Serendipity—the fact of finding valuable or interesting things by chance—has long been a key element in scientific research. This is exemplified by Sir Alexander Fleming’s accidental discovery of penicillin, which revolutionised medicine: “I did not invent penicillin. Nature did that. I only discovered it by accident.” With this definition, serendipity for me has played a significant role in both the discoveries in our research as well as my career journey. This time of year offers opportunities to reflect on different areas in our lives, and I have often used the term serendipity for describing my journey. But what do I mean by this? Is it needed or just a normal part of the discovery process? And with the rapidly evolving landscape of how science is conducted, will this continue? 

My team’s research focuses on a super group of proteins called G protein-coupled receptors (GPCRs), which are found in cell membranes—thin barriers that protect cells and control what goes in and out to keep them functioning properly. The human body has over 800 types of GPCRs, making them essential for cells to communicate with each other and ensuring that every organ in the body works properly. I like to think of them not just as sensors helping individual cells respond to their surroundings, but as part of how we, as individuals, interact with the world around us. Whether it’s the joy of watching a classic Christmas movie while savouring a mince pie and glass of mulled wine, or managing the mix of happiness and stress the festive season can bring, it all involves the activation of different GPCRs. Some of the receptors we study are essential for reproductive health, including pregnancy. We’re also interested in GPCRs in the gut that respond to metabolites, small substances produced when our body breaks down food or drinks. A key challenge in our field is that while many medications target GPCRs, there’s an unmet need for more precise drugs with fewer side effects and longer-lasting effects. Developing these improved drugs requires an in-depth understanding of the molecular machinery that control how these receptors work. 

Unlocking new treatment possibilities for PCOS  

One important example of serendipity in my team’s research comes from a single microscopy experiment. Many GPCRs, when activated, move from the surface of the cell to compartments inside the cell called endosomes. Since my PhD, I’ve been interested by how a receptor’s location in the cell can impact its signal activity. This particular experiment took place in the early days of establishing my research team. I was working alongside my first PhD student and postdoc on what we thought would be a straightforward experiment to track how a GPCR for luteinising hormone (LH)—a key hormone for fertility and early pregnancy—moves inside the cell. We expected the LH receptor to behave like other GPCRs, moving inside the cell in a similar way. Instead, what we saw was surprising: the LH receptor ended up in endosomes that looked completely different from what was expected. Was this just an unusual observation, or a clue to something more significant?

Driven by sheer curiosity, I encouraged the team to delve into this a little more. This one experiment set us on the path to developing new models of GPCR signalling—essentially mapping a new ‘island’ in our cell atlas. What’s amazing is that other GPCRs, both inside and outside of the reproductive system, use this ‘island’ for signalling. Even more exciting is that it has given us important insights into health conditions caused by faulty GPCR signalling, and we now know we can tinker with this pathway pharmacologically to help fix it. Together, we believe we can find new therapeutic ways to target and reprogram these receptors. For the LH receptor, which has become our prototype for this pathway, we believe we’ve found promising options to help women with certain forms of polycystic ovarian syndrome (PCOS). This could provide a therapeutic solution not only for women seeking fertility treatment, but also for women who live with the everyday challenges of this condition. 

It’s been a 15-year journey from that first observation to where our work is today. Looking back, there were times when I wondered if taking a different approach might have led to results more quickly, given the pressures of academic life. It took five years alone from that first experiment to publishing our findings. This period also coincided with having my two children, and there were at least two years spent convincing others that what we were seeing wasn’t just an anomaly. However, this challenge ultimately helped strengthen the data we had.

Can AI replicate the human touch in serendipity? 

Are these serendipitous events necessary in research? No, I don’t think so. It’s obviously not something we plan for in our grant proposals. But serendipity can come about in a variety of ways, and for me, it is a form of nurturing creativity, open mindedness and the innate inquisitiveness that inspired me to pursue a career in scientific research. As we move towards a rapidly changing, AI-driven world, there’s already been growing debate about how AI will shape the future of scientific discovery, including whether it can replicate serendipity. If serendipity is about ‘lucky mistakes’, then AI can simulate and learn from permutations of experiments at a scale and speed beyond what any individual or team could achieve. But what about creativity or the perceived value of these AI-driven findings? This is perhaps where serendipity, as a distinctly human concept, stems from—the stories of human endeavour that we value. I am certainly embracing a faster pace of discovery science, one that ultimately accelerates advancements in health for us all. Whether serendipity will continue to be part of our scientific stories remains to be seen. 

When people think about cancer, they often focus on the illness itself—the diagnosis, the treatments, and the fight to survive. But once the treatment ends, another important challenge begins: what happens after cancer? As a researcher in cancer survivorship, my focus is on understanding what life is like for people who have been treated for cancer, and how we can improve that life for them. 

Here, I’ll explore the significance of cancer survivorship research, the insights we’ve gained, and what drives my commitment to this field. I‘ll also highlight how my work contributes to improving the lives of cancer survivors, supporting their families, and strengthening the healthcare system. 

What is cancer survivorship? 

When a person is diagnosed with cancer, they often face a long and difficult journey. They go through treatment, which can include surgery, chemotherapy, or radiation. But after the treatment ends, the patient’s journey does not simply stop. Life after cancer can bring its own set of challenges. 

Cancer survivorship research focuses on understanding what happens after treatment—both the physical and emotional effects. For example, many cancer survivors experience ongoing fatigue, anxiety, or, for the oesophageal and gastric patients I am focusing my research on, difficulties with eating. Others might face challenges in returning to work or adjusting to their new lifestyle. These issues do not always receive the attention they deserve, even though they affect millions of people worldwide. That’s where my research comes in. 

Why am I passionate about cancer survivorship? 

As a specialist nurse working closely with oesophageal and gastric cancer patients from referral to end of follow up or end of life, I have seen firsthand how cancer affects people’s lives—not just during treatment, but long after. It was during my clinical work that my research interest started. I wanted to know more about the factors that impact patient’s survivorship and what we could do to help patients in their recovery. People might think that once cancer treatment ends, patients are "done" with cancer, but that is rarely the case.  

Cancer research tends to focus heavily on survival rates and medical treatments. While these are incredibly important, we often overlook the fact that many cancer survivors face long-term health issues. These can include physical symptoms like pain or trouble sleeping, or emotional challenges such as depression and anxiety.

Nowadays, I work full-time as a researcher both in Sweden and in the UK and my contacts with patients do not come daily. Nevertheless, this has led to continued close collaboration and involvement of patients and their next of kin in my research, from idea generation through to publication. This is a collaboration I value extremely, especially since my research is focusing on cancer survivorship. 

What are we learning through survivorship research? 

Through ongoing research, we are learning that cancer survivorship is about much more than just being "cancer-free." It’s about rebuilding life after cancer, addressing the short- and long-term challenges that survivors face, and ensuring their wellbeing in the years following treatment. In our research we have shed light on the short- and long-term physical and emotional challenges faced by survivors of oesophageal and gastric cancer. These challanges can significantly impact daily life, highlighting the need for better post-treatment care to address these issues. To help manage these concerns, our research aims to develop programs and tools that support recovery after treatment and empower patients to regain control over their health and future. 

A central theme in my work is the importance of personalised survivorship care, which tailors rehabilitation programs and follow-up care to meet the unique physical and psychological needs of each survivor. Ultimately, our research is helping to shape more effective clinical guidelines and interventions that ensure cancer survivors receive the comprehensive care they need for the long-term.  

Why should this matter to the public? 

Survivorship research is not just for the medical community—it is for everyone. If you or someone you love has had cancer, the challenges of survivorship will be real for you, too. Understanding what cancer survivors go through is essential for improving their quality of life. 

For example, if we can help clinicians recognise the long-term effects of cancer treatment, they can provide better care for their patients. If society becomes more aware of the struggles cancer survivors may face, it can lead to more support—whether that is through better workplace accommodations or better insurance coverage for long-term care. 

It also gives us hope that cancer survivorship does not have to mean simply "living through it"—it can mean living well. We can help cancer survivors lead full, healthy, and productive lives, even after they have finished their treatment. 

What’s next in survivorship research? 

There’s still so much more to learn. We are continually exploring new ways to improve the care and wellbeing of cancer survivors and to make such new ways personalised and tailored. As we continue this work, it is important to remember that cancer survivorship is a journey, not a destination. Every survivor’s experience is different, but by understanding those experiences better, we can improve the lives of everyone touched by cancer. 

So, to summarise, cancer survivorship is a critical yet often overlooked part of the cancer journey. My research aims to fill this gap, focusing on the physical, emotional, and social challenges faced by oesophageal and gastric cancer survivors after their treatment ends. By better understanding these challenges, we can offer more effective individualised support and care. As one patient said to me when we were talking about recovery – “there is no way back, only a way forward.” Ultimately, my goal is to identify interventions and provide support to help patients on their way forward in life. This research is not just for cancer patients, but for anyone who may one day be affected by cancer, whether personally or through a loved one. 

In addition to my survivorship research, I also lead the Healthcare Professional Academic Group (HPAG) at Imperial. HPAG is dedicated to building a supportive network for healthcare professionals, including nurses, midwives, allied health professionals, healthcare scientists, pharmacy staff, psychologists & clinical research practitioners (NMAHPPs),who engage in academic work. By fostering collaboration within and across disciplines, we aim to improve clinical care and research outcomes.

We are fortunate in the UK to have a well-developed infrastructure for research in life sciences. Our universal healthcare system within the NHS, world-leading academic institutions, and dedicated researchers provide a unique environment for innovation. Most importantly, it is our incredible patients—who not only understand the need for research but are willing to participate—that make groundbreaking studies possible. This unique combination allows us to lead the world in delivering research that tests novel treatments, evaluates existing practices, and paves the way for guideline-changing clinical practice.

As a clinical trialist, I have been privileged to work within this exceptional ecosystem. It has allowed me to carry out work that I do not believe could have been conducted in many other places in the world. My focus has been on treatments for ‘stable’ coronary artery disease, a condition that affects around 2.3 million people in the UK and causes chest pain, breathlessness, and sometimes pain throughout the body. Treatments often include medicines or angioplasty, a procedure where stents—wire mesh tubes—are placed into arteries to open blockages. However, since its introduction, there has been ongoing debate about whether the relief patients experience is due to the procedure itself or a placebo effect.

Breaking new ground: The ORBITA trials

To address this, I led the ORBITA trial, which analysed the effect of stenting versus placebo procedures for patients with stable angina, a type of chest pain usually caused by coronary heart disease. It was the first of its kind and our patients were remarkable; they consented to being sedated and wearing headphone during the procedure, not knowing whether they received an actual stent or a placebo. They remained blinded to the treatment for months. It was inspiring to work with patients who demonstrated such trust in the research process. Their willingness to contribute helped us gain insights that were translatable to patients worldwide.

Building on the foundation of ORBITA, we launched ORBITA-2 to broaden the scope of our research. This trial recruited a more diverse patient population, integrated real-world medication regimens, and emphasised patient-centred outcomes. These efforts were essential in refining our understanding of coronary artery disease.

In ORBITA-2, patients stopped their chest pain medications before receiving either a stent or a placebo procedure. The trial confirmed that stents can relieve angina symptoms for some patients, with more than a third becoming symptom-free. However, over half of patients with a stent continued to experience chest pain, highlighting that stenting isn’t universally effective.

The personal impact of research

Conducting the ORBITA trials has been a defining moment in my career. Some of the trials we conducted were initially thought to be impossible. Yet, with the right team and the right environment, we proved that innovative research can be done. This experience has reinforced my belief in the power of asking new questions and pursuing research that pushes the boundaries of what we know.

One of the most rewarding aspects of this work is also the deep connection I develop with patients. Research allows me to spend more time understanding their experiences and needs, something that isn’t always possible in routine clinical practice.

Mentorship and shaping the future

Research has not only defined my career but has enriched it with diversity and depth. When I began my PhD at Imperial, I never imagined becoming a researcher. Since then, it has opened countless opportunities—from building my own team to mentoring the next generation of cardiologists. Teaching and inspiring others to push boundaries, just as we have done with the ORBITA trials, is a particularly fulfilling part of my journey. I feel proud to work in an institution that has supported my work and is not scared to support me in answering research questions in a new way.