Breast Cancer Researcher Honoured with Order of Australia

Breast Cancer Researcher Honoured with Order of Australia

Medical oncologist and founder of Breast Cancer Research Centre-WA (BCRC-WA), Professor Arlene Chan, was awarded a Member of the Order (AM) of Australia as part of the Queen’s Birthday Honours list this year for her services to oncology, particularly breast cancer treatment.

The Order of Australia is the principal and most prestigious means of recognising outstanding members of the community who have benefitted their communities, and ultimately their country.
This is certainly the case with Professor Chan, who has cared for more than 4000 women with breast cancer, including many metastatic patients some of whom are now cured because of their involvement in clinical research that’s the result of evidence based clinical trials.

A breast cancer specific oncologist since 1999, Professor Chan is also an adjunct professor at the School of Medicine at Curtin University, and the Director of the Breast Clinical Trials Unit (BCTU) and Vice-Chair of BCRC-WA, at Hollywood Private Hospital.

She has been the principal investigator of more than 90 breast cancer trials and advises for several pharmaceutical companies involved in breast cancer treatments. Professor Chan has also authored more than 150 publications and spoken at approximately 160 local, national and international breast cancer meetings.

Her areas of interest include clinical research in understanding biological determinants of therapeutic response, optimising symptomatic care in early and advanced breast cancer, and developing data collection systems for clinical research and measuring patient outcomes.

Through BCTU, Professor Chan conducts numerous clinical trials to investigate new and better ways to treat breast cancer. Clinical trials are the only way to find out which new approaches to cancer treatment work better than existing ones and are crucial to finding a cure for breast disease.

Clinical trials are therefore vitally important and they have many benefits. Firstly, they can uncover new and better ways to treat breast cancer. Secondly, patients who participate in trials get access to the most up to date treatments often years before they’re available to the market. This can mean saving a person’s life or giving them more years of life than what they would have had without the trial treatment. Thirdly, participation in the trials is free; there is no cost to patients.

Of the 90 clinical trials Professor Chan has overseen, 13 have had an important practice changing impact on the care of breast cancer patients worldwide. A true pioneer in breast cancer research, Professor Chan’s work has added to the understanding and treatment of breast cancer globally and she regularly collaborates with experts from all over the world.

An area Professor Chan is particularly passionate about is increasing the quality of life for breast cancer patients and their families. This is demonstrated clearly by her involvement in clinical trials on a pro-bono basis. The funding she receives from pharmaceutical companies for whom she conducts the trials, is channelled back into BCRC-WA’s operating costs. This means that any donations we receive can be put fully towards support services for patients, their families and loved ones.

Family support is a subject close to Professor Chan’s heart, as she firmly believes patient care and wellbeing while undergoing treatment is critical to recovery, as it lessens patient stress and stress upon families.

This belief has been the driver for a dedicated new breast cancer facility for patients and their families that BCRC-WA will open in 2020.

The new centre, to be located at Hollywood Private Hospital in Perth, Western Australia, will continue to conduct research and provide first class treatment, but it will also offer an extended range of support services accentuating the level of care that patients and their families can access.

Currently, if you are a breast cancer patient, you have no option but to go all over Perth to access various services and medical professionals. This can be time consuming, stressful and inefficient, not to mention frustrating for patients when they have to repeat their story over and again to different doctors.

At the new centre, patients will be assigned a breast cancer nurse who will coordinate their care and treatment. The nurse will guide patients seamlessly through each health and medical discipline and provide an expedited process, lessening patient distress.

When a patient has finished a course of treatment, they need to adjust back to normal life, to ongoing follow-up appointments and to the consequences of their treatment. At the new centre, a team of people will already have been assigned to the patient by this stage and will help them at every step with their survivorship. The same people, those they now trust, will take them through the entire process.

BCRC-WA’s new centre will be a Western Australian first and will enable us to provide a coordinated approach to patient care where allied health workers and clinicians will be able to work together in one central place.

Together with Professor Chan, BCRC-WA is having a significant impact on the treatment of breast cancer and is seeing higher cure rates and increasing survival rates. WA is fortunate to have a pioneer of breast cancer research – who is also now a Member of the Order of Australia – making such a marked difference to the lives of many.

If you would like to know more about the planned new centre or how you or your organisation can become involved, please contact our office on (08) 6500 5501.

Thought Leadership article #2, published in Business News, 4 November 2018
By Carmelo Arto

BCRC-WA is Reshaping the Future of Breast Cancer Treatment

Thought Leadership article #1, published in Business News, 4 Oct 2018
By Carmelo Arto

 

There’s a lot of talk in the media about breast cancer with many charities devoted to its causes and treatment. We know of celebrities who have been affected by breast cancer and most people these days have either been touched by the disease personally or they know a family member or friend who has been diagnosed with it.

The facts are the incidence of breast cancer is increasing due to the very effective public awareness campaigns over the past decade encouraging early detection. However, death rates of breast cancer are decreasing because of the significant impact of research.

To illustrate the impact and potential power of research, consider this: if you were diagnosed with breast cancer 20 years ago, there was a 5 year survival rate of around 73% to 75%. Today, this rate is sitting at 92%. This increase is due to research which is finding new and better ways of treatment.

At Breast Cancer Research Centre-WA, located at Hollywood Private Hospital, we conduct clinical trials to help us investigate new ways to fight breast cancer.

We are the biggest breast cancer research unit in Australia and currently we have 17 globally significant research projects on the go. We are significant players in the breast cancer space in world terms and 13 of our projects have influenced breast cancer treatment worldwide.

When we conduct clinical trials, not only do they give us the opportunity to investigate new drugs and treatments, they also importantly enable us to give patients access to treatment several years earlier than if they were to wait for that drug to receive regulatory approval. Obviously, this can be life-saving but equally so, it can greatly improve the quality of a person’s life and that of their loved ones caring for them.

All trials conducted at BCRC-WA are overseen by Professor Arlene Chan AC, a world-renowned breast cancer researcher and medical oncologist.

Professor Chan treats patients in her own practice but also spends approximately a third of her time overseeing clinical trials. Pharmaceutical companies pay for these trials to be undertaken but because Professor Chan opts to undertake these trials on a pro-bono basis, all funds received go back to BCRC-WA to fund patient services such as breast cancer nurses and oncology fellows.

Some of our current trials are investigating the impact of exercise on breast cancer treatment; scalp cooling to reduce hair loss while undergoing chemotherapy and the impact of a breast cancer diagnosis on offspring as well as the economic, social and psychological impact on breast cancer patients and their families.

The scientific merit, operational feasibility, methodology and originality of each potential trial is assessed, and due consideration is always given to how a trial will benefit not only our own patients but how it will add to the understanding and treatment of breast cancer worldwide.

Apart from multi-centre trials for pharmaceutical companies or collaborative research groups, BCRC-WA also conducts and initiates its own research. These are called ‘investigator-led trials’ and they are often performed to answer a clinical question or address clinical needs important to patients.

While early stage breast cancer is the chief focus of most researchers internationally, at BCRC-WA we direct more than half our research – 57% – into metastatic, or advanced cancer, where the breast cancer has metastasised in another part of the body, such as the brain or bones. Finding a cure for metastatic breast cancer drives our research at BCRC-WA.
Women diagnosed with metastatic breast cancer have the odds stacked against them however, access to trial treatments is helping women defy their predicted life expectancy.

For many years, the average life expectancy for a patient with a metastatic diagnosis was around 2 to 3 years. Now we’re seeing 15% of our patients living beyond 5 years, and 5% are still going strong after 10 years.

By allowing patients to participate in clinical trials, they can gain access to treatments that are not only at no cost (to them), but also sometimes 10 years earlier than if they had to wait for the treatments to come onto the market.

Next year, BCRC-WA plans to open a comprehensive breast cancer centre where we can continue to treat patients and conduct our research and trials, but we’ll also be able to offer a range of support services to breast cancer patients and their loved ones. At the moment, patients are forced to go from one specialist to another and from one support service provider to another in different locations all over Perth. Having a range of services together under one roof will be far more convenient for patients, lessening their stress and that of their families which will contribute to patient wellbeing and quality of life.

BCRC-WA doesn’t receive any government funding. We are a registered charity however, so donations are tax deductible. Any donations we receive are used to directly fund patient services.

Rather than donating a sum of money that goes into a large pool, some of our generous contributors like to know their donation is going directly to fund an advanced breast cancer nurse for 12 months or a for a 2-year period for example. People can then feel their contribution is having a direct impact on the wellbeing of people affected with breast disease.

The research conducted at BCRC-WA is increasing survival rates and helping to reshape the future of breast cancer care.

New USA Trial Results on the Need for Chemotherapy

Chemotherapy for women with early breast cancer in Australia: Relevance of a new study from USA

An American breast cancer clinical trial (TAILORx) has recently been published which reports: “70% of women do not need chemotherapy after surgery for breast cancer”.

Whilst it is true that the trial did provide important information about some patients having very little benefit from chemotherapy in addition to taking an anti-hormone tablet, some of the reporting around this trial is misleading.

Large scale studies over the past 40 years have shown that chemotherapy after surgery can reduce breast cancer relapse, to a very large degree in some patients; whilst other patients may only get very little benefit. A lot of research has been done to try and identify those patients in the “grey-zone” where the benefit from chemotherapy may be very small. The TAILORx trial looked at whether a specific test called OncotypeDX (which is performed on the cancer specimen), could show which patients fall into the “grey-zone”. Thus, these patients could be advised only to have an anti-hormone tablet. This test is not covered by Medicare at the moment, costs $4,500 and takes 2 to 3 weeks for the results to be made available.

The important points to take from the TAILORx study are as follows:

  • The TAILORx study found that 70% of women in the study were in the “grey zone” and thus having chemotherapy before an anti-hormone tablet only gave a very tiny additional protection against a breast cancer relapse to these women.
  • The TAILORx trial was done in America where traditionally chemotherapy would have been recommended to 100% of the women included in the trial. However, this would not be the same practice in Australia, where many women with the same breast cancer characteristics as the trial patients, are already being recommended for an anti-hormone tablet only.
  • Another reason why the 70% figure is misleading, is that the TAILORx trial states that their trial applies to women with hormone receptor positive, HER2 negative and lymph node negative breast cancer. Within this group of breast cancer, there is a wide range in the risk of a breast cancer relapse. What is omitted from the media reports is that the vast majority of women in the TAILORx trial had a very good prognosis tumour, and thus finding 70% of these patients being in the “grey zone” is not at all surprising.
  • Another important result of the trial that has not been highlighted, is that if a woman in the trial was aged under 50yrs and the test confirmed a tumour in the “grey zone”, having chemotherapy before an anti-hormone tablet, did actually significantly lower that woman’s risk of a breast cancer relapse.

So, to conclude, the media reports of this trial over-estimates the importance of doing this test in Australian breast cancer patients. Having the OncotypeDX test done on your breast cancer specimen may be worthwhile if you are found to have a cancer in the “grey zone” and are aged over 50yrs. In using this test now and even in the future when it is likely to be covered by Medicare, it is important that you discuss your own personal risk of breast cancer relapse with your treating medical oncologist and see how the TAILORx study results apply to you. In particular, the results of this trial are specific to using the OncotypeDX test and not to other similar tests that are out on the market.

Professor Arlene Chan & Dr Chris Lomma