Burden of disease measures the impact of living with illness and injury or dying prematurely.
However, bowel cancer received around 46 percent less research funding from the National Health and Medical Research Council (NHMRC) compared to breast cancer (2017: $12.2 million v $22.8 million); and receives no government funding to support dedicated Bowel Care Nurse Specialists, compared around $80 million for Breast Care Nurse Specialists and $30 million for Prostate Cancer Nurse Specialists.
To help address this research funding inequity, Bowel Cancer Australia established the Bowel Cancer Research Foundation Australia.
Through the Foundation, Bowel Cancer Australia has made a significant investment in the Lawrence Penn Chair of Bowel Cancer Research, dedicated to leading edge bowel cancer discoveries that aim to have an everlasting impact on Australia's health future.
The establishment of the Lawrence Penn Chair, in collaboration with the University of Sydney and the Kolling Institute, strengthens our collective pursuit of a bowel cancer cure.
Other major bowel cancer projects funded to date, include the ASCOLT Clinical Trial; ICHOM Colorectal Cancer Standard Set; patient-reported experiences (My Colonoscopy Experience), community awareness and understanding; patient and metastatic patient lived-experiences; and demographic research;
To date, Bowel Cancer Australia, collaboratively with funding partners, has funded $11.6 million in bowel cancer research projects.
You can make a lasting contribution to bowel cancer research through a donation or a bequest (a gift made in your Will) to Bowel Cancer Australia or by calling us on 1800 555 494.
| The gut microbiome and bowel polyps
| Mass Spectrometry Core Facility Opens
Professor Molloy’s focus is on molecular analysis, which can improve understanding of tumour biology and help clinicians make decisions about treatment. It is an area of research that could have a profound impact on the care of bowel cancer patients.
“There is no doubt that technology is driving a big revolution in clinical care,” Professor Molloy said.
One example of this technological transformation is the use of mass spectrometers – sophisticated weighing devices that allow researchers to determine the molecular make-up of various substances.
With two new mass spectrometers installed at the Kolling Institute, Professor Molloy and his team will analyse the molecular features of proteins and metabolites in individual tumours, to tailor treatment pathways according to the needs of each patient.
"When combined with genomic analysis, this gives us a more complete molecular picture of bowel cancer, which is essential to better understand prevention and treatment strategies," Professor Molloy said.
Mass spectrometers could also be used to monitor medication levels in a patient’s body, allowing clinicians to deliver a dose precisely calibrated to suit the individual patient.
The goal is to find ways of integrating molecular analysis into everyday patient care. Professor Molloy envisages that within the next five years clinical teams working with bowel cancer patients could include a molecular scientist.
“Today, these multidisciplinary teams discuss imaging, surgery, approaches to chemotherapy and so on,” he said.
“I’d like to see clinicians also asking how molecular analysis could help add to the fuller picture.”
At the opening of the new facility earlier this month, Professor Molloy explained how the two state-of-the-art mass spectrometry instruments would underpin his research team's effort to map the proteome (the proteins) and metabolome (the metabolites) from specimens provided by bowel cancer patients.
The facility was made possible with a significant financial gift of $500,000 from Bowel Cancer Australia and the Bowel Cancer Research Foundation Australia.
“These new mass spectrometers will have a profound impact on the future of patient treatment and care by allowing researchers to more closely examine bowel polyps, precancerous growths that can grow into cancers, to better understand why they develop in some people,” said Professor Molloy.
Professor Molloy demonstrated how the mass spectrometer can map the proteome using a very small amount of bowel cancer on a pathology slide, revealing the instrument’s incredible capabilities in providing biological information compared to older systems.
“This is viewed as a key aspect of understanding the triggers that allow bowel cancers to grow and metastasize to other body locations,” he added.
Research undertaken by the Lawrence Penn Chair of Bowel Cancer Research is aiming to give new information to clinicians that will better inform them of appropriate treatment pathways based on the molecular information encoded in a patient’s polyp or tumour.
The Lawrence Penn Chair continues to emphasise the importance of research to understand ways we can prevent bowel cancer and to lead the way in providing better treatments for bowel cancer patients.
"We will also explore if this molecular information may be useful for guiding follow-up colonoscopy surveillance timing as this would help improve scheduling and costs," Professor Molloy said.
| Researching why some early stage bowel tumours metastasise to lymph nodes
Funding from the Colorectal Surgical Society ANZ Foundation will support new research to improve our understanding of why some early stage bowel tumours metastasise to lymph nodes.
“This is important because patients with lymph node disease have worse prognosis and face more intense treatment than patients whose cancer remains within the bowel wall,” said Lawrence Penn Chair of Bowel Cancer Research Professor Mark Molloy.
The $60,000 research grant awarded to the Chair will enable molecular analysis to refine risk of dissemination in early stage tumours and transformation potential of some bowel polyps.
“Patients with Stage I bowel cancer have a greater than 98% 5-year rate of survival which falls to around 70% when the tumour has metastasized to lymph nodes,” Professor Molloy said.
“We need to better understand this process to develop medical interventions and stop the tumour disseminating elsewhere," he added.
The project will generate preliminary data using genomic sequencing of early stage tumours and malignant bowel polyps. Professor Molloy and his team aim to link these mutations with those early tumours which spread to lymph nodes, providing a biomarker of risk which may inform surgical pathways.
| Dr Pascal Steffen awarded Early Career Fellowship
A new grant secured by the Lawrence Penn Chair of Bowel Cancer Research laboratory from the Cancer Institute NSW will enable further investigation into the prognostic contribution of immune cell infiltration in rectal cancer.
The $600,000 grant will provide a three-year fellowship salary for Dr Pascal Steffen and help to cover some research costs for him to apply proteomic techniques to investigate the role of immune cells in rectal cancer.
Approximately 5,000 Australian men and women are diagnosed with rectal cancer each year. The aim of Dr Steffen’s CINSW fellowship is to understand the involvement of immune cell infiltration in rectal cancer, how this impacts tumour biology and how it affects patient outcomes.
To conduct the study over the next three years, Dr Steffen will apply his knowledge of protein mass spectrometry with access to the large archival rectal cancer tissue database at Royal North Shore Hospital. He will map the proteome (proteins found in the cancer) of these rectal cancers to understand their biology and how this links to patient prognosis, and work to resolve the complex immune cell architecture of these cancers by using a new technique of imaging mass cytometry.
The outcome of this research will lead to new prognostic biomarker panels, provide a better understanding of immune cells in rectal cancers and pave the way for new treatments.
“I am very excited to receive the CINSW fellowship as it will allow me to apply my expertise in proteomics to the cause of advancing the understanding of the role of immune cells in rectal cancer and furthering the research of new ways to combat this disease. This fellowship will also grant me the opportunity to broaden my knowledge especially in the field of immunology and imaging techniques,” said Dr Steffen.
Dr Pascal Steffen will conduct his fellowship in the Bowel Cancer and Biomarker Laboratory at The Kolling Institute, Royal North Shore Hospital in Sydney under the supervision of Professor Mark Molloy, Lawrence Penn Chair of Bowel Cancer Research, The University of Sydney.
“One of the key objectives for the Chair of Bowel Cancer Research is to increase research capacity and foster researcher development. I am delighted that the CINSW is supporting our vision through the award of this prestigious fellowship to Pascal. His research will reveal important new understandings in rectal cancer which is an essential step towards improving the outcomes for people with this disease,” Professor Molloy said.
Dr Pascal Steffen is a post-doctoral research associate (early career research fellow) and the newest member of the team working with the Lawrence Penn Chair of Bowel Cancer Research, Professor Mark Molloy.