Sophia Waldenstedt: Risk factors and diagnostics in rectal cancer recurrence
Each year, around 2,000 people in Sweden are diagnosed with rectal cancer. For some, the disease returns after surgery. Sophia Waldenstedt has examined how these recurrences affect patients. Her research reveals critical signs of recurrence and significant issues in cancer data registration.
SOPHIA WALDENSTEDT
Dissertation defense: 5 December 2024 (click for details)
Doctoral thesis: Local recurrence of rectal cancer: risk factors, diagnosis and quality of life
Research area: Surgery
Sahlgrenska Academy, The Institute of Clinical Sciences
Surgery is the most common treatment for rectal cancer. However, five to ten percent of patients experience what is known as local recurrence, where the tumor reappears in the pelvic area following surgery. These recurrences are often challenging to treat and cause considerable suffering for patients.
Sophia Waldenstedt is a surgeon at the Transplant Center at Sahlgrenska University Hospital and a doctoral candidate at the Institute of Clinical Sciences. In her doctoral thesis, she investigates various aspects of these local recurrences.
She has examined how complications during the initial surgery may be linked to a higher risk of local recurrence and which symptoms are most common when the tumor returns. In addition, she has reviewed how these recurrences are registered in the Swedish Colorectal Cancer Registry. The registry is used to evaluate the quality of cancer care and for research.
Many recurrences missing from the registry
What are the key research findings?
“We found that adverse events during surgery for rectal cancer are associated with a higher risk of local tumor recurrence. This could be important to consider when planning follow-up care for these patients. We observed that most patients diagnosed with local recurrence were diagnosed outside of planned follow-up visits, and the majority exhibited symptoms at diagnosis,” says Sophia Waldenstedt, adding,
“Pain appears to be an indicator of local recurrence and should prompt a check-up for these patients. But I believe the most important finding is that we discovered that over 40 percent of all local recurrences are missing from the Swedish Colorectal Cancer Registry. This is a major issue, as this data is widely used in research, and inaccuracies in the registry may result in misleading conclusions that ultimately affect patient care.”
Rewarding to interview patients
What have been the most enjoyable and rewarding aspects of the doctoral project?
“Being able to delve into scientific research and learn to design and conduct my own studies. It has also been rewarding to learn how to critically review other studies, with a focus on understanding the importance of scientific methods. I have been fortunate to work in the excellent research group SSORG, where people with various skills and experience create a very supportive environment for research. I also found it incredibly meaningful and rewarding to interview patients and hear their stories about how local recurrence and its treatment have affected them.”
And the greatest challenges?
“One of the biggest challenges has been obtaining medical records from across the country, which required several years to complete. This is partly because laws are interpreted differently by different hospitals, and it often requires a lot of groundwork before records can be released.”
Text: Jakob Lundberg