Pioneering care for patients facing cancer surgery: Dr Julia Dubowitz
3 min read 16 June 2025
Specialist anaesthetist Dr Julia Dubowitz shares her hopes to improve surgical outcomes for cancer patients globally, and how support from Peter Mac Cancer Foundation is helping to provide the time and resources to make it happen.
Providing meticulous and considerate care for her patients is what drives clinical and research anaesthetist, Dr Julia Dubowitz.
“People joke that anaesthetists don’t like to talk to their patients, because you want them to be asleep”, Julia says. “But they only sleep for the operations.”
Julia explains that she first meets her patients about half an hour before their surgery – a tiny window in which to build rapport with someone who may feel scared, anxious and frustrated.
“You’ve got 30 minutes to build the trust that you’re going to put them to sleep, breathe for them, keep them alive, keep them safe. I think it’s a real privilege and a special skill to connect with patients in such a short matter of time and build that rapport.”
Patient-centred care is what motivated Julia to complete a PhD in Oncoanaesthesia – a specialised field that focuses on the unique needs of cancer patients facing surgical procedures.
Today, her post-doctoral research continues to focus on interventions in the perioperative period to improve patient recovery and long-term cancer outcomes.
“Patients are vulnerable, and it’s our responsibility to offer them nothing but the best. To do that, you need ongoing research to answer the questions that we still haven’t answered.”
“We can do better, and when the impact is the survival of cancer patients, there’s no excuse than to do the best with every part of our perioperative care – before, during and after surgery.”
Receiving a Discovery Partner Fellowship from the Peter Mac Cancer Foundation means Julia can advance her research to reduce complications in cancer surgeries, and help patients recover better. It’s vital work that could make a big difference in how patients respond to their cancer treatments.
Minimising stress during surgery
“Cancer touches everyone”, says Julia. “Most people have been affected by cancer, either a family member or a friend.”
For Julia, Peter Mac represents the epitome of holistic cancer care.
“Peter Mac is a place where you know you're going to be part of a team that is working every day doing what we do clinically, but also being part of a bigger picture that's trying to improve the lives of patients with cancer,” she says.
“It’s not just a hospital, it's a program of care to support patients through their cancer journey.”
To further assist her patients, Julia is using the fellowship to explore ways to minimise the stress response the body undergoes during surgery.
Surgery remains the primary treatment for many solid cancers, but major surgery places the body under significant stress.
“There's a stress response to surgery, which is normal. Like when you cut yourself - the body springs into action to get all the blood cells and clotting factors working to clear the damage and heal the tissue. We want the body to heal and then settle back down, because that's really important for getting patients back up on their feet and moving after surgery.”
This is critical for cancer patients, with about 60 percent needing surgery as part of their treatment. Of these patients, up to 25 percent can experience complications that can delay or impair their recovery, quality of life, and importantly, their ability to receive other life-saving cancer therapies.
It’s thought that if the body's stress response can be reduced, this will improve outcomes for patients who go on to receive other treatments like immunotherapy.
The Discovery Partner fellowship is providing support for Julia to identify which patients are more likely to respond to surgery in an inflammatory way, and which drug interventions might help reduce this inflammation.
Multi-purpose medications
The medications Julia and her team are testing to help reduce stress in the body are cheap, readily available, and commonly used in everyday practice.
If they can demonstrate that these medications improve outcomes, the benefits could have far-reaching benefits for patients here in Australia and in countries where immunotherapy drugs may be out of reach.
“The ability to help patients globally with our interventions is massive,” Julia says.
Some of the drugs they are looking at are beta blockers similar to Nurofen used through a drip during and after surgery directly blocking the inflammation and the adrenergic sympathetic nervous system pathways.
Another is lignocaine, a local anaesthetic drug, used as an infusion rather than an injection. It’s been shown to have significant anti-inflammatory effects and may help to modulate the body's immune response.
The final intervention Julia and her team are exploring involves using the flu vaccine to boost the immune system.
“We're doing a pilot where we're using the flu vaccine and some immune-nutrition drinks containing arginine, which is an amino acid,” Julia explains.
The essential amino acid is used in a form like Gatorade powder, and it’s thought that it can help prime the innate cells of the immune system, and inflammatory cells that come into action at the time of surgery.
“If we can boost the good immune cells at the time of surgery then we might be able to reduce the immunosuppression that patients experience.”
The gift of time
Julia describes balancing clinical work and research as a constant juggling act.
“I have a certain commitment to clinical care, but then I’m also trying to squeeze in meetings and writing papers and applying for grants,” she says.
“One grant can require 10 to 20 hours of work, so if you’re applying for five or six a year that’s up to 120 hours. It adds up, but you just squeeze those hours in – when you’re eating your lunch, on weekends, late at night after you’ve put the kids to bed.”
“Sometimes you might plan to sit and write for two hours, and then you’re stuck in the operating theatre and you can’t get it done. The reality is that clinical care will always trump what you’re doing in research. But now I have time. This fellowship is going to open up so many opportunities over the next five years. I can get the ball rolling and really start to achieve something.”
Ultimately, while the end goal would be for cancer patients not to need surgery, the more realistic goal for Julia is that if patients still require it as a treatment option, then “it’s nothing more than a 24-hour blip in the cancer journey”.
“We don't want what happens in surgery to be the make-or-break moment for cancer cells to spread or develop or breakthrough into metastatic disease that could be fatal for a patient,” she says.
Julia explains that while we’ve made significant strides in improving cancer treatment, many patients will develop cancer again, with metastatic disease accounting for 90 percent of cancer-related deaths overall.
“I want to see cheap, affordable, safe, evidence-based interventions and a pathway of perioperative care for cancer patients that we can develop and roll out at Peter Mac, at Royal Melbourne, at Ballarat Hospital or Uganda Hospital.”
With your help
Finding better ways to treat patients requires research and that needs time and funding. That’s why support from generous donors is critical for programs like Julia’s, which support the “humdrum of research that occurs in the background”.
“Without that continually ticking along and cutting down questions as you go, you're not going to get through the wealth of information that exists,” she says.
“It’s humbling to receive a Discovery Partner fellowship at this stage of my career. It’s a real boost of confidence too, to have people believe in you and trust the vision of what you can achieve in the next few years.”
Julia says receiving the Fellowship is a recognition from Peter Mac and the Foundation that anaesthesia is a key part of the care of cancer patients.
“We can do really important work and develop the best quality cancer care by being innovative and pushing the boundaries of research to see what we can discover for our patients.”
She says supporters like Peter Mac’s Discovery Partners are an important piece of the puzzle and they shouldn't underestimate the impact of their support.
“Everyone is trying to live and care for their families and pay their mortgages, and philanthropy for research comes at the end of that. For people to take what they have left and altruistically give that away just speaks so highly of the type of people they are.”
“It’s a testament to their optimism for the future - that they are so generous on such a consistent and ongoing basis.”
Our wonderful Discovery Partners make regular monthly donations to Peter Mac to fund life-changing research like Julia's.
By making a donation to the Peter MacCallum Cancer Foundation, you can help other early or mid-career researchers like Julia continue their vital work to help improve outcomes for people facing cancer.
Become a Discovery Partner to support cancer research like Julia's
