Burden of the present – hope of the future

Many of us are touched by cancer in some way during our lives, and with an ageing population and growth in population numbers, we can expect to see a rise in the number of cases of cancer diagnosed. Incidence is increasing, with 30 per cent more cancer cases expected in Australia over the next 10 years. Cancer death rates have fallen with the introduction of screening, earlier diagnosis and new therapies. However, many cancers still have a very poor outlook and all cancer outcomes urgently need further improvement.

A vision now exists to provide Victorians with the best possible chance in the future fight against cancer by linking clinical care with research and teaching at the Victorian Comprehensive Cancer Centre (VCCC). The vision is to significantly accelerate the reduction in deaths in collaboration with other cancer centres in Victoria and around the world.

The VCCC is a powerful alliance of eight successful cancer programs with each of the partners bringing strengths, quality high-impact work, outstanding research capabilities and histories of caring for patients. Participants are: the Peter MacCallum Cancer Centre, Melbourne Health, the University of Melbourne, the Walter and Eliza Hall Institute of Medical Research, the Royal Women’s Hospital, the Royal Children’s Hospital, Western Health and St Vincent’s Hospital Melbourne. These partners will work together to develop new knowledge and innovation, shared with colleagues around the State.

The VCCC will focus on the needs of the person with cancer and those in our community at risk of cancer. As part of this alliance, the University of Melbourne offers a depth of world-class teaching and is a leading light in new genomics markers for diagnosis and understanding cancer risk. With a strong Department of Pathology and a well-developed school of Public Health, the University is well positioned to make advances by developing more innovative methods of diagnoses and to support clinicians in their work to reduce the burden of cancer in our community.

The University will also continue to make a significant contribution to the ‘bigger picture’ through its School of Population Health and its molecular epidemiology program. This program’s large collection of tissue and data offers University researchers and geneticists valuable insights into the population at risk of cancer.

Genomics will be a key factor in determining how we identify, classify and treat cancers in the next 20 years. It gives us a prism through which to look at prevention, behaviour detection, potential new therapies and eventually cures. This future promises us the science to discover the unique make-up of individuals, giving us a deeper understanding of who is really at risk of cancer and who has little or no risk.

If researchers, clinicians and geneticists can offer more specific information to the general population about their lifetime risk of cancer, then we can expect to engage more people more effectively in preventive behaviours. Health promotion programs such as QUIT, SunSmart and screening initiatives promote positive health messages we absorb and use to make changes in our daily lives. These, in the future could be targeted to people at higher risk due to their genetic make up.

We know that some families carry increased genetic risks. Genomics enables us to quantitate the risks for such families and alleviate anxiety for those at reduced or no risk.

In the future genomics will also give us an insight into which cancer patients will respond to specific treatments, or not. Genomics will enable us to make discoveries of new therapies and, being a science of precision, offers us increased hope for the future through personalised medicine. Many patients are already beginning to benefit from the development of personalised or targeted therapies against specific genetic mutations in diseases such as melanoma and chronic myeloid leukaemia.

By harnessing the best ideas and research, the VCCC aims to increase cancer survival rates and improve the quality of life of those living with cancer. This world-class centre of excellence will change the way we care for patients linked with cancer programs across the State. The benefits of this model of integrated care, research and teaching working collaboratively with other centres will also support students as they learn to practice medicine immersed in a research culture, with an evidence-based approach to patient care coupled with the inquisitive, creative thinking required of the researcher.

The development of the VCCC and its increasing research capacity will bring benefits to all cancer patients through knowledge generation and transfer, strengthening Australia’s role as a world leader in biomedical research.

There are still many challenges ahead. We must all be advocates for the lesser-known cancers, especially those with poor outcomes. Patients diagnosed with cancers that have poor survival rates, we hope, will be major beneficiaries of new scientific knowledge in the future.

Integrating teaching, research and clinical expertise and by incorporating the new knowledge and innovation in collaboration with colleagues around Victoria and internationally, makes the future of cancer medicine brighter.

www.vcccproject.vic.gov.au