A further step in cancer research at Cabrini
Cabrini Cancer Institute, opened in April 2021, is a further step in the development of cancer research at Cabrini. Research at Cabrini is currently carried out by the departments of medical oncology, surgery, urology, radiation oncology, psycho-oncology and palliative care and there are currently more than 100 active clinical trials for patients to participate in.
A grant from the Federal Government has allowed us to develop phase one of a two-part project to create the Cabrini Cancer Institute. Phase one allows us the capacity to double the number of clinical trials within the next two years and create a state-of-the-art exercise research facility to better understand how to integrate exercise into every cancer patient’s treatment. Associated with the exercise research is a fully functional gymnasium staffed by Cabrini exercise physiologists.
The development of the Cabrini Cancer Institute also allows the expansion of research in patient experience using Patient Reported Outcome Measures (PROMs), development of novel techniques to determine best therapies, such as tumour organoids, collection and analysis of data to improve patient outcomes, and provision of exercise and wellbeing programs. Cabrini is committed to providing innovative, integrated, individualised, multidisciplinary, personalised cancer care for patients from pre-diagnosis through to treatment and survivorship, including palliative care.
As one of Australia’s leading providers of cancer services, the integration of the Cabrini Cancer Institute within the Cabrini Malvern hospital allows researchers and clinicians to better work together, developing breakthroughs to deliver better health outcomes for all cancer patients.
We place our patients at the very centre of a multidisciplinary team, recognising a patient’s right to actively participate in decisions concerning treatment and ongoing care. A range of healthcare professionals from different specialties work together to provide the optimum care. This approach ensures access to the right people who can help with every aspect of patients’ treatment and recovery, whether it be surgery, nursing, rehabilitation or counselling.
Clinical trials – new cancer treatments
The Cabrini Cancer Institute allows better access to new cancer treatments of all types. Collaboration with the Monash Academic Health Sciences Centre allows the integration of exciting translational research, where findings from the laboratory can be used to design more effective and less toxic treatments for patients. It allows the ability to tailor treatments for individual patients, better known as precision (or personalised) medicine.
Precision medicine is an emerging approach for disease treatment and prevention, which takes into account individual variability in genes, environment, and lifestyle for each person. This approach allows doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people. It is in contrast to a one-size-fits-all approach, in which disease treatment and prevention strategies are developed for the average person, with less consideration for the differences between individuals.
It involves the following:
- New Drug Discovery: For many years, the only available options for treating cancer were to surgically remove it or to kill the rapidly dividing cells with cytotoxic chemicals or radiotherapy. These were blunt tools compared to today’s therapeutic strategies. Although all three modalities still play a vital role, their use is now often in combination with a more sophisticated generation of targeted drugs and immunotherapies. Cabrini currently has more than 100 clinical trials using novel cancer drugs. Furthermore, we have a cancer organoid (3-D tumours developed in vitro) program in colorectal, breast and ovarian cancers, that involves drug sensitivity and toxicity profilings.
- Cancer Genomics: Cancer genomics is the study of the totality of DNA sequence and gene expression differences between tumour cells and normal host cells. It aims to understand the genetic basis of tumour cell proliferation and the evolution of the cancer genome under mutation and selection by the body environment, the immune system and therapeutic interventions. Beyond the identification of individual targetable alterations, genomic methods can gauge mutational load, which might predict a therapeutic response to immune-checkpoint inhibitors or identify cancer-specific proteins that inform the design of personalised anticancer vaccines. Emerging clinical applications of cancer genomics include monitoring treatment responses and characterising mechanisms of resistance. Cabrini participates in the Monash Partners Comprehensive Cancer Consortium (MPCCC) precision medicine program, identifying actionable tumour mutations for specialised treatment programs. Immunotherapy: Cancer immunotherapy is a therapy used to treat cancer patients that involves or uses components of the immune system. Cabrini currently has more than 50 active immunotherapy drug trials, and works in partnership with the Hudson Institute and Peter MacCallum Cancer Centre in development of CAR-T therapies in solid tumours.
Visit our cancer trials page
Organoids are a promising area of research that have the potential to shape the future of personalised cancer treatment for patients. Organoids are three-dimensional cultures of cells grown in a laboratory dish from tissue biopsies from healthy patient tissues and tumours. Organoids mimic the complex features of the tissue from which they are derived and are a powerful research tool that can be used to test common therapeutics to determine if a patient is likely to respond to treatment. As a research tool combined with extensive patient data captured at Cabrini, organoids can also be used in high-throughput drug testing to identify novel agents, improve our understanding of cancer biology and make predictions about patient survival outcomes. The Cabrini Cancer Institute is at the forefront of organoids research, collaborating with Professor Helen Abud’s laboratory at the Monash Biomedicine Discovery Institute, Monash University, a world leader in organoid research development. Organoid research at the Cabrini Cancer Institute is currently being conducted in colorectal cancer, breast cancer and ovarian cancer, with the aim of expanding into other cancers. The research teams, Cabrini Monash University Department of Surgery and Cabrini Monash University Department of Medical Oncology, are leading organoid research at the Cabrini Cancer Institute.
Epigenetics is the study of inheritable changes in gene function that are not associated with changes in the DNA sequence. The epigenetic outlook of a cell is determined by status of DNA methylation, histones covalent modifications, chromatin structure, and non-coding RNAs and networking with each other. The Department of Medical Oncology and Department of Surgery at Cabrini work closely with the Department of Biochemistry and Molecular Biology, Biomedical Discovery Institute at Monash University in epigenetic research.
Measuring the experiences of patients and reporting back to the health system enables cancer services and health professionals to better understand the unique needs of people affected by cancer. Understanding a patient’s perspective throughout each stage of their cancer experience can enable more personalised treatment and drive improvements in the quality of care provided by cancer services. Patient Reported Outcome Measures (PROMs) capture the perspectives of patients on their experiences and outcomes of their cancer care. Gathering patient-reported measures involves asking cancer patients about their experiences and outcomes, which ultimately measures their overall wellbeing. Cabrini currently has PROMs research in chemotherapy toxicity and lung and pancreatic cancers. We are currently developing the PROMs instrument for the Victorian Lung Cancer Registry.
A complete and detailed collection of data about every cancer is the key to understanding this complex disease – the symptoms people have, how their cancer is diagnosed, how they respond to treatment and how their cancer progresses over time. The current areas where Cabrini uses medical informatics include:
- Cancer registries: Australia has comprehensive population-based cancer registries in each state and territory. The primary role of these registries is broad population health surveillance and research support. They are coordinated nationally through the Australian Institute of Health and Welfare (AIHW) and the Australasian Association of Cancer Registries (AACR).
- Individual cancer databases: Cabrini cancer care is divided into tumour streams, allowing multimodality treatment. There are currently comprehensive databases in colorectal, breast, lung, and gynaecologic cancers. There are plans to develop further databases in all other tumour streams.
- Big data: Extremely large data sets may be analysed computationally to reveal patterns, trends, and associations. This helps identify novel therapeutic targets, design biomarker-driven clinical trials and find genomic determinants of response to therapy. Artificial intelligence algorithms are already beginning to affect cancer research and clinical care, such as early diagnosis and prevention, drug discovery, matching patients to clinical trials and treatment decisions. It impacts cancer research in sequencing cancer genomes, high-throughput sequencing of patient samples, and analysis of transcriptomes for better cancer monitoring, incorporating machine learning algorithms for diagnostic modelling, presenting greater clarity on disease prognosis, and research into cancer relapses.
Exercise and wellbeing research
It has been estimated that 30–40 per cent of all cancers can be prevented by lifestyle and dietary measures alone. Dietary management, exercise and psychological intervention can also reduce the deleterious effects of cancer treatment and improve overall survival results.
- Exercise during and following cancer treatment has many benefits. It can improve physical and emotional wellbeing and improve quality of life. Exercise can help manage treatment and cancer related side effects such as fatigue, pain and lowered bone density. It can also improve mood, sleep, body weight, muscle strength, confidence, depression and anxiety. There is very strong evidence that targeted exercise can also reduce the risk of cancer recurrence. Cabrini has been given a grant by the Federal Government to develop a comprehensive cancer exercise program, including building a state-of-the-art exercise laboratory. The exercise laboratory at the Cabrini Cancer Institute is one of only a few exercise laboratories in the world dedicated to cancer patients. The new world class exercise research laboratory at the Cabrini Cancer Institute will investigate the potential positive benefits of exercise and exercise therapy/rehabilitation in patients across the entire cancer continuum. Positive research findings will be incorporated into programs offered through the Cabrini Cancer Exercise and Wellness Centre.
Clinical psychologists and psychiatrists offer specialist help with the often complex emotional journey of cancer diagnosis and treatment. They work closely together to provide all aspects of psycho-oncology care, including counselling and psychotherapy to patients and their families to address significant emotional adjustment concerns following a diagnosis of cancer and associated treatment effects and lifetime adjustment concerns. There are currently three projects ongoing at Cabrini:
- The feasibility of implementing an innovative collaborative care model to treat cancer-related depression in the community: evaluation report
- Return to usual activities after breast cancer treatment
- Meaning and purpose (MaP) therapy in advanced cancer patients: a multi-site randomised controlled trial
Obesity, nutrient sparse foods such as concentrated sugars and refined flour products, low fibre intake, consumption of red meat, and imbalance of omega 3 and omega 6 fats all contribute to excess cancer risk. Appropriate dietary management can not only reduce the incidence of cancer, it can reduce toxicity from treatments and aid full recovery from cancer. Furthermore, the gastro-intestinal microbiome has been shown to have a role in response to cancer treatment, with evidence suggesting that modulating the gut microbiome may impact responses to numerous forms of cancer therapy. Cabrini has an academic dietetics unit, as part of the department of allied health, and is involved in a number of research projects.
Cabrini Cancer Exercise and Wellness Centre
The Cabrini Cancer Exercise and Wellness Centre will embed research into the development and evaluation of its program structure and delivery of its programs and services. In a relaxed, welcoming and comfortable environment, this centre will be overseen by dedicated wellness coordinators. The Cabrini Cancer Exercise and Wellness Centre is dedicated to focusing on cancer exercise and wellness and providing information and support to cancer patients and their carers throughout their journey, ensuring that Cabrini better meets the needs of each cancer patient.
At Cabrini we continue to develop creative, new and evidence-based rehabilitation programs and services dedicated to cancer patients. We want to ensure our patients are active participants in their cancer recovery in terms of their health, physical function and quality of life.
Our integrated cancer services are designed to lessen a patient’s worry, by giving them access to the latest information, peer support, nutritional advice, individually tailored exercise programs, counselling and symptom management to better manage their health and wellbeing. These programs are designed to support patients who may experience functional decline, weakness, fatigue or emotional issues related to their treatment and management of cancer.
We offer many individualised and group programs specifically tailored for patients diagnosed and living with cancer. These programs can be accessed before, during and after cancer treatment, both in and outside the hospital setting. They are aimed to ensure cancer survivors are engaged in their own health behaviours, promote wellness and to empower people living with cancer.
Our free group sessions, Wellness Education, are facilitated by discipline-specific experts in exercise, nutrition, psychology, health and wellness, and is held regularly throughout the year and are available free of charge to all patients.
We are your specialists in supportive integrated cancer care at diagnosis, during treatment, into survivorship and beyond, and we look forward to welcoming you.
Did you know?
- Recent research suggests that exercise benefits most people both during and after cancer treatment, from reducing fatigue and improving your wellness and physical fitness, to building your confidence.
- Good nutrition helps to manage the side effects of treatment and boosts your body’s immune system and ability to fight infections.
- A cancer diagnosis can bring emotional challenges; talking to others, attending support groups and trying complementary therapies such as relaxation and meditation have proven benefits.
For referrals and enquiries regarding our allied health services and programs, please contact ACCESS on (03) 9508 1700 or email email@example.com.
View our Cancer Exercise and Wellness Programs