At this time, 800,000 people in the US undergo cancer surgery each year.  As many as 50% of these patients develop recurrences despite curative resections.  As a surgeon who primarily focuses on cancer, my research interest lies in preventing recurrences after surgery.  Relapses typically occur locally or distally, thus our group has taken two approaches to overcome these issues.

First, local recurrences are likely due to tumor cells that are in the wound bed and margins at the conclusion of the operation.  To prevent local recurrences, we are developing technologies to optically image tumors at the conclusion of an operation.  The underlying hypothesis is fluorescent contrast agents can be designed to target tumors prior to surgery and thus allow cancer surgeons to find small tumors, locate lymph nodes containing metastatic disease and identify in situ disease.  Thus, by optically enhancing the tumor, we can improve the cancer operation by drawing attention to any area of a patient’s disease that may remain after surgery. 

Second, systemic recurrences are due to metastatic tumor cells that have migrated from the primary tumor site.  Our group has been interested in preventing systemic recurrences by augmenting the immune response to small quantities of residual disease that may have escaped the surgeon.  Specifically, our work has focused on the innate immune system, the immune response to tumor cells as they begin to re-populate, and a detailed description of myeloid cells in the tumor microenvironment of human lung cancers.