Cliona Kirwan

Cliona Kirwan, MBBS BSc (Hons) FRCS(gen) PhD

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Overview

Cliona Kirwan is a Clinician Scientist in Surgical Oncology and Consultant Oncoplastic Breast Surgeon. Her work is split equally between clinical work and academia. Clinically, Cliona leads diagnostic and follow up clinics for breast disease, particularly breast cancer. She performs all forms of surgery for the treatment of breast disease, particularly breast cancer surgery including breast reconstruction, symmeterisation operations and oncoplastic remodelling to minimise the cosmetic impact of breast surgery. Cliona trains medical students, allied staff and trainee surgeons and she is a lecturer for the Manchester University medical undergrauate course and the ASiT (Association of Surgeons in Training) MRCS (Membership of the Royal College of Surgeons) course. Academically, as a Senior Lecturer, she leads a team investigating the symbiotic relationship between cancer and the clotting system. Cliona specialises in translational research and runs clinical and laboratory based studies, and supervises PhD, MD and MRes students. In addition, her managment roles include membership of the NCRI Early Disease Subgroup of the Breast Cancer Studies Group, Trials Management Group for the IMPORT Low and High and POETIC national randomised controlled trials, Manchester University Womens Cancer Centre Principal Investigators Board, Manchester Breast Centre Principal Investigators Board and the Genesis Breast Cancer Prevention Medical Advisory Board. She is also mentor to the Northwest Research Collaborative (a trainee led collaborative) and the Northwest and Mersey Breast Trainees Research Collaborative.

Biography

Cliona Kirwan obtained her medical degree from Charing Cross and Westminster Medical School. She completed her basic surgical training in London (Chelsea and Westminster Hospital), Poole and Bournemouth, Bristol (general and paediatric surgery) and South Africa (emergency and trauma surgery). She then studied for her PhD, entitled 'The Role of Procoagulants in Cancer and Chemotherapy Induced Venous Thromboembolism' at the University of Manchester. Whilst completing her general surgery specialist training in the Northwestern deanery, she was awarded a NIHR Clinical Lecturship, to continue her research into cancer and clotting. Simultaneous with her clinical lectureship, Cliona completed a National Oncoplastic fellowship in the Mersey Deanery. She was then awarded a NIHR Clinician Scientist Award, which she commenced in March 2012 at the University of Manchester and University Hospital of South Manchester. 

Research interests

Cliona Kirwan’s main focus of research is the symbiotic relationship between cancer and clotting. It is well recognised that cancer patients are at increased risk of deep vein thrombosis (clots in the legs) and pulmonary embolism (clots in the lung). Cancer seems to promote clotting. Cancer patients, especially those with more advanced disease, have increased levels of clotting molecules in their blood. However it is now known that this is a two-way process. The clotting system is also helping cancer grow and spread. Cliona is exploring ways to treat cancer through targeting the clotting system.

Cliona’s PhD was entitled ‘The Role of Procoagulants in Cancer and Chemotherapy Induced Venous Thromboembolism. This was a prospective cohort study of patients receiving chemotherapy for advanced and early breast cancer. She investigated alterations in circulating levels of procoagulant molecules expressed by cancer cells (tissue factor; tumour necrosis factor; vascular endothelial growth factor by ELISA, thrombospondin by radio-immunoassay and cancer procoagulant by an indirect chromogenic assay). This was compared to markers of angiogenesis (VCAM), hypercoagulability (D-dimer, thrombin-antithrombin, prothrombin fragments 1+2, plasminogen activator inhibitor), development of venous thromboembolism, response to treatment and death.

As part of her post-doctoral research, she is chief Investigator of the CHAMPion (Cancer-induced Hypercoagulability as A Marker of Prognosis) Study, a 540-patient multicentre study, adopted by the NCRN (database number 8685), investigating clotting in early breast and colorectal cancer patients. She is also Principal Investigator on ‘Post-radiotherapy Perfusion’, a cohort study assessing the role of near-infrared spectroscopy in assessing long term breast radiotherapy damage and co-Investigator on the Northwest Research Collaborative (http://nwresearch.org/)  PPAC (Packing of Perianal Abscess Cavities) feasibility study and planned RCT study.

AS part of her NIHR Clinician Scientist Award, entitled ‘The Thrombin Pathway in Breast Cancer Dissemination: a potential biomarker and novel therapeutic target’, she is chief investigator on the T-POETIC multicenter study (UKCRN database number 12314), the TuFCLot study (investigating circulating tumour cells in breast cancer), and the TIP Trial, due to commence soon. In addition she has laboratory studies exploring the role of clotting on cancer stem cells and the tumour microenvironment.

Qualifications

PhD, University of Manchester

FRCS(gen), Royal College of Surgeons of England

MB BS, Charing Cross and Westminster Medical School

BSc (Hons) History of Medicine, Univeristy College London 

Expertise related to UN Sustainable Development Goals

In 2015, UN member states agreed to 17 global Sustainable Development Goals (SDGs) to end poverty, protect the planet and ensure prosperity for all. This person’s work contributes towards the following SDG(s):

  • SDG 3 - Good Health and Well-being

Areas of expertise

  • RD Surgery

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre

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