TRANSCRIPT
Roseanna Bricknell was just thirty when doctors told her she had stage three Hodgkin’s lymphoma, a type of blood cancer affecting the lymphatic system.
Young, fit and free from a family history of cancer, Roseanna never thought she was at risk.
“Oh man. Well, I definitely thought was, there was no way I possibly thought I would ever get cancer.”
It wasn't until she decided to see a G-P for a few things that she thought were minor problems.
“I first noticed like I had a tumour in my neck that was pretty big and that I noticed in April 2022, and I didn't get diagnosed until November. And I sort of ignored it. I just didn't think anything of it, I was really busy. I was finishing exams for my masters and then backpacking around Europe, so I didn't think much of it, and got back to Australia and thought, oh, I'll probably check that out.”
In the midst of planning her wedding, Roseanna was referred to a haematologist.
“I remember getting sent off with my referral to the cancer centre to see her and sitting in the waiting room of the cancer thinking, 'oh wow this blood doctor, must be convenient for her to see me here and thinking I'm so sorry for all the people in this waiting because I must be the only person who doesn't have cancer.' And then I obviously went into the appointment and she told me that I did have cancer. And I was so shocked, I was clearly in denial beforehand.”
Blood Cancer is one of Australia's deadliest cancers, claiming around 6000 lives every year.
New research from the Leukaemia Foundation shows that one in twelve Australians will be directly affected by blood cancer.
General Manager of Blood Cancer Partnerships for the Leukaemia Foundation Tim Murphy says the rate of blood cancer in Australia is up by 47 per cent over the last decade.
“There are about 140,000 Australians who are living with the blood cancer today, and we anticipate that will double by 2035. So that means that about 8% of all Australians will be diagnosed with the blood cancer at some stage in their life. And that means that today, that means that one in 12 Australians in fact, will be affected by blood cancer. So it's a huge number of people.”
Mr Murphy says blood cancers like Leukaemia and Hodgkin’s lymphoma are most prevalent in people over fifty, but says they can and do impact people of all ages.
“So the blood cancers, because they are cancers of our blood and our immune system, and we all have blood and an immune system they can affect at any point. They can occur at any point in time from birth right through to your latter stages of your life. It's one of the great challenges of being human is that our blood system can in fact go awry, and when it does, it can become cancerous.”
Despite estimations that blood cancer impacts around 8 per cent of the population, many Australians, including Roseanna, knew very little about the condition.
“No, I didn't really know very much about blood cancer. Obviously I knew about Delta Goodrem having had it, and I had the same one as her. But otherwise I just sort of knew about leukaemia generally. But I didn't know how many different kinds of blood cancer there were and the different ways that they can present with symptoms or anything like that.”
One in three Australians diagnosed with blood cancer will die within five years of receiving a diagnosis.
Cancer researchers like Dr Ashwin Unnikrishnan from the University of New South Wales are trying to bring that statistic down to zero.
As the Head of the Molecular Mechanisms in Leukaemia laboratory, Dr Unnikrishnan says his research is currently focused on the types of blood cancer with the lowest survival rates.
“ So to give you an example, individuals over the age of 65 who get diagnosed with acute myeloid leukemia typically only survive 12 to 15 months post initiation of the best forms of treatment that we have. So you can make out that what we have in our arsenal to currently treat leukemia isn't sufficiently good enough because people aren't living long enough. And that really is the motivation for what we are doing as well. So everything that we study and research in my lab is aimed at improving treatment options”
Dr Unnikrishnan's research lab has received a $1 million grant from the Leukaemia foundation to fund research into better treatment for Blood Cancer.
The Foundation says that, as well as reducing mortality rates among Blood Cancer patients, it's also important to improve the quality of life for those living with it.
Roseanna Bricknell says it made a difference having people to make sure she was comfortable.
“It changes everything, obviously. It's pretty scary. Everyone makes it really nice. It's kind of this weird thing where chemotherapy I think is a very scary word. And I was terrified when I went in and it's actually a really nice environment in some ways. You sit there and you don't usually need a needle. I had a PICC line in my arm that had been installed by a surgery the previous week ... So chemo itself is quite a nice guided experience with all these kind nurses. “
After undergoing four rounds of chemotherapy and an extreme reaction to fertility drugs , Roseanna says the effects the treatment had on her body were worse than she'd imagined.
“ I expected all the vomiting and I knew I would get tired and foggy headed, but I didn't realize that I would be on a massive dose of steroids and that would give me insomnia or that I'd be allergic to one of my drugs. And so every time I had that one, which they couldn't take out of the protocol, I would go to hospital for a week. And I've still got scars all over my back from it. One of them is a neuroactive agent, so when they give it to you, actually the first time I had this really cool tingling sensation and I was like, oh, this is sort of fun actually. But then it would give me terrible, terrible pain in my cranial nerve and I wouldn't be able to swallow or talk for a week. And I still can't feel my toes. It kills the peripheral nerves in your fingers and toes, and then there's all the usual stuff. You lose heaps of weight. I lost 10% of my body weight in one week. And that was probably a bit much, all your hair falls out, that sucks. You don't need to go and get a wax, I guess, which is handy.”
Dr Unnikrishnan says there are various limitations on the current cancer research and treatment options.
Likening it to a sledgehammer, he says the current approach to treating cancer involves trying to kill any cell that divides quickly, hitting everything in the hopes the cancer cells will die.
But, like cancer cells, our hair cells and the cells lining our guts for example also divide quickly, which is why many undergoing chemotherapy treatments will lose their hair and experience gut problems.
He says his research is working to create a more targeted treatment, reducing the damages caused to other parts of the body and DNA.
“ A smarter way to do this would be if you can find what's unique or different about the cancer cells, what makes them different from healthy blood stem cells, you can then leverage that difference to create something that is more targeted.”
Dr Unnikrishnan's lab works on a molecular process called RNA splicing, which, simply put, works to detect and edit different kinds of protein sequences in the gene.
What they've found is that process of RNA splicing in leukaemic cells, as well as in other cancerous cells, is altered, but works normally in other healthy cells.
“There's a process specific to the Leukemic cells that could potentially be therapeutically targeted. And that's the approach that we've been taking and the funding that we've received as well. Can we leverage this aberrant process of faulty RA splicing that's happening within the leukemic stem cells? We develop a drug that specifically target this process and hopefully therefore specifically eliminate the leukemic cells whilst not affecting the healthy cells.”
If successful, treatments targeting cancer cells directly could help people like Roseanna return to life as they knew it.
“I just can't do the same things I used to be able to do. And so you actually, there are physical signs like the hair and stuff, but I really miss the person I used to be and how energetic and fun she was and what she could do with her life. I can't do those things anymore.”
Despite the lifelong impacts of blood cancer, Roseanna was declared in remission over a year ago, her wedding, though a little later than she anticipated, will be in June.
She says she was lucky.
“So I absolutely would say, if you ever notice anything funny with your body, don't leave it a long time. Go and talk to someone to see your GP get it checked out. I was so lucky that my GP knew how to do more tests and get to the bottom of this thing. And I had a tumor the size of it was three centimeters long in my neck. You could see it. I can see it in photographs of that time. And don't leave it because you think you're young and it's probably fine because it might not be.”
