Sudha Sundar

Colleges, School and Institutes

Research interests

My research programme investigates clinical challenges in patients with gynaecological cancer combining clinical trials/studies and translational research.


Test accuracy/accurate detection in Ovarian Cancer 

Ovarian cancer is the fifth most common cancer in women and is the leading cause of death from gynaecological cancer, with approximately 5,900 newly diagnosed cases each year in England. Most women present with late stage disease as symptoms are nonspecific; five year relative survival is around 40%. Not only is survival relatively poor, but living with late stage ovarian cancer is associated with poor quality of life as a consequence of: disease symptoms, surgical morbidity and the toxicity of chemotherapy.

I am the Chief Investigator of the NIHR funded ROCkeTS project which is an international collaboration between myself, Prof Sean Kehoe, Prof Jon Deeks, UoB, Prof Usha Menon, UCL, Prof Richard Neal, Bangor University, Imperial and the IOTA group Profs Dirk Timmerman, Tom Bourne and Ben VanCalster, KU Leuven University, Belgium to derive and validate novel risk scores to detect ovarian cancer. This project will be delivered in 4 Phases – Phase 1 Systematic reviews, Phase 2 – re-analysis of large established datasets/biobanks UKCTOCS, UKOPS, IOTA, Phase 3 – Prospective study in 2400 women, Phase 4 – generation of pathways. Phase 3 is a unique opportunity to build an extremely novel sample collection and will offer significant opportunities for translational research with collaborator Dr Jean-Baptiste Cazier in next generation sequencing technologies. ROCkeTS establishes Birmingham as the UK/EU hub for ovarian cancer diagnostics research and was awarded against intense competition from Manchester.

 

This research theme builds on my previous work in the evaluation of diagnostic tests in gynaecological cancer with Prof Khalid Khan at Queen Mary’s, London.

 

Metabolism research in Ovarian cancer

Obesity contributes to the development of several cancers. Working with Dr Paul Foster, Prof Weibke Arlt at CEDAM and Prof Jeremy Tomlinson at Oxford, I am investigating the impact of metabolic syndrome and dysregulation of hormone signalling pathways in Ovarian Cancer. I am investigating the use of Metformin, a well-tolerated anti-diabetic drug in serous ovarian cancer aiming to establish clinical trials with survival and translational endpoints to identify biomarkers of response with collaborators Prof Hani Gabra, Imperial and Prof Chris Poole, Warwick. Translational research with Dr Jo Morris, exploring DNA repair and Metformin has yielded interesting preliminary results which we aim to build on.  

 

Poor prognostic groups of endometrial cancer

Poor prognostic histotypes of uterine cancer contribute to 10% of the incidence of endometrial cancer but up to 50% of mortality from endometrial cancer. Working with Dr Fedor Berdevetski/ Dr Odintsova’s group, we are investigating the role of these novel proteins in metastasis in ovarian and uterine serous cancer.   

 

Surgery in Ovarian cancer

Extensive surgery has been shown to significantly improve survival in ovarian cancer in a paradigm shift from conventional approaches. I am Chief Investigator of SOCQER-2 - a prospective multicentre cohort study evaluating the short term and long term outcomes, including quality of life following extensive surgery in ovarian cancer. NICE has commissioned this study following on from the SOCQER-1 pilot study which has elicited international interest for its findings on Quality of life. This project will have substantial impact on ovarian cancer surgery in the UK as it will directly influence NICE guidance in 2017 on this subject.

Biography

Teaching design, delivery and enahncement

Undergraduate teaching – Year 4 Lead for Oncology for MBChB (2012 – date) s

Prior to my appointment, Oncology received poor student feedback with formal complaints made from students. I have  implemented curriculum change – revision of learning outcomes, revamped and designed assessments including both multiple choice questions and Objective structured clinical examination questions, improved e- learning resources. I have worked with trust leads in Oncology through a ‘Oncology reference group’ to promote ownership and delivery of high quality oncology teaching in trusts. These and other system wide changes have resulted in improved student satisfaction – student satisfaction for oncology is now good. I am introducing an innovation - ‘Survivors teaching students’ delivered by a charity in Ovarian Cancer on 21st October this year. This is a UK first event, if student feedback for this event is good, I plan to develop this concept further across oncology to promote patient voices in teaching.  

Biography

Teaching leadership

 

Postgraduate teaching – Clinical Lead for fulltime programme MSc in Clinical Oncology, 2011 - 2013

I devised and helped deliver this innovative course which is the first in the United Kingdon to combine clinical observership in an NHS hospital with taught modules and a dissertation thesis. This course aimed at international students, has been extremely well received (student interview at http://www.birmingham.ac.uk/students/courses/postgraduate/taught/med/clinical-oncology-full-time.aspx). The course has enabled School of Cancer Sciences to engage pro-actively with the agenda of international recruitment. I was awarded the Teaching and Supporting Learning Award for 2011-2012 for this work from School of Cancer Sciences and was nominated Cancer Sciences’ Star of the Year’ for 2011-2012.

Surgical Oncology module, MSc in Clinical Oncology, 2012.  

Working with Olga Tucker, Senior Lecturer in Surgery, I helped devise and deliver the first blended learning module in the School of Cancer Sciences. The ‘Surgical Oncology’ module comprises electures accessible by students prior to attendance at the face to face contact days. The module was well received in 2012 with a course evaluation of  3.5 out of  5. I also deliver lectures on gynaecological oncology during the Pathology module of this course.

Biography

Career to Date

Present Appointment

Senior Lecturer/ Hon NHS consultant in Gynaecological   Oncology

(03.12.2007 to   date including 13 months off in 2 episodes for adoption leave/unpaid leave)

Pan Birmingham   Gynaecological Cancer Centre, City Hospital and

School of   Cancer sciences, University of Birmingham

I have a busy clinical practice (50% of time commitment) as a gynaecological cancer surgeon based at the Pan Birmingham Gynaecological Cancer Centre at the City Hospital - a large tertiary centre for gynaecological malignancy with a catchment population of over 2 million patients that currently receives in excess of 600 new cases of gynaecological cancer annually. Our centre has currently the best 3 year, 5 year ovarian cancer survival in the country (http://www.ncin.org.uk/profiles/gynae/cancer_networks/health_profile_map/atlas.html). I have been awarded 2 clinical excellence points for my contributions to clinical service in 2011.

Biography

Previous Appointments

Subspecialty Trainee in Gynaecological Oncology (12.07.2004 to 14.10.2007)

Cheltenham General Hospital

Cheltenham

Programme Director: Mr RJ Gornall

This is a 3 year programme recognised by the RCOG for subspecialty training. This centre serves the 3 counties cancer network comprising Gloucestershire, Herefordshire and Worcestershire and treats 250 new cases of gynaecological cancer each year.

 

CRUK Clinical Research Fellow (01.05.2002 to 30.04.2004)

Ovarian Cancer Group

Weatherall Institute of Molecular Medicine

JohnRadcliffeHospital, Oxford

Cancer Research UK

Supervisor Dr T S Ganesan

This period of research in Molecular Oncology was funded by Cancer Research UK and a fellowship from the Oxfordshire Health Services Research Committee.

 

Visiting Specialist Registrar Years 1 - 5 (March 1998 to July 2005)

I completed 4 years of Specialist Registrar training in Obstetrics and Gynaecology in the Oxford Deanery.

 

Senior House Officer/Acting Registrar in Obstetrics and Gynaecology. October 1995-Feb1998. (16 months SHO, 12 months senior SHO)

Birmingham Heartlands and Solihull NHS Trust (Teaching).

West Midlands

Biography

Knowledge Exchange

I was invited as part of a select group representing stakeholders in the care of women with gynaecological cancer to the House of Commons by the Chair of the All Party parliamentary group on Ovarian Cancer, Member of Parliament Sharon Oates in January 2013 to hear the results of the Pathfinder study on Ovarian Cancer. This study conducted by the charity Target Ovarian Cancer focuses on patient experiences in ovarian cancer diagnosis and treatment.

I was interviewed by BBC Midlands television and radio on endometrial cancer in April 2012 focusing on the link between endometrial cancer and obesity, following my publication in the British Journal of Cancer.

Biography

WIDENING PARTICIPATION

I participated in the Cancer Research UK Race for life in 2012, representing the University and have volunteered in the race in previous years.

Biography

CITIZENSHIP

EXTERNAL ENGAGEMENT - MARKERS OF ESTEEM

I am an opinion leader in my specialty with a significant national profile.  

 

  1. Council member – British Gynaecological Cancer Society. April 2011- date. This is the professional body representing surgeons, oncologists and nurses involved in the care of women with gynaecological cancer.
  2. Chair guidelines committee of the British Gynaecological Cancer Society. November 2012- date. Lead for BGCS Endometrial cancer guideline
  3. Member Ultraradical Surgery in Ovarian cancer Steering committee, 2013 to date.
  4. Member of NCRI Gynaecological Cancer Clinical Studies Group. 2008 – 2013. Current Member of ovarian and endometrial cancer subgroups of the Gynaecological cancer CSG.
  5.  Grant panel member Wellbeing of Women charity ( 2014 September for 3 years)
  6. Reviewer for British Journal of Obstetrics and Gynaecology, International Journal of Gynaecological Cancer, European Journal of Obstetrics and Gynaecology and Reproductive Biology, Science Translational Medicine, British Medical Journal
  7. Reviewer for grant applications to Wellbeing of Women and Research for patient benefit, NIHR
  8. Invited Speaker at national and International conferences

 

  • Invited panel guest (4 member panel) for the ‘Wellbeing of Women’ charity meeting on Ovarian Cancer, June 27th, 2013.
  • September 2013 – European Society of Gynaecological Oncology biannual meeting, Liverpool. Sentinel nodes in Vulval Cancer
  • March 2014 – RCOG World Congress, Hyderabad India. Laparoscopic surgery in gynaecological cancers.
  • July 2014 – British Gynaecological cancer society annual conference, London. Insulin Resistance and Metformin in Endometrial and Ovarian Cancer
  • January 2015 - Federation of Obstetrics and Gynaecological Societies in India ( FOGSI) annual conference. Keynote speaker on Conservative management in Endometrial Cancer

Research interests

GRANT FUNDING

Applicants (CI /   PI)

Grant title

Awarding Body

Value of award

Date of award

Date of end of   award

Sudha   Sundar

Chief   Investigator

SOCQER-2

NICE

£121, 480

Provisional   award, final expected November 2014

2017

Sudha   Sundar

Chief   Investigator

ROCkETS   – Refining Ovarian cancer test accuracy scores

NIHR  HTA

£1,000,037

20/06/2014

End   2018

Sudha   Sundar

(Co-PI)

 

 

Folic   acid for menopausal symptoms in women with breast and gynaecological cancer

RfPB

£250,000

July   2012

Trial   in setup

Sudha   Sundar

(   co PI)

 

Collaborating   with Prof Andrea Rockall, Imaging  at   Barts (CI)

MAPPING   study, BIDD grant .

Diagnostic accuracy of MRI, diffusion-weighted   MRI, FDG-PET/CT and

Fluoro-ethyl-choline PET/CT in the detection of   lymph node metastases in surgically

staged endometrial and cervical carcinoma

 

BIDD  

(CRUK)

£   225,698

Nov   2010

 

Site   open for recruitment

Sudha   Sundar

(   co PI)

 

Key   collaborators – Prof Tracy Roberts, Health economics , Bham and Prof Khalid   Khan, QMUL, CI

Sentinel   lymph node status in vulval cancer: Systematic quantitative reviews and   decision analytic model based economic evaluation

 

 

HTA

£229,000

June   2010

Peer   reviewed. Dec 2013

Sudha   Sundar

(   co-PI)

 

Key   collaborators – Prof Tracy Roberts, Health economics , Bham and Prof Khalid   Khan, QMUL, CI

Clinical effectiveness of PET-CT imaging in restaging recurrent cervical cancer: Systematic review of evidence and economic modelling

 

HTA

£332,000

Jan   2010

Passed   peer review. April 2013

Sudha   Sundar, PI

Evaluation of autotaxin and lipid metabolites in ovarian cancer

Sandwell and West Birmingham Hospitals Research and   Development award – January 2009

£24,000

Jan   2009

Work   completed

Sudha   Sundar, PI. Collaborative research   project with Professor Roy Bicknell, University Of Birmingham.

 

To investigate antiangiogenic and epidermal growth factor receptor   antagonists as novel therapies in poor prognostic types of endometrial   cancer.

Cobalt appeal fund, Cheltenham

£84,450

May   2007

Work   completed

Biography

CONTRIBUTION TO UNIVERSITY MANAGEMENT

India Champion for Medical and Dental School October 2011 to January 2013

In this role, I contributed to Research and Teaching engagement activities with India as part of the College international engagement committee to guide the College of Medical and Dental school on research links as well as promotion of recruitment. I represented the College of Medical and Dental Sciences at the India group chaired by Prof Adam Tickell, along with representatives from other Colleges. I organised a high profile international visit by Dr Sankaranarayanan, Head of the Early detection and Prevention section, International agency for Research in Cancer/World Health Organisation in May 2012 to foster research collaborations in India.

 

Contribution to international student recruitment agenda

I visited Saudi Arabia, on behalf of the University of Birmingham to promote postgraduate recruitment in April 2012. I explored collaborative links with King Saud University, the most established University in Saudi Arabia at their behest - the international office are now working to build on these links.

 

CONTRIBUTION TO DEVELOPMENT OF OTHERS

I regularly act as home supervisor for international and domestic electives for students. In my role as an academic, I support NHS colleagues in grant applications and advice. For instance, I helped develop the concept of Folic acid supplementation for menopausal women with contraindications to hormone replacement therapy (PI – Ayman Ewies, Consultant in Obstetrics and Gynaecology, SWBH trust) from a concept to an NIHR funded trial. I am also local PI for Phase 1 of CRUK Stratified Medicine and BRITROC studies.

Education/Academic qualification

  • Master of Philosophy, Oxford Brookes University

    24 months laboratory research as CRUK Research Fellow conducted at the Weatherall Institute of Molecular Medicine, John Radcliffe, Oxford by Oxford Brookes University

  • Bachelor of Medicine and Bachelor of Surgery, The Tamil Nadu Dr. M.G.R. Medical University

Professional Qualifications

  • MRCOG, Memeber of the Royal College of Obstetricians and Gynaecologists

    1998

Willingness to take PhD students

Yes

PhD projects

Sudha Sundar’s research interests are in surgical trials in gynaecological cancer, novel therapies in endometrial cancer and minimal invasive radical surgery. Another research strand focuses on evaluation of diagnostic tests in gynaecological cancer and their economic evaluation. This enables the NHS to make evidence based and cost effective decisions on choosing appropriate tests in the management of women with gynaecological cancer. She has received over £700,000, as co-PI from HTA and CRUK since 2007.

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