In vitro spheroids and metastatic epithelial ovarian cancer

This thesis investigated the role of cellular aggregation in the spread of epithelial ovarian cancer. Cell aggregation was studied in vitro in order to identify markers of disease progression and cell-cell adhesion. Proteomics was then used to identify additional proteins associated with cell aggregation and survival.

Participation, relational justice and social identity in cervical cancer screening

Extending existing health literature by drawing on social and community psychology, this thesis represents the first attempt to explore the conceptualisation of 'participation' in cervical cancer screening. Quantitative and qualitative findings suggested that women's experiences of 'patient participation' and 'voice opportunity' were important and related to various social processes and variables in this health context. Using four case studies, the professional portfolio demonstrates a biopsychosocial approach to assessment and intervention as used by a provisional health psychologist working with clients with intellectual disabilities in order to promote sexual health.

Conquering and coping with the "Big C" : a phenomenological study of exceptional cancer survivorship

A study of the healing journeys of cancer survivors. The research questions were: "Do cancer survivors have anything in common?" "Is there such a phenomenon as cancer survivorship?" Ten exceptional survivors were interviewed in depth and their stories were analysed for themes. These themes were Overcoming issues of commitment, challenge, control, caring and confidence. The thesis also explores the issues of obstacles to survivorship. These were couses, costs and controversies. The conclusion is that healing journeys will never be prescriptive but that they will always be possible.

Illness representations and cancer screening in older women

This research investigated why some older women do not obtain screening mammograms and Pap smear tests. In-depth interviews found many beliefs which are contrary to screening and influenced the women's screening behaviour.

Sociology of cancer in men and women : sexuality, identity and body changes

Prostate and breast cancers are a common group of gender specific diseases that affect men and women respectively. This study explores the impact of the cancer and the social processes involved in re-establishing the self in the aftermath of cancer. The study's premise is that the self is an embodied social agent and that the body is the medium where illness is expresses and experienced by the embodied self.

Risk perception, risk communication and message framing : breast cancer and family history

Examines the relationships between risk perception, risk communication, and health protective behaviour in relation to breast cancer and family history. Qualitative research was conducted to develop a printed community resource. Theoretical and practical implications for health behaviour theory and risk communication are identified.

Hormonal breast and prostate cancer cytotoxic agents

Details 13 novel hormone compounds, designed and synthesised for the purpose of aiding the detection and treatment of breast and prostate cancers. Cellular and electromechanical studies of 3 of these synthesised hormones indicate a potential for human application.

Multicellular spheroids in ovarian cancer metastases: Biology and pathology

Epithelial ovarian cancer (EOC) has a relatively high mortality rate (~55%). One of the presiding causes is that the current chemotherapeutic regimes are unable to achieve sustained remission, despite frequently producing a positive response at first treatment. One of the reasons that EOC is difficult to treat is that the mechanism of dissemination is unusual. EOC dissemination characteristically involves local invasion of pelvic and abdominal organs. Unlike many epithelial cancers, initial dissemination rarely requires the vasculature, although the vasculature is often implicated in the advanced stages of disease. Recently, it has become apparent that aggregates of malignant cells (spheroids) contained within malignant ascites represent a significant impediment to efficacious treatment of late stage EOC. In vivo, spheroids are present in the malignant ascites of EOC patients, while in vitro cultured spheroids are capable of tumorgenesis in vivo and display a reduced response to chemotherapeutic drugs when compared to monolayers. A major problem associated with the current generation of chemotherapy agents is that they do not address the anchorage and vascular-independent growth conditions associated with a 3-dimensional structure that has formed and/or grown in suspension. Thus, spheroid formation may represent a key component of platinum/taxanesensitive recurrence. If this is correct, a better understanding of spheroid biology may contribute to the identification of new treatment opportunities for the sustained treatment of metastatic EOC. This review article outlines the key biological features of spheroids, specifically discussing their role in EOC dissemination and chemo-response as well as providing insights into spheroid functionality.

Early breast cancer identification : Which way to go? Microarray or image based computer aided diagnosis!

The goal of this research is to develop a computer aided diagnostic (CAD) system that can detect breast cancer in the early stage by using microarray and image data. We verified the performance of six well known classification algorithms with various performance matrices. Although we do not suggest a unique classifier algorithm for a CAD system, we do identify a number of algorithms whose performance is very promising. The algorithms performance was validated by 3 images dataset; two have been used for the first time in this experiment. Multidimensional image filtering is adopted for the final data extraction. The image data classification performance is compared with microarray data. Results suggest the most effective means of breast cancer identification in the early stage is a hybrid approach.

The role of folate in colorectal cancer : human studies into folate in those at risk of colorectal cancer

Colorectal cancer is one of the most common cancers worldwide and specific nutients have been associated with the risk of developing it, one of which is folate. As cancer starts at a cellular level, it is important to look at known markers or precursors of cancerous changes to see what effect a nutrient or toxin may have. It is also important to define the nutrient of concern within the exact tissue of interest as well as more easily available samples like blood. This text seeks to define folate concentrations within human colonic tissue and blood and then using a specialised technique known as single cell gel electrophoresis examine the level of damage seen in precursors of cancerous change associated with folate status. An intervention trial will also be discussed whereby folic acid supplementation was conducted in a double blind placebo controlled environment in those at risk of developing colorectal cancer.

A nurse-assisted screening and referral program for depression among survivors of colorectal cancer : feasibility study

Objective: To test the feasibility and acceptability of a telephone-based program to screen survivors of colorectal cancer (CRC) for distress, and to refer distressed patients to their treating health service.

Design, setting and participants: A prospective, multicentre study involving 59 patients with CRC recruited from six public and private health services in Melbourne, Victoria, from 15 June 2008 to 22 September 2009. Patients who had completed adjuvant chemotherapy for CRC were contacted (7–10 days after recruitment [outcall one] and again 4 weeks later [outcall two]) by the Cancer Council Victoria’s helpline nurse, and screened for distress with the Distress and Impact Thermometer (DIT); participants were given tailored information and support and those with distress scores of ≥5, and impact scores of ≥4, were referred for follow-up. Telephone interviews were conducted 4 weeks after outcall two. Participating helpline and health service staff were surveyed on the feasibility and acceptability of the service. Main outcome measure: Anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS).

Results: Of the 59 patients (87%) who agreed to participate, 63% were men; their mean age was 59 years (SD, 9.5 years). HADS depression decreased significantly from baseline (mean score, 4.93; SD, 4.22) to follow-up (mean score, 3.84; SD, 4.10; Z = −2.375; P= 0.02). However, there was no significant difference in HADS anxiety between baseline (mean score, 5.29; SD, 4.11) and follow-up (mean score, 4.78; SD, 3.65). Outcall one generated two referrals (4% of participants) and outcall two generated four referrals
(8%); five of these six participants took up the referrals. Satisfaction with the program among participants was high; 82% found outcall one “quite or very helpful” and 79% found outcall two “quite or very helpful”. Helpline and health service staff reported a straightforward process that did not adversely affect workloads.

Conclusion: This model of care carries the potential to meet ongoing psychosocial needs of survivors of CRC.

An exploratory study of the factors that influence physical activity for prostate cancer survivors

Purpose To gain an understanding of the factors that influence participation in physical activity for survivors of prostate cancer and to examine changes in participation in physical activity pre- and post-diagnosis.
Methods Eighteen men who had completed treatment for prostate cancer 6 months prior were interviewed for this study. Constant comparison was used to examine the main themes arising from the interviews.
Results Barriers to physical activity tended not to be related to the physical side effects of treatment, however lack of confidence following treatment, co-morbidities, older age physical decline and lack of time were barriers. Motivations for physical activity included psychological benefits, physical benefits, and the context of the activity. Participants did not recall receiving information about physical activity from clinicians and few were referred to exercise specialists. Physical activity 6 months post-treatment was similar to physical activity levels prior to diagnosis, although there was some decline in terms of the intensity of participation.
Conclusions Interventions to increase physical activity for this group will need to take into account co-morbidities and decline associated with older age, as well as treatment side effects and psychological issues associated with a cancer diagnosis. Encouragement from health care professionals
and referral to an exercise specialist is likely to give men more confidence to participate in physical activity.