BULLETIN WINTER 2019 BURNSIDE
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BURNSIDE
WINTER 2019
BULLETIN
New targeted treatments are improving
the outlook for ovarian cancer patients
Professor Martin Oheler, Director of Gynaecological Oncology at the Royal Adelaide Hospital and Clinical Professor in the Discipline of
Obstetrics and Gynaecology at the University of Adelaide
Ovarian cancer is the leading cause of death from a gynaecological malignancy in Australia. It is estimated that
about 1,600 new cases of ovarian cancer will be diagnosed and over 1,000 women will die from the disease in
2019. This equates to about one woman dying every 9 hours from ovarian cancer in this country.
One reason for the poor chemotherapy. Initial chemotherapy, ovarian cancer studies and hold the potential
prognosis in ovarian cancer responses are high, but the mortality rates have not of improving the outlook for
is late diagnosis, as early majority of patients eventually changed considerably over ovarian cancer patients.
symptoms are unspecific relapse. The clinical course of the last two decades and new Burnside Hospital was selected
and a screening test does not ovarian cancer is then marked treatments for ovarian cancer as one of ten Australian sites
currently exist. Consequently by periods of remission of are therefore warranted. for the international Phase 3
over 70% of patients present shortening duration with ATHENA trial which for the first
with advanced disease in which development of chemotherapy Various newly-developed time investigates whether two
the cancer has spread through resistance and ultimately a targeted treatment anti-cancer agents (Rucaparib
the abdominal cavity, requiring fatal outcome. Despite some approaches are currently and Nivolumab) given as
radical surgery and aggressive developments in surgery and under investigation in clinical maintenance therapy after
By Professor Martin Oehler
Visiting Gynaecologist and Gynaecological Oncologist at Burnside Hospital OVERLEAF TO READ MORE >
Chief Executive Officer’s message
4
Perioperative Oral
Anticoagulants
Management
– DOACs vs Warfin
5
Robotic Assisted
Orthopaedic Surgery
Patient Information
Sessions
6
Professor Oehler
Cycles towards Its been a busy start to Ms Zeelie’s background is in ICT planning to construct a
a Cure for Cancer the year for everyone and has involved working with purpose built CSSD that is
in the Inaugural large organisations, including vertically integrated with
here at Burnside Hospital
South Australian significant implementations the Perioperative Suite.
Tour de Cure including the Board of within the health care industry. The new CSSD will comprise
Directors. The Chairman, Ms Zeelie has great experience approximately 360 square
Mr Frank Kite, Chair of in project management and metres, with the facility located
brings a new skillset and depth outside of the main traffic/
7 the Finance and Audit
of experience to our Board. access area of the hospital
Welcome to Burnside Committee Ms Anne She has challenged us already it will have dedicated access
Hinton and I conducted with her knowledge of the to the Perioperative Suite
a recruitment and gig economy and has been via a lift. This new purpose
8 selection process for new
influential in considering value built area for our CSSD, not a
Burnside Hospital added matters pertaining redevelopment of the existing
Board members earlier to staff superannuation. facility will mean there is no
Foundation launches
Otto von Rieben in the year, with over 50 business interruption to the
A Central Sterile Services Hospital and our patients. It
Giving Circle applications for the two
Department (CSSD) will also ensure that staff who
positions received. is a critical unit in any work within this environment
hospital. A specialised area will have a state of the art
I am delighted to announce
responsible for the collection, facility with inbuilt work health
the appointment of Mr Rod
decontamination, assembling, and safety risk mitigations.
Buchecker and Ms Linda Zeelie
packing, sterilisation, storing Importantly the development
who both commenced their
and distribution of sterile will ensure that the Hospital
orientation and induction
goods and equipment to conforms to the AS/NZS
earlier in the year and are
patient care areas, the 4187:2014 by December 2021
already actively contributing
Hospital has been working and accommodate future
to the corporate governance
towards ensuring that our growth. We’re pleased to
of the Hospital.
CSSD is able to meet growing advise that project planning
Mr Buchecker, who is an demand and that we will has commenced with a tender
industry expert in marketing be compliant with the new planned for late 2019 and
is a valuable addition to the Australian Standard, AS/NZS construction anticipated to
Board of Directors. The Board, 4187: 2014 Reprocessing of commence in the third quarter
executive management team reusable medical devices in of 2020. The construction
and I are working closely with health service organisations. of a new purpose built CSSD
Mr Buchecker, and a soon to Two concept plans were reaffirms the Hospital’s
be announced agency on a presented to our Board of commitment to providing safe,
new brand strategy which we Directors in May by Cheesman contemporary care for every
envisage will help position the Architects and a decision patient, every time in current
hospital well into the future. made to proceed with detailed and well equipped facilities.
CONTINUED OVER > >
02
BURNSIDE BULLETIN /// Winter 2019
CONTINUED OVER > >
front-line treatment improve A number of other mutations PD-1 and its ligand PD-L1 Contacts for
ovarian cancer survival. and epigenetic DNA changes, belong to the family of immune the ATHENA Trial
Rucaparib belongs to a class such as BRCA1 promoter checkpoint proteins that act as
of targeted anti-cancer hypermethylation, can also co-inhibitory factors which can Principle Investigator:
agents known as PARP inhibit the HR repair process, limit the development of a T Professor Martin K. Oehler
inhibitors. PARP proteins are and about 40–50% of high- cell response. PD-1/PD-L1 Ph: 8332 6622
involved in a wide range of grade serous ovarian cancers interaction ensures that the
cellular functions including are estimated to be deficient immune system is activated Co-Investigator:
DNA repair. When PARP in HR repair. PARP inhibitors only at the appropriate time Dr Meena Okera
enzymatic activity is inhibited, have recently become a in order to minimize the (Visiting Oncologist)
single-strand DNA breaks standard of care for patients possibility of a chronic Ph: 8292 2220
accumulate and are converted with recurrent BRCA-mutated autoimmune reaction. PD-L1
Trial-Coordinators:
to double-strand breaks ovarian cancer. In addition, is commonly over-expressed
during the DNA replication a statistically significant on cancer cells, leading to the Diana Caruso
process. If those breaks are improved median progression inhibition of cytotoxic T cells in Ph: 7074 2353
not repaired by a repair- free survival was shown in the tumour microenvironment Cheryl Lennon
process called homologous patients with platinum- and impaired natural anti- Ph: 8331 1926
recombination (HR), the sensitive recurrent ovarian cancer immunity. Inhibition
For further information on
resulting genomic instability cancer, regardless of BRCA of PD1 immune checkpoint
leads to cell death. In high- mutation. signaling by Nivolumab how Professor Oehler spends
grade serous ovarian cancer enables tumour-reactive T some of his spare time, refer
various mechanisms can lead Nivolumab is an cells to overcome regulatory to page 6.
to deficiencies in HR. The most immunotherapy drug mechanisms and mount an
common cause is BRCA which seeks to enhance an anti-tumour response.
mutations which occur in individual’s own immune
approximately 20% of system’s ability to eliminate Approximately 1,000 patients
patients. Most are inherited cancer cells. It is targeted with ovarian cancer are
but 6 – 8% of patients have against the programmed expected to be enrolled in the
somatic BRCA mutations death receptor-(PD)-1 ATHENA study at clinical trial
which are confined to the inhibitor. centres in the United States,
tumour. Australia and internationally.
on all matters pertaining
to further improving the
patients experience at The Hospital’s Code of
Burnside Hospital. Conduct has recently been
revised and approved by
It provides valuable feedback the Board of Directors.
in the design and delivery of a This central document sets
range of healthcare services out the desired standards
and we thank them along with of conduct by all who work
our staff and many volunteers and who are credentialed
for making a difference to at Burnside Hospital across
the way patients feel and are a number of aspects for
Aside from our CSSD we have the procedure digitally, both looked after in our hospital. our organisation.
in line with our strategic plan for patient records and for
committed significant funds presentations. We are most On behalf of the Burnside All accredited visiting
to support other medical grateful to the Burnside Hospital team, thank you Medical Officers to
equipment purchases in the Hospital Foundation for their for your ongoing support Burnside Hospital should
2020 FY thus ensuring that generous donation of $150k, of Burnside Hospital and have received a copy of
we remain relevant in terms towards the purchase of this we all look forward to working the updated Code of
of emerging clinical technology new microscope. with you in the second half Conduct.
enhancements. of the year.
I would like to make welcome If you have not received
A new generation of two new members to the it, please contact our
microscopes have improved Executive Office on
Consumer Advisory Group.
functionality for surgery 08 8202 7208.
the opthalmologists perform This group works with the with HEATHER MESSENGER
enabling them to also record the senior management team Chief Executive Officer
03
BURNSIDE BULLETIN /// Winter 2019
Perioperative Oral Anticoagulants Management –
DOACs vs Warfin
By Dr Mark Finnis, Senior Specialist Intensivist at Burnside Hospital
The Clinical Review Committee has seen a small number of cases where perioperative oral anticoagulant
management has been potentially suboptimal. This may have resulted from inadvertent application of the
“usual” perioperative plan for warfarin being applied to patients taking a direct acting oral anticoagulant
(DOAC), such as dabigatran, apixaban, or rivaroxaban.
As opposed to warfarin, cessation of anticoagulation Whereas therapeutic For further information
where hepatic synthesis of for a week prior to surgery anticoagulation with warfarin please see - “Perioperative
new clotting factors requires places the patient at undue may take several days, the management of patients
cessation for 5+ days prior and unnecessary risk. For DOAC group reach peak receiving anticoagulants”:
to surgery, depending upon procedures with low bleeding plasma activity within 1-2 https://www.uptodate.com
thrombotic versus bleeding risk, DOAC agents need only hours and the timing of
risk, the DOAC group need be omitted on the day prior, i.e. their reintroduction, with or
only be ceased 1-2 days prior last dose on ‘day minus 2’. For without bridging prophylaxis,
to surgery in the setting of procedures with high bleeding needs to occur with reference
normal renal function. risk, the last DOAC dose can to the bleeding versus
be given on ‘day minus 3’. thromboembolic risk.
Where a patient is at high
thromboembolic risk, such as Similarly, the kinetics of
atrial fibrillation with prior the DOAC group differ
embolic stroke or recurrent markedly from warfarin
pulmonary thromboembolism, upon reintroduction.
Skilled obstetrician cares
for Burnside families
Dr Sarah Cash is a skilled obstetrician with experience in all-risk obstetric models.
She has been caring for families for the last 10 years at the Women’s and Children’s
Hospital and is now excited to be able to provide care for women
and their families at Burnside Hospital.
Sarah believes that birth Sarah will continue her Sarah has an active
is an enormous privilege involvement with the provision involvement in education
and considers it one of her of care at the Women’s and across many arenas which
greatest honours to be able Children’s Hospital, so for include medical student
to provide continuity, support unexpected complications, education, junior doctor and
and care for families on their can provide continuity of care registrar teaching including
journey. to women who choose to PROMPT and simulation Sarah seeks to
She acknowledges that no
deliver at Burnside Hospital, if
necessary across both sites.
training for paramedics and
air retrieval services and
support and
two women are the same, and
seeks to support and empower
also available for teaching empower women
opportunities.
women through choice. through choice.
04
BURNSIDE BULLETIN /// Winter 2019
Robotic Assisted Orthopaedic Surgery Patient
Information Sessions
Could a robotic assisted hip or knee
replacement be the right choice for
your patient?
Burnside Hospital acquired Orthopaedic Surgeons;
the state-of-the-art Dr Robert Baird, Dr Robert 2019 Patient information sessions
MAKOplasty® Robotic Fassina, Dr Justin Munt,
Assisted Joint Replacement Dr Andrew Morris and Wednesday 24th July Wednesday 18th September
in December 2015. It A/Professor Mark Rickman 6pm to 7.30pm 6pm to 7.30pm
enables surgeons trained are all credentialed in
and accredited to use this robotic-assisted surgery Saturday 3rd August Saturday 22nd October
technology to offer robotic and collectively have now 10am to 11.30am 10am to 11.30am
total hip replacement (robotic performed over 850 of
hip surgery) and robotic total these operations at
and partial knee replacement Burnside Hospital. Bookings for these sessions are essential and can be made via
(robotic knee surgery) to email to events@burnsidehospital.asn.au with your preferred
suitable patients. Patient information sessions session date, or by phoning 08 8202 7250.
are free to attend, and
Robotic-assisted joint will be held at Burnside Visit burnsidehospital.asn.au for further details.
replacement surgery is an Hospital with one of our
innovative procedure that robotic-credentialed visiting
allows surgeons to use Orthopaedic Surgeons,
minimally-invasive techniques Physiotherapist and
and achieve high levels Nursing Admission /
of accuracy. Discharge Planner.
05
BURNSIDE BULLETIN /// Winter 2019
Professor Oehler Cycles towards a Cure for
Cancer in the Inaugural South Australian
Tour de Cure
As a Gynaecological Oncologist at Burnside Hospital
and cancer researcher, Professor Oehler is dedicated
to beating women’s cancer, and last month he was
cycling towards a cure for the disease.
This year’s Tour de Cure Did you know?
marked the third annual tour »»About 1,500 women are
supporting cancer projects diagnosed with ovarian
in South Australia and saw cancer and 1,000 die from
cyclists visiting the pristine this disease in Australia each
wilderness of Kangaroo Island. year. This means that one
With native bushland, wildlife woman is dying from ovarian
and white beaches, they cycled cancer every nine hours in
over 300kms in three days, this country.
experiencing some wonderful
»»The majority of women
communities and a challenging
with ovarian cancer are
ride.
diagnosed at advanced
Cyclists also visited primary stage which is associated
schools where they shared with a poor five year survival
Tour de Cures ‘Be Fit, Be of only 30%. In contrast, five
Healthy, Be Happy’ cancer year survival with organ-
prevention message with confined Stage I disease
1,000 kids in the region. exceeds 90%, and a large
number of women are cured.
Professor Oehler has a special Early detection is therefore
focus on ovarian cancer, the most effective means to
which is the leading cause of improve survival. Professor
death from gynaecological Oehler’s main research effort
malignancies and as a is therefore directed towards
result wants to see great the development of an early
improvements in early detection test for ovarian
detection to give women
Burnside Hospital was pleased to support Professor
cancer. Oehler’s ride by making a donation towards this
who are affected a greater
chance of survival. worthy cause.
06
BURNSIDE BULLETIN /// Winter 2019
Welcome to Burnside
DR PAUL VAN MINNEN DR JESSE BEUMER
Plastic and Reconstructive Surgeon General Surgeon
Dr Paul van Minnen is a plastic and reconstructive surgeon Dr Jesse Beumer is an Australian trained General Surgeon.
with a special interest in hand and wrist surgery. He takes After completing medical school and a Masters in Surgical
pride in providing the highest standard of care for adults Science at the University of Adelaide, he received surgical
with hand and wrist problems, always with a personal, training in the speciality of General Surgery across multiple
respectful and affable approach. sites throughout South Australia’s metropolitan hospitals,
gaining experience in the expert care of complex elective
He studied medicine, obtained his PhD and completed
and emergency general surgical patients.
Plastic, Reconstructive and Hand Surgery training at
Utrecht University in The Netherlands.
Committed to providing precise
Learning from the country’s most and modern care.
reputable surgeons, hand and
wrist surgery became his major Following on from attaining Fellowship to the Royal
Australasian College of Surgeons and accreditation with
interest from very early on in RACS-GESA Conjoint Committee for adult endoscopy,
his training. Dr Beumer has undertaken further advanced speciality
training in the field of Hepatobiliary and Pancreatic
Surgery at the Royal Adelaide Hospital.
He qualified as a Netherlands Board (NVPC) and European
Board (EBOPRAS) certified plastic surgeon before arriving in With a particular interest in minimally invasive approach to
Australia in 2012. hernia and gallbladder surgery, he is committed to providing
precise, modern care applied across a wide variety of general
In Adelaide he completed three years of advanced fellowship
surgical procedures, including endoscopy and colonoscopy.
training in Reconstructive Microsurgery, Burns Surgery and
Hand and Wrist Surgery at the Royal Adelaide Hospital and East Adelaide Medical Centre
Level 1, Suite F7
Flinders Medical Centre. 50 Hutt Street
Adelaide SA 5000
In 2015 he was awarded Fellowship of the Royal Australasian (08) 8210 9488
College of Surgeons (FRACS) as a plastic and reconstructive
surgeon.
Dr van Minnen’s private practice is set up exclusively for hand
and wrist surgery and is co-located with SA Hand Therapy for
a seamless and convenient (postoperative) patient journey.
Dr van Minnen has a particular interest in surgery for base
of thumb osteoarthritis, joint replacement surgery and the
management of Dupuytren’s disease.
GRIP Hand, Wrist and Reconstructive Surgery
285 Wakefield Street The accuracy of each profile published above is the sole responsibility
Level 2, Suite 5 of the visiting specialist. For a full list of all visiting specialists and allied
Adelaide, SA 5000 health professionals consulting on site and/or regularly operating at or
(08) 7127 0365 practising at Burnside, go to burnsidehospital.asn.au/patients/doctors
07
BURNSIDE BULLETIN /// Winter 2019
ABOUT THIS
PUBLICATION
Burnside Hospital Foundation
launches Otto von Rieben Giving Circle
By Martin Carolan, Foundation Manager at Burnside Hospital We welcome your feedback
Do you have a story idea,
comment or suggestion?
If so, please direct these to:
Cathy Antoniou
Communications
and Marketing Coordinator
E: cantoniou@
burnsidehospital.asn.au
Ph: (08) 8202 7250
Receive this newsletter
electronically
If you would like to receive
this newsletter electronically,
please send your name and
email address to mail@
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Thank you for your cooperation
in conserving our precious
resources.
Burnside Bulletin
Burnside Bulletin is the official
newsletter of the private, not-
for-profit Burnside Hospital.
Pictured above: Otto von Reiben with his niece Gertrude Engelhart
The Burnside Hospital Foundation recently launched their first donor Giving Circle
Burnside Hospital
to small number of its closest supporters. Giving Circles and collective giving is 120 Kensington Road
the coming together of individuals or foundations to jointly fund worthy not for Toorak Gardens SA 5065
profits and causes. They are an example of how collective giving through peer Ph: (08) 8202 7222
support can help scale up the impact of a group of supporters’ donations to a Fax: (08) 8364 0038
Web: burnsidehospital.asn.au
support a particular cause.
The Burnside Hospital Foundation hopes Martin Carolan, Foundation Manager hopes
to recruit up to 20 people to join our Giving to see the fund grow to more than $50,000 Chief Executive Officer
Circle this year to help fund vital medical over time and is excited about the prospect Ms Heather Messenger
and surgical equipment as well as support of the Foundation supporting the Hospital
patient care projects and building in this way.
developments and refurbishments. The information contained in this
If you would like to find out more about the publication is offered by the Burnside
Hospital solely for informational purposes
We are pleased to announce that The Giving Otto von Rieben Giving Circle or contribute to and does not constitute professional,
commercial or technical advice. It is not
Circle Fund is growing progressively with the Giving Circle Funds then please contact intended to be comprehensive and may
over $18,000 in funds pledged to date. Martin Carolan, Foundation Manager not take into account all the factors that
need to be considered before putting the
With an average gift from our generous on 08 8202 7248, or via information into practice. Accordingly, no
person should rely on anything contained
supporters of more than $2,600 per annum email to mcarolan@burnsidehospital.asn.au here as a substitute for specific advice.
this demonstrates how a small group of Burnside Hospital will not be responsible
for any loss caused by reliance upon
donors can make a significant difference this information or for the accuracy of
information supplied by third parties.
to the Foundation.
CD4800
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