histopathology – and my current role as Lead Editor for the (in preparation) sixth edition of Morson and Dawson’s Gastrointestinal Pathology
What do you love most about research?
My favourite part is crystallising my thoughts into a coherent script and then having the satisfaction of seeing this published. So I derive pleasure from many types of publication – not just pure research articles.
What advice would you give to academic pathology trainees?
My advice would be to take the opportunities that they are given to become involved in academic pursuit and while they are doing this, to try and decide what it is about academic activity that interests them the most. This may help them to plan their next career steps e.g. in terms of aiming for a fully academic career – e.g. as a senior lecturer; or an ‘honorary’ one like mine – e.g. as an NHS consultant in a teaching hospital setting.
4. Dr Nic Orsi
Clinical Lecturer
What has been the biggest impact of your research?
Using mathematical models to understand protein mediator interactions in vivo.
What is your greatest research achievement?
Developing automated diagnostic algorithms in histopathology.
What do you love most about research?
The stimulation of being able to discover answers to questions about fundamental biology and pathophysiology.
What advice would you give to academic pathology trainees?
Be tenacious and learn from your mistakes. Academic life is a series of peaks and troughs of successes, so if things don’t appear to be working, keep at it - it gets much easier with time. Have fingers in many pies and manage your academic:clinical balance with care.
5. Professor Val Speirs
What has been the biggest impact of your research?
I work in breast cancer research. Breast cancer also occurs in men and about 10 years ago I recognised this was understudied. I set about trying to do something about this and through international collaboration with pathology colleagues, established a large collection of >500 male breast cancers which has allowed us to do multiple studies at the transcriptomic, immunohistochemical and, just starting now, functional level. These show that male and female breast cancer are not identical, as previously thought, and have opened up new avenues of research for this understudied disease.
What is your greatest research achievement?
There are quite a few things I’m proud of but the think the most important is being involved in setting up and running the Breast Cancer Now Tissue Bank (www.breastcancertissuebank.org). It was a massive undertaking to bring the project together across multiple sites and gave me satisfaction and a real sense of pride to be involved in this with other pathology colleagues and then to oversee its successful launch to the biomedical research community and see it flourish.
What do you love most about research?
The sense of the unknown and the great feeling you get when the ideas you have developed and nurtured come to fruition. This doesn’t always happen and it can be frustrating at times but every piece of information you gather is useful - even if the results are negative.
What advice would you give to academic pathology trainees?
Get yourself an enthusiastic mentor who is well respected in their particular field. It doesn’t always have to be a clinical person as there are many good scientists involved in pathology-based translational research who are willing to help you and get you embedded in their lab teams. Give it a go – it might seem daunting at first but research is fun and having the right mentor can revolutionise your career.
6. Professor Philip Quirke
What has been the biggest impact of your research?
The identification of the main cause of local recurrence in rectal cancer, the development of a simple method to detect it leading to an enhanced awareness of the importance of the quality of surgery and the contribution that pathologists can make to it.
What is your greatest research achievement?
Our young academics who will go on to enhance our understanding of disease and its alleviation and causation.
What do you love most about research?
Seeing new data emerge from our staff and the excitement of the possible implications of the findings together with development of the next generation of young academics who will go on to have a major impact on the world.
What advice would you give to academic pathology trainees?
Start with the end in sight.
7. Dr Emyr Benbow
What has been the biggest impact of your research?
Saving lives by providing the evidence that diversion of methadone, in the era where it was dispensed without supervision, was killing non-addicts. Our simple, autopsy-based research, may have changed the direction of national policy.
What is your greatest research achievement?
Demonstrating that medical students value the autopsy, and what they can learn from it.
8. Dr Kathryn Griffin
What has been the biggest impact of your research?
My research has had a huge impact on my life personally and professionally and was one of the key factors in why I changed clinical specialty and discovered my love of Histopathology! In terms of academic impact; I conducted some work during my PhD which aimed to identify the cellular source of the coagulation Factor XIII-A. Previous work had been conflicting and contradictory but we managed to show that resident macrophages maintain plasma FXIII-A levels - a really important finding for the field and one which wouldn’t have been possible without my work with genetic murine models.
What is your greatest research achievement?
My greatest research achievement has got to be completing my PhD - I don’t think I've ever been as nervous as I was before defending my thesis at my Viva! PhDs don’t happen by accident though, they require a lot of hard work, team work and collaboration and I feel that my degree reflects the efforts of my whole research group not just my own.
What do you love most about research?
The term "research" can mean different things to different people. For me, my academic career has given me opportunities; to teach, to travel, to work with inspirational colleagues and to investigate important scientific questions whilst still maintaining my clinical career. I love the variety it gives my working life - no two weeks are the same.
What advice would you give to academic pathology trainees?
Make sure you join a group or department that has experience in developing academic clinical trainees - the training needs of an academic clinician differ from those of either a pure clinician or a pure scientist and it's really helpful to have senior trainees around who have "gone through the system" and have been successful. Also...say "yes" to as many opportunities as possible but don’t be afraid to say "no" every now and again...juggling an academic and clinical career is difficult and it's easy to become overwhelmed - make sure you're not taking on too much, especially at the early stages.
9. Dr Kathreena M Kurian
Academic Reader in Brain Tumour Research, University of Bristol
What has been the biggest impact of your research?
Better understanding of brain tumours.
What is your greatest research achievement?
Hopefully still awaited.
What do you love most about research?
I love the need for independent thinking and I love publishing papers.
What advice would you give to academic pathology trainees?
Need to be pleasantly persistent and very thick skinned.
