Head first

The statistics on brain cancer do not make uplifting reading. While significant progress have been made in the treatment and even the cure of many different types of cancer, the survival rates for brain cancer sufferers have not improved in more than 35 years. It accounts for the lives of more Australians under 40 than any other cancer and kills more children than any other disease.

The body’s most complicated organ does not surrender its secrets easily and when affected by cancer, the outcomes are all too often tragic.

But despite the sobering statistics and on-going challenges, Professor Charlie Teo is unwavering in his singleminded determination to find a cure. Teo’s name has become inexorably associated with brain cancer, or more accurately to treating it. His life saving surgeries both here and around the world have won him a legion of faithful supporters, but Teo is acutely aware of the fact that for every life saved or prolonged, too many succumb to the disease. Eternally optimistic, Teo is convinced that the answer is out there, just waiting for the right type of enquiring mind to find it, and to that end, he founded the Charlie Teo Foundation (CTF) in 2018 to help fund research and search for that illusive cure. In that same year, the Audi Foundation formed a partnership with the CTF which exists to this day, helping to support the numerous avenues being explored to find more effective treatments and ultimately, a cure for brain cancer.

Customarily unorthodox in his approach to most things, Teo’s approach to the CTF and to research in general is likewise unorthodox, exploring not only the accepted areas of research, but also looking at what he calls ‘left field’ approaches that he hopes will yield results. 

From the outset, the CTF was designed to do things differently, running a particularly ‘lean ship’ in a deliberate effort to keep running costs to a minimum and maximise funds actually going to research projects. This remains true to this day, with a full-time staff of just three people and overheads of less than 20 percent of funds received.

Also, from the outset, Teo was determined to find researchers who look at things differently – disruptive thinkers – whose different approach might just be the thing to ‘crack it’. 

“Our initial mandate of trying to break the mould and find the disruptive thinkers is working,” says Professor Teo “And it’s working because we’re finding them.”

Head of research at CTF, Nicole Caixeiro, PhD, is the one charged with seeking out the disruptive thinkers and she has been busy scouring the globe in her search.

These disruptive thinkers are highly credentialed scientists whose areas of research just might be what unlocks this complicated puzzle. CTF currently funds research in the United States and Israel, as well as projects in Australia examining new approaches to existing thinking and treatments as well as some of those ‘left field’ areas.

In terms of existing treatments like radiation therapy, work is being carried out into ways of targeting the radiation which unfortunately also damages the brain as it attacks the cancer cells. By developing a sensitiser that makes the cancer more sensitive to the radiation than the brain itself, inroads can be made in targeting the cancer and minimising the accompanying damage to the brain.

Chemotherapy too faces unique challenges when used against brain cancer, in that in order to get to the tumour and attack the cancer cells, it must first get past the brain’s own defence mechanism, the blood brain barrier. 

Finding a way to get the chemo agents to bypass the blood brain barrier to do their job is another area of investigation, with work being carried out into the likes of nanoparticles – microscopic particles that can be used to carry the agent into the brain.

Then there is immunotherapy, or utilising the body’s own immune system to attack disease, a treatment that has been used with positive results against many different cancers. But these are largely homogenous cancers says Teo, while brain cancer is a heterogeneous cancer, which he says has been described as being ‘like 300 cancers in one’. Such is the diverse nature of brain cancer, that where finding an antibody to combat a homogenous cancer might result in the destruction of the majority of the tumour, a single antibody used against a heterogenous tumour would only target that one antigen but not the majority of the tumour.

But the very diverse nature of brain cancer itself is an area being researched that Teo feels will deliver results. 

“Instead of looking at ways to treat brain cancer,” he says. “What if we were to look specifically at treating YOUR brain cancer?” says Teo.

Tailored treatment or personalised treatment seeks to find the particular nature of each patient’s brain cancer and development treatments aimed specifically for them. Called Single cell RNA Sequencing, this research which is being supported by the CTF is being undertaken by the Garvan Institute of Medical Research and seeks to collect data on the different types of cancer cells to then be used in developing algorithms to treat individual cancers. 

Already significant inroads have been made in this world first research under Associate Professor Joseph Powell, with Teo hopeful that this will deliver positive outcomes by allowing a very targeted approach for each individual.

“We don’t boast because at this point it hasn’t translated into better treatments for patients,” says Teo, “but it’s been fruitful and is very encouraging for the future.”

But in addition to these existing areas of treatment and research, are the left field initiatives that take the view that a completely new approach might just be what it takes. One such treatment explores the fact that some cancers have been shown not to grow in an anti-gravity environment, and to that end, the CTF is funding a research scientist who has built an anti-gravity machine to examine the effect of zero gravity on cancer cells. 

“It may sound weird,” says Teo “but we’re also sending cancer cells into space in an effort to identify what it is that makes certain cancer cells stop growing in this environment.”

Then there is the Circadian rhythm – the body’s own ‘clock’ or natural rhythm and research exploring the timing of chemotherapy and the effect that that timing has on the effectiveness of the chemotherapy. This has been shown to produce results in other cancers so the hope is that brain cancer too can benefit from this area of enquiry.

Of the ‘left field’ approaches, perhaps the area that has Teo most excited is the growing evidence that suggests that the ‘gut microbiome’ has a significant impact on brain function. This impact says Teo, suggests that a disease like Parkinson’s disease for example, is potentially caused or is affected by an abnormality of the gut microbiome. Research has already shown that some abnormalities of the gut microbiome can travel up the Vagus nerve to affect the brain, which suggests that this could likewise lead to a way of treating brain cancer via the gut microbiome.

The CTF has found a scientist in Israel who has had some success manipulating the gut microbiome for other diseases, so the hope is that he may be able to develop ways of using the same pathways to benefit those with brain cancer.

It’s an expensive and painstaking business, but Teo says that they are making ‘small steps in the right direction’.

“There’s so much more to do and we always need funds for more research projects until we find the answers,” he says. 

The search for a cure goes on and with it the search for more disruptive minds to add their unique perspectives to that search. Whether it is to be found in a new approach to an existing treatment or in zero gravity, Teo is eternally optimistic that a cure will be found – and there is no one more driven to find it.