Flinders Medical Centre Foundation
Flinders Medical Centre Foundation

Breast cancer


Victory at Sea for Cancer Research

Oxygen's Role in Cancer Spread

Helping Save Our Mothers, Sisters and Daughters From Breast Cancer

Can We Prevent Heart Damage Caused By Chemo

Teaching Computers To Detect Hard To See Cancers

Loosen Your Bra Straps For Lymphoedema
Rebuilding After Breast Cancer

Improving Screening For Inherited Cancers

Volunteer Service Supports Fresh Ideas

MicroRNA Patent Returns Outstanding Results

Screening For Inherited Breast And Ovarian Cancers

Healing Properties Of A Common Sea Snail

How Cancers Form Under Investigation

Do You Have Lymphoedema?

Cancer-Causing Genes Under The Microscope



Victory at Sea for Cancer Research
First Published: Enews - April 2012


A new grant from the FMC Foundation is helping Flinders Centre for Innovation in Cancer investigators to determine whether potential anti-cancer properties of tropical sea anemones will show positive effects against a range of breast cancers.


Sea anemones, such as the kind with many tentacles that clown fish live in, secrete active compounds and toxins as part of their defence and feeding mechanisms. Some of these toxins have been found to have medicinal uses such as in painkillers.


The team in the Department of Medical Biotechnology, led by Dr Barbara Sanderson, have a colony of sea anemones (in collaboration with Karen Burke da Silva in Biological Sciences) which are milked for cell culture testing on breast cancer cells.


"We collect the toxins in a non-invasive way simply by placing the anemone in a plastic bag and capturing the venom milk," Barbara said.


In preliminary investigations the team have found that toxins produced by two types of sea anemone can kill one type of breast cancer cells.


The new FMC Foundation grant is allowing the team to test the toxins against a number of breast cancer cell lines.


"Very little work has been done testing potential therapies across multiple types of breast cancers," Dr Sanderson said. "We hope through this research to isolate novel compounds which have high efficacy against cancer cells and low side effects."


If the toxins obtained from the sea anemone are shown to kill cancer cells without harming healthy cells, then the toxin mixture will be divided into all of its active compounds.


Each active compound will then be tested against the cell lines to determine which one has the cancer fighting properties.


"We will then determine what affect the compound has the effect on the cell and what causes the breast cancer cell to die, which may be beneficial for many types of cancers," Dr Sanderson said.



Oxygen's Role in Cancer Spread
First Published: Southern Area Health Service news - April 2011

A Flinders Medical Centre kidney specialist is embarking on a new study to understand how oxygen-depleted cancer cells survive by hijacking and manipulating the body's good cells.

Conducted by Flinders Consultant Nephrologist Professor Jonathan Gleadle, the one-year research project will examine the way in which breast and renal cancer cells develop despite a lack of essential oxygen, a condition known as hypoxia.

According to Jonathan, oxygen is vital for the health of all cells in the body, whether cancerous or not.

He said cells produce small spherical structures called 'exosomes' which send messages to other cells and, in cases of cancer, affect the behaviour of tumours.

Jonathan said the study, funded through a $12,000 grant from the FMC Foundation, would investigate how hypoxic cells respond to low oxygen by communicating with exosomes in a bid to source oxygen.

"We're interested to know whether cancerous cells send out more exosomes when they're starved of oxygen and message other cells to help them," he said.

"While these exosomes probably play a part in the normal body, it seems that in cancer they might get hijacked or have a role in communicating with other cells to support the cancer."

He said it was important to understand not only the behaviour of malignant cells but also the role of healthy cells in facilitating cancer.

"When you're a cancer cell you don't just overtake normal cells - you need their help to survive, whether that be for attracting blood vessels, providing nutrition or manipulating the immune system to prevent it recognising cancer cells.

"If you look at cancer under a microscope, a lot of the cells are cancer cells but there are many different types of normal cells there too.

"So it's important to understand why normal cells are present in a cancerous tumour and the role they play in facilitating that tumour."

He said the study was also significant because the most hypoxic cancer cells often resulted in the worst patient outcomes.

While it remains unclear why hypoxic cancer cells are the most deadly, Jonathan said one explanation could be that hypoxic tumour cells grow differently and act more aggressively.

"We think this basic and fundamental work examining breast and renal cancer cells will lead to a better understanding of how cancers develop.

"And the support of the Lyn Wrigley Breast Cancer Research and Development Fund, along with the assistance from the FMC Foundation, is crucial for establishing new avenues for research such as this."


Helping Save Our Mothers, Sisters and Daughters From Breast Cancer
First Published: SAHS News - April 2011

Women with a family history of breast cancer could be a step closer to finding out if they are carrying a gene defect that causes the disease, thanks to a new study funded by the Flinders Medical Centre Foundation.

Chief researcher Karen Lower and colleague Scott Grist have launched an investigation into two genes (BRCA1 and BRCA2) which - when mutated - are known to cause familial inherited breast cancer.

About five per cent of women with breast cancer in Australia have a family history of the disease.

Yet in 80 per cent of women with familial breast cancer, a mutation in one of these two genes cannot be detected - meaning there is no way of telling whether relatives of these women are at a greater risk of developing breast cancer.

Karen said the research, therefore, would use alternate ways of analysing the gene sequence, or 'sentence', at a DNA level in a bid to find the 'spelling mistake (mutation) in the sentence'.

She said some women may not have inherited the cancer-causing mutation while others will have - but at present 'we can't tell the difference'.

'Basically the study will look at how we can find the mutation in that 80 per cent margin - it's like looking for a change in punctuation rather than reading the whole sentence to find the error,' Karen, who works in FMC's Haematology and Genetic Pathology Department, said.

'There's no guarantee these families will have a mutation but we think there's a good chance that some do, we just can't find it the way we've been doing it previously.'

Besides detecting hidden mutations, Karen said the study would also help lead to a greater understanding of the role BRCA1 and BRCA2 genes play in the development of breast cancer.

The improved detection methods, she said, would potentially help provide family members with additional advice on screening methods and medical intervention, such as whether they should undergo a mastectomy.

'Where we find mutations in these families will help them to make more informed decisions, and it will also give us important information in understanding how these genes are involved in the development of breast cancer.'

The study will be carried out over the next year, thanks to a $24,000 research grant awarded last November by the Flinders Medical Centre Foundation's Lyn Wrigley Breast Cancer Research and Development Fund.


Can We Prevent Heart Damage Caused By Chemo

First Published: Enews - March 2011

A research team funded by the 2010pinkyellowblueball is investigating the effects chemotherapy for breast cancer has on the heart.

Chemotherapy is critical in the treatment of cancer, but current research is showing more than five per cent of all cancer patients develop abnormalities of the heart as a result of treatment.

Professor Joseph Selva-Nayagam, Professor of Cardiovascular Medicine, Flinders University and Director of Cardiac Imaging, Flinders Medical Centre, and his team are recruiting patients to examine what negative changes occur in the heart from chemotherapy for breast cancer, and whether these changes can aid in the prevention or early detection of heart conditions later in life.

The team hope to recruit 100 patients to the study, which has been funded by the FMC Foundation, and anyone who is newly diagnosed with breast cancer or has a metastatic disease and hasn't yet started treatment is eligible to join.

The heart function of participants will be examined using echocardiography (ultrasound screening) and MRI scanning before, during and after their course of chemotherapy.

"As well as being able to show overall heart function and movement of the heart walls, we will be able to detect subtle changes in the heart such as inflammation and scarring," Professor Selva-Nayagam said.

"By determining which changes happen and when, we hope we can influence chemotherapy regimes to include monitoring of the heart.

"We believe this research could potentially lead to heart-protecting drugs being included with chemotherapy to prevent any irreversible damage occurring."

For more information on the trial please contact Dr Suchi Grover on (08) 8204 5751.


Teaching Computers To Detect Hard To See Cancers

First Published: Enews - March 2011

Not only did the girls who took part in the Borneo for Breast Cancer Challenge in December 2010 have a fabulous time, their hard work in raising $62,000 has funded two vital research projects at Flinders Medical Centre.

One of these projects is led by Dr Murk Bottema, from the School of Computer Science, Engineering and Mathematics, who is working to develop a computer program which will improve breast cancer screening by more accurately picking up and identifying suspicious masses shown on a mammogram.

"Because a mammogram is a 2d image of a 3d object, occasionally suspicious masses are unable to be seen by radiologists." Dr Bottema said.  "Computers can look at a much greater variety of patterns and contrast than human beings can."

While computer programs are now in operation in some clinics to assist radiologists decide if cancer is present, Dr Bottema says the current systems do not adequately reduce the number of false positive results which causes unnecessary stress for patients.

Dr Bottema and his team hope to develop a more reliable program which focuses on identifying cancers unable to be seen by the naked eye.

The project funded through Borneo for Breast Cancer is to create a computer mapping of the breast, which a computer can then draw upon to identify irregularities on a mammogram image.

"We are using computers to try to better understand what cancer looks like in a mammogram image," Dr Bottema said.

"We then hope to write a program that can firstly identify suspicious masses, and then identify whether they are benign or malignant."

Borneo for Breast Cancer, led by Channel 7's Jane Doyle, has also funded a project led by Dr Michael Michael investigating the role of hormones and other chemical signals in breast tissues to determine whether they encourage or retard cancer growth.

The FMC Foundation is launching a second Borneo for Breast Cancer trek which will take place 3rd - 12th March 2012. For more information please email Tristanne or telephone 1300 905 188.


Loosen Your Bra Straps For Lymphoedema
First Published: Enews - March 2010

Flinders researchers are investigating whether a patient's bra may play a key role in helping cause or exacerbate lymphoedema of the breast or arm.

Lymphoedema, a condition of localised swelling, occurs when the fluid in the body's tissues cannot be moved by the lymphatic system (a delicate network of small vessels responsible for managing the body's fluid levels).

Women who have undergone surgery and radiotherapy for breast cancer are particularly susceptible to lymphoedema as their treatment may have resulted in damage to the lymphatic system of the breast, chest and armpit.

Professor Neil Piller (pictured) and his team from the FMC Lymphoedema Assessment Clinic are investigating whether other factors may play a role in causing the swelling, such as bras which exert higher pressures on remaining lymph pathways.

The team are conducting a long term trial to determine whether made-to-measure bras, which are less restricting and allow for better lymphatic drainage than shop-bought-bras, will reduce the incidence and severity of breast lymphoedemas.

"There is no doubt that the superficial lymphatic system is susceptible to constant external pressure. It could be that the wrong placement of the shoulder strap of the bra is a factor in causing the arm or breast to swell unnecessarily," Professor Piller said.

25 women recruited from the Flinders Surgical Oncology Clinic are currently participating in the trial, which invoves measuring the pressures exerted by their bras and the changes in the composition in the breast using a range of equipment developed by Flinders biomedical Engineering. The women are then followed up every three months.

Professor Piller said early findings show excessively high bra strap, side panel and under-wire pressures are leading to reduced lymph flow, poor breast tissue health and fluid accumulation in some women.


Rebuilding After Breast Cancer
First Published: Investigator - August 2009

With funds from the Pink Ribbon Ball, Flinders Medical Centre doctors are holding one of Australia’s first studies into how women feel about their post-cancer breast reconstruction to make sure it is a success in their eyes and not just their surgeons.


In 2008 Dr Nicola Dean helped establish the Breast Reconstruction Unit in the FMC Breast Unit to help women discuss their options and plan their reconstruction with specialists.


“The main reason breast reconstruction after mastectomy or an operation for cancer is undertaken is to preserve or improve the patient’s psychological well-being,” said Dr Dean.


Dr Dean is also leading research projects into the different areas of the psychology of breast reconstruction after cancer.


“There have been no established standards for outcomes in breast reconstruction and no commonly used measurement tool which makes it difficult to know whether any one breast reconstruction case is a ‘success’ in the patient’s view,” she said.


The acclaimed Sloan Memorial Kettering Institute in New York has been working on this issue in North America and recently developed the Breast-Q, an in-depth questionnaire that evaluates patient satisfaction.


Drs Dean and Jia Miin Yip have identified the Breast-Q as suitable for several projects they plan to carry out, and will test its effectiveness for an Australian population.


One such project will investigate the Rotation Flap Approach Mastectomy (RoFA), which uses a new surgical incision to allow for a more aesthetic breast reconstruction.


So far a small number of women have undergone the RoFA mastectomy and have given positive feedback, saying that they like the position of the scar and that the sensation over the skin is not affected.


“We feel that this could be a better operation for patients, but we need to prove this with a formal randomised clinical trial,” said Dr Yip.


Improving Screening For Inherited Cancers
First Published: Investigator - August 2008

Important research at Flinders has continued to make inroads into inherited breast and ovarian cancers thanks to a $16,000 contribution from Angela Condous and the Advertiser and Sunday Mail Foundation (ASMF).


Dr Scott Grist and his team are developing a cost-effective pre-screening laboratory test to better identify individuals who may carry a harmful BRCA1 or BRCA2 gene defect.


The BRCA genes are responsible for repairing DNA damage in a cell. If a defect is inherited in one or both genes there is a 60-80% chance that breast or ovarian cancer will develop as DNA damage accumulates over time.


“Approximately 20% of those screened carry DNA variants that cannot be easily identified as those that cause cancer,” said Dr Scott Grist, Head of the Inherited Cancer Genetics Lab at Flinders Medical Centre.


“This represents a large group of individuals with an uncertain diagnosis who are not benefiting from the testing and who are put under additional psychological stress.”


The current screening method is also quite costly, limiting it to those who know they have a strong family history of breast and ovarian cancer.


Using a technique that screens for DNA damage, this test can measure the rate of DNA repair of a possible BRCA gene defect carrier against the rate of repair from a healthy BRCA gene sample.


This will identify if a full screening of the BRCA genes is required, both saving un-necessary and extensive screening and easing the minds of those who don’t know their family’s medical history or have an unknown defect in a BRCA gene.




Volunteer Service Supports Fresh Ideas
First Published: Investigator - February 2008

Thanks to the hard-working Volunteer Service for Flinders Medical Centre Inc. two bright young minds now have the means to pursue PhDs in groundbreaking fields.


Lauren Thurgood, one of two new Volunteer Service scholarship holders dedicates her time to researching the causes of kidney stones. Her doctorate is on how proteins help to control kidney stones, a field in which Flinders is leading internationally.


As an honours student Ms Thurgood was part of the research team led by Professor Rosemary Ryall who received a $1.2 million grant from the US National Institutes of Health in 2004. They were the first to discover and publish the existence of proteins inside the minerals, predominately calcium oxalate, which cause kidney stones when they attach to kidney cells.


Ms Thurgood hopes to build on this research by identifying the proteins within the crystals, and look at what effects single proteins have on the attachment of the crystals to the kidney cells.


She hopes her research will one day have clinical implications for preventing the formation of kidney stones.


Likewise, scholarship recipient Vicki Edwards is building on the research of Biological Scientists Dr Kirsten Benkendorff and Dr Catherine Abbott, who sought to harness the anti-cancer potential of a local species of sea snail.


It has been found the bioactive compounds involved in the Dicathais orbita or Australian Dogwhelk’s production of a purple dye have many possible medicinal uses, including a novel anti-cancer agent.


Under the supervision of Dr Fiona Young in Medical Biotechnology, Ms Edwards’ doctorate builds on “promising” research by Dr Benkendorff and Dr Abbott into the effects of the compounds on lymphoma and colorectal cancer cells.


Ms Edwards hopes to determine whether the compounds can also kill reproductive cancer cells, or whether they can have an effect on gynaecological conditions caused by hormonal imbalances such as endometriosis and polycystic ovary syndrome.


She also hopes to investigate the viability of a homeopathic treatment for uterine cancer, Murex Purpurea, which has an active ingredient sourced from the same family of mollusc as the Australian Dogwhelk.


At present the Volunteer Service for FMC Inc. provides $194,000 annually to support medical research grants and have recently increased their support to provide for these two new PhD scholarships.


MicroRNA Patent Returns Outstanding Results
First Published: Investigator - July 2007

Flinders Medical Centre (FMC) investigators have received outstanding results on an international Patent application for their research in utilising specific molecules that could lead to better cancer therapies.


Dr Michael Michael and his team have contributed important information into the link between microRNAs and cancer formation, placing them at the forefront of this field of research.


“MicroRNAs were thou ght to be a quirk of nature when first discovered in nematode worms over a decade ago,” said Dr Michael. “By 2002 it was discovered that these tiny by-products of genes are in fact present in all plants and animals.”


Cells have various functions which are dictated by their proteins. These proteins are, in turn, created by different genes within the cell. MicroRNAs are responsible for targeting and shutting down specific genes where necessary and occasionally stopping the production of a protein that is harmful to the body.


Dr Michael and his team identified two microRNAs (145 and 143) in 2002 that appear in low quantities or are not present at all within cancer cells. This finding could shine light on what happens within a cell for it to turn cancerous while also helping to create better treatments.


Research is a highly competitive field with scientists vying for grants around the world. This can lead to knowledge and technology not being readily shared.


The Patent is still pending, but once awarded, Dr Michael’s microRNA technology can be used by scientists around the world to create better outcomes, not only for cancer but possibly for other diseases.


Screening For Inherited Breast And Ovarian Cancers
First Published: Investigator - April 2007
Updated:Helping Save Our Mothers, Sisters and Daughters From Breast Cancer

Thanks to money raised at the Pink Ribbon Ball a more sensitive and accessible test to screen for hereditary breast and ovarian cancer is currently being devised by scientists at Flinders Medical Centre.


Dr Scott Grist, Head of the Inherited Cancer Genetics Lab, and his team are focusing on perfecting a technique that can simplify screening for genetic defects within the BRCA1 and BRCA2 genes.


BRCA1 and BRCA2 are tumour suppressors involved in repairing DNA breaks within cells. If a defect is inherited in these genes there is an 80-90% chance that breast or ovarian cancer will develop. Inherited BRCA gene defects are also the leading risk factor for male breast cancers.


“The BRCA genes are important as they are central to DNA repair,” said Dr Grist. “DNA in our cells is damaged all the time. If you have a defect in the BRCA genes this damage cannot be fixed which leads to an accumulation of mutations that often result in cancer.”


Currently screening patients for these defects is costly and time consuming as the BRCA genes are quite large. This test is also limited to families with a proven history of cancer, unless individuals wish to spend the money required to undergo the screening.


It has been found that if there is a defect within these BRCA genes, double strand DNA breaks repair slower than they normally would. The team are working toward a sensitive way to measure how different this rate of DNA break repair is compared to when the BRCA genes are healthy.


Once this is discovered it will be much simpler to test a patient’s blood and see if the rate of repair indicates that there is a BRCA1 or BRCA2 defect. This will allow those with a family history of cancer to be screened much quicker and more cost effectively to identify if a full screen of the BRCA genes is required. Making this information much more accessible to those who think they may be at risk.


“The test will enable us to quickly screen larger numbers of people,” said Dr Grist. “If we find a gene defect in a familial cancer patient we can then do a simple screening on all family members to inform them if they carry the same gene defect or not.”


This test is still being fine tuned however once it is ready for use it will be a vital tool for those with a familial history of breast or ovarian cancer, to ease minds or prepare individuals for the possibility of cancer.


Healing Properties Of A Common Sea Snail
First Published: Investigator - April 2006

Flinders investigators are currently involved in harnessing the natural anti-cancer property created by a common sea snail which could be used to treat many different forms of cancer.


Dr Kirsten Benkendorff and Dr Catherine Abbott, Lecturers in Biological Sciences at Flinders University, have been investigating this marine snail, the Australian Dogwhelk Dicathais orbita, which is found throughout shallow rocky reef habitats along the southern coast from New South Wales to Western Australia.


This snail produces a purple dye, known as Tyrian purple, which appears to be a means of protecting its egg masses. It has been found that the compounds that produce this dye have many possible medicinal uses, one of these being a potent anti-cancer agent.


This agent appears to cause programmed cell death within cancerous cells, triggering these unwanted cells to self-destruct by shrinking and fragmenting slowly rather than a sudden disintegration that can be harmful to healthy neighbouring cells.


Currently the project is delving into the biological mechanisms that take place within this snail to create the purple dye. It is hoped that part of the process, the anti-cancer agent, can be harnessed and possibly used as a treatment for cancer.


As this project is only in the very early stages much research needs to be undertaken to make sure that biological material such as DNA, metabolic processes, enzymes and the membrane of healthy cells are not harmed or destroyed by using a treatment that utilises this agent.


The next step in this project will be to look at the gastro-protective elements of the snail and to ascertain whether it could be used as a functional food with healing properties, perhaps for colorectal cancers.


Dr Benkendorff is also interested in further investigating homeopathic remedies used for hundreds of years to treat female health issues by testing the healing properties of this snail on reproductive cell lines such as ovarian and breast cancers, and hormone production.


“This is a huge project with exciting potential, particularly as this snail has several interesting biological compounds that haven’t been seen before; this study could provide some very useful information in the treatment of cancers,” says Dr Benkendorff.


How Cancers Form Under Investigation
First Published: Investigator - February 2006
Updated:  MicroRNA Patent Returns Outstanding Results

Flinders researchers are leading the world in an area of cancer research that is providing a vital insight as to how cancerous cells may or may not form within the breast and bowel.


Headed by Dr Michael Michael from the Department of Gastroenterology and Hepatology, this research is focused on two specific microRNA’s; tiny products of the genes within our cells.


In 2001 it was discovered that microRNA’s are present in all plants and animals and have the ability to control the formation of proteins within cells. This information took the scientific world by storm when it was realised that this could provide a simpler approach to manipulating genes and therefore altering genetic disorders and diseases, such as cancer.


Each protein within a cell has a specific function causing the cell to act in a certain way, for example grow hair or cause pigmentation. RNA, often called a messenger, helps create these proteins by taking a copy of a sequence of the DNA held within a cell and carrying it into another area of the cell where the protein can be created.


MicroRNAs are involved in the defence against diseases, as they are responsible for controlling the creation of proteins. They are thought to fine-tune delicately balanced processes that control how cells behave. These processes include how the cells mature, divide and move relative to each other. If a microRNA is missing, this could lead to a cascade of events and become deleterious to the cell creating, for example; a cancerous tumour.


Dr Michael and his team have found that microRNA’s 145 and 143 are often in low quantities or not present at all within breast cancer cells – and may be responsible for the disease. This information stemmed from an earlier finding by Dr Michael that microRNA’s 145 and 143 are also not present in bowel cancers.


“These microRNA’s are important for two reasons,” says Dr Michael. “First, they might potentially control the processes that lead to cancer and create better understanding of what is happening within a cancerous cell. And secondly, the potential application to regulate genes in cells may be available for a wide range of disorders.”


Whilst this research is still in the early stages, a possible outcome could be a gene therapy utilising the defensive systems of these microRNA’s and leading to the destruction of cancerous tumours.


Do You Have Lymphoedema?
First Published: Investigator - February 2005
Updated: Loosen Your Bra Straps for Lymphoedema

The Flinders Lymphoedema Assessment Clinic is undertaking three large scale clinical trials.


One trial involves the application of an ointment to the arms of women with lymphoedema following treatment for breast cancer.


The second trial involves the use of a new lymphatic vessel stimulatory program to the legs of men and women who have lymphoedema following treatment for cancer of the bowel, reproductive systems, or due to the removal of lymph nodes in the groin associated with melanoma.


The third trial involves the testing of a Tai Chi exercise program - one hour per week for nine weeks for women with arm lymphoedema following treatment for breast cancer.


If you have lymphoedema and would like further information on the Clinic please call 8204 4711.


Cancer-Causing Genes Under The Microscope
First Published: Investigator - April 2004
Updated: How Cancers Form Under Investigation

A major scientific discovery in 2001 has opened the door for Flinders researchers to further study the genes responsible for the development of colorectal cancer.


European and US scientists working on fields as diverse as worms and plants discovered microRNAs. Found in all animal cells, these molecules have the ability to turn off gene function.


Once thought to be a bit of ‘junk’ MicroRNA's have turned out to be very useful. They play a vital role in the development of various organisms, and are likely to be involved in many human diseases, including cancer.


Dr Michael Michael from the Department of Gastroenterology, believes Flinders is at the leading-edge in studying the microRNA controlled genes that may cause colorectal cancer.


"We are the first to find a correlation between microRNA's and solid tumours. This is novel work. Our lab is one of only a few in the world that have published in this area,” said Dr Michael.


"Although in it's early stages one of the strengths of this research is access to Flinders Tissue Bank. This enhances our ability to discover what causes the changes in gene activity that are associated with many cancers."


It is hoped that by understanding these processes Flinders researchers may be able to develop new diagnostics and cancer treatments.

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