Australia has one of the highest rates of bowel cancer in the world with about 14,410 Australians told they have bowel cancer every year. Affecting both men and women, young and old, bowel cancer is the second highest cause of cancer death because fewer than 40% of bowel cancers are detected early.
Bowelcancer (also known as colorectal cancer) refers to cancer of the colon or rectum. It is a malignant growth that develops most commonly in the lining of the large bowel. Most bowel cancers develop from tiny growths called ‘polyps’. Not all polyps become cancerous.
Causes of bowel cancer
The causes of bowel cancer are not clearly understood. However in 2013, Perkins researcher Dr Terry Boyle found that too much sitting was a risk factor for several cancers, and his research was one of the first to show that long-term sedentary work may increase the risk of bowel cancer.
Risk factors that make it more likely that a person will develop bowel cancer include:
- are aged 50 years and over;
- have had an inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis;
- have previously had special types of polyps, called adenomas in the bowel; or
- have a significant family history of bowel cancer polyps.
Surgery is the main treatment for bowel cancer. The surgeon removes the section of the bowel affected by cancer and then joins the two ends. Chemotherapy or radiotherapy is nearly always used in addition to surgery.
Bowel cancer research at the Perkins
Perkins bowel cancer research revolves around investigating the impact of two key pathways in cancer progression to chemoresistant, metastatic disease – these are the SLIRP gene and oncogenic Notch signalling. Notch signalling has been identified as a major driver for the growth of a wide range of tumours, from leukaemia to breast cancer. Evidence is emerging to suggest that inhibiting Notch can suppress tumour growth. Presently there are 25 different Notch inhibitors being tested in clinical trials to reduce the death of cancer patients.
We focus on the clinical significance of the Notch signalling pathway in bowel cancer patients, investigating its effects on overall survival, risk of relapse following surgery and chemotherapy response rates. Ultimately, our research aims to provide information to guide therapeutic decisions that may improve patient prognosis, through personalised medicine for cancer patients.
We have found that SLIRP regulates hormones in the body, limiting the spread and resistance of cancers to chemotherapy. Furthermore, we found high tumour SLIRP levels were linked to improved survival of patients. This has led to us producing tangible outcomes such as developing new ways to repress oncogenic Notch signalling in bowel cancer using SLIRP.