Current Studies

Lead investigators: Professor Andrew Lloyd, Professor David Goldstein and Dr Barbara Bennett .

Based on two decades of clinical research and treatment development for patients with chronic fatigue states by Professor Lloyd, this group has established a multi-disciplinary treatment program for patients with post-cancer fatigue, based in the Lifestyle Clinic. The Fatigue Clinic program incorporates cognitive-behavioural therapy including graded exercise therapy, which has been successfully piloted and evaluated. With funding from Cancer Australia’s Priority-driven Collaborative Cancer Research Scheme, a randomised controlled trial (the TOPS trial) is currently evaluating the effectiveness of the treatment, and developing protocols and training materials to implement the program more widely. Dr Bennett also currently holds a Fellowship from the National Breast Cancer Foundation under which she has developed a structured clinical interview to enable more reliable evaluation of patients with cancer-related fatigue; this is now being implemented in the TOPS trial (link).

This clinical service also provides a platform for research studies of the pathophysiology of post-cancer fatigue (and other comparable fatigue states such as post-infective fatigue) including studies of autonomic activity, cognitive performance, and sleep-wake cycle disturbances. These studies are conducted in collaboration with A/Prof Ute Vollmer-Conna from the School of Psychiatry with funding from the Mason Foundation.

Lead investigators: Dr Fiona Naumann, Mr Chris Tzar, Ms Carolina Sandler.

Utilising the expertise of the UNSW Medicine Lifestyle Clinic, a number of research studies related to exercise and cancer are underway, both originating at the centre and collaborative studies with other research groups. This research is exploring the feasibility and optimum dose of exercise in people with cancer, the role of exercise in survivorship and novel methods of exercise program delivery including online resources. .

Lead investigators: Professor David Goldstein, Professor Matthew Kiernan, Dr Susanna Park and Professor Michael Friedlander.

Based upon the established expertise of Professor Matthew Kiernan in neurophysiological changes underpinning peripheral nerve damage, this project is investigating the mechanisms of the chemotherapy agents oxaliplatin and paclitaxel-related neurotoxicity which are significant causes of both early and delayed toxicity. The objectives are twofold: firstly to identify which patients are more likely to develop long term neurotoxicity so that treatment can be stopped earlier, and secondly, to develop pharmacological means to prevent or reduce neurotoxic injuries during cancer treatment. This is now being tested in an NHMRC funded randomized trial of a neuroprotective agent. Additional studies are now underway to search for predictive genetic polymorphisms and to trial potential interventions, in collaboration with the Lifestyle Clinic, guided by early identification of those at risk. 

Chemotherapy-induced peripheral neuropathy (CIPN) is a major side effect of commonly used cancer treatments.  It can lead to long-term functional disability and reduced quality of life, but at present there is no effective treatment or cure.

The IN FOCUS research project is working towards finding effective assessment and treatment strategies for CIPN. Our research program is investigating the disorder from a variety of angles, including:

-  assessing the functional impact of CIPN on people who are undergoing or who have completed chemotherapy treatment.

-  evaluating an exercise training program as a treatment for CIPN.

-  investigating the impact of CIPN in Australia via a national survey.

- research aiming to improve the accuracy and sensitivity of CIPN assessment.

- identifying risk factors for developing the condition.

- a clinical trial of a drug treatment for CIPN.

If you would like more information, or if you are interested in taking part in our research, please contact us at in_focus@unsw.edu.au

Depending on the type of tumor, between 40% and 100% of cancer patients will experience some sort of sexual dysfunction during their cancer journey. This can have a wide ranging and long lasting effect on physical functioning, mental wellbeing, and relationship health, and has been shown to affect both patients and their partners.

Rekindle is a study being run by the University of Sydney and Cancer Council NSW, which aims to help patients and partners who have been through a cancer experience overcome and adapt to changes in their sex life. 

The resource provides practical information, testimony from experts and real cancer survivors, as well as interactive activities and a little bit of homework to try.  All of this is done through a program tailored to your individual background and the unmet needs which you identify as important, so that the information you receive is specific and relevant to you.  Rekindle can be completed at your own pace, in the privacy of your home and with or without the involvement of a partner.

A sample of some of Rekindle’s content is located on www.rekindleonline.org.au as well as a page to sign up for the study.  To be eligible, you must be over 18, currently living in Australia, and either a partner or patient, who has completed their primary cancer treatment (i.e. surgery, chemotherapy or radiotherapy) at least six months ago.  If you have any questions, please contact us via:

Email:  rekindle@nswcc.org.au

 

With regard to the immediate effects of a cancer diagnosis and its treatment, the Centre conducts specialist survivorship consultations for adult patients on completion of cancer treatment. This consultation contains both clinical and psycho-educational components and aims to identify both the immediate, and the potential late, complications relevant to each individual survivor. During this consultation an individualised “Cancer Treatment Summary and Survivorship Care Plan” is developed and shared with both the survivor and each of the clinicians involved in his or her care. This tool outlines tumour and treatment details, and contains recommendations for both cancer specific follow-up and lifestyle modifications to improve future health. The plan is intended to empower survivors with the knowledge to become the drivers of their own health care.

The NCCS will use the platform of the survivors clinic to systematically evaluate the impact of these Care Plans on outcomes including patient knowledge, adherence to recommended follow-up, self-efficacy, mood and anxiety, and quality of life.

Some people have problems with a profound lack of energy (fatigue) after finishing cancer treatment - known as post-cancer fatigue. They also commonly have difficulties in concentration, sleep disturbance, and low mood. The experts in the Lifestyle Clinic have developed a management program for people with post-cancer fatigue, which is now being evaluated in the TOPS Trial.

The program has several elements, including a physical component provided by an exercise physiologist:

  • Activity pacing – that is helping to balance day-to-day activity levels in relation to fatigue and other symptoms; and
  • Graded exercise – a slowly increasing activity plan to improve capacity to manage day-to-day tasks.

The program also has a mental and emotional component, provided by a clinical psychologist, including:

  • Assistance with memory, and concentration difficulties;
  • Management of sleep disturbances; and 
  • Help with anxiety, mood and coping issues.

What does the Trial involve?

As it is not yet known whether this treatment will benefit people with post-cancer fatigue, those eligible for the TOPS Trial will be randomly allocated to receive the treatment via an ‘education’ approach or a more intensive ‘clinical intervention.’

Who can participate?

People who have completed adjuvant treatment (chemotherapy, radiotherapy and/or hormonal treatment) for breast or bowel cancer, more than 3 months but less than 12 months ago, who have unexplained fatigue reducing their activity levels.

Lead investigators: Prof Andrew Lloyd, Prof David Goldstein, A/Prof Claire Vajdic, Dr Efty Stavrou, Dr Kate Webber.

A data linkage study is underway utilising the 45 and Up Study cohort of 250,000 individuals in NSW, to examine health and psychosocial outcomes of participants identified at baseline as having a prior diagnosis of cancer (cancer survivors) in comparison to an age and sex-matched control group. Outcomes of interest will include: second malignancies (or incident malignancies in control group); premature mortality; lifestyle behaviours; co-morbidities; and employment, as well as the financial costs associated with a cancer diagnosis.

Participants for this study have already been recruited. No further participants are required.

Lead investigators: Professor Andrew Lloyd, Professor David Goldstein, A/Prof Ute Vollmer-Conna, Dr Kate Webber.

After finishing active cancer treatment, survivors commonly experience fatigue, mood disturbance, and cognitive impairment that sometimes persist and cause significant disability. Previous research by Professor Lloyd in relation to acute infection and post-infective sequelae has demonstrated genetic polymorphisms which are associated with these illness manifestations, including in immunological and neurobehavioural host response pathways. This project will evaluate genetic polymorphisms associated with fatigue, mood disorders, and cognitive impairment after cancer therapy. This study is part of the PhD program of Dr Kate Webber, who is funded by a scholarship from the Ride for Life Foundation. .

Participants for this study have already been recruited. No further participants are required.

Lead investigators: Professor Afaf Girgis, Professor David Goldstein, Dr Kate Webber.

A survey of approximately 600 adult cancer survivors who originally received cancer treatment in five Sydney teaching hospitals is in progress to better understand the aspects of survivorship care that they are currently receiving, and the areas which they feel are not being adequately addressed. Survivors will also report on their preferences for follow-up care. This information will inform the development of services better able to meet the long-term needs of this group.

This cohort includes 3,000 survivors treated from 1980-2006. Survivors have provided DNA and health information for studies into late mortality, second cancers and genes that predict the risk of severe late effects. 10) Metabolic syndrome after cancer: These studies are documenting the incidence and risk factors for the development of metabolic syndrome in a longitudinal study to analyse changes in patients’ metabolic parameters. The laboratory studies include investigations of possible pathogenetic pathways of metabolic syndrome. In collaboration with the Lifestyle Clinic the benefits of an exercise intervention to decrease the risk of premature cardiovascular disease is being evaluated.

Participants for this study have already been recruited. No further participants are required.

Childhood cancer survivors have a significantly increased risk of both melanoma and non-melanoma skin cancers. This project is assessing: the sun exposure and sun protection behaviours and attitudes among survivors of childhood cancer; lifestyle behaviours survivors would be willing to ‘trade off’ in order to reduce their risk; survivors’ preferences for the delivery mode of behavioural interventions; and the efficacy of a video-based psycho-educational intervention delivered via YouTube.

Participants for this study have already been recruited. No further participants are required.

This research focuses on strategies to optimise the nutritional intake of childhood cancer patients from diagnosis to survival, looking at diet interventions, enteral feeding and related issues in bone marrow transplant recipients. The project will test the efficacy of the ENeRgy-KIDS program in improving dietary quality and eating behaviours in paediatric patients who have recently completed treatment for cancer; and evaluate the feasibility, cost and acceptability of the ENeRgy-Kids intervention.

 

 

Testimonials

"At first a felt a bit funny about talking to a lady about my problems after my cancer treatment, but my doctor is really nice and really understanding.  Plus she is an oncologist so she understands all the medical stuff that goes along with cancer treatment so I didn't have to explain things to her the way I did to my GP.  I felt like she really understood where I was coming from and gave me some good strategies to help with my issues.  And she wrote a care plan and sent a copy to my GP as well, so hopefully now when I go to see him he will feel like he is better able to treat me."

Anthony, prostate cancer survivor
"At 26 I was diagnosed with a rare form of ovarian cancer... having survived this (thanks to a great medical team), I ‘floundered’ for many years with the resulting impact of early menopause, fertility issues and general fatigue. Even worse, I felt extreme guilt that I should be able to overcome these issues easily as I survived when others didn’t, I really didn’t have the right to ever complain again. This impacted directly on my confidence, self esteem and identity. ……I am now 46, have 2 children, a partner, a career and a good life.  However, the struggle I had undergone, in pretty much isolation, has been hard.  Even friends and family who were great during treatment felt I should ‘just move on’.  The establishment of this centre is a great comfort as it shows there is now a greater awareness of cancer survivor issues to hopefully ensure better long term support for people who have had cancer."

Melinda, ovarian cancer survivor 
"I am aware of the National Centre for Cancer Survivorship and support them in their mission to find new and better ways to care for cancer survivors through research. With the high number of Australians now surviving cancer or living with ongoing cancer for many years, we need to better understand the health issues confronting this group and develop interventions to address their unique and often complex needs. As someone who has worked in the medical oncology setting for 20 years, I believe the National Centre for Cancer Survivorship is leading the way in this work."

Dr Elizabeth Hovey, MB BS FRACP MSC - Medical Oncologist, SESIAHS & UNSW, Prince of Wales Hospital
"As Director of the Kids Cancer Centre, Sydney Children’s Hospital and Professor of Paediatrics at the University of NSW, I have watched the development of the National Centre for Cancer Survivorship over the last few years. I strongly support the opportunity the Centre provides to bring together research focusing on survivors of childhood cancer with that focusing on adult survivors. In both areas it is clear that there are many unresolved challenges in understanding the health care needs of cancer survivors, and developing best practice interventions for both prevention and treatment of those problems. I believe wholeheartedly that the work that being undertaken through the Centre will benefit both kids and adult survivors people for many years to come."

Professor Glenn Marshall, AM, MB, BS, FRACP, MD Paediatric Haematologist & Oncologist, Director, Kids Cancer Centre, Sydney Children’s Hospital