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Future forum, Hobart, October 29, 2017: examining the role of medical physics in cancer research

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Abstract

This commentary reports on a forum held in October 2017 in Hobart, Tasmania, attended by 20 Australasian medical physicists, to consider the future role of medical physics, as well as non-medical physics and allied disciplines, in oncology research. Attendees identified important areas of oncology research which physicists can be contributing to, with these evaluated in the context of a set of “Provocative Questions” recently generated by the American Association of Physicists in Medicine. Primary perceived barriers to participation in research were identified, including a “lack of knowledge of cancer science”, together with potential solutions. Mechanisms were considered for engagement with the broader scientific community, consumers, advocates and policy makers. In considering future opportunities in oncology research for medical physicists, it was noted that a professional need to focus on the safety and accuracy of current treatments applied to patients, encouraging risk-aversion, is somewhat in competition with the role of physical scientists in the exploration and discovery of new concepts and understandings.

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Acknowledgements

We are very grateful to Dr Robert Jeraj for support in organisation of the forum and provision of information regarding the AAPM’s FUTURE Working Group and Provocative Questions for Medical Physics in Oncology.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Sir Charles Gairdner Hospital, Hospital Ave, Nedlands, WA, 6009, Australia

    Martin A. Ebert

  2. Department of Physics, University of Western Australia, Crawley, WA, Australia

    Martin A. Ebert

  3. Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia

    Martin A. Ebert, Nicholas Hardcastle & Tomas Kron

  4. Department of Physical Sciences, Peter MacCallum Cancer Centre, Parkville, VIC, Australia

    Nicholas Hardcastle & Tomas Kron

  5. Sir Peter MacCallum Cancer Department, Melbourne University, Melbourne, VIC, Australia

    Tomas Kron

Authors
  1. Martin A. Ebert
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  2. Nicholas Hardcastle
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  3. Tomas Kron
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Corresponding author

Correspondence to Martin A. Ebert.

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Conflict of interest

All authors declare no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Appendices

Appendices

Appendix 1: participants

Eva Bezak, University of South Australia, South Australia.

Martin Caon, Flinders University, South Australia.

Stephanie Corde, Prince of Wales Hospital, New South Wales.

Jeff Crosbie, RMIT University, Victoria.

Scott Crowe, Royal Brisbane and Women’s Hospital, Queensland.

Yves De Deene, Macquarie University, New South Wales.

Martin Ebert, Sir Charles Gairdner Hospital, Western Australia (forum facilitator).

Rick Franich, RMIT University, Victoria.

Peter Greer, Calvary Mater Newcastle, New South Wales.

Nick Hardcastle, Peter MacCallum Cancer Centre, Victoria.

Annette Haworth, University of Sydney, New South Wales.

Lois Holloway, Liverpool Hospital, New South Wales.

Price Jackson, Peter MacCallum Cancer Centre, Victoria.

Tanya Kairn, Genesis Cancer Care, Queensland.

Tomas Kron, Peter MacCallum Cancer Centre.

Jayde Livingstone, Australian Synchrotron, Victoria.

Peter Metcalfe, University of Wollongong, New South Wales.

Natalka Suchowerska, Chris O’Brien Lifehouse, New South Wales.

Brendan Whelan, University of Sydney, New South Wales.

Ivan Williams, Australian Radiation Protection and Nuclear Safety Agency, Victoria.

Appendix 2: AAPM’s 2017 provocative questions

Printed here with the kind permission of the AAPM’s Future Working Group.

  1. 1.

    Can we develop physical models of “tissue homeostasis”—maintenance of a stable state?

  2. 2.

    What factors cause the disruption of “tissue homeostasis” that allow emergence of a cancer phenotype?

  3. 3.

    Is there a critical tumour mass that leads to progression to a malignant cancer phenotype?

  4. 4.

    How can we model cell population dynamics across the continuum of cell phenotypes?

  5. 5.

    Is aging a fundamental input to the cancer model?

  6. 6.

    How can we measure factors (e.g., physical, biological, mechanical) that affect cancer induction, local progression and metastatic spread, and inter-patient variability?

  7. 7.

    Why are the fundamental changes of tissue homeostatic state to malignant phenotype (e.g., metastases, acquired drug resistance, altered metabolism, resistance to apoptosis and immune protection) coordinated?

  8. 8.

    How can we model multi-stable systems that describe biological systems, such as immune system function?

  9. 9.

    How can we model cancer’s different usage of resources (e.g., energy) which do not appear optimal, but which help cancer survive?

  10. 10.

    How can we model plasticity and measure the heterogeneity of epithelial cells and stromal components (intra-lesion, inter-lesion, inter-patient) and their dynamics?

  11. 11.

    How do we model cancer treatment and treatment effects?

  12. 12.

    What is the optimal treatment regimen (modality, dose, timing) to achieve different endpoints (containment of cancer, cancer cure, normal tissue damage)?

  13. 13.

    Can we measure treatment resistance (intrinsic, acquired, compensatory)?

  14. 14.

    Can we localize the source of pain (e.g., with imaging)?

  15. 15.

    How can we quantify and address uncertainty in all clinical measurements (e.g., imaging, other tests)?

  16. 16.

    How can we model the parameters to bridge the gap between microscopic and macroscopic sciences, different model organisms?

  17. 17.

    What can replace clinical trials as a means of generating evidence?

  18. 18.

    Can we determine the most cost-effective clinical pathways for any individual patient in a given healthcare system?

Appendix 3: outcome survey results

See Fig. 2.

Fig. 2
figure 2

Summary of responses to survey questions. Numbers indicate frequency of response out of 19 complete surveys

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Ebert, M.A., Hardcastle, N. & Kron, T. Future forum, Hobart, October 29, 2017: examining the role of medical physics in cancer research. Australas Phys Eng Sci Med 41, 571–579 (2018). https://doi.org/10.1007/s13246-018-0659-2

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