The research and practice of Heidi Nelson, M.D., is in the field of colon and rectal cancer. The long-term goal of her research program is to improve both the duration of life and quality of life for patients with colon and rectal cancer. She has made use of both comprehensive clinical research databases and clinical trials to achieve her research goals.
Dr. Nelson's research efforts have helped reduce the impact of surgery on patients with early-stage disease through the safe introduction of laparoscopic and minimally invasive surgical approaches. Her work has helped reduce the cancer burden in patients with locally advanced and recurrent rectal cancer through studies examining the role of complex surgeries and intraoperative radiation therapy.
Dr. Nelson's research has been funded by the National Institutes of Health, American Cancer Society, American Society of Colorectal Surgeons and other organizations.
- How can the impact of surgery be reduced without compromising cancer care? Dr. Nelson led a multi-institutional National Institutes of Health-funded phase III prospective randomized trial comparing laparoscopic versus open surgery, confirming the benefits and oncologic safety of minimally invasive colon cancer surgery. For early-stage rectal cancer, ongoing investigations include the testing of laparoscopic rectal cancer surgery and the use of selective local excision to spare patients the need for colostomy.
- What environment factors contribute to the development of colon and rectal cancer? Modern sequencing technologies allow a new look into the bacteria that constitute complex microbial communities (i.e., microbiome) living within the human body, including the gut. The human body is now known to be rich with bacteria; indeed, bacterial cells outnumber human cells by a factor of 10, and the microbiome encodes 100 times the number of genes as the human genome. Increasing evidence points to gut microbial communities as a key environmental influence for conditions leading to colon and rectal cancer. Dr. Nelson and her colleagues are conducting studies investigating gut bacterial communities and the metabolic and regulatory pathways that interact with the human genome and lead to cancer development. This may allow earlier detection of high-risk environmental factors and earlier prevention strategies.
- What factors can be modified to improve patients' lives and cancer outcomes? Many lifestyle factors are known to influence patient outcomes, including diet, weight and smoking. Research by Dr. Nelson and her group shows that tobacco exposure from smoking increases the rate of treatment-related complications and is associated with higher risk of polyps, aggressive polyps and aggressive cancers. They are developing smoking cessation programs for patients at "teachable moments," such as at the time of polyp or cancer diagnosis or the time of surgery.
Significance to patient care
Dr. Nelson's research is designed to help reduce the cancer burden and treatment burden in patients with colon and rectal cancer, or those at risk for these malignancies.
- Fred C. Andersen Professor, Mayo Clinic, 2005-present
- Vice Chair for Research, Department of Surgery, Mayo Clinic, 2011-present
- Co-Chair, American College of Surgeons Oncology Group, 2005-2011
- Chair, Division of Colon and Rectal Surgery, Mayo Clinic, 1996-2006
- Traveling Fellow, James IV Association of Surgeons, 1998