Cancer has evolved in many different ways, leading to about 250 distinct forms of disease with numerous variants. At the cellular level, two patients with the same kind of cancer may have two very different disease processes. If we target the specific defects, we require a multitude of different treatments, each tailored to the individual cancer. One way around that is to look at the shared characteristics of cancers, the common behaviours that have developed to allow the malignant disease to invade the patient's tissues. For this reason we are interested in the primitive behaviours that were first acquired by cancers in order to survive within the human body and spread. The cancer cells have found ways to change their behaviour and undermine the normal rules of the healthy tissue. This happens whichever type of cancer is involved.

Our interest is in understanding the spread of cancer, particularly colorectal cancer, and how it may be fought on behalf of the patient. We focus upon the ‘negotiation’ between the cells of the cancer and those of the normal tissues. This negotiation occurs at each stage of disease progression – the cancer escaping from its original location (invasion), crossing into the bloodstream (intravasation) and leaving the bloodstream at a distant location (extravasation) to form a new area of cancer growth (metastasis). Our work encompasses looking at the enzymes used to move through tissues (matrix metalloproteinases), the anchors that the cells use to hold on to their surrounding scaffold (primarily integrin receptors) and the molecules that the cancer cells use to home toward their preferred distant location (particularly chemokines).

We use different experimental models to elucidate these shared cancer behaviours, seeking new ways to be able to block the cancer expansion process. As part of this we are also working together with the company Ourotech, developing ways in which to use 3-D printing of bioInk to be able to study the metastatic process. We also have a clinical collaborative project with the Grand River Regional Cancer Centre in which we are examining blood samples from colorectal and breast cancer patients for the small number of cancer cells that can be found there during disease (‘circulating cancer cells’, CTCs). We are evaluating CTCs for particular behaviours that might give clues as to the future course of disease and possible ways to interfere with its spread.