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.
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.
Improving Screening For Inherited Cancers
First Published: Investigator - August 2008
Updated: Helping Save Our Mothers, Sisters and Daughters from Breast Cancer
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.
Screening For Inherited Breast And Ovarian Cancers
First Published: Investigator - April 2007
Updated: Improving Screening for Inherited Cancers
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.
New Studies Underway Into Cervical Cancer
First Published: Investigator - April 2005
Researchers at Flinders Medical Centre are leading the nation in developing ways to improve the early detection of cervical cancer.
The incidence of cervical cancer has decreased in South Australia by 35 per cent in the past 20 years due to the participation of many women in screening programs that focus on detection of pre-cancerous lesions.
Lead by Dr Robert James, the research team is the only one of its kind in Australia carrying out molecular research to determine the characteristics of pre-cancerous cells in the cervix.
The intensive study seeks to compare the characteristics commonly found in normal cells with those of abnormal cells to establish a profile to enhance the rate of early detection and patient survival.
Dr Robert James says the team chose to focus its molecular studies on cervical cancer because it was an area that was in need of improvement.
“Early detection of pre cancerous cells in the cervix is likely to reduce the risk of cervical cancer significantly,” Dr James said.
“The current method of examining cervical tissue was introduced in 1943 and there have been very few attempts in the intervening years to improve it.
“We are looking to better understand what makes up a normal and abnormal cell so the screening process can become more accurate.”
The team’s research will take place along side other leading edge research projects at the proposed Flinders Centre for Innovation in Cancer.
The integrated Cancer Centre will be the first of its kind in Australia, focusing on innovative prevention strategies, translational clinical and biomedical research and comprehensive and holistic patient care.
“There has always been a great focus on finding a cure for cancer, but we believe more resources should be directed to the areas of prevention and early detection, the real key to increasing cancer survival,” Dr James said.
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 technologies, 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.