Giving cancer a hi-tech taste of its own medicine

The Kinghorn Cancer Centre in Sydney is bringing together the best of research and clinical expertise for the benefit of patients. Will Turner reports.

The Challenge: Making best use of cancer research and clinical knowledge in order to improve treatment for people with cancer.

The Approach: A centre where cancer specialists and researchers work together to find personalised solutions to each person’s cancer, by understanding an individual’s needs at the molecular level.

The Outcomes: It is anticipated that this approach will fast track locating therapies that will be specifically effective for each patient and in the process reduce costs to the health system.

The Lessons Learned: Patients, researchers and health professionals working together is a powerful mix for maximising the success of cancer treatment.

The Upside for:

Clinicians: More resources on hand to determine the best treatment path for their patients, able to contribute to research efforts through open and regular communication with scientists.

Patients: Placed at the centre of all decisions, plus more precise treatment meaning less side effects from regimens that do not benefit them.

The Organisation: Has unique capabilities to address the challenges being faced by individuals and society at large in dealing with cancer.
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Cancer patients stand to benefit from the latest high-tech research and ehealth systems available at a new cancer centre launched by Prime Minister Julia Gillard and pop diva Delta Goodrem.

The Kinghorn Cancer Centre, operating within St Vincent’s Research Precinct, was commissioned in late August and is the focus of new efforts to improve care for cancer patients.

Professor Allan Spigelman, the centre’s inaugural clinical director, said the building represents a merging of interests between the Garvan Institute of Medical Research and St Vincent’s Hospital.

“On the St Vincent’s [Hospital] side we wanted to improve how we treat patients, and Garvan saw an opportunity to improve their research.”

He added that until now there has been a divide between the clinical and research arms of the St Vincent’s precinct, signified by the respective facilities being on different sides of the street.

One of the key aspects of what the centre offers is what is calls genomic medicine. Professor Spigelman said research knowledge about genetic profiles now enables doctors to “sub-stratify” patients and be more clear-cut about what treatments will work most effectively for them.

“Genomic medicine holds the promise of more precise treatment because a person’s molecular profile can help determine the most appropriate therapy rather than the typical scattergun approach,” he said.

In practical terms this could mean a person with bowel or breast cancer might be spared from chemotherapy and its debilitating side effects if it can be shown that treatment won’t work.

However, the centre’s activities are not limited to hi-tech science. Professor Spigelman said holistic care is a critical part of the enterprise, an ethos reflected in the building design which incorporates large amounts of natural light and attractive spaces for patients to have time away from areas that are unavoidably sterile. “It doesn’t look like a typical hospital,” he remarked.

Another important element is the wellness centre where patients can go for massage therapy and seek information and advice about how they can best manage their health. Professor Spigelman said patient surveys consistently report a focus on “quality of life” is lacking in many  hospitals, and hopes these services will help address such concerns.

This has also led to the centre offering advice about how patients can make best use of alternative therapies such as chinese acupuncture. “We want to get away from the negativity around evidence-based complementary medicine,” he said.

On the topic of information technology, Professor Spigelman said electronic patient records and clinical decision support systems will go “hand in hand” with delivering the best care. He said contracts have now been signed with a vendor to supply an IT system that gives both clinicians and researchers real-time access to patient records.

The goal is to share information related to each of the diagnosis, treatment and research stages, and do so over the course of a patient’s treatment for a period of between one and five years.

Meanwhile, Professor Spigelman said the centre will take advantage of telehealth technologies, building on St Vincent’s existing facilities at clinics across the state. This will let rural and remote doctors take part in multidisciplinary team meetings, research discussions and clinical presentations.

He also said telehealth will also mean the centre’s unique area of expertise in genomic medicine will benefit rural people with cancer. For example Professor Spigelman said the images of a patient’s tumour could be analysed by experts at the centre with his or her doctor virtually in the room discussing the situation with them.

Professor Spigelman, who also directs cancer services at St Vincent’s Hospital, added the centre will also build on existing resources and expertise across the health sector. For example, it will not attempt to treat and research every type of cancer across every age group.

“We are more of a boutique than a supermarket - which makes us more responsive to the task at hand,” he said.