DNA Damage Induced By UVA And UVB In Squamous Cell Carcinoma Progression
Funder
National Health and Medical Research Council
Funding Amount
$65,000.00
Summary
Australia has the highest incidence of skin cancer in the world. This results from immigration of individuals with fair skin to Australia. Skin cancer is three times as common as all other cancers combined. Overall, the incidence of skin cancer continues to rise in Australia and it will be several years before the true effectiveness of preventative programs are known. In the meantime, 1000 Australians die each year from skin cancer. Modern sunscreens, even those with high SPF and labelled as bro ....Australia has the highest incidence of skin cancer in the world. This results from immigration of individuals with fair skin to Australia. Skin cancer is three times as common as all other cancers combined. Overall, the incidence of skin cancer continues to rise in Australia and it will be several years before the true effectiveness of preventative programs are known. In the meantime, 1000 Australians die each year from skin cancer. Modern sunscreens, even those with high SPF and labelled as broad spectrum do not protect very well from UVA, though they are very effective UVB filters. Most sunscreens absorb or reflect only about 50% as much UVA as UVB. Thus sunscreen use alters the spectrum of UV received. This is an important issue, because if sunscreens are used to prolong sun exposure they will selectively increase the amount of UVA reaching the skin, and the sun contains a lot more UVA than UVB. There is only limited evidence to suggest they protect from skin cancer in humans whereas there is good evidence that they protect from precursor lesions. We have developed a new hypothesis, that UVB is primarily responsible for development of preneoplastic lesions (solar keratosis and dysplastic nevi) whereas UVA plays a relatively more important role in their progression to malignancy. This hypothesis would explain why sunscreens are more effective at preventing nevi and solar keratosis formation than they are at preventing melanoma and squamous cell carcinoma. Until the action spectrum defining the wavelengths responsible for skin cancer induction is known, the optimal methods for protection from skin cancer will be difficult if not impossible to design. That different wavelengths may be involved in different phases of skin cancer development in humans is a novel hypothesis: if it is correct it will have profound implications for both the design of sunscreens and our current public health programmes for skin cancer prevention.Read moreRead less
The Role Of Support Services, Diet And Exercise In Alleviate Distress In Women With Ovarian Cancer And Their Partners
Funder
National Health and Medical Research Council
Funding Amount
$304,794.00
Summary
A significant proportion of ovarian cancer patients and their partners experience elevated levels of distress. Determining if particular services, diet or exercise are effective in alleviating this distress will help to inform service provision and clinical practice. This research approaches this issue by firstly evaluating use of psychosocial services, diet and exercise in relation to quality of life, and secondly by piloting a lifestyle intervention for patients and partners with distress.
Prospective Study Of Medical Emergency Team Calls To Define Issues Of End Of Life Decision Making
Funder
National Health and Medical Research Council
Funding Amount
$48,700.00
Summary
A Medical Emergency Team (MET) is a specialised team of doctors and nurses from the Intensive Care Unit who urgently come to patients on the general wards whose medical condition is very unstable. They have to make crucial decisions about their treatment in a very short time. The previous research in this area has been focussed on improving medical outcomes, however it is also apparent that the patients having MET calls are often seriously ill with life limiting illnesses. This study aims to exp ....A Medical Emergency Team (MET) is a specialised team of doctors and nurses from the Intensive Care Unit who urgently come to patients on the general wards whose medical condition is very unstable. They have to make crucial decisions about their treatment in a very short time. The previous research in this area has been focussed on improving medical outcomes, however it is also apparent that the patients having MET calls are often seriously ill with life limiting illnesses. This study aims to explore the broader aspects of care at this time, which are of paramount importance to patients and their families, such as various aspects of communication, particularly focusing on changing goals of care; and also the symptoms that may be causing significant distress for the patient. This project will provide information that will assist development of interventions that will both aim to improve quality of life and also communication in the setting of medical emergencies in patients with life limiting illness.Read moreRead less
An Exploration Of Functional Decline And The Potential For Rehab In Patients With Advanced Non-small Cell Lung Cancer
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
Lung cancer is one of the commonest human cancers and the leading cause of cancer deaths. People with advanced cancer experience significant decline in functional capacity as their disease advances and they approach death. This decline is likely to have significant impact on quality of life. In lung cancer this decline can be exacerbated by chronic illnesses such as chronic obstructive pulmonary disease (COPD). While significant clinical benefits have been demonstrated in COPD patients with the ....Lung cancer is one of the commonest human cancers and the leading cause of cancer deaths. People with advanced cancer experience significant decline in functional capacity as their disease advances and they approach death. This decline is likely to have significant impact on quality of life. In lung cancer this decline can be exacerbated by chronic illnesses such as chronic obstructive pulmonary disease (COPD). While significant clinical benefits have been demonstrated in COPD patients with the introduction of pulmonary rehabilitation, little research has been conducted to either map the functional status of lung cancer patients or to explore the application of pulmonary rehabilitation in this setting. This study seeks to begin a program of work in this area through first exploring the characteristics of functional decline in this group and then assessing the feasibility and acceptability of a rehabilitation program specifically addressing the functional status needs identified.Read moreRead less
Improving QOL At The End Of Life: A Randomised Controlled Trial Of A Doctor-nurse-patient Intervention.
Funder
National Health and Medical Research Council
Funding Amount
$687,655.00
Summary
This project aims to promote mutual understanding between patients with incurable disease, carers and clinicians about prognosis, end of life issues and treatment goals in order to improve the quality of remaining life. Currently many patients do not understand their prognosis and make poor decisions about treatment, receiving costly, futile and invasive treatments just days before death. This project will empower patients and doctors to better discuss these issues.
Patient Preferences For Adjuvant Chemotherapy In Early Breast Cancer: What Makes It Worthwhile?
Funder
National Health and Medical Research Council
Funding Amount
$69,420.00
Summary
Adjuvant chemotherapy, used in addition to surgery and radiation, improves recurrence and survival rates in women with early breast cancer. These gains must be balanced against the side effects and inconvenience of chemotherapy including hair loss, nausea, tiredness and risk of infection. This study will determine the gains considered necessary to make modern adjuvant chemotherapy for early breast cancer worthwhile by asking women who have had such treatment. It will determine factors that might ....Adjuvant chemotherapy, used in addition to surgery and radiation, improves recurrence and survival rates in women with early breast cancer. These gains must be balanced against the side effects and inconvenience of chemotherapy including hair loss, nausea, tiredness and risk of infection. This study will determine the gains considered necessary to make modern adjuvant chemotherapy for early breast cancer worthwhile by asking women who have had such treatment. It will determine factors that might influence the gain considered necessary, such as the kind of treatment, the severity of the side effects experienced, social and other factors. Three hundred women who have had modern adjuvant chemotherapy in an ongoing international clinical trial will be recruited and interviewed. The interviews are standardised, scripted and administered by trained researchers to avoid influencing the subjects. Diagrams and props are used to make the questions clearer. Evaluation of these aids is an additional aspect of the project. This information will be invaluable for women and clinicians considering this potentially curative treatment over the next 15 years. The study will also provide new knowledge on how best to provide information about the benefits of treatment. This can then be applied to discussions about treatment in routine clinical practice. The methods are suitable for a wide range of questions in other diseases and settings. The project will be extended to develop the materials for other questions in breast cancer and other settings.Read moreRead less
SNAC1:A Randomised Trial Of Sentinel Node Based Management Versus Axillary Clearance For Women With Small Breast Cancers
Funder
National Health and Medical Research Council
Funding Amount
$1,338,436.00
Summary
SNAC1 compares two operations for assessing cancer spread to the lymph nodes in women with early breast cancer: 1) axillary clearance and 2)sentinel node biopsy. Axillary clearance involves removal of most lymph nodes in the armpit. In sentinel node biopsy only a few lymph nodes most closely related to the breast cancer are removed. The trial will determine if sentinel node biopsy reduces lymphoedema and gives equivalent cure rates. If it does, then it should become standard practice.
SNAC1:A Randomised Trial Of Sentinel Node Based Management Versus Axillary Clearance For Women With Small Breast Cancers
Funder
National Health and Medical Research Council
Funding Amount
$240,187.00
Summary
Over 13,000 ANZ women are diagnosed with breast cancer each year. Most need surgery to remove the cancer and determine if it has spead to glands in the armpit (axillary lymph nodes). Knowing whether the cancer has spread to the axillary lymph nodes helps determine prognosis and plan treatment. Surgical removal is the most reliable way to assess the axillary lymph nodes. SNAC1 compares two operations for assessing cancer spread to the lymph nodes in women with early breast cancer: 1) axillary cle ....Over 13,000 ANZ women are diagnosed with breast cancer each year. Most need surgery to remove the cancer and determine if it has spead to glands in the armpit (axillary lymph nodes). Knowing whether the cancer has spread to the axillary lymph nodes helps determine prognosis and plan treatment. Surgical removal is the most reliable way to assess the axillary lymph nodes. SNAC1 compares two operations for assessing cancer spread to the lymph nodes in women with early breast cancer: 1) axillary clearance and 2) sentinel node biopsy. Axillary clearance involves removal of most lymph nodes in the armpit. In sentinel node biopsy only a few lymph nodes most closely related to the breast cancer are removed. Axillary clearance is the current standard operation. However, it is associated with risks including infection, pain, stiffness, numbness and lymphoedema (arm swelling). Lymphoedema may occur in 5-50% of women treated for breast cancer and can cause major suffering and disability. In many women their breast cancer has not spread to the lymph nodes, and axillary clearance is unnecessary. Recent studies suggest sentinel node biopsy may provide as much information as axillary clearance. Scans and dye are used to help locate the sentinel nodes. Minimising the amount of surgery to the armpit should reduce the side effects. However, the long term safety and effectiveness of removing only a few nodes is unknown. The trial will determine if sentinel node biopsy reduces lymohoedema and gives equivalent cure rates. If it does, then it should become standard practice. The study complements comparable studies being done in US, UK and Europe by providing unique information about arm symptoms and quality of life. SNAC1 recruited 1,088 women in 4 years. This application is for the work needed to report on outcomes after all women have been followed for 5 years.Read moreRead less
Radiotherapy Vs Chemotherapy For Low-grade Gliomas Stratified For Genetic 1p Loss: Efficacy And Quality Of Life Benefits
Funder
National Health and Medical Research Council
Funding Amount
$410,316.00
Summary
Low-grade glioma is an uncommon malignant brain tumour. Surgery, radiotherapy and chemotherapy delay growth of this tumour, but cure is uncommon. Currently the goal of treatment is to control tumour growth for as long as possible whilst maintaining quality of life. This study compares treatment with radiotherapy with a new form of chemotherapy to see which treatment controls tumour growth most effectively, which produces the least side effects and which results in the better quality of life.