Dr Janine Lombard is changing the way breast cancer is being diagnosed, treated and managed – and saving lives along the way.
The South African-born medical oncologist is a board director of the Newcastle-based Breast Cancer Trials group, an independent oncology research group responsible for most of the major developments in breast cancer research over the past 40 years.
Breast Cancer Trials is a group of world-leading breast cancer doctors and researchers based in Australia and New Zealand committed to exploring and finding better treatments for people affected by breast cancer through clinical trials research.
Established in Melbourne in 1978 by a small group including Professor John Forbes AM, it relocated to Newcastle in 1987 and has co-ordinated its trials program from the city ever since. Breast Cancer Trials has approximately 800 members across Australia and New Zealand who are involved in the research program and more than 15,300 women have participated in their clinical trials.
Herceptin and Tamoxifen are two of their success stories. Both have saved millions of lives across the globe. Breast Cancer Trials also conducted the vital research that saves women’s fertility when they go through breast cancer treatments, and has helped reduce the number of mastectomies required.
Dr Lombard was heavily involved in the Tamoxifen study.
“It showed that if women at high risk of developing breast cancer were prepared to take this oral medication, their lifetime risk of ever developing breast cancer was reduced by about a third,” she tells Weekender, the excitement and pride still evident in her soft voice.
“Another exciting thing about research is looking at protecting women with, for example, several members of the same family with breast cancer. We now know there is a higher risk of developing breast cancer if there is a family history.”
Other groundbreaking research Breast Cancer Trials has been involved in includes:
- The HERA trial for women with HER2-positive breast cancer showed that Herceptin (trastuzumab) can significantly reduce the risk of recurrence; and
- The POEMS trial which increased the chances of younger women with breast cancer being able to have children after their cancer treatment.
Breast Cancer Trials was recognised for its life-saving work at a Key to the City ceremony in March.
Dr Lombard has worked with the group since 2006. She has steered three of the studies in the past decade on an international level and is on the organisation’s scientific advisory committee.
“My Mum and Dad and my only sibling had emigrated to Australia in the decade before me and I had to make a decision,” she says.
“South Africa is a very resource-poor place and there are not very many oncologists there. The place I trained in Pretoria had a very strong research unit, though, that was affiliated with a big organisation in the US.
“But I had a very strong background in research and I knew that if I came to Australia I would find my niche here.”
Dr Lombard grew up in East London and completed her undergraduate training at Cape Town. Her physician training took place at Pretoria. Her father and sister are doctors and her mother a physiotherapist.
“East London really reminds me of Newcastle. I felt at home when I arrived here. It is very similar with a big port and regarded as being maybe not the most trendy place in the world, but the people who live there love it,” she says, laughing.
“I’m very privileged to have gotten this job in Newcastle. I was very lucky both in South Africa and in Australia to have mentors who encouraged me to pursue my research in the breast cancer field.
“Three decades ago people were general oncologists – they treated all cancers – but now with this fantastic trend towards precision medicine, we’re actually being able to treat tumours much more specifically. We’ve got drugs that can treat specific things about a cancer.
“What we understand now is that breast cancer isn’t just one illness, it is actually several different diseases that all just seem to arrive in the breast but all have different targets. That means we can offer women much more specific therapy. Most oncologists now sub-specialise so we treat two or three tumour types.”
Breast cancer research, treatment and prevention over the past 20 years has resulted in a 25 to 30 per cent reduction in the number of deaths due to breast cancer.
Twenty-five to 30 per cent. That’s a lot of lives that would otherwise have been lost.
Dr Lombard attributes this to the generosity of the women who participate in clinical trials.
“We rely on altruism, on people being prepared to say yes and participate in a trial,” she says.
What we understand now is that breast cancer isn’t just one illness, it is actually several different diseases that all just seem to arrive in the breast but all have different targets.Dr Janine Lombard
“If you ask them, their primary objective is to help someone else who has to go through this journey. And that is amazing.
“Maybe that’s the biggest message I can get out there: if you’re diagnosed with breast cancer, ask your oncologist about participating in research because this is how we can hopefully improve the outcome for not only the women in front of us, but also for future generations.”
She says being face to face with patients in a hospital setting and discussing options is essential to her research work.
“When you stay at the coalface you realise how important it is to be able to offer people trials.
“One of the things that is so amazing about oncology is that there are so many new avenues and ways of understanding the tumours, and the drugs that can target them, better. We can prevent a lot of the traditional and horrible side effects of drugs and improve quality of life in that way.
One of the things that is so amazing about oncology is that there are so many new avenues and ways of understanding the tumours, and the drugs that can target them, better. We can prevent a lot of the traditional and horrible side effects of drugs and improve quality of life in that way.Dr Janine Lombard
“If you’re not treating patients you may lose that connection.
“There’s also the fact that no one is immune from breast cancer. That includes me.
“There’s the possibility that you might go through this journey yourself, and that inspires you as a woman to want to improve outcomes. One in eight women in Australia get breast cancer. It doesn’t discriminate.
“There has definitely been a gradual shift over the past decade, with women being much more at the forefront. The original founder members were all men and now women are the majority, and it’s been fantastic to see that happen.
“Women are very much part of every hierarchy in our organisation.”
Another trend is the group’s growing international status.
“Instead of us just doing studies about people in the US or Europe after being asked to participate, we are starting to turn that around and do great studies of our own and asking if other countries want to participate.”
Dr Lombard met her husband, Dr Sanjiv Gupta, a fellow oncologist, in Newcastle and they have a young son. The typical juggling act experienced by working mothers has, in her case, been mitigated by the couple’s shared profession.
“Being a professional woman trying to juggle all those balls in the air, well, if you have good support it just makes all the difference,” she says.
“Because my husband is an oncologist there is a lot of empathy about a tough day. A tough day can be a really sad day. I am so lucky to have him, he helps me to stay grounded and keep all the balls in the air.
“That’s probably one of the best things about moving here – meeting him.”