Skip to main content

Professor Tim Underwood

Prof Underwood is a professor of gastrointestinal surgery at the University of Southampton.

BSc(Hons), MBBS, PhD, FRCS

Training and education


  • BSc in molecular medicine, first class honours - Royal Free Hospital School of Medicine, University of London, 1997
  • MBBS, distinction in medicine and clinical pharmacology and therapeutics, certificate of merit in surgery and obstetrics and gynaecology - Royal Free Hospital School of Medicine, University of London, 1998


  • MRCS - Royal College of Surgeons of England, 2002
  • PhD - University of Southampton, 2007
  • FRCS (general surgery) - Royal College of Surgeons of England, 2011


Prof Underwood is a professor of gastrointestinal surgery at the University of Southampton. He trained in London and the Wessex region before completing a PhD in molecular biology and taking up a National Institute for Health Research Clinical Lectureship in surgery in 2008.

In 2011, Prof Underwood was awarded a Medical Research Council (MRC) Clinician Scientist Fellowship, and in the same year he was awarded the Association of Surgeons of Great Britain and Ireland prize and gold medal for outstanding performance in the intercollegiate specialty examinations (general surgery). He became a Cancer Research UK & Royal College of Surgeons of England Advanced Clinician Scientist Fellow in April 2017.

Here at UHS, Prof Underwood leads the multidisciplinary team for upper gastrointestinal (GI) cancers. The team provides a local and tertiary sub-specialty service for the central south coast region, the Isle of Wight and the Channel Islands. He also treats the full range of benign and emergency GI conditions.

In addition to his cancer practice, Prof Underwood has a special interest in surgery for complex hiatus hernias and antireflux procedures. He has given invited expert lectures on new techniques for antireflux surgery.

Key achievements

  • Prof Underwood has directed the development of Southampton into an internationally recognised centre for oesophageal cancer research. He’s secured over £10 million in external grant funding, including a personal senior fellowship from Cancer Research UK.
  • Prof Underwood delivers consistently excellent clinical outcomes benchmarked against the National Oesophago-Gastric Cancer Audit, driven by continuous service evaluation and development. He’s published UK-leading results for enhanced recovery after cancer surgery, demonstrating significant reductions in complications and reduced lengths of stay (from twelve to nine days). This work was shortlisted for the Surgical Team of the Year award in the BMJ (British Medical Journal) Awards 2017.
  • Prof Underwood has developed a portfolio of activities to raise public awareness of the symptoms of oesophageal cancer with the goal of early diagnosis, including numerous radio and TV appearances. Cancer Research UK selected him for a 'Flame of Hope' award in 2014 in recognition of these efforts. He is a former chairman of the Oesophageal Cancer Westminster Campaign and a trustee of Heartburn Cancer UK.

Awards and prizes

  • Advanced clinician scientist fellowship awarded by Cancer Research UK: cellular interplay in oesophageal cancer - five years (2017-2022), £1.4 million, personal award
  • Cancer Research UK Network Accelerator Award: molecular analysis of the success determinants and mechanisms of solid tumour immunotherapy – five years (2016-2021), £4.3 million, co-investigator
  • Association of Surgeons of Great Britain and Ireland Prize and gold medal for outstanding performance in the intercollegiate specialty examinations (general surgery)


Prof Underwood leads a programme of research studying the role of the tumour microenvironment (the cells surrounding a tumour) in cancer development and progression, with a particular interest in oesophageal cancer and cancer associated fibroblasts (cells in connective tissue that produce fibres, the body's scaffolding).

His team looks at the body at a molecular level, focusing on understanding how features of a patient’s molecular make-up can predict their body’s response to chemotherapy. They also work to develop new therapies that target the tumour microenvironment and enhance the effectiveness of conventional treatments.

The team is also studying how gene expression (the process by which genes are activated to produce a specific protein) is regulated by metabolism in patients with oesophageal cancer. Other topics of study include how exercise can influence a patient’s response to chemotherapy and tumour microenvironment in different types of tumour. The team develops and applies advanced technologies to understand complex tumours in patients with oesophageal cancer.

Prof Underwood is a member of the National Cancer Research Institute’s upper GI clinical studies group and oesophagogastric sub-group. He’s a member of the steering committee of the Oesophageal Cancer Clinical and Molecular Stratification consortium, a UK-wide collaboration that is defining the genetic make-up of a oesophageal cancer, including a new molecular classification. He is part of the trial management group for the upper GI arm of the largest and most important study of aspirin as secondary prevention after cancer therapy ever conducted (AddAspirin).

To learn more about Prof Underwood's research, see his profile on the University of Southampton's website. You can also follow him on Twitter @timthesurgeon.


You can contact Prof Underwood via his secretary on 023 8120 3091.