Meet Sue Haupt, Research Associate, Women's Health Program, The George Institute

At the end of her secondary schooling, Sue Haupt faced a choice between two very different passions – pursuing her love of art via a graphic design degree or following an equally powerful pull into science.

“I told the design school, ‘I’m choosing science, because I want to give it a shot’, and they said, ‘Come back to us when you're bored with science.’ Well, I never got bored - science just got me in.”

One double-major in biochemistry and botany, many hours of lab- and field-work, and multiple publications later, it’s clear where Sue’s destiny lay!

An interest in humanitarian-based work led her to securing Australian aid funding for field work in India - central to her PhD based at ANU - studying the genetics of a particular fungus, which produces toxins in crops that are potent activators of liver cancer in the presence of hepatitis B.

“This fungus is a huge problem in areas with poverty, where people sell their best quality crops and consume what’s left, which tends not to be properly stored or screened for the toxins. As hepatitis is prevalent in these communities as well, they’re particularly vulnerable to developing liver cancer.”

This initial link to cancer research has been a thread in her later work.

Sue continued her overseas research in biochemistry and human diseases caused by parasites for some years, and in developing drug delivery platforms, including for cancer. Returning to Australia from her various travels, Sue found her learnings about cancer were converging with that of her husband, Ygal.

“My husband is a cancer researcher, and he was working on the major molecule that defends the body against cancer. To cut a long story short, the fungus toxins I’d studied were actually causing mutations in this same molecule. It's got the humble name of p53 and is also known as the ‘guardian of the genome’, because it kicks in to prevent genetic damage flowing into the next generation of cells.”

In setting up animal models to better understand how the p53 protein suppresses tumours, Sue’s research turned up yet another fascinating twist – this time in the way cancer operates in males compared to females. This is an area she is now exploring further in her current role at The George Institute, where Sue started work in March 2023.

“I started to see differences between male and female mice in longevity and disease burden, which at the time I had not heard anyone talking about. I began digging into the literature and, just the year before, somebody had analysed human cancer data and realised that there are disparities between men and women in incidence, morbidity and mortality in cancers of the non-reproductive organs.

“I figured that chromosomes could also be influencing our tendency to develop cancer in disparate ways. So, with colleagues in Australia and overseas, we formed a group and just started to pull this thought apart and came to some really interesting findings on how this major tumour suppressor actually partners with molecules on the X chromosome, of which females have two and males only have one.”

This work was published in Nature Communications, which then invited Sue and her team to write a Perspective article in Nature Reviews Cancer – this became a COVID lockdown project.

“We looked at what could be a molecular basis for these differences, and then at the ramifications for treatments that are given without consideration of whether the patient is male or female for example, radiation, where there have been some studies.”    

Sue feels that while there is an increasing appreciation of the need to consider the sex of patients for treatment, rigorous studies need to be set up specifically to examine the effect of sex and gender including for treatments like chemotherapy and immunotherapy. 

“The George Institute is taking a lead in how sex and gender impact health outcomes. It has come at this through stroke and cardiovascular disease, where it’s been shown that women are not necessarily presenting with the same symptoms as men, leading to women being frequently misdiagnosed and under-treated.

“I'm very excited to bring my fundamental research observations in cancer to The George Institute, to cover more diseases areas on sex and gender based on our collective knowledge, and for this to inform actual policy recommendations across the entire sector.

“And I couldn't be more passionate about it. It’s amazing to go from that microscopic level to the macro and be finding ways to encourage governments to introduce sex and gender considerations as routine in health and medical research.”

According to Sue, there is a great potential to improve knowledge through better-constructed trials, but also to raise awareness that sex and gender differences in cancers and treatment is even ‘a thing’.

“It has just been assumed there is no difference; it's not generally taught, and I think that's what must change. There has to be awareness and education, and then a real understanding of how to go about the analyses and the experiments in a proper way, which requires a lot of training that people just haven't had.

“And awareness is beginning to grow now, because more and more papers are coming out internationally that are identifying these differences. But it's still not something that's automatically considered nor included in the curriculum for people studying medical research, and we need to change that.”

Learn more about The George Institute’s work in Improving health care outcomes through sex and gender policies in health and medical research