Today is International Hand Hygiene Day – a great day for us to re-invigorate the great practices we all developed over the past few years.  

Did you know that human hands are one of the main ways infections are spread. 

From the pole on a train, to a pedestrian crossing button and then into a hospital – infections like COVID-19, influenza and staphylococcus are constantly on the move. 

When we touch our eyes, nose, or mouth with contaminated hands, we can unknowingly introduce viruses and bacteria into our bodies.

Hand hygiene is essential because it helps to break the chain of infection.

Peter Mac’s Infection Prevention Manager Elizabeth Gillespie said cancer patients and their families need to be extra vigilant with hand hygiene.

“Hand hygiene is essential for everyone, but it is particularly important for cancer patients and their families and carers,” Gillespie says. 

“Cancer patients may have weakened immune systems, which makes them more susceptible to infections which could lead to complications, delay or interrupt cancer treatment, or even be life-threatening.”

Handwashing with a mild soap and warm water is the most effective method of hand hygiene, as it physically removes dirt and germs from the hands. It should be done for at least 20 seconds, ensuring that all parts of the hand, including the nails, fingertips and the backs of hands are thoroughly cleaned. 

“Alcohol-based hand sanitizers are also effective in reducing the number of germs on the hands, and are used as a substitute for handwashing, when hands are not visibly soiled”, Gillespie explains.

“When using the sanitizer hand hygiene method, make sure you get in between fingers too.”

Cancer patients need to be mindful of their surroundings and take precautions when visiting public places, such as hospitals, clinics, and public transportation. Try to avoid crowded areas as much as possible, wear a mask to protect against respiratory infections, and avoid touching surfaces.

Hand hygiene is simple and incredibly effective – 20 seconds is all it takes.  

According to Australian guidelines, women with newly diagnosed breast cancer should be offered genetic testing when they meet certain strict criteria - such as being diagnosed at a very young age or if many family members have had breast cancer - amounting to a 10% or more risk of having a rare, hereditary gene mutation.

The Melbourne-based study provided genetic testing to 474 women with newly diagnosed breast cancers irrespective of their risk of having a gene abnormality, such as BRCA1 or BRCA2 mutation.

Cancer-causing gene mutations were identified in 31 of the women and more than half (18) of these patients would not have been eligible for genetic testing under the current guidelines.

The study is a collaboration between the Parkville Breast Service (Peter MacCallum Cancer Centre, Royal Melbourne Hospital and Royal Women’s Hospital), the Parkville Familial Cancer Centre and WEHI (Walter and Eliza Hall Institute), and results are published this week in the Medical Journal of Australia.

Peter Mac’s Professor Ian Campbell said the study showed that current Medicare-funded testing guidelines mean many patients miss out on vital information that could change the course of their treatment.

“Our study expanded this genetic testing to all women with newly diagnosed breast cancer and found 58% of patients identified as having a faulty gene had a risk factor of less than 10%, meaning these patients would not have been picked up under current screening guidelines,” said Prof Campbell, who is head of the Cancer Genetics Laboratory at Peter Mac.

“This demonstrates that more than half of breast cancer patients are missing out on their treatment being properly managed based on additional genetic information currently unavailable to them and their treating team.”

“The adoption of universal genetic testing for women with newly diagnosed breast cancer has the potential to improve outcomes by identifying hereditary mutations in patients and their families, leading to better treatment options and outcomes,” he said.

Approximately 5% of breast cancers occur in people who have inherited a gene abnormality from a parent.

WEHI’s Professor Geoff Lindeman said identifying these cases was vital to providing the best medical advice and intervention to patients and their wider families, and it often impacted surgery decisions.

“For example, a patient with a BRCA1 or BRCA2 gene mutation may choose to have a double mastectomy, rather than radiation therapy,” said Prof Lindeman, who is also a medical oncologist at Peter Mac and the Royal Melbourne Hospital.

“Similarly, a patient with a high risk of developing ovarian cancer might elect to have their ovaries removed as a preventative measure.”

“When a faulty gene is found, it also means family members can be tested and referred to a familial cancer clinic to manage their risk factor for developing breast or ovarian cancer.”

Professor Bruce Mann, Head of the Parkville Breast Service, said for most women in the study identified as having a gene abnormality, their recommended treatment changed as a result.

“With this additional information, the multidisciplinary team modified treatment recommendations for 77% of the women with hereditary mutations, including those not currently eligible for Medicare-funded testing,” Prof Mann said.

“We were able to incorporate this genetic testing into our existing multidisciplinary model of care, expediting treatment for patients.”

“Having their doctors initiate genetic counselling and testing streamlined the process and improved access to testing.”

Associate Professor Lesley Stafford, a clinical psychologist at the Royal Melbourne Hospital and the Parkville Familial Cancer Centre, said the research also found strong acceptance of genetic testing.

“Of the women who participated in our study, 87% agreed or strongly agreed that all women with breast cancer should be offered genetic testing,” she said.

“There was no decision regret among the participants in our study about having the genetic testing.”

The research was supported by funding from the National Breast Cancer Foundation and the National Health and Medical Research Council.

The study is titled ‘Universal genetic testing for women with newly diagnosed breast cancer in the context of multidisciplinary team care’.

DOI:  https://doi.org/10.5694/mja2.51906

Contacts:

For more information:
• Contact Peter Mac Communications on 0417 123 048 or email This email address is being protected from spambots. You need JavaScript enabled to view it.
• Contact WEHI communications on 0475 751 811 or email This email address is being protected from spambots. You need JavaScript enabled to view it.
• Contact RMH Communications on 0431 481 588 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

About Peter Mac
Peter MacCallum Cancer Centre is a world-leading cancer research, education and treatment centre and Australia’s only public health service solely dedicated to caring for people affected by cancer.

Smoking is the biggest preventable cause of cancer, accounting for about 90 per cent of lung cancer cases in males and 65 per cent in females.

In 2021-22, lung cancer patients were admitted to Peter Mac more than 2800 times. More than 6500 lung cancer patients were treated at Peter Mac over the past five years.

Peter Mac Chief Executive Professor Shelley Dolan welcomed the $737 million that is to be invested in the 2023-24 Federal Budget, with a focus on protecting Australians from tobacco and vaping.

“Our mission at Peter Mac is to provide research-led expert cancer care – and we all know that prevention is incredibly important” Professor Dolan said.

“At Peter Mac, we stand with the Australian Government, prevention and advocacy bodies and health service colleagues to prevent cancers caused by tobacco and vaping.”

Professor Dolan said the $63 million commitment for a public health campaign to discourage smoking and vaping, and the $30 million committed towards cessation programs were much needed.

Lung cancer is the leading cause of cancer-related deaths worldwide, with tobacco use remaining the single greatest preventable cause of death and disease in Australia.

Peter Mac and Royal Melbourne Hospital Respiratory Physician, Associate Professor Lou Irving, said the funding announcement was very exciting for the lung cancer community in Australia.

“These new measures will help prevent people from taking up what can become a deadly habit,” Associate Professor Irving said.

“Screening is particularly important because we know it can detect lung cancer at a time when it can be successfully treated.

“This increased screening alongside additional education about smoking cessation will save lives, including among high-risk groups across Australia both in metropolitan and rural areas,” he said.

Peter Mac currently employs two Specialist Nurse Consultants who provide specialist smoking cessation advice and support.

Associate Professor Irving said the community can be confident that there is extraordinary expertise in lung cancer at Peter Mac from diagnosis to the latest treatment and clinical trials.

Contacts:

For more information:

• Contact Peter Mac Communications on 0417 123 048 or email This email address is being protected from spambots. You need JavaScript enabled to view it.

About Peter Mac

Peter MacCallum Cancer Centre is a world-leading cancer research, education and treatment centre and Australia’s only public health service solely dedicated to caring for people affected by cancer.