Peter MacCallum Cancer Centre Annual Report 2009 People/Opportunities Discovery/Care Peter MacCallum Cancer Centre St Andrews Place Peter MacCallum Cancer Centre is a world leader East Melbourne Victoria 3002 Locked Bag 1 A’Beckett Street Victoria Australia 8006 in cancer treatment, research and education. Telephone (03) 9656 1111 Facsimile (03) 9656 1400 www.petermac.org At Peter Mac, we treat more cancer patients each year than any other hospital and our highly skilled Image At work in the Chemotherapy Day Unit, East Melbourne medical, nursing and allied health team is backed Front cover image by the largest cancer research group in Australia. Professor Bob Thomas OAM Director of Surgical Oncology Chief Clinical Advisor on Cancer for Victoria In this year’s annual report we feature our clinicians Design by Canyon and researchers on the world stage. Over 225 Photography by Lynton Crabb Image on page 18, Chemotherapy Robot, courtesy of Jane Poynter Peter Mac clinicians were invited to present their Printing Rothfield Print Management work at conferences and meetings around the For more copies of this publication or to provide feedback please contact: Peter Mac Communications and Marketing world and our clinicians and researchers between via [email protected] them attracted nearly $40 million in new grants and funding this year. The success of our researchers is profiled in a separate publication, the Peter Mac Research Report 2008.

1 Contents/

Vision Report from Chair Our values in action 16 Report from the Director and Chief Executive Officer 4 Excellence of Research 58 Peter Mac will be recognised by the community and Innovation Report from the Chief Finance Compassion People 60 professional peers, nationally and internationally, as Officer and Financial Summary 8 Education and Training a premier resource for cancer patients in the provision Chief Medical Officer’s Report 22 Workforce 2008-09 Performance Summary 10 Community of integrated treatment, research and education. Care/ Tumour Stream Reports 24 Report from the Director of Breast Corporate Governance 76 Strategy and Redevelopment 12 Gastrointestinal Organisational Structure 90 Mission About Peter Mac 14 Gynae-oncology As Australia’s leading specialist cancer centre, Peter Haematology Financial Statements 91 Head and Neck Glossary 144 Mac provides quality treatment and support to patients Lung and their families. Underpinned by research and the Melanoma and Skin Contacts 145 Paediatrics, Adolescents, best evidence available, Peter Mac broadly influences Young Adult and Late Effects cancer care in the community through multidisciplinary Bone and Soft Tissue Sarcoma Uro-oncology partnerships, research and education. Familial Cancer Centre OnTrac@PeterMac Values Care/ Treatment 38 We strive for Excellence, ensuring that clinical practice Surgery Intensive Care Unit is evidence-based, patient-centred and is provided by Chemotherapy Day Unit qualified and experienced staff who are accountable Pharmacy and appropriately credentialed. We strive to ensure Pathology Centre for Blood Cell Therapies that Innovation is fostered by supporting research and Diagnostic Imaging a learning culture. Adhering to the strongest ethical Centre for Molecular Imaging Pain and Palliative Care standards to ensure a culture of openness, mutual Radiation Therapy Services respect and trust, Compassion is at our core. Allied Health

Image Emma, Registered Nurse

Peter MacCallum Cancer Centre Annual Report 2009 Contents 3 Report from the Chair and Chief Executive Officer/

Chair: Board of Directors As a major Victorian service provider, We are delighted with this announcement, Financial and activity performance Ms Patricia Faulkner AO The past 12 months have been Peter Mac has not been immune from as it will enable our East Melbourne Peter Mac recorded a surplus before these influences, but has also had much campus to be relocated to Parkville as Chief Executive Officer capital income and depreciation of to give thanks for over the past year. We an integral component of a worldclass Mr Craig Bennett some of the most difficult in living $350,000 – an excellent result, given the celebrated our 60th anniversary; we helped comprehensive cancer centre. We believe prevailing economic conditions. All staff are memory in Victoria. The horrendous secure State and Commonwealth capital that this new centre will ensure better thanked for their efforts and commitment funding for our relocation to Parkville as a outcomes for people with cancer and will during the year. key part of the worldclass comprehensive positively influence the care and treatment bushfires in February; the ongoing We exceeded all our inpatient, outpatient cancer centre to be built there; we of cancer patients at many other hospitals and radiotherapy activity targets and achieved a number of our other strategic throughout Victoria and Australia. drought; and the economic downturn met or exceeded all the other targets as objectives and we delivered a strong This announcement is the culmination of specified in the 2008-09 Statement of operational result. And... we continued have had a significant impact on much hard work by many Peter Mac staff Priorities Agreement between the Minister to engender a culture of continuous over a long period of time. In particular, for Health and the Chair of the Board. improvement across our five sites and many aspects of Victorian society. we are greatly indebted to Daniel Pilbrow: earn the respect and support of Director of Strategy and Redevelopment Other significant operational issues government, our peers, our friends and his team – Lisa Thompson, Danielle We continued to work on refining the and the Victorian public. Kabos and Adelle Van Der Linden – for systems, procedures and use of space The comprehensive cancer centre their tremendous efforts over the past by our outpatient clinics. to be built at Parkville 18 months or so. With funding support from the Department On Thursday 7 May 2009, the Premier of Detailed work is now proceeding on of Human Services, we appointed a Victoria: The Hon John Brumby MP and the Functional Brief, the governance Redesigning Care Team and commenced the Commonwealth Minister for Health arrangements and the proposed projects to improve patient flows in day and Ageing: The Hon Nicola Roxon MP configuration of clinical services at Parkville. surgery and in the Medical Day Unit. jointly announced Commonwealth and A small number of patients presented State Government capital funding support Construction is expected to be completed at Peter Mac with H1N1 Influenza 09 for a comprehensive cancer centre to be in late 2015. (Human Swine Flu) during the height of built at Parkville. The State Government will Other major strategic issues the outbreak in the community. Our clinical contribute $426.1 million to this project, During the year, we commenced a refresh staff managed well. Ongoing vigilance is in as will the Commonwealth Government. of our strategic directions and worked with place to monitor for further presentations. The overall project cost is estimated to be the Department of Human Services just over $1 billion, and will draw on funds The Improved Clinical Engagement and to clarify our statewide role. raised through philanthropy and the sale Leadership (ICEL) Project progressed of Peter Mac’s East Melbourne site among We were very pleased to reach agreement during the year, with the way forward to be other sources. The partners who will join with Southern Health to extend the tenure agreed by the end of 2009. Peter Mac at the new site are: Melbourne of our Moorabbin Satellite Unit. Space and infrastructure issues continued Health; The University of Melbourne; We worked closely with the Cancer and to be challenges at our East Melbourne the Ludwig Institute for Cancer Research; Palliative Care Unit, Department of Human campus, although the opening of the new the Walter and Eliza Hall Institute of Services; the Department of Innovation, retail cafe, Macchiato, will provide us with Medical Research; and The Royal Industry and Regional Development; the some greater flexibility in dealing with Women’s Hospital. Victorian Cancer Agency; Cancer Council space demands. We also continued our Victoria; Quit Victoria; the Western and focus on energy efficiency and how water, Central Melbourne Integrated Cancer electricity and gas use could be improved Service and Cancer Australia. We value our across all sites. relationships with all these agencies. Our East Melbourne and four satellite sites all had busy and productive years.

Peter MacCallum Cancer Centre Annual Report 2009 Report from the Chair and Chief Executive Officer5 Report from the Chair and Chief Executive Officer/

Research at Peter Mac Our Staff With Grateful Thanks! 60 Wonderful Years Looking Ahead In Conclusion At the end of his second five year term in Our staff continue to be our greatest asset. In April 2009, having served almost six In late April 2009, we celebrated our The next 12 months will most likely We commend this report to you and hope December 2009, Professor David Bowtell During the year, many staff published the years, Board Director: Martin Smith 60th anniversary with a week of special continue to be dominated by economic that you will enjoy reading about our many will retire as Director of Research. We results of their work, some were promoted, resigned from the Board to take up an lectures and events. We were delighted considerations. and varied activities. gratefully acknowledge Professor Bowtell’s others changed roles and a few were appointment overseas. In June 2009, that both The Hon Nicola Roxon MP and Nevertheless, we hope to see considerable On behalf of Peter Mac, thank you for significant contribution to research at Peter honoured. Well done to all these staff. Board Directors: Canon Alan Nichols The Hon Daniel Andrews MP, together with progress on the comprehensive cancer your interest in, and support of, our work. Mac and fully support his return to full-time AM and John Patterson OAM retired representatives of Sir Peter MacCallum’s We welcomed back surgeons Cuong centre project; the public radiotherapy We look forward to keeping you informed research, by which he will continue to lead from the Board, having both served nine family, were able to join us for the start of Duong and John Spillane. Associate facility being built at Sunshine Hospital, about our progress in the years to come. a number of important research studies years. Martin, Alan and John all made our week of celebrations, as well as for the Professor Ygal Haupt joined us as one which will be jointly operated by Western at Peter Mac. Professor Joe Trapani very significant contributions to the good formal launch of: Our History – a thematic of the two 2009 Victorian VESKI Health and Peter Mac; and on our has kindly agreed to act as Director of governance of Peter Mac and were overview of Peter Mac since 1949. Innovation Fellows. emerging focus on survivorship, as Research until a new Director takes up his/ farewelled at special Board functions. As part of these celebrations, we also supported by the Pratt Foundation and the her appointment. An international search Dr Sebastian Dworkin won the 2008 Peter The Board worked on a number of launched a refresh of our website Department of Human Services through Ms Patricia Faulkner AO is currently underway. Mac Postgraduate Research Medal. diverse and important matters during the (www.petermac.org). Many thanks to the Western and Central Melbourne Chair: Board of Directors Peter MacCallum Cancer We also farewelled a number of senior or year, particularly in advising and guiding Anne Rahilly: Public Affairs Manager and Integrated Cancer Service. Foundation Ltd long-serving staff, including: Adrian Brown, management on some of the major Danielle Kabos: Communications and In addition, the Australian Council on Rachel Dalton, Anna DeFlorio, Dr Julia strategic issues central to Peter Mac’s role Marketing Manager for all their hard work The Board of the Peter MacCallum Cancer Healthcare Standards will be conducting Fleming, Dr Erwin Loh, Associate Professor and function and, of course, in relation to in organising this special week for Peter Foundation Ltd, chaired by Professor an accreditation survey across all our sites Michael McKay, Dr John Reynolds, Libby our future at Parkville. Mac. We were delighted with the very Lester Peters AM, were very much in October 2009. Mr Craig Bennett Skewes, Eileen Thompson, Dr Hugh Turner positive publicity and feedback that this engaged in progressing our key strategic The Executive Committee and Heads of Chief Executive Officer and Christina Wilson. week generated. Finally, we will continue striving to manage issues during the year, notwithstanding Department worked diligently throughout the increasing demand for our services, the enormously challenging fundraising Vale the year to support both the Chief environment. so evident throughout the past 12 months. Joan Atkinson, Ruben Fried, Kim Lane, Executive Officer and the Board. A comprehensive review of the Professor Chris O’Brien AO, Richard Les Manson: Corporate Secretary and Foundation’s activities is contained later Pratt and Dr Tom Sandeman died during Kerry McDonald: Executive Assistant to the in this report. the year. They were all great friends and Chief Executive Officer provided wonderful supporters of Peter Mac. We will miss them support to the Board and ensured that the very much. Office of the Chief Executive Officer was We were honoured and privileged that run both efficiently and cheerfully. Professor O’Brien was able to address Many thanks to all those senior staff of our 2008 Annual General Meeting. His the Department of Human Services with advocacy of comprehensive cancer whom we worked closely during the year. centres in Australia is one of his We are very pleased that the Minister for enduring legacies. Health: The Hon Daniel Andrews MP is so committed to improving outcomes for people with cancer and is so supportive of our work. Last, but by no means least, a special thank you to the many volunteers, community groups and corporate supporters who contributed so much to Peter Mac during the year.

Peter MacCallum Cancer Centre Annual Report 2009 Report from the Chair and Chief Executive Officer7 Report from the Chief Finance Officer and Financial Summary/

The Peter Mac entity continues Consolidated Financial Results Summary 2009 2008 2007* 2006 2005 to grow at a significant rate, $’000 $’000 $’000 $’000 $’000 with overall consolidated revenue Total Revenue excluding Capital Income 231,126 207,046 189,625 181,555 163,181 increasing from $216 million in Total Expenses excluding Capital Expenditure 229,873 205,820 186,966 171,156 158,032 2007-08 to $240 million in Surplus/(Deficit) Before Capital 1,253 1,226 2,659 10,399 5,149 2008-09, which represents Balance Sheet Statistics an 11 per cent increase. Total Assets 198,382 239,775 237,666 210,759 197,545 Total Liabilities 55,893 49,060 45,312 41,609 34,802 Operating Result Peter Mac has received enormous public Land and Buildings were revalued by the Total Equity 142,489 190,715 192,354 169,150 162,743 The Peter MacCallum Cancer Centre support over many years. The 2008-09 Valuer General Victoria for all Victorian financial year has seen the most difficult public hospitals as at 30 June 2009. The recorded a consolidated surplus of Net Current Assets (3,145) 3,184 304 10,096 9,119 $1,253,000 before capital and specific economic times in recent memory, Peter Mac buildings were valued based on items, which compared to a $1,226,000 yet despite the economic downturn, depreciated replacement cost, which took consolidated donations and bequests to into account Peter Mac’s move to Parkville surplus in 2007-08. Patient activity levels continue to grow The Peter Mac Foundation has a long The Department of Human Services has Peter Mac increased from $11.6 million in in 2015 when calculating the remaining at Peter Mac, particularly with regard to term investment strategy whereby untied continued to support agencies through the The Peter Mac entity continues to grow at 2007-08 to $13.9 million (19.33 per cent). useful life of our East Melbourne buildings. radiotherapy services whereby 2008-09 reserves have been placed in a balanced Targeted Equipment Program. Peter Mac a significant rate, with overall consolidated This overwhelming generosity has enabled The net result of the Peter Mac Land and activity exceeded funded targets by more portfolio. In recent times this portfolio has received funding to the value of $2.2 million revenue increasing from $216 million Peter Mac to increase the level of support Building revaluation was a decrease in than 10 per cent, the costs of which were been heavily weighted towards cash and through this program in 2008-09, which in 2007-08 to $240 million in 2008-09, for our research activities. overall value of approximately 31 per cent. partly offset by increased Medicare billings. fixed interest investments (57.2 per cent), was used to fund several new pieces of which represents an 11 per cent increase. It is important to note that the revaluation Cost pressures are significant in the health with the balance invested in property and equipment including a new 64-slice CT Several streams of revenue contributed resulted in a capital expense of $30.98 The commissioning of a fifth operating sector. Wage pressures, growth in staff equities (domestic and global). machine ($1.5 million). Peter Mac is also to the overall revenue increase, with grant million in the 2008-09 financial statements. theatre in February 2009, combined with numbers, activity growth, price increases, greatful to the department for assistance revenue from the Department of Human a general increase in patient complexity, The sharp decline in global markets had and a fluctuating Australian dollar have provided through the New Technologies Services (increase of $7.1 million), contributed to inpatient activity exceeding a negative impact on the Foundation’s all contributed to an overall increase Program, in particular for the funding clinical and laboratory research ($5.8 the 2008-09 target by two per cent. Public investment performance in 2008-09, in expenditure. Peter Mac continues to provided for our new chemotherapy million), and recoupment from private outpatient attendances were down on last resulting in an overall investment portfolio monitor all costs closely, and continues robot ($900,000). practice billing ($6.2 million) amongst year’s levels but still exceeded target by decline of approximately 11 per cent. As to implement cost saving measures the main contributors. eight per cent. Several initiatives have been at 30 June 2009, the Foundation held where possible. successfully implemented to reduce the managed funds with a market value level of unfunded outpatient activity. that has been below cost for more than 12 months. In accordance with the international accounting standards, we have reported these unrealised losses as a financial asset impairment expense in the Mr Andrew Kinnersly financial statements to the value of $1.67 Chief Finance Officer million, of which $0.85 million related to market losses incurred during the 2008-09 financial year.

Peter MacCallum Cancer Centre Annual Report 2009 Chief Financial Report and Financial Summary 9 2008-09 Performance Summary/

This year was another busy year for Peter greater complexity in the patients treated. complexity model was introduced this year patients by service/external campus in 2008-09 patients by age in 2008-09 Mac. As the incidence of many cancers The average length of stay for overnight to recognise the additional cost of providing continues to rise in our community, so too and multi-day admissions in 2008-09 was specialised treatments that include Presentations at does the number of patients attending 6.5 days which is similar to the previous Stereotactic Radiotherapy and Intensity tumour stream clinics Peter Mac. This increase in demand for our year. Surgical activity increased this year Modulated Radiation Therapy. Bone & Soft Tissue 2.8% 50% clinical services is reflected in Peter Mac’s with the number of surgical procedures Our pharmacy and chemotherapy day unit Breast 5.1% three core Department of Human Services increasing by 13.7 per cent – a clear were also kept busy in 2008-09 as 20,904 Gastrointestinal 6.5% funded programs. demonstration of the increased capacity chemotherapy preparations were provided Gynaecology 2.8% our new fifth operating theatre has allowed. 40% • Admitted Patient Care – measured as to patients. Haematology 6.3% Head & Neck 6.2% Weighted Inlier Equivalent Separations Our radiotherapy services were also in We take great pride in delivering a Lung 3.8% (WIES) under the Casemix Funding high demand and we delivered 6,017 new high quality service and meeting the Neurology/Stereotactic 0.8% 30% program – 1.5 per cent above target. courses of radiotherapy megavoltage community’s need for cancer care and Paediatrics 0.8% treatment – an increase of 10.9 per cent. • Ambulatory Clinic/Allied Health treatment and we continue to work Skin 11.5% This year the Bendigo treatment centre Consultations – measured as Weighted towards reducing the impact of cancer Unknown 10.2% was funded under the Weighted Activity Urology 5.7% 20% Episodes through Victorian Ambulatory on our community. Classification System (VACS) program Units program for the first year. A new WAU Presentations at < 20 years 1.8% –12.2 per cent above target. external campuses Bendigo 7.0% 20 – 39 years 10.4% 10% • Ambulatory Radiotherapy Treatment Performance at a glance Box Hill 7.8% 40 – 59 years 31.8% – measured through Radiotherapy 2008-09 % Epworth 7.3% 60 – 79 years 44.7% Weighted Activity Units (WAU) under the All patients Moorabbin 15.4% Non-Admitted Radiotherapy program – 80 + years 11.3% 0 100.0% 0 300 600 900 1,200 1,500 PATIENTS <20 20-39 40-59 60-79 80+ YEARS 10.1 per cent above target. New patients 8,628 ↑2.6 Total Patients 24,986 ↑5.5 In 2008-09 Peter Mac cared for a total of 24,986 patients, an increase of nearly 1300 Outpatients patients Registration by region in 2008-09 people on the previous year. Roughly a third Occasions of service 202,515 ↓1.9 of our patients were new referrals to Peter Attendances 95,731 ↑5.5 Mac (8,628) and two thirds were patients receiving ongoing treatment and care. Inpatients Same Day 15,518 12.4 LODDON MALLEE The majority of our services are able to REGION be provided to patients on an outpatients Multi-Day 4,265 ↑1.8 852 PATIENTS/ 9.9% basis. In 2008-09 we provided 202,515 Total bed days 43,373 ↓3.5 outpatient occasions of service and Average length of stay 2.2 ↑6.4 19,783 admitted (inpatient) episodes Bed days in ICU 1,141 ↑22.3 of care. Ward bed occupancy 76.3 (of 88) ↑2.3 ICU bed occupancy 3.1 (of 6) ↑22.3 The number of overnight and multi-day Treatment GRAMPIANS HUME REGION inpatient separations increased this year REGION 423 PATIENTS/ 4.9% 130 PATIENTS/ 1.5% by nearly two per cent. The average WIES Surgery – day procedure 2,552 ↑13.3 EASTERN METRO per episode for this group of patients Surgery – theatre procedure 4,683 ↑13.7 1,760 PATIENTS/ 20.4% increased by 3.8 per cent, which indicates Radiotherapy fields 472,867 ↑17.9 Chemotherapy preparations 20,904 ↑1.9 NORTH & WEST METRO 2,178 PATIENTS/ 25% GIPPSLAND REGION Prescriptions dispensed 99,945 ↑8.7 453 PATIENTS/ 5.3% BARWON DHS Service Measures SOUTH WESTERN REGION 161 PATIENTS/ 1.9% SOUTHERN METRO WIES 14,222 ↑1.9 2,194 PATIENTS/ 25.4% VACS 55,669 ↓9.8 WAU 212,810 ↑36.8 INTERSTATE/UNSPECIFIED 397 PATIENTS/ 4.6% OVERSEAS 80 PATIENTS/ 0.9%

Data Source: Patient master index where first attend date in 2008-09

Peter MacCallum Cancer Centre Annual Report 2009 2008-09 Performance Summary 11 Report from the Director of Strategy and Redevelopment/

Leveraging off our current Strategic Plan Peter Mac has had a very successful (2006-10) and responding to the policy directions within the broader cancer history, and this is largely due to system, particularly the Victorian Cancer Action Plan 2008-11, our strategic the concerted effort we place on planning processes throughout 2008-09 provide the basis for the development planning for our future, and the value and strengthening of our services and programs through this next phase of our we place on the important role we history. Much work has been done on developing the Peter Mac Strategy (2009- have in our community. 15) which will be completed shortly and a revised Peter Mac vision, mission and strategic directions announced. Peter Mac is now poised at one of the The planning for our new home at In the meantime, planning within Peter most significant points of its history, Parkville requires coordination and much Mac for the next five years must continue Throughout the course of the year we at a time where there are significant consultation to ensure it meets the needs to ensure we use the space, staff and have continued to work closely with our developments in the way that cancer is of the community both in five years when equipment available to us to our best ends. partners on various initiatives. We have treated – personalised therapy and the it opens and beyond that for several In addition, we must continue to update worked with the Victorian Department of increasing roles of molecular medicines generations. New technologies, new and upgrade the infrastructure at East Human Services on the clarification of and genomics are providing a new research methods, and new models of Melbourne to ensure that we can continue our statewide role, with Western Health paradigm for cancer care, and Peter Mac care all need to be planned, scoped and to deliver our high quality of service – we in the development of our fifth satellite is at the forefront of these developments. catered for in the design, technology, will work very closely with the Victorian radiotherapy service at Sunshine equipment and fittings. This has required Department of Health to ensure we are Hospital, which will open in 2011, and With planning for the redevelopment of literally hundreds of meetings this year, able to do so. with the Ministry of Health, Malaysia, our East Melbourne campus as part of both internally and with our project partners in the development of our relationship the comprehensive cancer centre to be Over the course of 2008-09 we welcomed and experts around the world. There are beyond the existing Memorandum built at Parkville well underway, we are Zouki on the Park Pty Ltd as a commercial more than 25 committees meeting monthly of Understanding. entering an exciting phase with a worthy retail cafeteria provider. The new in addition to many informal meetings and mission – to be the leading contributor in redeveloped staff cafeteria gives back discussions. At various times in the project the development of a truly comprehensive to Peter Mac approximately 350 square this year, 50 or more user groups met as response to cancer care and treatment for metres of space to be used for more frequently as weekly. The expertise within Victoria, Australia and beyond. patient services, and also provides space Peter Mac, and opportunity to look forward for new staff. to a purpose designed facility, has made Mr Daniel Pilbrow this a truly inspirational project. I would like Another critical function within the strategy Director of Strategy and Redevelopment to thank all at Peter Mac for their passion team at Peter Mac is communications and dedication to this significant task over and marketing. We have commenced the last 18 months, and as we continue a process of consolidating resources in the planning and development of our with the appointment of a dedicated new home. Communications and Marketing Manager and relocation of the Webmaster/Graphic Documenting the project is a particularly Designer into our team. The results are important aspect to ensure that public already improving Peter Mac’s reach to our monies are spent wisely and accountability stakeholders with a new website, in house maintained – particularly when the production of this annual report, and a specifications for the project and budget refresh of our brand this year. will be critical at tender time. Many hours have been spent ensuring transparency throughout this project and the result is a functional brief of over 400 pages.

Peter MacCallum Cancer Centre Annual Report 2009 Report from the Director of Strategy and Redevelopment 13 About Peter Mac/

Who we are What we do Where we are Our people Our community

The Peter MacCallum Cancer Centre is a Peter Mac’s mission is to minimise the Centre for paediatric radiation therapy Peter Mac has five locations across Victoria A big part of what makes Peter Mac a Peter Mac has strong links to our global leader in cancer treatment, research impact of cancer on our patients and our Peter Mac is the only hospital in Victoria and provides services to patients from world-leading cancer centre is having community – our patients, our carers, and education. Affectionately known community. We do this through treating providing radiotherapy services for across Victoria and Australia as well as world-leading people. This year Peter our donors, and our staff are our greatest to most simply as ‘Peter Mac’, we are and caring for patients with cancer in our children. It’s a highly specialised form overseas. Our base is in East Melbourne Mac people continued to contribute on supporters. Peter Mac strongly believes Australia’s only public hospital dedicated public hospital and through conducting of treatment and we have a dedicated where the majority of complex cases are the world stage with eight of our clinicians that patient satisfaction and health to cancer and one of an elite group of research into better ways to treat and team of paediatric specialists to care for treated and our research laboratories and researchers presenting at the outcomes are maximised when the hospitals worldwide to have its own prevent cancer. We see around 25,000 our youngest patients. Children as young are located. American Society of Clinical Oncology’s hospital works with the community to meet integrated cancer research program patients each year, provide over 220,000 annual meeting – the largest and most their expectations of us. as one year old come to Peter Mac for There are satellite campuses of Peter and laboratories. episodes of care, and care for inpatients important annual gathering of international radiation therapy and often return 5-6 days Mac in Bendigo, Box Hill, Moorabbin and Peter Mac has long recognised the requiring around 43,000 bed days. oncologists. This year Peter Mac celebrated 60 years of a week, sometimes for several months. We Richmond and many of our clinicians wisdom of involving patients, their families, helping people with cancer and furthering Our research program encompasses have dedicated one of our six radiotherapy work from more than one location. All of Nationally, Peter Mac people received carers and the wider community in key our knowledge of how to better treat and some 25 laboratories and over 520 bunkers to be ‘child friendly’ – as much our sites offer state of the art radiation widespread recognition in their fields decisions relating to the planning, delivery prevent cancer. From a start with just a scientists, clinician-researchers, research as a radiotherapy bunker can be. Fairy therapy which allows many of our patients through awards, grants, scholarships and and evaluation of all of our services. Our handful of staff in a one-room clinic, Peter nurses, allied health professionals and lights, music they can choose themselves to access ongoing treatment closer to their academic qualifications. We are proud Community Advisory Committee ensures Mac has grown to over 2000 staff at five support staff. It attracts students and playing, a dedicated play area for waiting homes. In January 2009, the first sod was to receive these honours as recognition that decisions about Peter Mac keep sites across Victoria. researchers from around the world and time with DVDs and toys, all help to ease turned to mark the start of construction from our peers and acknowledgement that in touch with community views and our the impact of Peter Mac’s publications are an often stressful situation. on a sixth location for Peter Mac in we’re doing a good job for our patients. Consumer Register allows us to seek input We have come a long way in 60 years, again this year in the top three of Australian Sunshine. This site will bring much needed and feedback on a range of issues before cancer is no longer such a mystery to us Comprehensive cancer centre medical research institutes (Thompson radiotherapy services to the western decisions are made. and survival and survivorship has improved We strongly believe that treatment informed Scientific, 2008). suburbs of Melbourne from late 2011. immensely. But some things at Peter Mac by research, and research informed by One of the best signs that we’re have remained constant. In the words of Multidisciplinary care treatment, is the key to progressing better connecting with our community is the Peter MacCallum, ‘Nothing but the best is Our model of treating patients with cancer cancer care. The best way to facilitate this success of the Peter MacCallum Cancer good enough for the treatment of cancer’. is not to fit the patient to the treatment, but integration of clinical practice and research Foundation. With a small, dedicated staff This sense of purpose and commitment to rather to tailor the treatment to the patient. is to collocate treatment, research, allied and board, the Foundation raises around making life better for people with cancer To do this we gather a multidisciplinary health and other cancer services into a $15 million annually from donations, continues at Peter Mac. team of doctors, nurses and allied health single comprehensive cancer centre. Peter corporate partners, bequests and other professionals who are specialists in a Mac is not alone in this approach – the fundraising activities. It’s the community’s tumour type to develop a comprehensive world’s top comprehensive cancer centres way of saying thanks and keep doing what and coordinated treatment plan for the such as the Royal Marsden Hospital in you’re doing. patient. Our multidisciplinary teams are London, the Memorial Sloan Kettering organised into ‘Tumour Streams’ and we Cancer Centre in New York and the have 11 streams which cover different Princess Margaret Hospital in Toronto areas of the body and types of cancers. also follow this model. This ensures that patients get both Peter Mac has long supported the case treatment and a team tailored to for a comprehensive cancer centre to be their needs. built in Melbourne and congratulates the Federal and Victorian Governments on the announcement of the comprehensive cancer centre at Parkville. We look forward to being a part of it.

Image Steph, Registered Nurse

Peter MacCallum Cancer Centre Annual Report 2009 About Peter Mac 15 Our values in action/ Excellence

Advancing cancer genomics research Getting to the bottom of colorectal Excellence in action For Peter Mac, excellence is part In March 2009, Peter Mac was awarded cancer $2.5 million to help establish the Australian Colorectal cancer, commonly called bowel Professor Joe Trapani Awarded Senior Principal Research Fellow of everything we do, every day. Cancer Research Foundation (ACRF) cancer, is the second most common Acting Director of Research National Health and Medical Research Cancer Genomics Program at our East cancer in men and women with around Council Whether it’s seeing a patient for a Melbourne site. The program will provide 13,000 new cases every year. Over 4100 Associate Professor David Thomas Awarded the 2008 Victorian Public new and enhanced technologies in whole people die of colorectal cancer every year. Medical Director of OnTrac@PeterMac Healthcare Awards: Highly Commended ‘five year clear’ review, getting a genome screening and analysis. This will Treatment for colorectal cancer often Premiers Award for Excellence in Improving greatly accelerate research by changing a involves surgery, chemotherapy, Cancer Care in Victoria gene-by-gene examination process to one child through radiotherapy without radiotherapy, supportive care and allied where hundreds of genes can by analysed Appointed to the Lance Armstrong health services. Patients who are provided in a single plate and thousands can be Scientific Taskforce needing a general anaesthetic care by a multidisciplinary team often screened in a single experiment. have the best outcomes. At Peter Mac, all Recognised for one of the NHMRC’s Top every day, or receiving international This technology will enable Peter Mac’s patients being treated for colorectal cancer 10 Research Projects of 2009 researchers to identify genes that control are provided a tailored and comprehensive Associate Professor Ben Solomon Awarded Young Investigator of the Year awards for our research – cell growth, cell death and response to treatment plan by a multidisciplinary team. Medical Oncologist new and existing anti-cancer therapeutics, International Association for the Study of Peter Mac colorectal surgeon, Associate excellence is all around at and is likely to lead to important outcomes Lung Cancer Professor Sandy Heriot, arrived in Australia in cancer research. The technology is from London in 2006 and immediately Peter Mac. considered to be one of the greatest Ms Anna Ugalde Awarded Young Investigator of the Year saw the need for an educative meeting recent advances in molecular biology and Researcher and PhD Student Multinational Association of Supportive to promote multidisciplinary care for Image its developers were awarded the Nobel Care in Cancer colorectal cancer patients. Sandy sought Karen, Research Assistant Prize in 2006. out sponsors and colleagues within Ms Suzanne Graham Awarded Excellence Award at the Peter Mac greatly appreciates the support Peter Mac to put together a program of Registered Nurse International Society for Nurses in Cancer of the ACRF for helping its cancer research speakers, and the first Colorectal Cancer Care conference in Singapore. program to find faster results that will Multidisciplinary Care conference was benefit all Australians. held in Melbourne in 2007. It was clear that Associate Professor Kieran Harvey Young Tall Poppy Science Award Peter Mac had filled a much needed gap Group Leader, Cell Growth and Proliferation Australian Institute of Policy and Science with nearly 300 doctors, surgeons, nurses and allied health professionals attending Ms Verna Wallroth First pharmacist to be awarded the to learn more about multidisciplinary Senior Pharmacist Fellowship of the Australasian Association management of colorectal cancer patients. for Quality in Health Care The conference is now an annual event, providing an update on state of the art Associate Professor Ygal Haupt Awarded Innovation Fellow multidisciplinary colorectal cancer care in Group Leader, Tumour Suppression Victorian Endowment for Science, Australia for several hundred attendees. Knowledge and Innovation This year the conference attracted guest speaker Professor Anthony Senagore, Associate Professor Roger Martin Recognised for one of the NHMRC’s Top President of the American Society of Colon Group Leader, Molecular Radiation 10 Research Projects of 2009 and Rectal Surgeons. It’s another way that Biology Peter Mac strives for excellence – both for our patients and for advancing knowledge of cancer treatment.

Peter MacCallum Cancer Centre Annual Report 2009 Our values in action/ Excellence 17 Our values in action/ Innovation

Quicker and safer chemotherapy Personalised medicine for skin cancer New CT scanners New PET/CT scanner Finding better ways to treat and preparations Melanoma is the most deadly form of Computed tomography (CT) scanners are The Centre for Molecular Imaging has Chemotherapy drugs are highly toxic, cancer in Australia as there are few a central tool in cancer imaging. They work a new combined PET/CT scanner. The prevent cancer is something we do not only to cancer cells, but to those who treatment options and chemotherapy is by taking an image of a cancer at various scanner allows the patients to have handle them. They must be handled with generally successful in only 10 per cent ‘slices’ to show the size of a tumour at two scans done in the same visit – thus everyday at Peter Mac. Research, extreme care and the dosage must be of patients. Over 2000 Victorians are various points. The more ‘slices’ you take streamlining patient visits and improving exact to ensure staff and patient safety. In diagnosed with melanoma each year. images of, the more detail and clearer care. The new scanner has a large field of an Australian first, in November 2008 Peter picture of the tumour you will get. All view and high sensitivity PET detector with collaborative teamwork, and In June 2009, Peter Mac released early Mac introduced a state of the art robot Peter Mac satellite sites have 16-slice CT a 64-slice CT camera. This enables scans findings from a clinical trial of a new drug to prepare chemotherapy drugs to exact scanners on site for radiotherapy planning to be performed in a shorter time and with adopting new technologies and that targets a particular mutated gene – requirements in a clean room environment. and this year Peter Mac installed and less dose, which makes it more easily BRAF V600E – that occurs in 50 per cent commissioned a new state of the art 64- tolerated by patients, allows higher patient ways of working are some of the The new chemotherapy robot is expected of melanomas and about eight per cent slice CT scanner in the Diagnostic Imaging throughput, and no increased radiation to radically improve the way chemotherapy of all solid cancer tumours. The trial is Department at our East Melbourne site. dose to staff. ways we’re working to make life drugs are prepared at Peter Mac. The robot being led in Australia by Peter Mac medical better for cancer patients. This year will increase production capacity (Peter oncologist, Associate Professor Grant The new scanner in Diagnostic Imaging New MRI Mac prepares around 20,000 doses of McArthur, and involved 55 cancer patients provides faster and clearer detailed In August 2008, Peter Mac’s new $4 was a particularly strong year for chemotherapy a year and the robot adds – of which 16 were melanoma patients with images of tumours, allowing improved million Magnetic Resonance Imaging capacity to prepare up to 30,000 doses the mutated gene identified. Of these 16, investigations and it can perform a whole (MRI) machine was commissioned at our innovation at Peter Mac with several per year), has excellent quality control over half had their tumours shrink by more body scan in about 10 seconds. In terms East Melbourne site. The new machine processes built in, and offers improved than 30 per cent and ongoing disease of patient comfort, the faster scanning has double the strength of our previous safety standards for both patients and staff. control while they continued to take the means shorter breath holds while patients MRI and reduces the time of scanning new technologies allowing us to remain as still as possible during the scan. Previously, pharmacists were required to drug. By contrast, those without the patients by half. This means a total body mutation had no treatment response and prepare chemotherapy preparations of up This year Peter Mac became one of the first scan which took about 40 minutes now provide improved services and progression-free survival was less than two to 20 different drugs in special clean-room public hospitals in Victoria to introduce 4-D takes only 20 minutes – a significant months (consistent with historical data). outcomes for our patients. facilities in two-hourly shifts. The robot is CT scanning in the planning and treatment improvement for patient comfort and able to undertake this work more efficiently, This is an incredibly exciting and important of patients with types of lung cancer, where increased productivity. The increased field reducing the amount of time patients wait development for melanoma patients it is important to know exactly how and strength of the MRI machine yields images for their chemotherapy. and Peter Mac is proud to be part of this where the tumour moves during breathing. of greater detail and facilitates several new By understanding the tumour’s movement research applications. The chemotherapy robot was launched by research which is providing real hope to with the patient’s breathing pattern, the Victorian Minister for Health, the Hon melanoma patients. complex calculations can be undertaken Daniel Andrews MP, and made possible by Innovations in cancer imaging to better target the radiotherapy beams. a $900,000 grant from the Government’s Cancer Imaging involves the detection This means more accurate treatment to the New Technologies Program. of cancer tissue inside the patient’s tumour, and less damage to the healthy body. This is done to determine the most cells around it. appropriate therapy for the patient, or to assess whether previous therapy has been successful. These are important tests in planning how to manage patients so that the best outcome can be achieved. Imaging is used to guide treatment. Radiation oncologists and therapists use imaging to plan where the radiotherapy beams will be aimed to directly target the Image tumour. Surgeons use imaging to work Our new chemotherapy robot can produce up to out their surgical plans, and medical 30,000 doses of chemotherapy each year. oncologists use imaging to plan which chemotherapy drugs and dosages are best for the size, extent and type of tumour.

Peter MacCallum Cancer Centre Annual Report 2009 Our values in action/ Innovation 19 Our values in action/ Compassion

Cancer is a difficult and complex disease. The program is designed on the basis Dr Dave’s amazing work with kids Dr Dave and his Amazing Radiotherapy Compassion is one of Peter Mac’s Being told you have cancer can affect that if people are prepared about their with cancer Machine people profoundly. Often, dealing with treatment, they feel in control of their Peter Mac provides the only radiotherapy To further enhance the information offered key values. It’s not just something cancer requires far more than treatment treatment and confident in the process. service for children in Victoria. To help to children having radiation therapy and a day or two out of normal life. It’s The program draws on high-level research children undergoing radiation therapy at at Peter Mac, a new comic book style we say. It’s something that is about managing work, family, finances, and evidence about preparing patients Peter Mac, our two talented ‘Dr Dave’s’ information book has been developed. friends, relationships, feelings of for potentially threatening medical – radiation therapists David Tongs Acclaimed children’s author and illustrator everywhere at Peter Mac and loss, hopelessness and uncertainty – procedures. It tailors education to patients, and David Willis – together with the team Danny Katz and Mitch Vane have sometimes during months of ongoing and coaches patients on evidence-based Head of Paediatrics, Dr Greg Wheeler, produced ‘Dr Dave and his Amazing in everything we do. treatment. self-care procedures, which can ease the have developed a few special ways of Radiotherapy Machine’. effects of chemotherapy and put them communicating to children what radiation Treating people with cancer means treating The book is aimed at primary school aged in control. therapy is about. ‘The radiation treatment was people with compassion. children and is designed to be customised Patients are invited to visit the We know that treating cancer is more than Souvenir personal DVDs and easily updated so that hospitals not scary and didn’t hurt. Chemotherapy Day Unit at Peter Mac prior surgery, chemotherapy and radiotherapy, Many children undergoing radiation around the world can provide localised to their first treatment appointment, and Making the DVD was definitely and we know that sometimes the biggest therapy find it hard to explain their editions for their patients. The book was are shown around the unit and provided the highlight of my treatment.’ fears our patients have are things treatment to their friends, school mates presented at the International Paediatric a range of information materials about Radiation Oncology Society Congress patient Kassidy, 10 happening outside the hospital. So we’ve and extended family. Our ‘Dr Daves’ are their treatment, including information developed, trialled and introduced a new producing souvenir DVDs of children’s in Montreal in July 2009. Several other about potential side-effects and self- Image screening tool at Peter Mac designed to treatment, which offers our younger hospitals in Australia and New Zealand care brochures to help them manage Our ‘Dr Daves’ behind the camera with radiation identify these issues as soon as someone patients the opportunity to tell their story to have already expressed interest in using therapy patient Kassidy, 10. side effects at home. A key part of comes to Peter Mac, and find ways to help family and friends via a recorded message. the book and Peter Mac is proud to have the education program is a new DVD resolve them. It’s called supportive care. produced such a useful resource for which focuses on preparing patients for This is the first time a program such as Really, it’s peace of mind. children with cancer. We hope it makes chemotherapy and self-management of this has been done anywhere in the world. dealing with their treatment a little easier. Preparing patients for chemotherapy common side effects. Each DVD is customised to the individual child, including the choice of music and Chemotherapy is the treatment of cancer A recently completed randomised with drugs that destroy cancer cells. in some cases the ‘theme’ of the video. controlled trial of the program showed that Movies for younger children are often The drugs are highly toxic and are often participating patients had improvements associated with both physical effects – hosted by roving puppet reporter Max Von in distress levels and were less likely to Püppét. Older children prefer ‘music video’ nausea, fatigue, hair loss, infection – and experience severe levels of some side- emotional effects – fear, anxiety, worry style productions. The opportunity to tell effects through the self-management their story, their way, is really important about family – which cause significant education. These important developments distress for patients. We see this often when so many decisions are being made have now been reported at local and about them, for them. at Peter Mac and a few years ago some international meetings and in international of our people, led by Professor Sanchia journals to be shared with other hospitals Aranda (with Associate Professors and patients around the world. Penelope Schofield and Michael Jefford), decided to find a way to try to reduce the emotional distress of chemotherapy. The result, rolled out at Peter Mac this year, is the Pre Chemotherapy Education Program.

Peter MacCallum Cancer Centre Annual Report 2009 Our values in action/ Compassion 21 Chief Medical Officer’s Report/

Our radiotherapy services at East We continue to provide patient care using The clinical care and research that we This year has seen Peter Melbourne and our satellite centres at our multidisciplinary team model, through deliver have been enhanced this year Bendigo, Box Hill, Moorabbin and Epworth 11 clinical services – each devoted to by the installation of state of the art MRI Mac busier than ever, with Hospital have been working at full capacity, a particular tumour site (referred to as and CT scanners, and combined PET- with an increase in activity of 10 per cent Tumour Streams). Many of our clinicians CT imaging. These facilities support the increased clinical activity from the previous year. Two innovations in are international leaders in their fields, accurate diagnosis and staging of our Haematology and Medical Oncology have which ensures great depth of expertise patients, and are increasingly used to aid across the organisation. allowed patients to receive chemotherapy to provide optimal patient care. This also in the planning of the highly advanced more safely and efficiently: the introduction provides a common platform with our techniques used in radiotherapy. They Our operating suites are being of an integrated computerised booking/ future partners around which to develop also add significantly to the clinical prescribing system, and the installation the best model of patient care at the research programs conducted across redesigned and expanded, of an advanced chemotherapy robot to comprehensive cancer centre to be built at the organisation. prepare highly complex drug regimens Parkville. In addition we have an increasing Research at Peter Mac for the benefit of in a very safe environment. focus on supportive care for the cancer allowing additional and more cancer patients is part of core business. patient, going beyond the pure medical Peter Mac staff have presented key intervention. A development grant from the complex surgery. findings in both laboratory and clinical Pratt Foundation has enabled us to screen research at the premier international Acting Chief Medical Officer patients to identify and manage these meetings in the field. They continue to Professor Gillian Duchesne needs at presentation. publish widely and achieve great success The onTrac@PeterMac program for in obtaining peer-reviewed funding adolescents and young adults with cancer to support their research activities. exemplifies our statewide contribution to The cornerstone of our success is the cancer control. It provides holistic care integration of the basic, translational and for these patients who face particular clinical components of research. difficulties when diagnosed with life- The clinical staff have worked tirelessly threatening illnesses at a young age. to provide first class care to our patients. Since its inception in 2004, the program Over and above this, they have contributed has developed a national and international an enormous amount to the development reputation as providing best practice care of the plans and business case supporting to the specific adolescent and young the comprehensive cancer centre initiative adult oncology population in Victoria. at Parkville, for the future benefit of all This program has been paralleled by the Victorians and Australians with cancer. development of our outreach program in I offer a vote of thanks to them all for their the Late Effects clinic – critical in helping skill, dedication and compassion. long-term survivors of cancer therapy to lead normal and productive lives. Our statewide role is also reflected in the development of radiotherapy services for the western suburbs, which this year saw the turning of the first sod for the Professor Gillian Duchesne radiotherapy centre at Sunshine. It Acting Chief Medical Officer. will be jointly run by Western Health and Peter Mac.

Peter MacCallum Cancer Centre Annual Report 2009 Chief Medical Officer’s Report23 Care/ Tumour Stream Reports

Breast Gastrointestinal

Chair Major research studies • Co-BIG1-98: This international study led Presentation highlights Chair Colorectal Service Associate Professor Michael Henderson • A phase I/II study of external beam partial from Peter Mac is examining the impact Associate Professor Boon H Chua Dr Michael Michael The Colorectal Service within the GI Breast Nurse Coordinator breast irradiation in early breast cancer: of adjuvant hormonal treatments on • Interdisciplinary Radiation Oncology Nurse Coordinator Service participates in colorectal cancer Ms Katherine Howard A multidisciplinary team of researchers cognitive function in post-menopausal Seminar No. 9, Sydney, 2008. Ms Meg Rogers screening programs and offers up- Clinical Nurse Specialist have successfully completed patient women with early-stage breast cancer. Invited speaker. Clinical Nurse Specialist to-date videoendoscopy facilities for Ms Sarah Pratt accrual to this national clinical trial • Co-SOFT: This international study led Associate Professor Kelly A Phillips Ms Claire Sage patients. It also leads the nation in the investigating the novel technique of from Peter Mac is examining the impact • Australian and New Zealand Breast novel treatment of locally advanced and The Breast Service is a specialist partial breast irradiation using external- of adjuvant hormonal treatments on Cancer Trials Group Annual Scientific The Gastrointestinal (GI) Service recurrent rectal cancers and the use of multidisciplinary service caring for up to beam three-dimensional conformal cognitive function in premenopausal Symposium, Wellington NZ, July 2008. continued to provide a multidisciplinary intra-operative radiotherapy. Recently we 1,000 patients each year and covering radiation therapy for women with early women with early-stage breast cancer. Invited speaker. evidence-based therapeutic program for have commenced providing abdominal the whole treatment spectrum from breast cancer. This clinical trial is funded It is funded by the NHMRC and US patients with cancers involving both the peritonectomy with hyperthermic benign to advanced malignant disease. by the NHMRC. A phase III randomised National Institutes of Health. Prizes and awards upper and lower gastrointestinal tracts. intraperitoneal chemotherapy for patients We provide multidisciplinary consultation study is in development to further • Efficacy of goserelin in preventing Dr Prue Francis Most gastrointestinal cancers require with peritoneal malignancies. It is also and care with specialists from surgical investigate the role of partial breast chemotherapy-induced menopause: The • Doctor of Medicine (MD), The University multimodality therapy for optimal treatment, provides postgraduate courses in oncology, radiation oncology and medical irradiation using external beam conformal Australian, New Zealand and European of Melbourne, December 2008. Thesis hence the interaction between surgery, laproscopic surgical techniques. oncology in conjunction with breast radiation therapy in women with early entitled: ‘Oncology Drug Development: radiation therapy and medical oncology components of this international study Upper GI Service pathologists and radiologists, specialist breast cancer. Testing the Taxanes’. is critical to the successful outcome are led by Peter Mac. This study will The Upper GI Service has a particular breast nurse coordinators, plastic • Analysis of low radiation dose outside for patients. determine whether a GnRH agonist Dr Linda Mileshkin interest in oesophageal cancer, Barrett’s surgeons, psychologists, physiotherapists, of the treatment field to cancer patients given during adjuvant chemotherapy for • Victorian Cancer Agency: The GI Service comprises specialists from oesophagus and gastric cancer, and a geneticists and counsellors, social workers undergoing radiotherapy: This study breast cancer is effective in preventing A Supportive Care Fellowship. all these disciplines, who work together number of clinical trials in these areas are and palliative care specialists. aims to develop a Monte Carlo dose chemotherapy-induced menopause. Dr Kathryn Field to provide their expertise in a coordinated being led by our team and conducted The Breast Service at Peter Mac is one calculation tool to allow assessment of • Prognosis in BRCA1 and BRCA2 carriers • American Society of Clinical Oncology fashion, which gives patients efficient through national and international trials of the largest clinical service providers risks associated with low dose radiation with breast cancer: The Australian Merit Award 2008. management of their cancer. The service groups. Studies are also undertaken (such as cardiovascular side effects) and for breast diseases in Australia and component of this international study depends upon the expertise of GI-focused in the areas of pancreatic cancers, provide clinicians and patients with data Associate Professor Michael Henderson is supported by a strong translational is led from Peter Mac and is funded by histopathologists, radiologists and nuclear gastrointestinal stromal tumours and that can assist in decision making for • Vellar Family Memorial Lecture. research program. Many of the Breast the US National Institutes of Health. The medicine physicians. The GI Service liver tumours. The service has recently Service members are active investigators individual patients. The study is funded study aims to determine whether BRCA Grants and funding also participates, and in some cases has commenced thorascopic guided in a broad range of studies. A number of by the NHMRC and is in progress. designed and led, institutional, national status independently affects breast • NHMRC Project Grant: $320,522, oesophagectomies. members are also leading investigators • IBCSG 24–02 (BIG 2–02) SOFT: and international clinical studies, evaluating cancer prognosis. 2009–11. who chair large-scale national and This international randomised trial new therapeutic strategies for GI cancers. The Hepatobiliary Service is growing in In addition, Breast Service members international research initiatives focusing tests the treatment effect of ovarian • VCA Clinical Trial Infrastructure Grant: terms of its in-house surgical capabilities also led and supported multiple research The service has recently expanded with on breast cancer prevention, management function suppression on the relapse $213,000, 2008. including major hepatic resections, initiatives focusing on novel radiation the commencement of an additional of early-stage and advanced disease, and rate in women with hormone receptor- Whipples resection as well as hepatic therapeutic techniques, breast cancer consultant radiation oncologist Dr Kirsty survivorship issues. positive early breast cancer who microwave ablation and transarterial genetics and survivorship issues. Wilshire, and the return of two upper remain premenopausal, and the role chemotherapy embolisation. gastrointestinal surgeons Mr Cuong Duong of an aromatase inhibitor plus ovarian and Mr John Spillane. In addition the GI Neuro-endocrine Clinic suppression compared with tamoxifen. service has a new clinical nurse specialist, The GI Neuro-endocrine Clinic, comprising Recruitment has now reached over 75 Ms Claire Sage. medical oncologists, hepatobiliary per cent of the planned 3,000 women. surgeons and nuclear medicine physicians, has developed into a major statewide and national referral centre for the management of these rare and complex diseases as well developing translational research in this area. The GI service offers state of the art facilities for patients with this complex group of diseases, and continues to expand and interact with the other major hospitals in Melbourne.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Tumour Stream Reports 25 Care/ Tumour Stream Reports

Gynae-oncology Haematology

Highlights Associate Professor Sam Ngan Chair • The patterns of failure, outcome and Chair • Maintenance of the TGA-licensed • The 3rd Colorectal Cancer Conference: • Colorectal Cancer: A multidisciplinary Associate Professor Kailash Narayan toxicity of locally advanced cervical Associate Professor John Seymour Apheresis Service for stem cell collection, A multidisciplinary approach, took place approach, Melbourne, March 2009. Nurse Coordinator cancer patients with positive common Nurse Coordinators blood product collection and therapeutic in March 2009 and was organised • Australia & New Zealand Joint Oncology Ms Leanne Webb iliac or para-aortic nodes, treated Ms Trish Joyce, Ms Suzanne Eerhard, apheresis, achieved through a strong through the Colorectal Service, led by Scientific Meeting Christchurch, New radically with extended field radiotherapy. Ms Linda Clark, Ms Sharna Moloney, commitment to implementing quality Associate Professor Alexander Heriot. Zealand, August 2008. Best Poster The Gynae-oncology Service brings • The loco-regional failure and toxicity in Ms Odette Blewitt (Skin lymphoma), systems, overseen by Dr Simon Harrison It attracted over 200 registrants with Award. together expertise from the three major locally advanced patients given either Ms Yvonne Panek-Hudson together with the apheresis specialist gynaecology oncology surgical units nursing team. an outstanding local and international • Royal Australian and New Zealand lymph node boost or parametrial boost (Allogeneic transplant) in a multidisciplinary clinical setting. faculty. (See page 17 for more detail). College of Radiologists 2008 Annual depending on PET nodal status and not • Ongoing multidisciplinary involvement in Gynaecology oncologists, medical The Haematology Service continued • Three training sessions in laparoscopic Scientific Meeting, Adelaide, October parametrial invasion. the Cutaneous Lymphoma service run in oncologists, oncologic imaging to provide the highest standard surgery using our digital operating 2008. • Pattern of failure and toxicity in patients association with the Dermatology Unit of radiologists, radiation oncologists, nuclear multidisciplinary inpatient and outpatient theatre to train general surgeons from treated with central pelvic radiotherapy in St Vincent’s Hospital. Satellite services Associate Professor Trevor Leong physicians and pathologists continued to care to patients with a wide range of across Victoria and Tasmania. gynaecological cancer. have now been established in a number • 10th Annual Scientific Meeting of the work together at bi-monthly tumour panel haematologic diseases. The service of other state capital cities, based on the • Patterns of failure in cervical carcinoma Presentation highlights Australasian Gastro-Intestinal Trials meetings to devise the best treatment prides itself on its multidisciplinary team successful Melbourne model. Group (AGITG), Sydney, September plan for every new patient referred to the assessed by post therapy positron approach, which utilises world’s best Associate Professor Alexander Heriot • Commencement of a program for the • 29th Annual Turnbull Symposium 2008. service. This multidisciplinary approach emission tomography. chemotherapy/immunotherapy, radiation preparation and evaluation of Peter honouring Dr VW Fazio, Cleveland, incorporates diagnostic laparoscopy therapy and autologous stem cell • Annual Scientific Meeting of the Clinical Presentations Mac patients for allogeneic stem-cell November 2008. and histological and cytopathological transplantation approaches, as well as Oncological Society of Australia, Sydney, Associate Professor Kailash Narayan transplantation (performed at the Royal investigations, as well as Magnetic the full spectrum of supportive care. Our • Victorian Annual General Scientific and November 2008. Invited speaker. • 12th Biennial Meeting International Melbourne Hospital) and their long-term Resonance Imaging (MRI) and Positron committed participation in clinical and Fellowship Meeting, 2008. Gynecologic Cancer Society – IGCS follow-up, in conjunction with the Late Associate Professor Michael Jefford Emission Tomography (PET) services. translational research initiatives ensures • UICC World Cancer Congress, Geneva, Bangkok, October 2008. Oral poster Effects Clinic, by Associate Professor • Colorectal Cancer: A multidisciplinary development of, and access to, novel August 2008. Invited speaker and oral All types of gynaecologic cancer, including presentation. David Ritchie and Ms Yvonne Panek- approach, Melbourne, March 2009. investigational therapies, including immune presentation. patients with complex and uncommon Hudson. This broadens the range of Mr Craig Lynch • 30th Annual Conference of the system modulators and cellular therapies. presentations, as well as those requiring clinical services provided by Peter Mac • 29th Annual Turnbull Symposium Professor John Zalcberg OAM Association of Radiation Oncologists of palliative care, are managed and treated Major projects and enhances the continuity of care of honouring Dr VW Fazio, Cleveland, • Novartis Oncology Asia Pacific Summit, India, Mumbai, November 2008. Invited by the service. The Gynae-oncology these patients. November 2008. Phuket, September 2008. Invited speaker. The Haematology Service continued to Service utilises state of the art radiation develop its strengths in supportive care • Continued emphasis on a broad • Victorian Annual General, Scientific and speaker. • ANZGOG ASGO Inaugural Joint therapy, including Ultrasound and MRI to optimise patient education and reduce repertoire of scientifically innovative and Fellowship Meeting, 2008. • Chevra Hatzolah Melbourne, August Conference, Noosa, April 2009. image based 3-D dosimetry. the stress of patients’ experience through clinically promising clinical trials. In the 2008. Invited speaker. • Cervix State of the Science Meeting, • Colorectal Cancer: A multidisciplinary the various stages of their journey. This Major research studies Manchester UK, June 2009. ANZGOG Haematology Service, there are currently approach, Melbourne, March 2009. • World Congress on GI Cancer, Asian is highlighted by a number of initiatives 40 clinical trials open for recruitment, with Perspectives, Bangkok, October 2008. • Prospective study, PORTEC 3, a representative. Dr Michael Michael including: patients receiving therapy, or in follow up. Invited speaker. randomised controlled multi-institutional • Cervical Cancer Seminar, Royal Hospital • Australian Medical Research Congress, trial comparing radiotherapy alone for Women, Sydney, June 2009. • Work on the development of a post- Highlights Brisbane, November 2008. • 8th Princess Margaret Hospital to concurrent chemo-irradiation and transplantation nurse led clinic with Conference, Toronto, October 2008. Ms Sylvia van Dyk • Dr Andrew Wirth awarded his MD • Endocrine Nurses Society of Australia, adjuvant chemotherapy in high risk emphasis on integration of supportive Invited speaker. • Australasian Brachytherapy Group, degree for his thesis entitled: ‘The Role Sydney, March 2009. endometrial cancer patients. care needs for patient follow up, funded 17th Annual Scientific Meeting, Sydney, of Radiotherapy and Imaging in the by grants from VMIA and WCMICS. • Colorectal Cancer: A multidisciplinary Grants and funding Retrospective studies July 2008. Management of Lymphomas’. approach, Melbourne, March 2009. • Cancer Australia/Cancer Council • Taking part in a multi-institutional • 12th Biennial Meeting International • Dr Kirsten Herbert awarded the Cancer Australia Grant: $596,625, 3 years (national) retrospective study Gynecologic Cancer Society, Bangkok, Council of Victoria Early Career Clinician from 2008. comparing pelvic radiotherapy to October 2008. Researcher Fellowship, which involves • Cancer Australia Grant: $40 000, extended field radiotherapy in node clinical and translational research studies • 18th Australasian Brachytherapy Group 2008-09. positive endometrial cancer. in autologous progenitor cell mobilisation Annual Scientific Meeting, Gold Coast, and haematopoietic cell expansion for • Peter Mac Foundation: $74 672, 2008-09. March 2009. Invited speaker. therapeutic use. • NHMRC Grant: $2,418,375, 2009-13. Dr David Bernshaw • American Brachytherapy Society Annual Meeting, Toronto, 2009.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Tumour Stream Reports 27 Care/ Tumour Stream Reports

Head and Neck

• The ongoing growth and development Presentation highlights Grants and funding Chair • Prospective study of percutaneous Major presentations of the Haematology Immunology Associate Professor John Seymour • Peter Mac Foundation Morris Grant: Associate Professor June Corry endoscopic gastrostomy tubes versus Associate Professor Danny Rischin Translational Research Laboratory • GELA Scientific Committee Meeting, $150,000, 2008. Clinical Nurse Coordinator nasogastric tubes for patients with head • American Society of Clinical Oncology, (HITRL) lead by Associate Professor and neck cancer undergoing (chemo) Paris, August 2008. Invited speaker. • Peter Mac Foundation Project Grant: Ms Wendy Poon Orlando USA, May 2009. Oral David Ritchie. radiation. J Corry, W Poon, N McPhee, • European Mantle-cell Lymphoma $50,000, 2008. presentation. The Head and Neck Service at Peter A Milner, D Cruickshank, S Porceddu, • The central involvement of Dr Dennis Network Meeting, Turin, October 2008. • 1st Australia Hong Kong Scientific • Australian Cancer Research Foundation Mac is the largest in Australia. It offers D Rischin, and L Peters. Accepted Head Carney in the ongoing development of Invited speaker. Meeting of Head and Neck Oncology. (ACRF): $1,200,000, 2008. comprehensive diagnostic and treatment Neck, October 2008. the CLL Australian Research Consortium Hong Kong, November 2008. Invited oral • German Low-grade Lymphoma Study • National Collaborative Research services for patients with cancers of (CLLARC). • Protocol PMCC 01/61. A single arm presentation. Group, Munich, August 2008. Invited Infrastructure Strategy Capability 5 the head and neck region. Patient • Dr Stefan Peinert, Haematology Fellow, prospective trial to evaluate the policy speaker. Project: $50,000, $50,000, $50,000, care is provided by an experienced Professor Lester Peters being awarded the Albert Baikie Memorial of staged neck dissection or elective • American Society of Hematology, San $50,000, $68,000, $92,000, $100,000 multidisciplinary team consisting of head • International Conference of Head and Medal for the best abstract presentation radiotherapy in the management of the Francisco, December 2008. Session 2008. and neck surgeons, plastic surgeons Neck Oncology, Barcelona, February at the 2008 Haematology Society of neck in patients with clinical T1-2 N0 SCC Chairman oral faciomaxillary surgeons, radiation 2009. Oral presentation. Australia and New Zealand annual • Victorian Cancer Agency: $250,000, of the oral tongue. S Brennan, J Corry, oncologists, medical oncologists, social meeting. In addition, Dr Peinert also Professor Miles Prince 2008-09, $149,195, 2009. S Kleid, B Lyons, A Sizeland, N Vallance, Associate Professor June Corry workers, speech pathologists, dieticians, received a travel award to attend and • T-cell Lymphoma Workshop, Bologna • WCMICS Information Strategy Funding and L Peters. Accepted Head Neck, 2009. • Asian Oncology Summit, Singapore, and dentists, all coordinated by the head present at the International Workshop Italy, March 2009. Invited speaker. Program: $71,300. • The impact of demographics, tumour March 2009. Invited for two oral and neck clinical nurse coordinator. on Waldenstrom Macroglobulinemia in characteristics and treatment factors on presentations. • 5th International Symposium on the • Rotary Australia: $162,000, 2008-10. Radiotherapy planning and treatment staff, Stockholm, Sweden. swallowing after (chemo)radiation for • Practical Approaches To Radiotherapy Clinical Use of Cellular Products, • Cancer Australia, Support for Cancer diagnostic radiologists, nuclear physicians, head and neck cancer. J Frowen, Symposium, Ho Chi Minh City, Vietnam, • Dr Kate Burbury, Haematology Registrar, Nuremberg Germany, March 2009. Clinical Trials Program: $1,294,000, Ward 7 staff and the psycho-oncology S Cotton, J Corry, and A Perry. Accepted March 2009. Invited oral presentation. received the Australasian Thrombosis Session Chairman. 2008-10. team all provide additional excellent and Haemostasis Society award for best Head Neck, 2009. • 1st Australia Hong Kong Scientific Associate Professor David Ritchie • NHMRC Clinical Trial Grant: $350,000, support to our patients. abstract at the HSANZ Annual Meeting. • Phase I/II trial to evaluate Iressa and Meeting of Head and Neck Oncology. • Haematology Society of Australia & New 2009-11. The service has a strong international • Dr Saar Gill, Haematology Registrar, was Zealand Annual Meeting, October 2008. concurrent postoperative chemoradiation Hong Kong, November 2008. Invited for • VMIA Ron Champion Bursary: $75,000. profile based particularly on its published awarded the HSANZ New Investigator in patients with advanced resectable two oral presentations. Presidential Symposium presentation record of clinical research, which Award. • Novartis Pharmaceuticals: $270,000, head and neck cancer. D Rischin. and three oral abstract presentations. underpins optimal patient management. • 7th International Head and Neck $339,000, 2008-10. Accrual completed. Awaiting analysis. Conference, San Francisco, USA, July • A continued high level of research Dr Gail Ryan Clinical studies • BeyondBlue. An investigation into the 2008. Invited for two oral presentations. publications in high ranking journals, • International Extra-nodal Lymphoma prevalence of depression, anxiety including Lancet Oncology, Journal Study Group Meeting, Toronto, April The Head and Neck Service completed a Grants and funding symptoms and overall psychosocial of Clinical Oncology, Clinical Cancer 2009. Invited speaker. number of important studies this year: • Victorian Cancer Agency: $70,000 over function of an Australian head and neck Research and Blood. • Pathology reporting in head and neck 12 months. cancer population: Part A – Validation of • Publication of the results of a landmark cancer – snapshot of current status. the DASS21 and Part B – Psychosocial • Victorian Cancer Agency Early Career study establishing azacitidine, member B King, J Corry. Accepted Head Neck, risk factors. J Couper, A Pollard, J Corry, Seed Grant: $60,000. of a novel class of hypomethylating July 2008. A Boonzaier, D Smith, D Castle, agents, as the first agent able to prolong • Randomised study of percutaneous M Gray, K Mead. Accrual completed, the survival of patients with high risk endoscopic gastrostomy versus awaiting analysis. myelodysplastic syndromes [Lancet nasogastric tubes for enteral feeding in Oncology 10:223, 2009]. head and neck cancer patients treated Achievements • Peter Mac Haematology Service staff with (chemo)radiation. J Corry, W Poon, Associate Professor June Corry were authors on 27 abstracts presented N McPhee, A Milner, D Cruickshank, • Doctor of Medicine (MD), The University at the prestigious American Society S Porceddu, D Rischin, and L Peters, of Melbourne, May 2009. Thesis entitled: of Hematology Annual Meeting, San Medical Imaging Radiation Oncology, ‘Improving Outcomes in Head and Neck Francisco, December 2008. 2008 Oct; 52 (5): 503-10. Cancer Patients’.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Tumour Stream Reports 29 Care/ Tumour Stream Reports

Lung Melanoma and Skin

Chair Highlights • Colorectal Cancer: A multidisciplinary Chair Major projects Major presentations Associate Professor David Ball • Improved bronchoscopy service using approach, Melbourne, March 2009. Mr David Speakman • Members of the unit have been Professor Michael Henderson presented at Nurse Coordinator radial endobronchial ultrasound. Invited speaker. Nurse Coordinator instrumental in the development of the American Society of Clinical Oncology Ms Mary Duffy • Purchase of a respiratory phantom • Combined Annual Scientific Congress Ms Marianne Griffin (Melanoma) the Melbourne Melanoma Project – a Annual Meeting in Orlando, USA, with the for radiation dosimetry of moving lung of College of Surgeons of Hong Kong Clinical Nurse Specialist statewide initiative to collect all relevant results of a randomised trial on early or The Lung Service provides comprehensive tumors (made possible through a and Royal Australasian College of Ms Elizabeth Le Hunt (Skin) clinical and pathological information delayed adjuvant radiotherapy in stage diagnostic, consultative and treatment donation from the Toccolan Club and Surgeons in Hong Kong. Three invited on newly diagnosed melanomas in the 3 melanoma. This is the only trial of its services for patients with lung Serge Pignata). presentations. The melanoma and skin unit sees over state. The eventual aim of this project type in the world, which was completed and mediastinal tumors. We hold 500 new melanoma and 1500 new other is to predict high risk melanomas in Australia and is lead by Peter Mac multidisciplinary clinics twice a week. • Ms Zoe Wainer, PhD Student, awarded Ms Sarah Everitt skin cancers per year. All these patients at diagnosis and offer appropriate clinicians. It was a highlight of the ASCO Inaugural Thoracic Surgical Oncology • Chicago Multidisciplinary Symposium continue to be treated in an excellent interventions to these patients as early conference this year. Evidence-based and investigational Translational Research Fellow, partly in Thoracic Oncology, November 2008. multidisciplinary environment. Our team as possible. treatment of thoracic malignancies funded by the Peter MacCallum Cancer Invited presentation. consists of surgical oncologists, radiation • The See and Treat Program has includes: Foundation and partly by the Royal Professor Tomas Kron oncologists, and medical oncologists continued to expand offering patients Australasian College of Surgeons • Multi-modality approaches such as • Engineering and Physical Sciences in with a particular interest in translational a ‘one-stop shop’ for diagnosis and Research Foundation. concomitant 3-D conformal radiation Medicine Conference, Christchurch, research. We are fortunate to have an treatment of many less complicated therapy with chemotherapy and • Associate Professor Ben Solomon was November 2008. Invited for two excellent team of nursing and allied health skin cancers. This is considerably more biological agents. awarded Young Investigator of the Year presentations. staff working with us as well as nationally convenient for many patients, saving recognised pathologists in this field. The • Radiotherapy treatment planning based by the International Association for the Dr Linda Mileshkin multiple visits to the hospital. unit maintains close links with the Skin and on hybrid FDG-PET/CT imaging. Study of Lung Cancer. • Australian Lung Cancer Conference, • We continue to make improvements Cancer Foundation. • Phase I and II studies of new drugs. Presentation highlights Surfers Paradise, August 2008. Oral in the patient journey through the unit, Our referral base extends across the state • Participation in national and multinational Associate Professor David Ball presentation. in particular with a focus on providing and nationally. We continue to provide phase III clinical trials addressing • Grand Rounds, Royal Hobart Hospital, • WCMICS Supportive Care Conference, the full range of treatment options for some highly specialised treatments, such combined modality questions. July 2008. Invited presentation. Melbourne, October 2008. Oral patients with early skin cancer at a as isolated limb infusion, and have a single site. • Testing for mutations in tumours with the • 2nd Australian Lung Cancer Conference, presentation strong focus on transitional research, with • We have long been involved in aim of individualising treatment. Gold Coast, August 2008. Invited Ms Belinda McInnes many phase I and phase II international investigating new treatments for patients • Advanced radiotherapy technology presentation. • 2nd Australian Lung Cancer Conference, clinical trails involving novel agents in with more advanced melanoma. This to perform volumetric image guided Associate Professor Michael MacManus Gold Coast, August 2008. Oral melanoma being conducted through year Professor Grant McArthur has treatment. • Chicago Multidisciplinary Symposium presentation. the unit. been a lead clinician in exciting new in Thoracic Oncology, November 2008. Surgical procedures performed on site Grants and funding developments in this area – in particular Invited presentation. include endobronchial ultrasound; video- • Cancer Australia Priority Driven Cancer one agent, a bRaf inhibitor, which has assisted thoracoscopic surgery (including • European Society for Therapeutic Research Scheme: $260,000, 2009-11. shown startling improvements for VATS lobectomy); and endoscopic surgery, Radiology and Oncology, Gothenburg, • Victorian Cancer Agency Supportive some patients. including laser resection, stenting and Sweden, September 2008. Invited Care Fellowship: $258,671, 2008-09. • This year we have obtained a brand new, intraluminal brachytherapy. speaker. • NHMRC Palliative Care Research state of the art, operating microscope The service maintains its strong focus Mr Gavin Wright Development Grant: $50,000, 2009-10. to enable our plastic and reconstructive on identifying the psychosocial unmet • 2nd Australian Lung Cancer Conference, team to perform extremely delicate • International Association for the Study of needs of patients and providing holistic Gold Coast, August 2008. Proffered and complicated repairs to the defects Lung Cancer Young Investigator Award supportive care beyond the patient’s paper. caused by removing many of the large $40,000 for 2 years. medical requirements. cancers we see. This has benefited not • Australian Sarcoma Group Annual • Royal Australasian College of Surgeons only patients of the melanoma unit, but Scientific Meeting, Melbourne, October Research Foundation Grant: $60,000, those of many other units throughout 2008. Invited speaker. 2009. the hospital.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Tumour Stream Reports 31 Care/ Tumour Stream Reports

Paediatrics, Adolescents, Bone and Soft Tissue Young Adults and Late Effects Sarcoma Service

Chair We have also been involved in the planning • Regional outreach clinics have been • A particular focus has been improved Chair • The importance of PEDF in preventing Dr Greg Wheeler of paediatric services at the Parkville developed and an initial clinic in June visibility and awareness of Late Effects Professor Peter Choong growth and metastasis in osteosarcoma. Nurse Coordinators Comprehensive Cancer Centre and in in Bendigo was a success. Over the in blood cancer survivors. Following Nurse Coordinators • Developing a new invivo model of Ms Suzie Taylor (Paediatrics), the strategic planning of the Paediatric coming year it is planned to continue the the commencement of the Late Ms Marianne Griffin, Ms Esther Yeoman chondrosarcoma. Ms Natalie Goroncy (Late Effects), Integrated Cancer Service for Victoria. Bendigo clinic as well as create a similar Effects Nurse Coordinator position, Ms Priscilla Gates (Late Effects) clinic in Hobart in conjunction with the presentations have been given at both The bone and soft tissue sarcoma service Research by the Thomas group is studying Major projects Ms Lisa Brady (Late Effects) Royal Hobart Hospital. Further sites will patient and healthcare professional at Peter Mac is the largest group of its the molecular switches that propel bone • An external review was conducted be considered following assessment of forums. Twenty presentations have been kind in Australia and focuses on the and soft tissue cells down the pathway of The Paediatric Service continued to deliver of Peter Mac’s service provision to the current efforts. given over the past 12 months: one management of primary and secondary, cancer formation. children and adolescents. The findings its two main clinical services – Paediatric • Development of Comfort First – an internationally at the European Bone benign and malignant tumours of bone • Identification and characterisation were grouped under three major Radiation Oncology and the Late Effects integrated program of information, music Marrow Transplant Meeting (EBMT) in and soft tissue in a multidisciplinary setting. of a novel tumor suppressor gene in clinic. The number of patients involved headings: provision of anaesthetic Sweden; five national presentations therapy and bespoke video production, Spanning treatment ages from adolescent osteosarcoma, Wif1. in the Late Effects clinic has dramatically services; strengthening the overall and 14 Victorian presentations, which often involving roving puppet reporter to adults, clinicians from Peter Mac, St increased in the past year, and efforts are system including inpatient services; included five in rural centres. Clinical trials Max Von Puppet, has led to dramatic Vincent’s, Royal Melbourne Hospital and being made to increase the clinics ability to and governance and implementation Clinical research is an important part of effects in improving the ability of children Presentation highlights the Royal Children’s Hospital form the respond. Consideration is also being given of the recommendations. The following the sarcoma program. Close interactions to receive treatment without the need for surgical, medical and radiation oncology to providing a small paediatric radiation improvements have been implemented: • Leukemia Foundation Australia Support between this group and other international a general anaesthetic. arms of the service and are supported by a therapy service at Moorabbin Peter Mac. – Improved coordination of care Services National Conference, October sarcoma interest groups and industry • Participation in the Neuro-oncology dedicated team of oncology nursing, social between the Children’s Cancer Centre 2008. Presentation. sponsored groups has resulted in our Membership of the Children’s Oncology late effects committee of the Childrens work and psychology professionals. at the Royal Children’s Hospital and • Leukemia Foundation Australia Inaugural participation in a number of investigator Group continued, ensuring a number Oncology Group commenced this year. Peter Mac. Conference, Melbourne, January 2009. Through weekly multidisciplinary diagnostic driven and international collaborative trials. of children are enrolled in international • The Nurse Coordinators in the Late Presentation. (St Vincent’s) and therapeutic (Peter Mac) cooperative group studies, and even more – Improved resources for the provision • Denosumab in Giant Cell Tumor Effects service have developed meetings, new and review patients are are treated according to international of general anaesthetics to children, • Price Waterhouse Coopers Foundation, of bone. This world-first study was educational tools to assist quality discussed and appropriate protocol driven protocols. Our unit’s primary research aim including better recovery processes October 2008. Presentation. led from our group at Peter Mac, and of life in cancer survivors, including management instituted. The uniqueness of is to participate in the Children’s Oncology and the availability of recovery nurses. • European Group for Blood and Marrow demonstrated an 87 per cent response supportive care initiatives, patient this service is the immediate professional Group cooperative trials in conjunction – Increased availability of paediatric Transplantation 35th Annual Meeting, rate in patients with unresectable, education packages and an information interactions that can take place between all with the Royal Children’s Hospital and trained staff in the hospital and Sweden, March 2009. Presentation. advanced giant cell tumour of bone. brochure. They have also been actively members of the team who attend a weekly the St Jude Children’s Research Hospital ensuring that paediatric qualified The outcomes of the study were collaborating and assisting with the • Cancer Nurses Society of Australia outpatient clinic together. reported as an oral presentation at the (Memphis, USA) Meduloblastoma nurses are employed for the shifts development of other Late Effects clinics Annual Winter Congress, Newcastle, American Society of Clinical Oncology consortium. when children are admitted to nationally including with The Alfred June 2009. Presentation. Major research the ward. Annual Meeting in 2008. The manuscript Education remains a priority with Hospital Melbourne, The Royal Children’s The clinical service is underpinned by a • Cancer Nurses Society of Australia, has been submitted to the Journal of continuing registrar education and active – Increased nursing resources in the Hospital Melbourne and the Queen strong basic research and clinical trials Perth, February 2009. Presentation. Clinical Oncology. participation by the consultant staff in the Paediatric Unit from 0.6 to 1.2 EFT. Elizabeth Hospital Adelaide. program. Basic sarcoma research is Biennial Paediatric Radiation Oncology – Provision of training for health medical undertaken by two groups, headed by • Hypoxic imaging of sarcomas. This training weekend in May 2009. We have officers in basic life support for Professor Peter Choong and Associate program is based upon the observation actively encouraged and facilitated paediatrics. Professor David Thomas. that many sarcomas are hypoxic, that radiotherapy is mitigated in the presence attendance in paediatric-oriented Research by the Choong group explores We have added a part time project of hypoxia and the development of novel educational programs for medical, allied molecular mechanisms for regulating the officer to progress implementation of the therapies targeting tumour vasculature. health and nursing staff to improve growth and progression of sarcoma and review recommendations, and created a We have accrued 23 patients to a services for children. includes studies: Paediatric Steering Committee to provide pilot study utilising 18F-azamycin governance and advise on further service • The efficacy of DZ-13 dnazyme for arabinoside and PET to image hypoxia enhancements. targeting sarcoma – an invivo and invitro in patients with sarcoma undergoing model. pre-operative radiotherapy. The studies • Developing a novel deliver system have revealed a very high incidence for anti-sarcoma therapy based on of PET-detectable hypoxia in primary nanotechnology. sarcomas (46 per cent), which has adverse clinical significance.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Tumour Stream Reports 33 Care/ Tumour Stream Reports

Uro-Oncology Familial Cancer Centre

Highlights • Dr Julie Chu is working on three major • GEIS (Spanish Group for Research of Chair Presentation highlights Chair • The Australian Sarcoma Study Group studies: 4-D CT based radiotherapy Sarcomas) Annual Meeting, Madrid, Dr Farshad Foroudi Professor Gillian Duchesne Dr Gillian Mitchell (ASSG) was formed through a specified for solitary liver lesions; the DECO trial November 2008. Invited speaker. Nurse Coordinator • RANZCR, Adelaide, October 2008. Senior Genetic Counsellor (a randomised phase II trial of weekly Ms Mary Leahy Ms Mary-Anne Young grant from Cancer Australia and the • Annual Seminar Day, Israeli Society Associate Professor Michael Jefford secretariat is located at Peter Mac. The docetaxel chemoradiotherapy +/- of Pediatric Hematology/Oncology, • UICC World Cancer Congress, Geneva, The Peter Mac Familial Cancer Centre aims of this national group are to develop cetuximab in the treatment of localised Jerusalem, November 2008. Invited The Uro-oncology Service continued August 2008. Invited speaker for two (FCC) is a comprehensive cancer genetics and coordinate a cohesive clinical trials resectable cancer of the oesophagus); speaker. to provide multidisciplinary care for sessions and one oral presentation. centre with a commitment to clinical and basic research group while still and a study that aims to determine the patients with all forms of urological • Connective Tissue Oncology Society service and research. The FCC continues focusing on community education and pattern of utilisation of radiation therapy malignancies. The service consists of Dr Keen Hun Tai Annual Meeting, London, November to provide risk assessment, genetic patient advocacy of sarcomas. Through in soft tissue sarcomas in the adult specialist urologists, radiation oncologists, • Trans-Tasman Radiation Oncology Group 2008. counselling and genetic testing, medical the significant efforts of Dr Sally Whyte population in Australia. medical oncologists, nurses, physicists (TROG) Prostate Research Meeting, • Davidoff Cancer Centre Seminar Series advice and management as well as (CEO ASSG) and Associate Professor Patent: and radiation therapists, and has close Sydney, November 2009. Tel Aviv, November 2008. Invited speaker. links with The Royal Melbourne, Box Hill, psychological support to individuals and David Thomas (Chair ASSG) significant Ta, HT, Larson, I, Dass, CR, Choong, PFM, Dr Farshad Foroudi • Australian Health and Medical Research Epworth Richmond, Epworth Eastern, families who have concerns about their further funding was received from Cancer Dunstan, DE. (2008). Novel hydrogel • RADaim 2008, Gold Coast, July 2008. Conference, Brisbane, November 2008. and St Vincent’s hospitals and Monash personal and or family history of cancer. Australia and philanthropic groups. system for cancer drug delivery. Aust. Prov. Invited speaker. Medical Centre. Various research studies Grants and funding • Professor Peter Choong was appointed Patent Application, filed October 2008. People with a strong family history of and clinical trials are active, predominately • Victorian Cancer Agency Platform the Sir Hugh Devine Chair of Surgery Dr Jayesh Desai any types of cancer may be referred to Presentation highlights in the areas of prostate, bladder and Technology Capacity Building Grant: and Head, University of Melbourne, • Sarcoma Satellite Symposium. ASCO us. Genetic testing is available for many renal tumours. $445,328, 2008-09. Department of Surgery, St Vincent’s Associate Professor Samuel Ngan 2009, June 2009. hereditory cancer syndromes. • Australia & New Zealand Joint Oncology Hospital. • Australian Sarcoma Group Annual Major projects • Peter Mac Foundation: $46,125, 2008-09. Scientific Meeting, Christchurch, Ongoing large scale research studies: Scientific Meeting, Melbourne, October • Nurse led clinics have been expanded • Cancer Australia: $600,000, 2009-11. • Professor Peter Choong was awarded September 2008. • The IMPACT study: Identification of the RACS John Mitchell Crouch 2008. beyond patients during radiation • Victorian Cancer Agency: 2009. Men with a Genetic Predisposition to • Royal Australian and New Zealand Fellowship. • Peter Mac Grand Rounds, July 2008. therapy and now include patients who Prostate Cancer – International study College of Radiologists 2008 Annual have completed treatment for low and of targeted PSA screening in male • Associate Professor David Thomas Scientific Meeting, Adelaide, October • Canberra Hospital: Medical Oncology intermediate risk prostate cancer. BRCA1/2 mutation carriers and controls was promoted to Associate Professor 2008. Rounds, Canberra, July 2008. with title of Principal Research Fellow, Highlights – Australian coordinating site. • Colorectal Cancer – A Multidisciplinary • Annual Meeting of the Korean GIST University of Melbourne. • The AOCS study – Germline BRCA1 and Approach, 3rd Annual Meeting, Study Group, Seoul, September 2008. • Dr Michael Jefford promoted to Principal BRCA2 genetic profiling in the Australian • Associate Professor David Thomas was Melbourne, March 2009. Fellow with title of Associate Professor. Grants and funding Ovarian Cancer Study (AOCS), which will awarded the Queensland Cancer Council • Dr Scott Williams was awarded Doctor of Associate Professor David Thomas • RACS John Mitchell Crouch Fellowship: have significant implications for clinical Sam Sciacca Travelling Fellow. Medicine (MD) from Monash University. • Lorne Genome Conference, Lorne, $82,000, 2008. practice in selecting women for BRCA • Associate Professor David Thomas Thesis entitled: Prostate-Specific February 2009. Invited speaker. mutation testing. was awarded the 2008 Victorian Public • Liddy Shriver Foundation, USA: $64,000, Antigen as a Prognostic and Outcome • AMGEN Oncology Symposium, Sydney, Healthcare Awards: Highly Commended 2008. Index for Prostate Cancer Treated with • IBIS II – This study is examining the role February 2009. Invited speaker. Premiers Award for Excellence in • Cancer Council: $190,400, 2009-10. Radiotherapy. of aromatase inhibitors in breast cancer Improving Cancer Care in Victoria, • RMIT University School of Medical • AOA Research Foundation: $52,000, prevention. Chair, Inaugural COSA AYA Steering Sciences Research Seminars, 2009. • kConFab clinical follow up – prospective Committee. Melbourne, August 2008. Invited speaker. • Cancer Australia: $700,000, 2008. follow up of kConfab participants to • Associate Professor Sam Ngan was • Queensland Cancer Council Sam determine risk management practice, • Victorian Cancer Agency Clinician awarded the Best Poster Award at the Sciacca Lecture, Brisbane, August 2008. cancer risks and associated cancer Scientist Fellowship: $150,000 per year, Australia & New Zealand Joint Oncology Invited speaker. risk factors. 2008-10. Scientific Meeting 2008. • Molecular Biology and Therapeutics of New research studies • AGITG: 2008-13. Musculoskeletal Oncology, Salt Lake City • kConFab SNP – Using the kConFab September 2008. Invited speaker and • Hilton-Ludwig: 2008-11. cohort of women to investigate the clinical session moderator. implications of new breast cancer loci discovered over the last year using new technical approaches to gene discovery.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Tumour Stream Reports 35 Care/ Tumour Stream Reports

onTrac@PeterMac The Victorian Adolescent and Young • FCC SNP – A translational study to Presentation highlights Grants and funding Adult Cancer Service investigate the clinical significance of Dr Gillian Mitchell • National Breast Cancer Foundation: low penetrance breast cancer genes in • Familial Cancer Research and Practice, $5,000,000, 2009-13 (joint award with the Medical Director Major projects Presentation highlights a cohort of Victorian hereditary breast/ Annual Meeting, Couran Cove, August Peter Mac Pathology Department). Associate Professor David Thomas • Funding through Cancer Australia and • Cancer Nurses Society of Australia 11th ovarian cancer families. 2008. Invited speaker and poster • Cancer Australia: $479,189, 2009-11. Manager CanTeen to develop a National Education Winter Congress Workshop, Brisbane. • BRCA MLPA study – To investigate the presentation (with others). Ms Kate Thompson Program for clinicians with an interest in Invited speaker. • Victorian Cancer Agency: $136,000, 2009. contribution of large deletion and gene • Leura VI International Breast Cancer AYA oncology. This collaborative project • 7th Annual Australian & New Zealand • Victorian Cancer Agency, Clinical Trial onTrac@PeterMac is Australia’s leading rearrangement in BRCA1 and BRCA2 Conference, Sydney, September 2008. with The Centre for Adolescent Health is Adolescent Health Conference 2009. genes in Victorian families with familial Invited speaker and poster (with L Capacity Building Grant: $150,000, multidisciplinary health care team that under development for commencement • Davidoff Cancer Centre Seminar Series, breast/ovarian cancer. Hossack, and others). 2008-09. offers specialised, age appropriate care to in 2010-11. Adolescent and Young Adult (AYA) cancer Tel Aviv. • Mutation-carrier needs assessment – • Australian Sarcoma Group Annual • Victorian Cancer Agency: $82,500, • Funding through Cancer Australia to patients treated within adult hospitals. Our • WCMICS Supportive Care Conference, Qualitative research studies aimed at Scientific Meeting, Melbourne, August 2008-09. develop an implement an Australian team includes a medical and paediatric Melbourne. Two invited presentations. identifying the ongoing support needs of 2008. Invited speaker. • NHMRC: $295,250, 2008-10. first model of group support for AYA oncologist, clinical nurse consultant, patients who carry a mutation in a cancer completing cancer treatment. This • Australian Music Therapy Association, Ms Lucinda Hossack (with M-A Young, psychiatrist, psychologist, social worker, predisposition gene living in metropolitan model of support is currently being Brisbane. M-A Aitken and G Mitchell) palliative care clinical nurse specialist, areas and regional areas. implemented in other Australian • Familial Cancer Research and Practice, education advisor, music therapist, Grants and funding jurisdictions. • Gynaecological cancers in Lynch Annual Meeting, Couran Cove, August education and training officer and • Cancer Australia: $40,000, 2008. syndrome – To estimate the age and • onTrac@PeterMac in collaboration 2008. Poster – awarded 3rd prize. research officer. We provide: • Rainbow’s for Kate Australian Sarcoma gene specific risks of gynaecological with the Victorian Department of Human Dr Alexander Boussioutas Kindred Study: $500,000, 2008-11. cancers in Mismatch Repair (MMR), • Direct clinical care and support for young Services is working towards the further • 1st Annual Scientific Meeting of gene mutation carriers, identify people undergoing cancer treatment. development of a model of statewide • Victorian Cancer Agency: $391,877, Singapore Gastric Cancer Consortium, environmental and lifestyle factors • A secondary consultation service to AYA cancer care through national 2008-11. Singapore, July 2008. Invited speaker. modifying gynaecological cancer risks healthcare professionals, young people funding under the Youth Cancer • Lance Armstrong Foundation: $79,000, in carriers and examine treatment and • Grand Rounds, Western Hospital, and the broader community. Network Program. 2008-09. survival outcomes in gynaecological September 2008. Invited speaker. • Training, education and professional cancers in carriers with respect to Highlights Dr Belinda Kiely development programs. females with gynaecological cancers • 2008 Victorian Public Healthcare Awards: • Leura VI International Breast Cancer unselected for family history. • Medical and psychosocial translational Highly Commended Premiers Award for Conference, Sydney, September 2008. research. Excellence in Improving Cancer Care in • The association between endometrial Poster Presentation. cancers and BRCA1 and BRCA2 carriers • Leadership in both jurisdictional and Victoria. – This study assessed endometrial Ms Linda Cicciarelli (with R Doherty, national health reforms in AYA oncology. • David Thomas and Kate Thompson cancer risk associated with BRCA1 or L Hossack, M-A Young, C Michael-Lovatt appointed to the newly established and G Mitchell) onTrac@PeterMac receives over 160 BRCA2 mutation status +/- tamoxifen in referrals each year for direct clinical COSA AYA Steering Committee. David 57 Australasian breast-ovarian families. • Familial Cancer Research and Practice, Thomas appointed Inaugural Chair. Annual Meeting, Couran Cove, August care and provides over 600 secondary • Tamoxifen and risk of contralateral breast 2008. Poster Presentation. consultations to a range of healthcare • David Thomas appointed to the Lance cancer in BRCA1 and BRCA2 carriers – professionals and community agencies. Armstrong Scientific Taskforce. Ms Mary-Anne Young Data collected from international cohorts • Release of ‘A Practice Framework for • Into the Mainstream: Future Challenges of BRCA mutation carriers to evaluate Working With 15-25 Year Old Cancer for Genetic Health Care, March 2009. whether tamoxifen is an effective Patients Treated Within the Adult Health Invited speaker. secondary prevention strategy in Sector’. 2008 Palmer, S, Thomas, D.M. BRCA carriers. • Colorectal Cancer – A Multidisciplinary Approach, Melbourne, March 2009. Invited speaker. • Familial Cancer Research and Practice, Annual Meeting, Couran Cove, August 2008. Invited speaker and two poster presentations (and contributed to two posters above).

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Tumour Stream Reports 37 Care/ Treatment

Surgery Intensive Care Unit

Director A new fifth operating theatre was Director Major projects Professor Robert Thomas OAM commissioned in February 2009 providing Dr David Charlesworth Improved patient outcomes at General Manager greater capacity and timely treatment for Nurse Unit Manager cardiac arrest Mr Shane Ryan patients. The digital operating equipment Ms Jo Pickford Our ICU educator was instrumental in the installed in Operating Theatre 1 last rollout and education of staff in the use of year has been put to excellent use with As Australia’s only specialist oncology the Automated External Defibrillator, which In 2008-09, our surgical program a number of training courses being intensive care unit, and a statewide referral assisted in early defibrillation and improved conducted with surgery transmitted to service, our six-bed ICU is staffed with patient outcomes. continued to deliver the most a meeting room where others watch experienced Critical Care Nurses, 24-hour the procedure live, and interact with the medical cover and consultants who are Piloting new programs advanced treatments available, surgical team. Fellows of the Joint Faculty of Intensive We’ve worked on the development of an Care Medicine. This year we welcomed a Acute General Medical Service Pilot to New surgery techniques added in the past new Director of Intensive Care, Dr David commence in mid 2009. An additional along with adding new techniques 12 months include: Charlesworth, an experienced Intensive general medical registrar based in the to busy operating theatres that • Use of intra-abdominal chemotherapy Care Consultant and Respiratory Physician ICU, and available to assist across the for the treatment of pseudomyxoma. who trained in Australia and the UK. hospital, will provide increased support for performed more than 4600 • Microwave ablation of liver tumours. patients non-cancer related acute medical Activity in the ICU doubled this year as conditions. procedures. • Laparoscopic gastrectomy. more patients with complex medical • Thorascopic assisted oesophagectomy. conditions were treated at Peter Mac. Our Highlights patients often have complex multiorgan • Addition of an ICU liaison nurse, funded • Microvascular free flap reconstructive disease in addition to their oncological by DHS. Image surgery. Bryce, Registered Nurse condition, and the ICU provides a range • Updating clinical handover, admission and Associate Nurse Unit Manager, We continue to attract outstanding of interventions to critically unwell patients. and discharge records to enhance Operating Suite surgeons and staff and provide advanced patient management and care planning. training for local and international trainees • Initiation of infection control measures to in surgical oncology. improve safety to patients and staff. • Clinical audits conducted on numerous clinical indicators to maintain high standards of clinical care.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 39 Care/ Treatment

Chemotherapy Day Unit Pharmacy

Director Director Highlights Presentation highlights Associate Professor Danny Rischin Ms Sue Kirsa • Director Sue Kirsa was awarded a • Dan Mellor was invited to conduct Nurse Unit Manager Fellowship from the Society of Hospital a specialist induction for new With just over 40 staff, the pharmacy Mr Michael Cooney Pharmacists of Australia and appointed oncology sales representatives from provides specialist manufacturing, for a second term on the Victorian GlaxoSmithKline, Melbourne, August dispensing, clinical support, education Quality Council. 2008. and information services. The pharmacy supports clinical drug trials and • Deputy Director of Pharmacy Dan Mellor • Dan Mellor was invited to speak at in The Chemotherapy Day Unit is a participates in pharmacy practice is undertaking a PhD project studying the plenary of the annual Pharmamed research activities. genetic differences in patients which may Logistics Conference, Sydney, 24-bed specialist treatment facility, predict response to cancer medications. September 2008. In 2008-09, our specialist oncology delivering over 8500 treatment pharmacy dispensed 99,945 prescriptions; • A project examining barriers and • Dan Mellor presented on the use of off- prepared 20,904 chemotherapy doses; opportunities for funding of high cost label and unlicensed medicines in the episodes per year, with up to 20 provided 23,610 medicines on discharge; pharmaceuticals by private health funds. oncology setting, Bangkok, September and provided 24 undergraduate student • Development and implementation of 2008. per cent of daily treatment being placements. new technologies, including: MedNET • Dan Mellor and Gail Rowan invited to act Major projects wireless medication administration safety as tutors for the Cancer Pharmacists’ delivered within a clinical trial. An Australian first in new technology software; Charm prescribing software; Group ‘Clinical Skills for Cancer and Merlin-MAP clinical pharmacist Pharmacy Practitioners’ course, Brisbane A cytotoxic preparation robot was installed software with Pharmhos, which provides May 2009. Major projects Better education for chemotherapy Highlights with funds from a DHS new technologies grant, to enable Peter Mac to provide electronic records of clinical activities. • Dan Mellor was invited to speak on Streamlined patient scheduling with a patients • An excellence award at the International quality, efficient chemotherapy services to • Verna Wallroth became Australasia’s first Pharmacogenomics of Cancer Therapy, new electronic system This year the CDU commenced rollout Society for Nurses in Cancer Care patients (more information p18). pharmacist to be awarded the fellowship Hong Kong, June 2009. In November 2008, a new electronic of our new Pre Chemotherapy Education conference in Singapore was won by of the Australasian Association for Quality scheduling system was introduced, which Program. All patients scheduled to Peter Mac’s Suzie Graham. The Global Integrated Cancer Services • Gail Rowan invited to present lectures commence their chemotherapy treatment funded project in Health Care and was also invited to and online case study moderation for allowed clinicians to select and propose • CDU has again had a member of nursing in the CDU are supplied with an join two Therapeutic Guidelines Expert Monash University Master of Clinical a chemotherapy treatment pathway for a staff participate in the Clinical Research Funds were granted to create consensus patient, with automatic links to the required educational DVD and question prompt guidelines on the treatment of febrile Editorial Groups. Pharmacy course. Fellowship program, with Carolyn Boyden series of appointments in CDU or the sheet and are scheduled for a specific neutropenia to be developed by specialists • Clare Francis participated in the COSA investigating the use of a standardised • Verna Wallroth invited to present on inpatient area. Scheduling or re-scheduling pre-treatment education and information in infectious diseases, haematology and working party to develop guidelines tool for undertaking chemotherapy the use of Posaconazole prophylaxis in patients is now more accurate, and appointment with a member of the CDU oncology, and pharmacy. for health professionals discussing the symptom assessments in CDU. The Acute Myeloid Leukemia (AML) patients facilitates better treatment patterns with nursing staff. At this time, any concerns use of complementary and alternative outcomes of the project are in the Consumer influenced medicines at Australian Society of Antimicrobials, less anxiety for patients wanting to about the proposed treatment can be medicines with cancer patients, and process of being implemented in the unit. management Melbourne, February 2009. change bookings. raised and addressed. The intervention identifying appropriate resources for The consumer participation in medication also provides for all patients to receive a • The CDU staff continue to act as clinical health professionals. Clare also was Grants and funding reconciliation project, funded by DHS and follow up phone call within the first two experts in delivery of Peter Mac’s • WCMICS: $100,000. led by project officer Senthil Lingaratnam, invited to contribute a chapter on Cancer days following their initial chemotherapy chemotherapy education programs, examined ways consumers could help and the Safety of Complementary • DHS New Technologies Grant: $900,000. treatment. Early results show that patients lecturing in both Module 1 and Module health professionals ensure continuity of Medicines to the book ‘Herbs and on the program had improvements in 2 chemotherapy programs. Nurses medicines management as they move in Natural Supplements’. distress levels and ability to reduce side from across Victoria and interstate effects through better self-management. and out of the acute hospital setting. have travelled to Peter Mac to attend the training.

Image Associate Professor Michael Jefford Medical Oncologist and part of the team to develop and deliver the Pre Chemotherapy Education Program

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 41 Care/ Treatment

Pathology Centre for Blood Cell Therapies

Director Presentation highlights Grants and funding Director Assisted other states to set up cell Associate Professor David Ritchie Professor Miles Prince processing facilities • Haematology Society of Australia and Professor Stephen Fox Professor Stephen Fox • Cancer Australia/National Breast Cancer New Zealand Haematology groups, Operations Director • Ludwig Institute of Cancer Research, Foundation: $600,000. Operations Director CBCT personnel directly and indirectly Adelaide, August 2008, and Perth, Dr Dominic Wall Melbourne, July 2008. Invited speaker. Dr Dominic Wall assisted Victorian and interstate institutions • Cancer Australia: $367,000, 2008-09. set up and run cell processing facilities. September 2008. Invited speaker. • Roche sponsored breast cancer The Pathology Department is a NATA • Victorian Cancer Agency (VCA): The Centre for Blood Cell Therapies • Haematology Society of Australia education meeting, September 2008. Highlights accredited laboratory and provides $150,000, 2008. (CBCT), its collaborators at the Australian and New Zealand Annual Scientific Invited speaker. • New cryopreservation product storage diagnostic services on thousands of • DHS: $366,000, 2008. Red Cross Blood Service, and Cell Meeting, Perth, October 2008. Session • International Academy of Pathologists, Therapies Pty Ltd continue to facilitate the area commissioned. patients samples every year and is a • NHMRC: $335,000, 2008. Chair. Athens, October 2008. Invited speaker. translation of cellular therapy research • Supported two clinical trials involving critical component of cancer diagnosis, • Taiwan Society of Infectious Diseases, • Department of Human Services: from the bench into the clinic. The Centre gene modified cells for treatment of treatment and research. The department Associate Professor Alex Dobrovic Taipei, Taiwan, January 2009. Invited $650,000. holds two Therapeutic Goods Authority cancer patients. encompasses most pathology • REGISTER study meeting, Sydney, 2009. speaker. subspecialities including anatomical Invited speaker. • National Breast Cancer Foundation: manufacturing licences, and provides • Supported IND submission to FDA. $5,000,000, 2008 (joint award with the a mix of standard of care treatments for • Taiwan Haematologists Meeting, Taipei, pathology (five staff specialists and three • Maintained strong representation at • Peter MacCallum International Peter Mac Familial Cancer Centre). cancer patients, cell and tissue processing Taiwan, January 2009. Invited speaker. residents), and haematopathology (three Symposium on Cancer Epigenetics, the International Society for Cellular for clinical trials (internal and external) and Dr Dominic Wall staff specialists and three residents), Melbourne, 2008. Convenor. • Cancer Council Victoria: $300,000, Therapies. biochemistry and molecular pathology all 2009-11. consulting services. • 2nd Melbourne Gene Therapy • Key facilitator in the delivery of Federal underpinned by a highly skilled scientific • Murdoch Children’s Research Institute, Symposium, 2008. Invited speaker. • Peter Mac Foundation: $79,000, 2008. Over the past year, CBCT has expanded Government’s National Collaborative and administrative staff of 67.70 EFT. Melbourne, 2009. Invited speaker. • Department of Human Services: its manufacturing capacity to include cell Research Infrastructure Strategy (NCRIS) • Preclinical Development of Regenerative Associate Professor David Westerman We are a referral centre for complex $45,000, 2008. banks, and other ‘in-process’ material program to assist researchers access Therapies – Global Regulatory • Bendigo Educational Trainee Weekend, for cellular therapies. Resources include Perspectives Miami, 2008. Chair and diagnostic cases and molecular pathology • Federal Government and Royal code of Good Manufacturing Practice September 2008. Invited speaker. two collection sites, a central processing Organising Committee Member. assays, both germline and somatic, with Australasian College Pathologists (cGMP) compliant infrastructure. outside referrals accounting for 20 per • AIMS Annual Scientific Meeting, facility, apheresis and cryopreservation. • Bureau of Food and Drug Analysis, 3rd of Australasia: $150,000, 2008-09. Presentation highlights cent of our case mix. We are the largest Melbourne, October 2008. Invited Cell Therapies P/L manages the Annual Taipei International Symposium Professor Miles Prince reference centre for HER2 (breast cancer speaker. commercial activities of CBCT to provide on Human Cell and Tissue-based • 29th Australasian Dermatopathology gene) testing in Victoria. We also have a Dr William Murray an efficient connection to the scientific, Products, Taipei, October 2008. Society Conference, Melbourne, August wealth of experience in assessing novel • Australasian Dermatopathology Society regulatory and business communities. Invited speaker. 2008. Invited speaker. biomarkers in normal and neoplastic tissues Conference, Melbourne, August 2008. • Ausbiotech, Melbourne, October 2008. Major projects using conventional immunohistochemistry, Invited speaker. • Haematology Society of Australia Perth Invited speaker. in situ hybridisation, flow cytometry and A series of projects in malignant and Chapter, August 2008. Invited speaker. Dr Sarah Swain Grants and funding molecular characterisation. non-malignant conditions • Cancer Council Western Australia – • Australasian Dermatopathology Society Current projects include studies Public Forum, August 2008. Invited • Celgene Australia: $150,000, 2008-09. Conference, Melbourne, August 2008. involving dendritic cells, chimeric T-cells, speaker. • National Collaborative Research Convenor and Scientific Program haemopoietic stem cells, mesenchymal • American Society of Haematology Infrastructure Strategy: $50,000, Chairman. stromal cells and chondrocytes. Annual Scientific Meeting, San Francisco, $50,000, $50,000, $68,000, $100,000, Applications range across a wide range Dr Catherine Mitchell December 2008. Session Chair. $192,000, 2008. of clinical indications for both malignant • Australasian Dermatopathology Society • Peter Mac Foundation: $150,000, 2008. Conference, Melbourne, August 2008. and non-malignant conditions. • Satellite Symposium at Annual Scientific Program Contributor. Hematology Meeting, San Francisco, • Victorian Cancer Agency: $250,000, Helped establish the first Australasian December 2008. Invited speaker. 2008-09. Dr Stephen Lade ISCT meeting • Panobinostat 2006-20, Bologna Italy, • DHS: $100,000, 2009. • Australasian Dermatopathology Society We were instrumental in gaining approval March 2009. Invited speaker. Conference, Melbourne, August 2008. for the first Australasian meeting Scientific Program Contributor. International Society for Cellular Therapies (to be held in Adelaide in October 2009).

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 43 Care/ Treatment

Diagnostic Imaging Centre for Molecular Imaging

Director • A mobile ‘C’ arm image intensifier was Dr Nick Ferris Director The first human studies into a receptor Invited presentations Dr Colin Styles purchased in December 2008 for use • Integrated Health Enterprise Australia Professor Rodney Hicks associated with seizure Professor Rodney Hicks in the operating theatres. The larger 12 Connectathon, Canberra, July 2008. In conjunction with the CRC-Biomedical • Lilly Oncology Symposium. Sydney, Diagnostic Imaging – Radiology provides inch field size allows for better definition Invited speaker. The Centre for Molecular Imaging (CMI) Imaging Development, the Department January 2009. a comprehensive imaging service for our incorporates the nuclear medicine and of both upper and lower level of the field • New Zealand Branch, Royal Australian of Neurology at Melbourne Health and • 6th Symposium for Future Drug patients. The modalities include state of art Positron Emission Tomography (PET) reducing geometric errors in patients and New Zealand College of Australian Nuclear Science and Technology Discovery and Medical Care. Sapporo, 3 Tesla MRI scanner, ‘Adaptive scanning’ imaging facilities. Its primary focus is undergoing high dose Brachytherapy. Radiologists, Annual Scientific Meeting, Organisation (ANSTO), the first-in-human Japan, March 2009. CT scanner, digital mammography unit and diagnostic imaging using minute doses of • Major research projects, including Auckland, August 2008. studies were made with the GABAA digital fluoroscopy unit. The department radiopharmaceuticals administered to the • Asian Oncological Summit. Singapore, a phase Ib/II study of Sunitinib in central benzodiazepine receptor targeting is also supported by the Picture Archiving • Australian Sarcoma Group, Annual patient. The nuclear medicine discipline April 2009. combination with neo-adjuvant radiation radiopharmaceutical, F18-Flumazenil. It is and Communication System (PACS), which Scientific Meeting, Melbourne, October also provides treatment for selected • 5th Uppsala Spring Meeting. Uppsala, in patients with resectable soft-tissue hoped that in the future this test will assist delivers images to the referring clinician’s 2008. cancers with the use of larger doses of Sweden, April 2009. sarcoma; a phase I, two-stage dose- in identifying foci of epilepsy seizure in the desktop in an instant. • Abdominal Radiology Group of Australia radiopharmaceuticals. escalation study of BNC105P (a novel human brain. • Australian Neuroendocrine Tumour and New Zealand, March 2009. (NETs) Consensus Workshop. The department performs approximately vascular disrupting agent, in patients with The clinical service of the CMI continues Support for other Australian hospitals • Health Informatics Society of Australia, Melbourne, July 2008. Two presentations. 35,000 studies per calendar year and advanced solid tumours); collaborative to grow markedly. PET continues to have The Nuclear Medicine Department at Peter Health Informatics Conference, has five radiologists, 20 radiographers, research with Siemens Australia into a prominent role in research trials of Mac continues to be a major referral site • 10th Annual Scientific Meeting of the Melbourne, September 2008. six registered nurses, two patient service breast MR Spectroscopy and Dynamic molecularly targeted therapies, and has for novel radionuclide therapies, receiving Australian and New Zealand Head and assistants and 10 administrative staff. Contrast-Enhanced MRI. • Royal Australian and New Zealand strong linkages to translational research patients from throughout Victoria and from Neck Society. Melbourne, September College of Radiologists, Annual Scientific groups both within and outside Peter Mac. 2008. Major projects Highlights many other states of Australia. In particular Meeting, Adelaide, October 2008. Four The service employs approximately 27 staff the treatment of somatostatin receptor • COSA-IACR Joint Scientific Meeting. • The 3 Tesla Siemens MRI Scanner was • Purchase of new 64-slice CT scan (128 posters presented. and performed over 4800 studies in PET positive neuroendocrine cancers continues Sydney, Australia. November 2008. installed July 2008 and a new MRI breast slice capable with X-Ray tube oscillation). and 3200 studies in nuclear medicine in to grow, leading to the establishment imaging service was introduced in 2008 Grants Mr Eddie Lau • Further exploration of new imaging 2008. of a dedicated neuroendocrine tumour • Second Australian Lung Cancer to evaluate selective patients from the sequences with the recently purchased • Department of Human Services: multidisciplinary clinic within the Upper Peter Mac Familial Cancer Centre (FCC). $4,000,000, $1,500,000. Major projects Conference, Gold Coast, August 2008. 3 Tesla MRI such as perfusion GI Service. Invited speaker. • A new 64-slice CT scanner was installed and diffusion as a means of better • National Health and Medical Research Investing in leading PET/CT scanning • Contemporary Oncological Practice in May 2009. This will reduce waiting highlighting the presence and activity Council Project Grant: $396,375, 2009. The increased demand and reliance Highlights • A Gallium generator has been obtained Symposium of Hong Kong College of times and improve service delivery in this of tumour. • The Royal Australian & New Zealand on PET now and into the future was recognised by the replacement of one of that allows production of 68Ga-DOTA Radiologist, Hong Kong, November area. New tumour perfusion studies will • Continued high quality breast MRI College of Radiologists Radiology our earlier PET/CT scanners with a new analogues suitable for imaging on PET 2008. Invited speaker. be implemented shortly, which will assist diagnostic and research program with Research Grant: $12,000, 2008. state of the art machine. The new scanner scanners. This has particular importance • Inaugural Lung Cancer Preceptorship at in determining the characteristics of the Familial Cancer Centre and breast incorporating a large field of view, high in identifying neuroendocrine tumour Peter Mac, Melbourne, February 2009. blood flow to tumours. surgeons. sensitivity PET detector and a 64-slice CT targets more accurately than existing Invited speaker. • Availability and continuance of an camera, enables scans to be performed SPECT technology and for planning • Abdominal Radiology Group of Australia interventional program for arterial liver in a shorter time and with less dose. This radionuclide therapy. and New Zealand Inaugural Annual treatment. improves patient comfort and departmental • The availability of PET is limited in Scientific Meeting, Sydney, March 2009. Invited presentations efficiency by allowing higher throughput Australia and therefore the Centre Invited speaker. Dr Robin Cassumbhoy without increased radiation dose to staff. for Molecular Imaging at Peter Mac • 4th Annual ANZAPNM Cross-Sectional • Neuropathology/Head and Neck performs a large proportion of its studies Anatomy Course, Melbourne, May 2009. refresher cause, attended by 320 on patients from other hospitals. An Invited speaker. initiative to transfer PET/CT scans via a Radiologists, Melbourne, February- Dr Kate Moodie March 2009. Invited presenter. secure network to hospitals in the region has resulted in hospitals receiving their • Australian Neuroendocrine Tumour • 4th ANZAPNM cross sectional anatomy patient’s scans in a timely and reliable (NETs) Consensus Melbourne, July 2008. course, Melbourne, May 2009. Main fashion and making the data more speaker. easily incorporated into their local management process.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 45 Care/ Treatment

Pain and Palliative Care

Grants Director Highlights • NHMRC Project Grant: $396,375, 2009. Dr Odette Spruyt • Recruitment to the methoxyflurane for • The Royal Australian & New Zealand bone marrow biopsy-associated pain trial With two registrars based in the Peter Mac continues, which ultimately may result in College of Radiologists Radiology inpatient and outpatient areas, we grew Research Grant: $12,000, 2008. less intravenous sedation used with this our capacity even further in 2008-09 with a procedure and reduced patient burden. • National Institutes of Health (USA): new community-based registrar position. ‘Defining Molecular Markers of Hypoxia’: The department has also grown in the past • The project, ‘Improving palliative care US$133,380, 2009. year including five new dedicated research of adolescents and young adults, • Transport Accident Commission/Victoria staff – Dr Judi Greaves as Research a collaboration between the Pain Neurotrauma Initiative: $433,522, 2008; Coordinator, Suzanne Lipshut, Sylvie Griek and Palliative Care Department and $278,769, 2008. and Dale Long as Research Nurses, and onTrac@PeterMac’, was completed in May 2008 under the management • Federal Government of Australia Vivien Ong as Research Assistant. of Gayle Jones. As well as various Collaborative Research Consortium Major projects conference presentations throughout the Grant 2005-12. CRC for Biomedical The National Standards Assessment life of the project, recommendations are Imaging Development with partners, Program (NSAP) being carried forward with educational Monash University, ANSTO, Cyclotek We’re continuing to implement best and dissemination strategies planned Pty Ltd, GE Medical Systems Inc, and practice, as set out in the National Palliative for the coming year. The impact of the IBM Inc. Grant value $23.2 million to all project continues to shape the work of participants with approximately $4 million Care Standards, through developing new both the Pain and Palliative Care and to Peter Mac. materials to support and enhance palliative care services. onTrac@PeterMac teams. • Leukemia and Lymphoma Society (USA) • We undertook a voluntary quality Project Grant: US$600,000. Trials to reduce the symptom burden for patients initiative to improve practice through Two commercially sponsored international benchmarking with other services, with a pharmaceutical trials have commenced, common dataset and quality indicators. involving use of methlynaltrexone in opioid- induced constipation, in the hope of reducing patient symptoms. National trials in pharmaceutical interventions for pain We are one of the principal sites involved in the federal government funded Palliative Care Clinical Studies Collaborative, a national palliative care research collaboration which is gathering evidence on several pharmaceuticals to enable application for Pharmaceutical Benefits Scheme listing, and thereby increase patient access to palliative care medicines.

Image Val, Peter Mac Volunteer for 9 years

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 47 Care/ Treatment

Major projects New service for Melbourne’s western – Lung Cancer: High dose short course Radiation Therapy Services Less trauma and sedation of our young suburbs underway radiation therapy (Hypofractionated Director patients As part of the Sunshine Hospital Stereotactic Radiotherapy) as an Mr Aldo Rolfo Introduction of the Children’s DVD redevelopment, Peter Mac will deliver alternative to surgery for early stage production unit, enabling themed DVDs much-needed radiation therapy services to lung cancer in selected patients to be produced to help our younger Melbourne’s western suburbs. The Minister – Bladder Cancer: The use of online patients understand, explain and input for Health, the Hon Daniel Andrews adaptive radiation therapy for patients Peter Mac is home to Australia’s into the treatment process. Compliance MP, turned the first sod in January this with muscle invasive bladder cancer. with treatment requirements is greatly year, construction is now underway, and largest radiation therapy centre – improved, evidenced by the reduction in services are set to commence by 2011. Other research during 2008-09 the use of anaesthesia and sedation. included: Investment into innovation we have more than 190 staff at five • A multi-site study into the optimal bladder The DVDs, and the new children’s radiation We’ve invested in the latest radiation filling instructions for prostate cancer therapy book, ‘Dr Dave and his Amazing sites across Victoria and this year therapy and associated equipment this patients undergoing radical radiation Radiotherapy Machine’ form part of our year to improve our treatment services. Our therapy using IGRT to verify daily bladder successful child education and trauma we delivered 474,900 radiotherapy carefully invested funds have purchased: volume. reduction initiatives introduced this year. • A linear accelerator with full image • 4-D scanning in lung cancer to improve fields (treatments) during 116,147 New understanding of lung cancer guidance capability (Moorabbin). tumour coverage. movements • A 4-D CT scanner which allows state of • Adaptive radiation therapy in head and With the introduction of the ‘4-D CT patient visits. the art planning for patients (Bendigo). neck cancers. scanning program’ at East Melbourne and Moorabbin, we have better information • A new 3-D CRT and IMRT treatment • Optimal bladder preparation for patients Image about the movement path of lung cancers planning system to provide state of the undergoing prostate cancer radiotherapy. Associate Professor Trevor Leong, art complex treatments (Box Hill). • Optimal positioning for patients Radiation Oncologist with breathing – which is critical for • A new tumour movement management Director of Peter Mac Moorabbin planning, and accurate placement of undergoing breast cancer radiation beams throughout treatment. Work is now system that detects cancers moving therapy. underway to introduce this approach to all during treatment to ensure cancers • Use of PET/CT and PET related Peter Mac sites by the end of 2009. are accurately within the path of the compounds in the tracking of lung treatment beam (Moorabbin). tumour responses to radiotherapy. • A new stereotactic body stabilisation • Management of diet and improvement system enabling the treatment of in treatment accuracy for patients very small cancers with high doses of undergoing prostate radiotherapy. radiation as an alternative to surgery (East Melbourne). • Assessment of prostate motion and impact on treatment planning – • A new patient records system assessment of 3-D imaging vs 2-D was introduced to improve timely marker based imaging. management, appointment and scheduling of treatment (all sites). Research partnerships We’ve made crucial advances in our field with research specialists at all Peter Mac facilities, and major research partnerships. In the past year, our work has included: • Joint national studies (backed by the Trans Tasman Radiation Oncology Group) with the Division of Radiation Oncology and the Physical Sciences Unit looking into:

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 49 Care/ Treatment

Knowledge growth Bendigo Radiotherapy Centre Highlights We have sophisticated planning facilities Peter Mac Moorabbin Tattersall’s Cancer Centre Epworth Richmond In the past year, our rigorous training and Director • The installation of a new Brilliance Big and two linear accelerators and we Site Director development programs have led to: Dr Michael Lim Joon Bore 16-slice CT scanner. specialise in IMRT and Image Guided Associate Professor Trevor Leong Site Director Radiotherapy for the treatment of prostate Deputy Director • The inaugural Radiotherapy Rural Deputy Site Director Dr Patrick Bowden • An Australian first, with the ongoing cancer and Adaptive Radiotherapy for training and credentialing of staff in the Ms Judy Andrews Cancer Nursing Forum, which provided Ms Shirley van Graas Deputy Site Director workshops for nursing and allied health bladder cancer. We also treat other Ms Laura Sparks use of Adaptive Radiotherapy Treatment As a satellite site of Peter Mac, Bendigo Moorabbin has had another busy year professionals in the Loddon Mallee sub-specialities such as breast, gastro approach. Radiotherapy Centre provides access to with an increase in referrals, outpatient The Tattersall’s Cancer Centre (TCC) is region. intestinal, sarcoma, lung and skin cancers. • Development of an in house training the latest clinical management, technology, attendances and radiotherapy treatments. a leading radiotherapy treatment facility program – known as Strengthening research and clinical trials for patients in • The appointment of a Research Highlights Two new radiation oncologists commenced located at the Epworth Hospital and Checking Program – which improves the Loddon Mallee region, while reducing Radiation Therapist to coordinate our • A feasibility study assessing organ in 2008-09 and shifts were introduced for operated in partnership with Peter Mac. skills in quality assurance and leads to the need for people to travel long distances research program, which now enables motion during preoperative radiotherapy the first five months of 2009 to address the TCC provides radiotherapy treatment for safer treatment delivery. for treatment. In 2008-09, we serviced 725 significantly more research to be for rectal cancer using Cone Beam has increasing waiting list. The shifts were able patients with cancer from across Victoria, conducted at Bendigo. received expedited review approval and • Improved treatment accuracy with patients from the Loddon Mallee region. to be ceased when the third new linear interstate and internationally. This year we • The graduation of two radiation therapists is being progressed by our radiation accelerator commenced clinical work in welcomed Ms Laura Sparks as our new continued annual testing and training We work closely with consultants in our pilot program Radiation Therapist therapists. May this year. Deputy Site Director. of new staff in the reading of treatment throughout regional Victoria and are Radiation Engineering Assistant. • All radiation therapy staff have been related images. committed to providing seamless patient Peter Mac continues to work collaboratively The past 12 months have been a busy credentialed to perform on line adaptive • Extended scope of practice roles in a care throughout the treatment process, • The 2008 Peter Mac Award for Team with Southern Health in establishing period with more than 800 new courses of bladder treatment. range of areas such as breast cancer which involves regular communication with Innovation for the Radiotherapy multidisciplinary meetings and clinics and treatment started – an increase of almost planning specialist, adaptive treatment our patients’ general practitioners, and Electronic Treatment Chart Project. • Paper publication by Wirth, A, Kron, it is anticipated that we will commence 200 compared with the previous year. specialist in bladder cancer, and imaging facilitating patient access to local health T, Wittwer, H, Sullivan, K, Sorell, G, treating Southern Health head and neck Whilst there has been a significant increase specialist in lung and prostate cancers. care resources. Epworth Eastern Medical Cramb, J, ‘Phantom Measurements patients later in 2009. in activity at TCC the department’s Centre at Box Hill and Computed Estimates of Breast strong focus on patient care and prompt • Link and Learn Grants, enabling staff Each of our attending radiation oncologists Moorabbin looks forward to celebrating Site Director Dose With Radiotherapy for Hodgkin’s commencement of radiotherapy treatment to travel oversees to study the latest specialises in specific tumour types, and our 15th year of operation on 1 December Dr Andrew Wirth Lymphoma: Dose Reduction With the has been sustained. innovative treatment strategies. is a member of a specialist unit involved 2009. Deputy Site Director Use of the Involved Field’. Published • Development of a self directed learning in research and education at Bendigo and Highlights Ms Julie Wills in the ‘Journal of Medical Imaging and Major projects and highlights to improve skills and competency in the our central campus in East Melbourne. • The IMRT program continues to be Radiation Oncology’, August 2008. • The redevelopment of the first of the two use of Adaptive Radiation Therapy for Our specialties are urology, breast, lung, Peter Mac Box Hill is a satellite campus of strong with a large number of patients • Collaborative educational programs with original bunkers was completed in May pelvic, head and neck cancers. gastro-intestinal, head and neck, skin, Peter Mac at the Epworth Eastern Medical referred for high-dose prostate IMRT. Epworth Eastern Hospital to enhance 2009. The third new linear accelerator haematological, sarcoma and central Centre. It is co-located with Epworth IMRT, along with another speciality With continued investment in education, professional development for local GPs was installed in this bunker and the nervous system malignancies. On site, we Eastern Private Hospital and opposite Box option, dose escalated radiotherapy technology, and our own knowledge, in tumour streams such as breast and machine has On-Board Imaging (OBI), have state of the art radiotherapy planning Hill public hospital. We service patients treatment for prostate cancer, contributed we’ve broken new ground – and our urological cancers. and treatment facilities staffed by an from the eastern suburbs of Melbourne Cone Beam CT (CB CT) and respiratory leading experts remain at the forefront to approximately 25 per cent of the expert team of radiation therapists who are and in 2008-09 we provided 834 new gating – all state of the art equipment of global advances in radiotherapy workload during this financial period. competent in the delivery of IMRT for the radiotherapy treatment courses. which will enable us to implement cancer treatment. • Continued business development treatment of prostate cancer. cutting-edge radiotherapy techniques We work closely with colleagues at Box and potential to improve treatment for activities, including strengthening Allied health services including dietetics, Hill Hospital, Epworth Eastern and with some tumour sites. sustainable referral bases throughout occupational therapy, speech pathology, other physicians and surgeons in the local Victoria led to high activity levels, with an • The third new linear accelerator physiotherapy and psychology are area to provide seamless patient care average of 1350 attendances per month. commenced clinical service in May provided by our partner, Bendigo Health throughout the treatment process. Our 2009, which now provides for three linear • Referrals continued from New Zealand, within the radiotherapy centre. Social radiation oncology staff includes specialists accelerators fulltime and a fourth in use with about 50 patients travelling work and welfare services are available representing most tumour streams and 50 per cent of the time, with Superficial/ internationally for treatment at TCC for patients to assist with dealing with we have multidisciplinary team meetings Orthovoltage therapy also provided. during the period July 2008 to April 2009. a cancer diagnosis and also provide in five tumour streams. Our staff includes advice with accommodation and transport radiation therapists, physicists, specialist • Clinical trials and research papers arrangements. Palliative care services are oncological nurses and clerical staff as well presented nationally and internationally accessed through Bendigo Health. as radiation oncologists who visit according by our radiation oncologists, radiation to tumour stream sub-specialties. therapists, nursing and physicists.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 51 Care/ Treatment

Clinical Psychology Allied Health Head of Department Clinical studies Presentation highlights Ms Tessa Jones • A Couple-Focused Psychological Ms Justine Diggens Allied Health delivers a broad The Department of Clinical Psychology Intervention for Men with Early Stage • EACH International Conference on is a leader in the delivery of specialised Prostate Cancer and Their Partners. Communication in Health Care: Oslo, spectrum of specialist care for psychological services. Our clinical Investigators: Jeremy Couper, Gillian Norway, September 2008. Oral and patients, families and carers to psychologists provide a specialised Duchesne, Ann Boonzaier, Anthony Love, poster presentation. psychology service to assist patients and Annette Street, Sidney Bloch and Judy Dr Kate Neilson improve quality of life and their families with emotional distress at all Dunai. A successful pilot has led to a • Poster and presentations at IPOS stages of their cancer journey. Treatment grant for a three year randomised Conference Vienna, June 2009. Invited optimal function throughout includes therapy for depression, anxiety control trial. for two presentations and poster. and adjustment difficulties for both • An Investigation of Levels of inpatients and outpatients at Peter Mac. Dr Maria Ftanou the cancer journey. Psychological Distress (Depression And • Breacan, September 2008. Invited We provide clinical supervision and training Anxiety) and Unmet Needs Amongst presentation. People Diagnosed with Head And Neck We provide our services for both inpatients and outpatients at our East Melbourne to postgraduate psychology interns and Cancer. Investigators: Jeremy Couper, Grants and funding campus, and some services are available at satellite centres. Made up of seven manage communication skills training for Annabel Pollard, June Corry, Ann • BeyondBlue: $250,000, 2009-11. departments, supported by 5.1 EFT of administrative staff, we have 45.5 clinical staff, clinical staff. We are engaged in research Boonzaier, Kate Neilson, David Smith, as detailed in the table below. We received project funding from the Western and Central that contributes to the well being of those • Victorian Cancer Agency: $5,000, 2008. David Castle, Marcelle Gray and Karen Melbourne Integrated Cancer Service (WCMICS) for a collaborative project investigating living with cancer. Mead. Recruitment of 122 participants for a data framework for Allied Health across the WCMICS sites. Led by Anna Boltong, the Major projects the study has recently been completed. final report was completed in May 2009. The proposed framework links inputs, outputs • Winning the Peter Mac Quality and • Breast Cancer Survivors Healthy Lifestyle and outcomes to enable effective benchmarking and evaluation of services. Safety Award 2009 (Effective Workforce Study: A Randomised Controlled Trial to Category) for the hospital-wide Test the Effects of Information and Advice Clinical Department Clinical Clinical Project/ Communication Skills Training Program on Adopting Healthy Lifestyle Behaviours Staff EFT Research EFT managed by Justine Diggens. in Breast Cancer Survivors. Investigator: Clinical Psychology 3.5* 1.7* 2.1 • Presentations and posters at national Annabel Pollard. Nutrition 8 7.6 1.7 and international conferences by our team, including the International Psycho- Occupational Therapy 5 4.1 Oncology Society 11th World Congress Pastoral Care 8 7 in Vienna and the European Association for Communication in Healthcare in Oslo. Physiotherapy 6 5.5 • Delivery of training courses for the Post Social Work 13 12.87 0.2 Graduate Certificate/Diploma in Cancer Music Therapy 1 0.84 and Palliative Care. Speech Pathology 1 0.7 • Delivery of communications skills training across Peter Mac to help our staff better Total Allied Health 45.5 40.31 communicate with patients, families *Permanent Clinical Psychology staff. Temporary clinical and research staff is 1.6 EFT. and carers.

Image Mandy, Physiotherapist, provides treatment to patient Isaac

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 53 Care/ Treatment

Music Therapy Nutrition Occupational Therapy Physiotherapy Coordinator Highlights Head of Department Head of Department Head of Department Research into potential breast surgery Dr Clare O’Callaghan • Dr O’Callaghan helped to establish the Ms Gwenda Roberts Ms Elizabeth Pearson Ms Rebecca Bramley links to lymphoedema Sarah Davies is collecting data for breast Music therapy is currently a 32 hour weekly International Association for Music and The Nutrition Department continued to With a focus on assisting people manage With six staff, we provide inpatient and surgery patients to identify the potential service at Peter Mac, providing music- Medicine, and its inaugural event was provide support and advice to patients in limitations caused by cancer, we assist outpatient services across all tumour relationship between type of breast surgery based methods focused on supporting held in Ireland. inpatient and outpatient settings at our East patients to maximise independence, streams to optimise patients’ function and and lymphoedema. people through cancer experiences. • Philippa Barry completed her masters Melbourne, Box Hill and Moorabbin sites well being, and quality of life. Our main treatment throughout the entire cancer Our clinical and theoretical research is research, examining the effects of as well as patients in the home. Gwenda focus of service is assessment of daily journey. Our services for inpatients include Commitment to education also advancing knowledge about the music therapy CD creation on paediatric Roberts returned from extended leave living activities and discharge planning regular exercise groups, comprehensive We continued our role in student education use of music therapy in oncology and patients’ first radiotherapy treatment. in April 09 to replace Anna Boltong, and for inpatients. Approximately 25 per cent assessments, treatment and discharge this year, receiving undergraduate palliative care. • Philanthropic funding from Redkite for Tracey Martin joined the department in our of our clinical time involves outpatient planning. We also provide acute physiotherapy students from both La fixed term, new graduate position. Kathryn assessments, interventions and follow up, cardiopulmonary services for surgical and Trobe University and The University of Major projects paediatric, adolescent and young adult Webb joined the department to provide including home assessments. intensive care unit patients and services Melbourne, and postgraduate placements A National Health and Medical Research music therapy services, for 16 hours/ clinical support for completion of projects. for outpatients, predominantly specialised were undertaken by Singaporean and Council grant week was generously provided. Highlights Major projects lymphoedema management. Swiss physiotherapists. Our team delivered Dr Clare O’Callaghan undertook research Presentation highlights Efforts to improve services further Greater contributions to education In addition to clinical patient care, a series of lectures to undergraduate into the relevance of music for adult, Dr Clare O’Callaghan A system for referring and triaging patient physiotherapists are involved in patient- students at Melbourne and La Trobe adolescent and child patients and their • Inaugural Conference of the International Student placements were supported at referrals with KPIs for initial contact was centred programs, such as the Falls universities and Sarah Davies and Anya companions. Collaborators included the Association for Music and Medicine, Deakin University and piloted at Kings College developed, and a review of records led to London, jointly with St Vincent’s Hospital; a Awareness Program and Falls Committee, Traill guest lectured at La Trobe University University of Melbourne, the Centre for Limerick, Ireland, June 2009. Presenter. new assessment and transfer forms. A new on lymphoedema and oncology for Palliative Care Research and Education, second Deakin University clinical oncology the Pressure Ulcer Point Prevalence • Grand Round Presentation at Limerick system for short term equipment hire was physiotherapists. To support our education Peter Mac and other local and international day was hosted; and Deakin University dietetic Survey Committee, the Patient Information Regional Hospital, Ireland, June 2009. also implemented. activities, Sharni Patchell attended the academic, hospital and community student honours project commenced. and Education Committee and the Invited speaker. Formalised evidence-based training Advanced Clinical Educators course. palliative care staff. Continued commitment to professional Tracheostomy Team. • 35th Canadian Music Therapy We developed evidence-based protocols development In 2008-09 we welcomed a new Grade 2 Highlights Published works in major medical Association Conference, Ottawa, May and training for OT management of Anna Boltong was awarded a PhD Physiotherapist to the team and farewelled • Anya Traill co-facilitated a Living with journals. 2009. Presenter and Invited speaker: breathlessness and relaxation therapy. scholarship via the VCA for research our Head of Department, Rachel Dalton. Cancer course in conjunction with the Dr O’Callaghan’s work was published Advanced Training in Music Therapy Exploring the Nature and Impact of Presentation highlights Myeloma Foundation. (or is in press) in The Oxford Textbook of in Oncology. Major projects Palliative Medicine, Journal of Palliative Taste Dysfunction on People Receiving Ms Jenni Bourke • 12th World Congress of Music Therapy, Research into exercise across the entire • A conference poster presentation by Care, Supportive Care in Cancer, Journal Chemotherapy and Anna Boltong and • WCMICS Supportive Care Conference Buenos Aires, Argentina, July 2008. cancer journey Anya Traill and Andrew Murnane: Would of Palliative and Supportive Care, Music Belinda Hodgson both completed Clinical 2008, Melbourne. Oral paper. Presenter. The department continued involvement a structured inpatient program improve and Medicine, Arts in Psychotherapy, and Research Fellowships. • Australian Lung Cancer Conference in the Breast Cancer Survivors’ Healthy functional outcomes and quality of life in Australian Journal Ms Philippa Barry 2008, Gold Coast. Poster. Highlights Living Study and the Functional Decline oncology patients? of Music Therapy. • 12th World Congress of Music Therapy, • Dietitian led clinic project in head and • OT Australia 23rd National Conference in Advanced Non Small Cell Lung Cancer Buenos Aires, Argentina, July 2008. Awarded excellence neck services funded by the Victorian 2008, Melbourne. Three poster Patients Project to further our knowledge of Presenter. Cancer Agency completed patient presentations. Dr O’Callaghan received the Ruth the role of exercise in the management of recruitment. Bright Award for Excellence: Australian cancer patients. Music Therapy Association conference • In house haematology study nearing Improved service delivery for presentation (Brisbane). completion. radiotherapy outpatients • Inaugural Dietitians Association of A Clinical Research Fellowship by Andrew Australia [PEC] seminar day for dietitians Murnane researching the potential for working in oncology hosted at Peter Mac. an outpatient exercise program for • Malnutrition strategy developed for radiotherapy patients is influencing our inpatients, and nutrition screening service delivery to patients. strategy commenced. • We continued the ‘Guest chef’ day this year with top chef Teague Ezard cooking for patients and families to encourage their continued interest in food which is often affected by cancer treatments.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 55 Care/ Treatment

Social Work Speech Pathology Head of Department Major projects • Kerryn Fulton was invited to participate Head of Department Ms Alison Hocking • A research collaboration with the and present at a social work research Ms Louise Dobbie forum, moderated by Professor Grace The Social Work Department provides University of Melbourne, bringing In a year marked by growth, the Speech Christ, visiting from Columbia University, social work, music therapy and language Associate Professor Lynette Joubert Pathology Department continued to deliver New York. services for our patients. In 2008-09 we to the department as Senior Research expert care to inpatients and outpatients, delivered social work services to over 4000 Fellow one day a week for two years to • Social workers have co-facilitated who presented with speech, language, patients at our East Melbourne, Box Hill build staff research capabilities. nine Communication Skills Training voice and/or swallowing problems due to and Moorabbin sites. Our social workers • Elena Pegoraro participated in the workshops for staff from across cancer or treatment. In part, this increase in are members of multidisciplinary teams Clinical Research Fellowship Program in Peter Mac. demand has been driven by the inclusion across all tumour streams and provide 2009. Her research, Parents with Cancer: Invited presentations of laryngectomy surgery (removal of the psychosocial assessment and care Communicating with Children, is now voice box due to cancer) at Peter Mac. • Denise Beovich with Mary Duffy, Jane planning for our patients and their families. being used to develop further research Speech pathology is a critical part of post- Hoy and Amber Carle, 2nd Biennial between Peter Mac and The Women’s laryngectomy care and recovery. Our social workers have a strong Australian Lung Cancer Conference, Hospital. commitment to student education. We Surfers Paradise, August 2008 and The service continues to provide student have provided clinical placements to eight • Social Work and Music Therapy have Supportive Care Conference, October supervision for four final year Speech social work students from four different continued their close working relationship 2008. Poster presentation. Pathology students each year, in addition with onTrac@PeterMac, with joint universities over the past year, as well as • Alison Hocking with Leanne Webb and to providing lectures to undergraduate participation in two pieces of work. participating in providing lectures Associate Professor Kailash Narayan, students at La Trobe University in both the Redkite Music Therapist Pip Barry, and to masters students at the University International Gynecologic Cancer Society area of laryngectomy and head and neck Redkite Social Worker Kerryn Fulton, of Melbourne. Conference, Bangkok, October 2008. cancers. collaborated to develop and facilitate a Poster presentation. song-writing creation group for onTrac Attendance at the annual Australia and patients. Kerrie Dunn, Language Services • Alison Hocking, Oncology Social Work New Zealand Head and Neck Cancer Coordinator and amateur photographer, Australia Conference, Sydney, November Society meeting has assisted the service was the creative force behind the 2008. to remain abreast of developments in this photographic exhibition, A Series of area as has membership in local special Grants and funding interest groups. Photos By and About Me, focussing • The department continues to have a on the experiences of young people Memorandum of Understanding with The Speech Pathology Department was undergoing treatment. Redkite, a charity that supports children, capably run by Ms Louise Malcolm from June 2008 to June 2009 while Louise Highlights adolescents and young people with Dobbie was on leave. • Denise Beovich was selected as one cancer. Redkite provide funding for a part of three scholars to take part in the first time social worker and music therapist. Melbourne-Singapore health social work exchange, where she studied social work and supportive care oncology services in hospitals. • Denise also participated in the script development and filming of the DVD, Conducting a Family Meeting, which will be used as a resource for health professionals working in cancer and palliative care. This DVD was part of a larger research initiative involving Peter Mac, St Vincent’s Hospital, the Centre for Palliative Care and The University of Melbourne.

Peter MacCallum Cancer Centre Annual Report 2009 Care/ Treatment 57 Report from the Director of Research/

There are now numerous examples of the Advances in bioscience technology allow us Our commitment to promoting scientific Research at Peter Mac success of rationally targeted therapies to address questions that were previously achievements and facilitating collaborative that are based on an understanding of the out of reach. At our site we place a heavy interactions was evident with the fundamental changes that drive the growth emphasis on the application of novel organisation of the first Peter MacCallum As Australia’s largest site for cancer of cancer cells. Our research program genomic and genetic, immunological, Cancer Centre Workshop Symposium is underpinned at all levels by a belief molecular pathological, and imaging on Cancer Epigenetics in October 2008. research, Peter Mac is a leader in in the importance of developing a deep technologies. A $2.5 million grant from the We thank the State Government of understanding of the processes that control Australian Cancer Research Fund (ACRF) Victoria for valuable financial support for the rapidly accelerating advances in cancer cells and employing this knowledge was awarded to support the development the Symposium and for a public lecture in the clinic to develop rational, evidence- of the ACRF Functional Genomics Program. given by Professor Jean-Pierre Issa (MD understanding of cancer causation, based protocols that improve cancer This generous ACRF grant, together with Anderson Cancer Centre, Houston) outcomes. This evidence-based approach funding from the Peter Mac Foundation, on ‘New Horizons in Cancer Research diagnosis, treatment and support. is extended to areas of allied health and has enabled the purchase of the key RNAi and Therapy’. supportive care research, where we seek technology and associated robotics to A new home for Peter Mac researchers Fundamental to our success is the to develop the most innovative approaches better understand how specific genes to patient care. control the growth of cancer cells and their Our extraordinary success since moving response to therapies. The RNAi technology to East Melbourne in 1994 has meant that fusion of an integrated research Cancer is a complex problem requiring will be complemented by implementation Peter Mac has outgrown its current home. an extraordinary effort if progress is to of second-generation DNA sequencing After an extensive process of evaluation environment within a dedicated be made. Peter Mac’s ability to make technology, made possible by a major grant and scoping with State and Federal significant contributions depends on from the Peter Mac Foundation. governments and precinct partners, we specialist cancer hospital, with over bringing together talented researchers, were delighted by the announcement of enabling them with advanced technology, Fuelled by a research budget of over $35 funding for a new cancer centre complex to 520 scientists, students, clinician- fuelling their research with funding, million per annum, mostly generated from be built in Parkville that will house the Peter maintaining active communication between peer-reviewed national and international Mac research laboratories and hospital. researchers, research nurses, scientists and clinicians, and ensuring that research grants, Peter Mac was again To be constructed by 2015, and with an our findings are translated to the clinic. one of the most successful sites for overall project cost of over $1 billion, the support staff, and allied health competitive National Health and Medical We are delighted to welcome Associate new complex will include 18,000m2 of Research (NHMRC) funds, receiving Professor Ygal Haupt from Israel and dedicated laboratory and clinical research professionals engaged in research. funding for new project grants, fellowships congratulate him on the award of a VESKI space for Peter Mac. Collocated with and program support amounting to more Fellowship to support his new research cancer researchers from Melbourne Health, than $17 million. Peter Mac receives Image program in Victoria. In 2009, Peter Mac Ludwig Institute for Cancer Research, and outstanding support from the public. Jordane, Postdoctoral Researcher. clinical and laboratory researchers held the University of Melbourne, and within The valuable bequests and donations a total of 17 fellowships and 13 career close proximity to other major research we receive through the Peter MacCallum development awards from a range of institutes, the new facility promises to be Cancer Foundation support the innovative research organisations, including the one of the most significant comprehensive treatment and research programs at Peter NHMRC, Cancer Council Victoria, and cancer centres in the world. Work is Mac, allowing us to pilot new ideas, seed Victoria Cancer Agency. Professor Joseph underway already to shape our research fund key technologies and recruit leading Trapani was recognised by the NHMRC programs to take full advantage of the researchers. This support enables us with a special award for his contribution to possibilities that the new building and the to demonstrate proof-of-principle of our Australian science and Associate Professor collaborative research environment of new research initiatives, in turn leading to Robin Anderson was awarded a prestigious Parkville will offer. competitive grant success, which ensures National Breast Cancer Foundation that research at Peter Mac continues to be Details of our many research achievements Fellowship to continue her research into at the forefront of discovery. are provided in the 2008 Research Report. breast cancer metastasis. www.petermac.org/research. Over the past year Peter Mac researchers have published about 300 papers, with high impact publications including New England Journal of Medicine, Journal of Clinical Oncology, Journal of the National Cancer Professor David Bowtell Institute, and the Nature family of journals. Director of Research

Peter MacCallum Cancer Centre Annual Report 2009 Report from the Director of Research 59 People/ Education and Training

As Australia’s only specialist cancer Training Web based application for training Sharing knowledge: laparoscopic Education in action: hospital and a global leader in ‘SPLASH’ is Peter Mac’s training data surgery Peter Mac Pharmacy Department base and self booking system for courses. In January 2008 a fully integrated digital The Peter Mac Pharmacy Department cancer therapy and research, Peter This year Splash has been enhanced operating theatre was installed at Peter provides and participates in many and to enable staff to access records of what Mac with the most advance laparoscopic varied educational activities through Mac has a commitment to share our training they have completed, see what equipment available. This year, not only the year both for our own staff and for they need to complete and book their own have many Peter Mac patients benefitted the broader pharmacy and health care knowledge and provide educational training. Managers can view the status from the new equipment, patients in other professions. Pharmacists make regular of people in their team. This automated hospitals are now benefitting following appearances in other departments opportunities for clinicians, program enables us to track, monitor and a new training program to teach other around Peter Mac, lecturing the nurses have greater accuracy and efficiency in surgeons new techniques in laparoscopic for their post graduate modules in pain, researchers and students. Learning reporting training data to ensure our people surgery for colorectal cancer patients. chemotherapy and antiemetics; health are receiving appropriate training. medical officer training and orientation; The courses, developed by Peter Mac’s and teaching is a significant part of teaching the cleaners aseptic cleaning colorectal surgeons Craig Lynch and Training needs analysis techniques; and continuing education Sandy Heriot, are held over two days work at Peter Mac and many of our Early 2009 we undertook an electronic lectures for the radiotherapists, and participants are general surgeons training survey of all staff. Results are being psychologists and nuclear medicine from public hospitals across Victoria people hold joint appointments with collated and this information will assist in teams. Medication safety week is another and Tasmania. The first day involves the direction of future and ongoing training. opportunity we take to get involved with participants watching live laparoscopic universities both in Australia and patient education up on the wards. Vocational education and training surgery via the digital operating theatre overseas. Peter Mac offers vocational education and from a lecture theatre. The operation is We also provide placements and training training for our food services and cleaning explained by a surgeon in the lecture for a range of undergraduate and graduate Image staff. This year the Vocational Education theatre and they are able to ask questions students such as clinical placements, Associate Professor Sandy Heriot, and Training (VET) Certificate III in Health of the operating surgeon via a link to summer schools and specialist training Colorectal Surgeon, conducts laparoscopic Support Services has been completed by the theatre. The second day provides courses – including the only nationally surgery training in the Peter Mac Digital two of our cleaning staff, and one food Operating Suite. participants with the opportunity to practice accredited course to train pharmacists services staff member began training as an the techniques they have been taught and technicians in cytotoxic preparation. apprentice chef. The training takes place and handle unfamiliar equipment used in It’s all in a years work in the pharmacy both at TAFE and on site at Peter Mac with laparoscopic surgery. department and a great example of the supervision from experienced staff. It is commitment to education that underpins intended we will take up opportunities for the Peter Mac values. other training in this sector where possible.

Peter MacCallum Cancer Centre Annual Report 2009 People/ Education and Training 61 People/ Education and Training

Learning opportunities are spread across the organisation and range from self directed online training courses to academic doctorates Higher degree awards to and learning new surgical techniques. Support is offered both for Peter Mac staff to continue their professional development and for Peter Mac staff and students students seeking experience and training at Peter Mac. in 2008-09 Tertiary Education and Training Programs Doctor of Medicine Masters Degree Bachelor of Science (Honours) Department Postgraduate/ June Corry Phillipa Barry Chris Chan Undergraduate Graduate Training Hons/Masters PhD/Doctoral Prue Francis Master of Music (Research) Dane Cheasley 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 Michael Michael Senthil Lingaratnam Elaine Chilcott Nutrition 4 10 3 Scott Williams Master of Public Health Kenneth Chin Andrew Wirth Tracy Pearce Aurelie Copin Speech Pathology 5 1 1 Master of Business Administration Social Work 5 9 3 3 Doctor of Philosophy Rebecca Pelzer Brad Bidwell Trevor Saunders Susie Roczo Physiotherapy 10 8 3 Nursing (Research) Jessica Bolden Tanja Schlosser Occupational Therapy 4 4 Joanne Chan Di Saward Hanna Wang Medical 36 70 1 3 Nursing (Research) Ailsa Frew Advanced Medical Science Nursing 110 110 24 29 30 33 1 2 Carole Poon Genevieve Toop Lucia Chochrane-Davis Radiation Therapy 85 76 36 36 17 15 3 4 Master of Business Megan Sanders (Human Resources Management) Michael Chung Pathology 4 1 5 2 3 2 Ella Thompson Kate Fielding Marijana Vanevski Pharmacy 24 26 2 2 2 4 1 1 Meaghan Wall Henry Yao Masters in Biotechnology and Business Infection Control 1 Ben Williams Physical Sciences 3 5 Gillian Mitchell Music Therapy 1 1 3 Research 54 28 12 22 51 73 Familial Cancer Centre 3 1 1 2 BaCT 3 Library 3 2 1 1 Human Resources 21 1 TOTAL 315 175 236 67 88 95 66 85

Peter MacCallum Cancer Centre Annual Report 2009 People/ Education and Training 63 People/ Education and Training

Graduate Nurse Program The Peter Mac program has a dedicated The Peter Mac Graduate Nurse The 52 week program consists of two six Graduate Support Team that functions in month rotations to build confidence and conjunction with Clinical Nurse Educators Program serves to facilitate the competence in generalist and cancer and Practice Development Nurses, specialist skills across a variety of clinical providing intensive bedside teaching growth and development of newly areas including intensive care, peri- and professional and personal support operative, medical, surgical, head/neck, throughout the entire program. registered nurses so that their lung and haematology units. The Graduate Nurse Program at Peter The program comprises a comprehensive Mac is a well tested and proven program, skill set is consolidated to meet orientation and 10 supernumerary days which offers a strong foundation for in the first rotation and five during the future development with opportunities the diversity and complexity of second rotation. During the supernumery to progress into postgraduate studies in time the graduate nurses share their cancer and palliative care, peri-operative contemporary patient needs. patient allocation with a nurse (buddy), and anaesthetics nursing, and/or critical thus assisting the graduate nurse care nursing. Image Sara, Graduate Nurse transition to the new environment. Short Recruitment for the program is a major 2009 intake courses are also a major component of component of the Graduate Support the program to address specialist issues Team’s role. In 2009 the team attended related to each rotation. Other educational the Nursing & Health Expo, organised an activities within the program include Information Evening for third year nurses, clinical learning packages, graduate presented at nine Victorian universities review meetings/leadership sessions and both rural and metropolitan, facilitated a series of competency hurdles. These over 30 tours of the organisation and met activities provide exploration of clinical skill with undergraduate nurses undertaking development and management of clinical placement at Peter Mac. In 1997 Peter based issues. Mac employed five graduate nurses; this number has increased each year to 29 in 2009. Since the inception of the program there has been a 97 per cent completion rate, and 45 per cent of all staff who complete the program, remain Peter Mac staff.

Peter MacCallum Cancer Centre Annual Report 2009 People/ Education and Training 65 People/ Workforce

Staff recognition People 2009 Volunteer Length of Our 2009 Length of Service Awards Service Awards The heart of Peter Mac is the dedication of Peter Mac Award Winners 2008 acknowledge the long term dedication Sophie Katsabanis Louis Irving its people – surgeons, oncologists, nurses, Presented each year at Peter Mac’s AGM of employees to Peter Mac. This year 91 Kate Khamly Patricia Jansen 5 years librarians, engineers, radiation therapists, to individuals and teams for outstanding staff members reach milestones of 10, 20, Kellie Knight Elchanan (Henry) Januszewicz Kim Considin e – Volunteer 25, 30, 35 and 45 years of service – with a pharmacists, physicists, psychologists, achievements in Excellence, Innovation, Bradley Longmuir Lorris Jones Lynn Demaio – Volunteer to name a few. What draws us together is collective total of 1515 years of service. Compassion and Community Contribution, Nicole Magnusson Stephen (Mark) Kleid Nancy Ferguson – Volunteer the challenge, and reward, of reducing the this year’s winners include: A further 25 volunteers and auxiliary Grant McArthur John Larcombe Dawn Harris – Volunteer impact of cancer on the lives of others. members were recognised at Peter Mac’s Excellence Adele McConnell Brown Swee Lim Ailsa Hales – Volunteer Our values of Excellence, Innovation and annual Volunteers Lunch for achieving five, • Individual: Haematology Nurse Christopher McCormack Debra Lewis Maudie Shacklefod – Volunteer Compassion are integral to the way we 10, 15, 20 and 25 years of service as at Coordinator Trish Joyce Belinda McCoy Myrna Maranon Wendy Vinen – Volunteer work together in a changing environment 30 June 2009. to maintain Peter Mac as the employer of • Team: Outpatients management team Deborah McPherson Mimi Ngieng Tracey Weatherby – Volunteer Duane Power – Port Melbourne Auxiliary choice for the world’s best cancer experts Innovation 2009 Length of Service Recipients Michael Michael Barbara Palmer Michael Moloney Maria Pisasale and future workforce. • Individual: Perioperative Nurse Manager 10 years 10 Years Darren Mulvihill Patricia Raicevic The human resources strategy and Naida Hutton Valerie Beachley – Auxiliary David Allen Kelly Anne Phillips Marcella Rodda vision is strongly aligned to that of Peter • Team: Radiotherapy Electronic Treatment Adele Bisiani – Auxiliary Kerry Ardley Janet Pinwill Janey Stone Mac in order to provide staff with the Chart Team Sue Breen – Volunteer opportunity to engage and participate Tenille Baker Gerard Powell Julie Tate Compassion Paul Cody – Volunteer in strategic activities as well as continue Daniela Barbalaco Helen Rainsbury Suzanne Walsham • Individual: Public Relations Manager Alan Gostin – Volunteer the great progress and outcomes in their Deborah Barnard Michelle Rutherford Katharine Wilkinson Anne Rahilly Elsa Muehlebach – Volunteer immediate roles and responsibilities. We Barbara Bergroth Dianne Saward strive to ensure that all staff share both the • Team: Peter Mac Apartments 25 Years Joan Naismith – Volunteer Bronwyn Berry Kathryn Schubach challenges and achievements of Peter Mac Housekeepers Ana Markovic and Paul Archer Rosalie Hammond – Port Melbourne Elaine Broomhall Amie Smith and that their commitment is recognised Draga Stojanovski Michelle Bishop Auxiliary and rewarded. Ian Campbell Odette Spruyt Jennifer Gordon 15 years Community Contribution Michelle Cassumbhoy Jacquelyn Streater We consult with staff to give them Barbara Langan Shirley Williams – Volunteer • Individual: Corporate Governance Unit Brent Chesson Samuel Towns opportunity to participate fully in our Consumer representative Wallace Crellin Catherine McGeehan Donna Christensen Robert Ware 20 years organisation, enjoy clear roles and have Adrian Roy • Team: Volunteer Headwear Service Dennis Cross Margaret Sommers – Volunteer strong accountability. We are a culture 20 Years Jadwiga Sitkowska that embraces change, with a ‘can do’ Carleen Cullinane Lois Ray – Auxiliary Marina Alessio approach to the persistent pursuit of our Mary Domonji 30 Years Pauline Campbell 25 years goals. Finding new and better ways to treat Michael (Miso) Domonji Judy Andrews Rae Churchill Isobel Angel – Auxiliary and prevent cancer is for many of Peter Jo Anne Elliott Melinda Brenker Mac’s people, a lifelong commitment. Donna Dorow Mary O’Conner – Auxiliary Michelle Elovaris Chai (Julia) Looi Chai Georgina Duncan Letty Carter – Volunteer Richard Fisher Kim Chan John Eastwood Jean Hadges – Volunteer Valeriy Gromov Rebecca Cully Joy Harvey Allison Hatton Kelvin Drew Carolyn Hearnden Lal Peiris Nanette Home 35 Years Brenda Basham Trevor Hayes Anne Munday 45 Years Roger Martin

Peter MacCallum Cancer Centre Annual Report 2009 People/ Workforce 67 People/ Workforce

Workforce data WorkCover 2008-09 2007-08 Peter Mac’s recorded injuries resulting in WorkCover claims have continued to decrease due to proactive efforts to claims, and return to work issues, and increasing awareness of occupational health and safety (OH&S) issues. However, the WorkCover EFT Headcount EFT Headcount premium has increased due to increasing remuneration. For the financial year 2008-09, the premium paid was $1,045,545 with Admin/Clerical 355.32 438 339.03 420 a total claims cost paid of $45,809 for a total of 21 standard claims. Ancillary Support 45.80 66 42.25 64 Insurance Remuneration Premium Paid Claims Statistical Total Incurred Days Average Total Hotel and Allied 85.62 108 92.55 119 Year or Wages (inc GST) Costs Case Claim Costs Comp Claim Standard Medical 61.86 75 61.63 66 Paid Estimate Paid Cost Claims Medical Support 699.28 875 620.26 786 2004-05 $87,975,968 $1,787,673 $197,600 $84,198 $281,798 1,033 $18,787 15 Nursing 350.57 568 309.94 546 2005-06 $93,848,010 $1,485,378 $63,652 $49,731 $113,383 160 $9,449 12 RMO’s 74.85 181 75.09 162 Specialist Sessional 32.06 137 33.14 105 2006-07 $98,810,070 $1,182,591 $473,281 $685,254 $1,158,535 1,616 $37,372 31 Total 1,705.37 2,746 1,573.89 2,269 2007-08 $106,030,531 $800,689 $172,251 $347,146 $519,397 829 $20,776 25 2008-09 $117,609,159 $1,045,545 $45,809 $319,270 $365,079 176 $17,385 21 Equal employment opportunity report 2008–09 Total $505,715,157 $6,301,876 $952,593 $1,485,599 $2,438,192 3,814 $23,444 104 Peter Mac is committed to the principles of merit and equity in the workplace, with respect to employment, promotion and opportunity. The following table shows the percentage of total and EFT (equivalent full-time) employees at 30 June 2009. Violence in the workplace A review of Occupational Violence in 2008 led to the installation of duress buttons in high risk areas, and upgrades to CCTV cameras. Female Male Total Change since A Code Grey procedure to manage aggressive behaviour of an individual, was also implemented in June 2009 following an increasing last year number of Code Black calls in the preceding 12 months. Clerical 7.00% 4.00% 11.0% Same Staff flu vaccination Labourers and related 0.00% 0.80% 0.80% Same Peter Mac’s staff influenza vaccination program for the winter 2009 flu season reached 72 per cent of all staff, up from 61 per cent last Management 2.30% 4.00% 6.30% 1.2% year. A goal of 80 per cent was set for next year. Personal services 2.30% 2.90% 5.20% Same Professional 49.00% 27.00% 76.00% 2.0% Emergency planning A major evacuation drill was held in the Smorgon Family Building Research divisions in November 2008 to improve our Emergency Totals for 2008–09 61.30% 38.70% 100.00% Response Plan and raise staff awareness. A total of 30 evacuation drills were conducted during 2008-09. Change 0.70% 0.70%

Occupational health and safety A range of activities were undertaken in our continuous effort to promote a safe and healthy culture. Efforts to encourage a culture of proactive reporting of near miss incidents has been very successful in helping us identify areas to improve. The increase in sprains/strains has led to the reformation of a working party to undertake risk assessments to address this issue. OH&S Incident Types 1 July 2008 – 31 May 2009

Injury 2008-09 2007-08 Fall 12 13 Laceration 7 8 Near miss 30 9 Splash/Spray 11 6 Sprain/Strain, inc back injuries 34 23 Total of all Injuries 139 187

Peter MacCallum Cancer Centre Annual Report 2009 People/ Workforce 69 People/ Workforce

Senior staff list to 30 June 2009

Chief Executive Office Operations Directorate Clinical Services Radiation Oncology Haematology and Medical Oncology Research Chief Executive Officer Director of Operations, Chief Medical Officer Director Director and Head of Medical Oncology Director Mr Craig Bennett Deputy Chief Executive Officer Professor John Zalcberg OAM Professor Gillian Duchesne Professor John Zalcberg OAM Professor David Bowtell and Director of Nursing (on sabbatical from April 2009) (on sabbatical from April 2009) Executive Director Commercial Services General Manager Professor Joseph Trapani (Acting from May Mrs Wendy Wood and Business Development Professor Gillian Duchesne Ms Julie Tate Associate Professor Danny Rischin (Acting 2009) Mr Andrew Kinnersly Director of Cancer Nursing Research (Acting from April 2009) from April 2009) Director of Radiation Therapy Services Deputy Director Professor Sanchia Aranda Corporate Secretary Breast Mr Aldo Rolfo General Manager Mr Ricky Johnstone Mr Les Manson Operations Director – Chair: Associate Professor Michael Ms Angelia Dixon Site Directors Director of Commercialisation and Ambulatory Services Henderson Director of Strategy and Redevelopment Peter Mac at Epworth Eastern Medical Director Pathology Associate Director of Research Mr Stephen Thomas Mr Daniel Pilbrow Gastrointestinal Centre, Box Hill Professor Stephen Fox Mr Jerry de la Harpe Operations Director – Inpatient Services Chair: Dr Michael Michael Dr Andrew Wirth Director Quality and Organisational Operations Director – Chief Operating Officer Ms Tracy Pearce (on maternity leave from Development Gynae-oncology Peter Mac at Monash Medical Centre, Pathology Laboratory Ms Mary Harney December 2008) Mrs Fiona Watson Chair: Associate Professor Moorabbin Dr Dominic Wall Ms Rebecca Paterson (Acting from Kailash Narayan Associate Professor Trevor Leong Peter MacCallum Cancer Director Information Management Director Pharmacy December 2008) Foundation Ltd Ms Katerina Andronis Haematology Peter Mac at Bendigo Radiotherapy Ms Sue Kirsa Operations Director – Support Services Chair: Associate Professor Centre, Bendigo Executive Director Mr Greg Phillips John Seymour Dr Michael Lim Joon Director Biostatistics and Clinical Trials Ms Jennifer Doubell Dr Dina Neiger Director Human Resources Head and Neck Peter Mac at Tattersall’s Cancer Centre, General Manager Mr Rob Davey Chair: Associate Professor June Corry Epworth Hospital (Richmond) Surgical Oncology Ms Jemimah Pentland Director Lung Dr Pat Bowden Professor Robert Thomas OAM Chair: Associate Professor David Ball Director of Radiology General Manager Melanoma and Skin Dr Colin Styles Mr Shane Ryan Chair: Mr David Speakman Director of Nuclear Medicine/PET Director of Anaesthesia Paediatrics Adolescents Professor Rod Hicks Dr David Skewes and Late Effects Director Physical Sciences Chair: Dr Greg Wheeler Mr Jim Cramb Director of Intensive Care Unit Dr David Charlesworth Neuro-oncology Chair: Mr Damien Tange Bone and Soft Tissue Sarcoma Chair: Professor Peter Choong Urology Chair: Dr Farshad Foroudi Familial Cancer Centre Chair: Dr Gillian Mitchell onTrac@PeterMac Director: Associate Professor David Thomas

Peter MacCallum Cancer Centre Annual Report 2009 People/ Workforce 71 People/ Community

Community Advisory Committee A new orientation program for members The Peter Mac Community Advisory Over the past 12 months the CAC has The program was launched so members identified and implemented key areas of were aware of their responsibilities and Committee (CAC) continues to work in line with the Peter Mac Community available resources to ensure they felt Participation Plan. Working to address supported in their role. consumer needs in relation to food provide consumers with a voice and A training partnership with Health Issues services, patient information, and Centre in Melbourne diversity are just a few areas of work provide us with the knowledge and Members have been able to access that the CAC have been involved in and training and networking opportunities with provided Peter Mac with advice on the understanding of what consumers members from other health services. consumer perspective. Other contributions have been made expect of us. The CAC is a sub- The CAC have also been actively involved with CAC members sitting on many key in the planning for the Comprehensive governance committees, including: committee of the Board with 11 lay Cancer Centre to be built in Parkville. • Board Quality Committee members, two Board members, Key outcomes this year included: • Clinical Governance Committee Providing staff with greater a Peter Mac senior executive and understanding of CAC activities • Expedited Review Committee An information brochure was produced • Education Committee a resource officer – and it tackles to help improve staff awareness and • Bendigo Radiotherapy Committee consumer and community matters understanding of the CAC and its activities. • Primary Care and Population Health Advisory Committee including food services, patient • Survivorship Research Committee and Safety information, and diversity. • Support Services Quality and Safety Committee Image • Food Services Quality Committee June, Peter Mac Volunteer for 19 years (and counting). • Pharmacy and Therapeutics Advisory Committee • Supportive Care Steering Committee

Peter MacCallum Cancer Centre Annual Report 2009 People/ Community 73 People/ Community

Support Groups Communication and media

Volunteer Services Public forums and training programs Since its establishment in 1998, the Peter On loan to the collection are Peter Mac online The Sunday Age featured non-smoking The Peter Mac Volunteer Service provides Our manager fulfils public speaking roles Mac Art Collection, now numbering close works from: In May 2009, Peter Mac launched a related lung cancer a wide range of products and services at service clubs and other community to 600 works and continually growing, Michael Cartwright new website (www.petermac.org), with In November 2008, one of our young to help make life better for patients and groups, and develops and delivers training has developed solely through generous Dean Holme & Blacksphere Gallery improved navigation, refreshed design, patients raised awareness and called donations by artists, collectors, galleries, their families. on volunteer management to a range Shoshanna Jordan and new content. We’ve already had for research in an article about his non- of services. corporations and interested individuals increased visits to the site, with visitors smoking related lung cancer. Volunteers are valued members of the Shona Nunan who recognise the positive contribution staying longer. Further improvements are Peter Mac family and our team now Peter Mac Auxiliary Carolyn Scroczynski Legislation changed after one patient art can make in a clinical setting. Most planned for the site. numbers 180 staff. Our team comes With 34 active volunteers and 56 members, of these donations have been made Maria Semple spoke out about sun beds from a wide variety of backgrounds and we raised $136,993 this year through sales through the Federal Government’s Cultural David Slattery Our online presence has also grown with Laws were changed to better protect occupations. Many volunteers bring from our gift shop, staffed by volunteers, Gifts Program, which offers donors a tax social media websites such as Facebook, young people against the dangers of sun Peter Mac Art Collection Committee with them skills and qualifications such and stocked with donated items, such deduction for the market value of their gift. MySpace and YouTube, and we can now bed exposure after cancer patient Clare as hairdressing and massage that are as knitted goods and stationery. Raffles Over the past year, a number of private Rae Rothfield – Patron be located on Google Maps, and Whereis. Oliver featured in the media telling her own needed by patients – others bring a willing added to our efforts, with all funds donated collectors have generously donated to the Ann Bryce We have also watched with interest as story about melanoma. Clare’s oncologist, pair of hands to operate the book trolley, for patient amenities and the purchase of collection for the second and third times, Geraldine Buxton some of our patients recorded their Associate Professor Grant McArthur guide patients to appointments and medical equipment, including: demonstrating continuing support for its Caroline Cornish treatment at Peter Mac via Twitter. received a Medical Media Award for his provide companionship for patients away commitment to honour the dying wish of • TTY Phone for patients with hearing growth. Artists also continue to be very Dianna Edgar In the media from home. All of them provide care, a 26 year-old Clare that her message reach impairment. forthcoming with gifts of their own works. Jo Hansky Several important issues have been willingness to listen and a genuine desire as many people as possible. to help. • Nerve Integrity Monitor. The dedicated voluntary Peter Mac Art Amit Holckner spotlighted by the media this year and • Flexible cytoscope. Collection Committee, which welcomed Anita Hughes paved the way to new and promising 60th anniversary celebrations receive This year, we’ve focused on expanding our widespread attention • Operating drill, saw and headlight. three new members this year, is Susi Inglis treatments, legislative changes, and reach with: recognition of patients and staff. Our birthday celebrations in April 2009 • Monphasic Defibrillator. responsible for raising funds to cover all Mem Kirby OAM costs associated with the arts program and received significant media coverage, Corporate sponsorships that deliver • Treatment couches. Maggie Nanut measurable outcomes organises a number of functions for this including four page feature in the Sunday Dr Paula Pitt OAM We’re working to develop long term The Auxiliary has a formal committee purpose each year. It aims to raise $50,000 Herald Sun. structure and the 2008-09 President is annually. Events this year have included Teresa Poon sustainable partnerships that support Government commitment to a Adele Bisiani. Our thanks to Pat Osborne its signature Art Tour to private collections, Dr Irene Sutton shared values and goals, and provide real comprehensive cancer centre for stepping in as Acting President from artists’ studios and galleries together with Sandra Velik outcomes in corporate social responsibility. Media witnessed history as the state and October 2008. a film night for 800 guests, sponsored by Professor John Zalcberg OAM federal governments jointly announced Engaging students as a part of Village Roadshow Pty Ltd. Lynette Zalcberg workforce planning Peter Mac Art Collection funding to build a new centre in Parkville as The combined efforts of this hard working Svetlana Karovich – Curator We’re working with secondary and tertiary The Peter Mac Art Collection continues the new home of Peter Mac. committee, together with the professional educational facilities to encourage students to play an integral part of everyday life in Valuers the hospital, enlivening our interiors and curator of the collection, Svetlana Karovich, to undertake volunteer service and ensure The following valuers also generously creating a friendlier and more welcoming have ensured that Peter Mac’s unique arts that the rewards of volunteering lead to a donated their services: environment for all. program continues to grow and develop. healthy future volunteer workforce. David Bradshaw Whether attending an appointment, Donors of artwork Alison Kelly (Alison Kelly Gallery) receiving treatment, walking down a David Band Claire Mitchell Fine Art corridor or simply waiting for a lift, patients, Troy Christmass David Thomas Fine Art visitors and staff regularly come face Patrick Corrigan AM to face with paintings, original prints, Jim Cousins AO and Libby Cousins drawings, watercolours, photographs Kathie Sutherland Fine Art Pty Ltd and sculpture by many of our best known contemporary Australian artists. Alison Kelly Emma Kranz Displayed throughout the hospital and Henryk Kranz its satellite centres, the artworks create Evan Lowenstein visual interest, provide diversion, stimulate conversation, and can assist David Thomas in relieving anxiety. Stephen Wickham

Peter MacCallum Cancer Centre Annual Report 2009 People/ Community 75 Corporate Governance

The Board of Directors The Role of the Board The Directors contribute to the corporate By-laws On 1 July 2000 a new Metropolitan Peter Mac is governed by a nine person The powers and duties of the Board governance of Peter Mac. The community The Peter Mac by-laws set out the Board appointed by the Governor-in- are detailed by Common Law and (and on their behalf, the Government) delegation of its powers and functions Health Service to be known as the Council, as recommended by the Minister legislation set out in the Health Services looks to the Directors to establish and that enables the Board to delegate certain for Health. Board members have a mix Act 1988 (No.49/1988). The Board has protect the reputation of Peter Mac. responsibilities. The Board in exercising Peter MacCallum Cancer Institute of qualifications, skills and expertise. The a responsibility to ensure that Peter Mac Directors are selected in part because they this delegation has approved a detailed Board must perform its functions and performs its functions under Section 65 of enjoy public confidence and respect. Their Delegations of Authority policy enabling was established under the provisions exercise its powers subject to any direction the Health Services Act 1988 (No.49/1988), experience and reputation in private and designated executives and staff to perform given by the Minister for Health (‘the including the requirement to develop public life defines the stature and authority their duties through the exercise of set of the Health Services (Governance) Minister’) and subject to the provisions of statements of priorities and strategic plans of the Board and its activities. Collectively authorities. In certain circumstances the the Health Services Act 1988 (No.49/1988) for the corporate governance of Peter Mac their knowledge, networks and influence is Chief Executive Officer may vary such Act 2000. The Board has approved (‘the Act’). and to monitor compliance with those intended to provide the pool of resources delegation downwards when tighter statements and plans. It is responsible for temporary controls are required, however, The Minister, pursuant to the Act, appoints which guarantees that Peter Mac can the appointment of the Chief Executive delegated authorities cannot be varied that the Institute uses as its trading Directors. The number of Directors is set respond to its opportunities, create its Officer and for overseeing Peter Mac’s upwards as this is the sole prerogative of at nine (9) by the Minister. The Directors solutions and ensure its long term viability audit, risk management, financial reporting, the Board as such an action would exceed name: Peter MacCallum Cancer contribute to the governance of Peter Mac and success. The responsibility to act quality, ethics, human resources, research delegations as approved by the Board. collectively as a Board through attendance in ways that enhance the reputation of and education. Centre – Peter Mac for short. Peter at meetings. The Board meets on average Peter Mac commences with an individual Mac, through the Board of Directors, monthly with 11 meetings normally The Board draws on corporate governance Director’s appointment. scheduled each financial year. There is no best practice to contribute to Peter Mac’s Individual Directors contribute to the reports to the Minister for Health, monthly meeting scheduled for January. performance. The Board has established governance of Peter Mac through Members of the Peter Mac Executive the key principles and framework for the participation in or Chairmanship of the the Hon Daniel Andrews MP. Committee who regularly attending Board’s annual self-assessment program. various Committees of the Board and Board meetings are: Craig Bennett (Chief During 2008-09, the Board focussed between Committee meetings they may Executive Officer), Andrew Kinnersly attention on completing self-assessing have contact with management through (Chief Finance Officer), and Wendy Wood questionnaires of the performance of Responsible Bodies Declaration Committee or project involvement. The (Director of Operations/Deputy Chief the Finance Committee and the Audit Chief Executive Officer has regular contact In accordance with the Financial Management Act 1994, I am pleased to present Executive Officer and Director of Nursing). and Risk Management Committee and with the Board Chair and Directors on the Report of Operations for the Peter MacCallum Cancer Institute (trading as the In addition, Les Manson (Corporate participated in a facilitated workshop on major issues. Peter MacCallum Cancer Centre) for the year ended 30 June 2009. Secretary) attends all Board meetings and Clinical Governance. The Chair: Ethics a representative of the Clinical Directors is Committee completed a number of Contact with Directors is restricted to senior in attendance on a rotational basis. performance assessments of members management and Committee secretariat. of the Ethics Committee whose term of General staff contact with Directors is appointment expired. The self assessment via the appropriate Executive Committee Ms Patricia Faulkner AO questionnaires and performance member or Corporate Secretary. Directors Chair: Board of Directors assessments identify areas where the are encouraged to contact the appropriate Board might improve its performance. Executive Committee member or East Melbourne Corporate Secretary in order to obtain Thursday 13 August 2009 any further information they may require on a particular matter. There is an active program for Directors and Committees to view the separate campuses of Peter Mac in order to obtain an insight into the activities and services provided.

Peter MacCallum Cancer Centre Annual Report 2009 Corporate Governance 77 Corporate Governance/ The Board of Directors

Access Services, The Link Centre Ltd, 6/ Canon Alan Nichols AM 8/ Professor Peter Sheldrake Meadow Heights Learning Shop Inc, the MA (Theol), Th.Schol, BA, MA, MSc, PhD, Hon FAIM, FRSA Meadow Heights Foundation, the Foundation Grad.Cert.Health Law for Rural & Regional Renewal, the Australian Peter joined RMIT Business in 1997, where Council for Children and Youth Organisations, Canon Alan Nichols is an Anglican priest who he is Professor of Business Entrepreneurship, Youth Junction Inc, Peter MacCallum Cancer conducts a consultancy on medical ethics, and currently is the Deputy Head of School, Foundation and a Council member of Lakeside strategy planning and international aid. He is Industry Engagement in the Graduate School Secondary College. Ian is a Fellow of the author of numerous books on ethics, church of Business. He began his working career as Australian Institute of Management. planning and international affairs. He has been an academic, teaching in the Universities of a Board Director of Peter Mac since 2000. Cambridge and Edinburgh, and at the Flinders Ian also has a significant involvement in the University of South Australia. He then left the 1/ 2/ 3/ Australian entertainment industry as a musician, Alan has served on a number of government Boards and Advisory Committees including the academic world, and for nineteen years worked musical director, tour manager, producer, in the private, government and not-for profit promoter and importer of international artists. Standing Review and Advisory Committee on Infertility, the Board of the Royal Victorian Eye sectors. He was a chief executive for twelve He was awarded the Order of Australia in 1998. years, and prior to joining RMIT University had Ian is a Peter Mac patient and a cancer survivor. and Ear Hospital, the Community Council Against Violence, and the Health Services Board spent nine years at the Australian Institute of Meetings attended: 11 of 12. of the Community Visiting Program of the Office Management. He has written seven books and of the Public Advocate. He is a member of the numerous articles, and is a regular speaker, 4/ MS Sue Carter Ethics Panel of the Infertility Treatment Authority. conducting workshops and programs on strategic leadership, innovation and related BA (Hons), ACA (UK), M App Sc Alan was the recipient of the award of Member issues. He has a long-term involvement with the (Organisation Dynamics), FAICD of the Order of Australia (AM) in 2006 for arts as a board member and source of advice 4/ 5/ 6/ Sue is a non-executive Director of AMP services to public policy and refugees. on management and leadership issues. Superannuation Ltd, ANZ Staff Superannuation Meetings attended: 9 of 12. (Australia) Pty Ltd, and Treasury Corporation Peter is a Director of the Royal Agricultural Society of Victoria, Red Stitch Theatre Company, of Victoria. Sue is also a member of the Private 7/ MR John Patterson OAM Health Insurance Administration Council and Urban Forum (Singapore), and Chairman of a member of the Compliance Committee of John’s business career spans over five Radio 3MBS. BlackRock Investment Management decades as the owner and Director of a Meetings attended: 12 of 12. (Australia) Ltd. plumbing supply and contractor company in Williamstown. Sue has a consulting practice specialising in 9/ MR Martin Smith corporate governance and board effectiveness John has had considerable experience in the BHA, LLB(Hons), MBA, GDipLPrac, FAIM, and is a tutor with the Australian Institute of health sector having held appointments as a FCHSE, MAICD Board member at the Fairfield Hospital and 7/ 8/ 9/ Company Directors. She is the former Australian (to 1 April 2009) the Prince Henry’s Hospital. His community Securities and Investment Commission (ASIC) Martin is a former Senior Associate with service has been through contributions as an The Directors for the financial year 2008-09 2/ Professor David Copolov a Peter Mac Board nominee to the Board of Regional Commissioner for Victoria. Wisewoulds Lawyers, a major Melbourne law Honorary Magistrate at the Williamstown Court were as follows: Directors, Peter MacCallum Cancer Foundation Meetings attended: 10 of 12. firm. In April 2009, Martin accepted a position Deputy Chair: Board of Directors House and as Chairman of Trustees of the Ltd and Board of Directors, The Bio21 Cluster. of Executive Director – Corporate Support, MB BS, PhD, FRANZCP, FRACP, MPM, DPM Altona Memorial Park. 1/ MS Patricia Faulkner AO 5/ Dr Cathy Hutton Hamad Medical Corporation, Doha, Qatar. Meetings attended: 11 of 12. A psychiatric researcher of international John was awarded a Medal in the General Chair, Board of Directors He was previously the Principal of Dunfermline standing, David has written over 230 peer- MB, BS, DRCOG, FRACGP, MPH Division of the Order of Australia in 2003 for BA, DipEd, MAdmin, FIPAA, FCHSE 3/ MR Ian Allen OAM Consulting Group, a firm specialising in the reviewed articles, primarily on schizophrenia. Cathy is a general practitioner with 25 years his services to the community. provision of management consulting services Patricia is KPMG’s Sector Leader for Healthcare. He was the Director of the Mental Health BEc, MAdmin, FAIM experience, the last 19 in Moonee Ponds. She Meetings attended: 11 of 12. to the health and legal sectors. From August 2000 until March 2007 Patricia Research Institute from 1985 to 2004 and is Ian’s business career spans over 30 years as an is currently an executive member of the AMA was the Secretary of the Department of Human currently the Senior Advisor in the Office of executive in the Victorian electricity industry and Council of General Practice and Vice president of Martin is the former General Manager of the Services. In this position she was the Chief the Vice-Chancellor and President of Monash the Victorian public sector followed by over 17 AMA Victoria. She has also served on the Board Law Institute of Victoria. He held a number of Executive Officer of a large state government University where he is engaged with major years with Pratt Holdings Pty Ltd. With the latter of North West Melbourne Division of General senior managerial positions in the public health department, with a portfolio including health, strategic developments, especially those relating he has been involved with a range of activities Practice and Regina Coeli, a community for sector, the last being General Manager of North public housing, disability services, child to new research collaborations and opportunities. including the arts, philanthropy, corporate homeless women. She is also involved in general West Hospital (now Melbourne Extended Care protection and juvenile justice. He is also Professor of Psychiatry and Professor citizenship, investment projects, major corporate practice based research at the Department of and Rehabilitation Service). He has served on a of Physiology at Monash University and Professor General Practice, University of Melbourne. number of Boards, including Victorian Hospitals Her main interests lie in structure of entertainment, Pratt Family entertainment, of Psychiatry at the University of Melbourne. He is Industrial Association, Carlton Community Health Government, policy development and analysis, recycling, cost reduction programs, property She has experience in providing general practice a Director on the Board of the Australian Nuclear Service and Youth Hostels Association Victoria. regulation and public sector governance. management, aviation and Government relations. services to a wide range of patients in suburban Science and Technology Organisation. He is a areas of Melbourne as well as providing Meetings attended: 6 of 9. Patricia currently Chairs the Prime Minister’s He is a trustee of The Pratt Foundation, the Pratt Fellow of both Queen’s College and St Hilda’s Indigenous health services in outback Australia. Social Inclusion Board and is a member of the College at the University of Melbourne. Family Foundation, Visy Cares, The Pratt Group COAG Reform Council and the Health and Scholarship Fund, the Carlton Football Club Cathy has a strong interest in ensuring the He is Deputy Chair of the Board of Directors, Hospitals Infrastructure Fund. She is also Foundation, the Carlton Football Community provision of high quality and safe medical Chair of the Research Advisory Committee and Chair of Jesuit Social Services. Fund, the Meadow Heights Foundation and a services to the people of Melbourne and Victoria. Board member of Musicares Australia, Youth Meetings attended: 12 of 12. Meetings attended: 10 of 12.

Peter MacCallum Cancer Centre Annual Report 2009 Corporate Governance 79 Corporate Governance/

The Terms of Reference of each of 3. Quality Committee (Head, Surgical Oncology Research), In addition to these Board Directors, Officer), Angelia Dixon (General Board Committees the Board Committee is pivotal to Chair Canon Alan Nichols AM. Helen McCallum (Senior Pastoral management representatives include – Manager of Haematology and The Board has established those the functioning of the Committee Member Dr Cathy Hutton and Carer), Dr Scott Williams (Radiation Craig Bennett (Chief Executive Officer), Medical Oncology), Stephen Thomas Committees required under the Act and and are updated on an annual basis. Professor Peter Sheldrake Oncologist), Associate Professor David Professor David Bowtell (Director of (Operations Director, Ambulatory Each Committee is required to report Ritchie (Haematologist), Dr Tessa Research – to 17 May 2009), Professor Care Services), Fiona Watson may from time to time establish such other The Quality Committees’ primary Committees as it considers necessary to to the Board through their minutes. Jones (Head, Clinical Psychology), Joe Trapani (Acting Director of Research (Director of Quality and Organisational Recommendations of the Committees are purposes are: to assist the Board to Stephen Thomas (Operations Director, – from 18 May 2009), Jerry de la Development) and Les Manson provide assistance to it in carrying out its ensure that effective and accountable functions. The Board may delegate the brought to the Board as separate agenda Ambulatory Care Services), Craig Harpe (Director of Commercialisation (Corporate Secretary). systems are in place to monitor and exercise of some or all of its powers to items requiring separate Board papers Bennett (Chief Executive Officer) or and Associate Director of Research), Also in attendance are Professor improve the quality and effectiveness those Committees. The Board ultimately and list the recommendations for Shane Ryan (General Manager of Professor John Zalcberg OAM (Chief Dallas English (Director: Centre for of health services provided by Peter remains accountable for the decisions of consideration by the Board. The Board, Surgical Oncology), Jeremy Kenner Medical Officer and Director of Molecular, Environmental, Genetic and the Board Committees and; at its meetings, discusses the Committee Mac; to ensure that any systemic (Ethics Coordinator) and Jyoti Sarna Haematology and Medical Oncology Analytic Epidemiology, The University minutes that are introduced by the relevant problems identified with the quality and (Minutes Secretary). Catharine McKean – sabbatical leave from 10 April 2009), of Melbourne), Jenny Byrne (Manager: • Each formally constituted Committee Committee Chair. effectiveness of health services are attends the meeting as a representative Associate Professor Danny Rischin Western & Central Melbourne Integrated will have a written charter, approved by addressed in a timely manner; to ensure of the Community Advisory Committee (Acting Director of Haematology and Cancer Service), Craig Sinclair (Director, the Board. 1. Finance Committee that Peter Mac strives to continuously and as layperson. Also in attendance Medical Oncology – from 11 April Cancer Prevention Centre, the Cancer Chair Ms Sue Carter. • Membership of Board Committees will improve quality and foster innovation are community members Dr Kate Jones 2009) and Les Manson (Corporate Council Victoria), Clare Amies (Chief Members Mr Ian Allen OAM and be based on the needs of Peter Mac and so that a comprehensive quality plan (appointed as layperson), Mary Rydberg Secretary). Also in attendance are Peter Executive Officer, Western Region the skill and experience of the individual Mr John Patterson OAM or strategy for Peter Mac and its (appointed as layperson), Anne Holmes Acton, Professor Ashley Dunn (Science Health Centre), Ross Joyce (Chief Directors and/or officers of Peter Mac. The primary function of the Finance component parts is implemented and (appointed as layperson), Tyson Consultant, AR Dunn & Associates), Executive Officer, Pivot West), Dr Jim The Board has sole responsibility for the Committee is to assist the Board in regularly reviewed; to receive reports Wodak (appointed as Lawyer) and Dr Professor John Mattick AO (Federation Kollious (Deputy Chair, Pivot West) and appointment of Directors and officers to fulfilling its oversight responsibilities that contain aggregate data from Grant Moss (appointed as layperson). Fellow, Institute for Molecular Bioscience Heather Watson as a representative of Committees. The Board expects that, of Peter Mac’s assets and resources senior executive and senior managers Meetings are held on a monthly basis. – Queensland) and Wayne McMaster the Community Advisory Committee. over time, Directors will rotate on and off (Partner, Mallesons Stephen Jacques – by the development of financial plans, within Peter Mac, quality committees 5. Community Advisory Committee The Committee’s primary function is various Committees taking into account Lawyers). strategies and budgets to ensure and such other persons or bodies Joint Chair Dr Cathy Hutton and to advise the Board of Directors of the needs of the Committees and the accountable and efficient provision of as the Board thinks fit; and to make Ms Heather Watson. The Research Advisory Committee’s strategies to ensure that Peter Mac’s experience of individual Directors. The health services by Peter Mac and its recommendations to the Board in primary function is to advise the Board cancer services are meeting the health Board Chair is an ex-officio member of Member Mr John Patterson OAM long-term financial viability. Meetings by providing both an effective oversight needs of its target population; that Peter each such Committee. relation to actions that should be taken The Community Advisory Committee are held bi-monthly. to improve quality systems and achieve mechanism of Peter Mac’s multifaceted Mac’s cancer services are planned is vital to the functioning of the research activities as well as a filter • The role, function, performance and best practice for patient care and within an evidence-based framework membership of each Committee are 2. Audit and Risk Management Board and acts as a conduit to key for the evaluation of commercial services being provided by Peter Mac. and delivered in consultation and reviewed on an annual basis as part of Committee community groups where more detailed opportunities that might emerge from Meetings are held on a bi-monthly basis. consideration of particular services and partnership with other appropriate the Board’s self-assessment process. Chair Mr Martin Smith (to 1 April 2009). research at Peter Mac. providers; that Peter Mac broadly 4. Ethics Committee programs is required. The appointment • The Board has established a number of Chair Ms Sue Carter (from 2 April 2009). of community members is on the basis The Board recognises that research influences cancer care, planning and Chair Professor Peter Sheldrake. Committees needed to assist in carrying Members Mr Ian Allen AOM and of their capacity to represent a broad is not just confined to the Research service development in the community Members Canon Alan Nichols AM out governance work (and those required Mr John Patterson OAM range of community views and interests. Division of Peter Mac but is a cross- through multidisciplinary partnerships, by government). The Audit and Risk Management The Ethics Committee’s primary function Meetings are held on a monthly basis. divisional effort spanning a variety research and education; that Peter Mac is to assist the Board by considering of clinical disciplines. The Board is plays a key role in contributing to the • During the year the following Committees Committee’s primary function is to Members of the Committee, ethical implications of all proposed aware of the growing need to advance planning and development of cancer continued to operate: assist the Board to understand Peter representing the community in which research projects and to determine the commercialisation of its research services in association with the Western – Finance Committee Mac’s risks, identification of issues and Peter Mac operates are Bryan Baker, whether or not they are acceptable through properly structured and effective and Central Melbourne Integrated to ensure that an Audit Plan and Risk Rosemary Bambery, Shirley Carvosso, – Audit and Risk Management on ethical grounds, and to provide for technology transfer processes and Cancer Service; and that Peter Mac Management Plan are in place. The Harry Howieson, Paul MacKinnon- Committee surveillance of research projects until proposes that the Research Advisory retains a critical mass of cancer services Audit and Risk Management Committee Clark, Helen Molloy, Pat Moran, Beryl – Quality Committee completion so that the Committee Committee will have a major role to play to fulfill its leadership role by being Shaw, June Smith, Margaret Sowak will evaluate the processes in place for may be satisfied that they continue in this regard. Meetings are held on a recognised by the community and – Ethics Committee and Heather Watson During the year assessing and continuously improving to conform with approved medical bi-monthly basis. its professional peers, nationally and – Community Advisory Committee internal controls, particularly those we farewelled, Catherine McKean and standards. The Ethics Committee is 7. Primary Care and Population internationally, as a premier resource – Research Advisory Committee related to areas of high and significant Cathy Winterburn. constituted under the National Health Health Advisory Committee for cancer patients in the provision of risk exposures. Meetings are held on a and Medical Research Council’s 6. Research Advisory Committee integrated treatment, research and – Primary Care and Population Health Chair Canon Alan Nichols AM. quarterly basis. guidelines for Institutional Ethics education. Meetings are scheduled to Advisory Committee. Chair Professor David Copolov. Members Dr Cathy Hutton Committees. Members Ms Sue Carter and be held three times a year. In addition to these Board Directors, In addition to Board representation, Professor Peter Sheldrake representatives from management other staff in attendance were – attend – Craig Bennett (Chief Executive Associate Professor Wayne Phillips

Peter MacCallum Cancer Centre Annual Report 2009 Corporate Governance 81 Corporate Governance/ Corporate Governance/ Statutory Statements Declarations

Disclosure Index The Annual Report of Peter Mac is prepared in accordance with all relevant Victorian legislation. This index has been prepared to Attestation on Data Accuracy facilitate identification of the organisation’s compliance with statutory disclosure and other requirements. I, Craig Bennett: Chief Executive Officer certify that the Peter MacCallum Cancer Centre has put in place appropriate internal Legislation Requirement Page Reference controls and processes to ensure that the Department of Human Services is provided with data that reflects actual performance. Peter MacCallum Cancer Centre has critically reviewed these controls and process during the year. Ministerial Directions Report of Operations Charter and Purpose FRD 22B Manner of establishment and the relevant Ministers 76 Mr Craig Bennett FRD 22B Objectives, functions, powers and duties 76 Chief Executive Officer and Accountable Officer FRD 22B Nature and range of services provided 14 East Melbourne Management and Structure Thursday 10 September 2009 FRD 22B Organisational structure 90

Financial and Other Information FRD 10 Disclosure Index 82 FRD 11 Disclosure of ex-gratia payments N/A FRD 21A Responsible person and executive officer disclosures 76 FRD 22B Application and operation of Freedom of Information Act 1982 87 FRD 22B Application and operation of the Whistleblowers Protection Act 2001 87 FRD 22B Compliance with building and maintenance provisions of Building Act 1993 87 FRD 22B Details of consultancies over $100,000 87 FRD 22B Details of consultancies under $100,000 87 FRD 22B Major changes or factors affecting performance N/A FRD 22B Occupational health and safety 68 FRD 22B Operational and budgetary objectives and performance against objectives 8 FRD 22B Significant changes in financial position during the year N/A FRD 22B Statement of availability of other information 87 FRD 22B Statement of merit and equity 68 FRD 22B Statement on National Competition Policy 87 FRD 22B Subsequent events N/A FRD 22B Summary of the financial results for the year 9 FRD 22B Workforce Data Disclosures 68 FRD 25 Victorian Industry Participation Policy disclosure N/A SD 4.2(j) Report of Operations, Responsible Body Declaration 141 SD 4.4.5 Attestation on Compliance with Australian/New Zealand Risk Management Standard 141

Financial Statements Financial Statements required under Part 7 of the FMA SD 4.2(a) Compliance with Australian accounting standards and other authoritative pronouncements 96 SD 4.2(b) Operating Statement 92 SD 4.2(b) Balance Sheet 93 SD 4.2(b) Statement of Changes in Equity 94 SD 4.2(b) Cash Flow Statement 95 SD 4.2(c) Accountable officer’s declaration 141 SD 4.2(c) Compliance with Ministerial Directions 96 SD 4.2(d) Rounding of amounts 96

Legislation Freedom of Information Act 1982 87 Whistleblowers Protection Act 2001 87 Victorian Industry Participation Policy Act 2003 87 Building Act 1993 87 Financial Management Act 1994 91

Peter MacCallum Cancer Centre Annual Report 2009 Corporate Governance 83 Corporate Governance/ Corporate Governance/ Performance Summary Statement of Priorities 2008-09

The following tables are from the Annual Financial Reports. Part A: Strategic Priorities for 2008-09 Activity Strategic Priority Deliverables Due Date Achievement Admitted Patients Acute Sub-Acute Mental Health Other Total 1 Continue as key project Work with DHS to develop Stage 2 October Completed. Separations partner in the development Governance Report for the comprehensive 2008 of the comprehensive cancer cancer centre in Parkville. Same Day 15,518 0 0 0 15,518 centre in Parkville Multi Day 4,265 0 0 0 4,265 Total Separations 19,783 0 0 0 19,783 Work with DHS to develop Final Business February Completed. Emergency 1,857 0 0 0 1,857 Case for the project. 2009 Elective 17,962 0 0 0 17,962 2 Progress Digital Health Define the way forward on Clinical Systems June 2009 Deferred to 2009-10, subject Other inc Maternity 0 0 0 0 0 Record and Patient and Client Management Systems to capital funding being Total Separations 19,783 0 0 0 19,783 in conjunction with HealthSMART. identified. Total WIES 14,222 0 0 0 14,222 Implement Voice recognition. June 2009 Deferred to 2009-10, subject Total Bed Days 43,373 0 0 0 43,373 to capital funding being identified.

Non-Admitted Patients Sub-Acute Mental Health Other Total Develop digital documentation December Completed. Emergency Department Presentations 0 0 0 0 0 templates. 2008 Outpatient Services – occasions of services (VACS and 202,515 0 0 0 202,515 Develop patient accessible portal. March 2009 Deferred to 2009-10, subject Non VACS clinics) to capital funding being Other Services – occasions of services 0 0 0 0 0 identified. Total occasions of service 202,515 0 0 0 202,515 Commence scanned medical March 2009 Commenced and ongoing. Victorian Ambulatory Classification System record archiving. – Number of encounters 47,753 0 0 0 47,753 – Weighted encounters 55,669 0 0 0 55,669 3 Participate in the Participate in projects; to support the rapid June 2009 Completed. Radiotherapy Activity Units 212,810 0 0 0 212,810 implementation of Victoria’s translation of research, facilitate consumer- Cancer Action Plan driven research, improve cancer screening, Revenue Indicators improve supportive care and survivorship Average Collection Days support. 2009 2008 4 Improve efficiency, Improve hospital infrastructure to improve June 2009 Completed. Private 59 52 effectiveness, safety and infection control, reduce consumption of TAC 0 0 environmental sustainability water and fuel and improve the management VWA 0 0 of general and infectious waste. Other Compensable 0 0 5 Implement Outpatient Improve outpatient referral management. June 2009 An Outpatient Innovation and Psychiatric 0 0 Improvement and Innovation Improve outpatient amenities. June 2009 Improvement Committee Residential Aged Care 0 0 Strategy established with agreed goals and outcomes. Debtors Outstanding as at 30 June 2009 6 Better Faster Emergency Work with DHS to investigate funding models February Completed. Non-Admitted Patients Under 31-60 61-90 Over 90 Total Total Care for patients requiring ambulatory services. 2009 30 days days days days 30/6/09 30/6/08 Private $473,512 $307,778 $52,864 $80,210 $914,364 $741,231 7 Redesigning Hospital Participate in the Redesigning Hospital June 2009 Completed. Care Program Care Program. TAC 0 0 0 0 0 0 Complete the redesign capability VWA 0 0 0 0 0 0 June 2009 Commenced and ongoing. building process. Other Compensable 0 0 0 0 0 0 Residential Aged Care 0 0 0 0 0 0 Abbreviations: ‘TAC’ means Transport Accident Commission ‘VWA’ means Victorian WorkCover Authority

Peter MacCallum Cancer Centre Annual Report 2009 Corporate Governance 85 Corporate Governance/ Corporate Governance/ Statement of Priorities 2008-09 Statutory Statements

Part B: Performance Priorities Annual Report Freedom of Information Peter Mac will comply with changes Financial Performance The 2009 Peter Mac Annual Report was (FOI Applications) implemented to Victorian legislation and made available to the Minister for Health Freedom of Information is a mechanism assess its compatibility with National 2008-09 Target 2008-09 Actual and Members of Parliament on Thursday by which the public may apply for Competition Policy. administrative, financial, personnel and Operating Result 15 October 2009. The Annual Report Protecting your Privacy was released to the public at Peter Mac’s patient related documents not normally Annual operating result $0.0M $0.353M Peter Mac complies with the provisions of Annual General Meeting on Thursday 19 available to them, in accordance with the the Health Services Act 1988 (No.49/1988), Cash Management/Liquidity November 2009. Freedom of Information Act 1982 – No. the Health Records Act 2001 (No.2/2001) Creditors <60 Days 44 9859/1982. Procedures for requesting and the Information Privacy Act 2000 Debtors <60 Days 59 Building Act 1993 information from records held by Peter Mac (No.98/2000) relating to confidentiality and Net movement in cash balance ($m) ($5.880M) ($6.251M) The Minister for Finance has issued are outlined in the Freedom of Information privacy by ensuring that all employees do instructions in accordance with the brochure, available from Peter Mac or from not disclose any information or records Service Performance Building Act 1993 – No.126/1993, such the Department of Human Services, the concerning Peter Mac, its patients, staff WIES1 Activity Performance that all public entities are required to Department of Justice, Public Records and customers acquired in the course WIES (Total) 14,014 14,222 ensure that all buildings under their control Office or the State Library. of their employment, other than for any WIES (Performance to target – %) 98% to 102% 101.5 % are safe and fit for occupation, comply with statutory requirements, buildings are Requests for access to information in authorised or lawful purpose. Critical Care documentary form in the custody of Peter maintained to a standard in which they Risk Management ICU minimum operating capacity 2 1.97 remain safe and fit for occupancy, and Mac should be made to Stewart Sandon, The Board monitors areas of clinical, to report annually on measures taken to Freedom of Information Officer, Health Quality and Safety business and research risk through the ensure compliance with the Building Act Information Service, Peter MacCallum Accreditation status (%) Full Full Audit and Risk Management Committee, 1993. It is Peter Mac’s practice to obtain Cancer Centre, Locked Bag 1, A’Beckett Cleaning standards (%) 85% 93% Quality Committee and the Clinical Building Permits for new projects and Street, Victoria, 8006. During 2008-09 Peter Submission of data to VICNISS2 (%) 100% 100% Governance Committee. The Board has Certificates of Occupancy or Certificates Mac received 43 FOI requests. Of these Participation in the Hand Hygiene Program Yes Yes retained Wyndarra Consulting as the Risk of Final Inspection for all completed requests 42 were for medical records Management and Business Assurance 1 WIES is a Weighted Inlier Equivalent Separation projects. Registered building practitioners documents with the remaining request (Internal Auditors) contractor to identify and 2 VICNISS is the Victorian Hospital Acquired Infection Surveillance System have been involved with all new building being for a corporate matter. Full access record key risks facing the organisation. works projects and were supervised by was granted to all these requests. Peter On an annual basis, Wyndarra Consulting Part C: Activity and Funding the Manager, Building and Engineering Mac provides a report on these requests facilitate a Board strategic risk identification Activity and Funding Type Services. In order to maintain buildings to the Victorian Department of Justice. session and an annual review and in a safe and serviceable condition, 2008-09 Activity Achievement Literature and Publications discussion on the organisation risk profile. routine inspections were undertaken. Literature and publications produced by These initiatives culminate in the delivery to Weighted Inlier Equivalent Separations (WIES) Where required, Peter Mac proceeded Peter Mac and available to the public the Board of an Integrated Enterprise Risk WIES Public Yes to implement the highest priority include brochures for patients’ rights, Management profile report for Peter Mac. recommendations arising out of these WIES Private No patient admission information, information inspections through planned rectification Total WIES (Public, Private and Renal) Yes relating to specific departments and Whistleblowers’ Protection Act 2001 – and maintenance works. No.36/2001 Acute Non-Inpatient services, the Peter Mac Annual Report, Comparative Information Research Annual Report and the Quality The Board has adopted a policy in VACS – Allied Health Yes compliance with the Whistleblowers’ On 1 July 2000, Peter Mac became a of Care Report. VACS – Variable Yes Protection Act 2001 – No.36/2001. No Metropolitan Health Service as a separate VACS – Other Yes Policy Statement on Competitive disclosures were received during the legal entity following the disaggregation VACS Allied Health – DVA Yes Neutrality financial year ending 30 June 2009. VACS Variable – DVA No of the Inner and Eastern Health Care Peter Mac supports the Victorian Radiotherapy – WAUs Public Yes Network. Government’s Competitive Neutrality Policy Radiotherapy – WAUs DVA No Consultancies as outlined in the Guide to Implementing Aged Care During the year there were four Competitive Neutral Pricing Principles. Other Aged Care Yes consultancies costing in total $145,947 that We see competitive neutrality as a assisted Peter Mac. All these consultancies complementary mechanism to the ongoing Community Health/Primary Care related to service development and quest to increase operating efficiencies Specified Grants Yes organisational redesign initiatives. There by way of benchmarking and embracing were no consultancies during the year that better work practices. cost in excess of $100,000.

Peter MacCallum Cancer Centre Annual Report 2009 Corporate Governance 87 Corporate Governance/ Executive Committee and their Responsibilities

Chief Executive Officer Director of Operations/Deputy Chief Executive Director Commercial Director of Research Chief Medical Officer and Director of Acting Director of Haematology and Mr Craig Bennett MSc (Health Econ), Executive Officer and Director of Services and Business Development Professor David Bowtell Haematology and Medical Oncology Medical Oncology BEcon (Hons), FCHSE Nursing Mr Andrew Kinnersly B.Bus, CPA BVSc (Hons), BAnSci, PhD Professor John Zalcberg OAM Associate Professor Danny Rischin Mrs Wendy Wood RN, BN, MHA, MRCNA, Responsible to the Board of Directors for Responsible to the Chief Executive (to formally retire as Director MBBS, PhD, FRACP, MRACMA, FAICD MBBS (Hons), MD, FRACP AFACHSE the efficient overall management of Peter Officer for the overall entity’s financial of Research on 31 December 2009) (Sabbatical Leave from 10 April 2009) (Acting from 13 April 2009) Mac and the achievement of its strategic Responsible to the Chief Executive Officer management and compliance, payroll Professor Joseph Trapani (pictured) Responsible to the Chief Executive Officer Responsible to the Chief Executive Officer objectives, as determined by the Board of for the efficient management of inpatient services, salary packaging services, MBBS, FRACP, PhD for Medical Services, monitoring of clinical for the overall effective and efficient Directors. Acts as principal advisor to the services, ambulatory services, support procurement and contract management (Acting Director of Research from quality and improvement programs and financial performance of the Division of Board of Directors and provides leadership services, human resources and cancer services, as well as the ongoing 18 May 2009) for the overall clinical and clinical research Haematology and Medical Oncology nursing research and education. Also of and guidance to the Executive development of existing and potential Responsible to the Chief Executive Officer programs as well as the effective and by taking a lead role in advising of the responsible for nursing recruitment and Committee of Peter Mac. business unit opportunities. for advising on the scientific and research efficient financial performance of the strategic directions, human resources and retention strategies and for standards of strategy, recruitment priorities and resource Division of Haematology and Medical operational key performance indicators nursing practice across Peter Mac. allocation policies of the Research Division, Oncology. This includes taking a lead within the Division. whilst also ensuring compliance with relevant role in managing the strategic direction, financial, regulatory and probity standards. human resources and operational key performance indicators within the Division.

General Manager Haematology and Director of Radiation Oncology and General Manager of Radiation Oncology Director of Surgical Oncology General Manager of Surgical Oncology Medical Oncology Acting Chief Medical Officer Ms Julie Tate DipDiagRad, GradDipEd, Professor Robert (Bob) Thomas OAM Mr Shane Ryan MBA, Grad Dip HR/IR, Ms Angelia Dixon Professor Gill Duchesne BSc (1st class GradDipHSM, MBus, FIR, AFCHSE MBBS, FRACS, FRCS(Eng.), MS Grad Dip Crit Care BAppSc, MBA, WCLP 2007 Hons), MB ChB, MD, FRCR, FRANZCR In conjunction with the Director: Radiation Responsible to the Chief Executive Officer In conjunction with the Director: Surgical In conjunction with the Director: (Acting Chief Medical Officer from Oncology, responsible to the Chief for the overall effective and efficient Oncology, responsible to the Chief Executive Haematology and Medical Oncology, 13 April 2009) Executive Officer for the day-to-day financial performance of the Division of Officer for the day-to-day operation of the responsible to the Chief Executive Officer Responsible to the Chief Executive Officer operation of the Division of Radiation Surgical Oncology by taking a lead role Division of Surgical Oncology by taking a for the day-to-day operation of the Division for Medical Services, clinical quality Oncology, including the four Radiation in advising of the strategic directions, lead role in human resources, operational of Haematology and Medical Oncology monitoring and improvement programs Oncology Satellites Sites, by taking a human resources and operational key key performance indicators and financial by taking a lead role in human resources, and for the overall effective and efficient lead role in human resources, operational performance indicators within the Division. matters within the Division. operational key performance indicators performance of the Division of Radiation key performance indicators and financial and financial matters within the Division. Oncology, including the four Radiation matters within the Division. Oncology Satellite Sites, by taking a lead role in advising of the strategic directions, human resources and operational key performance indicators within the Division.

Peter MacCallum Cancer Centre Annual Report 2009 Corporate Governance 89 Corporate Governance/ Financial Report 2008/09 Organisational Structure

FOR THE YEAR ENDED 30 JUNE 2009 Operating Statement 92 Board of Directors Balance Sheet 93 Statement of Changes in Equity 94

Peter MacCallum Cancer Foundation Cash Flow Statement 95 chief executive officer Board of Directors Notes to and forming part of the Financial Statements 96 Declaration by Chair, Accountable Officer and Accounting Officer 141 Director of Operations/Deputy Corporate Secretary CEO and Director of Nursing Risk Management Standard 141 Auditor-General’s Report 142

Executive Director Commercial Services and Director of Human Resources Business Development

Director of Quality and Organisational Executive Director Foundation Development

Chief Medical Director Director of Director of Surgical Officer/Director of of Radiation research Oncology Haematology and Medical Oncology Oncology

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 91 OPERATING STATEMENT BALANCE SHEET FOR THE YEAR ENDED 30 JUNE 2009 As at 30 June 2009

Parent Entity Parent Entity Consolidated Consolidated Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 Note $000s $000s $000s $000s Note $000s $000s $000s $000s

CONTINUING OPERATIONS Current Assets Revenue from Operating Activities 2 228,415 204,820 229,731 205,389 Cash and Cash Equivalents 6 9,219 15,470 16,429 22,589 Revenue from Non-Operating Activities 2 646 683 1,395 1,657 Receivables 7 17,819 13,710 17,942 13,642 Other Financial Assets 8 3,425 2,246 10,840 10,046 Employee Benefits 3 (154,386) (138,898) (154,734) (139,181) Inventories 9 1,313 976 1,313 976 Non Salary Labour Costs 3 (3,637) (3,152) (3,636) (3,065) Current Tax Assets – – – 4 Supplies and Consumables 3 (36,876) (34,679) (36,871) (34,829) Non-Financial Assets Classified as Held For Sale 10 – – 286 – Other Expenses from Continuing Activities 3 (34,125) (28,081) (34,632) (28,745) Other Assets 11 1,231 1,090 1,235 1,095 NET RESULT BEFORE CAPITAL & SPECIFIC ITEMS 37 693 1,253 1,226 Total Current Assets 33,007 33,492 48,045 48,352 Capital Purpose Income 2 9,661 9,324 8,964 9,121 Non-Current Assets Available-for-Sale Revaluation Reserve Gain/(Loss) Recognised 2, 19a (112) (15) (780) (349) Receivables 7 3,437 2,427 3,437 2,427 Impairment of Financial Assets 3 – – (1,667) – Other Financial Assets 8 2,000 5,500 2,000 5,500 Depreciation and Amortisation 3 (12,240) (11,340) (12,253) (11,354) Property, Plant and Equipment 12 144,196 182,596 144,230 182,632 Revaluation of Non-Financial Assets 3 (31,272) – (31,272) – Intangible Assets 13 657 851 657 851 Assets Provided Free of Charge 2, 2d 164 201 450 201 Deferred Tax Assets 14 – – 13 13 Expenditure Using Capital Purpose Income 3 (161) – (161) – Total Non-Current Assets 150,290 191,374 150,337 191,423 TOTAL ASSETS 183,297 224,866 198,382 239,775 NET RESULT FOR THE YEAR BEFORE INCOME TAX (33,923) (1,137) (35,466) (1,155) Income Tax Expense 3, 5 – – (26) (53) Current Liabilities Payables 15 14,844 11,203 15,160 11,493 NET RESULT FOR THE YEAR AFTER INCOME TAX (33,923) (1,137) (35,492) (1,208) Current Tax Liability – – 17 – Employee Benefits and Related On-Costs Provisions 16 35,986 33,890 36,013 33,675 Net Result is attributable to: Other Liabilities 18 1 1 – – Equity holders of Peter MacCallum Cancer Centre 19c (33,923) (1,137) (35,519) (1,282) Total Current Liabilities 50,831 45,094 51,190 45,168 Minority Interest 20 – – 27 74 (33,923) (1,137) (35,492) (1,208) Non-Current Liabilities Employee Benefits and Related On-Costs Provisions 16 4,703 3,866 4,703 3,866 This Statement should be read in conjunction with the accompanying notes. Deferred Tax Liabilities 17 – – – 26 Total Non-Current Liabilities 4,703 3,866 4,703 3,892 TOTAL LIABILITIES 55,534 48,960 55,893 49,060 NET ASSETS 127,763 175,906 142,489 190,715

EQUITY Property, Plant & Equipment Revaluation Reserve 19a 7,382 21,437 7,382 21,437 Financial Asset Available-For-Sale Revaluation Reserve 19a 6 171 6 (1,315) Restricted Specific Purpose Reserve 19a 23,524 30,731 23,524 30,731 Contributed Capital 19b 118,544 118,544 118,544 118,544 Accumulated Surpluses/(Deficits) 19c (21,693) 5,023 (7,040) 21,272 19d 127,763 175,906 142,416 190,669 Minority Interest 20 – – 73 46 TOTAL EQUITY 127,763 175,906 142,489 190,715

Contingent Liabilities and Contingent Assets 25 – – – – Commitments for Expenditure 24 16,158 20,723 16,158 20,723

This Statement should be read in conjunction with the accompanying notes.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 93 STATEMENT OF CHANGES IN EQUITY CASH FLOW STATEMENT FOR THE YEAR ENDED 30 JUNE 2009 FOR THE YEAR ENDED 30 JUNE 2009

Parent Entity Parent Entity Consolidated Consolidated Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 Note $000s $000s $000s $000s Note $000s $000s $000s $000s

TOTAL EQUITY AT THE BEGINNING CASH FLOWS FROM OPERATING ACTIVITIES OF THE FINANCIAL YEAR 175,906 175,669 190,715 192,354 Operating Grants from Government 125,769 123,364 125,769 123,364 Effects of changes in accounting policy Patient and Resident Fees Received 4,404 4,529 4,404 4,529 – Accumulated Surpluses/(Deficits) – – – – Private Practice Fees Received 6,813 6,155 6,813 6,155 RESTATED TOTAL EQUITY AT THE BEGINNING OF Donations and Bequests Received 10,670 12,920 13,206 12,255 THE FINANCIAL YEAR 175,906 175,669 190,715 192,354 GST Received From/(Paid to) the ATO 3,611 2,063 3,637 2,085 Recoupment from Private Practice for Use of Hospital Facilities 22,604 17,609 22,604 17,147 Gain/(Loss) on Asset Revaluation 19a (14,055) 353 (14,055) 353 Interest Received 874 930 1,258 1,421 Available-For-Sale Investments Reserve: Dividends Received 81 38 81 38 – Gain/(Loss) taken to Equity 19a (277) (32) (1,126) (2,171) Research and Program Grants 49,378 37,049 47,480 37,743 – Transferred to Profit or Loss for the Period 19a 112 15 2,447 349 Other Receipts 5,955 3,312 6,455 4,589 NET INCOME RECOGNISED DIRECTLY IN EQUITY (14,220) 336 (12,734) (1,469) Employee Benefits Paid (152,092) (134,934) (152,200) (135,348) Net Result for the Year (33,923) (1,137) (35,492) (1,208) Non Salary Labour Costs (2,327) (3,310) (2,392) (3,310) Payments for Supplies and Consumables (73,908) (65,412) (74,115) (66,572) TOTAL RECOGNISED INCOME AND EXPENSE FOR THE YEAR (48,143) (801) (48,226) (2,677) Income Tax Paid – – (31) (44) Cash Generated/(Spent) From Operations 1,832 4,313 2,969 4,052 Transactions with the State in its capacity as owner 19b – 1,038 – 1,038 TOTAL EQUITY AT THE END OF THE Capital Grants from Government 8,875 8,295 8,875 8,295 FINANCIAL YEAR 127,763 175,906 142,489 190,715 Other Capital Receipts 263 233 263 233 NET CASH INFLOW FROM OPERATING ACTIVITIES 21 10,970 12,841 12,107 12,580 Total Recognised Income and Expense attributable to: Equity holders of Peter MacCallum Cancer Centre (48,143) (801) (48,253) (2,751) CASH FLOWS FROM INVESTING ACTIVITIES Minority Interest – – 27 74 Purchase of Properties, Plant and Equipment (20,957) (8,598) (21,004) (8,569) Total Recognised Income and Proceeds from Sale of Properties, Plant and Equipment 583 206 584 206 Expense for the Year (48,143) (801) (48,226) (2,677) Purchase of Investments – – (1,000) (1,500) Proceeds from Sale of Investments 3,153 2 3,153 2,166 This Statement should be read in conjunction with the accompanying notes. NET CASH (OUTFLOW) FROM INVESTING ACTIVITIES (17,221) (8,390) (18,267) (7,697)

CASH FLOWS FROM FINANCING ACTIVITIES Contributed Capital from Government – 1,038 – 1,038 NET CASH INFLOW FROM FINANCING ACTIVITIES – 1,038 – 1,038 NET INCREASE/(DECREASE) IN CASH HELD (6,251) 5,489 (6,160) 5,921 CASH AND CASH EQUIVALENTS AT THE BEGINNING OF THE YEAR 15,470 9,981 22,589 16,668 CASH AND CASH EQUIVALENTS AT THE END OF THE YEAR 6 9,219 15,470 16,429 22,589 Non-Cash Financing and Investing Activities 22 1,204 312 1,204 312

This Statement should be read in conjunction with the accompanying notes.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 95 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 1: Statement of Significant Accounting Policies a) Statement of Compliance on consolidation. The consolidated financial statements include the j) Intangible Assets Revaluation decrements are recognised immediately as expenses The financial report is a general purpose financial report which audited financial statements of the controlled entities listed in Note 29. Intangible assets represent identifiable non-monetary assets in the net result, except that, to the extent that a credit balance has been prepared on an accrual basis in accordance with the f) Cash and Cash Equivalents without physical substance such as software. The Centre does not exists in the asset revaluation reserve in respect of the same class Financial Management Act 1994, applicable Australian Accounting Cash and cash equivalents comprise cash on hand and cash at have any intangible assets with indefinite useful lives. of asset, they are debited directly to the asset revaluation reserve. Standards (AAS), which includes the Australian accounting bank, deposits at call and highly liquid investments with an original Intangible assets are initially recognised at cost. Subsequently, Revaluation increases and revaluation decreases relating to standards issued by the Australian Accounting Standards Board maturity of 3 months or less, which are readily convertible to known intangible assets with finite useful lives are carried at cost less individual assets within an asset class are offset against one (AASB), Interpretations and other mandatory professional amounts of cash and are subject to insignificant risk of changes accumulated amortisation and accumulated impairment losses. another within that class but are not offset in respect of assets requirements. in value. Costs incurred subsequent to initial acquisition are capitalised in different classes. Revaluation reserves are not transferred to The entity is a not-for-profit entity and therefore applies the For Cash Flow Statement presentation purposes, cash and cash when it is expected that additional future economic benefits will accumulated funds on derecognition of the relevant asset. additional Aus paragraphs applicable to “not-for-profit” entities flow to the Centre. equivalents includes bank overdrafts, which are included as current In accordance with FRD 103D the Centre’s non-current physical under the AAS’s. borrowings in the Balance Sheet. Amortisation is allocated to intangible assets with finite useful lives assets were subjected to a detailed valuation in the current The financial statements were authorised for issue by the Board of g) Receivables on a systematic (typically straight line) basis over the asset’s useful financial year. Directors on 7 September 2009. life. Amortisation begins when the asset is available for use, that Trade debtors are carried at nominal amounts due and are due for m) Depreciation is, when it is in the location and condition necessary for it to be b) Basis of Preparation settlement within 30 days from the date of recognition. Collectability Assets with a cost in excess of $2,500 (2008: $2,500) are capable of operating in the manner intended by management. The The financial report is prepared on an accrual basis and in of debts is reviewed on an ongoing basis, and debts which are capitalised and depreciation has been provided on depreciable amortisation period and the amortisation method for an intangible accordance with the historical cost convention, except for the known to be uncollectible are written off. A provision for doubtful assets so as to allocate their cost or valuation over their estimated asset with a finite useful life are reviewed at least at the end of revaluation of certain non-current assets and financial instruments, debts is raised where doubt as to collection exists. Bad debts are useful lives using the straight-line method. Estimates of the each annual reporting period. In addition, an assessment is made as noted. Cost is based on the fair values of the consideration written off when identified. remaining useful lives and depreciation method for all assets are at each reporting date to determine whether there are indicators given in exchange for assets. reviewed at least annually. This depreciation charge is not funded Receivables are recognised initially at fair value and subsequently that the intangible asset concerned is impaired. If so, the assets by the Department of Human Services. In the application of AAS, Management is required to make measured at amortised cost, using the effective interest rate concerned are tested as to whether their carrying value exceeds judgments, estimates and assumptions about carrying values method, less any accumulated impairment. their recoverable amount. The following table indicates the expected useful lives of non- of assets and liabilities that are not readily apparent from other current assets on which the depreciation charges are based. h) Inventories Any excess of the carrying amount over the recoverable amount is sources. The estimates and associated assumptions are based on Inventories held for distribution are measured at cost, adjusted for recognised as an impairment loss. 2009 2008 historical experience and various other factors that are believed to any loss of service potential. All other inventories, including land held Buildings Up to 40 years Up to 40 years be reasonable under the circumstances, the results of which form for sale, are measured at the lower of cost and net realisable value. Intangible assets with finite useful lives are amortised over a 3-7 the basis of making the judgments. Actual results may differ from year period (2008: 3-7 years). Strata Titles – Up to 40 years these estimates. Bases used in assessing loss of service potential for inventories Plant and Equipment Up to 20 years Up to 20 years k) Property, Plant and Equipment held for distribution include current replacement cost and technical Medical Equipment Up to 10 years Up to 10 years The estimates and underlying assumptions are reviewed on an or functional obsolescence. Technical obsolescence occurs when Land, Strata Titles and Buildings are recognised initially at Computers and Communications Up to 3 years Up to 3 years ongoing basis. Revisions to accounting estimates are recognised an item still functions for some or all of the tasks it was originally cost and subsequently measured at fair value less accumulated Furniture and Fittings Up to 10 years Up to 10 years in the period in which the estimate is revised if the revision affects acquired to do, but no longer matches existing technologies. depreciation and impairment. The Centre performed a valuation only that period, or in the period of the revision and future periods if Functional obsolescence occurs when an item no longer functions of all it’s land, strata titles and buildings as at 30 June, 2009. The Motor Vehicles Up to 4 years Up to 4 years the revision affects both current and future periods. the way it did when it was first acquired. valuation now separates the land and buildings components of the Leasehold Improvements Up to 8 years Up to 8 years strata titles held, therefore they have now been reclassified to the Accounting policies are selected and applied in a manner Cost for all other inventory is measured on the basis of weighted appropriate classes. n) Net Gain/(Loss) on Non-Financial Assets which ensures that the resulting financial information satisfies average cost. the concepts of relevance and reliability, thereby ensuring that Plant, Equipment and Vehicles are measured at cost and Net gain/(loss) on non-financial assets includes realised and the substance of the underlying transactions or other events is Inventories acquired for no cost or nominal considerations are subsequently measured at fair value less accumulated unrealised gains and losses from revaluations, impairments and reported. measured at current replacement cost at the date of acquisition. depreciation and impairment. disposals of all physical assets and intangible assets. The accounting policies set out below have been applied in i) Other Financial Assets – Investments Cultural Assets that the Centre intends to preserve because of their Disposal of Non-Financial Assets preparing the financial statements for the year ended 30 June Investments are recognised and derecognised on trade date unique historical, cultural or environmental attributes are measured at Any gain or loss on the sale of non-financial assets is recognised 2009 and the comparative information presented in these financial where purchase or sale of an investment is under a contract whose the cost of replacing the asset less, where applicable, accumulated at the date that control of the assets is passed to the buyer and is statements for the year ended 30 June 2008. terms require delivery of the investment within the timeframe depreciation calculated on the basis of such cost to reflect the determined after deducting from the proceeds the carrying value of established by the market concerned, and are initially measured already consumed or expired future economic benefits of the asset. the asset at that time. On 1 July 2000, the Peter MacCallum Cancer Institute (trading as at fair value, net of transaction costs. Other financial assets are Impairment of Non-Financial Assets Peter MacCallum Cancer Centre) became a metropolitan health classified between current and non current assets based on the During the reporting period, the Centre held cultural assets that service as a separate legal Centre by amendment to the Health were all donated artworks. Such assets are deemed worthy of All the Centre’s assets, except for inventories, deferred tax Centre’s Board of Management’s intention at initial recognition with assets and financial instrument assets, are assessed annually for Services Act 1988 following the disaggregation of the Inner and respect to the timing of the disposal of each asset. preservation because of the social rather than financial benefits Eastern Health Care Network. they provide to the community. The nature of these assets means indications of impairment. The Centre classifies its other investments as available for that there are certain limitations and restrictions imposed on their c) Reporting Entity If there is an indication of impairment, the assets concerned are sale. This classification depends on the purpose for which use and/or disposal. tested as to whether their carrying value exceeds their recoverable The financial report includes all the controlled activities of the Centre. the investments were acquired. Management determines the l) Revaluations of Property, Plant and Equipment amount. Where an asset’s carrying value exceeds its recoverable d) Rounding of Amounts classification of its investments at initial recognition. Non-current physical assets measured at fair value are revalued amount, the difference is written-off by a charge to the Operating All amounts shown in the financial report are expressed to the Investments held by the Centre are classified as being available- in accordance with FRD 103D. This revaluation process normally Statement, except to the extent that the write-down can be debited to nearest $1,000. for-sale and are stated at fair value. Gains and losses arising from occurs every five years, based upon the asset’s Government an asset revaluation reserve amount applicable to that class of asset. e) Principles of Consolidation changes in fair value are recognised directly in equity, until the Purpose Classification, but may occur more frequently if fair value It is deemed that, in the event of the loss of an asset, the future The assets, liabilities, revenues and expenses of all controlled investment is disposed of or is determined to be impaired, at which assessments indicate material changes in values. Revaluation economic benefits arising from the use of the asset will be replaced entities of the Centre have been included at the values shown in time, the cumulative gain or loss previously recognised in equity increments or decrements arise from differences between an unless a specific decision to the contrary has been made. The their audited Annual Financial Reports. Subsidiaries are entities is included in the Operating Statement for the period. Fair value is asset’s carrying value and fair value. recoverable amount for most assets is measured at the higher controlled by the Centre, control exists when the Centre has the determined in the manner described in Note 23. Revaluation increments are credited directly to the asset of depreciated replacement cost and fair value less costs to sell. power to govern the financial and operating policies of the subsidiary The Centre assesses at each balance sheet date whether a revaluation reserve, except that, to the extent that an increment Recoverable amount for assets held primarily to generate net cash so as to obtain benefits from its activities. In assessing control, financial asset or a group of financial assets are impaired. Further reverses a revaluation decrement in respect of that class of inflows is measured at the higher of the present value of future cash potential voting rights that presently are exercisable are taken into details are provided in Note 1(o). asset previously recognised as an expense in the net result, the flows expected to be obtained from the asset and fair value less account. Any inter-company transactions have been eliminated increment is recognised immediately as revenue in the net result. costs to sell. Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 97 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 1: Statement of Significant Accounting Policies (Continued) o) Net Gain/(Loss) on Financial Instruments s) Functional and Presentation Currency Defined benefit plans leasehold Improvements Net gain/(loss) on financial instruments includes realised and The presentation currency of the Centre is the Australian dollar, The amount charged to the Operating Statement in respect of The cost of leasehold improvements is capitalised as an asset and unrealised gains and losses from revaluations of financial which has also been identified as the functional currency of defined benefit superannuation plans represents the contributions depreciated over the remaining term of the lease or the estimated instruments that are designated at fair value through profit or loss the Centre. made by the Centre to the superannuation plans in respect useful life of the improvements, whichever is the shorter. of the current services of current Centre staff. Superannuation or held-for-trading, impairment and reversal of impairment for t) Goods and Services Tax (GST) contributions are made to the plans based on the relevant rules of x) Income Recognition financial instruments at amortised cost, and disposals of Income, expenses and assets are recognised net of the amount of financial assets. each plan. Income is recognised in accordance with AASB 118 Revenue associated GST, unless the GST incurred is not recoverable from and is recognised to the extent it is earned. Unearned income at Revaluations of Financial Instruments at Fair Value the taxation authority. In this case it is recognised as part of the Employees of the Centre are entitled to receive superannuation reporting date is reported as income received in advance. The revaluation gain/(loss) on financial instruments at fair value cost of acquisition of the asset or as part of the expense. benefits and the Centre contributes to both the defined benefit and defined contribution plans. The defined benefit plan(s) provide Amounts disclosed as revenue are, where applicable, net of excludes dividends or interest earned on financial assets, which is Receivables and payables are stated inclusive of the amount of benefits based on years of service and final average salary. returns, allowances and duties and taxes. reported as a part of income from transactions. GST receivable or payable. The net amount of GST recoverable Impairment of Financial Assets from, or payable to, the taxation authority is included with other The name and details of the major employee superannuation funds Government Grants Bad and doubtful debts are assessed on a regular basis. Those receivables or payables in the Balance Sheet. and contributions made by the Centre are as follows: Grants are recognised as income when the Centre gains control of the underlying assets in accordance with AASB 1004 Contributions. bad debts considered as written off are classified as an expense. Cash flows are presented on a gross basis. The GST components Contributions Paid or For reciprocal grants, the Centre is deemed to have assumed of cash flows arising from investing or financing activities which Financial Assets have been assessed for impairment in Fund Payable for the year control when performance has occurred under the grant. For non- are recoverable from, or payable to the taxation authority, are accordance with Australian Accounting Standards. Where a 2009 2008 reciprocal grants, the Centre is deemed to have assumed control presented as operating cash flow. financial asset’s fair value at balance date has reduced by 20 per $000s $000s when the grant is received or receivable. Conditional grants may cent or more than its cost price, or where its fair value has been Commitments and contingent liabilities are presented on a be reciprocal or non-reciprocal depending on the terms of less than its cost price for a period of 12 months, the financial Defined benefit plans: gross basis. Health Superannuation Fund 711 741 the grant. instrument is treated as impaired. u) Employee Benefits indirect Contributions In order to determine an appropriate fair value as at 30 June 2009 Defined contribution plans: Wages and Salaries, Annual Leave and Accrued Days Off Health Superannuation Fund 8,896 8,429 • Insurance is recognised as revenue following advice from the for its portfolio of financial assets, the Centre obtained a valuation Liabilities for wages and salaries, including non-monetary benefits, University Superannuation Fund 1,119 972 Department of Human Services; based on the final closing unit price on 30 June 2009. annual leave and accrued days off expected to be settled within HESTA Superannuation Fund 1,708 1,213 • Long Service Leave (LSL) - Revenue is recognised upon Prices obtained from both sources were compared and were 12 months of the reporting date are recognised in the provision Other 301 362 finalisation of movements in Long Service Leave liability in line generally consistent with the full portfolio. The above valuation for employee benefits in respect of employees’ services up to the Total 12,735 11,717 with the arrangements set out in the Metropolitan Health and process was used to quantify the level of impairment on the reporting date, classified as current liabilities and measured at Aged Care Services Division Hospital Circular 34/2008. portfolio of financial assets as at year end. nominal values. Patient Fees p) Payables Those liabilities that the Centre does not expect to settle within The Centre does not recognise any defined benefit liability in These amounts consist predominantly of liabilities for goods and 12 months are recognised in the provision for employee benefits respect of the superannuation plan because the Centre has no Patient fees are recognised as revenue at the time invoices services. as current liabilities, measured at present value of the amounts legal or constructive obligation to pay future benefits relating are raised. expected to be paid when the liabilities are settled using the to its employees; its only obligation is to pay superannuation Private Practice Fees Payables are initially recognised at fair value, then subsequently contributions as they fall due. The Department of Treasury and remuneration rate expected to apply at the time of settlement. Private practice fees are recognised as revenue at the time carried at amortised cost and represent liabilities for goods and Finance administers and discloses the State’s defined benefit invoices are raised. services provided to the Centre prior to the end of the financial year long Service Leave liabilities in its financial report. that are unpaid, and arise when the Centre becomes obliged to Current Liability – unconditional LSL (representing 10 or more Donations and Other Bequests termination Benefits make future payments in respect of the purchase of these goods years of continuous service) is disclosed as a current liability even Donations and bequests are recognised as revenue when the and services. where the Centre does not expect to settle the liability within 12 Liabilities for termination benefits are recognised when a cash is received. If donations are for a special purpose, they may months because it will not have the unconditional right to defer the detailed plan for the termination has been developed and a valid The normal credit terms are usually Nett 30 days. be appropriated to a reserve, such as specific restricted purpose settlement of the entitlement should an employee take leave within expectation has been raised with those employees affected that reserve. q) Provisions 12 months. the terminations will be carried out. The liabilities for termination Provisions are recognised when the Centre has a present benefits are recognised in other creditors unless the amount Dividend Revenue The component of this current LSL liability is measured at: obligation, the future sacrifice of economic benefits is probable, or timing of the payments is uncertain, in which case they are Dividend revenue is recognised on a receivable basis. and the amount of the provision can be measured reliably. • present value: component that the Centre does not expect to recognised as a provision. Interest Revenue settle within 12 months; and The amount recognised as a provision is the best estimate of the On-Costs Interest revenue is recognised on a time proportionate basis that consideration required to settle the present obligation at reporting • nominal value: component that the Centre expects to settle Employee benefits on-costs (payroll tax, workers compensation, takes in account the effective yield of the financial asset. date, taking into account the risks and uncertainties surrounding within 12 months. superannuation, annual leave and LSL accrued while on LSL taken the obligation. Where a provision is measured using the cashflows y) Fund Accounting Non-Current Liability – conditional LSL (representing less than in service) are recognised separately from provision for employee estimated to settle the present obligation, its carrying amount is the The Centre operates on a fund accounting basis and maintains 10 years of continuous service) is disclosed as a non-current benefits. three funds: Operating, Specific Purpose and Capital Funds. present value of those cashflows. liability. There is an unconditional right to defer the settlement of v) Intersegment Transactions The Centre’s Capital and Specific Purpose Funds include r) Resources Provided and Received Free of Charge or for the entitlement until the employee has completed the requisite Transactions between segments within the Centre have been unspent capital donations and receipts from fundraising activities Nominal Consideration years of service. Conditional LSL is required to be measured at eliminated to reflect the extent of the Centre’s operations as a conducted solely in respect of these funds. Resources provided or received free of charge or for nominal present value. group. z) Services Supported By Health Services Agreement and consideration are recognised at their fair value when the transferee Consideration is given to expected future wage and salary levels, w) Leases Services Supported By Hospital And Community Initiatives obtains control over them, irrespective of whether restrictions or experience of employee departures and periods of service. conditions are imposed over the use of the contributions, unless Operating Leases Activities classified as Services Supported by Health Services Expected future payments are discounted using interest rates of Agreement (HSA) are substantially funded by the Department of received from another Centre or agency as a consequence of a Commonwealth Government guaranteed securities in Australia. Operating lease payments, including any contingent rentals, are restructuring of administrative arrangements. In the latter case, recognised as an expense in the Operating Statement on a straight Human Services and are also funded from other sources such such transfer will be recognised at carrying value. Contributions in Superannuation line basis over the lease term, except where another systematic as the Commonwealth and patients, while Services Supported the form of services are only recognised when a fair value can be Defined contribution plans basis is more representative of the time pattern of the benefits by Hospital and Community Initiatives (Non HSA) are funded reliably determined and the services would have been purchased if Contributions to defined contribution superannuation plans are derived from the use of the leased asset. by the Centre’s own activities or local initiatives and/or the expensed when incurred. Commonwealth. not donated.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 99 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 1: Statement of Significant Accounting Policies (Continued) aa) Changes in Accounting Policies Capital and specific items, which are excluded from this sub-total, ak) New Accounting Standards and Interpretations In accordance with Victorian Government Financial Reporting comprise: Certain new accounting standards and interpretations have been published that are not mandatory for 30 June 2009 Direction 103D ‘Non-Current Physical Assets’, the Centre measures • Capital purpose income, which comprises all tied grants, reporting period. As at 30 June 2009, the following standards and interpretations had been issued but were not mandatory plant and equipment, and medical equipment assets at fair value donations and bequests received for the purpose of acquiring for financial year ended 30 June 2009. The Centre has not and does not intend to adopt these standards early. from 1 July 2008. Previously these assets were measured at cost. non-current assets, such as capital works, plant and equipment This change in accounting policy is required to ensure Victoria’s or intangible assets. It also includes donations of plant and Standards/Interpretation Summary Applicable for Impact on Whole of Government financial report, to which the Centre is equipment (refer Note 1(r)). Consequently the recognition of reporting periods Entities Annual beginning on or Statement consolidated into, complies with the requirements of AASB 1049 revenue as capital purpose income is based on the intention of ending on Whole of Government and General Government Sector Financial the provider of the revenue at the time the revenue is provided; Reporting. As this change is the initial application of a policy to revalue assets in accordance with AASB 116 Property, Plant • Impairment of Financial and Non-Financial Assets, includes all AASB 8 Operating Segments. Supersedes AASB 114 Segment Reporting. Beginning Not applicable. and Equipment the change is treated as a revaluation in the impairment losses (and reversal of previous impairment losses), 1 January 2009 current year. related to non-current assets only which have been recognised in accordance with Note 1(n) and (o); AASB 2007-3 Amendments to Australian An accompanying amending standard, Beginning Impact expected ab) Comparative Information Accounting Standards arising from AASB 8 also introduced consequential amendments 1 January 2009 to be insignificant. • Depreciation and amortisation, as described in Note 1(m) and (j); Where necessary the previous year’s figures have been reclassified [AASB 5, AASB 6, AASB 102, AASB 107, into other Standards. to facilitate comparisons. • Assets provided free of charge, as described in Note 1(r); AASB 119, AASB 127, AASB 134, AASB 136, AASB 1023 and AASB 1038] ac) Asset Revaluation Reserve • Expenditure using capital purpose income, comprises expenditure which either falls below the asset capitalisation The asset revaluation reserve is used to record increments and AASB 2007-6 Amendments to Australian An accompanying amending standard, Beginning Not applicable. threshold (Note 1(j) and (k)), or does not meet asset recognition decrements on the revaluation of non-current assets. Accounting Standards arising from AASB 123 also introduced consequential amendments 1 January 2009 criteria and therefore does not result in the recognition of an [AASB 1, AASB 101, AASB 107, AASB 111, AASB into other Standards. ad) Financial Assets Available-For-Sale Revaluation Reserve asset in the Balance Sheet, where funding for that expenditure is 116 & AASB 138 and Interpretations 1 & 12] The available-for-sale revaluation reserve arises on the revaluation from capital purpose income. of available-for-sale financial assets. Where a revalued financial ai) Category Groups AASB 2008-3 Amendments to AAS arising from This Standard gives effect to consequential Beginning Impact expected asset is sold that portion of the reserve which relates to that AASB 3 & AASB 127 [AASB 1, 2, 4, 5, 7, 101, changes arising from revised AASB 3 1 January 2009 to be insignificant. financial asset, and is effectively realised, is recognised in the The Centre has used the following category groups for reporting purposes for the current and previous financial years. 107, 112, 114, 116, 121, 128, 131, 132, 133, 134, and amended AASB 127. The Prefaces Operating Statement. Where a revalued financial asset is impaired 136, 137, 138 & 139 and Interpretations 9 & 107] to those Standards summarise the main that portion of the reserve which relates to that financial asset is Admitted Patient Services (Admitted Patients) comprises all requirements of those Standards. recognised in the Operating Statement. recurrent health revenue/expenditure on admitted patient services, AASB 2008-5 Amendments to AAS arising from A suite of amendments to existing Beginning Impact is being ae) General Reserves where services are delivered in public hospitals, or free standing AASB 3 & AASB 127 [AASB 1, 2, 4, 5, 7, 101, standards following issuance of IASB 1 January 2009 evaluated. Funds where the Centre has possession or control of the funds day hospital facilities and palliative care facilities. 107, 112, 114, 116, 121, 128, 131, 132, 133, 134, Standard Improvements to IFRSs in and has complete discretion in the use of these funds. Outpatient Services (Outpatients) comprises all recurrent health 136, 137, 138 & 139 and Interpretations 9 & 107] May 2008. Some amendments result in revenue/expenditure on public type outpatient service, where af) Specific Restricted Purpose Reserve accounting changes for presentation, services are delivered in public hospital outpatient clinics, or free A specific restricted purpose reserve is established where the recognition and measurement purposes. Centre has possession or title to the funds but has no discretion to standing day hospital facilities and outpatient clinics specialising in amend or vary the restriction and/or condition underlying the funds palliative care. AASB 2008-6 Further Amendments to Australian The amendments require all the assets Beginning Not applicable. received. Aged Care comprises revenue/expenditure from Home and Accounting Standards arising from the Annual and liabilities of a for-sale subsidiary’s to 1 January 2009 Improvements project [AASB 1 & AASB 5] be classified as held for sale and clarify the ag) Contributed Capital Community Care (HACC) programs, allied health, Aged Care Assessment and support services. disclosures required when the subsidiary Consistent with Australian Accounting Interpretation 1038 is part of a disposal group that meets the Contributions by Owners Made to Wholly-Owned Public Sector Off Campus, Ambulatory Service (Ambulatory) comprises definition of a discontinued operation. Entities and FRD 119 Contributions by Owners, appropriations all recurrent health revenue/expenditure on public hospital type for additions to the net asset base have been designated as services including palliative care facilities and rehabilitation AASB 2008-7 Amendments to AAS Cost of an Changes mainly relate to treatment of Beginning Impact expected contributed capital. Other transfers that are in the nature of facilities, as well as services provided under the following Investment in a Subsidiary, Jointly Controlled dividends from subsidiaries or controlled 1 January 2009 to be insignificant. contributions or distributions, have also been designated as agreements: Services that are provided or received by hospitals Entity or Associate [AASB 1, AASB 118, AASB entities. contributed capital. (or area health services) but are delivered/received outside a 121, AASB 127 & AASB 136] ah) Net Result Before Capital & Specific Items hospital campus, services which have moved from a hospital to AASB 2008-8 Amendments to Australian The amendments to AASB 139 clarify how Beginning Not applicable. The sub-total entitled ‘Net Result Before Capital & Specific Items’ is a community setting since June 1998, services which fall within Accounting Standards – Eligible Hedged Items the principles that determine whether a 1 January 2009 included in the Operating Statement to enhance the understanding the agreed scope of inclusions under the new system, which have [AASB 139] hedged risk or portion of cash flows is of the financial performance of the Centre. This subtotal reports been delivered within hospital’s i.e. in rural/remote areas. eligible for designation as a hedged item, the result excluding items such as capital grants, assets received Other Services excluded from Australian Health Care should be applied in particular situations. or provided free of charge, depreciation, and items of unusual Agreement (AHCA) (other) comprises revenue/expenditure from AASB 2008-9 Amendments to AASB 1049 for Amendments to AASB 1049 for consistency Beginning Impact expected to nature and amount such as specific revenues and expenses. The Health and Community Initiatives implemented by the Centre. exclusion of these items are made to enhance matching of income Consistency with AASB 101 with AASB 101 (September 2007) version. 1 January 2009 be insignificant. aj) Non Financial Assets Classified as Held for Sale and expenses so as to facilitate the comparability and consistency Non financial assets (and disposal groups) classified as held for AASB 2009-1 Amendments to Australian Amendments to Australian Accounting Beginning Not applicable. of results between years and Victorian Public Health Services. sale are measured at the lower of cost and fair value less costs to Accounting Standards – Borrowing Costs of Standards to allow borrowing costs of 1 January 2009 The Net Result Before Capital & Specific Items is used by the sell, and are not subject to depreciation. Not-for-Profit Public Sector Entities [AASB 1, Not-for-Profit Public Sector Entities to be management of the Centre, the Department of Human Services AASB 111 & AASB 123] expensed. and the Victorian Government to measure the ongoing result of Non financial assets and disposal groups are classified as held Health Services in operating hospital services. for sale if their carrying amount will be recovered through a sale AASB 2009-2 Amendments to Australian Amendments to AASB 7 to enhance Beginning Impact expected transaction rather than through continuing use. This condition is Accounting Standards – Improving Disclosures disclosures about fair value measurements 1 January 2009 to be insignificant. regarded as met only when the sale is highly probable and the about Financial Instruments [AASB 4, AASB 7, and liquidity risk. Editorial amendments asset’s sale (or disposal group) is expected to be completed within AASB 1023 & AASB 1038] to AASB 4, AASB 1023 and AASB 1038 one year from the date of classification. resulting from the amendments to AASB 7.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 101 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 2: Revenue Parent Consolidated HSA HSA Non HSA Non HSA Total Total HSA HSA Non HSA Non HSA Total Total 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 Note $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s Revenue from Operating Activities Government Grants – Department of Human Services 116,142 108,961 – – 116,142 108,961 116,142 108,961 – – 116,142 108,961 – Commonwealth Government 11,291 11,077 – – 11,291 11,077 11,291 11,077 – – 11,291 11,077 Total Government Grants 127,433 120,038 – – 127,433 120,038 127,433 120,038 – – 127,433 120,038

Indirect Contributions by Department of Human Services – Insurance 1,834 1,845 – – 1,834 1,845 1,834 1,845 – – 1,834 1,845 – Long Service Leave 1,953 1,217 – – 1,953 1,217 1,953 1,217 – – 1,953 1,217 Total Indirect Contributions by Department of Human Services 3,787 3,062 – – 3,787 3,062 3,787 3,062 – – 3,787 3,062 Patient and Residents Fees 2b 4,572 4,656 – – 4,572 4,656 4,572 4,656 – – 4,572 4,656

Business Units & Specific Purpose Funds – Private Practice and Other Patient Activities – – 7,574 6,499 7,574 6,499 – – 7,574 6,499 7,574 6,499 – Cafeteria – – 576 896 576 896 – – 576 895 576 895 – Car Park – – 800 734 800 734 – – 800 734 800 734 – Property Income – – 512 477 512 477 – – 494 459 494 459 – Research – 105 37,303 31,012 37,303 31,117 – 105 37,303 31,344 37,303 31,449 – Salary Packaging – – 668 574 668 574 – – 668 574 668 574 – Other – – 1,956 1,692 1,956 1,692 – – 2,499 1,692 2,499 1,692 Total Business Unit & Specific Purpose Funds – 105 49,389 41,884 49,389 41,989 – 105 49,914 42,197 49,914 42,302

Donations and Bequests 7 – 13,467 12,031 13,474 12,031 7 – 13,981 11,638 13,988 11,638 Recoupment from Private Practice for Use of Hospital Facilities 23,801 17,643 – – 23,801 17,643 23,801 17,643 – – 23,801 17,643 Other Revenue from Operating Activities 724 686 5,235 4,715 5,959 5,401 724 686 5,512 5,364 6,236 6,050 Sub-Total Revenue from Operating Activities 160,324 146,190 68,091 58,630 228,415 204,820 160,324 146,190 69,407 59,199 229,731 205,389

Revenue from Non-Operating Activities Interest & Dividends – – 646 683 646 683 – – 1,271 1,553 1,271 1,553 Other Revenue from Non-Operating Activities – – – – – – – – 124 104 124 104 Sub-Total Revenue from Non-Operating Activities – – 646 683 646 683 – – 1,395 1,657 1,395 1,657

Revenue from Capital Purpose Income State Government Capital Grants – Targeted Capital Works and Equipment 2,196 4,278 – – 2,196 4,278 2,196 4,278 – – 2,196 4,278 – Radiotherapy Capital Replacement Program – – – – – – – – – – – – – Other 1,553 2,411 – – 1,553 2,411 1,553 2,411 – – 1,553 2,411 Commonwealth Government Capital Grants 3,951 2,163 – – 3,951 2,163 3,951 2,163 – – 3,951 2,163 Assets Received Free of Charge 2d – – 164 201 164 201 – – 450 201 450 201 Net Gain/(Loss) on Disposal of Non-Financial Assets 2c (386) (14) (132) (20) (518) (34) (386) (14) (136) (20) (522) (34) Net Gain/(Loss) on Disposal of Financial Assets – – (5) – (5) – – – (698) (203) (698) (203) Capital Interest 233 275 – – 233 275 233 275 – – 233 275 Donations and Bequests – – 263 231 263 231 – – 263 231 263 231 Other Capital Purpose Income 2a – – 1,988 – 1,988 – – – 1,988 – 1,988 – Sub-Total Revenue from Capital Purpose Income 7,547 9,113 2,278 412 9,825 9,525 7,547 9,113 1,867 209 9,414 9,322 Available-for-Sale Revaluation Reserve Gain/(Loss) Recognised 19a – – (112) (15) (112) (15) – – (780) (349) (780) (349) TOTAL REVENUE 2a 167,871 155,303 70,903 59,710 238,774 215,013 167,871 155,303 71,889 60,716 239,760 216,019

Indirect contributions by Department of Human Services: Department of Human Services makes certain payments on behalf of the Peter MacCallum Cancer Centre. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 103 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 2a: Analysis of Revenue by Source (based on the consolidated view of Note 2) Admitted Admitted Patients Patients Outpatients Outpatients Ambulatory Ambulatory Aged Care Aged Care Other Other Total Total Note 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s Revenue from Services Supported by Health Services Agreement Government Grants 71,208 66,525 54,018 51,444 185 176 2,022 1,893 – – 127,433 120,038 Indirect contributions by Department of Human Services 2,552 2,047 1,122 921 – – 113 94 – – 3,787 3,062 Patient and Resident Fees 2b 4,142 4,266 400 360 – – 30 30 – – 4,572 4,656 Donations and Bequests (non capital) 4 – 3 – – – – – – – 7 – Recoupment from Private Practice for Use of Hospital Facilities 3,617 2,779 20,162 14,822 – – 22 42 – – 23,801 17,643 Other Revenue from Operating Activities 321 377 393 305 – – 10 4 – – 724 686 Capital Purpose Income 2 2,123 3,240 5,756 5,869 – – 54 18 – – 7,933 9,127 Research – 98 – 7 – – – – – – – 105 Net Gain/(Loss) on Disposal of Non-Financial Assets 2c (185) (13) (190) (1) – – (11) – – – (386) (14) Sub-Total Revenue from Services Supported by Health Services Agreement 83,782 79,319 81,664 73,727 185 176 2,240 2,081 – – 167,871 155,303

Revenue from Services Supported by Hospital and Community Initiatives Donations and Bequests – – – – – – – – 14,244 11,869 14,244 11,869 Business Units & Specific Purpose Funds – Private Practice and Other Patient Activities – – – – – – – – 7,574 6,499 7,574 6,499 – Cafeteria – – – – – – – – 576 895 576 895 – Car Park – – – – – – – – 800 734 800 734 – Property Income – – – – – – – – 494 459 494 459 – Research – – – – – – – – 37,303 31,344 37,303 31,344 – Salary Packaging – – – – – – – – 668 574 668 574 – Other – – – – – – – – 2,499 2,342 2,499 2,342 Capital Purpose Income 2 – – – – – – – – 1,988 – 1,988 –

Other Activities Assets Received Free of Charge 2d – – – – – – – – 450 201 450 201 Net Gain/(Loss) on Disposal of Non-Financial Assets 2c – – – – – – – – (136) (20) (136) (20) Net Gain/(Loss) on Disposal of Financial Assets – – – – – – – – (1,478) (552) (1,478) (552) Interest and Dividends – – – – – – – – 1,271 1,553 1,271 1,553 Other – – – – – – – – 5,636 4,818 5,636 4,818 Sub-Total Revenue from Services Supported by Hospital and Community Initiatives – – – – – – – – 71,889 60,716 71,889 60,716 TOTAL REVENUE 83,782 79,319 81,664 73,727 185 176 2,240 2,081 71,889 60,716 239,760 216,019

Indirect contributions by Department of Human Services: Department of Human Services makes certain payments on behalf of the Peter MacCallum Cancer Centre. These amounts have been brought to account in determining the operating result for the year by recording them as revenue and expenses.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 105 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 2b: Patient and Resident Fees Note 2d: Assets Received Free of Charge or for Nominal Consideration

Parent Entity Parent Entity Consolidated Consolidated Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s $000s $000s $000s $000s

Patient and Resident Fees Raised During the reporting year, the fair value of assets received free of charge was as follows: Recurrent: Cultural Assets (Artwork) 155 201 155 201 Acute Plant & Equipment 9 – 9 – – Inpatients 4,142 4,266 4,142 4,266 Jewellery – – 286 – – Outpatients 400 360 400 360 Other 30 30 30 30 TOTAL 164 201 450 201 TOTAL 4,572 4,656 4,572 4,656

Note 2c: Net Gain/(Loss) on Disposal of Non-Financial Assets

Parent Entity Parent Entity Consolidated Consolidated 2008- 09 2007-08 2008-09 2007-08 $000s $000s $000s $000s

Proceeds from Disposal of Non-Current Assets – Motor Vehicles 48 176 48 176 – Plant & Equipment – – – – – Medical Equipment 535 29 535 29 – Computers and Communication – 1 – 1 Total Proceeds from Disposal of Non-Current Assets 583 206 583 206

Less: Written Down Value of Non-Current Assets Sold – Motor Vehicles 49 191 49 191 – Plant & Equipment – – – – – Medical Equipment 1,046 43 1,050 43 – Computers and Communication 6 6 6 6 Total Written Down Value of Non-Current Assets Sold 1,101 240 1,105 240 NET GAINS/(LOSSES) ON DISPOSAL OF NON-FINANCIAL ASSETS (518) (34) (522) (34)

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 107 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 3: Expenses Parent Consolidated HSA HSA Non HSA Non HSA Total Total HSA HSA Non HSA Non HSA Total Total 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 Note $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s Employee Benefits Salaries & Wages 98,585 92,809 36,942 29,639 135,527 122,448 98,585 92,809 37,243 29,903 135,828 122,712 WorkCover Premium 553 366 387 314 940 680 553 366 389 314 942 680 Departure Packages 618 782 404 20 1,022 802 618 782 404 20 1,022 802 Long Service Leave 3,370 2,782 825 488 4,195 3,270 3,370 2,782 837 488 4,207 3,270 Superannuation 9,461 8,619 3,241 3,079 12,702 11,698 9,461 8,619 3,274 3,098 12,735 11,717 Total Employee Benefits 112,587 105,358 41,799 33,540 154,386 138,898 112,587 105,358 42,147 33,823 154,734 139,181 Non Salary Labour Costs Fees for Visiting Medical Officers 474 351 115 16 589 367 474 351 115 15 589 366 Agency Costs – Nursing 1,547 1,121 1 3 1,548 1,124 1,547 1,121 1 3 1,548 1,124 Agency Costs – Other 759 875 741 786 1,500 1,661 759 875 740 700 1,499 1,575 Total Non Salary Labour Costs 2,780 2,347 857 805 3,637 3,152 2,780 2,347 856 718 3,636 3,065 Supplies and Consumables Drug Supplies 15,405 15,173 35 166 15,440 15,339 15,405 15,173 35 166 15,440 15,339 S100 Drugs 3,669 3,784 – – 3,669 3,784 3,669 3,784 – – 3,669 3,784 Medical, Surgical Supplies and Prosthesis 8,446 7,055 6,376 5,423 14,822 12,478 8,446 7,055 6,376 5,423 14,822 12,478 Pathology Supplies 1,364 1,145 228 134 1,592 1,279 1,364 1,145 223 283 1,587 1,428 Food Supplies 774 1,028 579 771 1,353 1,799 774 1,028 579 772 1,353 1,800 Total Supplies and Consumables 29,658 28,185 7,218 6,494 36,876 34,679 29,658 28,185 7,213 6,644 36,871 34,829 Other Expenses from Continuing Operations Domestic Services & Supplies 1,608 1,710 542 301 2,150 2,011 1,608 1,710 542 301 2,150 2,011 Fuel, Light, Power and Water 1,351 1,366 214 57 1,565 1,423 1,351 1,366 214 57 1,565 1,423 Insurance costs funded by DHS 1,834 1,845 – – 1,834 1,845 1,834 1,845 – – 1,834 1,845 Motor Vehicle Expenses 71 105 25 3 96 108 71 105 25 3 96 108 Repairs & Maintenance 445 1,077 3,053 1,882 3,498 2,959 445 1,077 3,054 1,882 3,499 2,959 Maintenance Contracts 3,015 2,473 670 510 3,685 2,983 3,015 2,473 670 510 3,685 2,983 Patient Transport 306 391 – 6 306 397 306 391 – 6 306 397 Bad & Doubtful Debts 115 224 (5) 24 110 248 115 224 (5) 24 110 248 Lease Expenses 362 405 4,403 3,145 4,765 3,550 362 405 4,403 3,145 4,765 3,550 Other Administrative Expenses 6,089 6,034 9,698 6,252 15,787 12,286 6,089 6,034 10,194 6,916 16,283 12,950 Audit Fees – VAGO– Audit of Financial Statements 74 53 – – 74 53 74 53 10 – 84 53 – Other 255 218 – – 255 218 255 218 – – 255 218 Total Other Expenses from Continuing Operations 15,525 15,901 18,600 12,180 34,125 28,081 15,525 15,901 19,107 12,844 34,632 28,745 Expenditure using Capital Purpose Income Other Expenses Repairs & Maintenance 161 – – – 161 – 161 – – – 161 – Total Other Expenses 161 – – – 161 – 161 – – – 161 – Total Expenditure using Capital Purpose Income 161 – – – 161 – 161 – – – 161 – Impairment of Financial Assets – Available-for-Sale Financial Assets * – – – – – – – – 1,667 – 1,667 – Total Impairment of Financial Assets – – – – – – – – 1,667 – 1,667 – Depreciation and Amortisation 4 9,145 10,269 3,095 1,071 12,240 11,340 9,145 10,269 3,108 1,085 12,253 11,354 Revaluation of Non-Financial Assets 12 23,363 – 7,909 – 31,272 – 23,363 – 7,909 – 31,272 – Income Tax Expense 5 – – – – – – – – 26 53 26 53 Total 32,508 10,269 11,004 1,071 43,512 11,340 32,508 10,269 11,043 1,138 43,551 11,407 TOTAL EXPENSES 193,219 162,060 79,478 54,090 272,697 216,150 193,219 162,060 82,033 55,167 275,252 217,227

*The Peter MacCallum Cancer Foundation held managed funds (designated as Available-for-Sale) as at June 30, 2009, that have been at a market value below cost for a period in excess of 12 months. Accordingly, the Foundation has booked a Financial Asset Impairment Expense (unrealised loss) of $1.67M in 2008/09, which represents the difference between market value as at June 30, 2009 and the original cost of the managed funds held. It should be noted that of the $1.67M impairment, $848K related to unrealised losses incurred in 2008/09 whilst $819K related to 2007/08. Global and domestic equity markets have strengthened since June 30, 2009. This upward movement has increased the value of the Foundation’s managed funds by approximately 9.5% as at August 19, 2009, noting that this increase is not reflected in the June 30, 2009 Balance Sheet.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 109 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 3a: Analysis of Expenses by Source (based on the consolidated view) Admitted Admitted Patients Patients Outpatients Outpatients Ambulatory Ambulatory Aged Care Aged Care Other Other Total Total Note 2008–09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s

Services Supported by Health Services Agreement Employee Benefits 50,686 46,979 59,319 55,909 – – 2,582 2,470 – – 112,587 105,358 Non Salary Labour Costs 1,924 1,732 844 583 – – 12 32 – – 2,780 2,347 Supplies and Consumables 16,674 16,025 12,828 12,003 – – 156 157 – – 29,658 28,185 Other Expenses from Continuing Operations 6,439 6,595 8,462 8,667 – – 624 639 – – 15,525 15,901 Depreciation & Amortisation 4 4,394 4,894 4,501 5,091 – – 250 284 – – 9,145 10,269 Revaluation of Non-Financial Assets 12 11,226 – 11,498 – – – 639 – – – 23,363 – Sub-Total Expenses from Services Supported by Health Services Agreement 91,343 76,225 97,452 82,253 – – 4,263 3,582 – – 193,058 162,060

Services Supported by Hospital and Community Initiatives Employee Benefits – – – – – – – – 42,147 33,823 42,147 33,823 Non Salary Labour Costs – – – – – – – – 856 718 856 718 Supplies and Consumables – – – – – – – – 7,213 6,644 7,213 6,644 Other Expenses from Continuing Operations – – – – – – – – 19,107 12,844 19,107 12,844 Impairment of Financial Assets 3 – – – – – – – – 1,667 – 1,667 – Depreciation & Amortisation 4 – – – – – – – – 3,108 1,085 3,108 1,085 Revaluation of Non-Financial Assets 12 – – – – – – – – 7,909 – 7,909 – Income Tax Expense – – – – – – – – 26 53 26 53 Sub-Total Expenses from Services Supported by Hospital and Community Initiatives – – – – – – – – 82,033 55,167 82,033 55,167

Services Supported by Capital Sources Other Expenses 63 – 95 – – – 3 – – – 161 – Sub-Total Expenses from Services Supported by Capital Sources 63 – 95 – – – 3 – – – 161 – TOTAL EXPENSES 91,406 76,225 97,547 82,253 – – 4,266 3,582 82,033 55,167 275,252 217,227

Note 3b: Analysis of Expenses by Internal and Restricted Specific Purpose Funds for Services Supported by Hospital and Community Initiatives

Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s

Private Practice and Other Patient Activities 6,870 6,391 6,870 6,391 Cafeteria 720 864 720 864 Car Park 101 133 101 133 Property Expenses 415 424 415 424 Salary Packaging 299 295 299 295 Other 1,932 1,463 2,426 2,236

Other Activities Fundraising and Community Support 1,480 1,295 1,835 1,532 Research and Scholarship 32,731 25,965 32,731 25,965 Other 23,926 16,189 23,926 16,189 TOTAL 68,474 53,019 69,323 54,029

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 111 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 4: Depreciation and Amortisation Note 6: Cash and Cash Equivalents For the purposes of the Cash Flow Statement, cash assets include cash on hand and in banks, and short term deposits which are readily Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 convertible to cash on hand, and are subject to an insignificant risk of change in value, net of outstanding bank overdrafts. $000s $000s $000s $000s Parent Entity Parent Entity Consolidated Consolidated Depreciation 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s Buildings and Leasehold Improvements 3,334 2,916 3,334 2,916 Strata Titles – 412 – 412 Cash on Hand 9 9 9 9 Plant and Equipment 483 321 484 321 Cash at Bank 3,710 1,749 7,969 6,075 Medical Equipment 7,026 6,364 7,034 6,374 Deposits at Call 5,500 6,600 5,500 6,600 Computers and Communication 1,035 955 1,039 959 Cash Management Fund – 7,112 2,951 9,905 Motor Vehicles 97 60 97 60 TOTAL 9,219 15,470 16,429 22,589

Total Depreciation 11,975 11,028 11,988 11,042 Represented by: Amortisation Cash for Health Service Operations (as per Cash Flow Statement) 9,219 15,470 9,219 15,470 Intangibles 265 312 265 312 Other – – 7,210 7,119 Total Amortisation 265 312 265 312 TOTAL 9,219 15,470 16,429 22,589 TOTAL DEPRECIATION & AMORTISATION 12,240 11,340 12,253 11,354 Note 7: Receivables

Note 5: Income Tax Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 Current $000s $000s $000s $000s Contractual a) The components of income tax expense comprise of: Inter Hospital Debtors 210 148 210 148 Current Tax – – 53 43 Trade Debtors 8,572 6,700 8,709 6,685 Deferred Tax – – (26) 20 Patient Fees 915 741 915 741 Recoupment of prior year losses not previously brought to account – – – (3) Accrued Investment Income 34 102 45 102 Deferred Tax Asset recognised – – (1) (7) Accrued Revenue – Other 7,191 5,471 7,148 5,434 Income Tax Expense – – 26 53 Less Allowance for Doubtful Debts Trade Debtors (305) (327) (305) (349) b) The prima facie tax on profit before income tax is reconciled Patient Fees (10) (6) (10) (6) to the income tax expense as follows: Prima facie tax payable on profit before income tax @ 30% (2008: 30%) – – (10,640) (347) Sub-Total 16,607 12,829 16,712 12,755 Add: Statutory Tax effect on non allowable items – – 3 2 GST Receivable 611 619 629 625 Less: Accrued Revenue – DHS 601 262 601 262 Revenue and expenses exempted from Income Tax – – 10,664 408 TOTAL CURRENT RECEIVABLES 17,819 13,710 17,942 13,642 Deferred tax assets recognised relating to the origination of temporary differences – – (1) (7) Non-Current Tax effect on recoupment of prior year losses not previously Contractual brought to account – – – (3) Other 20 20 20 20 Income Tax Expense – – 26 53 Statutory Long Service Leave – DHS 3,417 2,407 3,417 2,407 c) Franking credits available TOTAL NON-CURRENT RECEIVABLES 3,437 2,427 3,437 2,427 The balance of the franking account at year end available for subsequent years – – 94 40 TOTAL RECEIVABLES 21,256 16,137 21,379 16,069 The applicable weighted average effective tax rates are as follows: – – 0.07% 4.59% a) Movement in Allowance for Doubtful Debts Balance at beginning of the year 333 249 355 249 Amounts written off during the year (110) (248) (110) (248) Increase/(decrease) in allowance recognised in Profit or Loss 92 332 70 354 Provision for impairment recognised during the year – – – – Balance at end of year 315 333 315 355

b) Ageing analysis of receivables Please refer to Note 23(b) for the ageing analysis of receivables. c) Nature and extent of risk arising from receivables Please refer to Note 23(b) for the nature and extent of credit risk arising from receivables. Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 113 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 8: Other Financial Assets Specific Specific Operating Fund Operating Fund Purpose Fund Purpose Fund Capital Fund Capital Fund Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s

Current Australian Listed Equity Securities – – 1,925 1,246 – – 1,925 1,246 1,925 1,246 Australian Dollar Term Deposits – – – 747 – 253 – 1,000 1,000 1,000 Managed Investment Schemes – – 1,245 – 255 – 1,500 – 7,915 7,800 TOTAL CURRENT OTHER FINANCIAL ASSETS – – 3,170 1,993 255 253 3,425 2,246 10,840 10,046

Non-current Australian Dollar Term Deposits – – 415 1,867 85 633 500 2,500 500 2,500 Managed Investment Schemes – – 1,245 2,241 255 759 1,500 3,000 1,500 3,000 TOTAL NON-CURRENT OTHER FINANCIAL ASSETS – – 1,660 4,108 340 1,392 2,000 5,500 2,000 5,500 TOTAL OTHER FINANCIAL ASSETS – – 4,830 6,101 595 1,645 5,425 7,746 12,840 15,546

Represented by: Health Service Investments – – 4,830 6,101 595 1,645 5,425 7,746 5,425 7,746 Other – – – – – – – – 7,415 7,800 Total – – 4,830 6,101 595 1,645 5,425 7,746 12,840 15,546 a) Ageing analysis of other financial assets Please refer to Note 23(b) for the ageing analysis of other financial assets. b) Nature and extent of risk arising from other financial assets Please refer to Note 23(b) for the nature and extent of credit risk arising from other financial assets.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 115 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 9: Inventories Note 12: Property, Plant and Equipment

Parent Entity Parent Entity Consolidated Consolidated Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s $000s $000s $000s $000s

Pharmaceuticals – at cost 1,146 797 1,146 797 Land Catering Supplies – at cost 16 42 16 42 – Land at Fair Value (2009) 24,649 – 24,649 – Housekeeping Supplies – at cost 8 10 8 10 – Land at Fair Value (2006) – 24,600 – 24,600 Medical and Surgical Lines – at cost 83 79 83 79 Total Land 24,649 24,600 24,649 24,600 Administration Stores – at cost 6 6 6 6 Buildings Other – at cost 54 42 54 42 – Buildings at Fair Value (2009) 63,372 – 63,372 – TOTAL 1,313 976 1,313 976 – Buildings at Fair Value (2006) – 93,800 – 93,800 – Buildings at Cost 2,109 905 2,109 905 Less Accumulated Depreciation – (2,606) – (2,606) Note 10: Non-Financial Assets Classified as Held for Sale – Leasehold Improvements at Cost 2,520 2,520 2,520 2,520 Less Accumulated Depreciation (646) (332) (646) (332) Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 Total Buildings 67,355 94,287 67,355 94,287 $000s $000s $000s $000s Plant and Equipment Donated Jewellery – – 286 – – Plant and Equipment at Fair Value (2009) 1,310 – 1,320 – TOTAL – – 286 – – Plant and Equipment at Cost – 4,743 – 4,748 Less Accumulated Depreciation – (1,695) – (1,696) Total Plant and Equipment 1,310 3,048 1,320 3,052

Note 11: Other Assets Medical Equipment – Medical Equipment at Fair Value (2009) 46,966 – 46,987 – Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 – Medical Equipment at Cost – 92,799 – 92,835 $000s $000s $000s $000s Less Accumulated Depreciation – (51,636) – (51,647) Total Medical Equipment 46,966 41,163 46,987 41,188 Current Prepayments 1,231 1,090 1,235 1,095 Computers and Communication – Computers and Communication at Fair Value (2009) 1,248 – 1,251 – TOTAL 1,231 1,090 1,235 1,095 – Computers and Communication at Cost – 4,209 – 4,238 Less Accumulated Depreciation – (2,559) – (2,581) Total Computers and Communication 1,248 1,650 1,251 1,657 Motor Vehicles – Motor Vehicles at Fair Value (2009) 315 – 315 – – Motor Vehicles at Cost – 442 – 442 Less Accumulated Depreciation – (94) – (94) Total Motor Vehicles 315 348 315 348 Cultural Assets – Cultural Assets at Fair Value (2009) 1,245 – 1,245 – – Cultural Assets at Fair Value – 935 – 935 – Cultural Assets at Cost – 447 – 447 Total Cultural Assets 1,245 1,382 1,245 1,382 Strata Titles – Strata Titles at Fair Value (2009) – – – – – Strata Titles at Fair Value (2006) – 14,850 – 14,850 Less Accumulated Depreciation – (412) – (412) Total Strata Titles – 14,438 – 14,438 Work In Progress – Work In Progress at Cost 1,108 1,680 1,108 1,680 Less Accumulated Depreciation – – – – Total Work In Progress 1,108 1,680 1,108 1,680 TOTAL 144,196 182,596 144,230 182,632

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 117 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 12: Property, Plant and Equipment (Continued) Reconciliations of the carrying amounts of each class of asset at the beginning and end of the current and previous financial years are set out below for the Parent Entity.

Buildings & Freehold Leasehold Plant and Medical Computers & Motor Cultural Other Strata Work In Land Improvements Equipment Equipment Communications Vehicles Assets Titles Progress Total Note $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s

Balance at 1 July 2007 24,600 96,298 2,454 42,026 1,365 345 1,181 14,850 1,339 184,458 Additions – 312 915 5,544 1,246 254 201 – 581 9,053 Disposals – – – (43) (6) (191) – – – (240) Transfer between classes – 240 – – – – – – (240) – Revaluation Increments/(Decrements) 19a – 353 – – – – – – – 353 Depreciation and Amortisation 4 – (2,916) (321) (6,364) (955) (60) – (412) – (11,028) Balance at 1 July 2008 24,600 94,287 3,048 41,163 1,650 348 1,382 14,438 1,680 182,596

Additions – 1,205 3,189 13,875 639 113 155 – 827 20,003 Disposals – – – (1,046) (6) (49) – – – (1,101) Transfer between classes 4,967 15,314 (4,444) – – – – (14,438) (1,399) – Revaluation (Decrements) recognised in Operating Statement 3 – (30,980) – – – – (292) – – (31,272) Revaluation (Decrements) transferred from Reserve 19a (4,918) (9,137) – – – – – – – (14,055) Depreciation and Amortisation 4 – (3,334) (483) (7,026) (1,035) (97) – – – (11,975) Balance at 30 June 2009 24,649 67,355 1,310 46,966 1,248 315 1,245 – 1,108 144,196

Land and buildings carried at valuation An independent desktop valuation of the Hospital’s land, buildings and strata titles was performed by the Valuer General Victoria to determine the fair value of the land, buildings and strata titles. The valuation, which conforms to Australian Valuation Standards, was determined by reference to the amounts for which assets could be exchanged between knowledgeable willing parties in an arm’s length transaction. The valuation was based on independent assessments. The effective date of the valuation is 30 June, 2009. The valuation separates the land and buildings components of the strata titles held, therefore they have now been reclassified to the appropriate classes.

The Centre’s previous independent desktop valuation of it’s land, buildings and strata titles (30 June, 2007) was performed by Mr Gary Longdon, AVLE (Val) of Jones Lang LaSalle Advisory Services Pty Ltd to determine the fair value of the land, buildings and strata titles. The valuation, which conforms to Australian Valuation Standards, was determined by reference to the amounts for which assets could be exchanged between knowledgeable willing parties in an arm’s length transaction.

Cultural assets carried at valuation An independent valuation of the Centre’s artwork was performed by Claire Mitchell to determine the fair value of artwork. The valuation, which conforms to the Federal Government’s Cultural Gifts Program, was determined by reference to the amounts for which assets could be exchanged between knowledgeable willing parties in an arm’s length transaction. The valuation was based on independent assessments. The effective date of the valuation is 30 June, 2009. The Centre’s previous valuation was performed by Dr Irene Sutton.

Plant and equipment carried at valuation The Centre performed a fair value assessment of all its plant and equipment as at 30 June, 2009. The valuation based on depreciated replacement cost determined that the assets written down value approximated the carrying amount of each class of plant and equipment with no material differences.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 119 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 12: Property, Plant and Equipment (Continued) Reconciliations of the carrying amounts of each class of asset at the beginning and end of the current and previous financial years are set out below for the Consolidated Entity.

Buildings & Freehold Leasehold Plant and Medical Computers & Motor Cultural Other Strata Work In Land Improvements Equipment Equipment Communications Vehicles Assets Titles Progress Total Note $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s

Balance at 1 July 2007 24,600 96,298 2,454 42,026 1,405 345 1,181 14,850 1,339 184,498 Additions – 312 915 5,550 1,250 254 201 – 581 9,063 Disposals – – – (43) (6) (191) – – – (240) Transfer between classes – 240 4 29 (33) – – – (240) – Revaluation Increments/(Decrements) 19a – 353 – – – – – – – 353 Depreciation and Amortisation 4 – (2,916) (321) (6,374) (959) (60) – (412) – (11,042) Balance at 1 July 2008 24,600 94,287 3,052 41,188 1,657 348 1,382 14,438 1,680 182,632

Additions – 1,205 3,196 13,883 639 113 155 – 827 20,018 Disposals – – – (1,050) (6) (49) – – – (1,105) Transfer between classes 4,967 15,314 (4,444) – – – – (14,438) (1,399) – Revaluation (Decrements) recognised in Operating Statement 3 – (30,980) – – – – (292) – – (31,272) Revaluation (Decrements) transferred from Reserve 19a (4,918) (9,137) – – – – – – – (14,055) Depreciation and Amortisation 4 – (3,334) (484) (7,034) (1,039) (97) – – – (11,988) Balance at 30 June 2009 24,649 67,355 1,320 46,987 1,251 315 1,245 – 1,108 144,230

Note 13: Intangible Assets

Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s Intangible Assets – Software and Licences at Cost 1,428 1,357 1,428 1,357 Less Accumulated Amortisation (771) (506) (771) (506) TOTAL 657 851 657 851

Reconciliations of the carrying amounts of each class of asset at the beginning and end of the current and previous financial years are set out below for the Parent Entity.

Software Total Note $000s $000s Balance at 1 July 2007 972 972 Additions 191 191 Depreciation and Amortisation 4 (312) (312) Balance at 1 July 2008 851 851

Additions 71 71 Depreciation and Amortisation 4 (265) (265) Balance at 30 June 2009 657 657

Reconciliations of the carrying amounts of each class of asset at the beginning and end of the current and previous financial years for the Consolidated Entity are the same as the Parent Entity. Please refer to the above table.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 121 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 14: Deferred Tax Assets – Consolidated Note 16: Employee Benefits and Related On Cost Provisions

Charged Parent Entity Parent Entity Consolidated Consolidated Opening Charged to Directly to Changes in Exchange Closing 2008-09 2007-08 2008-09 2007-08 Balance Income Equity Tax Rate Differences Balance $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s Current Movements Provisions – 10 – – – 10 Employee Benefits Accruals – – – – – – – Unconditional and expected to be settled within 12 months 15,763 15,446 15,788 15,232 Other – 3 – – – 3 – Unconditional and expected to be settled after 12 months 17,182 15,796 17,182 15,796 Balance at 30 June 2008 – 13 – – – 13 TOTAL 32,945 31,242 32,970 31,028

Provisions 10 – – – – 10 Provisions related to employee benefit on-cost Accruals – – – – – – Unconditional and expected to be settled Other 3 – – – – 3 within 12 months (nominal value) 1,321 1,043 1,323 1,043 Balance at 30 June 2009 13 – – – – 13 Unconditional and expected to be settled after 12 months (present value) 1,720 1,605 1,720 1,604 The Deferred Tax Assets are expected to be recovered within 12 months. TOTAL 3,041 2,648 3,043 2,647 The Parent Entity is Income Tax Exempt therefore Deferred Tax Assets do not exist. TOTAL CURRENT PROVISIONS 35,986 33,890 36,013 33,675

Note 15: Payables Non-Current Employee Benefits 4,276 3,488 4,276 3,488 Parent Entity Parent Entity Consolidated Consolidated Provisions related to employee benefit on-costs 427 378 427 378 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s TOTAL NON-CURRENT PROVISIONS 4,703 3,866 4,703 3,866

Current Contractual Trade Creditors 7,578 5,864 7,616 5,896 Current Employee Benefits Accrued Expenses 3,852 4,008 3,969 4,172 Unconditional Long Service Leave entitlements 17,273 15,475 17,284 15,475 Income in Advance 2,533 901 2,688 954 Superannuation 881 430 881 430 Annual Leave Entitlements 10,500 9,188 10,514 9,201 Other – – 2 38 Accrued Wages and Salaries 4,546 6,099 4,546 5,872 Accrued Days Off 626 480 626 480 Sub-Total 14,844 11,203 15,156 11,490 Statutory Non-Current Employee Benefits GST Payable – – 4 3 Conditional Long Service Leave entitlements (present value) 4,276 3,488 4,276 3,488 Department of Human Services – – – – TOTAL EMPLOYEE BENEFITS 37,221 34,730 37,246 34,516 Sub-Total – – 4 3 On-Costs TOTAL CURRENT PAYABLES 14,844 11,203 15,160 11,493 Current On-Costs 3,041 2,648 3,043 2,647 Non-Current On-Costs 427 378 427 378 a) Maturity analysis of payables Please refer to Note 23(c) for the ageing analysis of payables. TOTAL ON-COSTS 3,468 3,026 3,470 3,025 b) Nature and extent of risk arising from payables TOTAL EMPLOYEE BENEFITS AND RELATED ON-COSTS 40,689 37,756 40,716 37,541 Please refer to Note 23(c) for the nature and extent of risks arising from payables. Movement in Long Service Leave including on-costs: Balance at the Start of the Year 20,873 19,394 20,873 19,394 Provision Made during the year – Revaluations 84 (44) 84 (44) – Expense recognising employee service 4,123 3,298 4,134 3,298 Settlement Made During the Year (1,407) (1,775) (1,407) (1,775) Balance at the End of the Year 23,673 20,873 23,684 20,873

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 123 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 17: Deferred Tax Liability – Consolidated Note 19: Equity and Reserves

Charged Parent Entity Parent Entity Consolidated Consolidated Opening Charged to Directly to Changes in Exchange Closing 2008-09 2007-08 2008-09 2007-08 Balance Income Equity Tax Rate Differences Balance $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s a) Reserves Movements Accrued interest – 1 – – – 1 Property, Plant and Equipment Revaluation Reserve¹ Other accrued income – 25 – – – 25 Balance at the Beginning of the Year 21,437 21,084 21,437 21,084 Balance at 30 June 2008 – 26 – – – 26 Revaluation Increment/(Decrement) – Land* (4,918) – (4,918) – Accrued interest 1 (1) – – – – – Strata Titles* – – – – Other accrued income 25 (25) – – – – – Buildings* (9,137) 353 (9,137) 353 Balance at 30 June 2009 26 (26) – – – – – Cultural Assets – – – – The Deferred Tax Liabilities are expected to be settled within 12 months. Balance at the End of the Year 7,382 21,437 7,382 21,437

The Parent Entity is Income Tax Exempt therefore Deferred Tax Liabilities do not exist. Represented by: – Land 7,382 12,300 7,382 12,300 Note 18: Other Liabilities – Strata Titles – 2,828 – 2,828 Parent Entity Parent Entity Consolidated Consolidated – Buildings – 6,309 – 6,309 2008-09 2007-08 2008-09 2007-08 – Cultural Assets – – – – $000s $000s $000s $000s Financial Assets Available-For-Sale Revaluation Reserve2 Current Balance at the Beginning of the Year 171 188 (1,315) 507 Bonds and Deposits 1 1 – – Valuation gain/(loss) recognised (277) (32) (1,126) (2,171) TOTAL 1 1 – – Cumulative (gain)/loss transferred to Operating Statement on sale of financial assets 112 15 780 349 Cumulative (gain)/loss transferred to Operating Statement on impairment of financial assets – – 1,667 – Balance at the End of the Year 6 171 6 (1,315)

Restricted Specific Purpose Reserve Balance at the Beginning of the Year 30,731 21,692 30,731 21,692 Transfer (to)/from Accumulated Surplus/(Deficit) (7,207) 9,039 (7,207) 9,039 Balance at the End of the Year 23,524 30,731 23,524 30,731

Total Reserves 30,912 52,339 30,912 50,853

b) Contributed Capital Balance at the Beginning of the Year 118,544 117,506 118,544 117,506 Capital Contribution Received from Victorian Government – 1,038 – 1,038 Balance at the End of the Year 118,544 118,544 118,544 118,544

c) Accumulated Surpluses/(Deficits) Balance at the Beginning of the Year 5,023 15,199 21,272 31,593 Net Result for the Year (33,923) (1,137) (35,519) (1,282) Transfers (to)/from Restricted Purpose Reserve 7,207 (9,039) 7,207 (9,039) Balance at the End of the Year (21,693) 5,023 (7,040) 21,272 d) Total Equity at End of Financial Year 127,763 175,906 142,416 190,669

(1) The Property, Plant and Equipment assets revaluation reserves arises on the revaluation of property, plant and equipment. (2) The Financial assets available-for-sale revaluation reserve arises on the revaluation of available-for-sale financial assets. Where a revalued financial asset is sold, that portion of the reserve which relates to the financial asset, and is effectively realised, is recognised in the profit and loss. Where a revalued financial asset is impaired that portion of the reserve which relates to that financial asset is recognised in profit and loss. * The Centre’s strata titles were revalued at 30 June, 2009. The valuation separates the land and buildings components of the strata titles held, therefore they have been reclassified to the appropriate classes in Note 12. This reclassification has also been applied to the strata title reserve.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 125 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 20: Minority Interest Note 22: Non-Cash Financing and Investing Activities

Parent Entity Parent Entity Consolidated Consolidated Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s $000s $000s $000s $000s

Interest in: Construction in Progress Received from DHS 1,204 312 1,204 312 Opening Accumulated Surpluses/(Deficits) – – 46 (28) TOTAL 1,204 312 1,204 312 Net Result for the year attributable to Minority Interest – – 27 74 TOTAL – – 73 46 Note 23: Financial Instruments a) Financial Risk Management Objectives and Policies The Centre’s principal financial instruments comprise of: Note 21: Reconciliation of Net Result for the Year to Net Cash Inflow/(Outflow) from Operating Activities – Cash Assets Parent Entity Parent Entity Consolidated Consolidated – Term Deposits 2008-09 2007-08 2008-09 2007-08 – Receivables (excluding statutory receivables) $000s $000s $000s $000s – Australian Listed Equities Securities – Managed Investment Schemes Net Result for the Year (33,923) (1,137) (35,492) (1,208) – Payables (excluding statutory payables) Depreciation and Amortisation 12,240 11,340 12,253 11,354 Revaluation of Non Current Assets 31,272 – 31,272 – Details of the significant accounting policies and methods adopted, including the criteria for recognition, the basis of measurement and the basis on which income and expenses are recognised, with respect to each class of financial asset, financial liability and equity Impairment of Financial Assets – – 1,667 – instrument are disclosed in Note 1 to the financial statements. Provision for Doubtful Debts (18) 84 (18) 106 The main purpose in holding financial instruments is to prudently manage the Centre’s financial risks within the government’s policy procedures. Non Cash Donations (1,114) (117) (1,408) (117) Resources Provided Free of Charge – – – – The Centre’s risk management policies and objectives strive to minimise the risk of permanent loss of capital within its portfolio. The Centre therefore has a policy that no trading in derivatives shall be undertaken. The Centre has various other financial instruments Resources Received Free of Charge (164) (201) (164) (201) such as trade debtors and trade creditors, which arise directly from its operations. Construction in Progress Received from DHS (1,204) (312) (1,204) (312) Categorisation of Financial Instruments Investment Distributions – – (235) (381) Details of each category in accordance with AASB 139, disclosed either on the face of the balance sheet or in the notes are: Investment Fees – – 66 91 Net (Gain)/Loss from Sale of Plant and Equipment 518 34 522 34 Parent Entity Parent Entity Consolidated Consolidated Net (Gain)/Loss from Sale of Investments 117 2 1,478 539 2008-09 2007-08 2008-09 2007-08 Note Category $000s $000s $000s $000s Change in Operating Assets and Liabilities (Increase)/Decrease in Receivables (5,315) (779) (5,721) (1,015) Financial Assets (Increase)/Decrease in Prepayments (142) (47) (140) (48) Cash and Cash Equivalents 6 N/A 9,219 15,470 16,429 22,589 (Increase)/Decrease in Inventories (337) 191 (337) 191 Receivables 7 Loans and Receivables 16,627 12,849 16,732 12,775 (Increase)/Decrease in Other Assets – 6 – 6 Other Financial Assets 8 Available for sale financial assets (at fair value) 5,425 7,746 12,840 15,546 (Increase)/Decrease in Deferred Tax Assets – – – (13) Total Financial Assets 31,271 36,065 46,001 50,910 Increase/(Decrease) in Payables 4,026 (84) 4,235 (558) Increase/(Decrease) in Accrued Expenses 249 697 228 782 Financial Liabilities Increase/(Decrease) in Interest bearing liabilities – – 22 (4) Payables 15 Financial liabilities Increase/(Decrease) in Income Tax Payable – – – – measured at amortised cost 14,844 11,203 15,156 11,490 Increase/(Decrease) in Employee Benefits 134 2,756 363 2,538 Total Financial Liabilities 14,844 11,203 15,156 11,490 Increase/(Decrease) in Prepaid Revenue 1,831 (892) 1,934 (530) Increase/(Decrease) in Long Service Leave 2,800 1,479 2,812 1,479 Increase/(Decrease) in Deferred Tax Liabilities – – (26) 26 Net holding gain/(loss) on financial instruments by category Increase/(Decrease) in Other Liabilities – (179) – (179) Carrying Amount NET CASH INFLOW FROM OPERATING ACTIVITIES 10,970 12,841 12,107 12,580 Parent Entity Parent Entity Consolidated Consolidated 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s Financial Assets Cash and Cash Equivalents – – – – Receivables – – – – Available for sale financial assets 61 399 (1,255) 871 Total Financial Assets 61 399 (1,255) 871

Financial Liabilities At amortised cost – – – – Total Financial Liabilities – – – –

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 127 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 23: Financial Instruments (Continued) b) Credit Risk Credit risk represents the loss that would be recognised if counterparties fail to meet their obligations under the respective contracts at maturity. The Centre has adopted a policy of only dealing with creditworthy counter parties as a means of mitigating the risk of financial loss from defaults. The Centre’s exposure is continually monitored and this risk is reviewed periodically. Receivables consist of patients and customers, spread across geographical areas throughout Victoria, although predominantly in healthcare. The Centre does not have any significant credit risk exposure to any single party or any group of counter parties having similar characteristics. The credit risk on financial assets of the Centre have been recognised on the Balance Sheet as the carrying amount, net of any provisions for doubtful debts. The Centre’s exposure to credit risk and effective weighted average interest rate by ageing periods is set out in the following table.

Parent Interest Rate Exposure Past Due But Not Impaired Weighted Non Not Past Due Impaired Average Carrying Fixed Variable Interest and Not Less than 3 Months- Financial Effective Interest Amount Interest Rate Interest Rate Bearing Impaired 1 Month 1-3 Months 1 Year 1-5 Years Over 5 Years Asset 2009 Rates* (%) $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s Financial Assets Cash and Cash Equivalents 4.98% 9,219 – 9,210 9 9,219 – – – – – – Receivables – Trade Debtors N/A 8,477 – – 8,477 4,596 2,543 653 679 6 – – – Other Receivables N/A 8,150 – – 8,150 8,150 – – – – – – Other Financial Assets – Australian Listed Equity Securities N/A 1,925 – – 1,925 1,925 – – – – – – – Australian Dollar Term Deposits 0.00% 500 500 – – 500 – – – – – – – Managed Investment Schemes 1.50% 3,000 – 1,500 1,500 3,000 – – – – – – Total Financial Assets 31,271 500 10,710 20,061 27,390 2,543 653 679 6 – –

2008 Financial Assets Cash and Cash Equivalents 7.28% 15,470 – 15,461 9 15,470 – – – – – – Receivables – Trade Debtors N/A 6,521 – – 6,521 1,862 2,891 1,668 100 – – – – Other Receivables N/A 6,328 – – 6,328 6,328 – – – – – – Other Financial Assets – Australian Listed Equity Securities N/A 1,246 – – 1,246 1,246 – – – – – – – Australian Dollar Term Deposits 5.79% 3,500 1,500 2,000 – 3,500 – – – – – – – Managed Investment Schemes 1.50% 3,000 – 1,500 1,500 3,000 – – – – – – Total Financial Assets 36,065 1,500 18,961 15,604 31,406 2,891 1,668 100 – – –

* Weighted average or effective interest rates for each class of assets.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 129 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 23: Financial Instruments (Continued) Consolidated Interest Rate Exposure Past Due But Not Impaired Weighted Average Non Not Past Due Impaired Effective Interest Carrying Fixed Variable Interest and Not Less than 3 Months- Financial Rates* Amount Interest Rate Interest Rate Bearing Impaired 1 Month 1-3 Months 1 Year 1-5 Years Over 5 Years Asset 2009 (%) $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s $000s Financial Assets Cash and Cash Equivalents 4.17% 16,429 – 16,420 9 16,429 – – – – – – Receivables – Trade Debtors N/A 8,614 – – 8,614 4,733 2,543 653 679 6 – – – Other Receivables N/A 8,118 – – 8,118 8,118 – – – – – – Other Financial Assets – Australian Listed Equity Securities N/A 1,925 – – 1,925 1,925 – – – – – – – Australian Dollar Term Deposits 2.70% 1,500 1,500 – – 1,500 – – – – – – – Managed Investment Schemes 2.50% 9,415 – 2,262 7,153 9,415 – – – – – – Total Financial Assets 46,001 1,500 18,682 25,819 42,120 2,543 653 679 6 – –

2008 Financial Assets Cash and Cash Equivalents 7.19% 22,589 – 22,580 9 22,589 – – – – – – Receivables – Trade Debtors N/A 6,484 – – 6,484 1,824 2,892 1,668 100 – – – – Other Receivables N/A 6,291 – – 6,291 6,291 – – – – – – Other Financial Assets – Australian Listed Equity Securities N/A 1,246 – – 1,246 1,246 – – – – – – – Australian Dollar Term Deposits 7.50% 3,500 1,500 2,000 – 3,500 – – – – – – – Managed Investment Schemes 4.98% 10,800 – 2,175 8,625 10,800 – – – – – – Total Financial Assets 50,910 1,500 26,755 22,655 46,250 2,892 1,668 100 – – –

* Weighted average or effective interest rates for each class of assets.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 131 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 23: Financial Instruments (Continued) c) Liquidity Risk Liquidity risk is the risk that the Centre will encounter difficulty in meeting obligations associated with financial liabilities. The Centre manages the liquidity risk by maintaining adequate cash reserves, and by continuously monitoring forecast and actual cash flows while matching maturity profiles of financial assets and liabilities. Given the surplus cash assets, liquidity risk is minimal. The following table discloses the contractual maturity analysis for the Centre’s financial liabilities. For interest rates applicable to each class of liability refer to individual notes to the financial statements.

Parent Interest Rate Exposure Maturity Dates Non Weighted Carrying Fixed Variable Interest Average Contractual Less than 3 Months- Amount Interest Rate Interest Rate Bearing Effective Interest Cash Flows 1 Month 1-3 Months 1 Year 1-5 Years Over 5 Years 2009 $000s $000s $000s $000s Rate (%) $000s $000s $000s $000s $000s $000s Payables 14,844 – – 14,844 N/A 14,844 12,419 2,425 – – – Total Financial Liabilities 14,844 – – 14,844 N/A 14,844 12,419 2,425 – – –

2008 Payables 11,203 – – 11,203 N/A 11,203 8,564 2,639 – – – Total Financial Liabilities 11,203 – – 11,203 N/A 11,203 8,564 2,639 – – –

Consolidated Interest Rate Exposure Maturity Dates Non Weighted Carrying Fixed Variable Interest Average Contractual Less than 3 Months- Amount Interest Rate Interest Rate Bearing Effective Interest Cash Flows 1 Month 1-3 Months 1 Year 1-5 Years Over 5 Years 2009 $000s $000s $000s $000s Rate (%) $000s $000s $000s $000s $000s $000s Payables 15,156 – – 15,156 N/A 15,156 12,731 2,425 – – – Total Financial Liabilities 15,156 – – 15,156 N/A 15,156 12,731 2,425 – – –

2008 Payables 11,490 – – 11,490 N/A 11,490 8,851 2,639 – – – Total Financial Liabilities 11,490 – – 11,490 N/A 11,490 8,851 2,639 – – –

d) Market Risk The Centre’s exposure to market risk is primarily through interest rate and other price risk with insignificant exposure to foreign currency. Objectives, policies and processes used to manage each of these risks are disclosed in the paragraph below. Interest Rate Risk Exposure Interest rate risk is the risk associated with variable market conditions. The Centre’s exposure to interest rate risk and effective weighted average interest rate by maturity periods is set out in (b) and (c). For interest rates applicable to each class of asset or liability refer to individual notes to the financial statements. Exposure arises predominantly from assets and liabilities bearing variable interest rates. The Centre does not enter into interest rate swaps. Equity Price Risk Exposure Equity price risk arises from available-for-sale securities held to generate income from surplus funds. Management of the Centre monitors the equity securities in its investment portfolio based on market indices. Investments are managed externally by fund managers whose performance and proposed investment strategies are reviewed by the Board of Management on a regular basis. The Centre’s exposure to equity price risk is set out in the table within the sensitivity analysis. Currency Risk The Centre is exposed to insignificant foreign currency risk through its payables relating to purchases of supplies and consumables from overseas. This is because of a limited amount of purchases denominated in foreign currencies and a short timeframe between commitment and settlement.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 133 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 23: Financial Instruments (Continued)

Sensitivity Analysis Taking into account past performance, future expectations, economic forecasts and management’s knowledge and experience of the financial markets, the Centre believes the following movements are ‘reasonably possible’ over the past 12 months. – A parallel shift of +0% and -0.5% in market interest rates (AUD) from the year end cash rate of 6%; – A parallel shift of +12% and -12% in price movement from year end prices. The following table discloses the impact on net operating result and equity for each category of financial instrument held by the Centre at year end if changes in the relevant risk occur.

Parent Interest Rate Exposure Price Risk -0.5% +0.5% -12% +12% Weighted Average Effective Interest Average Rates* Balance Profit Equity Profit Equity Profit Equity Profit Equity 2009 (%) $000s $000s $000s $000s $000s $’000s $000s $000s $000s Financial Assets Cash and Cash Equivalents 4.98% 10,294 (51) (51) 51 51 – – – – Receivables – Trade Debtors N/A 8,329 – – – – – – – – – Other Receivables N/A 7,995 – – – – – – – – Other Financial Assets – Australian Listed Equity Securities N/A 1,292 – – – – (18) (173) 18 173 – Australian Dollar Term Deposits 0.00% 1,917 – – – – – – – – – Managed Investment Schemes 1.50% 3,000 – – – – – – – – Financial Liabilities Payables N/A 13,695 – – – – – – – –

2008 -1% +1% -10% +10% Financial Assets Cash and Cash Equivalents 7.28% 9,203 (92) (92) 92 92 – – – – Receivables – Trade Debtors N/A 6,807 – – – – – – – – – Other Receivables N/A 6,522 – – – – – – – – Other Financial Assets – Australian Listed Equity Securities N/A 1,294 – – – – (2) (131) 2 131 – Australian Dollar Term Deposits 5.79% 2,500 (25) (25) 25 25 – – – – – Managed Investment Schemes 1.50% 4,000 (40) (40) 40 40 – – – – Financial Liabilities Payables N/A 10,172 – – – – – – – –

* Weighted average or effective interest rates for each class of assets.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 135 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 23: Financial Instruments (Continued) Consolidated Interest Rate Exposure Price Risk -0.5% +0.5% -12% +12% Weighted Average Effective Interest Average Rates* Balance Profit Equity Profit Equity Profit Equity Profit Equity 2009 (%) $000s $000s $000s $000s $000s $000s $000s $000s $000s Financial Assets Cash and Cash Equivalents 4.17% 16,952 (85) (85) 85 85 – – – – Receivables – Trade Debtors N/A 8,416 – – – – – – – – – Other Receivables N/A 8,019 – – – – – – – – Other Financial Assets – Australian Listed Equity Securities N/A 1,291 – – – – (18) (173) 18 173 – Australian Dollar Term Deposits 2.70% 2,917 (5) (5) 5 5 – – – – – Managed Investment Schemes 2.50% 9,603 (4) (4) 4 4 (1,018) (1,018) 1,018 1,018 Financial Liabilities Payables N/A 13,876 – – – – – – – –

2008 -1% +1% -10% +10% Financial Assets Cash and Cash Equivalents 7.19% 16,106 (161) (161) 161 161 – – – – Receivables – Trade Debtors N/A 6,763 – – – – – – – – – Other Receivables N/A 10,614 – – – – – – – – Other Financial Assets – Australian Listed Equity Securities N/A 1,294 – – – – (2) (131) 2 131 – Australian Dollar Term Deposits 7.50% 3,582 (25) (25) 25 25 – – – – – Managed Investment Schemes 4.98% 12,076 (48) (48) 48 48 (53) (847) 53 847 Financial Liabilities Payables N/A 10,811 – – – – – – – –

* Weighted average or effective interest rates for each class of assets.

Fair Value of Financial Assets and Liabilities The carrying amount of financial assets and liabilities contained within these financial statements is representative of the net fair value of each financial asset or liability.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 137 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 24: Commitments for Expenditure Note 27: Responsible Persons Disclosures In accordance with the Ministerial Directions issued by the Minister for Finance under the Financial Management Act 1994, the following Parent Entity Parent Entity Consolidated Consolidated disclosures are made regarding responsible persons for the reporting period. 2008-09 2007-08 2008-09 2007-08 $000s $000s $000s $000s Capital Expenditure Commitments Period Payable Responsible Minister Plant and Equipment 4,142 11,791 4,142 11,791 The Honourable Daniel Andrews, MLA, Minister for Health 01/07/2008 – 30/06/2009 Total Capital Commitments 4,142 11,791 4,142 11,791 Governing Board Plant and Equipment Ms Patricia Faulkner AO (Chair) 01/07/2008 – 30/06/2009 Not Later Than 1 Year 4,142 9,147 4,142 9,147 Professor David Copolov (Deputy Chair) 01/07/2008 – 30/06/2009 Later Than 1 Year and Not Later Than 5 Years – 2,644 – 2,644 Mr Ian Allen OAM 01/07/2008 – 30/06/2009 Later Than 5 Years – – – – Ms Sue Carter 01/07/2008 – 30/06/2009 Total 4,142 11,791 4,142 11,791 Dr Cathy Hutton 01/07/2008 – 30/06/2009 Canon Alan Nichols AM 01/07/2008 – 30/06/2009 Lease Commitments Mr John Patterson OAM 01/07/2008 – 30/06/2009 Commitments in Relation to Leases Contracted for at the Reporting Date: Professor Peter Sheldrake 01/07/2008 – 30/06/2009 Operating Leases 13,632 11,011 13,632 11,011 Mr Martin Smith 01/07/2008 – 01/04/2009

Total Lease Commitments 13,632 11,011 13,632 11,011 Accountable Officer Mr Craig Bennett, Chief Executive Officer 01/07/2008 – 30/06/2009 Operating Leases Cancellable Not Later Than 1 Year 4,443 3,831 4,443 3,831 Remuneration of Responsible Persons Later Than 1 Year and Not Later Than 5 Years 8,240 6,239 8,240 6,239 The number of Responsible Persons are shown in their relevant income bands: Later Than 5 Years 949 941 949 941 TOTAL 13,632 11,011 13,632 11,011 Parent Consolidated 2008-09 2007-08 2008-09 2007-08 Total Commitments for Expenditure (inclusive of GST) 17,774 22,802 17,774 22,802 No. No. No. No. Income Band Less GST recoverable from the Australian Tax Office (1,616) (2,079) (1,616) (2,079) $0 – $9,999 1 1 1 1 Total Commitments for Expenditure (exclusive of GST) 16,158 20,723 16,158 20,723 $10,000 – $19,999 6 5 6 5 $20,000 – $29,999 1 2 1 2 Operating Leases $40,000 – $49,999 1 – 1 – Rental Expense Recognised in the Year 4,765 3,550 4,765 3,550 $90,000 – $99,999 – – – – Represented by: $330,000 – $339,999 – 1 – 1 Minimum Lease Payments 4,765 3,550 4,765 3,550 $340,000 – $349,999 – 1 – 1 $350,000 – $359,999 1 – 1 – The Centre has entered into commercial leases on certain medical equipment, computer equipment and property where it is not in the best interest of the Centre to purchase these assets. Total Numbers 10 10 10 10 These leases have an average life of between 1 and 10 years with renewal terms included in the contracts. Renewals are at the option of the Centre. Total remuneration received or due and receivable There are no restrictions placed upon the lessee by entering into these leases. by Responsible Persons from the Centre amounted to: $523,725 $516,456 $523,725 $516,456

Note 25: Contingent Liabilities and Contingent Assets Amounts relating to Responsible Ministers are reported in the financial statements of the Department of Premier and Cabinet. The Centre has no contingent liabilities and assets as at 30 June 2009 (2008: Nil). Any claims made against the Centre are covered by public healthcare insurance managed by VMIA, with premiums being paid by the Parent Consolidated Department of Human Services. 2008-09 2007-08 2008-09 2007-08 Other Transactions of Responsible Persons and their Related Parties Note 26: Segment Reporting Donations received from Responsible Persons or their Related Parties $ 27,507 $ 138 $ 639,804 $ 503,161 The Centre operates and provides public health services predominantly in metropolitan Victoria. There were no other transactions between the Centre and its Responsible Persons or their Related Parties.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 139 NOTES TO AND FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2009

Note 27a: Executive Officer Disclosures Declaration by Chair, Accountable Officer and Accounting Officer

Executive Officers’ Remuneration We certify that the attached financial statements for the Peter MacCallum Cancer Institute (trading as the Peter MacCallum Cancer The numbers of executive officers, other than Ministers and Accountable Officers, and their total remuneration during the reporting Centre) have been prepared in accordance with Standing Direction 4.2 of the Financial Management Act 1994, applicable Financial period are shown in the first two columns in the table below in their relevant income bands. The base remuneration of executive officers Reporting Directions, Australian Accounting Standards, Australian Accounting Interpretations and other mandatory professional reporting is shown in the third and fourth columns. Base remuneration is exclusive of bonus payments, long-service leave payments, redundancy requirements. payments and retirement benefits. We further state that, in our opinion, the information set out in the Operating Statement, Balance Sheet, Statement of Changes in Equity, Cash Flow Statement and notes to and forming part of the financial statements, presents fairly the financial transactions during the year A change in the Government Sector Executive Remuneration Panel (GSERP) reporting guidelines for 2008/09 has resulted in an increased ended June 2009 and financial position of Peter MacCallum Cancer Centre at 30 June 2009. number of staff who need to be covered by this disclosure. The additional staff covered by these revised guidelines were all previously employed by the Centre. We are not aware of circumstances which would render any particulars included in the financial statements to be misleading or inaccurate. We authorise the attached financial statements for issue on this day. Parent Consolidated Total Remuneration Base Remuneration Total Remuneration Base Remuneration 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08

No. No. No. No. No. No. No. No.

Remuneration Bands Ms Patricia Faulkner AO Mr Craig Bennett Mr Andrew Kinnersly $0 – $9,999 – – – – 1 1 1 1 Chair: Board of Directors Chief Executive Officer and Accountable Officer Chief Finance Officer and Accounting Officer $20,000 – $29,999 – – – – 1 – 1 – East Melbourne East Melbourne East Melbourne $80,000 – $89,999 – – – – – – 1 – Monday 7 September 2009 Monday 7 September 2009 Monday 7 September 2009 $90,000 – $99,999 – – – – 1 – – – $120,000 – $129,999 – – – – – – – – $130,000 – $139,999 1 – 1 – 1 – 1 – $140,000 – $149,999 1 – 1 – 1 – 1 1 Attestation on Compliance with Australian / New Zealand Risk Management Standard $150,000 – $159,999 2 – 3 – 2 – 3 – I, Craig Bennett: Chief Executive Officer, certify that the Peter MacCallum Cancer Centre has risk management processes in place $160,000 – $169,999 1 1 1 – 1 2 1 – consistent with the Australian/New Zealand Risk Management Standard AS/NZS 4360:2004, as well as internal control systems in place $170,000 – $179,999 – 2 1 1 – 2 1 1 to enable the Board and the Executive Committee to understand, manage and satisfactorily control all risk exposures. The Audit and Risk Management Committee and the Clinical Governance Committee monitor and review ongoing risk management activities and associated $180,000 – $189,999 3 2 3 1 3 2 4 2 risk reporting, which are aligned with the Enterprise Risk Management Framework and Strategy. The Audit and Risk Management $190,000 – $199,999 1 – 1 2 1 1 1 2 Committee have ensured that the risk profile of Peter Mac has been critically reviewed during the last twelve months. $200,000 – $209,999 1 – – 1 2 – – 1 $210,000 – $219,999 2 1 2 – 2 1 2 – $220,000 – $229,999 – – – 1 – – – 1 $230,000 – $239,999 1 – – – 1 – – – Mr Craig Bennett $240,000 – $249,999 – – 1 – – – 1 – Chief Executive Officer and Accountable Officer $250,000 – $259,999 1 1 1 – 1 1 1 – East Melbourne $260,000 – $269,999 – – – 1 – – – 1 Wednesday 19 August 2009 $270,000 – $279,999 1 – – – 1 – – – $280,000 – $289,999 – – – – – – – – $290,000 – $299,999 – – 1 – – – 1 – $300,000 – $309,999 1 – – – 1 – – – TOTAL 16 7 16 7 20 10 20 10 $3,204,902 $1,357,454 $3,043,429 $1,304,042 $3,518,370 $1,713,229 $3,336,222 $1,635,670

Note 28: Events Occurring After Reporting Date The Centre had no events occurring after the reporting date.

Note 29: Controlled Entities The Centre’s controlled entities as at 30 June 2009 are detailed below:

Country of Class of Equity Name of Entity Incorporation Shares Holding Peter MacCallum Cancer Foundation Ltd* as Trustee for the Peter MacCallum Australia N/A 0% Cancer Foundation** Cell Therapies Pty Ltd Australia Ordinary 51%

* Control exists via being the sole member of the Company. ** Control exists via the Centre being the ultimate beneficiary of the Foundation.

Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 141 Peter MacCallum Cancer Centre Annual Report 2009 Financial Statements 143 Glossary/ Contacts/

ACHS the Australian Council on Healthcare standards Multidisciplinary involving/across several disciplines such www.petermac.org Cabrini Health 184 Wattletree Road is the body responsible for accrediting as surgery, chemotherapy, radiotherapy, Peter Mac Sites healthcare providers or allied health. Malvern Victoria 3144 East Melbourne ACRF Australian Cancer Research Fund NHMRC National Health and Medical Research Council St Andrews Place Telephone +61 3 9508 1908 East Melbourne Victoria 3002 Facsimile +61 3 9508 1098 AGITG Australian Gastrointestinal Trials Group OT Occupational Therapy or Occupational Therapist Telephone +61 3 9656 1111 The Royal Melbourne Hospital AMA Australian Medical Association Palliative care treatment for pain and symptoms Facsimile +61 3 9656 1400 Grattan Street Ambulatory a patient able to walk in and out of Peter Mac for PCCC Parkville Comprehensive Cancer Centre Parkville Victoria 3052 patient appointments. Also referred to as an ‘outpatient’ Epworth Eastern Medical Centre PET Positron Emission Tomography at Box Hill Telephone +61 3 9342 7000 ASCO American Society of Clinical Oncology Facsimile +61 3 9342 8032 PICS Paediatric Integrated Cancer Service 1 Arnold Street ASSG Australian Sarcoma Study Group Box Hill Victoria 3128 RACS Royal Australian College of Surgeons Royal Women’s Hospital AYA Adolescent and Young Adult Telephone +61 3 9895 7662 Cnr Flemington Road and Grattan Street RTS Radiation Therapy Services Facsimile +61 3 9895 7565 Parkville Victoria 3052 Bed day measurement for occupancy of hospital beds – one bed occupied for 24 hours Satellite a service run by Peter Mac from premises/facilities Monash Medical Centre – Moorabbin Telephone +61 3 8345 2000 other than East Melbourne 867 Centre Road Facsimile +61 3 8345 2259 CAC Community Advisory Committee East Bentleigh Victoria 3165 Separation leaving the hospital either through discharge, St. Vincent’s Hospital – Melbourne CBCT Centre for Blood Cell Therapies transfer or death Telephone +61 3 9928 8901 41 Victoria Parade CDU Chemotherapy Day Unit Supportive care that meets the many needs associated with Facsimile +61 3 9928 8911 Fitzroy Victoria 3065 care cancer and cancer treatment CMI Centre for Molecular Imaging Bendigo Health – Bendigo Telephone +61 3 9288 2211 TAC Transport Accident Commission Stewart Street Facsimile +61 3 9288 3399 COSA Clinical Oncology Society of Australia TCC Tattersalls Cancer Centre at the Epworth Richmond Bendigo Victoria 3552 CRC Cooperative Research Centre TGA Therapeutic Goods Association Telephone +61 3 5454 9234 CT Computed tomography Facsimile +61 3 5454 9289 TROG Trans Tasman Radiation Oncology Group DHS Department of Human Services, Victorian Tattersall’s Cancer Centre – Government Tumour care and treatment based upon tumour type/ Epworth Richmond Stream location, eg. breast, gastrointestinal, sarcoma. EFT Equivalent full-time employee Level 4 VACS Victorian Ambulatory Classification System – 32 Erin Street FCC Familial Cancer Centre measurement of outpatient services for DHS Richmond Victoria 3128 funding purposes FOI Freedom of Information Telephone +61 3 8420 1900 GI Gastrointestinal VCA Victorian Cancer Agency Facsimile +61 3 8420 1950 HMO Health Medical Officer, a recently graduated VCAP Victorian Cancer Action Plan 2008 Consulting clinics are held at: doctor VICNISS Victorian Hospital Acquired Infection Surveillance The Northern Hospital 185 Cooper Street ICU Intensive Care Unit System Epping Victoria 3076 IMRT Intensity Modulated Radiation Therapy VWA Victorian Workcover Authority Telephone +61 3 8405 8000 Inpatient a patient who is admitted to the hospital to WCMICS Western and Central Melbourne Integrated Cancer Facsimile +61 3 8405 8761 stay in a bed Service kConFab Kathleen Cuningham Foundation Consortium for WEIS Weighted Inlier Equivalent Separation – research into familial aspects of breast cancer measurement of inpatient services for DHS funding purposes Late Effects monitoring and treatment of long term effects from cancer treatment 3T MRI 3 Tesla Magnetic Resonance Imaging MRI Magnetic Resonance Imaging 3-D CT 3 Dimensional Computed Tomography 3-D CRT 3 Dimensional Conformal Radiation Therapy

Peter MacCallum Cancer Centre Annual Report 2009 Contacts 145 Image Mira, Research Assistant

Peter MacCallum Cancer Centre Annual Report 2009 147