Striving for continual improvement in patient care is the aim of Dr Gaius Longcroft-Wheaton, MD Novel Endoscopic Techniques‘ 11. A consultant gastroenterologist at Queen Alexandra Hospital in Portsmouth, and Honorary Reader of Medicine at the University of Portsmouth, Gaius combines academic research with clinical work to improve patient treatment and outcomes.
While completing his research degree, Gaius explored novel endoscopic techniques using dye sprays and electronic imaging to find and diagnose early gastrointestinal( GI) neoplasia- or abnormal cell growth. He investigated the use of acetic acid to find pre-cancerous cells in the oesophagus, a condition called Barrett’ s oesophagus. This important work is changing the way the condition can be treated. Finding these changes used to require biopsies and, even then, they couldn’ t be physically seen and were very difficult to treat. Using Gaius’ s technique, visualisation of a neoplastic change is now possible, making much more targeted therapy possible. Pre-malignant and early malignant changes can be removed with an endoscope rather than through an invasive oesophagectomy.
Intramucosal cancer visualised with acetic acid demonstrating early loss of aceto-whitening.
Gaius’ research has been published in high impact medical journals. After his MD he secured a £ 250,000 NIHR grant to take the research even further, moving it into a surveillance population in a multi centre mixed methods feasibility study, including results from a successful multicentre randomised control study using the technique. He is currently planning a study of the technique in over 2,000 patients in what will be a truly definitive study. Unfortunately, COVID has delayed the start of that study.
This research was just one aspect of what is, for Gaius, a most fulfilling career. After completing his research degree, he began clinical work, treating GI tract problems and illness. He is a specialist therapeutic endoscopist, with particular expertise in removing pre-malignant abnormal cells from the GI tract using endoscopic resectional techniques. In addition, he treats a range of cancers, inflammatory disease, functional and bleeding conditions in the GI tract. Informing this work is the ongoing research he carries out at the University of Portsmouth, enabling him to develop and refine new techniques to improve patient outcomes and care.
Dr Gaius Longcroft-Wheaton MD Novel Endoscopic Techniques
“ Everything I’ m doing in my research is connected to my clinical work. They’ re completely aligned. And the research techniques develop better treatments for managing our patients in these situations. The type of work we do moves things from being a concept into a clinically-deliverable treatment,” he explains.
“ If you discover neoplasia early enough, identify it, you can do a much less invasive treatment than if you discover it at a later stage. This result is less destructive techniques being required, better patient outcomes and less time in hospital. We do these as day cases.” Gaius is always looking to improve techniques and move things forward. He’ s working on the next stage of his acetic acid study and he’ s hoping to gain a grant to look at ways to improve diagnosis of chronic neoplasia by combining frequent chemical testing with endoscopy.
His decision to undertake a research degree has proved life-changing and, most definitely, career enhancing, opening doors and creating opportunities he would not have had otherwise. Gaius says“ I could have still become a consultant gastroenterologist without doing a research degree, but I couldn’ t have had the same kind of job as I’ m doing now. It’ s meant I’ ve been able to have a much more meaningful and much more fulfilled career.”
Gaius embodies a spirit of innovation. He is committed to finding ways to do things better tomorrow than they are done today. He credits both the Queen Alexandra Hospital and the University with creating environments in which his desire to improve, innovate, and make things better can thrive.“ It’ s a fact that we can see a brighter future. We can make all of our techniques better, more effective, more tolerable for patients. And we can give our patients a better quality of care.”
’ IF YOU DISCOVER NEOPLASIA EARLY ENOUGH, IDENTIFY IT, YOU CAN DO A MUCH LESS INVASIVE TREATMENT THAN IF YOU DISCOVER IT AT A LATER STAGE.’