Medicine and Health Sciences Commons^™

Cost-Effectiveness Of Exercise Medicine For Prostate Cancer, Kim Edmunds

Theses: Doctorates and Masters

Background

Androgen deprivation therapy (ADT) is associated with numerous adverse effects that impact on quality of life and contribute further to the cost burden of prostate cancer (PCa) via treatment and supportive care. Exercise medicine is effective in slowing PCa progression, reversing treatment adverse effects and improving quality of life and survival of patients, however, no economic analyses have been conducted to determine whether exercise is cost-effective in this population.

Objectives

Firstly, to examine the adverse effects of ADT for PCa and the evidence supporting the use of exercise medicine in their management. Secondly, to conduct the first economic evaluations …

Assessment Of The Clinical Validity Of Ctdna Analysis For Melanoma Management, Anda-Gabriela Marsavela

Theses: Doctorates and Masters

Metastatic melanoma is responsible for almost 80% of all skin cancer-related deaths and the incidence of people affected continues to rise worldwide. The emergence of targeted therapy and immune-checkpoint inhibitors has improved the clinical management of melanoma, but durable survival benefit is only seen in a minority of patients. The use of these very expensive systemic therapies on all appropriate patients also poses a high economic burden on health systems across numerous countries. Currently, surveillance for treatment failure is not optimal. Thus, reliable and accurate biomarkers of patient disease status are urgently required.

Circulating tumour DNA (ctDNA) analysis has emerged …

Exercise And Nutrition Induced Weight Loss For Prostate Cancer Patients, Rebekah Louise Wilson

Theses: Doctorates and Masters

This thesis encompasses six main chapters - two reviews and four experimental chapters, in addition to a general introduction and discussion.

Review 1 (Chapter 2) is a discussion of the negative impact of obesity on prostate cancer prognosis and common prostate cancer treatments.

Review 2 (Chapter 3) is an evaluation of the current literature examining prostate cancer patients receiving androgen deprivation therapy (ADT) and how exercise and nutrition interventions can be used to induce fat loss, while preserving or improving lean mass.

Study 1 (Chapter 4) is an examination of the efficacy of a weight loss program in altering body …

Circulating Tumour Dna: A Non-Invasive Biomarker For Melanoma, Ashleigh Cavell Mcevoy

Theses: Doctorates and Masters

Cutaneous melanoma accounts for 90% of all skin cancer deaths (Balch et al., 2010) and is responsible for 3.6% of deaths from cancer in Australia (Australian Institute of Health and Welfare, 2016). Whilst early detection and successful surgical removal of primary melanomas have improved survival rates (DeSantis et al., 2014), approximately 30% of these patients will have disease recurrence at some point in their lives (Soong et al., 1992; Soong et al., 1998). This is despite being considered disease free following treatment, which may have included surgical removal of the primary and/or its metastasis/es, radiation and/or systemic therapy. Whilst the …

Activity Behavior And Physiological Profile Of Advanced-Stage Ovarian Cancer Survivors, Christelle Schofield

Theses: Doctorates and Masters

Background: Advanced-stage ovarian cancer survivors (OCS) often experience a multitude of disease symptoms and treatment-related side-effects. Additionally, most OCS are older, have comorbidities, are overweight or obese, and report being insufficiently physically active. Ovarian cancer survivors may benefit from exercise oncology interventions to reduce symptom-burden, manage comorbidities, minimize functional decline and maximize health-related quality of life (HRQoL). However, current knowledge gaps regarding the physiological characteristics of OCS throughout the entire survivorship spectrum challenge the development of tailored exercise interventions.

Purpose: The overall purpose of this thesis was to provide a more comprehensive physiological and activity behavior profile of post-treatment advanced-stage …

Factors Influencing Resilience Among Haematological Cancer Survivors, Katherine S. Gallager

Theses: Doctorates and Masters

Haematological cancers in bone marrow (leukaemia) and the immune system (lymphomas or myeloma) represent the sixth most common adult tumour group in Australia. These cancers often develop without warning and require intensive treatment regimes that last on average eight months, but may continue for a lifetime depending on the diagnosis. Encouragingly, advancing cancer treatments, a key accomplishment of cancer research over the past 40 years, have resulted in a growing community of cancer survivors. Approximately two in three adults diagnosed with haematological cancer (HC) can now expect to survive more than five years. However, they must attempt to navigate the …

Just A “Click” Away From Evidence-Based Online Breast Cancer Information, Advice And Support Provided By A Specialist Nurse: An Ethnonetnographic Study, Cynthia Ann Witney

Theses: Doctorates and Masters

Breast cancer has had, and will continue to have, a devastating impact on the lives of many Australian women, their families, friends and the wider community. The concomitant treatment of this disease places a considerable burden on the health care system and the supporters of the person diagnosed with this disease. While there are many government and non-government organisations that provide treatment and support services for the person with breast cancer, these services are usually provided in person either in the home or at the organisation’s offices. This study extended the information advice and support aspects of these services to …

Saying ‘No’: A Biographical Analysis Of The Experiences Of Women With A Genetic Predisposition To Developing Breast/Ovarian Cancer Who Reject Risk Reducing Surgery, Doreen Molloy

Theses: Doctorates and Masters

Background: Genetic technologies have identified some of the genes implicated in cancer susceptibility. Women with mutations in breast/ovarian cancer-susceptibility genes (BRCA1 and 2) have a lifetime combined risk of breast/ovarian cancer of more than 80%. Risk reducing surgery (RRS) reduces cancer risk by as much as 90% in high risk populations. Despite this, some BRCA1/2 mutation-positive women say no to RRS.

Purpose: To illuminate an understanding of why women at high risk of developing breast/ovarian cancer say no to risk reducing surgery (RRS).

Design: Denzin’s (1989) interpretive biography was combined with Dolby-Stahl’s (1985) literary folkloristic methodology to provide a contextualised …

Heat Stress: A Risk Factor For Skin Carcinogenesis, Leslie Calapre

Theses: Doctorates and Masters

BACKGROUND: The incidence of skin cancer in Australia has increased rapidly in the last few decades. Ultraviolet radiation (UV) is a major risk factor for skin carcinogenesis. UV, particularly the UVB spectrum, causes formation of cyclobutane pyrimidine dimers (CPD) in cellular DNA. Persistent and incorrectly repaired CPDs lead to DNA mutations and consequently, formation of cutaneous lesions. Interestingly, recent epidemiological studies have shown a significant increase in skin cancer incidence in geographical locations with high environmental temperatures. Thus, heat stress may potentiate the effects of UV exposure and act as an additional risk factor for skin cancer. Previous studies …

Investigating The Role Of Dachshund Homolog 1 (Dach1) And Mir-200b In Group 4 Medulloblastoma Pathogenesis, Courtney George

Theses : Honours

Medulloblastoma is the most common malignant childhood brain tumour, and the most significant cause of childhood cancer-related mortality. Recently four core molecular medulloblastoma sub-groups have been identified, with distinct pathogenesis and responses to therapies. Current therapies, do not account for this molecular variation, and many patients may receive inappropriate treatment. To address this, targeted therapies for each molecular sub-group would be ideal. Unfortunately, for the more aggressive Group 3 and Group 4 subgroups, the underlying mechanisms of pathogenesis remain poorly understood. The current challenge is to identify the key tumour suppressors or oncogenes involved in Group 3 and Group 4 …

Role Of Physical Exercise In Reducing Depression And Improving Mental Health In Cancer Survivors, Gregory Levin

Theses: Doctorates and Masters

Cancer survivors are more than twice as likely as the general population to suffer the debilitating effects of depression. This comorbid condition is associated with several negative consequences, such as reduction in compliance with cancer treatments, and hastened mortality. Recent research has examined the therapeutic effect of exercise on depression and reported excellent results of similar magnitude to those achieved with pharmacotherapy or psychological intervention. However, no research, to date, has examined the effectiveness of exercise on reducing depression in depressed cancer survivors. In order to address this important question this thesis reviewed previous literature in the area of cancer …

Pax3 Expression, Protein Modifications And Downstream Target Gene Profiling In Melanocytes And Melanoma Cells, Danielle Bartlett

Theses: Doctorates and Masters

PAX3 is a transcription factor. It plays a major role in the development of melanocytes in the embryo. As a result of alternative splicing, the gene gives rise to eight different transcripts which encode proteins that have differing structures and are therefore likely to activate different downstream target genes. The presence of post-translational modifications has also been shown to alter the functions of the proteins.

PAX3 regulates the maintenance of undifferentiated melanoblasts and mediates pathways involved in proliferation, migration and survival. It has been shown to be expressed in melanoblasts, adult melanocytes, naevi and in most melanoma cells. This implies …

The Identification Of Diagnostic Serological Autoantibodies For Cutaneous Melanoma, Pauline Zaenker

Theses: Doctorates and Masters

Abstract not available.

The Experiences Of Cancer Survivors As They Transition From Chemotherapy Treatment To Life After Cancer, Violet Platt

Theses: Doctorates and Masters

This study explored and described the experience of people with a diagnosis of cancer, as they transitioned from life as a chemotherapy patient to life after treatment as a cancer survivor. The purpose of this study was to ultimately improve the care of people as they transitioned into life after completion of chemotherapy treatment. There is minimal information related to this phase of the cancer trajectory, therefore this study was intentionally exploratory and descriptive. To achieve the proposed outcome a two-phased approach was undertaken. In Phase One a qualitative approach was followed using Grounded Theory to the descriptive level of …

New Perspectives On Melanoma: The Role Of Pax3, Sandra Medic

Theses: Doctorates and Masters

Background: Cutaneous melanoma is an aggressive form of skin cancer, arising in cutaneous melanocytes. The transcription factor PAX3 is critical for the proper development of neural crest lineages including melanocytes. Melanocytic cells show continued PAX3 expression from melanoblast formation in the neural crest to their differentiation into melanocytes. While many studies clarify the importance of PAX3 in embryonic development of melanocytes, less well understood, and more perplexing, is the continued PAX3 expression in adult skin melanocytes. By contrast PAX3 is frequently found in melanomas and naevi, and its expression correlates with melanoma staging. In this study we explore the multiple …

Quantification Of Circulating Melanoma Cells, Jamie Freeman

Theses : Honours

Current prognostic techniques for Cutaneous Malignant Melanoma (CMM), a highly aggressive and drug resistant skin cancer, are inadequate at managing the disease and identifying early stage patients requiring treatment. It is thought that Circulating Tumour Cells (CTCs), which circulate in patient blood after being shed from solid tumours, may be useful in enhancing prognostic techniques and it has previously been shown in other malignancies that the presence of CTCs in patient blood is associated with poor prognosis. In CMM, CTCs can be detected through RT-PCR for melanoma associated markers, although this technique does not allow CTCs to be quantified. In …

Development Of A Blood Test For The Detection Of Cutaneous Malignant Melanoma, Rebecca Slattery

Theses : Honours

Cutaneous Malignant Melanoma is a highly aggressive form of skin cancer that has a tendency to metastasise. In its early stages, the 5-year survival rate of patients is greater than 90% following surgical excision of an in situ tumour. However, following metastasis of the tumour, the 5-year survival rate declines to 5-35%. Due to the correlation between metastasis and declining survival, studies have attempted to identify potential metastasis as early as possible. Molecular markers of melanoma cells in the peripheral blood of CMM patients have been investigated, as the invasion of tumour cells into the blood is one of the …

Storying The Body : Women's Narratives Through The Lens Of Breast Cancer, Janet A. Griffin

Theses : Honours

What can women's narratives contribute to our understanding of breast cancer and to feminist theories of the body? This thesis explores the meanings women construct to make sense of embodied experiences of breast cancer, and the profound experience of breast loss. Rich contextual data was elicited from in depth, guided conversations with five premenopausal women who have undergone mastectomy. Adopting feminist methodology, biographic-narrative was used to place the body at the heart of inquiry. This thesis explores the personal and theoretical meanings of mastectomy, embedded in the larger story of how these five women experience their breasts, throughout their lives. …

Developing And Testing A Pain Management Program For Family Caregivers Of Advanced Cancer Patients, Lynn Oldham

Theses: Doctorates and Masters

Increasingly, advanced cancer patients are receiving care in the community supported by families and hospice home care services. However, little or no preparation is provided to family caregivers who assume this supportive role, often 24 hours per day. Pain management is consistently identified by family caregivers as their primary concern related to care and support of a relative with cancer. This project involved a three-phase program of research to develop and test a pain management program (PMP) that would provide family caregivers of advanced cancer patients with information and skills to manage the patient's pain.

Factors Which Influence Women's Decisions For Choice Of Primary Surgery For Stage I And Stage Ii Breast Cancer, Barbara Mastaglia

Theses : Honours

A descriptive correlational study was conducted to describe the factors that Western Australian women with either Stage I or Stage II Breast Cancer, perceived to be important considerations when deciding upon either Modified Radical Mastectomy (MRM) or Breast Conserving Treatment (BCT) for surgical treatment. The Conflict Theory of Decision Making (Janis & Mann, 1977) was used as the theoretical framework to guide this study. Ward, Heidrich and Wolberg's (1989) Factor List, the Multidimensional Health Locus of Control (MHLC) Scale (Wallston, Wallston & De Vellis, 1978) and a demographic questionnaire were used to measure variables. Questionnaires were mailed to a consecutive …

What Is The Intimate Experience Of Couples Following The Woman's Cancer-Related Breast Surgery?, Lynne Amor

Theses: Doctorates and Masters

The purpose of this phenomenological study is to describe and interpret the experience of couples following the woman's surgery for breast cancer, in order to gain an in depth understanding of how this mutilating surgery affects their everyday lives. Breast cancer is the most prevalent form of cancer in Australian women, and in most industrialised nations. Women in Australia have a one in fourteen lifetime risk of developing the disease. Little is known concerning what meanings this surgery brings to the intimacy experienced between partners. It is important to seek knowledge of the phenomenon of intimacy, how the couples understand …

Nutritional Problems And Information Needs Of Patients Receiving Chemotherapy And Radiation Therapy, Margaret Joan Robinson

Theses : Honours

Nutritional status is a major factor in determining the successful outcome of treatment for cancer. The combined effect of cancer, and the treatment for cancer, has the potential to severely impair nutritional status. The purpose of this study was to investigate the incidence and severity of treatment-related side-effects which affect nutritional status in cancer patients and to determine the sources and helpfulness of information about nutrition which had been utilised by patients. A descriptive study was used to investigate two groups of patients, one group who was receiving chemotherapy, and the other, radiation therapy. A questionnaire developed by the researcher …