A study looking at finding which lymph nodes bowel cancer cells travel to first

Please note - this trial is no longer recruiting patients. We hope to add results when they are available.

Cancer type:

Bowel (colorectal) cancer
Colon cancer





This study is testing a dye and special light to see how well they show up the lymph nodes that bowel cancer cells will travel to first.

If you have surgery to treat bowel cancer, the surgeon will remove the cancer itself and all of the lymph nodes Open a glossary item nearby. A pathologist Open a glossary item will then work out the stage of your cancer Open a glossary item, and whether you need further treatment, by looking at whether it has spread into these lymph nodes. But removing all the nearby lymph nodes makes your surgery longer, and means you may lose more of your bowel than you need to. And, you are more at risk of complications such as damage to nearby organs, or leaking faeces Open a glossary item from the join made in the bowel.

Researchers want to make it possible for people to have as small an operation as they can. In this study, they are looking into a way of finding lymph nodes most likely to contain cancer cells during surgery. Doctors call these sentinel nodes.

They will recruit people having bowel cancer surgery. During surgery, they will inject a dye around the tumour, and shine a special light onto the area. The dye will glow under this light, so they will be able to see the first nodes the dye (and therefore any cancer cells) travels to. They will mark these nodes, and then remove the cancer and all nearby nodes for testing, as usual.

The aim of this study is to see if using this dye and light can identify the sentinel nodes. In future, knowing which are the sentinel nodes, and testing these during surgery would mean that people who do not have cancer in their lymph nodes could have a smaller operation.

You will not have any direct benefit from taking part in this study. But the results will be used to help people with bowel cancer in the future.

Who can enter

You may be able to enter this study if you

  • Have bowel cancer that has not grown beyond the muscle layer of the bowel wall (stage T1 or T2 bowel cancer)
  • Are due to have keyhole surgery to remove your cancer
  • Have satisfactory blood test results
  • Would be willing to use reliable contraception during the study and for a month afterwards if there is any chance you could become pregnant
  • Are at least 18 years old

You cannot enter this study if you

  • Are allergic to any of the dyes that will be used in the study – you can ask your doctor about this
  • Are allergic to shellfish
  • Have an overactive thyroid Open a glossary item, or a non cancerous lump on your thyroid called an adenoma
  • Are breastfeeding, pregnant or planning to become pregnant

Trial design

This pilot study will recruit 30 people.

The study team will send you some medication to take the day before your surgery. This is to prepare your bowel (bowel preparation Open a glossary item) for the operation. If you are female, they will phone you before posting this to check if there is any chance you are pregnant. They need to do this as they are not sure whether the dye they are using for the study will harm an unborn child, and they want to make sure that it is safe for you to have it.

You have the bowel surgery that was already planned for you, under a general anaesthetic Open a glossary item. During your surgery, you also have a camera examination of your bowel to show the surgeon exactly where your cancer is, and where to inject the dye. After injecting the dye, they will shine a special light onto the area. This will show up the first set of lymph nodes the dye reached. The surgeon will mark these lymph nodes and then remove your bowel cancer as they normally would.

A pathologist will examine all the tissue removed during your surgery, as they do routinely, but will also closely examine the marked lymph nodes for cancer cells.

Taking part in the study will add about 20 minutes to the length of your surgery, which would normally be about 3 hours.

Hospital visits

You do not need to make any extra visits to take part in this study. The team will phone you a month after your surgery to see how you are getting on.

Side effects

Risks of having the camera examination and dye injection include

  • Bleeding
  • A small tear in your bowel, which may need surgery to correct it
  • Allergic reaction

These risks are very small. They are increased if you have thyroid problems, or you (or others in your family) have had an allergic reaction to shellfish in the past. So people with thyroid problems or shellfish allergy cannot take part.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Robin Kennedy

Supported by

Imperial College London
London North West Healthcare NHS Trust
St Mark’s Hospital Foundation
St Mark’s Hospital and Academic Institute
The Barcapel Foundation
The Savvas Regas Foundation

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Over 60,000 cancer patients enrolled on clinical trials in the UK last year.

Last reviewed:

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