Helping our kids to beat the big C
Andrew Wood returns from US hoping to find cure and gentler treatment for acute myeloid leukaemia
Much to his parents’ amazement and joy, chirpy Elijah Amoah, 11, is in remission after twice fighting back from leukaemia.
Elijah’s mum, Olivia Amoah, says leukaemia is a huge ordeal for any family, and describes as exciting a fresh research effort looking at ways to ease the plight of young sufferers.
Dr Andrew Wood, who has returned home from America’s topranked children’s hospital, will lead the cutting-edge programme, targeting a particular leukaemia that sees patients endure intensive chemotherapy and sometimes stem cell transplants. Only 60 per cent of child patients with it are cured.
Speaking to the Herald ahead of Cure Kids’ Red Nose Day appeal on Friday, Dr Wood explains he has won many battles so far — but it’s those he has lost that drive him toward finding new treatments.
Dr Andrew Wood has won many battles in his war against child cancer, but says it’s those he has lost now driving him towards new treatments in a cutting-edge research programme.
The paediatric haematologist-oncologist has returned home from the United States’ top-ranked children’s hospital to lead a major effort targeting a type of cancer where only 60 per cent of children diagnosed with it are cured.
Those who do survive acute myeloid leukaemia, or AML — a cancer typified by an increased number of abnormal white blood cells, called myeloid cells — have to endure intensive chemotherapy and sometimes stem cell transplants.
Speaking to the Herald ahead of the Red Nose Day appeal on Friday, the former Fulbright scholar said his mission was to not only find potential cures for the disease, but also therapies that are more gentle.
Taking what he’s learned from seven years at the renowned Children’s Hospital of Philadelphia, his small team at the University of Auckland are now putting together genetic models of AML they hope could ultimately yield the disease’s Achilles heel.
“There has been an explosion of knowledge cataloguing all of the different types of mutations in cancer, but our understanding of how those different mutations work and how they co-operate — that’s what we are only just beginning to catch up on.”
His team are taking cancer cells from patients and genetically modifying them to help understand how these mutations work together to cause disease and resist current treatments.
They are also introducing them into tropical zebra fish, which have proven valuable to scientists because they develop blood in a similar way to humans.
“If you study things just in a petrie dish, it’s often got no chance of working in something as complex as a human being — yet this approach offers us a way to make genetic alterations and examine the mutations’ consequences in real life.”
Dr Wood expected the first models would be ready for testing within a year, but added there was no timeframe on the programme itself.
“There are so many different subtypes of cancer we need to model that there is going to be a continual flow of building models and testing them.”
Within a decade, he hopes patients will be treated with a broader range of options instead of relying largely on chemotherapy.
“I think things are particularly going to expand in the classes of small molecules that we use to inhibit biological circuits, and we are going to see big expansions in therapies that harness the immune system.
“All of that is going to be coupled with a much deeper understanding of the genetic complexity of each person, and the ultimate ideal is we will be able to better individualise different aspects of therapy.”
Today, leaps in basic science knowledge were being made faster than they could be applied, and Dr Wood hoped what his team discovered could help translate these medical discoveries into better treatments.
Dr Wood is also a clinician at Starship Children’s Hospital.
“It’s extraordinarily gratifying to be part of a team that can look after and more often than not cure children, but there are also many times where we can’t, and that’s an incredibly brutal experience for the child, the family and the team,” he said.
“For me, it was the frustration of that experience that really drove me into research — having seen that happen enough times, I wanted to have more cures and less failures.”
While he admitted New Zealand was a much smaller environment than his previous posting, Dr Wood said our country punched well above its weight when it came to cancer research.
“People have done research from New Zealand that has been so meaningful it’s had an impact on patients all around the world.”
Dr Wood’s work is being supported by Cure Kids, the Auckland Medical Research Foundation Goodfellow Repatriation Award and the Child Cancer Foundation.
More than 1200 Kiwis die from bowel cancer each year and New Zealand lags behind other developed countries in early detection and treatment of the disease, a report has found.
The report found about 30 per cent of bowel cancer patients in New Zealand first learned they had the disease when they presented acutely to hospital, compared with 20 per cent in Britain.
Sixty per cent of New Zealand patients with stage 3 bowel cancer — where the cancer has spread to the lymph nodes — had received chemotherapy. In Australia, a study found 74 per cent of similar patients had received chemotherapy.
Only half of patients with stage 4 bowel cancer — where it had spread to other organs — had received chemotherapy.
New Zealand also had higher rates of late presentation of bowel cancer, with 24 per cent of patients diagnosed at stage 4.
The project’s principal investigator, University of Auckland oncology Professor Michael Findlay, said the report highlighted that early detection and an increased use of chemotherapy could improve outcomes for patients suffering from bowel cancer.
He said researchers planned to undertake a detailed comparison with similar projects in Australia and Britain.
“Given New Zealand’s poor colon cancer statistics, we want to know how we perform on several key quality indicators — what we do well, and what we could do better.”
Bowel Cancer New Zealand chairwoman Mary Bradley said the research showed the Government was failing Kiwis by continuing to stall on implementing a national screening programme.
“People are dying from a preventable, treatable and beatable cancer because they are not being diagnosed early enough. Bowel Cancer New Zealand is calling for an immediate start to a staged rollout which could save hundreds of lives every year.”
Health Minister Jonathan Coleman has previously indicated the beginnings of a national programme could be in place from early 2017.
This year, $8 million was given to district health boards as a one-off to do more colonoscopies.
The findings from the threeyear Presentation, Investigation, Pathways, Evaluation and Treatment project were presented in Auckland yesterday. The project was the largest and most comprehensive colorectal study ever undertaken in New Zealand.
Meanwhile, a pilot screening programme is running in the Waitemata area for people aged 50 to 74.
It began in late 2011 and was to run until December this year, but in its May Budget, the Government granted a twoyear extension.
The cost of a national screening programme is between $40 million and $60 million a year.