Charlie’s Letters « Charlie Teo Foundation

The Gift of Time

14th December 2023

Hello Friends,

The meaning of ‘time’ and its impact on someone with brain cancer is quite telling…

Someone said to me once that when you are diagnosed with brain cancer it’s like having a use-by sticker placed on you. The need for more time to spend with loved ones and create memories becomes paramount.

I have a huge collection of clocks and watches that my patients have given me from all different walks of life as a token of their appreciation for giving them time.

Dr Teo in 1997 with the paediatric neurosurgery team

We can all give those less fortunate the gift of our own time – time to listen, learn, impart our knowledge and skills to make the world a better place.

Charlie Teo Foundation was built on this premise with volunteerism being key to success!

For over 25 years, I have been giving the gift of my time through global pro bono work. Peru was my first foray into neurosurgical volunteering.

The pictures in which I have hair was 1997 when I first went to Lima, Peru. I then went every year and organised neurosurgeons from the USA to go on a regular basis to teach paediatric neurosurgery.

Dr Teo awarded Honorary Membership to the Peruvian Neurosurgical Society in 2007

I was mentored by a beautiful and visionary neurosurgeon from UCLA, who introduced me to the good and bad of pro bono work in developing countries.

The bad was the corruption. Custom officers helped themselves to the equipment and disposable and reusable products that we had gathered from medical supply companies and that we would donate to the impoverished public hospitals.

The good was the feeling that you were genuinely making a difference, not to a person or a family alone, but to a nation. “Don’t give them fish. Teach them how to fish.”

Dr Teo doing pro bono neurosurgery on a child in Peru over 20 years ago

Back in the 90s the operating rooms were extremely primitive. Air conditioning was by the window which meant when it was open, flies would get in. There were limited ventilators, so our anaesthetist had to hand ventilate the patient, sometimes for hours!!! 

After a decade of multiple visits, teaching courses, and hundreds of demonstration operations, I moved on to concentrate on Vietnam, all the while wondering if I had made a difference… Any doubts that I may have had were dispelled with my trip back to Peru in November 2023. 

But what I witnessed was a level of care, commitment, excellence and dedication that rivals any world-class institution in which I have worked around the world. Visionary and altruistic local neurosurgeons who have a thirst for knowledge and the drive to make dreams a reality. Together they have advanced neurosurgical care to Peruvian children to a level that I never thought possible in that period of time!

Charlie with the charge nurse of the neurosurgical ward for the last 26 years, and the Chief of Neurosurgery at the largest children's hospital in Peru
The Spanish edition of Dr Teo's book on keyhole neurosurgery
Dr Teo with the department of neurosurgery in Peru
Dr Teo reviewing patient scans on his recent pro bono trip to Peru
The neurosurgical team in Dr Teo's recent pro bono work in Peru

The month prior in October 2023 I toured through the North-East of Brazil without breaks. The quality of neurosurgery was world-class and I sometimes wondered if I was learning more than I was teaching!

I had fruitful discussions with Oncologists and Surgeons at leading hospitals dedicated to cancer treatment. 

I also operated pro bono at public hospitals with limited resources and poor funding. It was inspiring to see their ability to improvise.

I was honoured to be an Invited Speaker in Sao Paulo at the 34th Annual Meeting of the Brazilian Neurosurgical Society. It was well organised with very high-quality talks, lovely people and a beautiful country.

We can all give those less fortunate the gift of our own time – time to listen, learn, impart our knowledge and skills to make the world a better place - Dr Charlie Teo

Leader of our research programs

I’d like to introduce our Head of Research who leads our brain cancer research programs. Peter proactively searches the world identifying brilliant brain cancer researchers for grant funding. It’s a HUGE task! 

Peter Truong, PhD - Head of Research

Peter is pictured here together with the entire Charlie Teo Foundation team of staff!

Peter joined us in June this year following five years at the Lowy Cancer Research Centre at the University of New South Wales. Previously to that he was a scientist at the Institute for Research in Immunology and Cancer in Montreal and Sanofi Pasteur Toronto.

As a researcher, Peter specialised in utilising genetic engineering approaches to discover novel therapies for leukaemia. Peter was awarded a prestigious abstract achievement award by the American Society of Hematology in 2022.

Peter has now turned his total focus to brain cancer! Read more below about Peter’s recent hard work to empower our funded scientists to advance treatments for brain cancer. 

Grant Announcement

Brain cancer is a global issue that affects people from all walks of life, regardless of their nationality or ethnicity. It is a shared burden across continents that demands a collective, unified and global response.

We are proud to officially announce our newest grant recipient! 

Professor Irina Balyasnikova, U.S.

We have just awarded Prof Balyasnikova from Northwestern University a better tools grant of $AUD 371,925

Prof Balyasnikova is at the forefront of a revolutionary non-invasive imaging technique. This project aims to transform the monitoring of immunotherapy response in GBM patients.

Presently, evaluating how a tumour responds to therapy relies on standard imaging methods like CT scans and MRIs

Unfortunately, these scans often fall short, leaving clinicians uncertain about whether a tumour is responding positively, progressing, or displaying pseudoprogression—where tumour features imitate progression but actually indicate positive therapeutic outcomes.

Distinguishing between pseudoprogression and real progression in cancer treatment is like navigating changing weather conditions. Pseudoprogression is like a passing storm, creating temporary illusions of disease progression. In contrast, real progression is more like a lasting shift in climate, indicating genuine and enduring progress. Just as a brief rain shower does not dictate long-term weather patterns, pseudoprogression may resolve without actual tumour growth. Recognising real progression suggests a substantial and potentially more significant transformation in the disease landscape.

Prof. Balyasnikova’s innovative imaging tool promises clinicians and researchers not only a more reliable but also an earlier indication of therapy effectiveness. This ensures timely adjustments to treatment plans, avoiding unnecessary delays. By incorporating an effective early monitoring program, we can provide patients with the gift of time, enabling a seamless transition to alternative therapies and enhancing the proactive and engaging approach to caring for brain cancer patients.

Brain cancer is a global issue that affects people from all walks of life, regardless of nationality or ethnicity. It is a shared burden across continents that demands a collective, unified and global response.

Progress & Impact

Here’s a snapshot from our Head of Research, Peter Truong, PhD, of some recent progress showcasing the impact of Charlie Teo Foundation global mission to cure brain cancer!

Recent Brain Cancer Research Panel

Two weeks ago, Richard Wilkins AM, proud ambassador of the Charlie Teo Foundation, led an enlightening discussion with brilliant brain cancer researchers supported by funding from the Charlie Teo Foundation.
 
Insights were shared by Prof Joseph Powell and Dr Ashraf Zaman of the Garvan Institute of Medical Research, and Prof Jeff Holst and Dr Sylvia Chung from the University of New South Wales.
 
We loved hearing their message of HOPE to patients and families, about how scientists cope with failure, the need for global collaborations, latest technological advancements and what drives their quest for scientific answers.

Dr Kristina Cook, Australia

In 2020, we awarded Dr Cook from the University of Sydney a Research Rebel grant to investigate the relationship between circadian rhythms, hypoxia and GBM.

We were thrilled to hear from Kristina that thanks to our grant funding, we have empowered her to focus on brain cancer for the long run! 

Consider circadian rhythms as the body’s daily symphony, orchestrating all bodily functions in perfect harmony and timing. Each cell adheres to an internal ‘molecular clock,’ synchronized by a ‘master conductor’ in the brain. GBM disrupts this symphony, acting as a rogue musician that capitalises on the resulting disharmony, making it more invasive and lethal. A key factor behind this disruption is the brain tumour’s creation of a low-oxygen environment known as hypoxia, comparable to how inadequate stage lighting affects an orchestra’s unity. If the lighting is too dim, musicians may miss cues from the conductor, causing them to fall out of sync.

Brain cancer resesarchers including Joseph and Kristina (first and second from left) with Charlie at our Bright Night Event

With our funding, Kristina’s research strived to restore harmony in this process by understanding how circadian rhythms and hypoxia contribute to GBM progression. She has unearthed novel insights into how GBM cells co-opt these rhythms to alter cell metabolism, allowing them to outgrow healthy tissue. 

Collaborating with Charlie Teo Foundation funded researcher, Prof Steve Kay, she demonstrated that novel circadian rhythm drugs can reverse these metabolic advantages and offer a potential new modality of treating GBM. 

By analysing large clinical datasets, she uncovered novel genetic findings explaining the observed circadian and metabolic dysregulation. These findings are significant as they could also explain how GBM develops from normal tissue, and offer a new framework for drug development.

I am very grateful for the Charlie Teo Foundation's support. My work in brain cancer would not have been possible without their funding and because of this, I plan to continue working in brain cancer for the long run - Dr Kristina Cook, Scientist

Prof Peter Fecci, U.S.

In 2021, we awarded Prof Fecci from Duke University a More Data grant in immunotherapy. A groundbreaking treatment using the body’s immune response to target tumours, immunotherapies have shown transformative potential, but impact on brain tumours remains limited. 
 
Prof Fecci’s laboratory discovered a crucial obstacle. The essential immune soldiers – T-cells crucial for battling tumours – are confined within the bone marrow and absent from the brain tumour site. This revelation highlights a key factor hindering the effectiveness of immunotherapy advances in treating brain tumours.
 

Imagine the bone marrow as a bustling airport, where T-cells are eager travellers ready for a mission. Yet in GBM, these vital immune soldiers are redirected to an isolated and locked departure gate within the airport, away from the tumour battle. The brain, acting like an overprotective air traffic controller, signals to keep these T-cells confined, preventing them from boarding the ‘planes’ of immunotherapy waiting on the treatment runway.

With our funding, the Fecci laboratory unravelled the molecular pathways locking T-cells in the bone marrow. By liberating these immune warriors, they were able to transform previously ineffective immunotherapies into powerful weapons. 

The team also discovered GBMs can manipulate the brain to release specific hormones causing T-cells to hide in the marrow. While efforts to develop specific drugs to free T-cells are underway, the Fecci laboratory are also exploring the usage of existing hormone-blockers to overcome this challenge, aiming to reopen the gates and unleash T-cell passengers, allowing immunotherapies to effectively combat GBM and offering the gift of time.

Prof Joseph Powell, Australia

Charlie Teo Foundation’s collaborative research with the Garvan Institute of Medical Research led by Prof Joseph Powell has gone from strength-to-strength over the last four years.

Think of brain cancer as a beehive, where different types of cells have different roles and functions, representative of the heterogeneity that underlies these complex tumours. Some cells are like worker bees, who do most of the work and are easy to kill. Some cells are like drone bees, who are only there for reproduction and are kicked out in winter. But the most dangerous cell is the glioma stem cell, which is like the queen bee. It can sustain the hive through producing more cells, resist traditional treatments, and escape to form new tumours. To cure brain cancer, we need more data to accurately identify and specifically target the queen bee of the tumour.

But the queen bee is hard to find, as it can hide and change among the other cells. We need advanced tools called single cell technologies, which can analyse each cell within a tumour and reveal its identity and features. Think of single-cell technologies as a detective meticulously examining every person in a bustling city crowd to find one elusive individual. This approach allows us to uncover the hidden identities and behaviors of glioma stem cells, paving the way for more effective and personalised treatments.

The Powell laboratory has successfully used single cell sequencing technology, on hundreds of brain tumours from Charlie Teo Foundation’s Brain Tumour Biobank to create one of the world’s largest brain tumour datasets. Through this impressive body of work, the Powell laboratory has uncovered individual cell identities within a brain tumour at an unprecedented resolution, including the highly elusive glioma stem cell, which will provide better insight on how we can develop more specific therapies for brain cancer.

Prof Matt Dun, Australia

We were honoured to attend the Dun Lab at the University of Newcastle in late November for a personal update from Prof Matt Dun. Scientists, DIPG families and philanthropic funders like the Charlie Teo Foundation all came together for a common goal – to give more time to children diagnosed with the most lethal childhood cancer in the world, DIPG.

In partnership with the Little Legs Foundation, we awarded Matt his first research grant in 2019 to study DIPG. 

This grant was awarded in the same month that Matt’s daughter Josephine was sadly taken by DIPG. Since then, Matt has made it his life mission to find better treatments for this devastating disease. 

Read our recent update on the outcomes of our first grant awarded to Matt. 

Hundreds of brain tumours from our Brain Tumour Biobank have led to the creation of one of the world’s largest brain tumour datasets

Australian cricket legends Steve Waugh & Gavin Robertson with Charlie Teo, Mick Dover, Peta Dover, Rugby League Legend Benny Elias and Charlie Teo Foundation Ambassador Richard Wilkins

This Giving Season, our corporate partner and regular donor, Cook’s Plumbing Supplies, are generously matching every donation up to $10,000 until my birthday on 24th December!!! 

I am proud to call their Managing Director, Mick Dover and Peta Dover my great friends!!!

Cook’s Plumbing Supplies is an incredible family owned and operated business, with doors first opening to Sydney’s plumbing trade in 1969. They have been a loyal, regular donor to the Charlie Teo Foundation since 2018, having contributed over HALF A MILLION dollars to crucial brain cancer research.

I urge you to think of others less fortunate this December and Give the Gift of Time to people with brain cancer. By doing so, you’ll enjoy your down time, your families and your blessings so much more. 

Lots of love to you all. Have a wonderful festive season.

Xx

Charlie

Charlie

Dr Charlie Teo AM
Founder