Oesophageal cancer
Dr Benjamin Sharpe
Creating lymph node maps to stop the spread of oesophageal adenocarcinoma.
Oesophageal adenocarcinoma – a cancer affecting the gullet – can spread to other parts of the body, including nearby lymph nodes. Dr Benjamin Sharpe has created detailed ‘maps’ of lymph nodes to show how this happens, and how we might stop it. This could eventually lead to better treatments to help more people survive this disease. Find out how your donations to Guts UK have made all this possible.

Oesophageal adenocarcinoma is the most common cancer affecting the oesophagus (gullet) in the UK. Treatment for this cancer involves an intensive cocktail of chemotherapy drugs or radiation, followed by surgery to remove the diseased part of the oesophagus. But not everyone is able to have surgery or chemotherapy, and the intensity of the treatments can be difficult for many people.
“It’s a devastating disease – the survival rates are rather poor, with only 15% of patients surviving five years” says Dr Benjamin Sharpe from the University of Southampton. “It’s up there with some of the worst cancers you can possibly have.”
Spread to the lymph nodes
Like many cancers, oesophageal adenocarcinoma can spread to other parts of the body, a process called metastasis. Cancers often first spread to nearby lymph nodes, the tiny organs where the cells of our immune system can meet and exchange information.
For oesophageal adenocarcinoma, the presence of cancer cells in someone’s lymph nodes can also provide clues about what might happen in the future. If the chemotherapy manages to clear the cancer from the lymph nodes, that person has a much better chance of surviving.
But we don’t yet understand why only some people have their lymph nodes cleared by chemotherapy, and not everyone. Benjamin thinks it has something to do with how the cancer cells talk to other cells in the lymph node, which could vary between people.
Understanding exactly how cancer cells talk to host cells could lead to the breakthrough people have been waiting for. “Any new innovation of treatment will make a huge difference to this group of patients,” says Benjamin.
Creating maps to understand cancer spread
Guts UK awarded Benjamin research funding to investigate what’s going on inside the lymph nodes of people with oesophageal adenocarcinoma.
For this project, Benjamin studied 20 lymph nodes, donated by eight people with the disease, which were removed during surgery after chemotherapy.
These were a mixture of healthy lymph nodes (ones that had never had any cancer in them), some that had been cleared by the chemotherapy, and others which still contained cancer cells.
Taking a tiny sample from each lymph node, Ben then used a cutting-edge technique called spatial transcriptomics, to create a series of detailed maps. These maps show where the different types of cells are within the lymph node – cancer cells, lymph node cells, and immune cells – as well as what these cells are doing, and what they’re saying to each other.
The lymph node maps are a unique and valuable resource for scientists to better understand cancer metastasis, and creating them is a major achievement. “It provides us with an idea of what metastasis looks like in this cancer, which we didn’t really have before.”
Benjamin will release the lymph node maps publicly when the study is published, so that other scientists at Southampton and around the world can use them to make their own discoveries.

Big data, huge potential
There’s a lot of work to do to analyse the information within these lymph node maps, but they hold a lot of promise. What they will reveal about how oesophageal adenocarcinoma spreads to the lymph nodes could be vital – for understanding why current treatments don’t work for some people, and for finding better treatments that do.
“If we have a fundamental understanding of how the different immune and the host cells within the lymph node talk to one another, especially when they’ve got a tumour sat right next to them, it will hopefully help us develop treatments that are more likely to target those tumours,” Benjamin explains.
He hopes his work will help develop new treatments with fewer side-effects that can give more people a better chance of living for longer.
The difference made by Guts UK
Because oesophageal adenocarcinoma hasn’t received a lot of research funding in the past, it is not as well understood as other cancers. But that also means any advance from the data contained in these maps could make a big difference for people affected by this awful disease.
That’s why Benjamin is so grateful to Guts UK supporters, whose donations made this work possible. “Thank you for contributing. The funding that you provide is quite rare, and well appreciated by early career researchers like myself,” he says. “A little goes a long way with these sorts of things.”