Associate ProfessorVisalini Nair-Shalliker

Project Opportunities

Title: A phase II randomised controlled trial of high dose vitamin D in localised prostate cancer cases with intermediate risk of progression (ProsD). Analysis of genome damage markers

Summary of opportunity:

A great opportunity to understand the underlying modifiable factors that are associated with prostate cancer incidence and progression. Suitable for a postgraduate candidate with a background in health sciences, statistics or epidemiology

Opportunity synopsis:

Active surveillance (AS) for prostate cancer (PC) patients with low risk of PC death is an alternative to radical treatment. A major weakness of AS is the uncertainty whether a patient truly has low risk PC based on biopsy alone. Multiparametric MRI scan (mpMRI), together with biopsy, appears useful in separating patients who need curative therapy from those for whom AS may be safe. Two small US trials have shown short-term high dose vitamin D supplementation prevents PC progression. There is no substantial evidence for its long-term safety and efficacy, hence its use in the care of men with PC on AS needs assessment.

Primary aim: (1) Improve the Active-therapy free survival during the first two years of AS.

Secondary aims: (2) Examine if optimal levels of total 25OHD between 75 and 80nmol/L are achieved in PC patients following vitamin D supplementation and characterise those whose serum 25OHD do not increase to a level of 75nmol/L in response to supplementation. (3) Examine if vitamin D supplementation is able to reduce the prevalence of DNA damage. We will also evaluate the utility of mpMRI scan in diagnosing PC progression in cases managed on AS. We will also examine if vitamin D supplementation needs to be extended for a longer period to prevent PC progression, through passive surveillance of clinical records after intervention has ceased.

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Project Opportunities

Title: Prescription use and risk of prostate cancer incidence and mortality: analysis of large datasets.

Summary of opportunity:

A great opportunity to understand the underlying modifiable factors that are associated with prostate cancer incidence and progression. Suitable for a postgraduate candidate with a background in health sciences, statistics or epidemiology.

Opportunity synopsis:

There is emerging evidence that various prescription use is associated with prostate cancer risk. More specifically, metformin which is a biguanide is associated with a reduced risk of prostate cancer incidence and mortality. Emerging evidence from clinical trials are beginning to show a similar trend. However not much is known about the interaction between metformin and other known prostate cancer risk factors. Likewise for statins. This study aims to examine the interactions between widely used prescriptions such as metformin and statins, and prostate cancer risk factors in prediction risk of prostate cancer incidence and and survival, using large datasets.

----------Current Research Projects----------

1. Prostate cancer risk factors in the NSW 45 and Up study

2. Role of melanoma as prostate cancer risk factor.

2. ProsD clinical trial: Vitamin D supplementation in men with intermediate risk prostate cancer to prevent disease progression.