Research Insights January 2013

Issue 20 | January 2013

ResearchInsights

Contents

Cancer Council Helpline 13 11 20 www.cancercouncil.com.au

Cancer Council NSW researchers have found that a quarter of long-term prostate cancer survivors use complementary and lifestyle therapies (CALTs), such as dietary supplements, meditation, prayer, diet and exercise changes for their prostate cancer. CALT users are more likely to be either:• anxiousabouttheirdisease,or• confidenttheycancontroltheircancer.

Doctors are encouraged to discuss CALT use with their patients, and for long term cancer survivors such discussions may help to identify men whoareanxiousandmaybenefitfromcounselling. Those who strongly believe that they can influence the course of their disease could be open to other healthy lifestyle changes.

Colorectal cancer2 Finding out why aboriginal

mortality rate is so highPancreatic cancer2 Personalised medicine may

be the key to treatment

Cervical cancer3 Three insights arising from

our researchCLEAR Study4 Our groundbreaking research

on the lifestyle and genetic factors that influence cancer is now available to the research community

The number of NSW men living with prostate cancer is expected to double overthenextfiveyears.ThisstatisticisnotasalarmingasitfirstappearsthoughitdoeshaveasignificantimpactontheNSW health system.

The growth in the numbers of men living with prostate cancer in NSW arises for three reasons:•wehaveagrowingagedpopulation,• diagnosisratesare

increasing,• thefiveyear

survival rate has risen to 92%, so more men are living with prostate cancer.

This research

insight provides the NSW health system with a little time to

respond to the demands that will be placed upon it by

the growing number of long-term

prostate cancer survivors and those who will require continued monitoring.

Twice as many men will be living with prostate cancer in 5 years, and our health system needs to be designed to cope.

Do long-term prostate cancer survivors use complementary and lifestyle therapies because of their cancer?

❧

Complementary and lifestyle

therapy use by long-term prostate cancer survivors

Lead: Sam Egger

A method to project prevalence by phase of care

for prostate cancerLead: Xue Qin Yu

In this special edition of ResearchInsights we’ve pulled together some of the most exciting results our Cancer Council NSW researchers have released

over the last year. From genetic breakthroughs to better cervical cancer tests, every study brings us

closer to understanding and defeating cancer.

ResearchInsights | Issue 20 | January 2013


Special edition — research insights

Pancreatic cancer breakthrough heralds the move toward personalised medicinePancreatic cancer is actually a number of different diseases that each need to be treated differently.

This breakthrough was discovered by Professor Andrew Biankin and his team at the Garvan Institute of Medical Research who looked at the genomes of 142 people and their pancreatic cancers, and found that no two were exactly alike.

More than 2,000 geneswereidentifiedthat are connected to pancreatic cancer. While four genes were present in half of all pancreatic cancers, the majority of mutations were found in less than two per cent of cancers.

This breakthrough led to the early stages of a new model for cancer treatment — personalised medicine.

Once the genetic code of their

tumour was understood, several study participants were put on different medicationsthatfocusonspecificgenes.

Pancreatic cancer is one of the most difficulttotreatcancerswiththelowestsurvival rate of any major cancer, and the survival rate has only barely improved

over the last 50 years. Cancer Council NSW was a

seed funder for this research with a commitment of $5 million. The project

has since gone on to leverage an additional $62.5 million in funding for pancreatic cancer research, which has led to their successful bid to be part of the International Cancer Genome Consortium. This research will dramatically improve our understanding of pancreatic cancer and hopefully lead to better, personalised treatments forthisdifficult-to-treatcancer. Importantly, it will also help the families of those affected by

pancreatic cancer, as it will help their cliniciansfindoutwhethertheyarealsocarrying genes that might increase their risk of cancer.

Cancer Council NSW is a leader in research into cancer among Aboriginal and Torres Strait Islander people. Recent results presented by the APOCC team found that Aboriginal people with colorectal cancer were twice as likely to diefromitwithinfiveyearsofdiagnosis,

than non-Aboriginal people.The reasons are not

yet known for certain, but there are several possible explanations that require further research. These include differences in follow-up after initial treatment, or the possibility they don’t receive additional treatments such as chemotherapy and radiotherapy, possibly due to cultural or practical barriers.

We are working to find out why the Aboriginal mortality rate from colorectal cancer is twice that of the rest of Australia

Disparity in survival between Aboriginal and non-Aboriginal

people with colorectal cancer in

NSWLead: Kristie Weir



The team performed a study on behalf of the National Cervical Screening Program in England to assess the role of surveillance testing for the presence of the virus that causes cervical cancer after treatment for pre-cancerous lesions. Previously in England, women who had high grade lesions removed had to be followed up every year.

Possibly the most important discovery was that an existing test could be used as a cheaper and more effective check for women following

treatment for pre-cancer of the cervix.

Currently, women who get high-grade pre-cancerous lesions removed must get screened every year for ten years.

The new method is to test for the virus that causes cervical cancer (HPV) six months after they have been treated for abnormal cells on the surface of the cervix. If the result is negative they can go back to normal screening intervals.

This new method is not only more cost effective (saving approximately $21,000 per 1,000 women treated), it has led to fewer colposcopies (a detailed examination of the cervix), and actually prevented more cases of cervical cancer than the current method.

The research group also performed two studies about cervical screening in migrant women.Thefirstfoundthat migrant women from Asian and Middle-

Eastern countries are less likely to participate in cervical screening.

However, the second study found that most (but not all) groups of

migrant women experienced a reduction in cervical cancer

due to screening. Together, the findingsreinforcetheimportanceofaddressing barriers to screening in migrant groups.

The modelling team has estimated just how much it costs to screen for cervical cancer in the Australian program using the current methods. This has

revealed that it cost $195 million in 2010, with half of this cost coming from routine screening tests.

These estimates are a benchmark for future assessment of changes in the screening program, and will help with determining how changes to the screening program (prompted by the introduction of the HPV vaccination, and involving new technologies and different screening intervals) might affect costs in Australia.

Successes in cervical cancer research

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Special edition — research insights

Join a research study NOW!

Help us beat cancer

Cancer Council conducts research studies with people from NSW. These studies may be questionnaire based surveys, focus groups and interviews or other types of research. (Study participants will not necessarily be cancer patients)

Register your interest to be included on our Study Mailing List. Your story or the story of someone you know will help us find the answers.

Yes, please include me on the study mailing list (if yes, we will write to ask you some additional questions relating to your health to allow us to match you to research studies that suit you)

Tick this box if you have been diagnosed with cancer in the past 18 months (you may be eligible for the CLEAR Study and we will send you information)

I know someone with cancer who might like to be in the CLEAR Study. Please send me a brochure.

At Cancer Council we recognise the importance of your privacy and the safeguarding of your personal information. If you have concerns about the privacy of the information, you may provide it securely on-line at cancercouncil.com.au/joinastudy. Please be assured that in collecting this information it will be used for research purposes only, and will be handled in accordance with our Privacy Management Plan (www.cancercouncil.com.au) which addresses our compliance with all legislative requirements.

You can also register atcancercouncil.com.au/joinastudy

Title

First Name

Last Name

Address

Town

Postcode

Email*

Phone*

Mobile** Optional Place the completed information in an envelope addressed to: Join A Research Study Reply Paid 79819

Potts PointNSW 1335

✄

The CLEAR Study collects lifestyle and genetic information from people with all types of cancer and, where possible, their partners, in order to provide an open access resource for cancer research.

In 2013, initial data and samples collected for the CLEAR Study will be available to the research community*.

Researchers who are preparing grant applications for funding may soon apply to use our precious resource. They can apply for in principle approval for data or blood samples, and approval will be granted provided their project ideahasscientificmeritandisrelatedtocancer causes or outcomes.

At December 2012, the study had

questionnaire data for 6,428 people with cancer (“cases”) and 1,841 people who do not have cancer (“controls”); bloods

are available for 4,711 cases and 1,260 controls.

Samples and data are also available for less common cancers. We expect that these will be sought after for collaborative studies on those cancertypeswhereitisverydifficulttocollectsufficientnumbersforresearch,either because the cancers are very rare or the survival rate is very low.

* Blood samples and questionnaire data will be made available to the cancer research community on a cost recovery basis.

Creating the resource to enable future breakthroughs

Male Data

Male Bloods

Female Data

Female Bloods

Total Case/Control

Total Bloods

Colorectal 468 337 368 265 836 602

Prostate 1040 832 N/A N/A 1040 832

Breast 10 8 1667 1270 1675 1278

Melanoma 247 180 276 178 523 358

Controls 872 583 969 677 1841 1260

Participate in this groundbreaking research project on the lifestyle and genetic factors that influence cancer in the NSW community. By helping us now you can help us defeat cancer in the future.

Please visit www.clearstudy.org.au or call the CLEAR Study Hotline on 1800 500 894. You can help if you or your partner have been diagnosed with cancer in the past 18 months, live in NSW and are aged 18 or over. Take the survey, make a difference.

Research Insights January 2013

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