Name: Dr Anna Singleton
Faculty: Faculty of Medicine and Health
Course: Doctor of Philosophy (Medicine)
Theme: Challenges
Photo: Dr Anna Singleton
The call you never want to receive
One day in 2017, my best friend Molly wanted to Facetime. Now, to give some context, I have been friends with Molly since we were 5 years old and she had never asked me to Facetime, even when I moved to Australia. Molly was NOT the Facetiming type. You know the ones… immediately hang up and text you instead? That’s her. So, I thought “She must have important news… maybe she’s pregnant!”. When the call started, I was smiling ear to ear, expecting to be surprised with a mini-Molly on the way.
Instead, Molly was very serious and looked a bit defeated, saying “Oh…you thought this would be good news…”. My heart sank. My mind started racing with the horrible possibilities, but reality was worse. Molly was diagnosed with breast cancer. Surgery was the next week. Over the next few months of treatment, I tried to support her in any way I could from across the world; text messages, funny images to cheer her up and little gifts to let her know I was thinking of her. Then, Molly’s journey with breast cancer took a surprising turn with one simple email...
PhD serendipity
I hadn’t shared Molly’s diagnosis with my colleagues yet… it was hard to talk about on the best of days. But on the day of Molly’s third chemotherapy treatment, I received an email from my PhD supervisor Prof Julie Redfern explaining that a Specialist Breast Cancer Surgeon (A/Prof Elisabeth Elder) had voiced interest in developing a PhD project around supporting women with breast cancer using text messages. I immediately burst into tears (thank goodness I was working from home!). Honestly, I wasn’t sure I could do it. Was it too close to home? Would I spend every day of my PhD crying? I mean, I expected a bit of crying (PhD students am I right?), but every day seemed excessive. I took the week to think about it. I talked to Molly, and she thought it would be a great opportunity to support people with breast cancer in a new way. Little did she know, she was SO RIGHT.
Turning a nightmare into a ray of hope
It turns out, each year over 20,000 Australian women finish breast cancer treatment like surgery, chemotherapy, and radiation. Although 98% are alive, the mental and physical toll treatment takes on the body can last years. Women’s most common request was to have more contact with their oncology team between medical visits to make recovery easier. Molly could 100% relate. Over the next year, Molly and I worked with a team of breast cancer survivors, health professionals and researchers to create a health and wellness program called “EMPOWER-SMS” to support women’s recovery after treatment. EMPOWER-SMS delivered 6-months of health tips, advice and links to helpful websites and free local wellness programs via text messages (4messages/week). Now, if I’m being honest, I didn’t see how a few text messages could help anyone. I’m guessing you were thinking the same thing? Luckily, we were both wrong.
160 women tested EMPOWER-SMS in a clinical trial; 80 received EMPOWER-SMS for 6-months and 80 received usual care. At the end of the program, 100% of women said EMPOWER-SMS was easy-to-understand, 91% said it was useful and 70% said it helped them manage their health. We also did focus groups (interviews), and women felt EMPOWER-SMS continued their care between medical visits, was a convenient way to receive health information from someone they trusted, and they appreciated the links to breast cancer websites and free programs. But the real moment I knew we had, had a real impact on people’s life, was when one participant (age 60) said:
“I remember one day I felt really down, and I got this simple message that said ‘You are important and you are beautiful – have a great day!’ And that just put me to tears. I was just like ‘Okay, I’m not alone in this’ and my day, I felt better.”
It feels silly, but a simple message CAN have a huge impact.
But that’s not where the story ends…
Photo: Dr Anna Singleton and her team
From COVID-19 lockdowns to Australia-wide support
COVID19 closed breast cancer support everywhere. People with breast cancer were scared and wondering how to stay safe. We quickly adapted EMPOWER-SMS into a COVID-19 version, that had updated health guidelines, helpful websites, and suggestion for how to stay healthy at home. We made it available to all Australians, promoting through social media and well-known networks (McGraths Foundation, Breast Cancer Network Australia, National Breast Cancer Foundation’s Register4 program). Within 6-months, 850 breast cancer survivors signed up. The feedback blew us away, with 88% of participants feeling supported and 70% saying it helped improve their diet and exercise. And did I mention it only cost us $15AUD to send to each person? I spend more on one pub feed!
What’s next?
I’m happy to end on some more good news. EMPOWER-SMS will soon be part of standard medical care at 2 hospitals, with hopes of integrating into more hospitals and GP practices by 2024. We’re also working with volunteer organisations and Indigenous leaders in Northwest Territories Canada to deliver a new ‘EMPOWER-NWT’ to rural and remote communities.
PS. Molly is still cancer-free and beyond proud that her breast cancer experience could help so many people.
In other news
The COVID-19 pandemic brought up a lot of questions about researchers. Who are we? What do we do? Are we evil people trying to do harm? To clear up misconceptions and introduce you to the wonderful researchers at the University of Sydney, my colleague Rebecca Raeside (PhD Candidate) and I co-founded the “We’ve done the research” podcast, available anywhere you get your podcasts from March 2022. We can’t wait to continue the conversation!