The most important thing oncologist Professor Tom Jobling says in a conversation about ovarian cancer isn’t even a word. It’s CXCL10.
It’s the name of a protein and Tom thinks it might be a key to achieving early detection of ovarian cancer within a decade.
The head of gynaecological oncology at Monash Health and visiting medical officer at the Peter MacCallum Cancer Centre is a cofounder and former chairman of the OCRF.
He’s a surgeon who has been treating ovarian cancer for more than 30 years.
The CXCL10 protein could be what’s hindering detection of cancer.
With ovarian cancer there’s some evidence that the cancer cells cover themselves in this protein and hide from the immune cells. If you can unravel it you can let the immune cells see (the cancer) and go, ‘aha, you thought you were hiding but not anymore you’re not’.
The Monash research, involving how to change the protein’s behaviour, could also improve treatment as well as facilitate early detection.
The protein has been the subject of research before but Tom is hopeful that scientists in Melbourne have hit on something new which could mean screenings in the near future.
“I guess realistically five to 10 years. It’s the most promising bit of research. I’m very hopeful.”
The “massive challenge” of ovarian cancer is what drew Tom to the specialty.
“If you’re going to make an impact and do something meaningful and worthwhile then research something that’s appallingly badly treated with terrible outcomes and you’ll have a much greater chance of making an impact.”
His dealings with ovarian cancer patients remind him of the challenge. “Some people have aggression, some people will have outright fear in their faces. We’re all different. Some people are brave, some are terrified. It spans all manner of human emotions. If you’ve got any empathy you’ll never become immune to that. It’s almost palpable sometimes.”
He says drugs known as check point inhibitors have recently resulted in improvements to the treatment of cancers and may in the future replace chemotherapy.
“We’ve had a few ovarian cancer patients who have had miraculous responses to it.
“I had one patient, who was only 32 years old. We’d operated on her, we’d given her chemotherapy, we gave her radiotherapy and she got a recurrence.” She then received the inhibitor drugs. “It just disappeared. She’s still alive and well three years later.”
The use of drugs known as PARP inhibitors have also shown promise in the last few years for treating some types of ovarian cancer.
“It’s getting more acceptance now and there are more patients being recruited into it so that’s been an improvement.”
Tom takes the attitude that we can look to history for hope in medical breakthrough, using as an example the scientist Alexander Fleming, who accidentally discovered penicillin in 1928 when he left a Petri dish of bacteria exposed and found that a mould which grew on it suppressed its growth.
“If you look at medicine and discovery, serendipity has been fantastic.”
He says one of the OCRF’s most important achievements has been to give scientists the ability to seek grants from the organisation, rather than go through the time-consuming process of applying for government grants.
“They should be in the laboratory doing the research. We enabled these people to get on and do the job rather than muck around writing applications.”
Tom, who received an Order of Australia medal in 2017 for services to ovarian cancer research says there is “plenty of active research” going on around the world. “It’s been interesting to watch the small increments of improvement in survival consequent upon optimal chemo, good surgery and good medicine in general.”