Research Insights January 2013

ResearchInsights Issue 20 | January 2013

In this special edition of ResearchInsights we’ve pulled together some of the most exciting results our Cancer Council NSW researchers have released over the last year. From genetic breakthroughs to better cervical cancer tests, every study brings us closer to understanding and defeating cancer.

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

Complementary and lifestyle therapy use by long-term prostate cancer survivors Lead: Sam Egger

Cancer Council NSW researchers have found that a quarter of longterm prostate cancer survivors use complementary and lifestyle therapies (CALTs), such as dietary supplements, meditation, prayer, diet and exercise changes for their prostate cancer. CALT users are more likely to be either: • anxious about their disease, or • confident they can control their cancer.

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

Contents Colorectal cancer

2 Finding out why aboriginal mortality rate is so high

Pancreatic cancer

2 Personalised medicine may be the key to treatment

Cervical cancer

3 Three insights arising from our research

CLEAR Study

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

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

A method to project prevalence by phase of care for prostate cancer Lead: Xue Qin Yu

The number of NSW men living with prostate cancer is expected to double over the next five years. This statistic is not as alarming as it first appears though it does have a significant impact on the NSW health system.

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The growth in the numbers of men living with prostate cancer in NSW arises for three reasons: • we have a growing aged population, • diagnosis rates are increasing, • the five year survival rate has risen to 92%, so more men are living with prostate cancer.

This research

insight provides the NSW health system with a little time to respond to the demands that will be placed upon it by the growing number of long-term prostate cancer survivors and those who will require continued monitoring.

ResearchInsights | Issue 20 | January 2013

Special edition — research insights

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

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

Disparity in survival between Aboriginal and non-Aboriginal people with colorectal cancer in NSW Lead: Kristie Weir

Cancer Council NSW is a leader in research into cancer among Aboriginal and Torres Strait Islander people.

Recent results presented by the APOCC team found that Aboriginal people with colorectal cancer were twice as likely to die from it within five years of diagnosis,

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

This breakthrough was discovered

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

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

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

Once the genetic code of their

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tumour was understood, several study participants were put on different medications that focus on specific genes.

Pancreatic cancer is one of the most difficult to treat cancers with the lowest survival rate of any major cancer, and the survival rate has only barely improved

over the last 50 years.

Cancer Council NSW was a seed funder for this research with a commitment of $5 million. The project has since gone on to leverage an additional $62.5 million in funding for pancreatic cancer research, which has led to their successful bid to be part of the International Cancer Genome Consortium.

This research will dramatically improve our understanding of pancreatic cancer and hopefully lead to better, personalised treatments for this difficult-to-treat cancer. Importantly, it will also help the families of those affected by pancreatic cancer, as it will help their clinicians find out whether they are also carrying genes that might increase their risk of cancer.

ResearchInsights | Issue 20 | January 2013

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

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Possibly the most important discovery was that an existing test could be used as a cheaper and more effective check for women following treatment for pre-cancer of the cervix.

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

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

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

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

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The research group also performed two studies about cervical screening in migrant women. The first found that migrant women from Asian and MiddleEastern countries are less likely to participate in cervical screening.

However, the second study found that most (but not all) groups of migrant women experienced a reduction in cervical cancer due to screening. Together, the findings reinforce the importance of addressing barriers to screening in migrant groups.

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The modelling team has estimated just how much it costs to screen for cervical cancer in the Australian program using the current methods. This has revealed that it cost $195 million in 2010, with half of this cost coming from routine screening tests.

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

ResearchInsights | Issue 20 | January 2013

Special edition — research insights

Creating the resource to enable future breakthroughs are available for 4,711 cases and 1,260 controls.

Samples and data are also available for less common cancers.

We expect that these will be sought after for collaborative studies on those cancer types where it is very difficult to collect sufficient numbers for research, either because the cancers are very rare or the survival rate is very low.

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

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

Researchers who are preparing grant applications for funding may soon apply to use our precious resource.

They can apply for in principle approval for data or blood samples, and approval will be granted provided their project idea has scientific merit and is related to cancer causes or outcomes.

At December 2012, the study had

Male Data Colorectal Prostate Breast

Male Bloods

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

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

Female Data

Female Bloods

Total Case/ Control

Total Bloods

468

337

368

265

836

602

1040

832

N/A

N/A

1040

832

10

8

1667

1270

1675

1278

Melanoma

247

180

276

178

523

358

Controls

872

583

969

677

1841

1260

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

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

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Join a research study NOW!

Title

Register your interest to be included on our Study Mailing List.

Your story or the story of someone you know will help us find the answers.

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

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

I know someone with cancer who might like to be in the

First Name

Address

Town Postcode Email*

CLEAR Study. Please send me a brochure.

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

You can also register at cancercouncil.com.au/joinastudy

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

Reply Paid 79819 Potts Point NSW 1335

CAN2030 01/13

Help us beat cancer

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