Sia Viborg Lindskrog

A single cancer cell from a tumour in the bladder contains far more information about potential disease progression than was previously understood. This lack of information has meant that hospitals had to provide undifferentiated oncological care for bladder cancer patients.

Now, Sia Viborg Lindskrog, PhD student from the Department of Clinical Medicine at Aarhus University/Aarhus University Hospital, has paved the way to changing that. By means of complex analyses of RNA molecules in bladder cancer cells, she has discovered multiple sub-categories of bladder cancer indicative of the aggressiveness of the disease.

For this research, she has now been awarded the Lundbeck Foundation's Talent Prize 2023.

‘My research basically involves analysing cancer cell genetics, meaning their DNA and RNA, in order to build our understanding of tumour biology, and investigate whether the new insights can be applied in improving bladder cancer care. So I’m investigating both the markers in the tumour, and in the patients’ blood,’ Lindskrog explains, adding:

‘In early-stage bladder cancer, my colleagues and I focus on the tumour itself, analysing the cell content of RNA molecules. That gives us information on which genes are expressed in the tumour. This has allowed us to divide tumours into several sub-categories that tell us how aggressive a given tumour is. So far, I’ve identified one high-risk type, two low-risk types and one intermediate type.’

Lindskrog also explains that she performs RNA analyses of different cells from the same tumour for comparison:

‘This reveals that there may be sub-categories of different tumour cells in the same tumour. The challenge is to find out what to do about these cell sub-populations in clinical practice,” she explains.

Blood tests to reveal cancer relapse

In another line of research, Lindskrog is investigating blood samples from patients in the late stages of bladder cancer, i.e. where the patients have had their bladder removed (see Fact Box). 
In this process, she tests the samples for circulating tumour DNA (ctDNA):

‘The presence of ctDNA in the sample indicates residual or recurring cancer. This means that ctDNA counts are a promising supplement to the diagnostic imaging (scans) currently performed as part of standard monitoring for cancer recurrence. This is promising because we're able to measure the level of ctDNA in the blood from a tumour before we can see that the cancer has come back on a scan. The aim is to be able to offer early-stage cancer care and targeted treatment for patients whose blood tests positive for ctDNA,’ explains Lindskrog.

This means that her studies may result in patients receiving tailored treatment, depending on whether the tumour is an aggressive type or carries a low risk of recurrence. 

‘My hope is that the type of analyses we’re doing will in future result in patients being offered individualised treatment’ says Lindskrog, who, ever since her undergraduate days, has been passionate about bioinformatics, which involves analysing large amounts of data from cells in the human body.

As she sees it, bioinformatics is one of the most promising and significant fields in cancer research today. ‘Analysis of large amounts of data from tumour cells is the way forward in understanding cancer biology, and investigating what causes a tumour to be aggressive or not. Once we know that, we’ll also be better able to tailor cancer care to the individual patient,’ says Lindskrog.