University of Cambridge - School of Clinical Medicine

Cambridge to Careers: skills and support that take you further

lw355 — Wed, 25 Mar 2026 10:22:40 +0000

Cambridge University is ranked best in the UK 2026 for "producing the most employable graduates", as judged by recruiters at top companies around the world. We spoke to Graham Philpott, Cambridge’s Head of Careers, about the key factors that shape employability for Cambridge students.

Cambridge to Careers: How my degree prepared me to be a confident doctor

lw355 — Wed, 18 Mar 2026 15:03:34 +0000

From a small Welsh town to top of her Cambridge medical exams, Liz Samuel discovered resilience, self-belief and ballroom dancing. She’s now returned home to start her career as a doctor.

Deaf opera singer welcomes new Cambridge-led cochlear implant trial

cjb250 — Wed, 06 May 2026 07:34:21 +0000

The UK trial will provide bilateral cochlear implants (cochlear implants on both sides) to some profoundly deaf adults. The results will be used to review NHS guidance for the provision of implants to adults.

Each year over 1,000 adults in the UK receive cochlear implants to restore their hearing. Under NHS guidance, adults currently only receive a single (unilateral) implant, yet evidence suggests having two could offer significant improvements in prospects and quality of life and may now be cost effective.

Janine said: “With bilateral implants, I no longer consider myself to be deaf. They have been utterly life changing and, for me, have broken a generational curse. I am excited that this trial will offer the same opportunity to others.”

Funded by the National Institute for Health and Care Research (NIHR), the trial is being co-led from Addenbrooke’s Hospital and the University of Cambridge. It will run in 14 hospitals and include over 250 adult participants, who will either receive one (unilateral) or two (bilateral) implants. Participants will be monitored for 12 months after surgery to assess the effects of the implants on wellbeing, ability to hear speech in noise, and quality of life. The study will also evaluate the economic benefits and cost of bilateral implants for the NHS.

Called LUCIA, the trial will be co-led by Dr Matthew Smith, an ear, nose and throat (ENT) surgeon at Addenbrooke’s Hospital, and Professor Debi Vickers, a speech and hearing scientist in the Department of Clinical Neurosciences, University of Cambridge, who leads the SOUND Lab.

Professor Debi Vickers, who also co-leads the Devices and Advanced Therapies theme at the NIHR Cambridge Biomedical Research Centre, said: “Children routinely receive bilateral cochlear implants. These can provide 3-dimensional hearing, enabling them to hear more naturally than unilateral, with improved access to sound and better engagement with society.

“Adults tell us, and I agree, that they should be given the same hearing opportunities as children. In turn these will result in reduced social isolation, enriched communication, improved mental health, and better overall quality of life.”

The trial, which is expected to begin recruiting patients in the autumn, has been designed in collaboration with Janine and other patients. By involving individuals with lived experience of cochlear implantation, the researchers aim to measure changes that patients consider to be most important.

The primary trial outcome will reflect participants’ own perceptions of their quality of hearing. The study will also measure common challenges faced by patients, such as listening effort and fatigue, a choice directly based on discussions with patient groups.

Dr Smith, who is also an academic surgeon at the University of Cambridge, said: “We know from giving bilateral implants to children that it can have a transformative effect on their quality of life and interactions with other people. Through this study, we can offer the same opportunity to adults who have become deaf, and understand the potential added value of bilateral cochlear implants, not just in terms of hearing, but also how they enrich quality of life.”

Janine was diagnosed as a teenager with a genetic condition that caused hearing loss and eventually led to her needing hearing aids. For over 30 years she hid her deteriorating hearing and became a well-known mezzo-soprano, performing in operas, operettas and musicals, including at the Royal Opera House in London.

It was only in 2019, after she had retired due to profound hearing loss, that she had cochlear implant surgery, and received bilateral implants partly through personal funding. She said: “Having two implants is lightyears away from just one. Sound quality is so much better, sounds are fuller, clearer, louder and more natural. It’s much easier to tell where sounds are coming from, especially in busy spaces.

“If you’re out in public, it can be hard to follow who is speaking, making joining in with conversations almost impossible. As a result, you have debilitating concentration fatigue at the end of every day.”

Just like at the cinema, multi-directional surround sound is a key part of creating an engaging immersive experience. By comparison, living with one implant can be like listening to life through a single, poor-quality speaker.

She explains: “Struggling to hear can be extremely isolating and many people experience anxiety or depression as a result. The implants are life changing. They reconnect you to the world and most importantly people. Communication is surely the longing of every human heart.

“I also feel safer and more secure having the two implants. I am more aware of and connected to what’s happening in the world around me. And, if anything goes wrong with one of the implants, I’m not suddenly plunged into a world of total silence.”

While hearing aids help people with mild to moderate hearing loss by making sounds louder, they often provide very little benefit for people with severe or profound hearing loss. Cochlear implants bypass the outer, middle and inner ear and send electrical impulses directly to the hearing nerve which carries signals to the brain.

Participants in the trial will need to have become deaf later in life and cannot already have an implant.

People with cochlear implants will also be involved in delivering the trial. They will be specially trained to participate in interviewing trial participants that will be used to measure the impacts of the trial.

Professor Anthony Gordon, Programme Director for the NIHR Health Technology Assessment Programme, which funded the trial, said: "We fund innovative trials like the LUCIA study which explore how advances in technology can help make a positive difference to the day-to-day lives of those affected. This study offers real hope to people with severe hearing loss and the chance of a significant improvement in their quality of life."

Adapted from a press release from Cambridge University Hospitals NHS Foundation Trust

Janine Roebuck, a formerly deaf opera singer who regained her hearing thanks to cochlear implants, has described as ‘life changing’ an upcoming Cambridge-led trial in hearing loss.

We know from giving bilateral implants to children that it can have a transformative effect on their quality of life and interactions with other people. Through this study, we can offer the same opportunity to adults

Matthew Smith

Janine Roebuck

Janine Roebuck as Flora in La Traviata by Verdi at New Sadler's Wells Opera

The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.

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Scientists confirm precursor to commonest form of oesophageal cancer – offering opportunities to catch the disease early

cjb250 — Thu, 16 Apr 2026 09:00:43 +0000

The findings, published today in Nature Medicine, could help improve screening for and early detection of oesophageal cancer, the sixth most deadly cancer, helping improve outcomes for the disease.

Cancer of the oesophagus, including its most common form oesophageal adenocarcinoma (OAC), is on the rise in western countries. It is difficult to treat because it is often caught at an advanced stage, when treatment options are limited.

Scientists and doctors have known for some time that the development of oesophageal cancer is linked with Barrett’s oesophagus, which shows up in endoscopy as a pink patch in the surface of the oesophagus. Barrett’s oesophagus affects around one out of every 100 to 200 people in the United Kingdom.

Between three and 13 people out of 100 with Barrett’s oesophagus will go on to develop oesophageal adenocarcinoma in their lifetime. However, around half of OAC patients have no detectable Barrett’s oesophagus when their cancer is found, raising doubts about whether it is always the precursor.

Professor Rebecca Fitzgerald from the Li Ka Shing Early Cancer Institute at the University of Cambridge said: “Cancer generally takes many years to evolve, giving us a window of opportunity to catch it before if develops into a life-threatening condition. Screening and preventative strategies can have a massive impact on the number of people who die from cancer, but if the link between precancers and cancer is unproven or unclear, screening programmes risk doing more harm than good.”

To answer the question of whether Barrett’s oesophagus is a pre-requisite for OAC, researchers from Professor Fitzgerald and colleagues analysed epidemiological and clinical data from 3,100 OAC patients undergoing surgery to remove their tumour or diseased tissue. Patients were recruited from 25 centres across the UK.

The team also analysed whole genome sequencing data from 710 patients, which allows them to look at all of an individual’s DNA, and whole exome sequencing from multiple samples taken from 87 patients, allowing them to understand how their tumours evolved and how different parts of the same cancer may differ genetically.

The researchers hypothesised that if OAC can arise through different routes – not always involving Barrett’s oesophagus – then genomic data and associated risk factors would differ between these two groups. Conversely, extensive overlap would strongly suggest that Barrett’s oesophagus plays a central role in OAC progression.

Just over a third of participants (35%) had a diagnosis of Barrett’s oesophagus. However, the DNA, mutations, genomic patterns, and cellular ‘identity’ inside the cancers were essentially indistinguishable, regardless of whether doctors could identify Barrett’s oesophagus during endoscopy or in pathology samples.

The only major difference between cancers with or without visible Barrett’s oesophagus was the tumour stage – those patients without signs of Barrett’s oesophagus tended to have more advanced cancers. However, the team found biomarkers for Barrett’s oesophagus, such as the proteins TFF3 and REG4 present in the oesophagus cells at all disease stages including before the cancer has developed. This suggests that the growing tumour can destroy the original Barrett’s tissue, but importantly that proteins such as TFF3 and REG4 could be used to find individuals at future risk of oesophageal cancer.

Dr Shahriar Zamani, joint first author from the Li Ka Shing Early Cancer Institute at Cambridge and now based at the National Institutes of Health in Bethesda, US, said: “We found no evidence for an alternative pathway to oesophageal adenocarcinoma other than Barrett’s oesophagus. Because it seems to be the universal precursor, detecting Barrett’s oesophagus earlier could offer a clearer route to preventing oesophageal cancer.”

Dr Lianlian Wu, joint first author, also from the Li Ka Shing Early Cancer Institute, said: “What we need now are more sensitive, minimally invasive tests that identify people at risk based on molecular markers rather than relying solely on visible changes found during endoscopy.”

The research was supported by Cancer Research UK and the Medical Research Council, with additional support by the National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre.

Dr Dani Skirrow, Research Information Manager at Cancer Research UK, said: "Detecting the earliest signs that cancer might develop gives us the opportunity to intervene and potentially prevent the disease.

“This research helps to clarify how the most common type of oesophageal cancer begins and, crucially, shows that the earliest signs are detectable even when doctors can’t see them.

“This opens the door to future tests that look for molecular clues of hidden pre-cancerous changes, helping people understand their risk of oesophageal cancer and get the necessary support to help keep the disease at bay."

Professor Fitzgerald is the Research Lead for Cambridge Cancer Research Hospital, a new hospital that will transform how we diagnose and treat cancer. She has led the development of a capsule sponge test to diagnose Barrett’s oesophagus, which can be easily administered at a GP surgery, speeding up diagnosis.

The University of Cambridge and Addenbrooke's Charitable Trust (ACT) are fundraising for Cambridge Cancer Research Hospital, where detecting cancer at its earliest stages will be a key goal. Set to be built on the Cambridge Biomedical Campus, the hospital will bring together clinical excellence from Addenbrooke’s Hospital and world-leading researchers at the University of Cambridge. The research that takes place there promises to change the lives of cancer patients across the UK and beyond. Find out more here.

Reference

Zamani, SA et al. Integrated epidemiological and molecular data yields insights into the relationship between precancer and cancer states of oesophageal adenocarcinoma. Nat Med; 16 Apr 2026; DOI: 10.1038/s41591-026-04331-8

Scientists have found the strongest evidence to date that a condition known as Barrett’s oesophagus is the starting point for all cases of oesophageal adenocarcinoma – the most common type of oesophageal cancer in the developed world – even when telltale signs of this pre-cancerous stage are no longer visible.

If the link between precancers and cancer is unproven or unclear, screening programmes risk doing more harm than good

Rebecca Fitzgerald

Stillvision

Rebecca Fitzgerald demonstrates the capsule sponge

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Most detailed map to date of breast tissue changes reveals role of menopause in cancer susceptibility

cjb250 — Tue, 31 Mar 2026 09:00:08 +0000

The map reveals how, as women age, the number of cells in their breast tissue decreases, and these in turn proliferate less, and the structure of breast tissue changes. This creates a ‘micro-environment’ in which cancer cells can thrive.

Details of the study, led by scientists at the Universities of Cambridge and British Columbia, are published today in Nature Aging.

Breast cancer is the most common form of cancer in women. It accounts for 15% of all new cancer cases, with four out of five cases occurring in women over 50. As many as one in seven women will develop breast cancer in their lifetime.

Pulkit Gupta from the Cancer Research UK Cambridge Institute at the University of Cambridge, joint first author, said: “Even though breast cancer affects well over two million women worldwide, we understand very little about why and when it occurs. As cells divide and replicate, they accumulate mutations that can drive cancer, but why is it that the body can get rid of these mutated cells when we’re younger, but struggles later in life?”

The team used advanced imaging techniques to analyse breast tissue from more than 500 women aged 15 to 86 years old. The tissue included biopsies taken from women for non-cancer-related reasons.

Combining these images with details of the hormone receptors and immune cells present, as well as the tissue architecture, the researchers were able to map how breast tissue changes over time in unprecedented detail. Their findings point to reasons why breast cancer risk increases with age and why tumours in younger women differ biologically.

Gupta added: “Our map revealed that as women age, their breast tissue goes through major changes, with the most dramatic changes occurring at menopause. There are changes, too, during their twenties, possibly linked to pregnancy and childbirth, but these are far less pronounced.”

The map revealed that all types of cells become fewer in number and divide far less often. Milk-producing structures known as lobules shrink or disappear, while the ducts that that carry milk become relatively more common, with the supporting layer around them becoming thicker. Fat cells increase while blood vessels decrease.

Meanwhile, changes occur in the immune environment. Younger breasts have more B cells and active T cells, which helps them identify and kill cancer cells. As tissue ages, these types of cells decline in number, replaced by other types of immune cell that indicate a more inflammatory and potentially less protective immune environment.

Co-senior author Dr Raza Ali from the Cancer Research UK Cambridge Institute at the University of Cambridge said: “We don’t know for certain why the types of immune cell change. We can speculate that one reason may be because breast milk contains a high concentration of immunoglobulins, probably to help build the infant’s immunity, and these are produced by B cells.”

At the same time, the cells begin to interact with each other less. Immune cells and stromal cells (those that create a tissue ‘scaffold’) become physically further away from epithelial cells (specialised cells that line the mammary ducts and lobules, forming a structure responsible for milk production and transport). This may make it easier for pre-cancerous cells to escape control.

Co-senior author Professor Samuel Aparicio from BC Cancer, University of British Columbia, Canada, said: “We’ve previously seen that age dependent changes in oestrogen activity occur strongly in milk secreting cells of the breast and now we can see the surprising extent of changes in all cell types, including the immune system, with age. We are now seeking to understand the relationship between changes in immune cells and surveillance of early mutations that can arise in milk secreting cells over time.”

Dr Ali added: “It isn’t surprising that we should see fewer epithelial cells, as these play a role in producing breast milk, something that becomes less important with age, but the sheer scale of changes across the breast surprised us.

“What is clear from our map is that all of these changes create an environment where cancer cells that emerge naturally find it easier with age take hold and spread.”

The research was supported by Cancer Research UK.

Reference

Gupta, P et al. Single-cell spatial atlas of the aging human breast. Nature Aging; DATE; DOI: 10.1038/s43587-026-01104-3

Image

The image visualises multiscale spatial remodelling of the ageing human breast, with a branching ductal network embedded within a dense, cell-rich microenvironment that progressively gives way to fat-rich tissue with age. Faint spatial network lines evoke the underlying cell-neighbourhood structure revealed by spatial proteomics.

Scientists have created the most detailed map to date, comprised of over 3 million cells, showing how breast tissue changes as women age – including dramatic changes during menopause.

Our map revealed that as women age, their breast tissue goes through major changes, with the most dramatic changes occurring at menopause

Pulkit Gupta

Raza Ali

Visualisation of part of the breast map

Cambridge Cancer Research Hospital

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Why Cambridge? And why it's right for you

lw355 — Thu, 26 Mar 2026 08:00:01 +0000

Students from every background belong at Cambridge. Discover how the skills you gain here open doors to exciting careers. Learn about the financial support available. Hear what makes Cambridge unique. Find out how to apply.

Cambridge cancer expert leads development of new NICE guideline on kidney cancer

cjb250 — Thu, 19 Mar 2026 13:00:32 +0000

The guideline, published today by the National Institute for Health and Care Excellence (NICE), promotes the gold standard approach to the management of kidney cancer across all stages of the disease.

The new recommendations aim to improve kidney cancer care across the NHS by helping healthcare professionals offer people the right treatments and support, while considering individual preferences.

Professor Grant Stewart, who co-directs the Urological Malignancies Virtual Institute at the University of Cambridge and is Director of Studies in Clinical Medicine at Selwyn College has been the clinical lead for developing the guideline on kidney cancer.

The guideline covers all stages of diagnosing and managing patients with renal cell carcinoma, the most common type of kidney cancer. It includes recommendations on imaging, biopsy, active surveillance, risk prediction, surgical and non-surgical treatments, and drug therapy.

One of the key recommendations in the guideline is to offer biopsies to more people with suspected kidney cancer. This would mean more people with a small kidney lump – which is a mass measuring 4 centimetres or less – are offered a biopsy to confirm their diagnosis.

A biopsy is when a sample of abnormal cells is collected using a needle through the skin into the tumour in the kidney during a CT or ultrasound scan. The cells are then tested to confirm whether or not the lump is cancer, or in fact benign. The results help clinicians offer the best treatment options, possibly avoiding unnecessary surgery in people with benign or low-risk tumours.

This recommendation could double the number of biopsies undertaken on suspected kidney cancer patients. The committee acknowledged that some hospitals would need to adapt their clinical pathways to offer biopsies to more patients, but that reducing unnecessary surgeries would benefit patients and save surgical costs.

Professor Stewart, who is also Consultant Urological Surgeon at Addenbrooke’s Hospital, said: “By offering more patients with a kidney lump a biopsy, clinicians can tell patients if the lesion is cancer or benign and if they need to consider a treatment like surgery, or if they can avoid these treatments which do have some risks associated with them.”

Another important recommendation is that patients should have access to a clinical nurse specialist with training and experience in kidney cancer to provide support and information, from their initial diagnosis through their treatment and follow-up.

The committee acknowledged that more clinical nurse specialists may need to be recruited, and specialist training provided, to be able to offer this support to all kidney cancer patients.

Professor Stewart added: “Access to a clinical nurse specialist, with training and experience in kidney cancer care, will ensure that patients have a single point of contact for all the questions at any time that arise during their care journey.”

Professor Stewart has long been championing practice-changing initiatives to improve the management and outcomes of kidney cancer patients.

He has already introduced a new kidney clinic at Addenbrooke’s Hospital where patients with suspected kidney cancer receive their diagnosis on the same day, reducing the anxiety of waiting days or weeks for test results.

Professor Stewart explained: “In Cambridge, we have developed a one-stop biopsy clinic for kidney cancer, so we can biopsy more patients while reducing the time patients wait between presentation and diagnosis to half the time for the traditional multi-appointment route.”

Adapted from a story from the Cancer Research UK Cambridge Centre

Professor Grant Stewart has led the development of the first national guideline on improving the diagnosis and management of kidney cancer.

By offering more patients with a kidney lump a biopsy, clinicians can tell patients if the lesion is cancer or benign and if they need to consider a treatment like surgery, or if they can avoid these treatments

Grant Stewart

SEBASTIAN KAULITZKI/SCIENCE PHOTO LIBRARY

Kidney cancer illustration

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Study highlights stroke risk linked to recreational drugs, including among young users

cjb250 — Mon, 09 Mar 2026 00:01:00 +0000

Stroke is a major global health challenge – the third leading cause of death and disability combined. But it also a condition that, for the most part, results from modifiable risk factors, such as poor diet, lack of exercise and other lifestyle factors.

In 2024, 8.8% of adults aged 16 to 59 years in England and Wales – around 2.9 million individuals - reported having used a legal or illegal recreational drug in the past year. Recent data from the USA reports that over half of all those aged over 12 have used drugs such as cocaine, cannabis and opiates at least once.

There is increasing evidence that these drugs may increase the risk of stroke, but the evidence is often of differing quality and is observational only, meaning it is impossible to say whether the use of these drugs itself increases the risk of stroke, or whether this is purely a correlation.

To investigate this further, a team from the Department of Clinical Neurosciences at the University of Cambridge first carried out a meta-analysis of studies encompassing more than 100 million people. A meta-analysis is a method for pooling and analysing cohort data from all of the published evidence. This approach allows researchers to bring together studies which, on their own may not provide sufficient evidence and sometimes disagree with each other, to provide more robust conclusions.

In findings published in the International Journal of Stroke, the team found that the use of cocaine and amphetamines was associated with around double the risk of stroke (cocaine increased the risk by 96%, amphetamines by 122%), while cannabis use increased the risk by around 37%. The team found no statistically significant link between opioid use and stroke risk.

When the researchers restricted their analysis to individuals under 55 years, they found that amphetamine use almost tripled the risk of stroke (an increase of 174%); cannabis use increase stroke risk but by a smaller amount (14%), while cocaine use increased the risk by 97%.

To analyse these links further, the researchers used a statistical technique known as Mendelian randomisation, which looks at naturally occurring genetic variants related to risk factors and stroke and uses these to evaluate whether there is evidence to support a causal association with a particular risk factor.

This analysis showed that cocaine use disorders were particularly associated with brain haemorrhage and cardioembolic stroke (where a blood clot forms in the heart and travels to the brain, blocking blood flow and leading to damage of brain tissue). Cannabis use disorders were associated with stroke overall, particularly large artery stroke. This genetic evidence suggests a causal link, rather than just correlation.

Problematic alcohol use was linked to an increased risk of cardioembolic stroke and large artery stroke, while alcohol addiction increased the risk of stroke overall.

The researchers were unable to use Mendelian randomisation to look at associations with amphetamine as there are currently no large genetic datasets available with information on their usage.

The researchers suggest that possible reasons why these drugs are linked to an increased risk of stroke include sudden spikes in blood pressure, blood vessel spasm and constriction, heart rhythm problems, increased blood clotting (especially cannabis), and inflammation or vasculitis (especially amphetamines). These are all well-established pathways known to cause both ischaemic strokes, which result from blood clots, and haemorrhagic strokes.

Dr Megan Ritson from the Stroke Research Group at the University of Cambridge said: “This is the most comprehensive analysis ever conducted on recreational drug use and stroke risk and provides compelling evidence that drugs like cocaine, amphetamines, and cannabis are causal risk factors for stroke. These findings give us stronger evidence to guide future research and public health strategies.”

Dr Eric Harshfield, Alzheimer's Society Research Fellow at the Department of Clinical Neurosciences, said: “Our analysis suggests that it is these drugs themselves that increase the risk of stroke, not just other lifestyle factors among users. Taken together, our findings emphasise the importance of public health measures to reduce substance abuse as a way of helping also reduce stroke risk.”

The research was funded by the British Heart Foundation, with additional support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre.

Reference

Ritson, M, et al. Does Illicit Drug Use Increase Stroke Risk? A Systematic review, Meta-Analyses and Mendelian Randomization analysis. International Journal of Stroke; 9 March 2026; DOI: 10.1177/17474930261418926

The recreational drugs cannabis, cocaine and amphetamines significantly increase the risk of stroke – including among younger users – Cambridge researchers have concluded after analysing data from more than 100 million people.

Our analysis suggests that it is these drugs themselves that increase the risk of stroke, not just other lifestyle factors among users

Eric Harshfield

Kindel Media (Pexels)

Close-up of a person holding a roll-up

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