Clearer Prognosis for Leukaemia
First Published: Enews - February 2012
The FMC Foundation has just given a grant to a project investigating the immune system's role in chronic myeloid leukaemia (CML) to determine which patients can safely stop their treatment without relapse.
CML is a blood disease where the bone marrow produces too many white cells. In the early stages of the disease the symptoms are often mild, but without treatment CML can transform to acute leukaemia.
It is treated by drugs such as imatinib, which can kill the cancerous cells and keep the disease at bay but which often causes a range of mild side effects that can affect a person's quality of life.
Dr David Ross from the Department of Haematology and Genetic Pathology says CML patients whose tests indicated no detectable leukaemia had the opportunity to come off imatinib as part of a clinical trial run by the Australasian Leukaemia & Lymphoma Group.
Some of the patients who entered the study have now been in remission without any treatment for more than 5 years. However, some patients relapsed within a few months of stopping treatment.
"In the clinical trial that we began in 2006 we have found that the CML came back in 60 per cent of patients who ceased treatment," Dr Ross said."These patients re-started imatinib and brought the disease under control again."
"This indicates that the cancer often remains in patients at very low levels even if it is undetectable in the routine blood test," he said.
Together with Lesley Snell from Genetic Pathology and Dr Peter Macardle from Immunology, Dr Ross hopes to determine why the cancer reappears in some patients and not others. He believes differences in the immune response to CML may offer an explanation.
"People traditionally haven't thought of response to imatinib involving the immune system," Dr Ross said. "We want to investigate whether the immune system is suppressing the low levels of cancer and preventing it from returning."
The new grant will allow the team to determine whether the presence of particular types of immune cells can influence whether patients are at lower risk of relapse.
"Being able to inform patients whether or not they can come off the drug without worrying about relapse will improve their quality of life, and could save considerable costs to the healthcare system," Dr Ross said.
He said the research will also inform future projects which could improve treatment for leukaemia.
"If we can determine whether the immune system plays a role in the regulation of CML we may also be able to stimulate this immune response against leukaemia by strategies such as vaccination," he said.
Brazil Nuts May Aid Bowel Health
First Published: Enews - August 2011
The results of a human intervention study in Flinders Medical Centre has found a dietary selenium supplement in the form of selenium-enriched milk is showing great promise in preventing bowel cancer.
Selenium is enriched in a few foods such as brazil nuts, some sea foods and the organs of some farm animals including kidneys.
It is possible to fatally overdose on too much selenium, but too little can also have adverse health effects.
While current selenium intake in Australia is sufficient to prevent deficiency diseases, studies have indicated that the typical Australian diet may not contain enough of this essential micronutrient - particular for the elderly, smokers and cancer patients.
As part of the Flinders study, 23 volunteers aged 52-79 years, considered at risk for colon cancer by virtue of their age, were given either selenium-enriched milk or a yeast version of selenium for a period of six weeks.
Regular blood tests found that both sources of selenium were effective in increasing blood selenium levels, but the dairy source of selenium in particular showed positive effects for bowel health.
"The increase in the expression of some selenoprotein genes in the bowel indicates these genes may be involved in protection against certain biological changes, which can cause colon cancer," Dr Ying Hu, who has been managing the study, said.
These results were published in the British Journal of Nutrition in March 2011.
"We would now like to undertake a longer study to encompass the effect of selenium supplementation on other changes in the bowel such as the recurrence of polyps," Dr Hu said.
The team hope that if the results are proven over the longer term, then new selenium enriched foods may be developed to improve bowel health and help prevent colon cancer.
Micro Machines Help Target Cancer
First Published: Enews - July 2011
Flinders researchers are seeking to better understand the relationship between cancer cells, tiny microRNA (miRNA) molecules within cells, and tiny bundles of cell material called exosomes, in the hope of uncovering new diagnostic tests and treatments for cancer.
This research is being led by Dr Michael Michael and his team in the Department of Gastroenterology at Flinders University, who, in 2002, identified two miRNAs (miR-143 and miR-145) that appear in low quantities or are not present at all within cancer cells.
Cells have various functions, which are dictated by their proteins. Each protein is the product of a specific gene. MiRNAs are responsible for targeting and shutting down specific genes to prevent the production of a particular protein.
A novel miRNA-based technology developed by Dr Michael is currently under examination in Europe as part of a patent application. The patent will provide the team the rights to target cancer cells, which lack particular miRNAs, with a gene treatment that will cause the cell to self-destruct.
"We would like to be able to use the body's own miRNAs to target cancerous cells," Dr Michael said.
The team would also like to look at the relationship between miRNA and exosomes - tiny bundles of cell material which are released from cells into bodily fluids.
"Exosomes contain the proteins which are on the membrane of the original cell, and also contain some of the cell's cytoplasm, RNAs and miRNAs," Dr Michael said. "We want to know whether exosomes, and particularly whether miRNAs within exosomes, are involved in the way cancer cells talk to their surrounding tissue."
Dr Michael believes exosomes are also showing promise as one day providing a simpler method for diagnosing cancer.
"If we can identify a miRNA which is only found in cancer cells, we could potentially create a blood test for cancer looking at the miRNA stored within these exosomes," he said.
Clearer Prognosis for Mesothelioma
First Published: Enews - July 2011
Flinders researchers have identified a protein which is showing promise as both a prognostic marker and a potential target for new treatments for deadly asbestos-related mesothelioma.
Mesothelioma is an aggressive cancer caused by exposure to tiny airborne asbestos fibres, and most commonly develops on the pleura (the protective lining that covers the surface of the lungs and the internal chest wall).
In Australia, asbestos was widely used in construction and other industries between 1945 and 1989. Because of this heavy use and the long latency of the disease, Australia has the highest incidence of mesothelioma in the world and its occurrence is still continuing to rise.
Globally, events such as the bombing of the World Trade Centre on 11 September 2001 have potentially exposed thousands of people such as tower workers, rescuers and nearby residents to asbestos-contaminated dust from building materials. Mesothelioma can take decades to develop, but once diagnosed the survival time for a patient is on average about one year. There is currently no cure, and upon diagnosis it is hard for clinicians to predict which patients will live for a few months and who will survive for a few years.
Flinders Medical Centre Pathologists Associate Professor Sonja Klebe and Professor Douglas Henderson are hoping a protein called aquaporin1 (AQP1), embedded in the cell membrane, will hold some answers for this aggressive disease.
Human cells have a number of aquaporins, which are responsible for a cell's transport of water and are also thought to play a role in pain perception and cell movement. AQP1 is showing particular promise as a prognostic marker.
"We have shown that increased levels of AQP1 are associated with significantly better survival in patients, compared to mesothelioma patients who have less AQP1," Associate Professor Klebe said.
"We have also been able to show that patients with more AQP1 also have an increase in fluid accumulating in the pleural cavity which surrounds the lungs and impairs breathing."
The team are working with Professor Yool from the University of Adelaide to trial a method of blocking AQP1 in cell cultures to see if it produces any positive effects.
"If successful, we hope to be able to inject the AQP1 blocker into the pleural space of a mesothelioma patient, to try to reduce the fluid accumulation and potentially slow progression of the disease," Associate Professor Klebe said.
The team are currently testing this method of blocking AQP1 in the laboratory on cells from the pleural effusion fluid of mesothelioma patients collected after diagnostic tests have been completed.
"If we can show an effect on these cells we hope to go directly to human trials," Associate Professor Klebe said.
The team hope the research could also have implications for the treatment of other tumours.
Ignorance Drives Radiation Fears
First Published: Flinders Journal - June 2011
The possibility that low doses of radiation may prevent or delay the progression of cancer is being explored by a Flinders University research team led by Professor Pam Sykes in a move that runs counter to the widely held perception that exposure to any radiation is harmful.
Professor Sykes, recently appointed to the University’s Strategic Professorship in Preventive Cancer Biology in the Flinders Centre for Cancer Prevention and Control says the public panic in response to nuclear accidents such as that at Fukushima in Japan is the result of a general ignorance about radiation.
“We have to ensure that radiation is respected and we have to understand what damage radiation can cause – but radiation is not the poison, the dose is,” Professor Sykes said.
“We need radiation in our environment, just as we need vitamins and minerals. Too much is a problem, too little is a problem,” she said.
“Chernobyl was obviously a disaster but there was no increase in leukaemia, solid tumours or birth defects among the 335,000 people who were evacuated and who received less than 100 milliSieverts of radiation – that’s five times the dose I’m allowed as a radiation worker.
“There was an increase in thyroid tumours but we’re not sure how much that related to the fact that everyone was screened for thyroid tumours, which wouldn’t normally happen.
“It’s now been accepted that they should not have evacuated so many people because the biggest detriment from Chernobyl was that they were dramatically disadvantaged, both economically and socially. Many suffered depression thinking they were going to die of cancer.
“And the frightening thing is that it’s been estimated that throughout Europe there were over 100,000 wanted pregnancies aborted, and these were people who didn’t live anywhere near Chernobyl.”
Professor Sykes’ research, which involves doses of radiation that are up to three orders of magnitude lower than those used by other investigators, has been funded by the US Department of Energy Low Dose Radiation Research Program for almost 10 years.
“Using a transgenic mouse that is very sensitive to stressors, we have identified regions in the dose range that cause different biological effects,” she said.
“Some of our colleagues in Germany and Oxford have shown that low doses of radiation to cells in culture trigger a mechanism which removes pre-tumour cells. We’re now working to see if we can identify this response in a mouse.
“If we can understand these mechanisms, we can manipulate them to prevent cancer,” adding it might be “several years” before the potential to humans could be confirmed.
Studies in Canada and Japan have also shown that low doses of radiation given to mice delay the onset of cancer, and reduce the symptoms of diabetes and atherosclerosis, improving the span and quality of life of the affected animals.
Professor Sykes and her team are currently examining low dose radiation therapy in reducing or preventing prostate cancer, with a grant from the Prostate Council Foundation of Australia.
Fundraisers Rally for Prostate Cancer Research
First Published: Investigator Newsletter - Autumn 2011
Thanks to two major donations, a new highly sensitive instrument is helping two different groups of researchers find revolutionary new means of treating and preventing prostate cancer.
Funded by The Brian & Maxine Newell Foundation for Prostate Cancer Research in addition to a donation from Smiling for Smiddy, the new Corbett Rotor-Gene 6000 is used to precisely measure how many times a particular DNA sequence or gene is present in a sample.
Professor Greg Barritt and his team in the Department of Medical Biochemistry will use the Rotor-Gene to measure the activity of channels embedded on the surface of prostate cancer cells which allow the cell to absorb calcium.
Prostate cancer cells have been found to have more of these channels than normal cells, which are known to play an important role in the rapid division and also the death of cells. The team hope to one day develop a drug which will stimulate these channels so the cancer cell absorbs more calcium, which could lead to the cell’s destruction.
For the past few years, the FMC Foundation has also been funding world-leading research which is showing that low doses of radiation, such as those you might get from an x-ray or from air travel, can help prevent cancer by activating defences within normal cells which can help to kill cancer cells and protect against further radiation exposure.
Associate Professor Pam Sykes and her team will use the Rotor-Gene to determine whether this research can specifically benefit prostate cancer by measuring the genetic changes in prostate-cancer prone mice after they are exposed to low doses of radiation.
The team hope to show that low doses of radiation can kill pretumour prostate cells and therefore prevent cancer forming, in addition to or in replacement of androgen ablation therapy.
The purchase of the equipment was enabled by a $31,000 donation from the Newell Foundation, which has been a long-term supporter of prostate cancer research at Flinders in memory of the late Brian Newell. Funds which contributed towards the Rotor-Gene were raised through a Rail to Rocket tag-along tour in conjunction with the Rotary Club of Coromandel Valley in August 2010.
This followed a $25,000 donation from Queensland group Smiling for Smiddy, which was created to commemorate the life of physiotherapist Adam Smiddy who passed away aged 26 to an aggressive cancer. Smiling for Smiddy raised $570,000 in 2010 for cancer research through a series of three, five and eight day cycling challenge events.
Researchers Banking on New Brain Tumour Resource
First Published: Investigator Newsletter - Autumn 2011
Brain Tumour research in South Australia will soon be boosted by the establishment of the state’s first brain tumour tissue repository at Flinders Medical Centre.
The SA Brain bank currently stores more than 250 brains from deceased individuals, and has another 286 future donors. This unique resource allows Flinders to lead the world in Neuroscience research into Parkinson’s, Alzheimer’s and Dementia with Lewy Bodies.
Thanks to funding from the Flinders Medical Centre Foundation in 2009, the South Australian Brain Bank has been able to expand its program to facilitate tissue donations from patients undergoing surgery for brain tumours.
Flinders Medical Centre is one of two public hospitals in the state which conduct adult neurosurgery, with about 60 malignant and benign brain tumours removed at Flinders Medical Centre every year.
Currently after surgery, a small section of tissue is analysed by pathologists to determine what type of tumour the patient has and what course of follow-up treatment needs to be taken. Until now, the remainder has been discarded.
Patients will now be asked to give consent for some of their tumour tissue to be stored for research purposes, in a move which will allow neuroscientists and cancer researchers from Flinders and Adelaide Universities greater opportunities to conduct experiments on this abnormal tissue.
“This research has the potential to benefit patients who are diagnosed with these cancers,” Robyn Flook, SA Brain Bank Coordinator, said. “For example, research will help us better understand the tumour type and development, and this will facilitate the design of more robust and specific drug treatments.”
Robyn said the tumour bank “will bring together neurosurgeons and neuroscientists to work collaboratively and allow greater sharing of knowledge.”
“For example, FMC Surgeon Santosh Poonnoose and neuroscientist Tim Chataway are planning to use the Flinders Proteomics Faciltiy to study differences in proteins between different types of tumours and healthy brains,” Robyn said.
Oxygen's Role in Cancer Spread
First Published: Southern Area Health Service news - April 2011
A Flinders Medical Centre kidney specialist is embarking on a new study to understand how oxygen-depleted cancer cells survive by hijacking and manipulating the body's good cells.
Conducted by Flinders Consultant Nephrologist Professor Jonathan Gleadle, the one-year research project will examine the way in which breast and renal cancer cells develop despite a lack of essential oxygen, a condition known as hypoxia.
According to Jonathan, oxygen is vital for the health of all cells in the body, whether cancerous or not.
He said cells produce small spherical structures called 'exosomes' which send messages to other cells and, in cases of cancer, affect the behaviour of tumours.
Jonathan said the study, funded through a $12,000 grant from the FMC Foundation, would investigate how hypoxic cells respond to low oxygen by communicating with exosomes in a bid to source oxygen.
"We're interested to know whether cancerous cells send out more exosomes when they're starved of oxygen and message other cells to help them," he said.
"While these exosomes probably play a part in the normal body, it seems that in cancer they might get hijacked or have a role in communicating with other cells to support the cancer."
He said it was important to understand not only the behaviour of malignant cells but also the role of healthy cells in facilitating cancer.
"When you're a cancer cell you don't just overtake normal cells - you need their help to survive, whether that be for attracting blood vessels, providing nutrition or manipulating the immune system to prevent it recognising cancer cells.
"If you look at cancer under a microscope, a lot of the cells are cancer cells but there are many different types of normal cells there too.
"So it's important to understand why normal cells are present in a cancerous tumour and the role they play in facilitating that tumour."
He said the study was also significant because the most hypoxic cancer cells often resulted in the worst patient outcomes.
While it remains unclear why hypoxic cancer cells are the most deadly, Jonathan said one explanation could be that hypoxic tumour cells grow differently and act more aggressively.
"We think this basic and fundamental work examining breast and renal cancer cells will lead to a better understanding of how cancers develop.
"And the support of the Lyn Wrigley Breast Cancer Research and Development Fund, along with the assistance from the FMC Foundation, is crucial for establishing new avenues for research such as this."
Women with a family history of breast cancer could be a step closer to finding out if they are carrying a gene defect that causes the disease, thanks to a new study funded by the Flinders Medical Centre Foundation.
Helping Save Our Mothers, Sisters and Daughters from Breast Cancer
First Published: Southern Area Health Service News - April 2011
Chief researcher Karen Lower and colleague Scott Grist have launched an investigation into two genes (BRCA1 and BRCA2) which - when mutated - are known to cause familial inherited breast cancer.
About five per cent of women with breast cancer in Australia have a family history of the disease.
Yet in 80 per cent of women with familial breast cancer, a mutation in one of these two genes cannot be detected - meaning there is no way of telling whether relatives of these women are at a greater risk of developing breast cancer.
Karen said the research, therefore, would use alternate ways of analysing the gene sequence, or 'sentence', at a DNA level in a bid to find the 'spelling mistake (mutation) in the sentence'.
She said some women may not have inherited the cancer-causing mutation while others will have - but at present 'we can't tell the difference'.
'Basically the study will look at how we can find the mutation in that 80 per cent margin - it's like looking for a change in punctuation rather than reading the whole sentence to find the error,' Karen, who works in FMC's Haematology and Genetic Pathology Department, said.
'There's no guarantee these families will have a mutation but we think there's a good chance that some do, we just can't find it the way we've been doing it previously.'
Besides detecting hidden mutations, Karen said the study would also help lead to a greater understanding of the role BRCA1 and BRCA2 genes play in the development of breast cancer.
The improved detection methods, she said, would potentially help provide family members with additional advice on screening methods and medical intervention, such as whether they should undergo a mastectomy.
'Where we find mutations in these families will help them to make more informed decisions, and it will also give us important information in understanding how these genes are involved in the development of breast cancer.'
The study will be carried out over the next year, thanks to a $24,000 research grant awarded last November by the Flinders Medical Centre Foundation's Lyn Wrigley Breast Cancer Research and Development Fund.
AHA Funds State-Of-The-Art Equipment for Cancer
First Published: Enews - April 2011
Liver cancer patients at Flinders Medical Centre (FMC) are benefiting from one of only two Microwave Ablation machines in operation in Australia, thanks to the Australian Hotels Association SA who kindly provided $30,000 to allow its purchase.
The new Microwave Ablation machine precisely targets and destroys cancerous tumours inside an organ using microwaves emitted from a fine needle. The needle is directed into the tumour via open or laparoscopic surgery or through the skin under ultrasound or CT guidance.
The Microwave Ablation machine is currently being used at FMC to successfully treat small tumours in the liver and to slow the progression of cancer for patients on the Liver Transplant waiting list. It is hoped this equipment will also benefit some patients with inoperable lung and kidney tumours.
FMC Surgeons said the new technology is more effective and less time consuming than other means of ablating tumours such as radiofrequency ablation or cryoablation (freezing the tumour).
Dr John Chen, Head of the South Australian Liver Transplant Unit at FMC, said "we are very grateful to the AHA for giving us this state of the art equipment, which will bring benefits for patients and may spare some patients from invasive surgery.
"This equipment will also mean that we will be able to treat tumours in patients who are too ill for a major operation, or to prevent the tumours of patients on the liver transplant waiting list from growing or spreading.
"It is very new technology and there are only two machine of this type in operation in Australia - I believe the other one is in Sydney. We have so far used it to treat five liver cancer patients at Flinders Medical Centre, and we are still waiting for the results of follow up scans but so far everything is looking very promising for those patients."
The Australian Hotels Association SA has provided more than $86,000 to the Flinders Medical Centre Foundation since 2000, which, amongst other projects has supported setting up a telemedicine video conferencing facility to allow long-distance consultations between country patients and cardiologists, the purchase of a vital signs patient monitor, and the purchase of a two-in-one heart monitor and defibrillator.
Can We Prevent Heart Damage Caused By Chemo
First Published: Enews - March 2011
A research team funded by the 2010pinkyellowblueball is investigating the effects chemotherapy for breast cancer has on the heart.
Chemotherapy is critical in the treatment of cancer, but current research is showing more than five per cent of all cancer patients develop abnormalities of the heart as a result of treatment.
Professor Joseph Selva-Nayagam, Professor of Cardiovascular Medicine, Flinders University and Director of Cardiac Imaging, Flinders Medical Centre, and his team are recruiting patients to examine what negative changes occur in the heart from chemotherapy for breast cancer, and whether these changes can aid in the prevention or early detection of heart conditions later in life.
The team hope to recruit 100 patients to the study, which has been funded by the FMC Foundation, and anyone who is newly diagnosed with breast cancer or has a metastatic disease and hasn't yet started treatment is eligible to join.
The heart function of participants will be examined using echocardiography (ultrasound screening) and MRI scanning before, during and after their course of chemotherapy.
"As well as being able to show overall heart function and movement of the heart walls, we will be able to detect subtle changes in the heart such as inflammation and scarring," Professor Selva-Nayagam said.
"By determining which changes happen and when, we hope we can influence chemotherapy regimes to include monitoring of the heart.
"We believe this research could potentially lead to heart-protecting drugs being included with chemotherapy to prevent any irreversible damage occurring."
For more information on the trial please contact Dr Suchi Grover on (08) 8204 5751.
Teaching Computers To Detect Hard To See Cancers
First Published: Enews - March 2011
Not only did the girls who took part in the Borneo for Breast Cancer Challenge in December 2010 have a fabulous time, their hard work in raising $62,000 has funded two vital research projects at Flinders Medical Centre.
One of these projects is led by Dr Murk Bottema, from the School of Computer Science, Engineering and Mathematics, who is working to develop a computer program which will improve breast cancer screening by more accurately picking up and identifying suspicious masses shown on a mammogram.
"Because a mammogram is a 2d image of a 3d object, occasionally suspicious masses are unable to be seen by radiologists." Dr Bottema said. "Computers can look at a much greater variety of patterns and contrast than human beings can."
While computer programs are now in operation in some clinics to assist radiologists decide if cancer is present, Dr Bottema says the current systems do not adequately reduce the number of false positive results which causes unnecessary stress for patients.
Dr Bottema and his team hope to develop a more reliable program which focuses on identifying cancers unable to be seen by the naked eye.
The project funded through Borneo for Breast Cancer is to create a computer mapping of the breast, which a computer can then draw upon to identify irregularities on a mammogram image.
"We are using computers to try to better understand what cancer looks like in a mammogram image," Dr Bottema said.
"We then hope to write a program that can firstly identify suspicious masses, and then identify whether they are benign or malignant."
Borneo for Breast Cancer, led by Channel 7's Jane Doyle, has also funded a project led by Dr Michael Michael investigating the role of hormones and other chemical signals in breast tissues to determine whether they encourage or retard cancer growth.
The FMC Foundation is launching a second Borneo for Breast Cancer trek which will take place 3rd - 12th March 2012. For more information please email Tristanne or telephone 1300 905 188.
Obesity Key in Oesophageal Cancer
First Published: Investigator - Autumn 2010
Flinders researchers are part of a national collaborative which has proven a direct link between the significant growth in oesophageal cancer cases in Australia and rising obesity rates.
The incidence of oesophageal cancer, which has a less than 10 per cent survival rate, has increased more than 400% in Australia in the last 30 years.
Flinders researchers worked in conjunction with Queensland, New South Wales and Victorian research institutes to collect lifestyle data and healthy and cancerous tissue samples from more than 1,000 endoscopy patients in the hope of explaining the exponential increase in oesophageal cancer cases.
The results of the five-year study showed the dramatic increase in cases of oesophageal cancer was directly linked to rising obesity rates and the hormone Leptin which regulates appetite and metabolism and is expressed in greater concentrations in obese people.
Obesity can also increase the risk of Barrett’s Oesophagus, a chronic gastric reflux condition which often progresses to cancer. The link also helps to explain why 90 per cent of oesophageal cancer incidences occur in males, which may be caused by men storing fat in the abdomen rather than distributing it evenly.
Alcohol and smoking and the human papilloma virus which is also responsible for, among others, cervical cancer, were also shown to be causes in both reflux and non-reflux related cancer.
Flinders researchers looked at microRNA changes, and specifically at how the molecules relate to cells changing from non-cancerous cells to cancerous cells in the oesophagus.
Professor David Watson, Head of Surgery in the Flinders School of Medicine, said the future of the research is in finding ways for clinicians to better diagnose patients and their suitability for surgery or chemotherapy.
“We have identified a number of changes in MicroRNA markers that might be of interest as mechanisms that may drive the cancer,” he said. “We hope to determine whether these markers can be used to identify which patients with oesophageal cancer will benefit from specific treatments such as chemotherapy and radiotherapy.”
Just Like Lance... Cancer Doctor to Cycle Tour for Charity
First Published: Media Release - July 2010
Dr Ganessan Kichenadasse, Oncologist from Flinders Medical Centre is getting on his bike, all in the name of charity as he competes in the social aspect of this year’s Tour de France.
Dr Kichenadasse will put his cycling skills to the test by riding 8 stages or 685km of the Tour de France, in order to raise $5,000 or more for both the FMC Foundation and the McGuinness McDermott Foundation.
Inspired by Lance Armstrong’s survival story, Dr Kichenadasse decided to specialise in Oncology – the branch of medicine concerned with the study and treatment of tumours (cancers); and over the last two years he has also developed a passion for cycling, just like his hero Lance.
Dr Kichenadasse will join seven other cyclists from the charity cycle team as they begin this legendary endurance race in the Pyrenees and finish with the grand final on the Champs Elysees in Paris.
With bulldozers set to move in on the site of the new $27 million Flinders Centre for Innovation in Cancer (FCIC) in a matter of weeks, Dr Kichenadasse is hoping that his cycling team will raise thousands of dollars to fund vital cancer research in the LIVESTRONG™ Cancer Research Centre within the new Flinders Centre for Innovation in Cancer; and to help care for kids with cancer at the Women and Children’s Hospital (WCH).
Dr Kichenadasse said: "I really enjoy cycling and I was looking for a new personal challenge, as well as helping to raise awareness about cancer and funds to fight the disease.
“One in three Australians will be affected by cancer within their lifetime. I am particularly interested in brain tumours, and although there is a lot happening in the understanding of the biology of such cancers, there has been only a marginal improvement in terms of survival outcomes.
“I hope that by completing this challenge I can inspire others to do something similar to raise awareness and funds for charity; as every single dollar raised will go to support vital research into cancer prevention, early intervention and innovative cures.”
You can support Dr Kichenadasse or the other riders participating in this challenge by making a donation online at his Everyday Hero page or call the FMC Foundation at 8204 5216.
Rebuilding After Breast Cancer
First Published: Investigator - August 2009
With funds from the Pink Ribbon Ball, Flinders Medical Centre doctors are holding one of Australia’s first studies into how women feel about their post-cancer breast reconstruction to make sure it is a success in their eyes and not just their surgeons.
In 2008 Dr Nicola Dean helped establish the Breast Reconstruction Unit in the FMC Breast Unit to help women discuss their options and plan their reconstruction with specialists.
“The main reason breast reconstruction after mastectomy or an operation for cancer is undertaken is to preserve or improve the patient’s psychological well-being,” said Dr Dean.
Dr Dean is also leading research projects into the different areas of the psychology of breast reconstruction after cancer.
“There have been no established standards for outcomes in breast reconstruction and no commonly used measurement tool which makes it difficult to know whether any one breast reconstruction case is a ‘success’ in the patient’s view,” she said.
The acclaimed Sloan Memorial Kettering Institute in New York has been working on this issue in North America and recently developed the Breast-Q, an in-depth questionnaire that evaluates patient satisfaction.
Drs Dean and Jia Miin Yip have identified the Breast-Q as suitable for several projects they plan to carry out, and will test its effectiveness for an Australian population.
One such project will investigate the Rotation Flap Approach Mastectomy (RoFA), which uses a new surgical incision to allow for a more aesthetic breast reconstruction.
So far a small number of women have undergone the RoFA mastectomy and have given positive feedback, saying that they like the position of the scar and that the sensation over the skin is not affected.
“We feel that this could be a better operation for patients, but we need to prove this with a formal randomised clinical trial,” said Dr Yip.
Resistant Starch Balances Red Meat Risks
First Published: Southern Health News - July 2009
Updated: July 2011
Flinders researchers are studying the potential role of a dietary fibre supplement in reducing the risk for bowel cancer in people who consume a diet rich in red meat.
‘The aim of the study is to ascertain whether the consumption of a diet high in red meat causes changes in certain markers for bowel cancer, and whether adding resistant starch to the diet can improve these effects,’ Flinders Cancer Prevention and Control researcher Dr Richard Le Leu, said.
23 participants in the study were asked to consume 300 grams of either beef or lamb daily for a total of eight weeks, interspersed with lower-meat periods. During one of the 4-week red meat phases of the study they were required to take a daily fibre supplement that is high in resistant starch.
‘Scientists have long suspected that a diet high in red meat may contribute to a greater risk of developing bowel cancer. What we want to determine is whether the addition of a resistant starch supplement may help counter this risk,’ Dr Le Leu said.
He said it would be good news for many Australians if it did. ‘Australia has a high consumption of red meat compared to many countries in the world, and we also have a high incidence of bowel cancer. Anything that could reduce that risk would be welcome.’
To date, the Flinders research team, working in conjunction with researchers from the CSIRO, have successfully completed all the volunteer dietary interventions. The samples that were collected (rectal biopsies, blood, faeces and urine) are currently being analysed for bowel cancer risk and protective factors.
Molecular ‘Markers’ For Cancer Treatment
First Published: Investigator - May 2009
An internationally-recognised Flinders-led clinical trial has provided proof in principle that molecular ‘markers’ can help predict a response to cancer therapy when treating bowel cancer.
The finding is considered so significant that the study’s principal investigator and primary author, Flinders Medical Centre Medical Oncologist Dr Chris Karapetis was short-listed for The Lancet’s Paper of the Year. The Lancet is one of the world’s best known and most respected peer reviewed medical journals.
Dr Karapetis headed a multi-site randomised clinical trial involving 572 patients from cancer care centres in Australia, Canada, New Zealand and Singapore to test the efficacy of a new monoclonal antibody called cetuximab in treating advanced bowel cancer. This treatment was given following failure of chemotherapy when no other treatment options existed. The antibody was given once per week as a one hour intravenous infusion and the effectiveness was compared to best supportive care, which is optimal palliative care for patients in this situation.
The trial initially found that those patients given cetuximab survived for longer, but the magnitude of benefit was small. The research team then began a retrospective examination to determine which set of patients benefited best from the treatment.
Dr Karapetis coordinated an analysis that examined specific changes in a gene within the cancer cells called KRAS.
‘We knew from previous research that bowel cancer tumours that contain KRAS mutations do not respond, that is shrink, when exposed to cetuximab-based therapy,’ he said.
‘So we examined cancer tissue from each patient and divided them according to the presence or absence of mutations in the KRAS gene. We found that patients with KRAS mutant tumours did not derive any benefit from cetuximab, which is what we predicted, but the survival time for patients with tumours without the KRAS mutation was doubled if they were treated with cetuximab.’
Patients were at end-stage illness, and gained on average an extra 4.5 months. Dr Karapetis said the research would one day lead to molecular ‘profiles’ being established for individual tumours so that patients could receive the most effective treatment, based on their molecular markers, rather than the organ of cancer origin.
Improving Screening For Inherited Cancers
First Published: Investigator - August 2008
Important research at Flinders has continued to make inroads into inherited breast and ovarian cancers thanks to a $16,000 contribution from Angela Condous and the Advertiser and Sunday Mail Foundation (ASMF).
Dr Scott Grist and his team are developing a cost-effective pre-screening laboratory test to better identify individuals who may carry a harmful BRCA1 or BRCA2 gene defect.
The BRCA genes are responsible for repairing DNA damage in a cell. If a defect is inherited in one or both genes there is a 60-80% chance that breast or ovarian cancer will develop as DNA damage accumulates over time.
“Approximately 20% of those screened carry DNA variants that cannot be easily identified as those that cause cancer,” said Dr Scott Grist, Head of the Inherited Cancer Genetics Lab at Flinders Medical Centre.
“This represents a large group of individuals with an uncertain diagnosis who are not benefiting from the testing and who are put under additional psychological stress.”
The current screening method is also quite costly, limiting it to those who know they have a strong family history of breast and ovarian cancer.
Using a technique that screens for DNA damage, this test can measure the rate of DNA repair of a possible BRCA gene defect carrier against the rate of repair from a healthy BRCA gene sample.
This will identify if a full screening of the BRCA genes is required, both saving un-necessary and extensive screening and easing the minds of those who don’t know their family’s medical history or have an unknown defect in a BRCA gene.
The ASMF will hold another fundraising lunch on 27 August 2008 to continue raising funds for breast cancer research at Flinders. Contact the Flinders Medical Centre Foundation on (08) 8204 5216 for more information or to book tickets.
Volunteer Service Supports Fresh Ideas
First Published: Investigator - February 2008
Thanks to the hard-working Volunteer Service for Flinders Medical Centre Inc. two bright young minds now have the means to pursue PhDs in groundbreaking fields.
Lauren Thurgood, one of two new Volunteer Service scholarship holders dedicates her time to researching the causes of kidney stones. Her doctorate is on how proteins help to control kidney stones, a field in which Flinders is leading internationally.
As an honours student Ms Thurgood was part of the research team led by Professor Rosemary Ryall who received a $1.2 million grant from the US National Institutes of Health in 2004. They were the first to discover and publish the existence of proteins inside the minerals, predominately calcium oxalate, which cause kidney stones when they attach to kidney cells.
Ms Thurgood hopes to build on this research by identifying the proteins within the crystals, and look at what effects single proteins have on the attachment of the crystals to the kidney cells.
She hopes her research will one day have clinical implications for preventing the formation of kidney stones.
Likewise, scholarship recipient Vicki Edwards is building on the research of Biological Scientists Dr Kirsten Benkendorff and Dr Catherine Abbott, who sought to harness the anti-cancer potential of a local species of sea snail.
It has been found the bioactive compounds involved in the Dicathais orbita or Australian Dogwhelk’s production of a purple dye have many possible medicinal uses, including a novel anti-cancer agent.
Under the supervision of Dr Fiona Young in Medical Biotechnology, Ms Edwards’ doctorate builds on “promising” research by Dr Benkendorff and Dr Abbott into the effects of the compounds on lymphoma and colorectal cancer cells.
Ms Edwards hopes to determine whether the compounds can also kill reproductive cancer cells, or whether they can have an effect on gynaecological conditions caused by hormonal imbalances such as endometriosis and polycystic ovary syndrome.
She also hopes to investigate the viability of a homeopathic treatment for uterine cancer, Murex Purpurea, which has an active ingredient sourced from the same family of mollusc as the Australian Dogwhelk.
At present the Volunteer Service for FMC Inc. provides $194,000 annually to support medical research grants and have recently increased their support to provide for these two new PhD scholarships.
Bowel Cancer Study
First Published: Investigator - February 2008
Updated: Brazil Nuts May Aid Bowel Health
Researchers are seeking people to take part in a study to test the effectiveness of two different selenium supplements which may improve bowel health.
Selenium might not be available in adequate amounts in the diet of Australian people. It is enriched in a few foods such as brazil nuts, some sea foods and the organs of some farm animals including kidneys.
The study will examine the benefits to bowel health of a selenium-enriched dairy milk product and a selenium yeast product. Both products are prepared naturally by feeding selenium supplements to dairy cows.
Professor of Gastroenterology at Flinders Medical Centre and Flinders University. Graeme Young said blood levels of selenium in Australians are barely adequate by international standards which is why dietary supplements could be important in improving bowel health and therefore reducing the risk of bowel disease.
Study participants will consume either the milk or yeast product for a period of six weeks with a follow-on monitored six week period without the selenium product. Blood tests and effects on bowel health will be assessed regularly during each period. 4711.
Volunteers aged greater than 50 years who are interested in taking part in the study can contact Gastroenterology Research Nurse Libby Bambacas on 8204 5534. Entry criteria does apply.
MicroRNA Patent Returns Outstanding Results
First Published: Investigator - July 2007
Flinders Medical Centre (FMC) investigators have received outstanding results on an international Patent application for their research in utilising specific molecules that could lead to better cancer therapies.
Dr Michael Michael and his team have contributed important information into the link between microRNAs and cancer formation, placing them at the forefront of this field of research.
“MicroRNAs were thought to be a quirk of nature when first discovered in nematode worms over a decade ago,” said Dr Michael. “By 2002 it was discovered that these tiny by-products of genes are in fact present in all plants and animals.”
Cells have various functions which are dictated by their proteins. These proteins are, in turn, created by different genes within the cell. MicroRNAs are responsible for targeting and shutting down specific genes where necessary and occasionally stopping the production of a protein that is harmful to the body.
Dr Michael and his team identified two microRNAs (145 and 143) in 2002 that appear in low quantities or are not present at all within cancer cells. This finding could shine light on what happens within a cell for it to turn cancerous while also helping to create better treatments.
Research is a highly competitive field with scientists vying for grants around the world. This can lead to knowledge and technology not being readily shared.
The Patent is still pending, but once awarded, Dr Michael’s microRNA technology can be used by scientists around the world to create better outcomes, not only for cancer but possibly for other diseases.
Screening For Inherited Breast And Ovarian Cancers
First Published: Investigator - April 2007
Thanks to money raised at the Pink Ribbon Ball a more sensitive and accessible test to screen for hereditary breast and ovarian cancer is currently being devised by scientists at Flinders Medical Centre.
Dr Scott Grist, Head of the Inherited Cancer Genetics Lab, and his team are focusing on perfecting a technique that can simplify screening for genetic defects within the BRCA1 and BRCA2 genes.
BRCA1 and BRCA2 are tumour suppressors involved in repairing DNA breaks within cells. If a defect is inherited in these genes there is an 80-90% chance that breast or ovarian cancer will develop. Inherited BRCA gene defects are also the leading risk factor for male breast cancers.
“The BRCA genes are important as they are central to DNA repair,” said Dr Grist. “DNA in our cells is damaged all the time. If you have a defect in the BRCA genes this damage cannot be fixed which leads to an accumulation of mutations that often result in cancer.”
Currently screening patients for these defects is costly and time consuming as the BRCA genes are quite large. This test is also limited to families with a proven history of cancer, unless individuals wish to spend the money required to undergo the screening.
It has been found that if there is a defect within these BRCA genes, double strand DNA breaks repair slower than they normally would. The team are working toward a sensitive way to measure how different this rate of DNA break repair is compared to when the BRCA genes are healthy.
Once this is discovered it will be much simpler to test a patient’s blood and see if the rate of repair indicates that there is a BRCA1 or BRCA2 defect. This will allow those with a family history of cancer to be screened much quicker and more cost effectively to identify if a full screen of the BRCA genes is required. Making this information much more accessible to those who think they may be at risk.
“The test will enable us to quickly screen larger numbers of people,” said Dr Grist. “If we find a gene defect in a familial cancer patient we can then do a simple screening on all family members to inform them if they carry the same gene defect or not.”
This test is still being fine tuned however once it is ready for use it will be a vital tool for those with a familial history of breast or ovarian cancer, to ease minds or prepare individuals for the possibility of cancer.
Healing Properties Of a Common Sea Snail
First Published: Investigator - April 2006
Flinders investigators are currently involved in harnessing the natural anti-cancer property created by a common sea snail which could be used to treat many different forms of cancer.
Dr Kirsten Benkendorff and Dr Catherine Abbott, Lecturers in Biological Sciences at Flinders University, have been investigating this marine snail, the Australian Dogwhelk Dicathais orbita, which is found throughout shallow rocky reef habitats along the southern coast from New South Wales to Western Australia.
This snail produces a purple dye, known as Tyrian purple, which appears to be a means of protecting its egg masses. It has been found that the compounds that produce this dye have many possible medicinal uses, one of these being a potent anti-cancer agent.
This agent appears to cause programmed cell death within cancerous cells, triggering these unwanted cells to self-destruct by shrinking and fragmenting slowly rather than a sudden disintegration that can be harmful to healthy neighbouring cells.
Currently the project is delving into the biological mechanisms that take place within this snail to create the purple dye. It is hoped that part of the process, the anti-cancer agent, can be harnessed and possibly used as a treatment for cancer.
As this project is only in the very early stages much research needs to be undertaken to make sure that biological material such as DNA, metabolic processes, enzymes and the membrane of healthy cells are not harmed or destroyed by using a treatment that utilises this agent.
The next step in this project will be to look at the gastro-protective elements of the snail and to ascertain whether it could be used as a functional food with healing properties, perhaps for colorectal cancers.
Dr Benkendorff is also interested in further investigating homeopathic remedies used for hundreds of years to treat female health issues by testing the healing properties of this snail on reproductive cell lines such as ovarian and breast cancers, and hormone production.
“This is a huge project with exciting potential, particularly as this snail has several interesting biological compounds that haven’t been seen before; this study could provide some very useful information in the treatment of cancers,” says Dr Benkendorff.
How Cancers Form Under Investigation
First Published: Investigator - February 2006
Flinders researchers are leading the world in an area of cancer research that is providing a vital insight as to how cancerous cells may or may not form within the breast and bowel.
Headed by Dr Michael Michael from the Department of Gastroenterology and Hepatology, this research is focused on two specific microRNA’s; tiny products of the genes within our cells.
In 2001 it was discovered that microRNA’s are present in all plants and animals and have the ability to control the formation of proteins within cells. This information took the scientific world by storm when it was realised that this could provide a simpler approach to manipulating genes and therefore altering genetic disorders and diseases, such as cancer.
Each protein within a cell has a specific function causing the cell to act in a certain way, for example grow hair or cause pigmentation. RNA, often called a messenger, helps create these proteins by taking a copy of a sequence of the DNA held within a cell and carrying it into another area of the cell where the protein can be created.
MicroRNAs are involved in the defence against diseases, as they are responsible for controlling the creation of proteins. They are thought to fine-tune delicately balanced processes that control how cells behave. These processes include how the cells mature, divide and move relative to each other. If a microRNA is missing, this could lead to a cascade of events and become deleterious to the cell creating, for example; a cancerous tumour.
Dr Michael and his team have found that microRNA’s 145 and 143 are often in low quantities or not present at all within breast cancer cells – and may be responsible for the disease. This information stemmed from an earlier finding by Dr Michael that microRNA’s 145 and 143 are also not present in bowel cancers.
“These microRNA’s are important for two reasons,” says Dr Michael. “First, they might potentially control the processes that lead to cancer and create better understanding of what is happening within a cancerous cell. And secondly, the potential application to regulate genes in cells may be available for a wide range of disorders.”
Whilst this research is still in the early stages, a possible outcome could be a gene therapy utilising the defensive systems of these microRNA’s and leading to the destruction of cancerous tumours.
Screening Program Sends a Lifeline To Luke
First Published: Investigator - April 2005
Luke Sincock would have never have thought at 22 years of age he was in the high-risk category for bowel cancer.
With a long and detailed family history of bowel cancer involving around 40 family members, Luke was recently delivered a lifeline when a screening program detected early signs of bowel cancer.
The Southern Cooperative Program for the Prevention of Colorectal Cancer (SCOOP) at the Flinders Medical Centre is the brainchild of Professor Graeme Young, a leading researcher in the field, and Dr Peter Bampton, Head of Endoscopy.
“The chances of more than one family member having bowel cancer currently stands at between two to three per cent, so the Sincock family’s situation is extremely rare,” Professor Young said.
“The aim of SCOOP is to ensure that those at high risk of developing bowel cancer have the appropriate tests done at the right time, and then have them repeated at the right interval. We do not want people to forget or be forgotten.
“If the majority of the population were to participate in screening using existing simple stool test techno
logies, within ten years the death rate from bowel cancer alone would be reduced by 40 per cent.
Professor Young said that in the context of a family risk for bowel cancer, colonoscopies traditionally take place every three to five years, allowing staff to detect abnormalities by viewing the inside of the intestine using a microscopic camera. Occasionally people require colonoscopies more frequently.
“We’ve further enhanced the screening program by introducing a home testing kit, known as faecal immunochemical test (FIT) for the 4,000 or so people currently involved in the program to carry out in between colonoscopies,” he said.
Professor Young says the home test can be used for the general population for screening, or for people with a family history in between colonoscopies.
“This allows us to detect certain abnormalities in the bowel, namely pre-cancerous polyps or early cancers, to be picked up in the curable stages. It is a more discreet and less obtrusive way of checking which reassures both the individual and the clinicians.” .
As an Australian-first, the SCOOP program has already proven to be highly successful and is attracting attention from hospitals around the country.
In his role as Director of Development for the proposed $14.5 million Flinders Centre for Innovation in Cancer, Professor Graeme Young says the Centre will focus on all aspects of prevention, and the SCOOP program is just one example of the type initiative that will be part of this Centre.
Beans Means Healthy Bowels!
First Published: Investigator - October 2004
Next time you shop at the supermarket, pick up a can of baked beans because they could be the key to reducing your bowel cancer risk.
A new study at Flinders has confirmed foods high in resistant starch, such as baked beans, rice and pasta, can improve bowel health and reduce the risk of bowel cancer, the most frequently occurring cancer in Australia today.
Most foods are digested in the small intestine but resistant starch resists digestion in the small intestine and reaches the bowel. In the bowel, it is fermented by bacteria, which produce short chain fatty acids. The fatty acids provide a source of energy for colon cells and are proven to be an effective anti cancer agent.
Professor of Gastroenterology at Flinders Medical Centre and Flinders University Graeme Young and Research Fellow Dr Richard Le Leu recently conducted the study using a product high in resistant starch called Hi-Maize® - a food ingredient made from specially bred Australian corn.
The study showed a 30 percent increase in the death of potentially cancerous cells in the colon when the diet included more than 20 percent Hi-Maize.
Death of genetically damaged cells occurs through an automatic biological function called apoptosis. Without apoptosis, the genetically damaged cells could multiply and develop into colorectal cancer. A diet high in resistant starch increases the apoptotic response and may reduce the risk of developing bowel cancer.
A 10 percent Hi Maize diet supplemented with probiotics has also been found to increase apoptotic response. Probiotics are a food ingredient commonly found in yoghurt and fermented milk drinks that deliver external ‘friendly’ bacteria to the gut.
Professor Young and Dr Le Leu now plan to test the resistant starch and combined starch probiotic diet for their effect on colonic tumour development.
Cancer-Causing Genes Under The Microscope
First Published: Investigator - April 2004
A major scientific discovery in 2001 has opened the door for Flinders researchers to further study the genes responsible for the development of colorectal cancer.
European and US scientists working on fields as diverse as worms and plants discovered microRNAs. Found in all animal cells, these molecules have the ability to turn off gene function.
Once thought to be a bit of ‘junk’ MicroRNA's have turned out to be very useful. They play a vital role in the development of various organisms, and are likely to be involved in many human diseases, including cancer.
Dr Michael Michael from the Department of Gastroenterology, believes Flinders is at the leading-edge in studying the microRNA controlled genes that may cause colorectal cancer.
"We are the first to find a correlation between microRNA's and solid tumours. This is novel work. Our lab is one of only a few in the world that have published in this area,” said Dr Michael.
"Although in it's early stages one of the strengths of this research is access to Flinders Tissue Bank. This enhances our ability to discover what causes the changes in gene activity that are associated with many cancers."
It is hoped that by understanding these processes Flinders researchers may be able to develop new diagnostics and cancer treatments.
Bowel Cancer Survey Helps To Save Lives
First Published: Investigator - February 2003
Last year Professor Graeme Young from Flinders Medical Centre's Department of Gastroenterology launched a study of community attitudes in both men and women towards bowel cancer screening. We are now pleased to report the following outcomes from Professor Young's research.
"What we have learnt from the survey will now assist us in providing a more acceptable screening program while also ensuring that proper marketing campaigns regarding the necessity of screening can be developed.
"The program was initially set up to examine barriers that stop people from being screened, for example why will some people be tested when others will not." said Professor Young."
The survey showed that some people will not be screened as they cannot see the value in being tested or don't believe that the test will work. The survey also addressed the issue of trust when it comes to patients being encouraged to take the test, with patients more likely to agree if their general practitioner suggests it rather than a family member or friend.
"This finding will help us work more closely with general practitioners to make them encourage patients in the bowel cancer age range to participate in screening.
"Most bowel cancer develops from polyps, but not all polyps are cancerous. Picking up the early signs of bowel cancer means it can be effectively treated." Said Professor Young.
The next stage of Professor Young's research will involve a $7 million dollar pilot study. Funded by the Federal Government it will screen over the next 18 months, 23,000 men and women aged between 55 and 74 years in nine southern district postcode regions in Adelaide.
If the study is successful it will lead to a national screening program aimed at picking up the early signs of the disease.
If you are over 50, or have a family history of bowel cancer or past bowel problems, then you should contact your general practitioner and ask to be screened.