I am very pleased to speak to this matter of public importance today on the importance of modern cancer facilities in the Canberra region. There would be few families in Canberra untouched by cancer. In 2015 it is estimated that 126,800 new cases of cancer will be diagnosed nationwide and there are up to 1,500 new cases each year among ACT residents.
In the ACT the most common cancers for 2005 to 2009 in men were prostate cancer, colorectal cancer, melanoma of the skin and lung cancer. And for women over the same period the most common cancers were breast cancer, colorectal cancer, melanoma of the skin and also lung cancer. Sadly, around 500 Canberrans will die of cancer this year and an estimated 46,500 people will die across Australia.
Australians benefit from a high life expectancy. However, it is expected that the incidence of cancer will generally increase with age. It is estimated that the risk of an individual being diagnosed with cancer by their 85th birthday will be one in two for men, and one in three for women.
Despite a decline in cancer deaths and an increase in survival over time, cancer is still the second most common cause of death in Australia after cardiovascular disease. It is these statistics that make it essential that we as a government not only provide first-class infrastructure to deliver cancer treatment and care for patients but also encourage preventative measures, contribute to research and, where it is, sadly, required, provide appropriate palliative care.
The Canberra Region Cancer Centre is a project of the health infrastructure program. It was officially opened by the then Minister for Health, Katy Gallagher, on 6 August 2014, with clinical services commencing on 18 August 2014.
The Canberra Region Cancer Centre is a world-class healthcare facility that brings together cancer treatment and related services in one purpose-built facility. The centre accommodates medical oncology including chemotherapy, clinical haematology and immunology, and specialist ambulatory services including outpatient clinics and day therapy. The service provides a comprehensive range of screening, assessment, diagnostic, treatment and palliative care services to the metropolitan population of the ACT and patients within the surrounding region of New South Wales. The service is not limited to providing cancer care, encompassing the departments of haematology and immunology as well as medical oncology, radiation oncology and the services of BreastScreen ACT.
Duffy House is the facility that provides accommodation for interstate cancer services patients and their carers. It was opened on 10 September 2012 and is less than 10 kilometres from Canberra Hospital. Duffy offers a relaxed environment in a quiet suburban street away from the hustle and bustle of a busy hospital campus.
In New South Wales outpatient services are delivered through outreach clinics in Goulburn, Young, Moruya, Cooma and Bega. The clinics are staffed by fully qualified oncology nurses who can administer chemotherapy and provide support to patients undergoing treatments. Telehealth consultations with the oncologists are also available in some clinics.
The Capital Region Cancer Service, CRCS, was formed in 2004 as part of a dedicated cancer service to the population of the ACT and surrounding New South Wales region. Dealing with the practical and emotional impact of cancer is virtually as important as physical care, and in the ACT it is supported by social workers and psychologists.
These professionals provide information, access to entitlements, practical support and counselling to assist cancer patients, their families and carers experiencing distress, depression or anxiety. This service is available through the consultation and treatment of a cancer diagnosis and discharge from hospital and includes support in the adjustment to or management of the condition or any re-occurrence. Support is also available for grief and loss with respect to changes in health status and cancer-related bereavement or death. Patients, their families and carers can be seen at CRCC or in the community.
Other important services include cancer nurse care coordinators who provide a pivotal link in support, education and coordination for patients moving between services and across community sectors. Dieticians supply individual nutritional advice and general information on diet and cancer. Physiotherapists work to help keep patients moving.
Services include assessments and programs, mobility retraining and fall prevention strategies. And speech therapists work with the patients who in particular have had head and neck cancers.
Childhood and adolescent cancer is uncommon and treatment is complex, and young adults also tend to have relatively uncommon cancers and require complex care. A sufficient case load does not exist in Canberra for a high quality paediatric cancer service locally, so children with cancer—that is, children aged 14 or younger—are referred to Sydney for their primary treatment so that they can get the best possible care.
For adolescents and young adults, some care is provided by the adult cancer service in certain clinical circumstances, often in collaboration with a service in Sydney. The best outcome for these patients and their families requires close cooperation with the large centres in Sydney and occasionally in Melbourne, and with the Canberra Hospital. That being said, some supportive care and maintenance-type treatment for children with cancer is provided by the generalist paediatric physicians based at Canberra Hospital.
In my time as an MLA I have had the privilege of meeting two inspiring families from the Gungahlin region who have each lost a child to brain cancer. Recently I have been working with them to look at options to make the lives of those living through the trauma of a child with cancer more manageable through specialist support.
Just last Saturday I attended the sixth annual Benny Wills gala dinner. Benny Wills was four years old when he died of diffuse pontine glioma, an inoperable brain stem tumour with a prognosis of just 12 months to live. DPG is a 100 per cent fatal disease, amongst the worst in the class of brain cancers amongst children, a terrible fact within the awful fact that brain cancer is the biggest killer of Australia’s children.
Benny’s mum and dad, Imogen and Dave, set up a foundation in his name to raise money for research into this rare but very deadly form of cancer. Through the significant contributions raised through events such as their annual dinner and with additional funding in the form of a grant from the Royal Australasian College of Physicians, the head researcher on the project, Dr David Ziegler, has been able to hire a full-time and highly qualified research assistant.
The money has also enabled them to purchase all the culture materials required to successfully grow DIPG neurospheres in the laboratory. The small team have successfully grown DIPG neurospheres and are in the process of testing the effects of thousands of drugs on cells, with some promising signs of success. I wish them every success in finding a cure.
Young adults with more common problems such as germ cell tumours and haematological malignancy are usually treated solely by the Canberra-based service at Canberra Hospital. The Division of Cancer, Ambulatory and Community Health Support employs an adolescent and young adult nurse care coordinator who provides a key point of linkage for adolescents receiving primary treatment in Sydney. Since February 2014 this coordinator has received 40 new referrals for patients receiving treatment in Canberra as well as those returning from Sydney.
Paediatric palliative care is predominantly provided through Clare Holland House by a paediatric multidisciplinary team. The Canberra Hospital palliative care team will provide a consultation service for neonates and children when they are within Canberra Hospital, in collaboration with specialists. Adolescent patients receive palliative care within Canberra Hospital through the CACHS team and are referred to Clare Holland House for community and hospice support. Health professionals and families largely agree, though, that palliative care is best provided close to or at home.
As part of this government’s commitment towards research and improving treatments for cancer patients, funding was provided to the Australian National University to assist in the establishment of a centenary chair in cancer research. Professor Ross Hannon has been appointed to this important role and is now working in collaboration with the clinicians of the Cancer Centre and has submitted a research grant in collaboration with clinicians from the Canberra Region Cancer Centre. Professor Hannon’s appointment will build research capacity in the health system and give researchers access to clinical expertise and settings.
Cancer comes in over 100 different forms and touches all demographics in our community. Whilst many cancers are unavoidable, prevention and early detection can play a significant role in improving survival rates. The World Health Organisation tells us that at least one-third of all cancer cases are preventable. Prevention is vital and is one of the Minister for Health’s key priorities. By making lifestyle changes such as eating a healthy diet, regularly exercising, limiting alcohol intake and refraining from smoking, many lifestyle-related conditions can be prevented.
Tobacco use is the single greatest avoidable risk factor for cancer mortality worldwide, and about 70 per cent of the lung cancer burden can be attributed to smoking alone. There is a link between obesity and many types of cancer, such as oesophagus, colorectal, breast, endometrium and kidney. Regular physical activity and the maintenance of a healthy body weight, along with a healthy diet, will considerably reduce cancer risk.
The risk of cancer also increases with the amount of alcohol consumed. Alcohol use is a risk factor for many cancer types, including cancer of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and breast. Also, in Australia we are particularly susceptible to exposure from UV radiation, in particular solar radiation.
Radiation is carcinogenic to humans, causing all major types of skin cancer, such as basal cell carcinoma, squamous cell carcinoma and melanoma.
The ACT government are investing in health promotion and prevention services to reduce the increasing burden of chronic disease and related, more costly healthcare impacts. We are also investing in campaigns to reduce smoking during pregnancy, which is designed to have a direct heath benefit to the mother and their newborns, by reducing low weight at birth and subsequent neonatal care costs. Other specific programs supported by our recent budget include healthier work, ride or walk to school, kids at play, it’s your move, fresh tastes, smoking cessation and an interactive web-based data platform. The programs support the ACT government priority to invest in preventive health services to promote physical and emotional wellbeing, prevent disease across the ACT community and support the government’s zero growth target.
Early intervention is also invaluable. If detected in the early stages, cancer can be treated successfully. Examples where early detection and intervention have been successful in reducing mortality rates include breast cancer and skin cancer. The lesson for all of us is to be vigilant about our own health and that of our friends and family. Encouraging those we love to undergo recommended screening tests such as pap smears and prostate checks, and not ignoring persistent coughs, changeable moles and lumps, will go a long way to reducing rates of cancer deaths. Unfortunately, despite our best efforts cancer will still occur and it is important that we have the health facilities and other supports available for those suffering this all too common disease.
The ACT government has made a significant investment in cancer health care through the Canberra Region Cancer Centre and allied services and through investment in research at the ANU. The 2014 Australian Institute of Health and Welfare report documented that Australian cancer survival rates are among the best in the world. In 2007 to 2011 the five-year relative survival rate was 67 per cent for all cancers combined, a significant increase from 46 per cent in 1982 to 1987. We all look forward to the day when cancer is a predominantly curable disease.