Keeping the best in Waikato
Denise Irvine finds out about an organisation that is working to keep the best and the brightest in Waikato.
Dr Michael Jameson got into a conversation the other day with a Hamilton couple who have set up a charitable trust and are contemplating what to do with the money.
Jameson immediately declared an interest, recommended that they look at the Waikato Medical Research Foundation, a local organisation where a little bit of money goes a long way and, better still, the funds stay in the region, supporting people to remain in New Zealand and do their research here.
Jameson isn't a salesman, but you can imagine him making a good pitch for the foundation, because he is strongly committed to its success.
Jameson is a consultant medical oncologist at Waikato Hospital. Wearing another hat, he is a trustee of the foundation and secretary of its grants committee.
He is also a researcher of cancer treatments, so such funding is personal for him, integral to his life.
He loves research. He says his wife has observed it's the thing that makes his face light up, causes him to wave his hands about. If he couldn't do research in Hamilton, he would have probably had to persuade his family to move elsewhere.
The foundation is one of the funders that keeps him in Waikato, and there is a simple scenario when the secretary of the grants committee puts up a proposal for money.
"Every time I apply for a grant, I walk out of the room. I'm not part of that decision, I don't always get my funding."
Jameson says it's a win-win for him to do research at Waikato Hospital. It means the two parts of his working life - clinical and research - can feed off each other, with benefits for both.
Jameson, 53, is typically more comfortable when he's dealing with patients or working on his latest project, but today, he has been put up for an interview to talk about the foundation and some of the research he is involved with.
In a way, he is playing the salesman again, because the foundation wants to boost its funds, and is campaigning for more backing.
The foundation, based at Waikato Hospital, has been helping fund medical research in the region for almost 30 years. The foundation has a pot of $1.3 million and wants to boost this to $5m.
It is not widely known outside the hospital campus, but with an increasing number of worthwhile proposals to deal with, and limited or no funding available from other sources, it is going public about its work and sharing some stories.
Last year, it had 19 applications requesting nearly a total of $465,000, far more than the money available. With assistance from Trust Waikato, the foundation distributed $136,963 among nine proposals from researchers at Waikato Hospital, the University of Waikato and AgResearch. The largest amount given was nearly $25,000 and the smallest $4500.
It's not big bucks and the foundation is unable to fund major projects, but Jameson is happy with these allocations. It works, he says. A little bit can go a long way, and small amounts can make an impact. Quite often they're a pilot study, an opportunity to get something going or test a good idea that might develop into something bigger. Then it could get money from elsewhere and maybe international recognition.
An example of this is a foundation-funded project by Hamilton AgResearch scientist Rex Munday. His research on the beneficial effects of broccoli sprouts on bladder cancer has been picked up by a major research group in the United States and is now going into clinical trials there.
Collaboration is the key to good results, Jameson says.
"Most of what we do is a team effort, locally, nationally and internationally. You have to lock in with other people."
Jameson has been involved in five pieces of research funded, at least in part, by the foundation. Some of the projects have been his ideas. In some, he has been supporting others.
"[With] people like bright young registrars, it gives them a taste of research, an opportunity to do it here, rather than go overseas."
The foundation funds a wide variety of projects, but Jameson's focus, of course, is cancer research.
Waikato Hospital is the second largest of six cancer centres in New Zealand and Jameson is a key researcher, in a unique position where his Waikato District Health Board salary is supported by a Waikato-Bay of Plenty Cancer Society grant that enables him to spend two days a week on research.
He has seen the growth of cancer research at Waikato Hospital. When he started in 2000, there was one half-time research nurse. Now, there are nine people in the oncology-haematology trials unit.
Jameson is an ex-Aucklander, which, he reckons, is a bit like being a reformed smoker. He went to medical school in Auckland, but spent some periods at Waikato during his training.
He loved it there, and when a job came up he moved south permanently with his wife, who is English, and their children. They like it too, and they would be loath to move.
Jameson enjoys Hamilton for itself, rather than for the oft-repeated mantra that it's a great place to live because it is so central.
Two or three days a week, he cycles to work along the Waikato River paths from his home in Flagstaff.
He relishes this and does a lot of cycling in the Waikato hinterland as well.
He also tramps in places such as Mt Pirongia and Hakarimata Scenic Reserve, and is partial to the zabaglione dessert at Italian restaurant Caffe Centrale in Alma St.
But Hamilton wouldn't work without his research. His self-confessed addiction to this started when he did his PhD on the trial of a homegrown New Zealand cancer drug.
The work began in 1996, conducted through Auckland Hospital and Auckland Cancer Society Research Centre, and Jameson loved every minute of it.
It was a phase-1 trial, which he describes as start of a long process, developing a drug that looks good in mice in the laboratory, but the dosage for people is unknown.
"We need to know how the body handles the drug, what it does to the body, what the side effects are, as well as beneficial effects.
"I was involved with everything on the trial, recruiting patients, treating them, taking bloods, observing things in the clinic, going back to the lab and looking into it.
"I love that dance between lab and clinical work. You are pushing beyond the boundaries. You get this with phase-1 trials. I cut my research teeth on these."
Jameson says trials of homegrown drugs have special significance, and a lot of patients are happy to sign on, keen to support local research.
"It is exciting looking into things that no one else knows, and always hoping to get the best results for patients."
Jameson is currently involved with three phase-1 cancer drug trials, run by companies in the US. One of these is testing a new drug with the unmemorable working title of PR610, developed at the Auckland Cancer Society Research Centre.
He says PR610 is a clever drug that is switched on preferentially in tumours and has great potential, particularly in lung and bowel cancers. Waikato Hospital is one of four centres worldwide to trial this.
The quest never stops. In July, Jameson starts another phase-1 trial, this one on selenium. He has a long interest in selenium, the trace mineral commonly taken by people hoping to treat or prevent cancer.
He has pioneered New Zealand clinical trials of the value of this in cancer treatment, and now he has got funding from the Genesis Oncology Trust to identify the optimal selenium compound and dose for cancer patients.
Jameson's study will compare the effects of three different types of selenium in people with prostate cancer and chronic lymphocytic leukaemia, looking at the drugs' safety, how the body handles them and what damage, if any, they may do.
"No one knows the best type of selenium and the best dose. That's what we are trying to find out. It will take at least a couple of years. That will keep me occupied for a bit."
As well as the Genesis funding, he has applied to the foundation for a stipend for a pharmacist to manage patients and do lab work, an example of his contention that every little bit helps, that interlocking funding and people are vital to success.
He mentions another "extraordinarily ambitious" Waikato study which is just winding up and awaiting analysis.
It looked at thinking, memory and concentration changes in 200 women who had had chemotherapy and/or hormone therapy, and/or radiotherapy after breast-cancer surgery. It followed each woman for two years from the start of treatment, to see the degree of change in their thinking and how quickly and completely it recovers.
This was another collaborative effort, with former University of Waikato Professor of Psychology Barbara Hedge and Waikato Hospital nurse-specialist Robyn Segedin, and it was supported by Genesis Oncology Trust and the foundation.
Jameson was also part of a foundation-funded study a few years ago conducted by Dr Eugene Tan, where teledermoscopy was used for the diagnosis of suspicious moles and other lesions.
In simple terms, teledermoscopy means using hi-tech equipment to photograph the lesions, then electronically transmit the images to specialists for examination.
The specialists who took part in the study found that using teledermoscopy, they could safely and effectively diagnose and manage a larger number of patients in a shorter time.
"The study changed the way we do things in this region," Jameson says.
The Waikato DHB has funded a virtual lesion clinic on the back of the research and the work has had international recognition.
It was published in the British Journal of Dermatology in 2009, with an accompanying editorial commending the study, saying that this was game-changing material. The foundation spent about $13,000 on the project.
"It was dirt cheap, with a really great outcome."
The foundation has given a similar amount for a new project of Jameson's, a randomised placebo/control study on cimetidine, an old ulcer-healing drug with the potential to prevent immune suppression after major surgery and take away the "landing sites" for any cancer cells that enter the bloodstream.
The study will involve 120 patients having surgery to remove bowel cancer, and recruitment for this will finish soon.
Jameson knew of five small overseas trials of cimetidine, thought "what a bloody good idea" and pushed for a Kiwi study.
He has secured a supplementary Genesis Oncology Trust grant to recruit patients from other parts of the country, as well as at Waikato Hospital.
He sees potential in older, cheaper drugs, such as cimetidine, which could make a big difference at a fraction of the cost of newer, big-ticket drugs.
Off the back of his cimetidine study is a foundation-funded trial at Waikato on the use of lipex, an older cholesterol-lowering drug, which may have the potential to prevent inflammation caused by radiation in breast-cancer patients.
The list and the enthusiasm go on, raising a couple of the questions he is probably most frequently asked: "Will there ever be a cure for cancer?" and "Why did he choose cancer as his specialty?"
On the first, he says it is similar to asking: "When will everyone be nice?" or "When will politicians stop telling lies?"
"It is easier to prevent cancer than cure it. Smoking is the most obvious thing, but exercise, a healthy diet, keeping weight down and minimising alcohol [consumption] are all preventive factors."
The second question, on why he chose cancer, has a more complicated answer.
"Cancer brings out the best in people. You get a diagnosis of cancer and you wake up to what is important in life. People with cancer are more alive than most. They are inspiring. It is a pleasure to work with them."
There is also the potential to make a big difference in people's lives.
For more information, see wmrf.org.nzorg.nz.