Exciting PrOSPeCTs for precision cancer treatments

September 21, 2023 by Renee Mantle Leave a Comment

A new study is underway aimed at getting thousands of Australian cancer patients onto potentially life-saving clinical trials and providing precision oncology treatments, with NSW Health Pathology’s Statewide Genomics Sequencing Service playing a key role.

The PrOSPeCT (Precision Oncology Screening Platform Enabling Clinical Trials) project, Australia’s largest cancer genomics initiative, is aiming to revolutionise cancer treatment and provide new hope for cancer patients.

Launched in July 2023, PrOSPeCT links Australia’s top cancer research institutes with industry partners and government organisations, opening up new treatment paths for 23,000 Australians with rare, or difficult-to-treat cancers, including ovarian and pancreatic cancer, sarcomas and cancer metastasis.

It will provide free access to NSW Health Pathology’s world-class genomic profiling, clinical assessment of results by an expert clinical team and matching to the best advanced precision (‘personalised’) treatments available locally, including early-stage clinical trials.

NSW Health Pathology is providing a range of services for PrOSPeCT including:

blood collection
supply of diagnostic tissue
central tissue sectioning at Prince of Wales Hospital Randwick anatomical pathology laboratory
genomic sequencing/comprehensive genomic profiling services at our Genomics State-wide Sequencing Service and Molecular Medicine Department in Newcastle
storage of blood samples at the NSW Health Statewide Biobank (NSWHSB), and
logistics, ICT infrastructure, bioinformatic, operational and research support.

NSW Health Pathology expects to receive more than 3,500 sample requests over the course of the program.

Senior Hospital Scientist for NSWHP’s Statewide Genomics Sequencing Service Michael Hipwell says it’s an exciting opportunity for his team, which will be expanding to provide this service.

“We are currently recruiting, and the positions will require high level analytical skills, as each patient will have thousands of genetic variants detected and we need to report on the few that are relevant to the case,” he says.

Mr Hipwell says the program is a glimpse into the future of cancer treatment options.

“This type of comprehensive genomic tumour profiling is probably going to be the way cancer treatments are planned in the future, particularly as oncologists become familiar with the additional information provided by these reports, giving them a complete picture of what’s happening genetically in the tumour.”

His team has been working for the past 12 months developing the new diagnostic assay, required for the research project.

“The assay we’re using for the comprehensive tumour profiling interrogates more than 500 genes in the tumour’s DNA to identify variations or mutations in these genes that could be responsible for the patient’s cancer,” Mr Hipwell explains.

“We’re also looking at the RNA of the tumour for a subset of the 500+ genes to identify any fusion events or gene amplifications that could cause the cancer.”

“We generate a report which is then sent to the study coordinators to investigate if there are any relevant clinical trials in which the patient can be enrolled. That information is then passed onto their treating oncologist.”

NSWHP’s Acting Chief Executive Prof Rob Lindeman said the PrOSPeCT project will allow the organisation to build on its already comprehensive genomic profiling capability.

“Providing services for PrOSPeCT will build vital capacity, establish our organisation as a leader in the provision of services for diagnostic and cancer research and ultimately benefit the people of NSW,” he said.

“Genomics diagnostic services and genomics research represent areas of strategic significance for NSW Health Pathology.”

The landmark national program is led by Omico, a government-backed, not-for-profit national network of Australia’s leading cancer research institutions and hospitals.

The $185 million PrOSPeCT project is jointly funded by the Federal and NSW governments, as well as private enterprise.

Michael Hipwell 4 EDIT — Michael Hipwell, Senior Hospital Scientist for NSWHP’s Statewide Genomics Sequencing Service

Meet Monu – Paediatric Pathology Collector – Hunter region

September 15, 2023 by Sally Topp Leave a Comment

Let’s learn more about Monu. Official title – Phlebotomist (adults and children) Pathology Collector.

How long have you worked with NSWHP?

Fourteen years in Newcastle, John Hunter Hospital. I started my pathology career with a private pathology provider for three or four years. There, I couldn’t go any further working with children as I had limited exposure with young patients. I always wanted to work with babies and kids, so I moved to public pathology for more paediatric experience.

What is different between paediatric and adult collections?

It’s very different. With adult patients, you can talk to them and make sure they understand what you are there to do. If they say no, that’s it; you respect their decision. But with kids, it takes work. I talk to the parents or carers and explain it to them to gain consent. Most of the time, their doctor has already explained it to them before we get there. The child may not understand or be able to talk, so you need to put them at ease in other ways and encourage the child to relax. Paediatric collections are not always easy – but it is unbelievably rewarding to know you are helping care for that child. It might take more than one attempt sometimes. You need to be mindful that there could be other things going on for that family. Families are often upset and can be understandably emotional, and you need to take time and not rush your time with them. This role is always challenging and I still learn new things every day, but that’s why I enjoy it. I see lots of children with intellectual or physical disabilities who have different needs. We use a different approach and often need two collectors to support these patients. We always try to collect blood on the first attempt to avoid the child getting too uncomfortable. Before seeing the patient, I have to know the environment I’m walking into. Every situation is unique, and every patient and their experience is individual. They may be upset or anxious. As professionals, we constantly assess the risk and the environment we are going into.

What characteristics or personality do you need to do your job well?

Well, you have to be a very calm person. You need a lot of patience when you work with children. But, not just the children, the parents too. I try to put myself in their shoes and think how I’d feel if it were my child. I step into that space without fuss and give quiet assurance.

What is the hardest thing about being a collector?

When I see kids and their parents suffering and not getting better, it’s so hard to deal with that. It’s tough to see that every day, and of course, it takes a toll on you too. You wish people didn’t have to go through that.

How do you switch off at the end of the day?

I learnt how to do it. One of my teachers told me, ‘You walk in the door in the morning, hang up your coat, and you’re at work – it’s work time’. When I walk out and put on my coat, that’s my signal; I don’t take anything home or let anything affect my family.

Would you recommend your job to others considering pathology collection?

Yes, I’d definitely recommend it. It’s a very family-friendly job you can shape around your lifestyle. You can work shifts and choose early or later shifts depending on what works with your commitments. It works for my family. I started by completing my Certificate III in Pathology Collection.

What makes you come to work every day?

It’s the love of teamwork; we work with the other girls as a team. I enjoy being around lots of different people and families. I prefer not to be in one spot all day, and the ward rounds give me variety plus I mainly work with children, which I love. I see the tiniest of bubs. I am passionate about sharing my experience working with children. I mentor new paediatric collectors and help them develop their skill sets.

What’s the best advice you’ve ever been given?

Working with paediatric healthcare teams is like a big family where you know everyone and they all know you. The nursing staff, the doctors, etc. We are a tight-knit multidisciplinary team. Working as a team – that’s the most crucial piece of advice I ever got. Your team is your family, and you support each other every day – never forget that.

Outside of work, what brings you joy?

I have three kids of my own. They’re big kids now, though. My baby is 18, so not much of a baby anymore. I’m in a choir, a church choir as a singer. I’m not very good, but I enjoy it. I also arrange flowers for friends and family.

If you hadn’t started in pathology, what do you think you’d be doing now?

Before pathology, I worked in the mental health sector with people with dementia for 16 years. Still caring for people and it worked well for my family and lifestyle because I could do night shifts while my kids were young. It was flexible and worked for us. When they started school, I decided to make the change, but I think I’d be doing something like that, still in health and wellbeing.

Are you interested in becoming a pathology collector? Find all our opportunities in our careers section.

New online research application portal – eResearchWithUs

September 14, 2023 by Shannon Ramadge Leave a Comment

NSW Health Pathology is making it easier to apply for our research services with a new eResearchWithUs digital portal.

“This innovative, user-friendly digital platform is a significant step forward in how we support researchers,” says Dr Shaun Roman, Associate Director of NSW Health Pathology.

“This new digital portal not only streamlines the application process but also reinforces our commitment to advancing scientific knowledge and ultimately improving the health and well-being of the community in partnership with the broader research industry,” Dr Roman said.

The portal allows researchers to apply for access to a wide range of essential bio-specimens, such as tissue, blood, cells, urine, DNA/RNA, or protein, as well as various research services like sample collection and pathology or forensic testing, as well as data only requests.

To ensure optimal service delivery, local Research Coordinators will thoroughly review each application. They will carefully assess the research project’s feasibility and offer applicants a tailored quote and research agreement if the lab has capacity to provide the service.

“We want to be able to provide you with an application form that only asks you for the information that is relevant to your research request,” Bente Talseth-Palmer, NSW Health Pathology’s Research Strategy Lead, said, highlighting the portal’s user-friendly design.

The eResearchWithUs portal uses smart logic that minimises requests for additional information, effectively preventing unnecessary delays in the research approval process.

“It means fewer follow-up questions and requests for more documents, preventing unnecessary delays, so we deliver a better service to researchers,” says Karla Jerez, who is one of NSW Health Pathology’s dedicated Research Coordinators.

NSW Health Pathology aspires to be at the forefront of translational research, where scientific discoveries can swiftly make their way from the laboratory to benefit the broader community. By providing researchers with easier access to their extensive research services through eResearchWithUs, we are fostering an environment for collaboration and innovation.

Try eResearchWithUs today.

Got a question?

Visit our research section for more information. Connect with our NSWHP Research Office to discuss potential research collaborations. You can also watch our eResearchWithUs overview video.

Meet Hayley – experienced pathology collector

September 13, 2023 by Sally Topp Leave a Comment

Hayley Byatt has been with NSW Health Pathology for 5 years, but working in pathology for more than 20 years.

I’m a “Phlebotomist”, though no one calls us that nowadays – I think it sounds like “Flowery Bottom”. We’re called Pathology Collectors.

It’s funny, I’m a real sook when I have my blood taken. If you wave my blood in front of me, I’ll faint on you. But I can look at yours, till the cows come home. So I know what it’s like to sit in the chair. If I can help somebody get through a blood test today, by learning a few tricks that will also help them conquer their fears for future visit too. That’s me doing my job properly. By paying it forward, if you will.

I started in the private sector and moved to public pathology. I’ve been doing this longer than some of my colleagues have been walking the planet. Gosh, it’s probably been a quarter of a century now.

Working across the region

I’m based in Kempsey, but I work across the region. I could be in a hospital on the wards or collecting in the outpatients at our Port Macquarie Lighthouse Beach or Lake Innes collection centres, or visiting patients in their homes.

The right job feels like home

I moved to public pathology for a change of scene and liked the idea of camaraderie and being part of a close-knit team. On my first day, two of the collectors I used to work with gave me the biggest hug, I’ll never forget. I instantly thought, ‘I’ve done the right thing, you know.’ I just knew I was home.

My Kempsey team feels like a second family and we look out for each other. We’re like puzzle pieces – we all bring something different and complement each other. People appreciate what we do, especially in a rural community where they travel considerable distances just to see you.

Key traits of a pathology collector

To be a collector, you need to have patience, kindness, resilience, and a lot of empathy. The key is to treat people how you’d like to be treated. Imagine if that was your mum, or sister, or grandmother. Then you can’t go wrong.

I encourage others to start a career in pathology

It’s nice to see new staff – watching them grow is lovely. Now more than ever, we must be human and kind to each other. Some days can be taxing, but others can be so unbelievably rewarding. Covid has put many things into perspective. At the end of a long or difficult day, I like to get back to nature. Whether it’s sitting under a tree or feeling the wind on your face. Sometimes you just need to take your shoes off to ground yourself. Be it in the dirt, the grass, the mud or the rocks. It simply reminds you it’s an enormous world and we’re just a tiny part of it.

I see a lot of people with cancer. They’ve got enough going on. Every day is a struggle just to get up and be part of the world; they’re so brave. By listening, chatting and having a giggle, whilst having a blood test, it can often make a difficult part of their journey just that little bit easier.

Another thing I do to unwind is a bit of ‘treasure hunting’ at op shops or antique stores. It helps me decompress. At my local it doesn’t matter what sort of day you’ve had. They know your name. They’ll smile at you and say hello. This helps restore your faith in human nature. Bargain or not, I go home to my family refreshed.

My journey to pathology

I grew up on a wheat farm in the country and am lucky enough to have travelled the world. Funnily enough, I found my husband back where I started in my hometown. We moved to Port Macquarie for his work. I attended a nursing conference and as fate would have it, I completed my Assistant in Nursing and trained on the job. I think of myself as an amalgamation of skills, amassed from all those fantastic nurses, and midwives I used to work with all those years ago.

I took some time off to have my son. When he was school-age, I decided to get some qualifications to hit the ground running. I returned to work with a Certificate III in Pathology Collection. It was my first time away from my husband and son. I stayed onsite in the nurses’ quarters on campus for about a month for the intensive course. I expected to leave with a piece of paper and refreshed skills, but I also came away with lifelong friends.

So, it just naturally progressed from there.

If I hadn’t started in the health sector, I’d be a retired jet fighter pilot or driving one of those massive Tonka trucks in the mines.

Find all our opportunities in our careers section.

It’s warming up and mozzies are coming. Here’s how to mosquito-proof your backyard

September 12, 2023 by Liz Farquhar Leave a Comment

The weather is warming up and that means more time in the backyard. It also means more mosquitoes.

Here are five ways you can mosquito-proof your backyard that don’t rely on spraying insecticides.

1. Get rid of water

Mosquitoes need water to complete their life cycles. They need blood – but water and warmth are just as important.

Getting rid of water around your backyard will go a long way to keeping mosquitoes away. Water trapped in blocked roof gutters, drains and tarpaulin covering boats and trailers can be a great home for mosquitoes.

Mosquitoes can exploit the tiniest of water sources too. It may just be the upturned lid of a discarded plastic drink bottle. If it traps water, mosquitoes will find it and lay eggs in it.

Flush out your bird bath once a week to disrupt the mosquito’s life cycle.

If you have a pond, installing a fountain will discourage mosquitoes. If you can’t keep water clean and circulating, consider filling it with sand and gravel to create an interesting garden bed for succulents or other plants.

Mosquitoes will avoid clean and chlorinated swimming pools but will quickly move into “green pools”. If you’re not using your pool, consider converting it to a “pond” so that fish can help keep mosquito numbers down.

2. Screen up – windows, doors and rainwater tanks

If you can’t get rid of permanent water, at least stop mosquitoes getting to it (or you).

Ensure rainwater and septic tanks have screens to stop mosquitoes entering.

Screen windows and doors to stop mosquitoes entering the home. There are plenty of flexible screening options for windows, doors and balconies.

If you live in a mosquito-prone area, creating a screened outdoor area (such as a pergola, courtyard, or balcony) will give you the opportunity to spend time outdoors without being hassled by mozzies.

Mosquitoes on a window screen — Screening windows and doors keeps mosquitoes out.

3. Choose your garden plants carefully

Some plants contain essential oils and other chemicals that, when extracted and concentrated, provide protection against biting mosquitoes. But there isn’t a lot of evidence that the whole plant will keep mosquitoes away from your garden.

Some types of plants are even marketed as “mozzie blockers” or “mosquito repelling”. But there isn’t any evidence of effectiveness. In fact, some of these plants, such as melaleucas, also happen to be associated with hot spots of mosquito breeding in coastal Australia.

The plants to avoid around the home are those that help mosquitoes breed, such as bromeliads, which trap water.

An outdoor pot plant with water in the base tray. — Water provides opportunities for mosquitoes to breed.

4. Encourage the animals that eat mosquitoes

Mosquitoes are food for a range of animals including birds, bats, fish, frogs, lizards, insects, spiders and dragonflies. But don’t expect them to eat enough to keep all mosquitoes away.

Bats are often promoted as a good “biological control” options but studies have shown mosquitoes are more likely to be a snack food for small bats, not an irresistible staple of their diet.

For garden ponds, frogs will eat a few adult mosquitoes but tadpoles of Australian frogs generally don’t eat many mosquito “wrigglers”.

Australian native fish will readily eat mosquitoes and may be useful for backyard ponds.

But not all fish are good. While “mosquitofish” (aka “plague minnow”) is distributed overseas to assist in mosquito control, it’s a disaster for local wildlife and, along with other exotic fish species, should not be released into local waterways.

Healthier habitats promote fewer mosquitoes so the best thing you can do is create habitats for the animals that eat mosquitoes.

5. Avoid traps and other gadgets

There are lots of devices purported to catch, kill, or repel mosquitoes from your garden. Some may catch a mosquito or two but they’re not very effective in knocking out big numbers.

“Bug zappers” with bright lights will collect lots of flying insects. It’s just that mosquitoes make up a very small proportion of collections.

Electrocuting devices, again, don’t seem to attract a lot of mosquitoes.

Devices that emit high frequency sounds won’t help either.

The best devices are typically those that are baited with carbon dioxide. These are a mainstay of state and territory mosquito and arbovirus surveillance programs. For a mosquito, the C0₂ tricks them into thinking the trap is a warm-blooded animal. The only problem is these can be expensive to run and don’t seem quite as effective for mosquito control unless used in large numbers.

Yes, you’ll still need repellent

Perhaps the best way to avoid mosquito bites is to pick an insect repellent recommended by health authorities and apply it to ensure all exposed areas of skin are covered. These products and safe, affordable and effective.

Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, NSW Health Pathology.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Helping to manage haemophilia and other rare blood disorders

September 11, 2023 by Liz Farquhar Leave a Comment

Haemophilia is a rare, inherited bleeding disorder where the blood doesn’t clot properly due to a lack of blood-clotting proteins. Our experts help treat these disorders and help patients to live a safe and healthy life.

Kent Chapman is NSW Health Pathology’s senior hospital scientist in charge of haemostasis or coagulation at Newcastle’s John Hunter Hospital.

“For those not familiar with it, that’s all the bleeding and clotting stuff,” he explains.

He says blood disorders often capture people’s attention, particularly haemophilia, because it is so rare and can be very dangerous.

“It is particularly rare, affecting about 1 in about 6 to 10,000 males and less than 1 in 300,000 females,” he says.

“Newcastle is the only haemophilia centre outside of Sydney, so we cover a large area of NSW, looking after patients from here to Tweed Heads and as far west as you can go.

“We help to manage about 70 children and about 400 adults with bleeding disorders.

“They range in severity from those with very mild cases, who we only treat on demand, to those who require product or factor VIII replacement every day, so they don’t have catastrophic bleeds.”

There are two major types of haemophilia:

• Haemophilia A is the most common form and is caused by having reduced levels of clotting factor VIII (eight).

• Haemophilia B, also known as Christmas Disease, is caused by having reduced levels of clotting factor IX (nine). The disease was named after Stephen Christmas, who was the first person diagnosed with the condition in 1952.

A gloved hand holds a test tube with the label 'Factor VIII test'. — Reduced levels of clotting factor VIII are the cause of Haemophilia A.

The ‘Royal Disease’

Haemophilia has also been called a ‘royal disease’. This is because the haemophilia gene was passed from Queen Victoria (haemophilia B carrier), who became Queen of England in 1837, to the ruling families of Russia, Spain and Germany.

Mr Chapman says the type most people have heard of is haemophilia A.

“The good news is the treatment for that is quite amazing, it’s come a long way in the last few years.”

He says a new product that has only become available in Australia in the last couple of years means patients don’t have to inject factor VIII every day, but only once every week or two.

The injection is also subcutaneous, rather than intravenous, which has made an enormous difference to the lives of many patients.

“It means if they’re on this product, they’ll have the same sort of life expectancy that you or I would have.

“Obviously they still have to be mindful of playing contact sports and all those types of things, but they have a much better quality of life, which is great.”

But Mr Chapman admits the improvement in haemophilia A treatment has made things slightly more complicated for his laboratory.

“Trying to monitor these different products in the lab can become more challenging.

“We’ve had to use different tests to be able to monitor these new therapies, and the new therapies get in the way of the testing for the way we used to do it.

“It’s made our work more complicated, but it’s exciting because it’s much better for people living with haemophilia.”

Other blood disorders

Mr Chapman has a particular interest in the clotting side of blood disorders and has spent time working on a group of disorders called thrombotic microangiopathies.

“We established testing for a particularly rare and fatal disease here over 10 years ago called thrombotic thrombocytopenia purpura,” he explains.

“It’s a particularly horrible disease where you basically start having blood clots from head to toe, particularly in the small blood vessels.

“If not detected early, you have a very high chance of dying within a couple of days of diagnosis.

“But with the appropriate diagnosis and treatment 95% of patients are okay.

“The treatment is quite intensive and involves plasma exchange, which is basically sucking all the patient’s plasma out and replacing it with more plasma, and that can take weeks until the patient goes into remission.”

Mr Chapman says he has been particularly fortunate to be working in the field of haemostasis, with talented colleagues and mentors, such as NSW Health Pathology’s Dr Emmanuel Favaloro (Westmead) and Geoffrey Kershaw (Royal Prince Alfred Hospital, Camperdown).

“There are not too many people who get to do this type of work, so I’m very grateful to have ended up here,” he says.

“It was a bit of a fluke that I ended up in pathology to be honest. My mother knew someone who worked in a path lab, she told me to get a haircut and helped get me the job.

“Twenty-something years later, here I am!”