Country profile: Australia,New South Wales. From validation to implementation: Progressing tobacco smoking cessation among people with cancer and beyond via relevant authorities

This paper delineates how a program of tobacco smoking cessation after a cancer diagnosis was achieved by engagement of multiple stakeholders, government, and non-government authorities in one jurisdiction in Australia, New South Wales. While it had become increasingly obvious that smoking cessation imparts benefits akin to other known treatment modalities, knowledge of this generalisation is without benefit unless this information is delivered in a trusted context and means to quit are made available. Against a backdrop of little enthusiasm among clinicians, the Cancer Institute NSW, charged with implementing tobacco control strategies, decided to focus its 2017 annual colloquium on the topic. While the evidence was unequivocal, better clarity was needed that this was indeed a clinical responsibility, and on the resources needed. The Clinical Oncology Society of Australia, (COSA) a non-governmental peak national body representing cancer care professionals, addressed this challenge. The society’s governing body resolved to develop a position statement indicating how smoking cessation might be integrated within hospital-based cancer care. The position statement, endorsed by nineteen other cancer and non-cancer organisations, provided reassurance to the Institute to improve record capture of hospital smoking information; upskill all clinical staff and develop an automatic “patient opt out” referral to existing resources such as the Quitline. Early pilot work shows that people newly diagnosed with cancer who smoke and who were advised at that time to quit increased from 55% in 2016 to 72% in 2019.     

Research to realisation: the challenging path for novel pest management products in Australia

In this Overview , we explore the linkages between basic research and the commercial development of novel pest management products in Australia. Despite the large volume of research in fundamental and applied aspects of entomology, very few new pest management products are developed and commercialised in Australia. Reasons for this include demanding and expensive regulatory requirements which (as in many other countries) mean that commercial development is the province of large multinational agrochemical companies. We describe the Australian regulatory system and the opportunities and difficulties it can present, using examples from recently registered Australian products, Magnet^® moth attractant and the MOOV^® range of insect repellents. The science behind these products is described in a series of papers in this issue of Australian Journal of Entomology . We also explore some of the commercial imperatives in novel product development, and aspects of the interactions between researchers and commercial partners. Finally, we discuss potential advantages of Australia as a locale for commercial development of novel products.     

Antidiabetic pharmacology: a link between metabolic syndrome and neuro-oncology?

One of the main topics of the annual meeting of the American Society for Clinical Oncology in 2011 were the results presented on breast cancer chemotherapy and concomitant administration of the oral antidiabetic metformin. The overall agreement was that current evidence is just enough to dramatically change the clinical practice of oncology, and in our case, brain cancer treatment, and that further research is needed to address the relationship between diabetes, metabolism, insulin analogues and neoplasia. Still, it is very interesting to explore the potentially beneficial effects of metformin in glioma chemo/immunotherapy and wait for results in the clinic. In the current paper we present the cell and molecular aspects of the metabolic syndrome, metformin administration and cancer chemotherapy, with a special emphasis in neuro-oncology, since brain tumors are usually devastating diseases with an extremely high mortality within two years of diagnosis even when surgical, radiotherapeutic and chemotherapeutic interventions are applied.     

The formation of the American Society of Clinical Oncology and the development of a medical specialty, 1964-1973

In April 1964, seven physicians met to discuss the formation of a new medical society for clinicians interested in the management of patients with cancer. Chemical warfare research during World War II had led to the advent of chemotherapeutic agents, a new, systemic approach toward cancer treatment. While skeptics questioned the benefits of chemotherapy, some internists viewed these drugs as promising new tools. Founders of the American Society of Clinical Oncology built their organization upon the importance, despite potential dangers, of utilizing chemotherapy as an essential component of cancer treatment, and positioned themselves as best qualified to manage the care of patients with cancer. The establishment of a new professional organization helped to anchor medical oncology as a distinct field during a time of increasing medical specialization in the United States. This essay examines the Society's early history within a broader context of the development of new chemical agents and cooperative groups, the formation of a new subspecialty, and increasing federal involvement in health care policy and funding, and describes the struggle of medical oncologists to solidify their authority over clinical cancer research and patient care.     

Do we want more cancer patients on clinical trials If so, what are the barriers to greater accrual

It is often stated that only a small proportion of adult cancer patients participate in clinical trials. This is said to be a bad thing, with calls for more trials to include more patients. Here I argue that whether or not greater accrual to clinical trials would be a good thing depends on the trials we conduct. The vast majority of clinical trials in cancer are currently early phase trials, and most do not lead to further studies even if they have encouraging results. The key metric is thus not the number of patients on clinical trials, but the number on the sort of large, randomized, Phase III trials that can be used as a basis for clinical decisions. I also address two important barriers to greater clinical trial participation. The first barrier is financial: clinical research has long been the poor cousin of basic research, with perhaps no more than a nickel in the cancer research dollar going to clinical research. The second barrier is regulatory: clinical research has become so overburdened by regulation that it takes years to initiate a trial, and dedicated staff just to deal with the paperwork once the trial starts. This not only adds significantly to the costs of clinical research, but scares many young investigators away. It has been estimated that nearly half of all US-sponsored trials are being conducted abroad, and it is plausible that excessive regulation is at least partly responsible. That statistic should serve as a wake-up call to the US clinical research community to implement the recommendations of the now decade-old report of National Cancer Institute Clinical Trials Program Review Group, which largely center around simplifying trials and streamlining trial procedures.     

The Human Oocyte Preservation Experience (HOPE) a phase IV, prospective, multicenter, observational oocyte cryopreservation registry

Background  

It has been recommended by the American Society of Clinical Oncology and the American Society of Reproductive Medicine that options to preserve fertility be presented at the outset of treatment for cancer. This recommendation may have arisen, in part, to the increasing survival of patients with cancer and the realization that certain forms of cancer treatment can lead to infertility. One option for these patients, particularly those with ethical or religious objections to freezing embryos is oocyte cryopreservation. However universal acceptance of these procedures has yet to be established, most likely due to a poor history of success and concerns that there has yet to be a comprehensive approach to evaluating these techniques. In light of this, a registry of patients undergoing oocyte cryopreservation, called the HOPE registry, is being implemented.     

Follow-up after breast cancer treatment

BackgroundBreast cancer (BC) is the most common malignancy in women. Due to improved detectability and modern methods of treatment, the number of breast cancer survivors is estimated at 6 million women globally and is still increasing. The follow-up (FU) visits carried out at the Greater Poland Cancer Centre were assessed for compliance with Polish Society of Clinical Oncology (PTOK) and European Society for Medical Oncology (ESMO) guidelines.Materials and MethodsThe database covered 484 women who were treated for breast cancer in the Greater Poland Cancer Centre in 2013. Of these, 233 attended FU visits for 5 years after completion of radical treatment and had no cancer relapse. The number of FU visits and the number and type of additional tests performed were analyzed.ResultsThe median number of FU visits over 5 years was 14, which is in line with the guidelines. 51.6% women had a mandatory annual mammography. A significant number of women had additional tests that are not recommended in the guidelines.ConclusionsThere is a need to educate both physicians and patients on the principles of FU check-ups.     

Personal orientations towards Australian national identity among British-born residents

An area of long-standing interest in sociological studies of nationality and ethnicity has been the implications of widespread cross-border movements of peoples for cultural identity. One important stream of research has been concerned with peoples who have moved to a new country that is culturally different from their “homeland”. Yet, far less attention has typically been given to those who shift to a country that is culturally alike. The study examines how peoples who have relocated from Great Britain to Australia feel about various ideas at the heart of contemporary debates about Australian national identity. Drawing on data from a 2001 survey of Australian national identity, analysis indicated that (i) British-born residents differ from the Australian-born in how their attitudes to key ideas about Australian national identity are “packaged” together, and (ii) among the British-born, views about Australian national identity vary across subgroups with different configurations of national pride.     

Proceedings from the Melanoma Research Foundation Mucosal Melanoma Meeting (December 16, 2022, New York,USA)

Mucosal melanoma remains a rare cancer with high mortality and a paucity of therapeutic options. This is due in significant part to its low incidence leading to limited patient access to expert care and downstream clinical/basic science data for research interrogation. Clinical challenges such as delayed and at times inaccurate diagnoses, and lack of consensus tumor staging have added to the suboptimal outcomes for these patients. Clinical trials, while promising, have been difficult to activate and accrue. While individual institutions and investigators have attempted to seek solutions to such problems, international, national, and local partnership may provide the keys to more efficient and innovative paths forward. Furthermore, a mucosal melanoma coalition would provide a potential network for patients and caregivers to seek expert opinion and advice. The Melanoma Research Foundation Mucosal Melanoma Meeting (December 16, 2022, New York, USA) highlighted the current clinical challenges faced by patients, providers, and scientists, identified current and future clinical trial investigations in this rare disease space, and aimed to increase national and international collaboration among the mucosal melanoma community in an effort to improve patient outcomes. The included proceedings highlight the clinical challenges of mucosal melanoma, global clinical trial experience, basic science advances in mucosal melanoma, and future directions, including the creation of shared rare tumor registries and enhanced collaborations.     

Human skeletal remains from Cossack,Western Australia

Human remains of a male individual from Cossack, northwestern Australia are described. Absolute dating is not possible but site geomorphology restricts the upper limit to 6500 B.P. Morphologically and metrically the skull differs from those of recent Western Australian male Aborigines, but it is very similar to that of Kow Swamp I and others included in the “robust” prehistoric Australian Aboriginal group (Thorne, 1977). The specimen is important as indicating the widespread nature and probable recency of a large, robust Australian Aboriginal population demonstrably different to recent populations.     

The importance of looking at small-scale patterns when inferring Gondwanan biogeography: a case study of the centipede Paralamyctes (Chilopoda, Lithobiomorpha, Henicopidae)

Gondwanan biogeography has fascinated zoologists and botanists for over a century, but most biogeographical work has used continent-scale areas as analytical units. More finely resolved patterns, as can be obtained from small invertebrates with limited dispersal abilities, will be obscured in those studies. A common case is treating Australia as a single biogeographical region. In the present study, the necessity of splitting Australia into multiple microareas is demonstrated using centipedes as an example. The lithobiomorph centipede Paralamyctes is distributed on fragments of Gondwana, with species in southern Africa, Madagascar, southern India, Patagonia, eastern Australia, and New Zealand. A cladogram for Paralamyctes is based on morphology and sequences for four molecular markers for 30 terminals that sample 20 of 26 known ingroup species and four outgroups. Analysis with direct optimization across a range of indel costs and transversion : transition cost ratios identifies two main clades: Paralamyctes ( Paralamyctes ) unites species from southern Africa, Madagascar, tropical and warm temperate Australia, and New Zealand. The other group includes the temperate Australian/New Zealand Paralamyctes ( Haasiella ) and Paralamyctes ( Thingathinga ) and a Chilean clade. Subtree analysis finds that different parts of Australia have closest affinities to other Gondwanan fragments, and some of these relationships (such as that between north Queensland and New Zealand) are based on taxonomically stable clades. Area delimitation for large continental fragments should use sufficiently fine resolution to test the 'monophyly' of those fragments and attempt to eliminate spurious geographical paralogy.  © 2006 The Linnean Society of London, Biological Journal of the Linnean Society , 2006, 89 , 65–78.     

Undergraduate cancer education in Spain: The debate,the opportunities and the initiatives of the University Forum of the Spanish Society of Radiation Oncology (SEOR)

Most medical schools in Spain (80%) offer undergraduate training in oncology. This education is highly variable in terms of content (theory and practical training), number of credits, and the medical specialty and departmental affiliation of the professors. Much of this variability is due to university traditions in the configuration of credits and programmes, and also to the structure of the hospital-based practical training. Undergraduate medical students deserve a more coherent and modern approach to education with a strong emphasis on clinical practice. Oncology is an interdisciplinary science that requires the input of professors from multiple specialties to provide the primary body of knowledge and skills needed to obtain both a theoretical and clinical understanding of cancer. Clinical skills should be a key focus due to their importance in the current model of integrated medical management and care.Clinical radiation oncology is a traditional and comprehensive hospital-based platform for undergraduate education in oncology. In Spain, a significant number (n = 80) of radiation oncology specialists have a contractual relationship to teach university courses. Most Spanish universities (80%) have a radiation oncologist on staff, some of whom are department chairs and many others are full professors who have been hired and promoted under competitive conditions of evaluation as established by the National Agency for Quality Evaluation.The Spanish Society of Radiation Oncology (SEOR) has identified new opportunities to improve undergraduate education in oncology. In this article, we discuss proposals related to theoretical (20 items) and practical clinical training (9 items). We also describe the SEOR University Forum, which is an initiative to develop a strategic plan to implement and organize cancer education at the undergraduate level in an interdisciplinary teaching spirit and with a strong contribution from radiation oncologists.     

The necessity, aim and tasks of establishing the Oncology Nursing Section of the Hungarian Cancer Society

The Hungarian Cancer Society organized its 27th Congress in Budapest on the occasion of its 50th anniversary. The 27th jubilee celebration congress took part in the spirit of this in the Budapest Congress and World Trade Center between November 8-10. The Oncology Nursing part had its turn on 10 November where within the frames of Oncology Nursing the invited could listen to presentations in 3 different sections: Prevention, Active Clinical Oncology Nursing and Cure of Souls-Rehabilitation. I could also call November 10th a day of historic importance since the Nursing Section had the opportunity for reorganization on its 50th anniversary and could hold its statutory meeting as a member of the Society of the same rank. Dr. Jan Foubert Ph.D., the former president and present Executive Director of EONS (European Oncology Nursing Society), honored the congress with his presence, assisting our work with his valuable pieces of advice. As a result of this on December 1, 2007 our Section could join EONS, which is centered in Brussels and has 29 countries as members well-prepared. With the Section having been reorganized, a wide cooperation amongst doctors, oncologists, oncology nurses and further experts could start, where they can all work together now against cancer, a serious problem of our age all over the world.     

Plate 468. Rhizanthella Gardneri Orchidaceae

Since the almost simultaneous discovery of two underground orchids in Australia, the western Rhizanthella gardneri R.S. Rogers and the eastern Rhizanthella slateri Rupp in 1928 and 1931, botanists have pondered the relationship between these elusive and enigmatic species. Here the biological and ecological relationships of the western underground orchid are discussed and new research to uncover the mysterious life histories of these unique Australian plants is described.     

Changes in prostate specific antigen (PSA) “screening” patterns by geographic region and socio-economic status in Australia: Analysis of medicare data in 50–69 year old men

BackgroundWhile it is known that national PSA testing rates have decreased in Australia since 2007, it is not known whether these trends are consistent by broad geographical areas, nor whether previously reported area-specific differences have remained in more recent time periods.MethodsPopulation-based cohort study of Australian men (n = 2793,882) aged 50–69 who received at least one PSA test (Medicare Benefit Schedule item number 66655) during 2002–2018. Outcome measures included age-standardised participation rate, annual percentage change using JoinPoint regression and indirectly standardised participation rate ratio using multivariable Poisson regression.ResultsDuring 2005–09, two thirds (68%) of Australian men aged 50–69 had at least one PSA test, reducing to about half (48%) during 2014–18. In both periods, testing rates were highest among men living in major cities, men aged 50–59 years, and among men living in the most advantaged areas. Nationally, the Australian PSA testing rate increased by 9.2% per year between 2002 and 2007, but then decreased by 5.0% per year to 2018. This pattern was generally consistent across States and Territories, and socio-economic areas, however the magnitude of the trends was less pronounced in remote and very remote areas.ConclusionsThe decreasing trends are consistent with a greater awareness of the current guidelines for clinical practice in Australia, which recommend a PSA test be done only with the informed consent of individual men who understand the potential benefits and risks. However, given there remain substantial geographical disparities in prostate cancer incidence and survival in Australia, along with the equivocal evidence for any benefit from PSA screening, there remains a need for more effective diagnostic strategies for prostate cancer to be implemented consistently regardless of where men live.     

Larvae of Nymphulinae (Lepidoptera: Pyralidae) associated with Hydrilla verticillata (Hydrocharitaceae) in North Queensland

Abstract  Australian Nymphulinae are a diverse group of moths with aquatic caterpillars that probably play an important role in determining the composition and abundance of aquatic macrophytes in Australian freshwater systems. Less than 10% of the nymphuline larvae in Australia have been described. As part of a project to develop biological control agents for hydrilla, Hydrilla verticillata , we encountered a variety of Nymphulinae larvae feeding on this and other aquatic plants. We illustrate, describe and provide a key to five species of Nymphulinae larvae ( Ambia ptolycusalis (Walker), Parapoynx diminutalis Snellen, Hygraula nitens Butler, Margarosticha repititalis (Warren) and Theila siennata (Warren)) that feed on hydrilla in North Queensland. Information on their host plants also is included. Our field research indicates that none of these species should be considered as potential biological control agents for hydrilla.     

Human embryonic stem cell research: an Australian perspective

A conscience vote of individual parliamentarians in the Australian government last month regarding amendments to current legislation regulating human embryonic stem cell research yielded a surprising outcome. Despite opposition by the Australian Prime Minister, the Senate and House of Representatives voted to adopt the recommendations of the Lockhart Review and approve human somatic cell nuclear transfer, thus providing a consistent national policy for all researchers in Australia.