Cancer Registry Research – Prof Iqbal Parker
Title of the project
Cancer epidemiology and the maintenance of a hospital-based cancer registry at Groote Schuur Hospital
Highlights of the project
We have now made good progress in setting up links with the clinicians in the Oncology Unit at Groote Schuur Hospital and we have set up a collaboration with Professor Christo van Rensburg at Tygerberg Hospital to collect blood and tumour biopsies from patients admitted to TBH so as to increase our sample collection. The same questionnaire is completed at both sites.
What has been achieved?
Patients presenting at a younger age was associated with a better survival. It could be that by presenting with the disease while young, it allows treatment before other complications become a major factor.
One of the presenting characteristics recorded when patients presented at the hospital were their breathing status, It was categorized as normal, short of breath at minimal exertion, and SOB at rest. There was a clear correlation between breathing status and survival. When p;atients presented with shortness of breadth while resting or at minimal exertion, this was associated with poot survival while presentation with normal breathing was associated with better survival.
Over the study period, patients that presented for treatment for oesophageal cancer who were on soft, fluid diet or with a blockage (unable to eat at all) are associated with decreased survival. There is almost a 10-fold difference in the survival of oesophageal cancer patients who are admitted while they can still tolerate normal diet to those either on fluid diet or having a blockage.
The state in which the patient is brought to the hospital was also a feature that was recorded and it was discovered that survival was reduced in patients who presented while they were already bedridden compared to those who were either symptomatic or bedridden for less than a day. It is possible that those patients who present while they are already bedridden could have delayed seeking medical attention and only presented when the disease had reached an advanced stage. Most of these patients would most likely be found among those patients who are given palliative or supportive care with no radical treatment.
After the patients were admitted, the management team also investigated characteristics associated with the tumour including histology, size of the tumour, the distance of the tumour from the mouth, the site of the tumour and treatment response. In the cohort under study, more than 95% of the patients presented with histologically confirmed squamouc cell carcinoma (SCC) while the rest were of the adenocarcinoma type (ADC). However, squamous call carcinoma was associated with poor survival.
There appeared to be no significant difference in the survival pattern of patients subjected to chemotherapy or radiotherapy, while there was a significant increase in the survival time of those subjected to oesophagectomy.
How was the project of value in the struggle against cancer
This study has attempted to establish a hospital based registry of all the Oesophageal cancer patients at Groote Schuur Hospital and also to compare the effectiveness of the different treatment modalities by doing a 10 year restrospective study. This study has clearly shown that the incidence of oesophageal cancer has not declines over the last few years as claimed in some reports.
Moreover, this study has created greater awareness of this disease amongst both hospital staff and patients.
- Davis, E., Teng, H., Parker, M.I., Goding, C. and Prince, S. (2008). Re-Expression of TBX2 in a Transformed Human Fibroblast Cell Line Blocks Cells in Mitosis, Resulting in Decreased Proliferation. Oncogene, 27, 976 – 984
- Copley, L., van der Watt, P., Wirtz, K.W., Parker, M.I. and Leaner, V.D. (2008).Photolon™, a chlorin e6 derivative, triggers ROS production and light- dependent cell death via necrosis. Int. J. Biochem. & Cell Biol. 40, 227-35
- Donninger, H, Binder, A, Bohm, L and Parker, MI. (2008). Differential Effects of Novel Tumour- Derived p53 Mutations on the Transformation of NIH 3T3 Cells. Biol. Chem, 389, 57-67
- Abrahams, A, Mowla, S, Parker, M.I., Goding, C.R. and Prince, S. (2008). UV Mediated Regulation of the Anti-Senescence Factor, Tbx2. J. Biol. Chem. 283, 2223 – 2230.
- Li, D-P, Dandara, C., Walther, G, and Parker, M.I. (2008). Genetic polymorphisms of alcohol metabolizing enzymes: their role in susceptibility to oesophageal cancer.Clin. Chem. Lab. Med. 46, 323- 328
- Teng, H., Parker, M.I. and Prince, S. (2008). Functional characterization of cis-acting elements involved in basal transcription of the human Tbx2 gene: A new insight into the role of Sp1 in transcriptional regulation. Gene, 423, 8 – 13
- Hunter, R.,Kaschula, C.H, Parker, M.I. Caira, M.R., Richards, P., Travis, S., Taute, F. and Qwebani, T. (2008). Substituted ajoenes as novel anti-cancer agents Bioorg.Med. Chem. Lett. 18, 5277 – 5279
- van der Watt PJ, Maske CP, Hendricks DT, Parker MI, Denny L, Govender D, Birrer MJ, Leaner, VD. The Karyopherin proteins, Crm1 and Karyopherin beta1, are overexpressed in cervical cancer and are critical for cancer cell survival and proliferation. Int J Cancer. 2008 Nov 11;124(8):1829-1840. [Epub ahead of print]
- Wang, B, Khachigian, LM, Birrer, MJ, Esau, L, Zhou, X. Parker, MI and Hendricks, DT. (2009). A key role for mediating and Maintaining GRO/CXCR2 proliferative signalling in oesophageal cancer. Mol. Cancer. Res. (In Press)
- Suvi Torniainen, M. Iqbal Parker, Ville Holmberg, Elisa Lahtela,Collet Dandara, Irma Jarvela (2009). Screening of variants for lactase persistence/non-persistence in populations from South Africa and Ghana. BMC Genetics (In Press)
- Kascula, C.H, Hunter, R, Parker, M.I. and Richards, P. Ajoene Analogues as Novel anticancer Drugs. AFMC Conference, Istanbul, Turkey, July, 2007
- Parker, MI, Li, DP and Dandara, C. A Hospital-based Oesophageal Cancer Registry: Groote Schuur Hospital. Cancer Research in Action, Johannesburg, South Africa, 20-22 August, 2008
- Parker, MI, Li, D-P. Gene-Environment Interactions in Oesophageal Cancer.International Symposium on Biotechnology, 4th-8th May,2008, Sfax, Tunisia
- Parker, M.I. The Role of HPV in Squamous Cell Carcinoma of the Oesophagus. Third International Congress of Molecular Medicine, Istanbul, Turkey, 5-8 May, 2009