This research will investigate spiritual well-being concepts and practices in New Zealand palliative cancer care. Mr Egan, is supervised by University of Otago's Professor of Palliative Care, Rod MacLeod. Egan suggests spirituality is associated with all levels of health and well-being and attending to it at the end of life is as important as good pain relief. The research will survey and interview key populations (staff, patients and family) associated with hospice facilities. Research outcomes will include the development of resources for staff who wish to enhance their work with people who are dying.
The development of new blood vessels is essential to support the growth and spread of tumour cells. Ms Gunningham will investigate the hypothesis that a novel receptor involved in the growth of blood vessels, Neuropilin-1, is particularly associated with the spread of tumour cells to other sites. The possibility that a soluble form of Neuropilin-1, that is antagonistic to this process, is significantly reduced in precancerous colorectal disease will also be studied. Understanding the functional mechanisms by which this occurs is a necessary first step to being able to target this process and design predictive tests for cancer.
An increasing number of cancer treatments are targeting the tumour's blood supply. When developing new drug schedules it is not always clear which dose works well and whether the drug truly works as a result of an effect on blood flow. There is international interest in developing a marker of the effect of therapy on tumour blood flow - such a marker needs to be simple and reliable. This study is designed to validate such a marker of antivascular effect in the context of a known vascular targeting treatment.
A male patient diagnosed with acute lymphoblastic leukaemia (ALL) presented with a novel chromosomal abnormality in his leukaemic cells. This investigation will characterise the genetic consequences of this abnormality at a molecular level. Dt Gough will then study other ALL patients so that we can determine how frequently this genetic change occurs and its clinical significance. This information is important because the genetic basis of as many as 50% of ALLs is still unknown. Genetic changes in leukaemia are essential indicators for accurate diagnosis, prognosis and appropriate treatment strategies. They are also potential targets for more specific and less toxic therapies.
The incidence of breast cancer in New Zealand is approximately 1 in 12 women with the highest incidence occurring in women over 50. Although the likelihood of breast cancer increases with age, the incidence is increasing over all ages. Breast cancer may be treated by chemotherapy if recognised early and after removal of the affected breast. The cure rate for this type of treatment is approximately 50%. However, 50% of the failure rate is attributed to drug resistance. This research will explore the mechanisms responsible for drug resistance so that more effective treatment regimes can be developed.
Oligodendrogliomas are a sub type of brain tumour. Treatment usually involves surgery often followed by radiation therapy. More recently this specific type of tumour has been shown in Canada and the USA to be sensitive to chemotherapy. The studies overseas have shown that the oligodendroglioma tumours which responded to chemotherapy all contained a specific genetic change. This study will look for the first time at whether patients in New Zealand, with a diagnosis of oligodendroglioma, also have the specific genetic change in the tumour. This will potentially provide information to help guide future patients' in their treatment decisions.
Palliative care is rapidly developing into a specialist field. In order to provide the best quality of life for people in the final stages of cancer, specialist training is required. A grant from the Genesis Oncology Trust will be used to provide general medical practitioners with six months training in palliative care medicine at the Mary Potter Hospice in Wellington.
In New Zealand, one in every 12 women will develop breast cancer and the incidence is increasing. Chemotherapy has been shown to reduce the relative risk of recurrence after surgery by 30% and can produce responses in 50% of patients with metastatic breast cancer. However, the development of drug resistance is responsible for the failure of chemotherapy in 50% of patients. This grant will be used to investigate the causes of the development of drug resistance so that more effective treatments can be developed.
Many palliative care patients are prescribed morphine to help relieve the symptoms of pain and breathlessness. The grant will fund the printing of an information leaflet "About Morphine" that will help patient's understanding of their Morphine use. It explains in a simple, clear way, how long-acting and rapid-acting Morphine work and provides answers to concerns people have about Morphine. It is designed as a teaching resource for nursing and medical staff to use when commencing a patient on Morphine, and as a guide for patients family/whanau at home.
Tumours are complex biological structures, in large part because of their disorganised blood supply. This leads to marked regional differences in cellular properties and response to treatment. Using computer-controlled microscopes it is now possible to map these features over distances large enough to investigate the relationships between blood supply, gene expression and response to anticancer agents. The grant will be used to modify an existing microscope by adding a computer-controlled x-y stage, making is possible to generate such maps for tumour tissue. This is a key research tool for development of new anticancer agents in the Auckland Cancer Society Research Centre.
To support a one year fellowship with the Department of Endocrine and Metabolic Surgery at the University Hospital (Hopital Claude Huriez) in Lille, France. Dr Cranshaw will then return to New Zealand.
To attend the 8th Australian Palliative Care Conference in Sydney , August /Sept 2005
To attend the 6th World Congress on Melanoma being held in Vancouver, BC, Canada on September 6-10, 2005.
To Attend the International Neuropsychological Society conference Dublin, Ireland on 6th - 9th July 2005 and to visit Paediatric Oncology units in London and Dublin.