Building interdisciplinary partnerships to drive innovation and improve cancer outcomes

The University of Cape Town’s (UCT) Cancer Research Initiative (CRI) has awarded three research grants for interdisciplinary research. By leveraging telehealth in the palliative care space, focusing on cancer diagnostics and treatment, and developing a tumour archive which holds patient metadata – these research advances are set to improve the impact of research on people living with cancer.

New diagnoses of cancer are on the rise globally. According to the World Health Organization’s Cancer Tomorrow resource, these cases are predicted to double over the next two decades, primarily affecting low-to-middle income countries. In South Africa while deaths from cancer account for at least 10% of annual deaths, it remains underdiagnosed. Prevention, timely diagnosis and effective treatment of cancer saves lives.

The CRI, based at the university’s Faculty of Health Sciences, brings together basic science, clinical and public health researchers to address the complex burden of cancer. With substantial support from the Cancer Research Trust, the initiative recently awarded three research grants to multidisciplinary teams focused on: improving palliative care services and support for patients with cancer; developing more effective diagnostic, prognostic and disease monitoring applications for cancer and building a comprehensive electronic database of malignant tumour specimens for improved cancer research.

“With better training and support for loved ones, EMS can help patients get the care they need, where they want it — and in a way that preserves their dignity and comfort.”

Telehealth to increase access, coverage and quality of palliative care

A collaborative project, led by Associate Professor Willem Stassen of the Division of Emergency Medicine in the Department of Family, Community and Emergency Care, will work to transform the way emergency medical services (EMS) support patients with cancer in palliative care.

About one in three patients under palliative care encountered by EMS have cancer. Most of them end up being transported by ambulance to an emergency centre. This increases their risk of infection, adds to overcrowding in already busy emergency centres, and is often against their wishes as many would prefer to be cared for at home.

To change this, the programme will leverage its interdisciplinary collaboration and telehealth technologies to strengthen the palliative care support that patients with cancer may receive from EMS. The programme aims to evaluate two interventions: first, EMS providers will receive specialised training on how to provide palliative care for patients with cancer; second, a dedicated cancer advice desk will be set up in the EMS dispatch centre. This advice desk will help patients and families when they need guidance and will also support EMS providers in making better decisions in the field. Ultimately, the advice desk will also track where calls come from, thus helping to identify areas where palliative care services may need to be strengthened.

The end goal of the project is to improve the quality and accessibility of palliative care. Ultimaltely, benefiting patients with cancer and their families while taking pressure off the public health system through fewer emergency centre visits.

“With better training and support for loved ones, EMS can help patients get the care they need, where they want it — and in a way that preserves their dignity and comfort,” said Associate Professor Stassen. “By building on the resources we already have, we hope this programme will make a meaningful difference and can be expanded and sustained over time.”

Improving cancer diagnostics and treatment at Groote Schuur Hospital

Professor Jeannette Parkes, of the Division of Radiation Oncology in the Department of Radiation Medicine, and Associate Professor Estelle Verburgh, of the Division of Clinical Haematology in the Department of Medicine, are working to develop more effective diagnostic, prognostic and disease monitoring applications for cancer at Groote Schuur Hospital’s Oncology and Haematology services.

The high cancer burden in South Africa provides unique challenges for timely and cost-effective diagnosis, treatment and follow-up of patients. Liquid biopsy, a modern, non-invasive method to analyse genetic material from bodily fluids to better diagnose and track disease progression, may offer a cheaper and more effective tool to guide future cancer research and treatment. It uses body fluids like blood, urine, saliva and sputum to analyse circulating tumour genetic material.

This project aims to develop a liquid biopsy repository, linked to a clinical database in lymphoma and breast cancer, two common cancers in South Africa, to build capacity and support research as well as for better clinical practice at Groote Schuur Hospital.

“Proof of concept of the utility of liquid biopsy in cancer already exists but its use has been limited in our African setting,” said Professor Parkes. “This project aims to build on existing local expertise to use liquid biopsy as the basis to set up a tumour repository and link it to a clinical database in order to provide the basis for future research in this area at UCT.”

Creating a central tumour specimen archive

Dr Brendon Price, of the Division of Anatomical Pathology in the Department of Pathology, is working with colleagues to develop a tumour archive for collaborative oncology research and education.

Progress in cancer research relies on ready access to tumour specimens. There is currently no central archive devoted to malignant tumour specimens with associated patient metadata. This hampers research as limited samples make it more difficult to identify patterns, trends and correlations.

This multi-disciplinary project will create a comprehensive electronic database of all malignant cancer diagnoses received at UCT’s Division of Anatomical Pathology. It will allow researchers to extend their findings from specific samples in the archive to a wider population or different contexts, resulting in a better understanding of cancer, improved diagnostic methods, better patient care and even development of new treatments.

“Pathologists, as tissue custodians, must take the lead in cancer research, leveraging our expertise in both science and medicine,” said Dr Price.

“While establishing a central tumour database is not inherently novel, integrating comprehensive patient medical and demographic data — along with clinical outcomes — will significantly enhance its value, enabling deeper insights from a wide range of planned experiments.”

Strength of interdisciplinary research

“Research is key to understanding the complex interplay of biological, epidemiological, genetic, socio-behavioural, economic, cultural factors and health systems factors that drive cancer.”

Much progress has been made globally in combating cancer. In fact, many cancers are now curable and those that are not can sometimes be managed to allow some quality of life for the person living with cancer. However, there is much more to be done in lower-and-middle-income countries (LMICs) where cancer rates are rising. Research projects like these, which respond to the particular context of people with cancer in LMICS, are key to tackling the disease globally.

“Research is key to understanding the complex interplay of biological, epidemiological, genetic, socio-behavioural, economic, cultural factors and health systems factors that drive cancer,” said Professor Jennifer Moodley, Director of the CRI.

“Strategic investment in research not only sparks innovation but also builds local capacity, strengthens collaboration and enables sustainable evidence-based solutions to transform lives and reduce the cancer burden.”