Medical Specialties Commons^™

Immediate Versus Delayed Exercise On Health-Related Quality Of Life In Patients Initiating Androgen Deprivation Therapy: Results From A Year-Long Randomised Trial, Dennis R. Taaffe, Robert U. Newton, Suzanne K. Chambers, Christian J. Nelson, Nigel Spry, Hao Luo, Oliver Schumacher, David Joseph, Robert A. Gardiner, Dickon Hayne, Daniel A. Galvão

Research outputs 2022 to 2026

BACKGROUND AND OBJECTIVE: An array of treatment-related toxicities result from androgen deprivation therapy (ADT) in patients with prostate cancer (PCa), compromising function and health-related quality of life (HRQoL). Exercise has been demonstrated to counter a number of these adverse effects including decreased HRQoL; however, when exercise should be initiated is less clear. This study aims to examine whether commencing exercise when ADT is initiated rather than later during treatment is more effective in countering adverse effects on HRQoL. METHODS: Men with PCa (48-84 yr) initiating ADT were randomised to immediate exercise (IMEX; n = 54) or delayed exercise (DEL; n …

Prevalence Of Autoimmune Diabetes Among Aboriginal Australians: The Fremantle Diabetes Study Phase Ii, Timothy M.E. Davis, Christine S. Bundell, Stephen Chubb, Daniel Mcaullay, Wendy A. Davis

Research outputs 2022 to 2026

The prevalence of autoimmune diabetes was assessed in 113 indigenous and 1555 non-indigenous participants in the Fremantle Diabetes Study Phase II. Both type 1 diabetes (3.5% vs. 8.2%) and latent autoimmune diabetes of adults diagnosed based on glutamic acid decarboxylase antibody (GADA) positivity (1.0% vs. 5.7%) were lower in Aboriginal participants (P = 0.101 and 0.039 respectively). Six Aboriginals with GADA-negative type 2 diabetes were positive for tyrosine phosphatase-related islet antigen 2 antibodies but did not exhibit relative insulin deficiency.

Resting Energy Expenditure And Metabolic Features In Children With Septo-Optic Dysplasia, David J. Cullingford, Jacqueline A. Curran, Mary B. Abraham, Aris Siafarikas, A. Marie Blackmore, Jenny Downs, Catherine S.Y. Choong

Research outputs 2022 to 2026

Context: Septo-optic dysplasia (SOD) is a major cause of congenital hypopituitarism and is known to be associated with overweight and obesity in up to 44% of children. Given the role of the hypothalamus in hormonal regulation, we sought to assess the association of resting energy expenditure (REE), appetite and physical activity with SOD. Objective: To characterize REE and other metabolic features in patients with SOD and evaluate relationships with elevated body mass index (BMI). Methods: Children with SOD above 5 years of age attending Perth Children's Hospital participated. A CosMED Q-NRG indirect calorimeter was used to calculate mean measure REE …

Autologous Blood Pleurodesis Through An Indwelling Pleural Catheter For The Management Of Prolonged Air Leak In A Malignant Hydropneumothorax, Vanessa Wong, Sathya Balaguruswamy, Bapti Roy

Research outputs 2022 to 2026

The British Thoracic Society guidelines recommend a surgical opinion in cases of prolonged air leak or failure of lung re-expansion after 3–5 days. The management of prolonged air leak in non-surgical candidates often proves to be more challenging, with no expert consensus guidelines on treatment options. There is a paucity of data for the treatment of patients with a prolonged air leak in the setting of a hydropneumothorax, who are not suitable surgical candidates. We present the case of a novel treatment approach for an 89-year-old male with a symptomatic, large malignant pleural effusion treated initially with a routine chest …

Comparison Between Antigen And Aalelic Hla Mismatches, And The Risk Of Acute Rejection In Kidney Transplant Recipients, Ryan Gately, Anne Taverniti, Narelle Watson, Armando Teixeira-Pinto, Esther Ooi, Rowena Lalji, Ross Francis, Lucy Sullivan, William Mulley, Kate Wyburn, Scott Campbell, Carmel Hawley, Germaine Wong, Wai H. Lim

Research outputs 2022 to 2026

Deceased donor kidney allocation relies on HLA compatibility at the antigen level, as optimal matching reduces the risk of acute rejection. Whether HLA allele-level mismatches improve, the prediction of acute rejection after transplantation remains unclear. Using data from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) from 2017 to 2020, HLA antigenic and allelic mismatches between recipients and deceased donors were calculated with imputation of two-field allelic equivalents undertaken where required. The discordance between antigen and allele mismatches was calculated, and oblique random survival forest models were used to predict acute rejection. Predictive performance of antigen (HLA-A, -B, …

Prognostic Utility Of Palliative Prognostic Index In Advanced Cancer: A Systematic Review And Meta-Analysis, Si Qi Yoong, Hui Zhang, Dee Whitty, Wilson Wai San Tam, Wenru Wang, Davina Porock

Research outputs 2022 to 2026

OBJECTIVES: To evaluate the prognostic utility of Palliative Prognostic Index (PPI) scores in predicting the death of adults with advanced cancer. METHODS: A systematic review and meta-analysis were conducted. Six databases were searched for articles published from inception till 16 February 2024. Observational studies reporting time-to-event outcomes of PPI scores used in any setting, timing and score cutoffs were eligible. Participants were adults with advanced cancer residing in any setting. Random effects meta-analysis was used to pool hazard, risk, or odds ratios. Findings were narratively synthesized when meta-analysis was not possible. RESULTS: Twenty-three studies (n = 11,235 patients) were included. …

Exercise And Psychosexual Education To Improve Sexual Function In Men With Prostate Cancer: A Randomized Clinical Trial, Daniel A. Galvão, Robert U. Newton, Dennis R. Taaffe, Prue Cormie, Oliver Schumacher, Christian J. Nelson, Robert A. Gardiner, Nigel Spry, David Joseph, Colin Tang, Hao Luo, Raphael Chee, Dickon Hayne, Suzanne K. Chambers

Research outputs 2022 to 2026

Importance: Sexual dysfunction is a common adverse effect of prostate cancer treatment, and current management strategies do not adequately address physical and psychological causes. Exercise is a potential therapy in the management of sexual dysfunction. Objective: To investigate the effects of supervised, clinic-based, resistance and aerobic exercise with and without a brief psychosexual education and self-management intervention (PESM) on sexual function in men with prostate cancer compared with usual care. Design, Setting, and Participants: A 3-arm, parallel-group, single-center randomized clinical trial was undertaken at university-affiliated exercise clinics between July 24, 2014, and August 22, 2019. Eligible participants were men with …

Somatic Acupressure For The Management Of The Fatigue-Sleep Disturbance-Depression Symptom Cluster In Breast Cancer Survivors: A Study Protocol For A Phase Iii Randomised Controlled Trial, Mengyuan Li, Tao Wang, Xian Liang Liu, Ren Li Deng, Wai Hang Kwok, Li Qun Yao, Jing Yu Benjamin Tan

Research outputs 2022 to 2026

Introduction The fatigue-sleep disturbance-depression symptom cluster (FSDSC) is commonly experienced by breast cancer (BC) survivors, leading to a deteriorated quality of life (QoL). Somatic acupressure (SA) has been recommended as a promising non-pharmacological intervention for cancer-related fatigue (the core symptom of the FSDSC) in the guidelines, showing its encouraging role in relieving cancer-related sleep disorders, fatigue and depression. This phase III randomised controlled trial (RCT) is designed to evaluate the effects, safety and cost-effectiveness of SA for managing the FSDSC in BC survivors. Methods This phase III RCT will be a partial-blinded, sham-controlled, three-arm, parallel clinical trial, involving a 7-week …

Treatment Efficiency And Quality Improvement Via Double Imaging Modality (Dim) Versus Single Imaging Modality (Sim) Image-Guided Radiotherapy For Prostate Cancer, Milad Mirzaei, Suki Gill, Mahsheed Sabet, Martin A. Ebert, Pejman Rowshanfarzad, Jake Kendrick, Angela Jacques, Clare Herbert, Jeremy Croker, Sean Bydder, Joshua Dass, Edward Bailey, Rohen White, Catherine Moffat, Colin Tang, Adriano Polpo, Nicholas Bucknell

Research outputs 2022 to 2026

Purpose: Daily image-guided radiotherapy (IGRT) for prostate cancer reduces treatment-related toxicity. However, positional and anatomical variations can result in patient re-setup, increased treatment time, and additional imaging dose. A simple technique of two distinct imaging modalities was investigated: initially, an anteroposterior kilovoltage (AP-kV) planar image was acquired, followed by cone beam computed tomography (CBCT). To determine whether this dual imaging modality (DIM) can reduce repeat CBCTs with an AP-kV screening image compared to CBCT alone, i.e. a single imaging modality (SIM). Methods: Patients were enrolled sequentially before and after the new departmental protocol for IGRT. Initially, all patients had a …

Implementing A Nurse-Enabled, Integrated, Shared-Care Model Involving Specialists And General Practitioners In Early Breast Cancer Post-Treatment Follow-Up (Eminent): A Single-Centre, Open-Label, Phase 2, Parallel-Group, Pilot, Randomised, Controlled Trial, Raymond J. Chan, Fiona Crawford-Williams, Chad Yixian Han, Lee Jones, Alexandre Chan, Daniel Mckavanagh, Marissa Ryan, Christine Carrington, Rebecca L. Packer, Megan Crichton, Nicolas H. Hart, Emma Mckinnell, Melissa Gosper, Juanita Ryan, Bethany Crowe, Ria Joseph, Carolyn Ee, Jane Lee, Steven M. Mcphail, Katharine Cuff, Laisa Teleni, Jon Emery

Research outputs 2022 to 2026

Background: Current models of post-treatment cancer care rely heavily on hospital-based, medical specialists and do not sufficiently leverage primary care. Many breast cancer survivors face ongoing unmet needs that may benefit from a multidisciplinary, shared-care approach. We aimed to evaluate the feasibility and preliminary effectiveness of implementing nurse-enabled, shared-follow-up care between the acute and primary care setting for early-stage breast cancer. Methods: In this single-centre, open-label, phase II, pilot, randomised, controlled trial, individuals diagnosed with breast cancer (Stage 0–III) were randomised 1:1 to either usual care or intervention, which includes a 1) Specialist Nurse Consultation to co-develop a survivorship care …

Healthcare Systems-Based Exercise Oncology Programs: Emphasizing And Speaking The Language Of The Clinic And Patient, Jessica S. Gorzelitz, Mary A. Kennedy, Kim Dittus, Sami Mansfield, Karen Wonders, Pamela A. Hansen, Adriana M. Coletta, Neil M. Iyengar, Kelley Covington Wood, Anna L. Schwartz, Melanie Potiaumpai, Anna Campbell, Kathryn H. Schmitz

Research outputs 2022 to 2026

Introduction Exercise oncology services are evidence based and aim to reduce symptom burden and potentially improve outcomes in adults living with and beyond cancer. Healthcare system-based exercise oncology programs include exercise prior to, during, and after treatment, but the implementation and maintenance of these programs are not well documented. We aimed to describe five healthcare system-based exercise oncology programs in the United States, including service information and barriers to and facilitators of program success. Methods This was a qualitative case study of five healthcare-based exercise oncology programs in the United States informed by the Exploration, Preparation, Implementation, Sustainment framework. We …

Families' Experiences Of End-Of-Life Care In An Acute Private Hospital: A Qualitative Study, Rosemary Saunders, Susan Alexander, Julie Andrew, Anne Wilkinson, Karen Gullick, Ashwini Davray, Manonita Ghosh, Karla Seaman, Michelle Gay

Research outputs 2022 to 2026

Objectives This study explored bereaved relatives' experiences of end-of-life care (EoL care) in the last 3 days in an acute private hospital in Australia. Methods An interpretative qualitative study was conducted. Semi-structured interviews with 8 bereaved relatives whose family member had died at an acute private hospital shared their experiences of the EoL care during the last 3 days of life. The transcribed interviews were analyzed using inductive thematic analysis. Results Bereaved family members had mixed experiences, and their primary concerns related to the need for improvements in support for the family; communication; and clinicians partnering with families. The need …

The Effect Of Non-Pharmacological Interventions On Cognitive Function In Cancer: An Overview Of Systematic Reviews, Darren Haywood, Ashley M. Henneghan, Alexandre Chan, Raymond J. Chan, Haryana M. Dhillon, Maryam B. Lustberg, Janette L. Vardy, Moira O’Connor, Norah Elvidge, Evan Dauer, Oscar Y. Franco-Rocha, Shradha Vasan, James Murray, Megan Crichton, Helen Wilding, Susan L. Rossell, Nicolas H. Hart

Research outputs 2022 to 2026

Purpose: A significant number of cancer survivors experience cancer-related cognitive impairment (CRCI), which can impact their ability to think, reason, make decisions, and perform daily actions. In recent years, non-pharmacological interventions for CRCI have gained significant attention. These interventions include exercise, cognitive behavioural therapy, cognitive training/remediation, dietary, mind–body, and multi-modal/complex interventions. This umbrella review provides a critical overview to inform guidelines and current practice, identify the most promising interventions, and uncover gaps in the research literature.

Methods: This umbrella review of systematic reviews was pre-registered on Open Science Framework and PROSPERO. Six databases were searched. Systematic reviews (SR) assessing any …

Trajectories Of Supportive Care Needs For People Who Travel To Receive Cancer Treatment: A Longitudinal Study In Australia, Susannah K. Ayre, Elizabeth A. Johnston, Michael Ireland, Sonja March, Jeff Dunn, Suzanne Chambers, Belinda C. Goodwin

Research outputs 2022 to 2026

Objective: To describe trajectories of change in unmet supportive care needs over a two-year period among people diagnosed with cancer and assess whether these trajectories vary as a function of sociodemographic and clinical characteristics. Methods: This analysis used data from a longitudinal study of people in Queensland, Australia who travelled largely from regional and remote areas to metropolitan centres to receive cancer care (N = 784). Supportive care needs were measured at baseline, then at 3-, 12-, and 24-month post-baseline across five domains (‘psychological’, ‘physical and daily living’, ‘health systems and information’, ‘patient care and support’, ‘sexuality’) using the Supportive …

Beyond Traditional Body Composition Metrics: Load-Capacity Indices Emerge As Predictors Of Cardiometabolic Outcomes—A Systematic Review And Meta-Analysis, Zhongyang Guan, Marianna Minnetti, Steven B. Heymsfield, Eleonora Poggiogalle, Carla M. Prado, Marc Sim, Blossom C.M. Stephan, Jonathan C.K. Wells, Lorenzo M. Donini, Mario Siervo

Research outputs 2022 to 2026

The adaptive and independent interrelationships between different body composition components have been identified as crucial determinants of disease risk. On the basis of this concept, the load-capacity model of body composition, which utilizes measurements obtained through nonanthropometric techniques such as dual-energy X-ray absorptiometry, was proposed. This model is typically operationalized as the ratio of metabolic load (adipose mass) to metabolic capacity (lean mass). In recent years, a series of load-capacity indices (LCIs) have been utilized to identify abnormal body composition phenotypes such as sarcopenic obesity (SO) and to predict the risk of metabolic, cardiovascular, and cognitive disorders. In this review, …

The Mascc Cog-Impact: An Unmet Needs Assessment For Cancer-Related Cognitive Impairment Impact Developed By The Multinational Association Of Supportive Care In Cancer, Darren Haywood, Alexandre Chan, Raymond J. Chan, Frank D. Baughman, Evan Dauer, Haryana M. Dhillon, Ashley M. Henneghan, Blake J. Lawrence, Maryam B. Lustberg, Moira O’Connor, Janette L. Vardy, Susan L. Rossell, Nicolas H. Hart

Research outputs 2022 to 2026

Purpose: Cancer-related cognitive impairment (CRCI) can have a profound impact on the lives of cancer survivors. A multitude of subjective and objective assessment tools exist to assess the presence and severity of CRCI. However, no purpose-built tool exists to assess the unmet needs of cancer survivors directly relating to CRCI. This paper details the development and initial validation of the Multinational Association of Supportive Care in Cancer - Unmet Needs Assessment of Cancer-Related Cognitive Impairment Impact (the MASCC COG-IMPACT).

Methods: A multistep mixed-methods measurement development and validation approach was taken with a strong emphasis on co-design. Qualitative interviews were conducted …

Feasibility And Psychometric Quality Of Smartphone Administered Cognitive Ecological Momentary Assessments In Women With Metastatic Breast Cancer, Ashley M. Henneghan, Emily W. Paolillo, Kathleen M. Van Dyk, Oscar Y. Franco-Rocha, Soyeong Bang, Rebecca Tasker, Tara Kaufmann, Darren Haywood, Nicolas H. Hart, Raeanne C. Moore

Research outputs 2022 to 2026

Objective: Metastatic breast cancer (MBC) is associated with burdensome side effects, including cognitive changes that require ongoing monitoring. Cognitive ecological momentary assessments (EMAs) allow for assessment of individual cognitive functioning in natural environments and can be administered via smartphones. Accordingly, we sought to establish the feasibility, reliability, and validity of a commercially available cognitive EMA platform. Methods: Using a prospective design, clinical cognitive and psychosocial assessments (cognitive batteries; patient reported outcomes) were collected at baseline, followed by a 28-day daily EMA protocol that included self-ratings for symptoms and mobile cognitive tests (memory, executive functioning, working memory, processing speed). Satisfaction and …

Neoadjuvant Anti-Pd-1 Alone Or In Combination With Anti-Tigit Or An Oncolytic Virus In Resectable Stage Iiib–D Melanoma: A Phase 1/2 Trial, Reinhard Dummer, Caroline Robert, Richard A. Scolyer, Janis M. Taube, Michael T. Tetzlaff, Alexander M. Menzies, Andrew Hill, Jean Jacques Grob, David C. Portnoy, Celeste Lebbe, Muhammad A. Khattak, Jonathan Cohen, Gil Bar-Sela, Inderjit Mehmi, Ronnie Shapira-Frommer, Nicolas Meyer, Andrea L. Webber, Yixin Ren, Mizuho Fukunaga-Kalabis, Clemens Krepler, Georgina V. Long

Research outputs 2022 to 2026

Neoadjuvant immunotherapies have shown antitumor activity in melanoma. Substudy 02C of the global, rolling-arm, phase 1/2, adaptive-design KEYMAKER-U02 trial is evaluating neoadjuvant pembrolizumab (anti-PD-1) alone or in combination, followed by adjuvant pembrolizumab, for stage IIIB–D melanoma. Here we report results from the first three arms: pembrolizumab plus vibostolimab (anti-TIGIT), pembrolizumab plus gebasaxturev (coxsackievirus A21) and pembrolizumab monotherapy. Pathologic complete responses occurred in 10 of 26 patients (38%) with pembrolizumab plus vibostolimab, 7 of 25 (28%) with pembrolizumab plus gebasaxturev and 6 of 15 (40%) with pembrolizumab monotherapy. Major pathologic responses occurred in 13 (50%), 10 (40%) and 7 (47%) patients, …

Igg N-Glycosylation Contributes To Different Severities Of Insulin Resistance: Implications For 3p Medical Approaches, Xiaohong Chen, Lois Balmer, Kun Lin, Weijie Cao, Ziyu Huang, Xiang Chen, Manshu Song, Yongsong Chen

Research outputs 2022 to 2026

Background: Reliable biomarkers capturing immunometabolic processes in insulin resistance (IR) remain limited. IgG N-glycosylation modulates immune responses and reflects metabolic disorders, yet its role in IR remains unclear. This study investigated its potential for early detection, risk stratification, and targeted prevention within the framework of predictive, preventive, and personalised medicine (PPPM/3PM). Methods: A total of 313 participants were categorized into three groups based on the homeostatic model assessment for insulin resistance (HOMA-IR): insulin-sensitive (HOMA-IR < 2.69 without diabetes, n = 75), mild IR (HOMA-IR ≥ 2.69 without diabetes, n = 155), and severe IR (HOMA-IR ≥ 2.69 with type 2 diabetes, n = 83). Canonical correlation analysis was conducted to explore the overall relationship between IgG N-glycosylation and IR-related inflammation, indicated by tumour necrosis factor-α, interleukin- 6, C-reactive protein, and adiponectin. Mediation analysis was performed to evaluate the effect of IgG N-glycans on IR. Ordinal logistic regression was used to assess the association between IgG N-glycans and IR severity, with discriminative power evaluated using receiver operating characteristic curves. Results: Pro-inflammatory IgG N-glycoforms, characterized by reduced sialylation and galactosylation, along with increased bisecting N-acetylglucosamine, were observed as IR severity increased. IgG N-glycosylation significantly correlated with inflammatory markers in the insulin-sensitive (r = 0.599, p < 0.05), mild (r = 0.461, p < 0.05), and severe (r = 0.666, p < 0.01) IR groups. IgG N-glycosylation significantly influenced IR (β = 0.406) partially via modulation of inflammation. Increased glycoforms FA2[6]G1 (OR: 0.86, 95% CI: 0.78–0.96) and A2G2S2 (OR: 0.88, 95% CI: 0.82–0.94) were associated with a lower IR risk, with respective area under the curves (AUCs) of 0.752, 0.683, and 0.764 for the insulin sensitive, mild, and severe IR groups. Conclusions: IgG N-glycosylation contributes to IR by modulating inflammatory responses. Glycoforms FA2[6]G1 and A2G2S2 emerge as protective biomarkers, offering potential for predicting and preventing IR through primary prevention strategies within the PPPM framework.

Quality Cancer Survivorship Care: A Modified Delphi Study To Define Nurse Capabilities, Gemma Mcerlean, Heidi Hui, Fiona Crawford-Williams, Nicolas H. Hart, Meinir Krishnasamy, Bogda Koczwara, Thomas Walwyn, Mahesh Iddawela, Rebecca Mcintosh, Raymond J. Chan, Michael Jefford

Research outputs 2022 to 2026

Purpose: To establish capabilities required by nurses to deliver quality cancer survivorship care in Australia. Methods: A two-round online modified Delphi involving Australian cancer nurses. Initial domains and capability statements were based on the Quality of Cancer Survivorship Care Framework and supplemented by national and international nursing frameworks. In Round 1 (R1), experts categorised the applicability of 53 capabilities for cancer nurses, across eight domains, in relation to Australian National Professional Development Framework for Cancer Nursing (EdCaN) groups: ‘All’, ‘Many’, ‘Some’, and ‘Few’ nurses, or not relevant. In Round 2 (R2), experts rated agreement with capabilities allocated to the nurse …

Clinical Impact Of Sub-Clonal Ras/Braf Alterations In Liquid Biopsies From Patients With Advanced Or Metastatic Crc, Peter Gibbs, Khalid Abubaker, Danyi Wang, Zheng Feng, Jawad Hamad, Jiemin Liao, Christopher Stroh, Soetkin Vlassak, Kathrin Heinrich, Adnan Khattak, Juergen Scheuenpflug

Research outputs 2022 to 2026

Introduction: Colorectal cancer (CRC), a global health concern, requires effective treatments. Anti-epidermal growth factor receptor (anti-EGFR) monoclonal antibodies are used for RAS wild-type and BRAFV600 mutation-negative metastatic CRC (mCRC) but are not indicated for RAS mutant CRC. Evidence suggests CRC patients with sub-clonal RAS/BRAF mutations in tumor tissue may benefit from anti-EGFRs. We assessed the outcomes of patients with sub-clonal RAS/BRAF mutated advanced/mCRC receiving anti-EGFRs using liquid-based GuardantINFORM real-world clinical-genomic analysis. Patients and Methods: GuardantINFORM analyzed US patients with advanced CRC with BRAFV600/KRAS/NRAS mutations who received anti-EGFR therapies within 90 days after a Guardant360 test. Primary endpoints were time-to-next treatment …

Exercise And Inflammation In Female Survivors Of Breast Cancer: Systematic Review And Meta-Analysis With Secondary Mediation Analysis On Body Composition, Francesco Bettariga, Dennis R. Taaffe, Anita Borsati, Alice Avancini, Sara Pilotto, Stefano G. Lazzarini, Pedro Lopez, Luca Maestroni, Umberto Crainich, Enrico Bandini, John P. Campbell, Timothy D. Clay, Daniel A. Galvão, Robert U. Newton

Research outputs 2022 to 2026

Purpose: Inflammation plays a key role in breast cancer recurrence and mortality by promoting tumor progression. Exercise significantly reduces pro-inflammatory markers such as IL-6, TNF-α, and CRP, potentially reducing mortality risk. However, it is yet to be determined whether exercise-induced changes in body composition can modulate inflammatory biomarker responses in the breast cancer setting. Methods: We conducted a secondary mediation analysis based on the findings from our previously published systematic review with meta-analysis. Randomized controlled trials examining the effects of exercise on IL-1β, IL-6, IL-8, IL-10, TNF-α, and CRP and body composition and anthropometry measures such as lean mass (LM), …

Treatment Refusal By Cancer Patients: A Qualitative Study Of Oncology Health Professionals’ Views And Experiences In Australia, Moira O’Connor, Ashleigh Pantaleo, Tracey Williams, Mary Theophilus, Jordan Joseph, Nicolas H. Hart, Darren Haywood

Research outputs 2022 to 2026

In some cases, against medical advice, a person with cancer decides not to undergo any conventional, evidence-based cancer treatments including chemotherapy, radiotherapy hormone therapy and others. Estimates for treatment refusal range from 2.6% to 14.55%. Refusing evidence-based conventional cancer treatments is linked to rapid deterioration, poor prognosis and a higher risk of premature death. This study aimed to explore oncology health professionals’ experiences and views on why patients refuse standard cancer treatments. We employed an in-depth qualitative research design, adopting a social constructionist framework. Fourteen health professionals in Western Australia (WA) with experience working in oncology were interviewed. Four themes …

Faculty Of Radiation Oncology 2022 Workforce Census, Hon Trinh, Nathan Stevens, Gerard Adams, Raphael Chee, Tuan Ha, Marcel Knesl, Jack Mitchell, Sakshi Nagpal, Edward Sia, Daniel Xing

Research outputs 2022 to 2026

Introduction: This paper reports the key findings of the Faculty of Radiation Oncology 2022 workforce census. This is the first census since the COVID-19 pandemic and questions have been updated to assess the impact on RANZCR trainees and fellows. This report focuses on the analysis of respondents from Australia, New Zealand and overseas members, with a separate paper to follow focusing exclusively on New Zealand respondents. Method: The census was conducted in mid-late 2022 with many questions repeated from previous censuses. New questions were asked about theranostics, working remotely, hypofractionation and the impact of COVID-19 on work practices. Results: The …

Prognostic And Predictive Value Of Gastric Acid Suppressants In The Eortc 1325/Keynote-054 Randomized Phase Iii Trial Of Pembrolizumab Vs Placebo In Resected Stage Iii Melanoma, Emanuel Bührer, Nina Glassee, Michal Kicinski, Oliver J. Kennedy, Christian U. Blank, Georgina V. Long, Victoria G. Atkinson, Stéphane Dalle, Andrew M. Haydon, Andrey Meshcheryakov, Adnan Khattak, Matteo S. Carlino, Shahneen Sandhu, James Larkin, Susana Puig, Paolo A. Ascierto, Piotr Rutkowski, Dirk Schadendorf, Marye Boers-Sonderen, Anna Maria Di Giacomo, Alfonsus J.M. Van Den Eertwegh, Jean Jacques Grob, Ralf Gutzmer, Rahima Jamal, Alexander C.J. Van Akkooi, Sara Gandini

Research outputs 2022 to 2026

Background: The gut microbiome plays a pivotal role in regulating immunity. Gastric acid suppressants (GAS) are known to alter the gut microbiome and might therefore modify response to immunotherapy in cancer patients. We estimated associations of GAS with recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) in the EORTC 1325/KEYNOTE-054 trial. Methods: Patients with resected stage III melanoma were randomized to receive 200 mg of pembrolizumab or placebo. Pembrolizumab prolonged RFS and DMFS (reported elsewhere). We used Cox models to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the association between GAS at baseline, and RFS and …

Advancing Person-Centred Care Through Palliative Care Wa’S Acp Workshops: The Longer-Term Impact, Gertrude G. Phiri, Emma Gunner, Philip Bafile, Davina Porock

Research outputs 2022 to 2026

Planning for end-of-life and associated decision-making is one of global significance as it impacts the quality of care in palliative care settings, including ensuring that personal preferences are honoured. It is a priority for the Australian health system to use Advance Care Planning (ACP) as it is an effective tool for individuals and their families to make their personal preferences known and implemented. The aim of this project was to evaluate the longer-term impact of the Palliative Care Western Australia (PCWA) ACP workshops. Semi-structured, open-ended questions were used to collect data from 21 participants. Reflexive thematic analysis was used to …

Elevated Inflammation Supra-Additively Promotes The Progression From Prediabetes To Diabetes: A Prospective Cohort Study, Yulong Lan, Dan Wu, Huancong Zheng, Xiong Ding, Hui Zhou, Kuangyi Wu, Weiqiang Wu, Zegui Huang, Xianxuan Wang, Wei Wang, Shouling Wu, Youren Chen

Research outputs 2022 to 2026

Background Factors impacting on the conversion of prediabetes to diabetes or normoglycemia remain unclear. This study aimed to investigate the role of subclinical inflammation, assessed by high-sensitivity C-reactive protein (hsCRP), in the progression to diabetes from prediabetes, assessed by impaired fasting glucose (IFG). Methods Time-to-event survival analyses were conducted among 82 475 participants without diabetes from Kailuan Study (a real-life prospective cohort in China) to access the isolated and joint effect of hsCRP and IFG on diabetes risk, and quantify their relative contribution to incident diabetes. Results Over a median 11-year follow-up, 14 215 diabetes cases were recorded. IFG and …

Prognostic Value Of Neutrophil-To-Lymphocyte Ratio, Platelet-To-Lymphocyte Ratio, And Lactate Dehydrogenase Level In Melanoma Patients Treated With Immune Checkpoint Inhibitors, Wynne Wijaya, Muhammad Adnan Khattak, Afaf Abed, Tarek Meniawy, Michael Millward, Elin Gray, Oliver Oey

Research outputs 2022 to 2026

Introduction: Metastatic melanoma carries a poor prognosis. Immune checkpoint inhibitors (ICIs) have improved outcomes, but responses remain variable, highlighting the need for simple prognostic biomarkers. Inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) reflect tumour burden and inflammation, though their clinical utility is unstandardised. Methods: We retrospectively analysed 103 metastatic melanoma patients treated with anti-PD-1 monotherapy at two centres in Western Australia (2014–2020). Baseline NLR, PLR, and LDH were assessed within 30 days pre-treatment. Outcomes included clinical benefit, progression-free survival (PFS), and overall survival (OS). Results: Poor ECOG performance status (PS ≥2) (RR 2.39, …

Intake Of Total, Classes, And Subclasses Of (Poly)Phenols And Risk Of Lymphoid Neoplasms: A Prospective Analysis In The Epic Cohort, Enrique Almanza-Aguilera, David Guananga-Álvarez, Yolanda Benavente, Alexandra Nieters, Caroline Besson, Fatemeh Saberi Hosnijeh, Cecilie Kyrø, Nicola P. Bondonno, Christina C. Dahm, Elisabete Weiderpass, Therese Truong, Mariem Louati-Hajji, Xuan Ren, Verena Katzke, Matthias B. Schulze, Fabrizio Pasanisi, Claudia Vener, Giovanna Masala, Maria Teresa Giraudo, Rosario Tumino, Amaia Aizpurua, Maria Jose Sánchez, José María Huerta, Marcela Guevara, Cristina Lasheras, Paolo Vineis

Research outputs 2022 to 2026

Background: Existing epidemiological evidence regarding the potential role of (poly)phenol intake in lymphoma development is limited. Methods: We investigated the associations between the intake of total and individual classes and subclasses of (poly)phenols and the risk of lymphoma, including main frequent subtypes in the EPIC cohort using multivariable-adjusted Cox proportional hazards models. Results: During a mean 14-year follow-up (time frame: from 1990–1994 to 2008–2013), 2394 incident lymphoma cases were diagnosed from a total of 367,463 individuals. No significant associations were observed between total intakes of (poly)phenols, flavonoids, and phenolic acids and overall lymphoma risk. Total (poly)phenols, phenolic acid and hydroxycinnamic …

Towards Equitable Cancer Outcomes For Rural And Remote Communities: Reflections, Lessons And Recommendations, Anna Ugalde, Hannah Jongebloed, Charlene Wright, Helena Rodi, Anna Chapman, Skye Marshall, Drew Aras, Rebecca J. Bergin, Sophie Boffa, Anna Boltong, Michele Conlin, Fiona Crawford–Williams, Carl De Wet, Wasek Faisal, Lan Gao, Harry Gasper, Kate Gunn, Nicolas H. Hart, Theresa Hayes, Florian Honeyball, Elizabeth A. Johnston, Deme Karikios, Nicole Kiss, Lucy Leigh, Patricia M. Livingston, Carmel O'Kane

Research outputs 2022 to 2026

People living in rural and remote areas continue to face significant inequities in cancer outcomes compared to their metropolitan counterparts. Despite advances in cancer control, these disparities persist across the cancer trajectory. This personal view consolidates findings from our Equitable Cancer Outcomes for Rural and Remote Communities series, highlighting survival disadvantages, challenges in measuring and reporting rurality, barriers to implementing evidence-based interventions, and shortcomings in historical policy. We argue for place-based, system-level reform that genuinely partners with rural communities, leverages local strengths, and embeds rural voices in research, policy, and service delivery. Key recommendations include adopting a formal partnership position …