Cancer exchange program bridging knowledge between Australia and China

A Clinical Knowledge Exchange program, led by the University of Melbourne Centre for Cancer Research and funded by the Li Ka Shing Foundation, is enabling the transfer of clinical skills and expertise between Victorian Comprehensive Cancer Centre (VCCC) partners and the Shantou University Medical College Cancer Hospital in China.

Dr Zhining Yang with UMCCR Director Dr Sean Grimmond

As part of the three-year program, clinical fellows from cancer centres affiliated with Shantou University Medical College will undertake three or six-month oncology placements to enhance their knowledge of treatment of a diverse cancer population.

Dr Zhining Yang, a radiation oncologist at the Shantou University Medical College Cancer Hospital, was excited to take part in the program to learn from a world-leading cancer centre. Dr Yang undertook placement in the Peter MacCallum Cancer Centre Department of Radiation Oncology, looking at tumour streams including upper gastrointestinal, lung, head and neck, and gynaecological.

Dr Yang said that the program provided him with a chance to experience a very different hospital and treatment environment.

“The workflow in Australia provides clinicians with much more time with patients to explain diagnoses and procedures in more detail, and treatment plans are made at multidisciplinary meetings with doctors, surgeons and researchers all bringing their own unique perspectives.

“It is wonderful in Australia that patients are able to process, understand and accept their diagnosis, due to greater access to doctors, nurses and psychologists. After seven years in radiation oncology, seeing patients with terminal diseases still smiling and joking is an incredible thing, and has been one of the most impactful experiences of my placement.

“I think that the positive experience of patients is a result of the close relationships developed with clinicians, as well as the excellent Australian healthcare system that means that there is no extra burden of costs.”

Dr Geng Wang, a thoracic surgeon also at the Shantou University Medical College Cancer Hospital, undertook a placement at the Peter MacCallum Cancer Centre Department of Surgical Oncology.

Dr Wang echoed sentiments on the impactful experience of exposure to a holistic approach to cancer treatment.

“Patients who undergo surgery do better in Australia because of a thorough evaluation of all aspects of their health. They are more than just the details of their disease, it is a whole-of-body, whole-of-lifestyle examination which unfortunately we do not have capacity to undertake in China.

“Australian patients have access to many different treatments, and quality of life is the main factor in decision making, not cost of treatment. Patients also have access to district nurses and at-home care, and palliative care as important as treatment or surgery.

“Though we cannot take the clinical tools back to China to implement immediately, we can begin to incorporate these more holistic methods in working with patients where time allows.”

The placement provided the doctors with an opportunity to gain practical experience with the latest radiation treatment techniques and technologies, some of which are not yet available at Shantou. Dr Yang noted the use of ultrasound guided brachytherapy (a cancer treatment using the insertion of radioactive implants) technology, that is not yet available in Shantou, would help to recommend future equipment purchases.

Dr Yang noted the differing approaches to treatments between Australia and China, in particular for hypopharyngeal carcinoma.

“In Australia, the first choice for treatment of hypopharyngeal carcinoma is radiotherapy, but in China it is surgery. Australian patients have a stronger focus on quality of life, and radiotherapy allows them to preserve their voice box. However, in China surgery is the first choice. Two thirds of radiology patients have recurrence, and Chinese patients just want a cure – surgery is easy to understand.

“As the younger generation age and have a greater understanding of cancer and the advanced treatments available, expectations are likely to change and our treatment approaches in China will be more similar to Australia in future.”

Though he is now back in China, Dr Yang will continue work on a research project with the Peter MacCallum Cancer Centre Radiation Oncology team, exploring the relationship between secondary cancers in patients receiving radiotherapy for cervical cancer.

Supported by almost US$3 million (AUD$3.75 million) in philanthropic funding from the Li Ka Shing Foundation, UMCCR researchers and clinicians at the Peter MacCallum Cancer Centre are targeting some of the world’s deadliest cancers – those of the upper gastrointestinal tract including the oesophagus, stomach and pancreas.

These cancers have an exceptionally high mortality rate and over the past 50 years there has been minimal improvement in treatments and survival rates for these cancers, which include pancreatic, stomach and oesophageal cancers.