Dedicated to cancer care ~ Featuring our Nursing Unit Manager
Corporate Newsletter ~ Excellence In Cancer Care ~ August 2016 Issue 13
Angela immigrated to Australia with her husband in 1990. Born in the small railway town
of Crewe in Cheshire, England, the untimely loss of a close family member to cancer
Cancer Care Associates
reshaped Angela’s life. After having her two children, she undertook a nursing degree and
oncology training in Townsville Queensland., and following her husband’s posting, she
Incorporating
moved to Sydney. Working initially at Mater Hospital, North Sydney, she increased not
only her skills in Oncology nursing, but also her passion for providing care to cancer
Northern Cancer Institute
Southside Cancer Care Centre
Riverina Cancer Care Centre
patients, and their families. She took up the position of Nursing Unit Manager in SCCC in
2014. Her devotion and commitment to the provision of excellence in cancer care is
reflected in the deservingly positive feedback received over the years from patients, their
families and SCCC staff members. Angela loves the opportunities her work in cancer care
provides in giving back to the community, and she feels most grateful for the support from
the management and her team of dedicated nurses and professionals. Angela continues to
Angela Whittingham
~ Miranda
be a staunch supporter of the Cowboys and Queensland NRL team. Currently, she is
enjoying participating in continuing education, and relaxes by walking her dogs.
From the Chairman’s desk
Hello everyone
Clinical trials in our Centres
continue to facilitate best
outcomes for cancer patients.
This is where we continue to
advance application of latest
research to facilitate best
outcomes for our patients.
The focus for our Clinical Trials Unit
is on advancing cutting-edge applied research in the world, as well as
building a portfolio that caters for the patient population in both urban
and rural regions through our multi-centre approach to research. This
enables our patients to have access to the latest protocols and
therapeutics for various disease in breast, prostate, gynaecological neoplasms, colorectal, head and neck, melanoma, lung, gastro-intestinal,
surgical trials involving breast, HPV-Associated Oropharyngeal Squamous
Cell Carcinoma as well as bladder carcinomas. In tandem with the
application of research required to develop new treatments, studies on
biological substances and psychosocial management have also been
progressed. Phase 2, 3 & 4 Clinical Trials have been conducted as well as
observational, questionnaire-based and psychosocial interventional
studies, some of which are listed in the section alongside .
We have been privileged to put the first patient in Asia Pacific on a trial
for bladder patients, who will receive Keytruda. Our Clinical Trials Unit
continues to be the highest recruiting centre in Australia for an ovarian
trial giving standard chemotherapy and a PARP inhibitor Velaparib or
placebo tablets. A new breast cancer study, in which both men and women will participate is in the planning stages. A global study to determine if
there is any difference in treatment benefit giving Nivolumab every two
or four weeks, on patients with non-small cell lung cancer, will begin in
the near future.
Other research projects are indigenous care provision, survivorship of
prostate, breast, lung, and CRC. The aim of all research undertaken, is to
constantly direct efforts towards improving outcomes for patients.
Finally, I should also mention that our Northern Cancer Care Centre has
been invited by Novartis to host the Global Head of Translational
Oncology.
I would like to express my thanks to staff from all our Centres for their
commitment and dedication to research and patient care.
With best wishes
TONY NOUN
Clinical Trials in-progress
STARS (Breast trial) ~ A randomised comparison of anastrozole
(aromatase inhibitor) commenced before and during adjuvant
radiotherapy for breast cancer versus anastrozole and subsequent
anti-oestrogen therapy delayed until after radiotherapy (STARS Study of Anastrozole and Radiotherapy Sequencing).
BRIGHTER (GI trial) ~ A Phase III Randomized, Double-Blind, Placebo
-Controlled Clinical Trial of BBI608 plus Weekly Paclitaxel vs. Placebo
plus Weekly Paclitaxel in Adult Patients with Advanced, Previously
Treated Gastric and Gastro-Esophageal Junction Adenocarcinoma.
ENZAMET (Urological trial) ~ Randomised phase 3 trial of
enzalutamide in first line androgen deprivation therapy for
metastatic prostate cancer.
POSNOC (Breast trial) ~ Positive Sentinel Node: adjuvant therapy
alone versus adjuvant therapy plus Clearance or axillary
radiotherapy. A randomised controlled trial of axillary treatment in
women with early stage breast cancer who have metastases in one
or two sentinel nodes.
CO-21 (Colon trial) ~ A phase III study of the impact of a physical
activity program on disease-free survival in patients with high risk
stage II or stage III colon cancer.
SNAC2 (Surgical Breast trial) ~ A randomised phase III study to
determine in women with early breast cancer whether sentinel
node based management increases the risk of loco-regional recurrence and in particular, axillary recurrence, compared with axillary
clearance in any subgroup of women.
PASS (Monoclonal Antibody observational study – lung or
melanoma) ~
Pattern of Use and Safety/Effectiveness of Nivolumab in Routine
Oncology Practice.
Follow-up and support
SURVIVORSHIP (Questionnaire) ~ Psycho-social stress in cancer
patients living in rural regions, following their active therapy, with
care not augmented by a formal Cancer Survivorship Care Plan.
Cohort One (Completed active treatment – face-to-face interview)
Cohort Two (Treatment 4-6 years earlier)
National Supportive Care Needs (Questionnaire & Interview) ~ A
national study to quantify the supportive care needs of Indigenous
cancer patients across Australia.
Man Plan ~ A fully flexible, 2 year program to inspire and support
men prescribed Lucrin following diagnosis of prostate cancer, to
manage potential side effects of Lucrin treatment.
Clinical trials approved & awaiting activation
HPV Oropharynx 12.01 – August 2016 ~ A Randomised Trial of
Weekly Cetuximab and Radiation versus Weekly Cisplatin and
Radiation in Good Prognosis Locoregionally Advanced HPVAssociated Oropharyngeal Squamous Cell Carcinoma.
RADIER - 2016 ~ A Randomised phase II trial of Adaptive Image
guided standard or Dose Escalated tumour boost Radiotherapy in
the treatment of transitional cell carcinoma of the bladder.
Innovations : Research facilitating cancer care
New approaches to cancer treatment
From history, CT pioneer Sir Godfrey Hounsfield
Dr Parvin Ataie-Kachoie, Pharmacist SCCC, discusses her research
Continuing the theme of doctors who
pioneered the tools to diagnose and monitor
tumours, we feature, Sir Godfrey Hounsfield
(28 Aug 1919- 12 Aug 2004) who developed
the CAT scan. As the pioneer of the CT scanner,
he is considered one of the greats in the
history of radiology. What makes it most remarkable is that he had no
previous experience in medicine, and prior to this innovation, worked as
an engineer developing computers and radar.
entitled “Monepantel a new first in class
potent inhibitor of
P70S6K potentiates the anti-tumor effects of gemcitabine and
doxorubicin”. As lead researcher of a team including Dr J Akhter
and Prof D Morris from the UNSW, the aim of the research was to
evaluate whether Monepantel (MPL) a new nematode-specific
anthelmintic agent could be combined with clinically approved
chemotherapeutic agents to enhance therapeutic efficacy. The
Dedicated to cancer care ~ Featuring our Nursing Unit Managers
Joanne Asgill ~ Wagga Wagga
Christian Steiner ~ St Leonards
Christian made the transition
Joanne first qualified as a
from Austria to Australia in the
Registered Nurse in 1979
summer of 2004. He came for a
commencing at the Wagga
holiday
Olympic
Wagga Base Hospital. She
games, and says “After my initial
subsequently worked across
adjustment
the Riverina including in a
during
to
the
celebrating
number
Christmas in 40° and with a
of
Hospital
effects of MPL and/or chemotherapeutic agents gemcitabine The youngest of five children of a farmer in Sutton-on-Trent
(Gem)/ doxorubicin (Dox) on the growth of a panel of cancer cell Nottinghamshire, from a very early age Hounsfield was intrigued by
lines were determined using SRB assay. In vitro drug synergy was mechanical and electrical machinery in his farm, and by the age of
determined using combination index methods derived from Chou- eleven, he began constructing electrical recording machines and
launching himself off haystacks with a homemade glider. At school he
Talalay equations using CalcuSyn software. For In vivo studies, the
was only interested in physics and mathematics, and left school at age
effect of MPL was evaluated, alone and in combination with Gem/
16 without any qualifications. His school record card refers to his
Dox on the growth of established human ovarian (OVCAR-3) “intellectual retardation”. He never attended university, and in 1939, at
tumors implanted subcutaneously in BALB/C nude mice. Toxicity the outbreak of World War II he joined the Royal Air Force as a
was evaluated measuring animal weight. In vivo combination volunteer reservist, studied radio mechanics, and worked as a radarmechanic instructor. Post-war, he studied at the Royal College of
effects was determined using Fractional Tumor Volume method.
Science and later at Cranwell Radar School. His work impressed the Air
In vitro, MPL in combination with Gem or Dox synergistically
Vice-Marshall, who obtained a grant for him to attend Faraday House
reduced survival rates of a panel of malignant cells from different
Electrical College in London, from where he received a diploma. In
origins while having no additive effect upon non-malignant cell 1951, he joined the research staff of Electrical and Musical Industries
(HOSE) survival rates. In vivo, antitumor activity was observed in (EMI) at Hayes. He worked on radar and guided weapons, and became
all treatment groups compared to the mock-treated animals after fascinated by the emerging field of computers. In 1958, he led the
4 weeks of treatment. However combination therapy with MPL design team which built Great Britain’s first all-transistor computer,
and chemo-therapeutics significantly attenuated tumor growth, EMIDEC 1100.
barbeque, I decided to stay”. supervisor positions. After more than 20 years of dedicated
Achieving registration to practice as a nurse was not as easy hospital and community base nursing, Joanne made the
though. After completing his training at the 3rd largest campus move to Oncology in 2002, just after the Riverina Cancer Care
compared to monotherapy without showing any toxicity. He later transferred to EMI Central Research Laboratories, and began
Assessment of therapeutic synergy with FTV method revealed work on combining X-Ray tomography and computers to see the inside
of objects, the forerunner of CT scans. He began working on a device
strong synergy in Gem 5 mg/kg + MPL 25 or 50 mg/kg, Gem 2 mg/
that could process hundreds of X-ray beams to obtain a 3D display of
kg + MPL 50 mg/kg and Dox 2 or 5 mg/kg+ MPL 50 mg/kg treatthe inside of a living organism. Combining computer and X-ray
ment groups. These findings provide a rationale to investigate MPL technology, and practicing on the brain of a cow, he evolved a machine
in combination with standard chemotherapeutics as that could produce detailed images of cross-sections of the brain in four
novel combination regimens which could hopefully provide strong and a half minutes. It was his work on pattern recognition and the use
of computers to analyse readings that made the invention of CAT a
anticancer synergy.
reality. In the words of Allen Lester, editor of the Journal of CAT,
“Hounsfield’s fundamental contribution was in the reconstruction
algorithm for CT…he figured out how to reform the multiple
Latest publications in cancer research facilitating Clinical Trials
projections of CT data into a coherent image”. In 1971, the first medical
CT scan was performed on a 41-year old woman at the Atkinson Morley
Pagani, O, Regan, MM & Francis, PA (2016) Are SOFT and TEXT Hospital in Wimbledon, London. It could only scan the brain and
revealed a cystic tumour. Eventually whole body CT scans were available
results practice changing and how? The Breast, 27, 122e125
from 1975. Unknown to Hounsfield, a South African nuclear physicist,
Ribi, K et al. (May 2016) Adjuvant Tamoxifen plus Ovarian Function Allan Cormack had worked on the same aspect of computerized
imaging, proposing in 1957 a reconstruction technique called Radon
Suppression versus Tamoxifen alone in premenopausal women
transform. Although Cormack’s work was not widely circulated, and he
with early breast cancer: Patient-reported outcomes in the
and Hounsfield had never met, in 1979 both shared the Nobel Prize in
Suppression of Ovarian Function Trial, Journal of Clinical Oncology
Physiology / Medicine for the development of computerized
34 (14)
tomography. Among many honours, Hounsfield was knighted in 1981.
Sir Hounsfield’s name is used today as the unit to measure and quantify
We gratefully acknowledge:
the radio-density of structures, evaluated in CT scans, the Hounsfield
 Dr Phil Norrie, Radiopaedia.org, Telegraph Media Group, & Scale defined in Hounsfield Units going from air at 1000 HU to water at
Ivan Oransky-The Lancet, for the article on Sir Godfrey 0 HU and through to the most dense cortical bone at +1000 HU. While
Hounsfield ~ Cancer doctor from history;
millions have benefited through better pain-free diagnosis, modern
 All staff at CCA, NCI SL-FF, RCCC, SCCC, THN & UTS for their
scanners have few features that were not envisaged by Sir Hounsfield.
contributions and invaluable support.
at St Leonards, uplifts me and inspires me to achieve the best unwavering dedication and respect ultimately led to her
results for anybody who may need our service.”
promotion through to Director of Nursing. Joanne’s main
hospital in Austria, he came here with nothing more than a Centre (RCCC) opened. Joanne was initially appointed as the
dream and the good wishes of his friends and family. It took Specialist Radiotherapy Nurse where she spent her first three
Christian five months to finally get registered and employed by years providing exceptional support and care to our Radiothe Royal North Shore Hospital, where he received training in therapy patients. Already a well-respected and experienced
oncology nursing, as well as at the College of Nursing, from nurse within the Riverina before arriving at the RCCC, Joanne
where he completed the post-graduate certificate in oncology quickly gained the respected of the entire RCCC team
nursing. After several years of working at the Royal North through the level of dedication shown to cancer patients on a
Shore Hospital, he was given the opportunity to apply for the daily basis. During this time consistent patient feedback was
position of Nursing Unit Manager at the NCI. He says “Assisting received regarding her kind and caring nature together with
in providing a safe and efficient work space for all my the great service she provided.
colleagues and staff gives me great joy…working together with Joanne made the move to Chemotherapy in 2005 and rapidly
such a knowledgeable, passionate and hard working group here became an outstanding Chemotherapy nurse. Her
Christian enjoys reading a good book at the
drive as an Oncology Nurse is to ensure regional cancer
beach or just watching the world go by from
patients achieve the best possible care and support.
the vantage point of a coffee shop, …stretching
addition to her passion for ensuring the cancer patient
out in front of an open fire place or a camp fire
journey is well supported, Joanne now has two grandchildren
when out and about.
to focus on. After more than 14 years of absolute dedication
… loving Australia!
Lisa Holland ~ Frenchs Forest
In
to cancer patients and the RCCC, Joanne is stepping back just
a little, to spend time with her beautiful grandchildren.
Lisa Holland, our Nursing Unit Manager from NCI, has been dedicated to patient care for more
than two decades. As a teen, endowed with a keen artistic aptitude, she decided to study
architecture. However, soon found her call in Nursing, she says “I guess it was the right move
as I’m still doing nursing 30 years later!”. Lisa worked in Cardiac and Bone Marrow Transplant
at St Vincents Hospital, and in 1990s moved to work in Boston Massachusetts. She spent
twenty years at Mater Hospital, mostly in chemotherapy, and joined NCI clinical trials in 2010.
She soon took up the position of NUM at NCI Frenchs Forest.
Lisa says “I love working in an organisation where everyone knows everyone else, and feel you
can really live our mission of excellent care, and make a difference each day. I am excited about
the future developments for the Frenchs Forest based Cancer Centre”. Her hobbies include slow cooking, rugby, reading and
stand-up boarding. She lives in the Northern beaches with her husband, two sons, and dog, Roxy. She is a regular at the South
Curly sea pool and an active member of the South Curl Curl Surf Club.