Research Activity
Report 2012
Contents
Message from the Board Chair . . . . . . . . . . . . . . . . . . . . . . 2
Our highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Fifteen years of cancer research . . . . . . . . . . . . . . . . . . . . . 6
Our research strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Who we are . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Changing skin cancer prevention worldwide . . . . . . . . . . 10
Making healthy food choices the easiest choices . . . . . . 12
Addressing liver cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Better cervical cancer screening . . . . . . . . . . . . . . . . . . . 16
Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Understanding the gap in Aboriginal cancer survival . . . . 19
Radiation’s effects on neighbouring cells . . . . . . . . . . . . . 20
New invention simplifying radiotherapy
treatment verification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
One treatment discovery impacting two cancers . . . . . . 22
Survivorship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Supporting those faced with the unknown . . . . . . . . . . . . 24
The factors influencing prostate cancer outcomes . . . . . . 25
Appendices
Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Grants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Publications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Board and committees . . . . . . . . . . . . . . . . . . . . . . . . . 36
Contact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Our vision
Cancer defeated
Our vision will be realised when lives are not cut short
nor the quality of life diminished by cancer.
Our mission
To defeat cancer through engaging the community
Cancer Council NSW connects people and organisations
to the cancer cause. Together we can build insights into
the significance of cancer in our lives and contribute
our talents towards the vision of cancer defeated.
We work across all cancers.
The impact from our work together will be visible in changing:
• The lives of cancer patients and carers
• Scientific knowledge
• Community understanding and behaviour
• Society, policy and practice to advance cancer control.
Increasingly, people will work in organisations and live in
families and social settings which advance the control of cancer
and where resources (people, ideas, services and funds) are
developed globally and locally to meet the challenges of cancer.
Message from
the Board Chair
“We want to know
the ‘whys’ of cancer,
so that we can best
understand how to
positively improve the
lives of those with
the disease, their
families and the
wider community.”
Mr Bruce Hodgkinson SC
Chair of the Board
2
Message from the Board Chair
At Cancer Council NSW, we fund research that significantly impacts the cancer landscape
through the investigation of cancer prevention, diagnosis, treatment and survivorship.
Research and
Cancer Council NSW
We want to know the ‘whys’
of cancer, so that we can best
understand how to positively
improve the lives of those with the
disease, their families and the wider
community. We focus on those
cancers that are the most lethal
yet underfunded, such as brain,
pancreatic and liver cancer. We also
focus on disadvantaged groups,
such as Aboriginal communities –
among whom the cancer mortality
rate is up to 60% higher than among
non‑Aboriginal Australians – and
seek to rectify such inequalities.
To realise our vision of cancer
defeated, Cancer Council NSW must
seek out opportunities to improve our
collective knowledge about cancer.
This understanding does not just lead
to better diagnostics and treatments,
but is also used to encourage healthy
behaviours in community members,
to persuade governments to
develop better policy, and to provide
programs and services to support
people through each step of their
cancer journey.
In the last fifteen years, we have
awarded well over $120 million
to Australia’s best and brightest
cancer researchers. As the largest
non-government funder of cancer
research in NSW, we are able to
invest strategically in research, and
contribute to sustaining research
momentum. Our research has found
that major advances in screening,
prevention and treatment have
resulted in thousands of cancer
deaths being avoided today
compared to rates 20 years ago.
More than 61,000 people are alive in
Australia today thanks to knowledge
that has been uncovered and put
into practice over this time.
All of this work is achieved
in collaboration with the best
universities, institutes and researchers
throughout Australia and across the
globe. These partnerships create
greater leverage and opportunities
than any single organisation could
achieve on its own.
Cancer Council NSW has solid
foundations on which to build and
grow. By combining scientific review
with the assessments of our trained
research consumers, we are able to
determine which areas of research
will best serve the wider community.
Recent research discoveries
The researchers that we fund have
made some remarkable discoveries
over the last 15 years. One of our
recent breakthroughs is the creation
of new drugs to fight neuroblastoma
and pancreatic cancer that could
slow cancer progression by 50%.
We also contribute funding to groups
at the Kinghorn Cancer Centre and
Melanoma Institute Australia, who
are on their way to mapping both the
pancreatic and melanoma cancer
genomes. This will dramatically
improve our understanding of
these cancers, paving the way
for new discoveries and more
personalised treatments.
Our funded researchers have
invented a new device that will
make radiotherapy safer and more
effective. They have also discovered
that vitamin B3 could be used to
prevent skin cancer, which may stop
thousands of people from being
diagnosed every year. And they have
made hundreds of discoveries about
the way cancers work, behave and
spread that move us ever closer to
defeating cancer.
Thank you to the community
In the pages that follow, you will be
presented with a snapshot of just
some of our research programs, both
those that Cancer Council NSW runs,
and those to which we contribute
vital funding. We share the stories
of people whose lives have been
affected by cancer, highlighting the
very reason that we fight this fight
each and every single day.
All of this is possible thanks to the
support of the community, who
contribute 96% of our funding, assist
with our research funding decisions,
participate in our research studies,
and help spread the message
about our work.
Thank you.
Mr Bruce Hodgkinson SC
Chair of the Board
Cancer Council NSW Research Activity Report 2012 3
Our highlights
Total funding
$14.9m
research
We fund all types
of cancer research
We provided $14.9 million*
in funding to support research
this year.
We currently fund research into more than
15 different cancer types. Almost half our
research funding is devoted to projects
that will benefit all cancers.
Fundamental – 25%
Causes – 10%
Prevention – 8%
Types of
research funded
in 2012
Detection – 15%
Treatment – 27%
Survivorship – 10%
Cancer Council NSW
is dedicated to driving
major advances in
research, ensuring
no cancer is ignored.
Model systems – 6%
What we funded
160
75
researchers
institutions
Investment
49
projects
The five cancers we
invested in most heavily were:
1
2
$1.4m*
3
$1.2m*
Pancreatic
4
4
Leukaemia
5
$790k*
*2011/12 financial year
$860k*
Melanoma
Breast
$760k*
Brain
We are dedicated
to our vision of a
society where lives
are not cut short
nor the quality of life
diminished by cancer.
Achievements
Discovered that
vitamin B3 could
prevent up to 50%
of non-melanoma
skin cancers
Changed the
landscape of liver
cancer prevention
in Australia
page 13
page 10
Created new drugs
to fight neuroblastoma
and pancreatic cancer
that could slow cancer
progression by 50%
Invented a new
device that will
make radiotherapy
safer and more
effective
page 21
who selects Grants
page 22
Cancer patients, survivors
and carers help us decide what
research to fund. Feedback
from community members is as
important as the assessments
of our scientific review panels.
Together, these two groups
determine which projects we
fund each year.
Global capabilities
Our researchers have global
collaboration and reach
We have hundreds of collaborations with
academics, organisations, networks and
communities around the world, which
enhance our research capabilities.
Cancer Council NSW Research Activity Report 2012 5
Fifteen years of
cancer research
Fifteen years of cancer research
Cancer Council NSW has focused on cancer research since our inception in 1955.
Better treatments, improved diagnostics and other innovations over the past 15 years
have transformed the cancer landscape, saving the lives of many thousands of people.
Our ageing population and better
detection mean that the number of
people diagnosed with cancer has
risen dramatically over the last 15
years – diagnoses in NSW alone
increased by 25% between 1997 and
2012. Yet thanks to the tireless efforts
of oncologists, researchers, GPs and
the support of the community, the risk
of dying from cancer actually dropped
by 20% in those 15 years. Four of the
most common cancers – prostate,
melanoma, breast and thyroid – now
have survival rates of 90% or higher.
Cancer Council NSW’s research
Cancer Council NSW is committed
to research as key to understanding
the causes of, and developing
treatments for, cancer. We provided
more than $120 million in funding
to support research over the last
15 years. Under the tenure of the
outgoing CEO, Dr Andrew Penman,
research thrived and expanded at
Cancer Council NSW, with our annual
investment in research more than
tripling since 1997, to just under
$15 million in 2011/12.
As a community-funded organisation,
it is vital that this investment is
dedicated to projects that positively
impact the community. To ensure
this, we bring community members
to the decision-making table to help
us decide which projects to fund.
This sees us at the forefront of an
important movement, where those
suffering from cancer and researchers
striving to control it can work
together. Since 2005, every grant
awarded by Cancer Council NSW has
been assessed by patients, survivors
and carers. Involving the cancer
community in every funding decision
ensures that we remain responsive
to the priorities and needs of the
community who fund us.
6
Research achievements
Research into practice
From unlocking the secrets to
cancer cell immortality to developing
new diagnostics, researchers
funded by Cancer Council NSW
have made many significant and
exciting breakthroughs.
Making sure that these research
breakthroughs are translated into
improvements for patients is a
fundamental part of our work.
Our funded researchers have
developed two new treatments for
brain and pancreatic cancer that
target the power source of the
cells, and could be 200 times more
effective than current chemotherapy.
New methods of targeting
radiotherapy have been developed
and the death rate from leukaemia
has reduced. Researchers have
begun to sequence the pancreatic
and melanoma cancer genomes,
and have also discovered how some
types of bowel cancer are passed
on in families. These findings build
on hundreds of other discoveries
into how cancer develops and
spreads, and the best ways to
detect and treat it.
Many of Cancer Council NSW’s
key internal research projects were
established under Dr Penman’s
leadership. Since 2006, the Cancer
Lifestyle and Evaluation of Risk
(CLEAR) Study has recruited
close to 9,000 people to help
understand the causes of cancer.
‘B Positive’, a project designed to
enhance prevention and treatment
of liver cancer, has documented the
cost-effectiveness of liver cancer
prevention; developed liver cancer
treatment guidelines and a wide
range of community resources;
and established disease registries
for hepatitis B and liver cancer.
Our researchers were also the first
to show just how significant the
differences in mortality are between
Aboriginal and non-Aboriginal
Australians, particularly in breast
and lung cancer.
A significant addition to our funding
portfolio over the last decade was
the creation of Strategic Research
Partnership grants, which aim to
advance research with the potential to
directly impact cancer control policy
and practice. These allow Cancer
Council NSW to actively partner
with researchers to reduce the time
between research discovery and
real-world application.
The research we fund and conduct
has had a substantial impact on
policies across the world. The work
of our internal researchers on the
human papillomavirus (HPV)
vaccination for prevention of cervical
cancer has changed vaccination
and cervical screening policy in
Australia, New Zealand, China and
the United Kingdom. Research we
funded into liver cancer has improved
Australian screening policies and an
investigation into radiotherapy has led
to improved protocols being used as
far away as Ireland and Canada.
The research we fund and conduct
has led to many significant
achievements in the continuing fight
against cancer. The benefits of this
key investment speak for themselves:
in 2012, Cancer Council NSW
researchers estimated that more
than 61,000 people are alive today
who would have died from cancer
during the last 20 years were it
not for the lessons learnt from
rigorous research.
Our research strategy
Our research strategy
Cancer Council NSW has funded and conducted cancer research for more than 50 years.
Our experiences and successes, and the collaborative relationships formed during this time,
allow us to work strategically in the fight against cancer.
Strategic thinking
One of Cancer Council NSW’s
Strategic Priorities is to drive major
advances in research, ensuring no
cancer is ignored. Our rigorous and
transparent governance processes
rely on the input of internationally
recognised research leaders, as
well as the community that funds
us. This ensures that every dollar
allocated to cancer research is
invested in projects that are not only
of the highest scientific merit, but
are also of value to the community
who support us.
As we look to the future of research
at Cancer Council NSW, our strategy
will build upon our established
solid foundations:
• We will continue to combine
rigorous scientific review with
the judgements of our trained
consumers to reach our
funding decisions.
• We will prioritise funding to
tumour types and disadvantaged
community groups which are
under-resourced and underserved,
and where clear inequities exist.
• We will develop and nurture
key research and funding
collaborations, ensuring we can
leverage our efforts against the
efforts of all those who share our
goals and objectives.
• We will continue to systematically
measure the benefit to the
community of the research we
support, ensuring that it makes a
real difference, not only to scientific
knowledge but also to the policies
and clinical practices that shape
the lived experience of cancer
prevention, diagnosis, treatment
and survivorship.
• We will continue to strive for
international ‘best practice’
research leadership, collaborating
with those who can ensure that
the research we fund will ultimately
help us to achieve our vision of
cancer defeated.
Our international collaborations
Our research capabilities and
reach are also enriched by our
international network, with hundreds
of collaborations with academics,
organisations, alliances and
communities. Our internal researchers
are contributing to ambitious and
influential international projects,
such as the InterSCOPE study into
oesophageal cancer, the biobank
stability study, and the skin health
study. Our national and international
collaborations enable us to extend
our capabilities and accelerate
breakthroughs in ways to prevent,
diagnose, treat and manage cancer.
Community involvement
We are a community-funded
organisation, so it is important that
the community has a say in the
research we fund. Cancer Council
NSW ensures that cancer survivors
and carers have input into every
one of our research funding decisions,
based on their understandings of
which projects will best serve the
community. They receive training
to prepare them for this role, and
their assessments are as important
to our final funding decisions as
those of the scientific panels who
review each application. We thank
each of our cancer consumers for
their fundamental contribution to
our funding process, as well as the
many community members who
assist our research projects.
90
%
or higher survival
rates for four
of the most
common cancers.
20
%
drop in the risk
of dying from
cancer between
1997 and 2012.
Cancer Council NSW Research Activity Report 2012 7
Who we are
We are an independent and forward-thinking community of people, where ideas and charity
come together to make a difference in the fight against all cancers.
What we do
By funding and conducting
world-class research into prevention
strategies and better treatments,
as well as providing advocacy and
support to those affected by cancer,
we are working towards realising our
vision of a society where lives are
not cut short nor the quality of lives
diminished by cancer.
Our research
We courageously prioritise previously
underfunded areas of research,
including pancreatic, oesophageal,
liver, lung and brain cancer; and
we judiciously invest in bold
ideas with the potential to create
significant impact.
8
We collaborate through partnerships
with other funding bodies to create
greater opportunities than a single
organisation alone can achieve;
and with leading researchers
and institutions, recognising that
researchers, policymakers, clinicians
and service providers must unite to
ensure the translation of research
breakthroughs into real differences in
cancer policy and clinical practice.
Our financial independence ensures
that we are accountable only to
the cancer cause and the needs of
our community, and can therefore
support our Strategic Priorities
and actively respond to research
opportunities and needs.
The rapidly evolving world of
cancer research means we
must be forward thinking to
anticipate new discoveries and
support the development of future
breakthroughs. This is demonstrated
by our longstanding and significant
investment in cancer genetics and
our commitment to long-term,
population-based infrastructure
studies, including our own Cancer
Lifestyle and Evaluation of Risk
(CLEAR) Study and the
Sax Institute’s 45 and Up Study.
Prevention
“... You’re supposed to go
home and get on with your
life. How can you do that?”
“I was a truck driver, working long hours, when a mole on
my ankle started scabbing up and bleeding. The GP took
one look at it and said it had to come out. Once melanoma
gets more than 1mm deep it can get into the bloodstream,
and mine was 1.95mm deep – they had to take out 14
lymph nodes from my groin plus some tissue from my
stomach. I had 44 staples from my stomach all the way
down to my thigh. Then I got the call – one lymph node
was positive for melanoma.
“We rushed our wedding through so we could have it before
I started immunotherapy. My wife’s been my rock – she kept
me on my feet. My melanoma was a result of my solarium
use, and I don’t want other people to suffer what I have been
through. Eight months after I was diagnosed, a friend of mine
suggested I call Helpline. They eased my fears and put me
onto support and advocacy groups. Cancer Council has
played a big part in my journey, and I’m forever grateful for it.”
Jay Allen
Melanoma survivor and advocate
Cancer Council NSW Research Activity Report 2012 9
Changing skin cancer
prevention worldwide
In a breakthrough that could dramatically reduce the number of skin cancers, Professor
Diona Damian and Professor Gary Halliday have found that vitamin B3, a non-toxic and inexpensive
vitamin, has a range of anti-cancer effects just by being rubbed into the skin or taken as a pill.
The vitamin helps to reduce existing pre-cancerous skin lesions, reduced numbers of new
non-melanoma skin cancers in a series of pilot studies, and may even help to prevent melanoma,
one of Australia’s most deadly cancers.
Lead researchers: Professor Diona
Damian and Professor Gary Halliday,
University of Sydney
The need
More than 60% of Australians develop
skin cancer during their lifetimes – it is
six times more common than all other
forms of cancer combined. The vast
majority of skin cancers rarely spread
throughout the body, but if left
untreated, they can cause extensive
tissue destruction. Although they are
less deadly than many other cancers,
non-melanoma skin cancers are by
far Australia’s most expensive cancer,
with costs predicted to rise to more
than $700 million by 2015.
Sun exposure is the biggest risk
factor for skin cancer: 90% of
non-melanoma skin cancer and 65%
of melanomas can be traced back to
exposure to ultraviolet (UV) radiation
from the sun. UV radiation causes
cancer by damaging the genes of skin
cells and by suppressing the immune
system, which normally protects
against skin cancer.
60
%
of Australians
develop skin
cancer during
their lifetimes.
6x
more common than
all other forms of
cancer combined.
10
Achievements
Professor Diona Damian and
Professor Gary Halliday, from the
University of Sydney, have made
a remarkable discovery that could
change skin cancer prevention
worldwide. Both UVB (the type of
light that is usually associated with
sunburn) and UVA suppress the
immune system when they hit the
skin. This is important because
the immune system is a big part
of the body’s defence against
cancer. Unusual cells, or cells that
are growing incorrectly, are often
targeted by the immune system and
destroyed before they can develop
into actual cancers. If the immune
system is weakened, it means that
the damage caused by sunlight
isn’t repaired as quickly and is more
likely to cause cancer.
Vitamin B3 is protective because it
replenishes cellular energy, helping
cells to repair the damage caused
to their DNA by sun exposure.
This means that vitamin B3 could
both protect against new skin
cancers and also help heal existing
sun damage. For example, actinic
keratoses are pre‑cancerous lesions,
normally appearing on chronically
sun-exposed skin as red, scaling
areas. If left untreated, many progress
into non-melanoma skin cancer.
The researchers found that applying
vitamin B3 to the skin of people
with these lesions accelerated their
regression within a few months.
They also found that simply taking
a vitamin B3 supplement twice daily
reduced the number of keratoses
by 35% compared to people
taking a placebo.
But perhaps the biggest benefit
from this discovery is the fact that
vitamin B3 actually seemed to prevent
new skin cancers (see Figure p.11).
Of the patients taking a placebo,
32% developed a new skin cancer
within 4 months. Of those taking the
vitamin, only 8% did. Overall, there
was an 80% reduction in numbers
of new skin cancers in patients
taking vitamin B3 in these Phase
II studies. This substantial fall in
cancers, thanks to a readily available
vitamin, could dramatically change
the number of people diagnosed
with non‑melanoma skin cancer in
Australia every year. The researchers
are suggesting including it in
sunscreen, especially because it
helps to fight the adverse effects of
UVA, which is less effectively blocked
by normal sunscreen.
The researchers have also found
a number of other uses for
vitamin B3. It helps to prevent the
immunosuppressive effects of
photodynamic therapy, which is
often used for skin cancer treatment.
This could boost cure rates after
this therapy. It also reduces DNA
damage after arsenic exposure, and
could work to fight arsenic‑induced
skin cancer. This is a major problem,
affecting millions of people in
areas like Bangladesh and West
Bengal, where there are high levels
of arsenic in the groundwater.
Prevention
Vitamin
B3
may help
to prevent
melanoma.
50
%
of non-melanoma
skin cancer could
be prevented.
The most exciting aspects of this
research may be yet to come.
Comprehensive testing of the effects
of vitamin B3 on skin cancers is
ongoing. Professor Damian is working
to complete a Phase III trial of its
effects in preventing non‑melanoma
skin cancer in 400 people at high risk
of developing it. This trial is currently
in the final stages of recruitment,
with more than 300 participants
enrolled to date. This multicentre
study will provide enough evidence to
show whether the vitamin should be
recommended for all people at high
risk of skin cancer. Until the Phase III
trial is complete vitamin B3 is not
recommended for the prevention
of skin cancer.
Preliminary results of this research
have also shown that vitamin B3 may
help to prevent melanoma, by helping
melanocytes in the skin to repair
their DNA more efficiently after UV
exposure. This could potentially
greatly improve the number of lives
saved, as melanoma is by far the
most deadly of the skin cancer types.
If the non-melanoma skin cancer
trial is successful, the next step will
be the development of a clinical trial
to test whether vitamin B3 can also
prevent melanoma.
The effect of vitamin B3
on skin cancers
25
20
Number of cancers
Future work
15
10
5
0
Placebo
Vitamin B3
Oral vitamin B3 given to 37 heavily
sun-damaged patients significantly
reduced the number of new
skin cancers.
Impact
Australia has the highest incidence of skin cancer in the world. If, as the researchers estimate, including vitamin
B3 in sunscreen could prevent 50% of non-melanoma skin cancers, this research has the potential to dramatically
improve skin cancer prevention. It can also help to heal existing pre-cancerous lesions, and may even prevent
melanoma and arsenic-induced skin cancer.
Research team: Dr Andrew Chen, Dr Devita Surjana, Dr Benjamin Thompson, Dr Georgia Frost, Dr Sula Thanos, A/Professor Fergal Moloney,
Dr Joohong Park, Dr Geetha Sivapirabu, Dr Eleni Yiasemides, Dr Malene Vestergaard, Dr Clare Patterson, Professor Ross Barnetson, Dr Anne Kricker and
Dr Andrew Martin, University of Sydney; Dr Patricia Lowe, A/Professor Josette Eris and Mr Branko Radojkovic, Royal Prince Alfred Hospital
Disclaimer: Information in this article is not meant to replace medical advice. As vitamin B3 is still being tested in clinical trials, we do not currently
recommend it as a cancer prevention measure.
Cancer Council NSW Research Activity Report 2012 11
Prevention
Making healthy food
choices the easiest choices
Obesity rates are on the rise in Australia, putting more people at risk of developing
obesity-related cancers. To help combat this, Cancer Council NSW researchers are investigating
new labelling systems for food, and scrutinising the fast food industry by analysing its products,
nutrition information and marketing practices. This can help Australians to make healthy choices
and reduce levels of obesity and chronic disease.
Lead researchers:
Lyndal Wellard and Wendy Watson,
Cancer Council NSW
The need
More than half of Australian
adults are overweight or obese,
increasing their risk of heart disease,
type 2 diabetes and cancer.
There is convincing evidence that
overweight and obesity are risk
factors for cancers of the bowel,
kidney, pancreas, oesophagus,
endometrium and breast. Obesity has
overtaken smoking as the leading
cause of premature death and
illness in Australia.
Healthy food choices are an essential
part of combating rising obesity
levels. Currently, reliable nutrition
information and ingredients lists
appear in fine print on the back or the
side of food packages, while nutrition
claims such as ‘97% fat free’ and
‘no added sugar’ appear prominently
on the front – grabbing consumers’
attention. Fast food also has a big
part to play in obesity, with research
showing that we are increasingly
eating away from home and that
eating fast foods regularly can lead
to weight gain.
Achievements
Cancer Council NSW has investigated
multiple ways to improve food
packaging to make it easier to identify
healthier choices. Our researchers
have conducted a number of studies
to demonstrate to policymakers that
adding simple nutrition information to
the front of food labels will influence
the choices people make. Our
2012 study asked 4,357 grocery
shoppers to use a range of labelling
systems to identify healthier foods.
Those packs without front-of-pack
labelling did not rate as well as
those with information about sugar,
fat and sodium. This research has
informed Cancer Council’s advocacy
to develop an effective front-of-pack
labelling system.
With Australians spending almost
one-third of their household food
budget on eating out, researchers
also looked at the healthiness of fast
food meals. Not surprisingly, fast
food meals made for children were
generally unhealthy, often exceeding
the recommended levels of energy
(kilojoules), saturated fat, sugar and
sodium for both 4- and 8-year old
children. Alarmingly, some meals
exceeded a 4–8-year-old child’s
recommended sodium and saturated
fat intake for an entire day. No meals
containing a cheeseburger were rated
a healthy choice, despite being the
default in many fast food children’s
meals. Another study looked at the
popularity of meals promoted as
‘healthy’ choices at one major fast
food chain. Few people actually
chose these healthier options, with
less than 1% of the 1,448 meals
observed being healthier selections.
Given that consumers do not
purchase the one or two items that
are offered as ‘healthy’ choices, the
next step is to see firm commitment
from both industry and government
to reformulate standard menu items
to make them healthier.
Less than 1% of the
1,448 meal choices
observed were
healthy options.
Impact
Cancer Council NSW uses this research to persuade the Government to act to reduce the impact that unhealthy
food and the food industry have on chronic diseases and obesity rates in Australia. Our advocacy in this area aims
to improve people’s ability to make healthy choices in the supermarket and when eating out. Cancer Council NSW
sits on a working group that is advising Federal and State Health Ministers about the best food labelling system to
implement - with our research demonstrating that front-of-pack labelling has a clear benefit to the public.
Research team: Clare Hughes, Kathy Chapman and Colleen Glasson, Nutrition Unit, Cancer Council NSW; Dr Bridget Kelly, School of Molecular and
Bioscience, University of Sydney; Dr Debra Hector and Lesley King, Prevention Research Collaboration, University of Sydney; and Jennifer Crawford and
John Sergeant, Curly Questions, Sydney
12
Addressing liver cancer
Over the last three decades, liver cancer diagnoses have steadily risen, bringing this cancer into the
top 10 causes of cancer deaths – a trend which is expected to continue beyond 2020. As infection
with the hepatitis B or C viruses are the key causes of liver cancer, Australians born in countries
where these infections are endemic bear the brunt of this disease. Fewer than 1 in 5 people are
alive five years after a liver cancer diagnosis, so researchers focus on disease prevention and early
detection to improve these dismal statistics.
Lead researchers: Professor Jacob
George, Westmead Millennium
Institute; and Dr Monica Robotin and
Mamta Porwal, Cancer Council NSW
The need
Deaths from liver cancer are
increasing faster than any other cause
of cancer death in Australia, yet
these deaths are largely preventable.
The key causes of liver cancer are
infections with the hepatitis B or
C viruses, which are preventable
and treatable. Despite the fact that
hepatitis B increases the risk of liver
cancer by more than 200 times, and
is treatable, it is estimated that only
65% of infected people know that
they have the disease.
So far, more than
600 patients are being
followed up in the
liver cancer Registry.
Achievements
Cancer Council NSW has funded
both the ‘B Positive’ Program and a
Strategic Research Partnership grant
to better understand liver cancer
and hepatitis B, and to improve their
diagnosis and treatment. To achieve
this, researchers and clinicians work
on a range of projects. They have
developed liver cancer treatment
guidelines, assisted clinicians in
managing liver cancer, and helped
establish Westmead and Royal
Prince Alfred hospitals as centres of
excellence for managing this disease.
As a direct result of this program,
more than 600 people are being
followed up in the liver cancer
Registry, and more than 500 have
their hepatitis B infection followed up
according to clinical guidelines, to
prevent disease complications.
The majority of people infected with
hepatitis B are from non-English
speaking backgrounds. Therefore,
developing a variety of culturally
appropriate information resources
and engaging with these communities
are critical to disease prevention.
The ‘B Positive’ Program delivers
community talks and programs in a
number of relevant languages, and
has developed a range of in-language
audiovisual resources – such as a
hepatitis B ‘travelling library’, flip
charts, videos, cartoons, posters
and flyers – demystifying the disease
and explaining strategies for disease
prevention. In the coming year,
researchers will work to identify the
information needs of people affected
by liver cancer as a step towards
developing relevant resources to
address these needs.
Impact
This program directly helps to prevent liver cancer by educating communities, promoting screening programs,
and identifying those at high risk of liver cancer. With many hundreds of people screened and treated as part of
this effort, and through awareness-raising in high-risk communities and among their treating clinicians, we have
real potential to reduce the impact of this largely preventable cancer.
Research team: Debbie Nguyen, Anne Fraser and Ximena Masgoret, Cancer Council NSW
Cancer Council NSW Research Activity Report 2012 13
“I’d never been a
hypochondriac, but now
whenever I get a little
cough or stomach pains,
I think, ‘This is it’.”
“I’d just had twins when I was diagnosed with cervical cancer.
I remember pushing the stroller down the street, screaming,
‘No, no!’ in my head, while trying not to show the kids.
People refer to it as a battle; that you’re a fighter, but you’re
not really. You’re feeling very helpless.
“Then, the same year, one of my boys was diagnosed with
leukaemia. That was shattering. Though the Children’s Hospital
was spectacular – because I was worried that one twin was
getting more attention than the other, they’d treat them both the
same, giving pretend X-rays and blood tests; even a pretend
lumbar puncture. He made it, and I’m so thankful for the amount
of research done into cancer. Twenty years earlier, my child
might not have survived. You just can’t be grateful enough.”
Robyn Bransby
Cervical cancer survivor
14
Diagnosis
Cancer Council NSW Research Activity Report 2012 15
Diagnosis
Better cervical cancer screening
Cervical cancer screening with Pap tests has been in place for many years in most developed
countries. However, new vaccines for the human papillomavirus (HPV, the virus that causes cervical
cancer) have changed the prevention landscape. In 2012, Cancer Council NSW’s Cancer Modelling
Group made important discoveries in their assessments of various options for cervical screening
and diagnosis. They estimated that cervical screening cost $195 million in 2010 in Australia alone,
and found that HPV testing for women who have had pre-cancerous lesions removed is likely
to improve outcomes. By looking at differences in screening uptake and outcomes for migrant
women, the researchers also identified areas where screening could still be improved.
Lead researcher: Associate
Professor Karen Canfell,
Cancer Council NSW/University
of New South Wales
The need
Thanks to the success of Pap
test screening programs in many
developed countries, cervical cancer
is no longer the scourge it once
was, although it is still one of the
most common cancers in women
in the developing world. However,
the introduction of HPV vaccination
changes the landscape for cervical
cancer prevention. Cervical screening
is being re-evaluated to take account
of these changes in order to ensure
that screening and vaccination
work together as complementary
preventative mechanisms. At the
same time, HPV testing, which can
be used at different points in the
screening and diagnostic pathway,
requires further evaluation.
Cervical cancer is no
longer the scourge it
once was, although
it is still one of the
most common cancers
among women in the
developing world.
16
Achievements
Cancer Council NSW researchers,
led by Associate Professor Karen
Canfell, have a comprehensive
research program that investigates
the outcomes and cost-effectiveness
of different screening options for
cervical cancer. The researchers use
mathematical models to predict the
effects of various future scenarios
for cervical screening and HPV
vaccination. These tools are then
used to answer questions such
as ‘How often should women be
screened for cervical cancer?’
and ‘What is the most effective
and cost-effective way to prevent
cervical cancer?’
One of the group’s most important
contributions in 2012 was to evaluate
HPV testing for the surveillance
of women following treatment for
pre-cancer of the cervix. Previously
in England, women were screened
every year for 10 years after treatment
of pre-cancerous lesions. Using data
from 6 sites across England, they
found that this traditional method led
to 29 cases of recurring lesions per
1,000 women treated, while using the
new HPV test led to 8 fewer recurring
lesions. In addition, HPV testing was
also more cost-effective, because this
test is better at detecting those at risk
of the disease recurring.
The researchers found that this
could save approximately £9,388 per
1,000 women treated, and would
also result in fewer unnecessary
medical examinations. These findings,
along with the results of pilot site
evaluation, have helped inform policy
change in England.
With the collaboration of Professor
Bruce Armstrong at the University
of Sydney, a PhD student in the
Modelling Group, Nayerreh Aminisani,
also conducted two studies looking
at cervical screening in migrant
women. The first found that 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 since
screening was implemented in 1991.
The researchers surmise that the
results for those groups who did not
appear to benefit from the organised
screening program in Australia may
be explained by a recent rise in
migration from countries with high
rates of cervical cancer. Together, the
findings reinforce the importance of
addressing barriers to screening in
migrant groups.
Associate Professor Karen Canfell’s work in
modelling cervical cancer prevention began
at the University of Oxford and continued at
Cancer Council NSW for seven years, from 2005
to 2012. Associate Professor Canfell and her
team of 10 researchers have now relocated to
the Lowy Cancer Research Centre at the
University of New South Wales, where they
continue their work. We wish them well in
their future endeavours and look forward to
continuing collaborations.
In 2010 the cost of the
National Cervical Cancer
Screening Program was
$195m
Finally, the team estimated just how
much Australia’s current cervical
cancer screening program costs.
Their study revealed that the National
Cervical Cancer Screening Program
cost $195 million in 2010, with half of
this cost related to delivery of routine
screening tests. These estimates
are a benchmark for future
assessment of the screening
program, and will help to
determine how changes to the
screening program (prompted by
the introduction of the cervical
cancer vaccination) might affect
costs in Australia.
“Modelling is a key factor in our
ability to best use the cancer
resources available in our community.
Our cervical cancer modelling
has already opened the door to
a wide range of opportunities to
improve cancer prevention here
and around the world.” – Associate
Professor Karen Canfell.
Cytology testing vs. HPV testing for detecting recurrent pre-cancers
after treatment
Predicted cases of pre-cancerous lesions
(per 1,000 women treated)
Demonstrating the international
collaborations that make Cancer
Council NSW a thriving research
hub, the researchers have also
undertaken a number of studies into
cervical cancer in China. The most
recent piece of research estimated
the aggregated costs associated with
cervical cancer screening, diagnosis
and treatment in rural China. Due
to economies of scale, diagnostic
costs were similar to screening costs
when the numbers of people being
screened were high, but when they
looked at smaller numbers of people
the diagnostic costs increased.
The study’s findings will help
cost-effectiveness evaluation and
budget planning for cervical cancer
prevention initiatives in China.
30
25
20
15
10
5
0
0
1
2
3
4
5
6
7
8
9
10
Time since treatment (years)
Cytology only
follow-up
HPV testing:
sentinel sites
Extended HPV
follow-up protocol
Reference: Legood R et al. BMJ 2012;345:bmj.e7086
Impact
The work of the Cancer Modelling Group continues to directly influence policy decisions in cervical screening in
several countries. Improving our understanding of screening rates in migrant communities, as well as how much
screening costs, will help to inform policy and guidelines in the future.
Research team: Megan Smith, Jie-Bin Lew, Robert Walker, Ming Xu, Dr Kate Simms, Dr Michael Caruana, Yoon Jung-Kang, Jessica Darlington-Brown
and Luke Testa, University of New South Wales
Cancer Council NSW Research Activity Report 2012 17
Treatment
“Nearly every Aboriginal
person I speak to knows
someone that’s got cancer
or died from cancer.”
“I’ve had two aunts on dad’s side and three on mum’s side die of
cancer. There’s always been cancer there, but you never think about
it. My dad has cancer and he’s in denial – I was there when he was
told and he just said to the doctor, ‘I haven’t got that dirty disease
that killed my sisters’. But he does.
“People have no idea what a lot of Aboriginal people have to deal
with in their own country. I really believe we need more black faces
in the cancer arena and more culturally appropriate ways to access
the services. I’m so happy that Cancer Council is doing this research
and that we’re finally getting somewhere. There’s a long way to go,
but at least something’s happening for our people.”
Veronica Saunders
Community Liason Officer
18
Understanding the gap in
Aboriginal cancer survival
Cancer is the second most common cause of death for Aboriginal people, and they are
60% more likely to die from their cancer than non-Aboriginal Australians. Cancer Council NSW
researchers are investigating how to close this gap. They have found evidence that there may
be barriers preventing Aboriginal people from receiving the best care, and that more research
is required to fully understand these barriers and to close the gap between Aboriginal
and non-Aboriginal cancer outcomes.
Lead researchers: Professor Dianne
O’Connell and Raj Supramaniam,
Cancer Council NSW
The need
In 2006, Cancer Council NSW
researchers found that Aboriginal
people were 60% more likely to
die from cancer compared to
non-Aboriginal people. Exactly why
this difference exists and what can
be done to reduce it are the issues
that the Aboriginal Patterns of Cancer
Care (APOCC) team is investigating.
Aboriginal people
were less likely to
receive surgery, which
might contribute to
poorer outcomes.
Achievements
Following this pioneering work
comparing Aboriginal and
non‑Aboriginal cancer death rates,
Cancer Council NSW researchers
released results in 2012 relating
to prostate cancer, breast cancer,
colorectal cancer and non-small
cell lung cancer – some of the most
common cancers in Australia. For
each study, the researchers examined
the cancer survival rates of Aboriginal
people compared to non-Aboriginal
people, and looked into why these
differences existed.
For all four cancers, Aboriginal
Australians had lower survival rates
than non-Aboriginal Australians.
However, the exact reasons for
this were difficult to identify. Some
problems identified could be the
source of some of the differences
for specific cancer types. For lung
cancer and breast cancer, Aboriginal
people were less likely to receive
surgery, which might contribute
to poorer outcomes. Yet by contrast,
Aboriginal people with bowel cancer
were just as likely to receive surgery,
but were still 30% more likely to
die from their disease. For prostate
cancer, even after the researchers
accounted for a range of additional
factors, including surgical treatment,
location and socioeconomic
disadvantage, Aboriginal men
were still 45% more likely to die
from their cancer.
Further research is required into
factors such as follow-up after
surgery, access to coordinated care,
and the impact of other diseases
limiting cancer treatment options.
The researchers have already begun
new research projects to learn more
about these reduced survival rates
for Aboriginal people with cancer.
One investigation is the Pathways to
Diagnosis Study, which is looking at
the lives and healthcare of Aboriginal
people in the lead-up
to a cancer diagnosis.
Impact
The discovery that, compared to non-Aboriginal Australians, Aboriginal people diagnosed with prostate cancer,
breast cancer, colorectal cancer or non-small cell lung cancer all have significantly lower survival rates has
highlighted the pressing need for better access to cancer care for Aboriginal people to help close this gap.
Cancer Council NSW is now extending its reach into Aboriginal communities to work with healthcare providers
and community groups to further advance this research and support the implementation of solutions.
Research team: Professor Phyllis Butow and Mr Anthony Dillon, University of Sydney; Professor Bruce Armstrong, Royal Prince Alfred Hospital;
Professor Carla Treloar and Dr Christy Newman, University of New South Wales
Cancer Council NSW Research Activity Report 2012 19
Treatment
Radiation’s effects
on neighbouring cells
By identifying a better way to use radiotherapy machines to treat cancer, Associate Professor
Natalka Suchowerska and her team have found a way to improve the quality of life of patients.
They discovered that cancer cells hit with radiation communicate with the cells around them,
affecting the outcome of radiotherapy. This means they can design a better way of administering
radiotherapy using equipment already found in hospitals across the world.
Lead researcher: Associate
Professor Natalka Suchowerska,
University of Sydney
The need
Radiotherapy is a common cancer
treatment and uses high-energy
beams of radiation to blast tumour
cells, while avoiding and sparing
normal tissue. Current radiotherapy
techniques assume that only cells
that have been directly hit by the
radiation will be killed. Previous work
by Associate Professor Suchowerska
and her team discovered that the
likelihood of a cancer cell dying
is also influenced by damage to
neighbouring cells.
20
%
more cancer cells can
be killed with the same
dose of radiotherapy
given in 5 minutes,
instead of 20 minutes.
Understanding this ‘bystander’
effect is essential to improving
radiotherapy techniques and
minimising its side-effects.
Achievements
Building on their earlier work, the
researchers discovered that up to
40% of cell death from radiation might
be due to bystander signalling, but
the effect isn’t as straightforward
as they thought. Being next to an
irradiated cell has two opposite
effects on the surrounding cells
– it can help them grow or cause
them to die, even if the bystander
cells weren’t actually hit by radiation
at all. Crucially, this outcome is
determined by how the radiation
was administered and the time
since the treatment.
These researchers have determined
how much irradiated cells
communicate to the surrounding
cells, and how treatments are
affected. Armed with this knowledge,
they developed a new mathematical
model that can predict the most
effective way to administer
radiotherapy treatment.
This new model will allow for the
maximum effect on a tumour with the
minimum of side effects.
Another of their key findings is
that giving the same amount of
radiotherapy in a shorter period of
time can be much more effective.
For instance, the same dose of
radiotherapy given in 5 minutes,
rather than the traditional 20 minutes,
can kill 20% more cancer cells.
This research could make a
substantial difference to patients
undergoing radiotherapy. The
radiotherapy machines currently in
use in Australian hospitals can rapidly
deliver extremely complex dose
distributions, but weren’t being used
at their full capacity, because accurate
models of what would happen did
not exist. This research means that
clinicians are able to tailor treatment
dose rates and distributions, making
more effective use of existing
radiotherapy machines and improving
patient quality of life. Follow up
research is now investigating how
bystander signalling applies to
other types of radiation treatment,
in the hope that other radiotherapy
techniques can be improved.
Impact
This research has changed our understanding of tumours’ response to radiation with a direct impact on
radiotherapy techniques across Australia and around the world. The experimental protocols the researchers
developed have been utilised internationally, most notably by the Queen’s University Belfast in Ireland. This
research has also been awarded several prizes including the Institute of Physics and Engineering in Medicine
Roberts Prize for best paper in Physics in Medicine and Biology, and the Australasian College of Physical
Scientists and Engineers in Medicine Omega Prize.
Research team: Professor David McKenzie, University of Sydney; A/Professor Martin Ebert, Sir Charles Gairdner Cancer Centre; Ms Elizabeth Claridge,
Dr James Bewes and Mr Atirak Taychasiraprapakul, Royal Prince Alfred Hospital
20
New invention simplifying
radiotherapy treatment verification
A new technology developed by researchers at Liverpool Cancer Therapy Centre and the University
of Sydney has the potential to improve the safety and effectiveness of radiotherapy. Dr Philip Vial
has invented a new detector that can track the exact location and dose of radiotherapy as it is
being delivered, substantially improving the accuracy of the treatment.
Lead researcher: Dr Philip Vial,
Liverpool Cancer Therapy Centre
The need
External beam radiotherapy, used
to treat up to 50% of cancers
worldwide, must be very accurate
in both the position and quantity
of the dose delivered. Too much
or too little radiation, or a beam in
the wrong place, can reduce the
effectiveness of the treatment and
cause significant side effects. This
makes it essential to verify that the
treatment is accurate, especially as
radiotherapy becomes increasingly
complex. At the moment, clinicians
can track where the radiation hits,
but can’t confirm exactly how much
radiation is delivered.
Achievements
This research group, led by Dr Philip
Vial, has developed a new technology
to solve this issue. They have
invented a next-generation detector,
which can accurately detect both how
much radiation is delivered during a
radiotherapy session, and where it
is delivered. Preliminary experiments
using a prototype detector have
demonstrated its effectiveness, with
excellent performance as a dosemeasuring device and promising
performance in detecting location.
This will not only improve patient
safety by helping to prevent errors
in treatment, it will also allow for the
correction of inaccuracies in treatment
that currently go undetected. One of
the most important aspects of this
device is its broad scope – it can be
used to assist with any radiotherapy
treatment, regardless of the complexity
or the aim of the therapy.
detection methods, but it may have
further applications. As one of the
most sophisticated detector models
of its kind in the world, it has already
shed new light on the physics behind
existing radiotherapy machines.
Research is ongoing, and based
on these encouraging results,
the research team is building a
second prototype, which they
hope to test in 2013.
As one of the most
sophisticated detector
models of its kind in the
world, it has already
shed new light on the
physics behind the
existing machines.
The researchers are also working on
a computer model of radiotherapy
which could improve the way current
treatments are delivered. The initial
aim of the model is to test whether
the new detector is significantly
better than the existing radiotherapy
Impact
A new invention that improves radiotherapy techniques has the potential to help many thousands of radiotherapy
patients a year in Australia alone. As this can apply to all radiotherapy treatments, no matter how complex, it can
improve the safety of advanced radiation therapy across a range of cancers. The modelling work has already
delivered significant insights into how existing radiotherapy detectors work, and has the potential to underlie
further discoveries as it is more widely applied.
Research team: Dr Lois Holloway, Dr Samuel Blake, Dr Aimee McNamara and A/Professor Zdenka Kuncic, University of Sydney; A/Professor Peter Greer,
University of Newcastle; Professor Michael Barton, University of New South Wales
Cancer Council NSW Research Activity Report 2012 21
Treatment
One treatment discovery
impacting two cancers
A new drug that may slow tumour progression by 50% has been identified by Dr Tao Liu at the
Children’s Cancer Institute Australia for Medical Research. This drug, which may be able to
treat both pancreatic cancer and neuroblastoma, works by targeting a protein that encourages
cancer cells to grow and spread.
Lead researcher: Dr Tao Liu,
Children’s Cancer Institute Australia
for Medical Research
The need
Pancreatic cancer and neuroblastoma
are both devastating diseases.
Pancreatic cancer is the fourth
leading cause of cancer death in
adults, and neuroblastoma is the
most common solid tumour of early
childhood. What ties these cancers
together is that many of them
are partially caused by the same
protein, called Myc oncoprotein.
Myc helps the cancers grow and
spread throughout the body by
accelerating the rate at which the
cancer cells divide. Although the role
of Myc in cancer has been known
for some time, researchers have had
little success in targeting it to stop
cancers from growing.
Achievements
Dr Liu and his team have discovered
a new way of reducing the amount of
Myc in cells by targeting a different,
related protein. This prevents the
cancer from spreading, and could
have important implications in the
treatment of these cancers. The
researchers found another protein,
called SIRT, which increases the
amount of Myc. By creating a
new drug that blocks SIRT, the
researchers were able to reduce the
amount of Myc, which stopped the
cancer from growing.
These new drugs reduced the
amount of Myc in all the cancer cell
lines in which they were tested, and
had a remarkable effect. Treating
cancers caused by Myc with these
new drugs reduced the extent of
tumour progression by approximately
50%. In addition, the researchers
have shown that the drugs partially
prevent cancers from developing in
the first place.
Interestingly, the new drugs had
another effect – increasing the
amounts of two other proteins
(called MKP3 and NEDD4). As low
levels of these proteins are known
to be related to poor outcomes for
neuroblastoma patients, this is a good
sign that the drugs could improve
the lives of those diagnosed with
this type of cancer.
Building on this significant
breakthrough, the important next
step is to create a version of the drug
that is suitable for therapeutic use in
cancer patients.
50
%
reduction in the
amount the tumours
progressed.
Impact
Given the dangerous nature of both pancreatic cancer and neuroblastoma, the creation of a new drug that may
slow their progression by 50% is a remarkable discovery. There is further hope that the drug may be able to help
prevent these cancers in the first place, which could improve treatments for the thousands of people diagnosed
with these cancers every year. With a few modifications, the researchers hope to test these drugs in clinical trials
in the near future.
Research team: Professor Andrew Biankin and Dr Chris Scarlett, Garvan Institute of Medical Research
22
Survivorship
“The post-operative pain
means I’m reminded of
my cancer every day.”
“In January 2012, I found a lump under my jaw, like a pea
under my skin. After all available tests, the doctors said that it
was the secondary cancer, and that there was no sign of the
primary. I started to get very concerned, thinking, ‘How can
they treat my cancer correctly if they don’t know where it is?’
“It’s classified as cancer of unknown primary, or CUP. It’s
difficult – if you have been diagnosed with breast or lung
cancer, you can picture where it is, but with CUP the cancer
could be anywhere so you have no idea what to picture.
My friends ask me when I will be in remission and the honest
answer is probably never, because they haven’t found all the
cancer. There’s a great need for more awareness, support
and funding for CUP, and I want to help others get through it.”
Robyn Wagner
Cancer of unknown primary survivor
Cancer Council NSW Research Activity Report 2012 23
Survivorship
Supporting those faced
with the unknown
With the help of a grant from Cancer Australia, Cancer Council NSW researchers created a project
to better understand the unique experiences of people affected by cancer of unknown primary,
and the support and information they most need. Using insights gained from this project, the
researchers developed resources designed to inform, empower and provide hope to those
affected by this cancer.
Lead researchers: Gillian Batt,
Amelia Beaumont, Helen Gooden and
Kath Skinner, Cancer Council NSW;
and Associate Professor Penelope
Schofield and Dr Anna Ugalde, Peter
MacCallum Cancer Centre
The need
Cancer of unknown primary, or
CUP, is cancer that has spread
from somewhere in the body other
than where it is found at diagnosis,
and where the location of the
primary cancer cannot be identified.
By definition, it is a diagnosis of
advanced cancer. Knowing where
the cancer started can be important
to help decide the appropriate
therapy that should be used. CUP
is the seventh most common
cause of cancer deaths in NSW,
and although there are exceptions,
it generally has a poor prognosis.
Before this project was conducted,
information and support resources
specifically designed
for people affected by CUP were
virtually non-existent in Australia.
Achievements
To fill this gap, a team of Cancer
Council NSW researchers worked with
colleagues from the Peter MacCallum
Cancer Centre, the Flinders Medical
Centre, the University of Sydney,
the University of New South Wales
and the University of Newcastle to
carry out both phone interviews
and surveys with CUP patients
and carers. This research provided
vital insights into the experience of
people affected by a CUP diagnosis,
and their information and support
needs. The team then worked closely
with health professionals who treat
CUP patients to develop a suite of
information and support resources,
including a booklet; a dedicated
CUP information webpage; a space
created for a CUP online community
to provide peer support via the Cancer
Connections website; and a DVD and
online video resources.
The DVD consists of four related
videos that draw on the remarkable
insights gained through the interviews
of patients and carers. The themes
identified in the research led directly
to the content of the videos.
They provide information about
the diagnosis, prognosis, intent of
treatment, and lived experience of
those affected by CUP, and explain
how people can access a range of
support and information. Patient and
carer stories are featured heavily,
because research has shown that
people learn not only from their own
experiences, but also by observing
the actions of others and the results
of those actions. These videos are
available free‑of‑charge in a variety
of formats to make sure that they are
available to those who need them.
Before this project was
conducted, information
and support resources
specifically designed
for people affected by
CUP were virtually
non-existent in Australia.
Impact
Thanks to this research project, CUP patients and carers now have dedicated resources to help them understand
that they are not alone in facing this difficult diagnosis. An online community gives patients and carers a place to
connect and receive support from people in similar situations; and the booklet, video and online resources provide
information and stories specific to this cancer. Previously, resources of this kind were virtually non-existent, making
this project even more important.
Research team: Professor Sanchia Aranda, Cancer Institute NSW; Ms Jane Barrett, consumer representative; Ms Nadine Hackl, Cancer Institute NSW;
Dr Chris Karapetis, South Australia; Dr Sylvie Lambert, University of Newcastle; Dr Monica Robotin, Cancer Council NSW; Professor Martin Tattersall,
University of Sydney; and A/Professor Claire Vajdic, University of New South Wales
24
The factors influencing prostate
cancer outcomes
With the rate of prostate cancer having rapidly increased in the last decade, Cancer Council NSW
researchers have developed a comprehensive program investigating a range of factors influencing
patient outcomes. This research includes looking at the link to sun exposure, examining the use
of complementary therapies, and investigating whether the adverse side effects of treatment
outweigh the benefits.
Lead researcher:
Associate Professor David Smith,
Cancer Council NSW
The need
Prostate cancer is now the most
common cancer in Australia (aside
from non-melanoma skin cancer),
with Cancer Council NSW research
recently predicting that the number
of men living with prostate cancer
will more than double in a decade.
This will place a substantial burden
on the health system, and makes
research into better prevention and
treatment all the more important.
5x
Men who spent
more time in
the sun on
weekends had
up to 5 times
greater risk
of prostate
cancer.
Achievements
To meet the needs of this growing
number of patients, researchers
at Cancer Council NSW, led by
Associate Professor David Smith, are
working on a program of research
to improve the understanding and
prevention of prostate cancer, as well
as treatments for the disease.
In one investigation, researchers have
shown that high sun exposure – in
addition to increasing the risk of skin
cancer – may also increase the risk
of prostate cancer. After looking at
the records of more than 1,000 men
with prostate cancer, they found that
men who spent the most time in the
sun on weekends had up to five times
greater risk of prostate cancer than
men with the least sun exposure.
Other studies suggest that too little
sun exposure can also be harmful
– so, as is often the case, the key is
moderation; and further investigation
is required to clarify the risks.
Another study found that long-term
survivors of prostate cancer often
turn to complementary or lifestyle
therapies. This work showed that
up to one quarter of survivors
used dietary supplements and
modifications, meditation, prayer,
and/or exercise changes to help
manage their cancer.
However, those who do use these
therapies tend to be at opposite
ends of the spectrum: either anxious
about their disease, or confident
that they can control their cancer.
If doctors discuss the use of these
therapies with their patients, they
are more likely to identify men who
are anxious and may benefit from
counselling, and help those with
more confidence to make additional
healthy lifestyle changes.
A further piece of research
investigated the difficult question
of how much treatment is too much?
Prostate cancer grows very slowly,
and for some men the side effects
can outweigh the benefits of the
treatment. Deciding on treatments is
difficult, as patients want increased
probability of survival, but don’t want
to endure diminished quality of life
during this time. After interviewing
men with prostate cancer, the
researchers found that incontinence,
bowel problems and erectile
dysfunction were the side effects
that most affected patients although
this depended on the severity of the
illness. With further research, this
knowledge will develop a shared
decision-making model for doctors
and their patients, acknowledging
the impact of treatment on the quality,
as well as duration, of their survival.
Impact
By influencing how men are treated for prostate cancer, this research will increase the quality of life of patients
and more accurately characterise the likely outcomes. Helping doctors to more effectively weigh up the benefits
and side effects of treatment will prevent unnecessary trauma for patients; while identifying patients in need of
counselling will help combat the devastating mental toll of the disease.
Research team: Dr Visalini Nair-Shalliker, Professor Dianne O’Connell, Suzy Hughes, Sam Egger, and Albert Bang, Cancer Council NSW;
Professor Bruce Armstrong and Professor Madeleine King, University of Sydney
Cancer Council NSW Research Activity Report 2012 25
Staff
Staff
Research Strategy Unit
Cancer Research Division
Kathy Chapman, BSc, MNutrDiet
Director, Health Strategies Division
A/Professor Freddy Sitas, BSc, MSc(Med),
MSc(Epidemiology), DPhil
Director, Cancer Research Division
Dr Libby Topp, BSc(Psychol)(Hons1), PhD
Manager, Research Strategy Unit
Dr John Williams, BSpSc, MPH, PhD
Research Governance Officer
Sam Thorp, BCom/BSc(Hons1)
Research Communication and Community
Engagement Officer
Nicci Bartley, BPsych(Hons)
Project Officer
Jane Bennett
Volunteer
Naomi Crain, BA, AdvDipFamTh
Executive Assistant to Director
Kate Christian, BSc
Operations Manager
Professor Dianne O’Connell, BMaths(Hons 1), PhD
Division Manager and Senior Epidemiologist
A/Professor Karen Canfell, BE(Hons), DPhil
Senior Research Fellow
A/Professor David Smith, BA, MPH, PhD
Research Fellow
‘B Positive’ Program
Dr Marianne Weber, BA(Hons), PhD
Research Fellow
Dr Monica Robotin, MBBS, FRACS,
MBA, MIH, MAppEpid
Medical Director
Dr Xue Qin Yu, MPH, PhD
Research Fellow
Mamta Porwal, BHMS, MPH
Project Coordinator
Ximena Masgoret, GDipOphth
Research Assistant
Yumi Patton, MBiostat
Research Assistant
Annie Fraser, BSc
Hepatitis B Community Educator
Debbie Nguyen, BHlth
Hepatitis B Community Educator
Dr Michael Caruana, BSc, DPhil
Post-doctoral Research Fellow
Dr Carolyn Nickson, BA, GDipEpidBiostats, PhD
Post-doctoral Research Fellow
Dr Ju Fang Shi, MD, MPH, PhD
Post-doctoral Research Fellow
Dr Kate Simms, BSc(Hons), PhD
Post-doctoral Research Fellow
Dr Louiza Velentzis, BSc(Hons), MSc, PhD
Post-doctoral Research Fellow
Dr Eleonora Feletto, BBus/BA(IntlStudies), DPhil
Post-doctoral Research Fellow
Dr Visalini Nair-Shalliker, BSc(Hons), MSc, MPH, PhD
Post-doctoral Research Fellow
Program Managers
Megan Smith, BE, MPH(Merit)
Program Manager – Cancer Modelling
Rajah Supramaniam, BSc, MPH(Hons)
Program Manager – Aboriginal Studies
Verity Hodgkinson, BSc, MSciMan
Program Manager – Biobanking
Katie Armstrong, BAppSc(HIM)
Research Data
26
Statisticians
Research Assistants
Albert Bang, BCom
Maria Albania, BSc/BEd
Sam Egger, BSc, MBiostat
Karen Allison, BBehavHlthSc
Alison Gibberd, BSc(Hons), MStats
May Chiew, BPharm, MHP(Professional Practice)
David Goldsbury, BSc(Hons), MPH(Merit)
Devisri Dharmaraj, BTech, MBiotech
Qingwei Luo, BSc, MAppStats
Bonnie Nixon, BMedSc
Project Coordinators
Geane Sharman
Kate Blacker, BSc(Nurs)
Susan Spratley, BPsych(Hons)
Leighna Carmichael, BA, MSc
Administration
Jessica Darlington-Brown, BSc(Population Health), MPH
Pinya Leeder, BA, MProfAcct
Suzanne Hughes, BSc(Hons), MNutrDiet
Elle McGlynn, BA
Clare Kahn, BMus(Hons), MMus(Perf)
Brodie Clarke, BPubHealth
Michael Revius, BSc
Annelouise Wells
Jenny Rodger, BA(Hons), MSc
Postgraduate Students
Data Managers
Nayerreh Aminisani, BSc(Nurs), MSc(Epid),
PhD (awarded 2012)
Sarsha Yap, BSc(Hons)
Johnson Yuan, BSc, BEd(Teach)
Research Programmers
Jie Bin Lew, BSc(Bioinformatics)
Robert Walker, BSc
Ming Xu, BEng(Mech)(Biomed), BMedSci
Laboratory Manager
Janis Jansons, BSc, MSc
Aboriginal Community Liaison Officer
Veronica Saunders
APOCC Communications Coordinator
Leonardo Simonella, BA, MPH, PhD (awarded 2012)
Yoon-Jung Kang, BA, MPH(Hons), (PhD candidate,
submitted 2012)
Qingwei Luo, BSc, MAppStats, (PhD candidate)
Usha Salagame, BSc(Microbiol),
PostgradCertBioinformatics, MSc(Biotech),
(PhD candidate)
Maria Albania, BSc/BEd, (MBiostats candidate)
Albert Bang, BCom, (MBiostats candidate)
Jie Bin Lew, BSc(Bioinformatics), (MPH candidate)
Elle McGlynn, BA, (MBA candidate)
Joanna Jarrald, BA(Hons)(Comm)
Sarsha Yap, BSc(Hons) (MBiostats candidate)
Senior Research Assistants
Julia Stanbury, BMedSc, MHP, (MPhil candidate)
Christina Christou, BHS, MPH, DipNat
Kristie Weir, BSc(Population Health)
Laboratory Research Assistant
Mahboobeh Hosseini, BEng
Cancer Council NSW Research Activity Report 2012 27
Grants
Grants
Grants awarded to Cancer Council NSW
Cancer Information and Support Services Division
New grants in 2012
Porwal M, Hillman B, Robotin M
Empowering CALD youth to reduce the burden of liver cancer
in high-risk communities
Cancer Institute NSW
2012–2013
$100,000
Robotin M, Danta S, Porwal M
Animated films as a medium to raise hepatitis B community
awareness in high-risk communities in SW Sydney
Gilead Australia Fellowship
Research Grants Program
2013–2014
$20,000
Robotin M, George J,
Porwal M, Strasser S
Applied medical education on health disparities:
chronic hepatitis B infection and liver cancer in Asian
communities in NSW
University of Sydney
Divisional Strategic Teaching
Enhancement Project
Scheme (STEPS) grant
2012–2013
$35,000
Robotin M, Porwal M, Batt G,
Bartels R, George J
Developing multimedia resources for liver cancer for
CALD communities
Cancer Australia
2012–2014
$160,000
Robotin M, Porwal M, Penman A
Supporting primary care providers to identify and optimally
manage patients with chronic hepatitis B to prevent liver cancer
NSW Ministry of Health
2012–2014
$183,400
Evaluation of Cancer Council Legal Referral Service
Law and Justice
Foundation Grant
2011–2012
$33,462
Condon J, Garvey G, Baade P,
Valery P, Brotherton J,
Lokuge K, Cunningham J,
O’Connell D, Canfell K
Cervical screening participation and outcomes for Indigenous
Australian women
NHMRC Project Grant
2013–2016
$576,701
Cancer Research Division
Independent Research Institutes Infrastructure
Support Scheme
NHMRC Independent
Research Institutes
Infrastructure
Support Scheme
2013
$151,476
Cancer Research Division
NHMRC Research Administering Institution Add-On Grant
NHMRC Research
Administering Institution
Add-On Grant
2013
$7,464
Garvey G, Cunningham J,
Centre for Research Excellence in Discovering Indigenous
O’Connell D, Valery P, Thompson S, Strategies to improve Cancer Outcomes via Engagement,
Condon J, McGrath P, Adams M,
Research Translation and Training (DISCOVER-TT)
Sabeson S, Brands J
NHMRC Centre of
Research Excellence
in Health Services
Research Grant
2012–2016
$2,499,998
Smith D, Batt G
A Survivorship Action Partnership (ASAP)
Movember Funds
2013–2015
$6,250,000
(to be split between
many collaborators)
Yu XQ
School of Public Health Travel Grant to present findings to the
Karolinska Institutet, Stockholm, Sweden
University of Sydney
2012
$3,000
Yu XQ
Travel Grant to present findings at the International Association
of Cancer Registries Conference in Cork, Ireland
Australasian
Epidemiological Association
2012
$3,000
Canfell K
Evaluation of future cervical cancer prevention
strategies in Australia
NHMRC Career
Development Award
2011–2014
$384,160
Canfell K
Evaluation of the cost-effectiveness of colorectal cancer
screening in Australia
Cancer Council NSW
2011–2012
$200,000
Canfell K, Clements M, Nickson C, Evaluation of primary HPV testing for cervical
Brotherton J, Castle P, Schiffman M, screening in Australia
Lord S, Shi JF
NHMRC Project Grant
2011– 2013
$677,522
Canfell K, Smith M, Walker R
Analytical services for National Cervical Screening Program
Monitoring Reports
National Screening Unit,
New Zealand
Ministry of Health
2011–2014
Chambers S, Baade P, Youl P,
Aitken J, Dunn J, Garvey G,
Valery P, O’Connell D
The effects of stigma and nihilism views on lung
cancer outcomes
Cancer Australia
Request for Tender
2011–2013
$588,112
Chambers SK, Smith D, Berry M,
Lepore S, Foley E, Occhipinti S,
Frydenberg M, Gardiner RA
A randomised controlled trial of mindfulness intervention for
men with advanced prostate cancer
Cancer Australia
2011–2013
$706,243
Haines M, O’Connell D, Young J,
Smith D, Kneebone A,
Brooks A, Watt H
Improving evidence-based care for locally advanced prostate
cancer: a randomised phased trial of clinical guideline
implementation through a clinical network
NHMRC Partnership
Project Grant
2011–2013
$533,442 (NHMRC);
$537,674 (PCFA)
Ingham J, O’Connell D, Phillips J,
Davidson P, Girgis A, Wilkinson A,
Piza M, Pigot M, Goldsbury D
Last days of life linkage study: patterns of health services use
and experiences of adult NSW residents in the year prior to
death from illness
Cancer Institute NSW
2011–2012
$83,748
Continuing grants in 2012
Boyes A, Zucca A
Cancer Research Division
New grants in 2012
Continuing grants in 2012
28
Neale R, O’Connell D, Janda M,
Merrett N, Goldstein D, Beesley V,
Wyld D, Gooden H
Patterns of care and quality of life in patients with
pancreatic cancer
NHMRC Project Grant
2010–2012
$655,213
O’Connell D, Butow P, Armstrong B,
Treloar C, Knight R, Dillon A,
Newman C, Supramaniam R
Patterns of cancer care for Indigenous people in NSW
NHMRC Health
Services Research Grant
2007–2013
$1,580,755
O’Connell D, Chambers S,
Moxey A, Smith DP
Use of complementary and lifestyle therapies by men with
prostate cancer: a population-based study
Prostate Cancer
Foundation of Australia
2009–2012
$137,766
O'Connell D, Supramaniam R,
Dillon A, Ingham J, Fernando P
Cancer comorbidity, treatment, survival and end-of-life care for
Aboriginal people in NSW
Cancer Institute NSW
2011–2013
$280,688
Shi J (supervisor Canfell K)
Cost-effectiveness evaluation of cervical cancer prevention
strategies in China
American Cancer Society
International Fellowships
for Beginning Investigators,
UICC/ACSBI Fellowship
2009–2012
Sitas F, Armstrong B, Banks E,
Kricker A, Weber M, Pawlita M
Infectious and lifestyle determinants of non‑melanoma
skin cancer
NHMRC Project Grant
2009–2013
$953,200
Sitas F, Canfell K, O’Connell D,
Banks E, Ward R, Baron M
The NSW Cancer Lifestyle and Evaluation of Risk
(CLEAR) Study
Cancer Council NSW
2006–ongoing
$3,000,000 to date
Yu XQ
Projecting prevalence by phase of care for colorectal, lung,
breast and prostate cancer in New South Wales
NHMRC Training Fellowship
2009–2012
$279,000
Freeman R, Chapman S, Kelly B,
King L, Chapman K, Baur L, Gill T
Online food and beverage marketing to children
and adolescents
Australian National
Preventive Health Agency
2012–2015
$259,159
Nutrition Unit
Grant to assist in the delivery of the Eat It To Beat It
fruit and vegetable promotion program in the Greater
Western Sydney Region
Nepean Blue Mountains and
Western Sydney Local
Health Districts Project Grant
2012–2015
$180,000
Nutrition Unit
Grant to support our strategic food policy research examining
nutrition information in fast food outlets and the promotion of
fast foods, consumer understanding of nutrition information
food labels, the extent of children’s exposure to food marketing
and influence of digital media, and food advertising complaints
NSW Ministry of Health
2012–2013
$70,000
Nutrition Unit
Grant to support the promotion of the NSW Ministry of Health
Get Healthy Coaching and Information Service
NSW Ministry of Health
2012
$21,685
Sanson-Fisher R, Tang A, Carey M,
Bryant J, Tzelepis F, Chapman K,
Vallentine P, Doran C, McElduff P
Improving cancer treatment systems: a randomised controlled
trial of a consumer action model for cancer patients
receiving chemotherapy
Australian Research
Council Linkage Grant
2012–2014
$249,408
(including $24,000
contribution from
CCNSW as the
industry partner)
Health Strategies Division
New grants in 2012
Grants awarded by Cancer Council NSW
New Research Project Grants in 2012
A/Prof Tracy Bryan
Involvement of helicase DHX36 in human
telomere maintenance
University of Sydney
2012–2015
$292,524
Dr Scott Cohen
Structure and inhibition of the human
telomerase enzyme complex
University of Sydney
2012–2015
$360,000
Dr Sue Firth
IGFBP-3 enhances autophagy to promote breast cancer cell
survival during stress
University of Sydney
2012–2015
$360,000
Dr Beric R Henderson
Novel regulation of beta-catenin intracellular transport and its
role in cell polarity and migration
University of Sydney
2012–2015
$360,000
Dr Megan Hitchins
The mechanistic basis for prediction of response to alkylating
chemotherapy in high-grade glioma patients by molecular
markers of MGMT activity
University of
New South Wales
2012–2015
$311,175
A/Prof Geraldine M O'Neill
A sting in the tail: focal adhesion targeting and
mechanotransduction
University of Sydney
2012–2015
$326,169
A/Prof Stuart G Tangye
Mechanisms underlying impaired anti-EBV immune responses
in the absence of SAP
Garvan Institute of
Medical Research
2012–2015
$357,140
Dr Nicole M Verrills
Activating a tumour supressor for leukaemia therapy
(co-funded with Cure Cancer Australia Foundation)
University of Newcastle
2012–2015
$360,000
Continuing Research Project Grants in 2012
Prof Mark Baker
A colorectal cancer ‘interactome’ paradigm that influences
patient survival
Macquarie University
2010–2012
$300,000
Prof Robert C Baxter
Targeting IGFBP-3 signalling pathways as a novel therapeutic
approach in triple-negative breast cancer
University of Sydney
2011–2013
$358,886
Dr Linda Bendall
The role of sphingosine-1-phosphate in haematopoietic stem
cell egress from the bone marrow
University of Sydney
2010–2012
$360,000
A/Prof Tracy Bryan
G-quadruplex stabilisers as cancer therapeutics
University of Sydney
2011–2013
$292,524
A/Prof Tracy Bryan
Recruitment of human telomerase to telomeres
University of Sydney
2010–2012
$368,750
Cancer Council NSW Research Activity Report 2012 29
Grants
Dr Megan Chircop
Dynamin as a new drug target for the treatment
of glioblastoma
University of Sydney
2011–2013
$360,000
A/Prof Anna DeFazio
Pathways of malignant progression in ovarian cancer
University of Sydney
2010–2012
$354,575
A/Prof Peter Greer
Does the initial treatment plan predict doses delivered to
normal tissues during prostate radiation therapy?
University of Newcastle
2011–2013
$349,794
A/Prof Peter Greer
Real-time dose monitoring for patient safety in
radiation therapy
University of Newcastle
2010–2012
$360,000
Dr Beric R Henderson
Regulation of APC intracellular dynamics and function
University of Sydney
2011–2013
$360,000
Dr Viive Howell
New opportunities for the study of ovarian cancer through
characterisation of mouse models
University of Sydney
2011–2013
$315,016
A/Prof Maija Kohonen-Corish
Functional characterisation of the putative tumour suppressor
gene MCC in colorectal cancer
Garvan Institute of
Medical Research
2010–2012
$360,000
Dr Tao Liu
Targeting Myc onco-protein degradation for the treatment of
Myc-induced malignancies
Children’s Cancer
Institute Australia
for Medical Research
2010–2012
$319,500
Dr Tao Liu
The critical role of the histone demethylase JMJD1A in cancer
Children’s Cancer
Institute Australia
for Medical Research
2011–2013
$330,750
Dr Richard Lock
Predicting the in vivo sensitivity of paediatric acute
lymphoblastic leukaemia to BH3-mimetic drugs
University of
New South Wales
2011–2013
$329,250
Dr Guy Lyons
Restoring epithelial differentiation to squamous cell carcinomas
University of Sydney
2010–2012
$360,000
Dr Karen MacKenzie
The prognostic and therapeutic significance of dyskerin and
telomerase enzyme activity in neuroblastoma
University of
New South Wales
2011–2013
$352,524
Prof Finlay Macrae
The effects of butyrylated high-amylose maize starch on
polyposis in FAP volunteers
Melbourne Health
2011–2013
$345,617
Prof John Rasko
Dissecting the multicomponent machine that controls
chromatin architecture
University of Sydney
2011–2013
$359,324
Prof John Rasko
The role of small non-coding RNAs (sncRNAs) in
alternative splicing
University of Sydney
2011–2013
$360,000
Dr Philip Vial
A next-generation detector for radiotherapy treatment
verification with dual capability for simultaneous
imaging and dosimetry
University of Sydney
2011–2013
$336,125
Prof Robyn Ward
Laterally spreading tumours of the colorectum: an
alternative pathway of colorectal cancer development in
the Western world
University of
New South Wales
2011–2013
$360,000
Prof Xu Zhang
Targeting pro-survival mechanisms to sensitise human
melanoma to immunotherapy
University of Newcastle
2011–2013
$359,250
New Priority-driven Collaborative Cancer Research Scheme grants in 2012
(co-funded through Cancer Australia)
Dr Kerrie L McDonald
Mechanisms underpinning how brain cancer cells
respond to drugs
University of
New South Wales
2012–2015
$486,175
Prof Anna Nowak
Phase III trial of concurrent and adjuvant temozolomide
chemotherapy in non-1p/19q non-deleted anaplastic glioma.
The CATNON Intergroup Trial
University of
Western Australia
2012–2015
$369,000
A/Prof Gianluca Severi
Risk and prognostic factors for glioma in Australia
Cancer Council Victoria
2012–2015
$600,000
Continuing Priority-driven Collaborative Cancer Research Scheme grants in 2012
(co-funded through Cancer Australia)
A/Prof Bettina Meiser
Too much, too soon? The impact of treatment-focused genetic
testing in patients newly diagnosed with breast cancer
University of
New South Wales
2010–2012
$21,149
Prof Robyn Ward
Role of dietary compounds on PGC-1alpha methylation in
colorectal cancer
University of
New South Wales
2011–2013
$321,261
Continuing Research Program Grants in 2012
Prof Philip Hogg
Metabolism inhibitors for the treatment of brain and
pancreatic cancer
University of
New South Wales
2011–2015
$2,250,000
A/Prof Lisa Horvath
Building capacity in pharmacogenomics across NSW: PRIMe
(Pharmacogenomic Research for Individualised Medicine)
University of Sydney
2010–2015
$1,498,668
Prof Murray Norris
Toward cure of childhood ALL: improved diagnostics,
therapeutics and prevention strategies
University of
New South Wales
2011–2015
$2,250,000
A/Prof Chris Ormandy
Personalising breast cancer management by discovering the
transcriptional basis for tumour phenotype
Garvan Institute of
Medical Research
2011–2015
$2,249,976
Prof Roger Reddel
Alternative lengthening of telomeres: from basic biology
to drug discovery
Children’s Medical
Research Institute
2011–2015
$2,250,000
30
Continuing Strategic Research Partnership (STREP) grants in 2012
Prof Andrew Biankin
Genotype-guided cancer therapy (genomic theranostics)
Garvan Institute of
Medical Research
2011–2015
$1,500,000
Prof Jacob George
Epidemiology, prevention and management of liver cancer
in NSW: towards a strategic research partnership
University of Sydney
2008–2012
$1,250,000
Dr Kerrie McDonald
Australian Genomics and Clinical Outcomes of High
Grade Glioma: AGOG
University of
New South Wales
2008–2012
$1,238,114
Laureate Prof Rob Sanson-Fisher
Behavioural Science Strategic Research Partnership:
the Newcastle Cancer Control Collaborative (New-3C)
University of Newcastle
2011–2013
$1,200,000
Prof David Whiteman
PROBE-NET: Progression of Barrett’s Esophagus
to Cancer Network
Queensland Institute of
Medical Research
2008–2012
$1,246,165
International Cancer Genome Consortium (ICGC) in 2012
Prof Andrew Biankin
Australian Pancreatic and Ovarian Cancer Genome Initiative
Garvan Institute of
Medical Research
2010–2014
$2,500,000
Prof Graham Mann
Melanoma Genome Project
Melanoma
Institute Australia
2012–2015
$479,428
Continuing Innovator Grants in 2012
Dr Anthony Don
Developing sphingosine kinase 2 inhibitors to block
glioblastoma cell proliferation
University of
New South Wales
2011–2012
$8,648
Prof Jacob George
Novel molecular targets for treatment of
hepatocellular cancer (HCC)
University of Sydney
2011–2012
$100,000
Prof Georges Grau
Deep sequencing of glioma-derived microparticles
University of Sydney
2011–2012
$100,000
Prof Michael Murray
Pharmacogenomic approaches to minimise sorafenib toxicity
in patients with liver cancer
University of Sydney
2011–2012
$97,730
A/Prof Wayne Phillips
Using familial genetics to identify genes involved in the biology
of Barrett’s oesophagus
Peter MacCallum
Cancer Centre 2011
2011–2012
$100,000
Dr Nicholas Shackel
Discovering novel non-invasive diagnostic and prognostic
markers in hepatocellular carcinoma
University of Sydney
2011–2012
$100,000
Dr Sarah Thompson
Sentinel lymph node biopsy in oesophageal adenocarcinoma
– improving staging accuracy and optimising treatment
The Royal Adelaide Hospital
2011–2012
$94,255
Dr Kathy Willowson
The role of imageable microspheres in radioembolisation
treatment planning for HCC
University of Sydney
2011–2012
$3,217
St Vincent’s Centre for
Applied Medical Research
2011–2012
$50,000
Continuing Clinical Trials Protocol Grant in 2012
Prof Reginald Lord
Randomised trial of endoscopic radiofrequency ablation versus
complete mucosectomy with stent for Barrett’s high-grade
dysplasia or intramucosal adenocarcinoma
Commissioned Research Grants in 2012
Consumer testing of front-of-pack food labelling
2012
$40,000
Skin cancer prevention in outdoor workers – an investigation of knowledge, attitudes and behaviours
2011–2012
$30,000
Sun protection attitudes and behaviours among first generation Australians with skin type lV
2011–2012
$40,000
The construction and experience of fertility in the context of cancer: patient, partner and health professional perspectives
2012
$30,000
The Quit Smoking Support for Young People project
2011–2012
$15,000
Cancer Council NSW Research Activity Report 2012 31
Publications
Publications
Cancer Information
and Support Services
Cancer Research Division
Fitz-Gerald L, Balakrishnan S, Orchard J. Little assurance
for overseas students’ health insurance. Aust Health Law
Bull. 2012;20(9):136-45.
Aminisani N, Armstrong BK, Canfell K. Cervical cancer
screening in Middle Eastern and Asian migrants to
Australia: a record linkage study. Cancer Epidemiol.
2012;36(6):e394-400.
Fraser A, Masgoret X, Robotin M, Porwal M. Using
hepatitis B registry data to improve liver cancer prevention
at primary care level. Asia Pac J Clin Oncol. 2012;8
Suppl 3:180. [A408]
Aminisani N, Armstrong BK, Egger S, Canfell K. Impact of
organised cervical screening on cervical cancer incidence
and mortality in migrant women in Australia. BMC
Cancer. 2012;12:491.
Olver I, Robotin M, editors. Perspectives on
complementary and alternative medicine. London: Imperial
College Press; 2012.
Cairns BJ, Travis RC, Wang XS, Reeves GK, Green J,
Beral V; Million Women Study Collaborators (including
Canfell K). A short-term increase in cancer risk
associated with daytime napping is likely to reflect preclinical disease: prospective cohort study. Br J Cancer.
2012;107(3):527-30.
Porwal M, Hillman B, Russell M, Robotin M. Engaging
youth in reducing the burden of liver cancer in culturally
and linguistically diverse communities. Asia Pac J Clin
Oncol. 2012;8 Suppl 3:180. [A408]
Robotin M. From traditional medicines to drug discovery.
In: Olver I, Robotin M, editors. Perspectives on
complementary and alternative medicine. London: Imperial
College Press; 2012. p.157-86.
Robotin M. Randomised controlled trials in the primary
treatment of hepatocellular carcinoma. In: Qiao L,
Li Y, Yan X, George J, editors. Molecular aspects of
hepatocellular carcinoma. Sharjah UAE, Oak Park Il USA,
Bussum The Netherlands: Bentham Science Publishers;
2012. p.174-95
Robotin M, Holliday C, Bensoussan A. Defining research
priorities in complementary medicine in oncology.
Complement Ther Med. 2012;20(5):345-52.
Robotin M, Patton Y, Kansil M, Penman A, George
J. Cost of treating chronic hepatitis B: comparison of
current treatment guidelines. World J Gastroenterol.
2012;18(42):6106-13.
Canfell K, Chesson H, Kulasingam SL, Berkhof J, Diaz M,
Kim JJ. Modeling preventative strategies against HPVrelated disease in developed countries. Vaccine. 2012;30
Suppl 5:F157-67. [Invited peer-reviewed paper]
Chambers SK, Dunn J, Occhipinti S, Hughes S, Baade
P, Sinclair S, Aitken J, Youl P, O’Connell DL. A systematic
review of the impact of stigma and nihilism on lung cancer
outcomes. BMC Cancer. 2012;12:184.
Chiew M, Weber MF, Egger S, Sitas F. A cross-sectional
exploration of smoking status and social interaction in a
large population-based Australian cohort. Soc Sci Med.
2012;75(1):77-86.
Clements MS, Roder DM, Yu XQ, Egger S, O’Connell DL.
Estimating prevalence of distant metastatic breast cancer:
a means of filling a data gap. Cancer Causes Control.
2012;23(10):1625-34.
Collaborative Group on Epidemiological Studies of Ovarian
Cancer (including Sitas F). Ovarian cancer and smoking:
individual participant meta-analysis including 28,114
women with ovarian cancer from 51 epidemiological
studies. Lancet Oncol. 2012;13(9):946-56.
Collaborative Group on Hormonal Factors in Breast
Cancer (including Sitas F and Canfell K). Menarche,
menopause and breast cancer risk: individual participant
meta-analysis, including 118 964 women with breast
cancer from 117 epidemiological studies. Lancet Oncol.
2012;13(11):1141-51.
32
Goldsbury D, Harris MF, Pascoe S, Olver I, Barton M,
Spigelman A, O’Connell D. Socio-demographic and other
patient characteristics associated with time between
colonoscopy and surgery, and choice of treatment centre
for colorectal cancer: a retrospective cohort study. BMJ
Open. 2012;2:e001070.
Goldsbury DE, Armstrong K, Simonella L, Armstrong
BK, O’Connell DL. Using administrative health data to
describe colorectal and lung cancer care in New South
Wales, Australia: a validation study. BMC Health Serv
Res. 2012;12:387.
Green J, Roddam A, Pirie K, Kirichek O, Reeves G, Beral
V; Million Women Study Collaborators (including Canfell K).
Reproductive factors and risk of oesophageal and gastric
cancer in the Million Women Study cohort. Br J Cancer.
2012;106(1):210-6.
Kahn C, Simonella L, Sywak M, Boyages S, Ung O,
O’Connell D. Pathways to the diagnosis of thyroid cancer
in New South Wales: a population-based cross-sectional
study. Cancer Causes Control. 2012;23(1):35-44.
Kahn C, Simonella L, Sywak M, Boyages S, Ung O,
O’Connell D. Post-surgical pathology reporting of
thyroid cancer in New South Wales, Australia. Thyroid.
2012;22(6):604-10.
King MT, Viney R, Smith DP, Hossain I, Street D, Savage E,
Fowler S, Berry MP, Stockler M, Cozzi P, Stricker P, Ward
J, Armstrong BK. Survival gains needed to offset persistent
adverse treatment effects in localised prostate cancer. Br J
Cancer. 2012;106(4):638-45.
Legood R, Smith M, Lew JB, Walker R, Moss S, Kitchener
H, Patnick J, Canfell K. Cost effectiveness of human
papillomavirus test of cure after treatment for cervical
intraepithelial neoplasia in England: economic analysis from
NHS Sentinel Sites Study. BMJ. 2012;345:e7086.
Litchfield MJ, Cumming RG, Smith DP, Naganathan V,
Le Couteur DG, Waite LM, Blyth FM, Handelsman DJ.
Prostate-specific antigen levels in men aged 70 years
and over: findings from the CHAMP study. Med J Aust.
2012;196(6):395-8.
Mayosi BM, Lawn JE, van Niekerk A, Bradshaw D, Abdool
Karim SS, Coovadia HM; Lancet South Africa Team
(including Sitas F). Health in South Africa: changes and
challenges since 2009. Lancet. 2012;380(9858):2029-43.
Nair-Shalliker V, Fenech M, Forder PM, Clements MS,
Armstrong BK. Sunlight and vitamin D affect DNA damage,
cell division and cell death in human lymphocytes: a
cross-sectional study in South Australia. Mutagenesis.
2012;27(5):609-14.
Nair-Shalliker V, Smith DP, Egger S, Hughes AM, Kaldor
JM, Clements M, Kricker A, Armstrong BK. Sun exposure
may increase risk of prostate cancer in the high UV
environment of New South Wales, Australia: a case-control
study. Int J Cancer. 2012;131(5):E726-32.
Plummer M, Peto J, Franceschi S; International
Collaboration of Epidemiological Studies of Cervical
Cancer (including Canfell K and Sitas F). Time since first
sexual intercourse and the risk of cervical cancer. Int J
Cancer. 2012;130(11):2638-44.
Sewram V, Sitas F, O’Connell D, Myers J, Klaassen L.
Esophageal cancer in South Africa. In: Eslick G, editor.
Esophageal cancer: epidemiology, diagnosis and
treatment. New York: Nova Science; 2012. p. 53-76.
Shi JF, Canfell K, Lew JB, Qiao YL. The burden of cervical
cancer in China: synthesis of the evidence. Int J Cancer.
2012;130(3):641-52.
Shi JF, Chen JF, Canfell K, Feng XX, Ma JF, Zhang YZ,
Zhao FH, Li R, Ma L, Li ZF, Lew JB, Ning Y, Qiao YL.
Estimation of the costs of cervical cancer screening,
diagnosis and treatment in rural Shanzi Province,
China: a micro-costing study. BMC Health Serv Res.
2012;12(1):123.
Shi JF, Kang DJ, Qi SZ, Wu HY, Liu YC, Sun LJ, Li L, Yang
Y, Li Q, Feng XX, Zhang LQ, Li J, Li XL, Yang Y, Niyazi M,
Xu AD, Liu JH, Xiao Q, Li LK, Wang XZ, Qiao YL. Impact
of genital warts on health related quality of life in men and
women in mainland China: a multicenter hospital-based
cross-sectional study. BMC Public Health. 2012;12(1):153.
Sitas F, Egger S, Urban MI, Taylor PR, Abnet CC, Boffetta
P, O’Connell DL, Whiteman DC, Brennan P, Malekzadeh
R, Pawlita M, Dawsey SM, Waterboer T, Webb PM,
Green AC, Hayward NK, Zaridze D, Holcatova I, Mates D,
Szeszenia-Dabrowska N, Ferro G, Janout V, Curado MP,
Menezes AM, Koifman S, Islami F, Nasrollahzadeh D, Hu
N, Goldstein AM, Gao Y, Ding T, Kamangar F. InterSCOPE
Study: associations between esophageal squamous cell
carcinoma and human papillomavirus serological markers.
J Natl Cancer Inst. 2012;104(2):147-58.
Nair-Shalliker V, Armstrong BK, Fenech M. Does
vitamin D protect against DNA damage? Mutat Res.
2012;733(1-2):50-7.
Cancer Council NSW Research Activity Report 2012 33
Publications
Smith M, Walker R, Canfell K. Independent Monitoring
Report Number 33 for January-June 2010: National
Cervical Screening Programme. Report to the NZ
National Screening Unit. National Screening Unit: New
Zealand; 2012.
Smith M, Walker R, Canfell K. Independent Monitoring
Report Number 34 for July-December 2010: National
Cervical Screening Programme. Report to the NZ
National Screening Unit. National Screening Unit: New
Zealand; 2012.
Swart A, Burns L, Mao L, Grulich AE, Amin J, O’Connell
DL, Meagher NS, Randall DA, Degenhardt L, Vajdic CM.
The importance of blood-borne viruses in elevated cancer
risk among opioid-dependent people: a population-based
cohort study. BMJ Open. 2012:2(5):e001755.
Urban M, Banks E, Egger S, Canfell K, O’Connell D,
Beral V, Sitas F. Injectable and oral contraceptive use and
cancers of the breast, cervix, ovary, and endometrium in
black South African women: case-control study. PLoS
Med. 2012;9(3):e1001182.
Walker R, Nickson C, Lew JB, Smith M, Canfell K. A
revision of sexual mixing matrices in models of sexually
transmitted infection. Stat Med. 2012:31(27):3416-32.
Wang JB, Jiang Y, Liang H, Li P, Xiao HJ, Ji J, Xiang W, Shi
JF, Fan YG, Li L, Wang D, Deng SS, Chan WQ, Wei WQ,
Qiao YL, Boffetta P. Attributable causes of cancer in China.
Ann Oncol. 2012;23(11):2983-9.
Yu XQ, Baade PD, O’Connell DL. Conditional survival
of cancer patients: an Australian perspective. BMC
Cancer. 2012;12:460.
Health Strategies Division
Deacon RM, Topp L, Wand H, Day CA, Rodgers C, Haber
PS, van Beek I, Maher L. Correlates of susceptibility to
hepatitis B among people who inject drugs in Sydney,
Australia. J Urban Health. 2012;89(5):769-78.
Glasson C, Chapman K, Gander K, Wilson T,
James E. The efficacy of a brief, peer-led nutrition
education intervention in increasing fruit and vegetable
consumption: a wait-list, community-based randomised
controlled trial. Public Health Nutr. 2012;15(7):1318-26.
Hull P, Salmon A, O’Brien J, Chapman K, Williams K. Can
social and community service organisations embrace
tobacco control for their disadvantaged clients? Health
Promot J Aust. 2012;23(3):183-7.
Islam M, Topp L, Conigrave KM, van Beek I, Maher L,
White A, Rodgers C, Day C. The reliability of sensitive
information provided by injecting drug users in a clinical
setting: clinician-administered versus audio computerassisted self-interviewing (ACASI). AIDS Care. 2012;
24(12):1496-503.
Islam M, Topp L, Conigrave K, White A, Reid S, Grummet
S, Haber P, Day C. Linkage into specialist hepatitis C
treatment services of injecting drug users attending a
needle syringe program-based primary healthcare centre.
J Subst Abuse Treatment. 2012;43(4):440-5.
Islam M, Topp L, Day CA, Dawson A, Conigrave KM.
Primary healthcare outlets that target injecting drug users:
opportunity to make services accessible and acceptable to
the target group. Int J Drug Policy. 2012;23(2):109-10.
Islam M, Topp L, Day CA, Dawson A, Conigrave KM.
The accessibility, acceptability, health impact and cost
implications of primary healthcare outlets that target
injecting drug users: a narrative synthesis of literature.
Int J Drug Policy. 2012;23(2):94-102.
Iversen J, Topp L, Wand H, Maher L. Individuallevel syringe coverage among Needle and Syringe
Program attendees in Australia. Drug Alcohol Depend.
2012;122(3):195-200.
Kelly B, Baur LA, Bauman AE, King L, Chapman K,
Smith BJ. Restricting unhealthy food sponsorship:
attitudes of the sporting community. Health Policy.
2012;104(3):288-95.
34
King L, Watson WL, Chapman K, Kelly B, Louie JCY,
Hughes C, Crawford J, Gill TP. Do we provide meaningful
guidance for healthful eating? An investigation into
consumers’ interpretation of frequency consumption
terms. J Nutr Educ and Behav. 2012;44(5):459-63.
Larney S, Topp L, Indig D, O’Driscoll C, Greenberg D.
A cross-sectional survey of prevalence and correlates of
suicidal ideation and attempts in prisoners in New South
Wales, Australia. BMC Public Health. 2012;12:14.
O’Brien J, Bonevski B, Salmon A, Oakes W, Goodger B,
Soewido D. An evaluation of a pilot capacity building
initiative for smoking cessation in social and community
services: the Smoking Care project. Drug Alcohol Rev.
2012;31(5):685-92.
O’Brien J, Salmon A, Penman A. What has fairness
got to do with it? Tackling tobacco among Australia’s
disadvantaged. Drug Alcohol Rev. 2012;31(5):723-6.
Pettigrew S, Roberts M, Chapman K, Quester P, Miller C.
The use of negative themes in television food advertising.
Appetite. 2012;58(2):496-503.
Pettigrew S, Roberts M, Pescud M, Chapman K,
Quester P, Miller C. The extent and nature of alcohol
advertising on Australian television. Drug Alcohol Rev.
2012;31(6):797-802.
Roberts M, Pettigrew S, Chapman K, Miller C, Quester P.
Compliance with children’s television food advertising
regulations in Australia. BMC Public Health. 2012;12:846.
Scully M, Wakefield M, Niven P, Chapman K, Crawford D,
Pratt IS, Baur LA, Flood V, Morley B; NaSSDA Study
Team. Association between food marketing exposure and
adolescents’ food choices and eating behaviors. Appetite.
2012;58(1):1-5.
Topp L. ATS use and risk-taking behaviours.
In: Allsop S, Lee N, editors. Perspectives on
amphetamine-type stimulants. Melbourne: IP
Communications; 2012. p. 69-82.
Wand H, Iversen J, Wilson D, Topp L, Maher L. Developing
and validating a scoring tool for identifying people who
inject drugs at increased risk of hepatitis C virus infection.
BMJ Open. 2012;2(1):e000387.
Wellard L, Glasson C, Chapman K. Fries or a fruit bag?
Investigating the nutritional composition of fast food
children’s meals. Appetite. 2012;58(1):105-10.
Wellard L, Glasson C, Chapman K. Sales of healthy
choices at fast food restaurants in Australia. Health Promot
J Australia. 2012;23(1):37-41.
Cancer Council NSW Research Activity Report 2012 35
Board and committees
Board and committees
Cancer Council NSW
Board of Directors
Mr Bruce Hodgkinson SC (Chair)
Barrister, Denman Chambers
Ms Jill Boehm OAM (Deputy Chair)
Prof Stephen Ackland
Senior Staff Specialist, Medical
Oncology, Calvary Mater
Newcastle Hospital
A/Prof Michael Back
Director, Northern
Sydney Cancer Centre
Prof Reginald Lord AM
Professor and Head,
Gastroesophageal Cancer Research
Program, St Vincent’s Centre for
Applied Medical Research
Mr John Moroney
Consumer Representative
Dr Monica Robotin Medical Director,
Cancer Council NSW
Ms Mary Chiew
CEO, Giorgio Armani Australia
A/Prof Natalka Suchowerska Head, Research and Education
(Medical Physics), Department of
Radiation Oncology, Royal Prince
Alfred Hospital
Mr Paul Lahiff
Consultant
Regina Sutton
CEO, Cancer Council NSW
Mr Stephen Roberts
Consultant
Prof Kate White Professor of Cancer Nursing,
University of Sydney Cancer Nursing
School, Royal Prince Alfred Hospital
Mr Robert Sendt
Consultant and former NSW
Auditor-General
Mr John Stubbs
Executive Director,
CanSpeak Australia
Cancer Council NSW
Ethics Committee
Mr Jim Grainda
Consumer Representative
Dr Monica Robotin
Medical Director,
Cancer Council NSW
A/Prof Freddy Sitas
Director, Cancer Research Division,
Cancer Council NSW
Consumer Reviewers
Mr James Butler (Chair)
Project and STREP panels
Ms Gillian Begbie
Project Grant panel
Ms Jane Bennett
Project Grant panel
Ms Linda Christenson
Project Grant panel
Ms Margaret Johnson
Project Grant panel
Ms Mara Lidums
Project Grant panel
Ms Meghan Carruthers (Chair)
Lawyer, HWL Ebsworth
Mr Dez Maule
Project Grant panel
Ms Melanie Trethowan
Consultant
Dr John Sanders (Deputy Chair),
Layman
Mr Tony Maxwell
Project Grant panel
Cancer Council NSW Cancer
Research Committee
Dr Megan Brock
Religious Representative
Ms Mary Potter
Project Grant panel
Prof Michelle Haber AM (Chair)
Executive Director and Head of
Experimental Therapeutics Program,
Children’s Cancer Institute Australia
for Medical Research
Prof Bill McCarthy AM
Medical Graduate with
Research Experience
Ms Bridget Whelan
Project Grant panel
Prof Mark Baker
Professor of Proteomics,
Macquarie University
Ms Joanne Muller
Lawyer
Reverend John Neasey Religious Representative
Ms Jane Bennett Consumer Representative
Mr Felix Ratcliff Allied Health Professional
Prof Andrew Biankin Professor and Head, Pancreatic
Cancer Research, Garvan Institute
of Medical Research
Dr Monica Robotin
Medical Graduate with
Research Experience
A/Prof Anna DeFazio Head, Gynaecological Oncology
Research Group, Westmead
Millennium Institute for Cancer
Research at Westmead Hospital.
Prof Sandra Jones Professor and Director,
Centre for Health Initiatives,
University of Wollongong
36
Ms Frances Taylor Laywoman
Research Review Committee
Prof Louisa Jorm (Chair)
Research Director, Sax Institute
Ms Gillian Batt
Director, Cancer Information
and Support Services Division,
Cancer Council NSW
Mr Jeff Winter
Project Grant panel
Ms Robyn Bransby
STREP grant panel
Ms Barbara Dawson
STREP grant panel
Mr James Falk
STREP grant panel
Mr John Moroney
STREP grant panel
Ms Jan Mumford
STREP grant panel
Contact
Cancer Research Division
Research Strategy Unit
Cancer Council NSW
PO Box 572
Kings Cross NSW 1340
Cancer Council NSW
PO Box 572
Kings Cross NSW 1340
P: (02) 9334 1837
F: (02) 8302 3550
E: crd@nswcc.org.au
P: (02) 9334 1993
E: research@nswcc.org.au
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© Cancer Council NSW 2013
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