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Can cancers be prevented?

Professor Adele GreenProfessor Adele Green

28 May 2009

Why do some people get cancers and not others? Can some cancers be prevented as well as treated? If so, what mechanisms cause them and how can these be controlled?

Seeking to better understand those questions, and find answers, medically-trained researcher Professor Adele Green and her team at the Queensland Institute of Medical Research investigated five cancers that pose serious, often fatal, health threats to Australians.

In addition to exploring the usual risk factors, the team went down a genetic pathway, looking at which genes were switched on or expressed in the different cancers they studied.

In this podcast, Professor Green tells Dr Andi Horvath how the team's findings may put us in a better position to control and prevent those cancers.

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Transcript of podcast

Voice-over: Welcome to this special National Health and Medical Research Council podcast on Ten of the Best Research Projects for 2008. Our podcasts aim to keep you in touch with major health and medical research issues and the people who shape them.

Introduction: Hi, I'm Dr Andi Horvath and I'll be speaking with Professor Adele Green who is a chief investigator of a project entitled ‘Towards Cancer Control — population and molecular strategies'. The investigation involved different types of cancers like cancer of the esophagus and ovarian cancer. She's at the Queensland Institute of Medical Research and we're going to talk to her now.

Interviewer: Professor Adele Green congratulations to you and your research team. Take us back in time, I know you work on a number of cancers, which ones and why and what did you decide at the outset that needed investigating?

Prof. Adele Green: Well we've got a bit of a collection of cancers that we've looked at Andi. We've looked at five cancers and they're all serious health issues in Australia. One of them is a particular type of cancer of the oesophagus or gullet and the problem this is causing is that it's rising really rapidly in Australian men and no one knows why and it's very often fatal. Another real problem is cancer of the ovary in Australian women. It's diagnosed late and it also causes premature death. Then we've got the skin cancers, which of course are a major issue for Australians with our white skins living in a very sunny place, these are so common that they cause enormous treatment costs. People don't really realize they're far, far higher than any other cancer in Australia, hundreds of millions of dollars they're costing the Government each year, and the major issue is that we as researchers don't really fully understand what causes these cancers to occur in some people and not in other people. What we set out to investigate was the causal mechanisms, the causal factors of these cancers because a better understanding of these questions will put us in a far better position in Australia to be able to control and prevent these five serious cancers.

Interviewer: Did you have any surprises in the outcomes of these research projects?

Prof. Adele Green: Well I guess with the cancer of the oesophagus Andi, the adenocarcinoma of the oesophagus, not much is really known about this. We still don't understand why men get this cancer more often than women and so we've been able to shine a little bit of light on this and show that besides heartburn or the frequent symptoms of reflux — and I guess we expected that — what we have shown is that overweight and obese people are at increased risk of this rising cancer, the men in particular and also smokers. And people think of other diseases and other cancers associated with smoking but perhaps we don't often think that the gullet might also be affected by smoking.

On the other side we were very pleased to see – and it was a bit of a surprise — that regular aspirin takers and also people who take anti-inflammatory drugs, for example for arthritis — non-steroidal anti-inflammatories – are somewhat protected from this serious cancer of the oesophagus. We have been going down the genetic pathway looking at what genes are switched on or expressed in the cancers and trying to marry this up with the pre-cancers of the oesophagus and that's been very interesting and then when we stepped back and looked at the cancer in women that we were investigating, the ovarian cancer, we came across similar risk factors there and these are important risk factors because these are amenable to prevention and that's really ultimately what we're looking for. So again we found that smoking causes one particular type of ovarian cancer — not something that people would immediately think about — and women who are overweight, women who are very obese, are at a significantly increased risk of ovarian cancer. Conversely we can do something about it, because those women who are engaged in regular recreational physical activity can lower their risk — and again this is a really good take-home message that we will be able to tell Australian women and indeed women in countries around the world, because ovarian cancer has always been a serious issue for women.

Interviewer: And what about the skin cancers?

Prof. Adele Green: Well the skin cancers, that's again one of our major Australian problems and we've been, I'd like to say, at the forefront of trying to look at long term prevention of these skin cancers. We really know that the sun is at the heart of this even if we don't understand the mechanisms, but very happily we've found out that even eight years after a bout of regular sunscreen use we can have long term protection of skin cancers in adults, particularly the type of skin cancer called squamous cell carcinoma, or SCC for short, and very surprisingly the foods that we eat can influence our risk of skin cancer, again not something that we were expecting, but we found that people who eat relatively high serves of green leafy vegetables are actually protected from getting second SCC's on their skin and also the anti-inflammatory medications can lower people's risk. And these are all new findings and quite exciting.

Interviewer: Adele, so I should keep tap dancing twice a week?

Prof. Adele Green: (Laugh), tap dancing, rumba dancing, you could even take up jogging Andi and you'd be ahead of your sisters who are sitting at home watching the daily serial.

Interviewer: Adele, if you could sum up why you do this research in one or two sentences, what would you say?

Prof. Adele Green: Well although I'm trained as a doctor to treat individual patients, which is the usual route of medical schools, I find that this research that aims to go beyond the treatment of a disease like cancer, is actually trying to prevent cancer in many people rather than just say individual people being treated, and this is really tremendously exciting and it's very rewarding because, as you can hear then, you actually see health benefits to a greater number of people in the community. And so the benefits of your work are potentially multiplied, and you know I'm sure that other members of my team would give similar answers to that.

Interviewer: Professor Adele Green, thank you.

Prof. Adele Green: It's a pleasure, thank you Andi.

Interviewer: I've been talking to an NH&MRC researcher, Professor Adele Green from the Queensland Institute of Medical Research on-line from Brisbane.

Voice-over: This podcast was brought to you by the National Health and Medical Research Council, working to build a healthy Australia. You'll find more information about this and other health and medical research issues on our website at www.nhmrc.gov.au.