Tumour

Advances in cancer genomics are transforming our understanding of cancer, and have profound implications for its prevention, diagnosis, and treatment. Evolutionary dynamics suggests that as few as two mutations can cause transformation of normal cells into cancer stem cells. A process of Darwinian selection, involving a further three or more mutations, taking place over a period of years, can then result in progression to a life-threatening tumour. In many cases the immune response can recognise and eliminate the mutant cells, but most advanced tumours have mutations that activate immune checkpoints and enable the tumour to hide from the immune system. For the most hard-to-treat tumours, future progress will require molecular diagnostics to detect cancer-causing mutations in healthy subjects, and new drugs or vaccines that prevent the progression process.

Most people will have an operation in their lifetime, but few of us have a clue what really happens once we are put to sleep. This series goes beyond the theatre doors of the surgical unit at the Queen Elizabeth Hospital Birmingham, where 700 operations are carried out every week, across 42 specialist theatres. Whilst many operations are vital but routine, this series focuses on some of the country's top surgeons as they perform high-stakes surgery that simply wouldn't have been attempted a few years ago, pushing the boundaries of modern medicine to its very limits. Unprecedented opportunities to save lives offer surgeons the chance to develop their astonishing skills - but also carry daunting risks and responsibilities.