ProfNicolas Hart

Cancer Patient Navigation - (Australian Cancer Plan and Nurse Navigation)
In 2022/23, I co-led a commissioned report for Cancer Australia on cancer patient navigation that was subsequently published as an authoritative paper (where I was senior author) presenting an overview of systematic reviews and emerging literature on Cancer Patient Navigation that informed the Australian Cancer Plan (Strategic Objective 2) and was co-authored with Cancer Australia. This was published in the worlds’ top-ranked journal – CA: A Cancer Journal for Clinicians (with an impact factor of 521.6). This led to an historic Federal government funding announcement for cancer nurses as a cornerstone workforce for the Australian Cancer Nursing and Navigation Program. Subsequently, the lead and senior authors (Professor Raymond Chan and I) were interviewed by the Lancet Oncology to discuss this historic investment. Specifically, we describe the focus of cancer patient navigation to directly focus on systems and individuals to reduce barriers of access to quality care and thus eliminate inequities of cancer treatment and cancer outcomes. This has led to the establishment of two international interrelated programs of work: 1) Global Initiative for Navigation in Oncology (GINO), funded by Novartis, delivered through the Multinational Association for Supportive Care in Cancer; and 2) Global Alliance for Patient Navigation in Cancer, led by the American Cancer Society, with the University of Technology Sydney as a key global partner and member of this consortia, focusing on developing practice frameworks and guidance for resource stratified patient navigation (education, competencies, models of navigation, and workforce) worldwide. 

World Health Organisation - (Package of Interventions for Cancer Rehabilitation)
In 2023/24, I co-produced a global package of interventions for cancer rehabilitation with the World Health Organization as one of only two Australian experts selected for this honourable role. This product provides information relating to 26 assessments and 48 interventions within 14 functioning domains and 3 secondary condition domains relevant to most people living with cancer and considered cost–effective and feasible to deliver in low- and middle-resource contexts, even if implementation requires strengthening rehabilitation workforce in these countries. This has been distributed to all 194 Member States of WHO and their health ministry’s worldwide, embedded within the World Rehabilitation Alliance. Furthermore, this product was endorsed by MASCC (the Multinational Association of Supportive Care in Cancer) that I co-authored with WHO, and aligned with MASCC’s Supportive Care Ambition 2030; and was also endorsed by IPOS (the International Psycho-Oncology Society) that I also co-authored. This has led to the establishment of two new WHO Technical Working Groups to (1) develop Global Standards for Rehabilitation Services; and (2) establishing global costing of breast cancer rehabilitation services as next iterations of this important work during 2025 and 2026. Concurrently, across 2026 and 2027, I am co-mentoring COSA Fellow (Dr Alanah Pike) to support the implementation of the WHO Package of Interventions for Cancer Rehabilitation into the Solomon Islands. In addition, I am engaged within the World Rehabilitation Alliance (a WHO-hosted network) representing MASCC to advance primary care, research, and workforce development.

Global Survivorship Care Standards for Advanced or Metastatic Cancer (MASCC-ASCO)
In 2023/24, I led the development of the worlds’ first global set of survivorship care standards and practice recommendations for people affected by advanced or metastatic cancer on behalf of MASCC and ASCO. This product describes best-practice care for these cancer survivors, with actions for people at all levels of the healthcare system (i.e., governments, policymakers, healthcare administrators and leaders, healthcare professionals, cancer survivors, and caregivers). I funded 14 language translations and developed a clinician toolkit including a pocketbook. This has recently been endorsed by COSA (the Clinical Oncology Society of Australia) to be published in the Asia-Pacific Journal of Clinical Oncology. This work has received widespread media attention across 11 news articles and 3 podcast interviews, and has been issued an invited presentation at the 2025 ASCO Annual Meeting in Chicago, IL, USA. The next phase(s) of this work are to develop global research priorities to improve survivorship care for people affected by advanced or metastatic cancer, and to establish an evaluation (self-assessment) tool for clinicians, health service administrators, and cancer survivors to determine the standard of care they are currently providing or receiving (and thus enable collaborative abilities to enhance the quality of survivorship care for these people through raised awareness and increased investment, education, and training). This collection of work and outcomes has extended upon the inaugural MASCC Terry Langbaum Survivorship Fellows, to the establishment of a further four funded MASCC Terry Langbaum Fellowships (2026 to 2027) focusing on addressing areas affected people with advanced or metastatic cancer across emerging toxicities, culturally diversity, exercise oncology, and survivorship; of which I am lead mentor, overseeing the entire process.

Clinical Exercise Guidelines for People with Advanced Cancer and Bone Metastases

Funded by the Cancer Council, National Breast Cancer Foundation, and Movember Foundation, I designed and delivered two world-first trials providing multi-modal targeted exercise to people with advanced prostate cancer and sclerotic bone metastases or advanced breast cancer and osteolytic bone metastases. These trials informed the design and evolution of a global Phase III randomised controlled trial (INTERVAL-GAP4 to examine whether exercise improves survival in advanced prostate cancer, for which I was the global exercise coordinator. These works changed clinical practice, and led to co-authoring the worlds’ first clinical recommendations for the provision of safe and effective exercise for people with bone metastases endorsed by 10 global cancer societies or exercise associations (ACSM, BCNA, COSA, CEPA, CSEP, ESSA, MOGA, MASCC, PCFA, SESNZ). Following on from this, in 2024 and 2025, to promote knowledge translation and guideline adoption, I supported Professor Kristin Campbell to develop and promote the BME Hub (Bone Metastases and Exercise Hub) which has clinician suitable, and patient accessible, resources that have been translated to several languages. Now, I am an NHMRC Investigator Fellow seeking to improve outcomes for people with bone metastases; and lead mentor for two MASCC Emerging Leader Fellows in 2025 to 2027 - (Dr Jordan Curry and Dr Shirin Shallwani) to examine the implementation (adoption and adaptation) of these clinical exercise guidelines in real-world practice; and to further explore the barriers and facilitators to exercise adoption by people with advanced cancer more broadly.