Life demands excellence
magazine – spring 2014
Fully equipped How our new scanners put The Royal Marsden at the cutting edge of cancer diagnostics
The women at the forefront of research How GPs learn from our expertise
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At The Royal Marsden, we deal with cancer every day, so we understand how valuable life is. And when people entrust their lives to us, they have the right to demand the very best. That’s why the pursuit of excellence lies at the heart of everything we do.
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Executive notes
Contents 12 Equipped to excel
Unveiling the new Reuben Imaging Centre in Chelsea
16 Combined efforts
Highlighting the work of our Cancer Therapeutics team
18 Sharing our expertise How our education series is proving a hit with the UK’s GPs
20 Making their mark
We talk to five women taking giant steps in cancer research
24 A day in the life
Meet Carol West, Healthcare Assistant on Oak Ward
Regulars 04 Hospital news 23 The Friends & PCAG 26 Fundraising 28 Foundation news 30 Puzzles & prizes
Cover photograph: Superintendent Radiographer Cheryl Richardson scans a patient in the Reuben Imaging Centre at The Royal Marsden’s Chelsea site
Welcome
Welcome to the spring 2014 edition of RM, the magazine for our staff, patients, carers and Foundation Trust members. In this issue, we take a look at our new Reuben Imaging Centre (page 12) at our Chelsea site. The combination of two new MRI scanners and two CT machines will allow us to offer our patients the very best diagnostic imaging. It is thanks to supporters of The Royal Marsden Cancer Charity, in particular a gift from The Reuben Foundation, that we were able to fund the two MRI scanners, ensuring we can continue to provide care over and above NHS standards. Our work with GPs is continuing, particularly through the GP Education Series (page 18), a programme of events and online learning opportunities that allows us to contribute to GP’s professional development by sharing some of our expertise and knowledge. We use feedback from GPs to continually improve and expand the content of our training days and website information, and ensure they feel as supported as possible when diagnosing possible cancer patients. Late last year, The Royal Marsden Cancer Charity joined forces with The O2 and its ticketing platform AXS.com in a groundbreaking charity partnership, where visitors will be encouraged to make donations. The O2 is a leading international brand and we are pleased to be on board as an official charity partner. I hope you enjoy reading this issue of RM.
Cally Palmer CBE, Chief Executive, The Royal Marsden
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HOSPITAL NEWS
Professor Nazneen Rahman (right) and Dr Clare Turnbull of The Royal Marsden’s Cancer Genetics Unit and The Institute of Cancer Research
ROYAL MARSDEN PILOTS NEW GENE-TESTING PATHWAY T
he Royal Marsden has completed a six-month pilot of a new ‘oncogenetic’ gene-testing pathway that is much faster and less costly than standard pathways, with more than 100 patients benefiting from BRCA1 and BRCA2 gene tests since the pilot began in July 2013. The oncogenetic pathway brings gene testing to the patient through their existing oncology appointments, allowing more people to have access to these tests. Previously, patients could only have a gene test via referral to genetics departments. Oncologists can order gene tests for eligible patients directly, but also retain the flexibility to refer them to geneticists. Any patient found to have a gene
mutation is seen by a geneticist; those with normal results can be referred in the standard manner, if required. The gene testing was performed by TGLclinical, a laboratory established with funding from The Royal Marsden Cancer Charity and The Institute of Cancer Research (ICR). TGLclinical’s state-of-the-art gene-sequencing equipment can perform more tests faster and at a lower cost than traditional methods. The new laboratory test and clinical testing pathway are now ready for roll-out to other hospitals, and a second pilot involving more centres is being planned. Professor Nazneen Rahman, Head of the Cancer Genetics Unit at The Royal Marsden and
Head of Genetics at the ICR, said: “Using new sequencing technologies and the oncogenetic testing pathway, we can make gene testing accessible to many more people. We are delighted that the feedback from patients and clinicians in the pilot has been overwhelmingly positive.” In 2013, the National Institute for Health and Care Excellence (NICE) recommended that people with a more than 10 per cent chance of having a mutation in either the BRCA1 or BRCA2 gene – which equates to more than 10,000 cancer patients a year – should be offered testing. However, limited capacity and the high costs of traditional gene-testing pathways limits the testing that doctors can provide.
Professor Rahman said: “The oncogenetic gene-testing pathway could be used to deliver the NICE recommendations cost-effectively. Ultimately, we hope that the clinical and technological advancements we are developing will benefit patients anywhere in the NHS.” Professor Martin Gore, Medical Director of The Royal Marsden and one of the Consultant Medical Oncologists who participated in the pilot, said: “Knowing whether a patient has a gene mutation is an important part of making personalised treatment plans. Patients are also increasingly aware of the value of gene testing, and more are requesting it. “The oncogenetic pathway makes gene testing quicker and simpler, but still provides input from genetics when we need it. Many of our patients have already benefited as a result of being able to have a gene test. The Royal Marsden is delighted that we can offer this testing to our patients.”
New technologies and the oncogenetic testing pathway make gene testing accessible to many more people PROFESSOR NAZNEEN RAHMAN, HEAD OF THE CANCER GENETICS UNIT AT THE ROYAL MARSDEN
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This photograph: surgeons Mr John Butler, Mr Des Barton and Ms Marielle Nobbenhuis using the PlasmaJet on a patient with ovarian cancer. Below: the surgical team with the PlasmaJet machine
NEW TECHNOLOGY TO TACKLE OVARIAN CANCER T
he Royal Marsden is one of the first UK centres to use a new high-energy surgical device for women with advanced ovarian cancer. Introduced at the hospital by Mr Des Barton, Consultant Gynaecological Surgeon, the PlasmaJet device uses the plasma energy from ionised argon gas to cut through and dissect tissue, stop bleeding and destroy cancer cells safely. Unlike most other energy devices used in surgery, it can destroy cells on the surface of organs and tissue with minimal collateral effect. In particular, the PlasmaJet has applications in advanced ovarian cancer, where the disease is typically in multiple nodules or ‘sheets’ on the surface of organs and tissue in the abdomen and pelvis. After a trial
period at The Royal Marsden to assess its applicability, safety and efficacy in ovarian cancer, it is now an essential part of the hospital’s surgical apparatus. Ms Marielle Nobbenhuis, Honorary Consultant Gynaecological Surgeon, said: “During PlasmaJet surgery, cancer cells are removed from structures such as the bowel and diaphragm, without causing damage to the surrounding tissue. This means there is often no need to resect or remove the tissue in these areas. “Previously, many women undergoing extensive surgery for ovarian cancer had to have parts of their bowel removed in order to eradicate the disease. Extensive removal of bowel tissue can mean that a stoma is required, which has a serious
impact on a patient’s quality of life after their surgery and the amount of time they need to spend in hospital afterwards. “There is a clear correlation between the amount of residual visible disease following ovarian cancer surgery and the patient’s survival. With the PlasmaJet, not only can we completely remove or destroy all visible disease, there is less need for bowel resection. This has the most impact on improving the survival time and offers the
potential for actually curing these patients.” The Royal Marsden’s experience with the PlasmaJet device was presented at an international meeting last year. Ms Nobbenhuis said: “No other surgical device can safely remove and destroy the same amount of cancer cells. At The Royal Marsden, a leading centre for the management of ovarian cancer, we are starting to deliver improved outcomes for patients with advanced disease.”
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Hospital news
Q&A: NIHR funding What is the NIHR? The National Institute for Health Research (NIHR) was set up by the Department of Health to improve the health and wealth of the nation through research. Its mission is to maintain a health research system in which the NHS supports outstanding individuals working in world-class facilities, conducting leadingedge research focused on the needs of patients and the public. What is a NIHR Biomedical Research Centre (BRC)? In 2007, the NIHR set up BRCs at the most outstanding NHS– university partnerships in the UK, to drive forward innovation and translate research from the university to the clinic. What does this mean for The Royal Marsden and The Institute of Cancer Research (ICR)? The Royal Marsden and the ICR were among the first wave of BRCs to be established in 2007 and were re-awarded BRC status in 2012. The £12-million funding we receive each year is essential to our work in developing new technologies and therapies for patients, based on the latest groundbreaking science. How does the Patient and Public Involvement (PPI) strategy contribute to The Royal Marsden BRC’s research? Input from patients and the public is crucial. We have a dedicated patient representative on our BRC Steering Committee who informs our funding decisions. We also have patient input into our communication strategy, so we get the right information out to patients and the public in the most effective way.
Dr Justin Roe
PATIENT PANEL HELPS PRIORITISE NIHR-FUNDED RESEARCH R oyal Marsden patients and the public have become instrumental in helping us improve the way we design and run research trials at our specialist Biomedical Research Centre, funded by the National Institute for Health Research (NIHR). The Patient and Public Involvement (PPI) panel – comprising up to 20 lay members of the public and our patients – meets four times a year and has given researchers valuable feedback on how to explain our research trials in leaflets designed for participating patients. Dr Justin Roe, Joint Head of Speech & Language Therapy and AHP Researcher – Project Lead, presented to the panel last year on two projects, including a research study
looking at swallowing difficulties in patients with head and neck cancer. He said: “The panel, some of whom have experience with this type of cancer, were able to provide input on when the problems occur and their views of the study.” Martin Lee, a Royal Marsden patient and a member of the PPI panel presented to by Dr Roe, said: “I think it is very important that patients are involved with research because it is us who will benefit from the results in the long run. “I was treated for mouth cancer and, for me, the rehabilitation is paramount. We are lucky that survival rates are improving, but it means people are living longer with the side effects of treatment, so it is vital that we are listened to. I feel the PPI panel has offered patients
like me a voice on shaping the way research is carried out for the benefit of future patients.” Dr Natalie Pattison, Senior Clinical Nursing Research Fellow and Trust Lead for PPI, said: “The panel’s advice is really helping The Royal Marsden to focus on what research is important to our patients.”
It is important that patients are involved with research because it is us who will benefit MARTIN LEE, ROYAL MARSDEN PATIENT
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Hospital news
UK APPROVAL FOR RADIUM-223 DRUG Lifetime achievement award for Royal Marsden pioneer
Dr Chris Parker (right) led the trial of Xofigo at The Royal Marsden
new drug trialled at The Royal Marsden for men with advanced prostate cancer has been given approval for use in the UK. Xofigo (radium-223 dichloride), which has been hailed as a “huge step forward”, is now available for the treatment of men with castrationresistant prostate cancer (CRPC) who have symptomatic bone metastases. The drug was so successful in the trial phase that it was stopped early once it became clear that the drug was effective. The drug not only enabled men to live longer but also reduced their side effects and pain, giving them a better quality of life. This announcement follows a positive recommendation from the European Medical Agency’s Committee for Medicinal Products for Human Use and the marketing authorisation for Xofigo by the European Commission, based on data from the Phase III ALSYMPCA study. Dr Chris Parker, Principal Investigator of the ALSYMPCA trial and Consultant Clinical Oncologist at The Royal Marsden, called the approval a “huge step forward” for prostate cancer patients. “The majority of men who develop castrationresistant prostate cancer will develop
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bone metastases, which can be painful and even life-threatening. Until now, treatment for bone secondaries has been limited to symptom control, rather than improving survival. The source of radiation, radium-223, acts like calcium and sticks to the bone, targeting the tumours and enabling men to live longer and experience less pain and fewer side effects. There are many men with this disease who will now benefit from the availability of radium-223.” On average, 10 to 20 per cent of prostate cancer patients develop CRPC within approximately five years of follow-up, and of those, almost 84 per cent have metastatic disease at the time of diagnosis.
Professor Maggie Watson has won the International PsychoOncology Society (IPOS) Arthur M. Sutherland Award for lifetime achievement in the field of psycho-oncology. She was presented with the award at the 15th World Congress of PsychoOncology in Rotterdam in November. “I am very honoured to have received this international award,” she said. “It is an important recognition by my professional peers throughout the world that I have made a substantive contribution to the development of psychosocial care of cancer patients and their families.” The IPOS is dedicated to fostering the science of psychosocial and behavioural oncology and improving the care of cancer patients and their families throughout the world. Professor Watson has worked at The Royal
Marsden since 1986, and currently holds the role of Consultant Clinical Psychologist. She was Head of the Psychological Medicine Service before stepping down in 2011. During her time at the Trust, she has worked to provide psychological care, including setting up the first onsite support groups for breast cancer patients in an English NHS hospital, integrating psychosocial care with cancer genetics, being Trust Lead for mental capacity and launching the first international academic journal. Professor Watson is now working on an honorary basis on the development of a Royal Marsden website to help patients cope with cancer, and continues to provide training workshops internationally for the development of psychosocial care in oncology.
This drug enables men to live longer and experience less pain and fewer side effects DR CHRIS PARKER, CONSULTANT CLINICAL ONCOLOGIST AT THE ROYAL MARSDEN
Professor Maggie Watson receives her award RM MAGAZINE 07
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Hospital news
Five-year-old Harry Parkes received CyberKnife treatment under general anaesthetic
New clinical trials facility coming to Sutton
The Royal Marsden’s new £2.6-million clinical research facility at Sutton is set to open this spring. The unit, which was funded by The Royal Marsden Cancer Charity, is a dedicated space for patients participating in clinical trials. The facility will increase the opportunities for translating early-phase studies conducted in the Trust’s Drug Development Unit into late-phase research. Work has been ongoing over the past year to create the new unit, which is based in the West Wing of the hospital. Professor David Cunningham, Director of Clinical Research, said: “This is an exciting new research facility for The Royal Marsden. The unit will enable the transition of early-research findings into large-scale trials, which is integral to our National Institute for Health Research Biomedical Research Centre strategy. “The facility will increase the amount of research we can do and improve our efficiency. It is an innovative space but it will also be a comfortable environment for patients receiving their treatment.”
THE ROYAL MARSDEN PIONEERS CYBERKNIFE TREATMENT FOR CHILDREN he Royal Marsden has made history by treating a paediatric patient with CyberKnife while he was under general anaesthetic. Five-year-old Harry Parkes was diagnosed with a brain tumour when he was just 15 months old, for which he received treatment with surgery followed by proton therapy in the US. When his tumour relapsed for the second time, the decision was made to treat him using CyberKnife, a state-of-theart machine that can deliver radiotherapy for brain tumours with pinpoint accuracy. Since its introduction at The Royal Marsden, CyberKnife has been used to treat eight paediatric patients – but Harry was the first for whom the treatment required the patient
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to be under general anaesthetic due to their age. This was a logistical challenge for the hospital, as CyberKnife is located at the Chelsea site while our paediatric services are based at Sutton. Preparing for Harry’s 45-minute treatment
Harry is doing really well. The CyberKnife treatment has made such a difference AMANDA COBB, MUM OF FIVE-YEAR-OLD CYBERKNIFE PATIENT HARRY PARKES
was a multidisciplinary effort involving consultants, clinical oncologists, radiographers, nurses, the paediatric oncology team and the paediatric anaesthetics team. Amanda Cobb, Harry’s mum, said: “We are delighted with how it went. Harry is doing really well. The CyberKnife treatment has made such a difference and his balance and speech are better. He is back at school now, and was a shepherd in his school nativity play.” Dr Henry Mandeville, a Consultant Clinical Oncologist who specialises in the treatment of children and young people, planned Harry’s CyberKnife treatment. He said: “It was quite a feat as it was the first time we had treated a paediatric patient using CyberKnife under general anaesthetic. It took a lot of planning and was a real team effort, but it was worth it to see Harry doing well and back at school.” The Royal Marsden is one of only a few NHS hospitals to have a CyberKnife machine. The revolutionary technology uses a robotic arm to deliver multiple radiation beams from almost any angle. Computercontrolled accuracy and tracking technology means that it can deliver treatment that was not previously possible. CyberKnife has X-ray cameras that track the position of the tumour. Sensors monitor the patient’s motions, enabling the robot to reposition the beam in order to minimise damage to healthy tissue and deliver radiotherapy with 1.5mm accuracy. With CyberKnife, the patient undergoes between one and five non-invasive, pain-free treatment sessions lasting from 35 to 90 minutes each.
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Hospital news
Youngest transplant patient returns to say thank you
CCU VALUES DEFINED F or many years, The Royal Marsden has promoted a set of 16 distinct values that help us ensure that patients receive the best possible treatment and care. Following the publication in February 2013 of the Francis Report, which stressed the importance of putting the patient at the centre of care, the Trust has committed to making these values more visible. The Critical Care Unit (CCU) has become one of the first departments at The Royal Marsden to re-evaluate its working culture. It identified four core values that staff members believe are most important to them and what they aspire to be: compassionate, personal, supportive and open. “We are always asking, ‘What can we do better for our
patients?’,” said Sister Keetje Gull. “Sometimes feedback isn’t positive, so we need to listen to this, then make changes. “It all comes down to the patient experience. Like other areas of the Trust, the CCU is helping patients and their families get through what is often a traumatic and difficult time.” Sister Clare Lucas said that the values translate to behaviours that underpin the Trust’s standards: “Part of our recruitment process is to ensure that staff share these nursing values, and that they are applied in relations with both patients and staff. “These values are not new. We have always upheld them but we have worked to articulate and redefine them. By identifying the four values, we hope that the process is cascaded throughout the organisation.”
At just 20 months old, Niamh Shelley became The Royal Marsden’s youngestever bone marrow transplant patient. Now a bright and bubbly nineyear-old, Niamh still holds this hospital record and recently raised money for The Royal Marsden Cancer Charity with a book sale as a way of saying thank you. Sarah Shelley, Niamh’s mum, said: “It was a massive shock when Niamh was diagnosed with acute myeloid leukaemia at 14 months old. Christopher, her dad, and I couldn’t
believe it was happening – it was devastating. “We were told she was in the poor risk group and unlikely to survive. She started treatment straight away but we were told she would need a bone marrow transplant. It was a very difficult time, but thankfully an unrelated donor match was found.” The transplant worked and Niamh has been well ever since. “We are so grateful for the excellent care Niamh received and especially to the staff at The Royal Marsden,” said Sarah. “Niamh is a gorgeous, lively little girl and her brothers James, Matthew, Joseph, Callan and Dillon all adore her.” Niamh presented the cheque to her former nurse Carly Snowball, Matron of the Oak Centre for Children and Young People. “It was lovely to see Niamh again,” said Carly, “and we are very touched that she thought of us and raised money for the hospital.”
The Trust’s 16 values What we are Pioneering Aspirational Knowledgeable Driven
How we act Determined Confident Open Resilient
How we relate to others Collaborative Supportive Trusted Personable
How we feel Compassionate Positive Calm Proud
Niamh Shelley as a 20-month-old transplant patient (right) and on her first day at school (above) RM MAGAZINE 09
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Hospital news
The winners of the 2013 Staff Awards were: Pursuing Excellence Markus Ward, Chelsea Ensuring Quality Shona Sobande, Administration Manager, OPD/RDAC Chelsea Ensuring Quality (team) Critical Care Outreach Team, Chelsea/Sutton Driving Efficiency Mo Bahrami, Projects & Property Manager, Estates Breaking Boundaries Tara McGovern, Research Nurse, Head and Neck Unit Developing Potential Carly Snowball, Matron, Oak Centre for Children and Young People Anything’s Possible Fiona Stimson, General Manager, Centre for Molecular Pathology Anything’s Possible (team) Sutton and Merton Community Services Administration Centre Working Together Elyas Talha, International Patients Advocacy Manager, Private Care Chelsea Working Together (team) Electrical & Mechanical Team, Estates Department, Sutton Unsung Hero/Heroine Caroline Langham, Play Specialist, Oak Centre for Children and Young People, Sutton Outstanding Leadership Elizabeth Sherlock, Contraception and Sexual Health Services Manager, Sutton and Merton Community Services Outstanding Contribution Professor Stan Kaye, Consultant Medical Oncologist
Professor Stan Kaye (centre) with Chief Executive Cally Palmer and Chairman R. Ian Molson at The Royal Marsden’s Staff Awards
STAFF RECOGNISED AT ROYAL MARSDEN AWARDS he Royal Marsden held its annual Staff Awards Ceremony evening at The Hilton on Park Lane. Chief Executive Cally Palmer, who hosted the awards along with Chairman R. Ian Molson, said: “The evening was a great success and I would like to congratulate the winners on their outstanding achievements. It is a credit to all staff that we received so many nominations from across the Trust.” Professor Stan Kaye, Consultant Medical Oncologist, received a standing ovation as he collected the Outstanding Contribution Award. Professor Kaye, who joined The Royal Marsden in 2000, has given more than 40 years of dedicated service to the treatment of patients and cancer research. In 2012, he stood down as Head of the Drug
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Development Unit and Professor of Medical Oncology at The Institute of Cancer Research. Professor Martin Gore, Medical Director, said: “Stan has provided outstanding leadership in many areas, but has combined this with being a real team player and is an extremely popular colleague. He has an international reputation for his work in ovarian cancer, and has been responsible for a number of influential clinical trials and bringing forward
Stan has provided outstanding leadership in many areas, and is an extremely popular colleague PROFESSOR MARTIN GORE, MEDICAL DIRECTOR AT THE ROYAL MARSDEN
therapeutic advances such as the PARP inhibitors. “The huge success of the Drug Development Unit is a legacy of which he can be very proud. It is hard to overemphasise the respect with which he is held among those involved in cancer drug development, within academia and within the industry. “Stan has received many prizes and accolades, but it is as one of his clinical colleagues that I would like to attest to his great contribution to patient care. Everything Stan does has the patient as an individual at its heart and he demonstrates a knowledge of, and concern for, each patient under his care. “I am delighted that after retirement, he will not be leaving us permanently, but will continue to work at The Royal Marsden giving us the benefit of his wise counsel.”
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Hospital news
DOUBLE SUCCESS FOR TRUST AT NATIONAL ONCOLOGY AWARDS
Honorary Fellowship for top surgeon
Professor Chris Nutting
oyal Marsden staff received national recognition at the Quality in Care (QiC) Excellence in Oncology Awards in December. The awards recognise, reward and share good practice in oncology management, education and patient care. Out of the four categories Royal Marsden staff were nominated in, we were successful in two, commended in one and a finalist in the fourth. Professor Stan Kaye, Consultant Medical Oncologist, was the winner of the Lifetime Achievement Award for more than 40 years of dedicated service to the research and treatment of cancer. Professor Kaye also won the Outstanding Contribution Award at the Staff Awards (see opposite page). The Trust’s Head and Neck Unit won the award for ‘Improving the quality of life and experience of care for people living with cancer’. Led by Professor Chris Nutting, the team ran a trial to modify the technique used in intensity-modulated radiotherapy. To address side effects from the treatment, the team significantly refined the technique, reducing the risk
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of patients suffering dry mouth to approximately 20 per cent compared with 80 per cent from traditional radiotherapy. The procedure was rolled out nationally and globally, and is now being used to treat some 300,000 patients worldwide. In the ‘Cancer team of the year’ category, radiotherapy staff were commended for their work on the HeartSpare trial, which aims to reduce the risk of heart disease from breast radiotherapy. Led by Dr Anna Kirby and Freddie Bartlett, our radiotherapy team pioneered the use of a simple, inexpensive technique (voluntary breath-hold or VBH) to reduce the amount of heart tissue exposed to radiation during treatment. The GI and Nutrition Support team was a finalist in the ‘Best innovation in service provision – partnership across the pathway’ category. This team helps manage chronic changes in bowel function as a result of cancer treatment, providing comprehensive care and improving long-term management for patients experiencing ongoing gastrointestinal symptoms and/or nutritional issues.
Royal Marsden surgeon Bill Allum has received Honorary Fellowship of the Royal College of Surgeons of Edinburgh, one of the top national accolades in this field. The Fellowship is awarded to current or former practitioners who are thought to have achieved distinction in their profession, showing special service to the ‘art and science of surgery’. Mr Allum (pictured above right, with the President of the Royal College of Surgeons of Edinburgh, Ian Ritchie) was recommended to the college’s Council following nomination by its awards committee. It cited his work in cancer surgery; in clinical trials in the treatment of oesophageal and gastric cancers; and in UK cancer service improvement, particularly for upper gastrointestinal cancers – as well as his extensive contribution to surgical training in the UK and Ireland. “I am both delighted and honoured to have received this prestigious award from my peers within UK surgery,” said Mr Allum.
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Reuben Imaging Centre
DIAGNOSTIC IMAGING
Equipped to excel
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Two state-of-the-art MRI scanners installed at the new Reuben Imaging Centre in Chelsea will accelerate the Trust’s research programme and transform the patient experience
he Royal Marsden has always led the way in diagnostic imaging, and by installing two new state-of-the-art MRI scanners in Chelsea, the Trust has ensured that the hospital will remain at the forefront of cancer diagnostics and continue to pioneer new methods. The newly built Reuben Imaging Centre has been equipped with the 1.5T and 3T MRI scanners thanks to £6.9 million raised by The Royal Marsden Cancer Charity. Two CT scanners will also be part of the centre, which is due to be completed this year. MRI scans enable us to look at a tumour in fine detail. They are particularly important for soft-tissue cancers, such as brain, spinal cord, bowel, gynaecological and prostate
cancers, as the magnetic resonance uses the properties of the soft tissue to create the detail in the image. The 1.5T MRI scanner has a large field of view and will enable the future development of whole-body imaging. In contrast, the 3T MRI scanner provides incredible detail over a smaller field of view, allowing us to undertake – and patients to participate in – clinical research trials that require this level of fine detail. CT scanners use X-rays to produce cross-sectional images of the body. When the images are reassembled by computer, the result is a detailed 3D view of the body’s interior. CT scans can be used to help make a cancer diagnosis or assess the effects of cancer treatment. ➜
BUILDING FOR THE FUTURE
Left: the introduction of MRI scanning at the Reuben Imaging Centre has transformed our capacity for diagnosis in Chelsea
The new Reuben Imaging Centre is the final part of the rebuilding and remodelling work at the Chelsea site following the fire there in 2008. As the centre is on the fourth floor, its construction was not without challenge and involved extensive structural work. Owing to the weight of the machines and the fact they were to be installed in a Victorian Grade II listed building, the floors had to be bolstered by 320 tonnes of steel. The scanner rooms were fitted with special windows so that the space would feel less confined. Image panels displaying pleasant scenes were added and audio-visual equipment installed to help patients relax during longer scans. To enhance the patient experience, the rooms were decorated with light colours, and a rooflight was installed to provide natural light.
A new extension in the courtyard at the back of the hospital provides support spaces, where clinicians can interpret the high-resolution images and monitor a patient’s progress in a comfortable environment. This is supported by columns that rise from foundations in the basement by the theatre changing areas and recovery area. There are also numerous temperature- and humidity-controlled technical rooms that keep specialist equipment in optimum condition. RM MAGAZINE 13
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The benefit of MRI scanners is that they produce exceptionally clear and detailed images. However, the combination of the two types of scanner is also useful, helping us to meet increased demand and to offer our patients the highest level of MRI diagnostic imaging – a standard that surpasses those set by the NHS. “With the new MRI 1.5T and 3T scanners in Chelsea, we can now scan more patients more efficiently using state-of-the-art technology,” says Bernadette Cronin, Deputy Director for Clinical Services. “We can now offer our patients and our research teams the best standard of care.” The new scanners will also improve our patients’ experience by increasing their comfort. In addition, by allowing the maximum flexibility in clinical practice, the new scanners will help our staff produce personalised treatment plans. Cheryl Richardson, Superintendent Radiographer for MRI at the Reuben Imaging Centre, believes the new scanners are already making a difference to patients’ experiences. “We are delighted with these new scanners, and the feedback we have had from our patients has been very positive,” she says. “They really are at the leading edge of imaging technology.” rm
With the new MRI 1.5T and 3T scanners in Chelsea, we are now able to scan more patients more efficiently using stateof-the-art technology BERNADETTE CRONIN, DEPUTY DIRECTOR FOR CLINICAL SERVICES
Q&A MRI IN RESEARCH
Dr Angela Riddell, Consultant Radiologist, and Dr Liam Welsh, Clinical Research Fellow, explain how the new 3T MRI scanner will benefit the Trust’s research programme
Which clinical trials are making use of the 3T MRI scanner at the Chelsea hospital?
The superior-quality images produced by the 3T scanner’s high field strength allow us to conduct studies that would be less effective at the 1.5T field strength. The Head and Neck Unit has three clinical trials that use the new 3T MRI scanner. These are among the first MRI research trials conducted at the Chelsea site and will facilitate the recruitment of patients to imaging studies, with the aim of accelerating the pace of new imaging discoveries. The first study investigates the effects of radiotherapy for head and neck cancer on the brain, using diffusion tensor imaging (DTI) to better understand the imaging changes associated with radiotherapy. The second study examines the effect of blood transfusion during radiotherapy on the oxygen status of head and neck cancers. The third trial makes use of the superior technology of the 3T scanner to show oxygen fluctuation within tumours. This has implications for future radiotherapy treatment. Together with our other 1.5T scanners at Chelsea and Sutton, the new 3T scanner at Chelsea will form part of the imaging infrastructure to support state-of-the-art cross-site research studies.
How will this benefit The Royal Marsden and its patients?
Our research aims to benefit patients by providing critical information that can be used for better patient management, thereby improving treatment outcomes. By applying and developing new imaging techniques, we hope to discover which treatment is effective and whether patients are likely to benefit from a particular treatment. Imaging can also identify treatment-related complications and inform clinicians when they occur. There is also a direct benefit to patients. Before the new scanners were installed in the Reuben Imaging Centre, Chelsea patients had to travel to Sutton for scanning if they wished to participate in a study. Now they will be able to undergo scans on the same site as their treatment.
What are the future plans for these clinical trials at Chelsea?
Having both 3T and 1.5T MRI scanners at Chelsea enables us to grow the research portfolio on this site. The head and neck DTI study is nearing completion. Future studies being planned include whole-bodydiffusion MRI scanning to assess the spread of disease to the bones, as well as new studies across a range of cancers treated at The Royal Marsden.
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Reuben Imaging Centre
CASE STUDY:
Seth Stiles
This photograph: MRI radiographer Cheryl Richardson (left) and colleague. Below: Cheryl oversees a scan
Royal Marsden patient Seth, 46, is being treated by Professor Kevin Harrington, and recently received a scan at the hospital. Seth, who was first diagnosed with cancer of the tonsils in Canada in 2010, became a Royal Marsden patient at the beginning of 2013, after it was revealed his cancer had spread to his lymphatic system. Following treatment, he began to receive follow-up scans every three months to see if his cancer has been successfully treated. A recent scan has shown an anomaly in his lung and he is now waiting for further results. “My experience at The Royal Marsden has been very positive,” said Seth. “The staff are great and very reassuring. “I am feeling well in myself and, whatever happens in the future, I know that with Professor Harrington and the whole team helping to treat me, I have the very best care.” RM MAGAZINE 15
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We believe that combinations of targeted therapies represent our best hope of delivering sustained benefits for our patients PROFESSOR JOHANN DE BONO, CANCER THERAPEUTICS THEME LEAD
BRC THEMES As part of our series looking at our work as a Biomedical Research Centre, we focused on the following BRC themes in previous issues: Cancer Imaging Dr Dow-Mu Koh Molecular Pathology Professor Mitch Dowsett Look out for future issues of RM, in which we will highlight the work of the remaining five BRC themes and the role of their leads: Breast Dr Nick Turner Prostate Professor David Dearnaley Clinical Studies Professor David Cunningham Cancer Genetics Professor Nazneen Rahman Radiotherapy Professor Kevin Harrington
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NIHR Biomedical Research Centre
CANCER THERAPEUTICS
Combined efforts As a Biomedical Research Centre, The Royal Marsden and The Institute of Cancer Research together receive National Institute for Health Research funding to support our pioneering work. Here, we find out why the Cancer Therapeutics team believes a combination of targeted therapies is the way forward
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he Cancer Therapeutics theme of the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) focuses on early-phase clinical trials. In particular, the focus is on subdividing cancers into different molecular sub-types, since there is increasing evidence that each will respond best to a certain treatment. This increased level of stratification to our treatment will help us deliver optimised and more precise cancer care and, importantly, reduce the number of patients taking drugs that will not affect their cancer. Professor Johann de Bono, Cancer Therapeutics Theme Lead, says: “We have published work that shows we can do this not only from tumour biopsies but also from blood tests containing tumour DNA. This is important, as a blood test is much less invasive to a patient than a biopsy – and it may prove to provide a more reliable result. “Our understanding of the genetic complexity of cancer has grown, and with this knowledge we are starting to change the way we treat cancer patients. For instance, we increasingly believe that combinations of targeted therapies, specifically hitting several different molecular targets at any one time, represent our best hope of delivering sustained benefits to patients. Therefore, many of our new early-phase clinical trials are testing combinations of drugs.”
Pooling resources
Much of the work in the Cancer Therapeutics BRC theme is focused on developing new strategies to bring leading-edge combination therapy research into the clinic, with the aim of creating a fundamental shift in thinking
on cancer treatment. Previously, most new drugs were simply expected to be better than those already available. Now, it is being shown that existing drugs can still have value – but only when combined with new therapies. Researchers are also investigating whether patients who experience resistance to an individual treatment on a clinical trial would benefit from moving to a suitable combination of treatments. Patient safety remains paramount, with the primary goal of minimising risk while maximising benefit. Patients within the Cancer Therapeutics theme are treated in the Drug Development Unit (DDU), which opened in February 2005 and comprises 10 inpatient beds, five treatment chairs and two outpatient suites. There are also laboratory facilities for sample preparation and storage, and a seminar room to give researchers space to meet and discuss trial progress or develop new trial ideas. In addition, a team of on-site research nurses provide 24-hour support five days a week to patients. “We are proud that our DDU is running more than 30 studies of exciting new rationally designed drugs, allowing us to offer many trial options to our cancer patients, some of whom are at an advanced stage and commonly have limited standard treatment options available to them,” says Professor de Bono, who is also Director of the DDU. “The DDU is also supported through funding as an Experimental Medicine Cancer Centre by Cancer Research UK and the Department of Health, and is a joint venture of The Royal Marsden and The Institute of Cancer Research.” rm
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PROFESSIONAL DEVELOPMENT
Sharing our expertise The Royal Marsden’s GP Education Series enables GPs to keep up to date with the latest developments in cancer diagnosis, screening, treatment and follow-up care
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s one of the world’s leading cancer centres, The Royal Marsden has been at the forefront of cancer diagnosis, treatment, research and education for the past 160 years. Our work has included forming relationships with GPs, who play a vital part in a patient’s cancer care pathway, from referral and diagnosis to supporting patients through treatment and co-ordinating their follow-up care. In 2009, we launched the GP Education Series, a programme of events and online learning opportunities that allows us to contribute to GPs’ professional development by sharing some of our expertise and knowledge. The series has met with great success, with more than 600 GPs attending our live events and thousands more – 26.4 per cent of NHS GPs – engaging with our content online. In a recent survey, GPs from London and the southeast ranked The Royal Marsden as the most trusted provider of GP cancer education. Following the latest GP Education Day, on lung cancer and lymphoma, 97 per cent of the GPs who attended said they would make a change to their day-to-day clinical practice as a result of what they had heard. Throughout 2014, we are continuing to host one-day and half-day interactive seminars covering aspects of cancer diagnosis, treatment and management that is relevant to GPs. The sessions will focus on different tumour types and will be delivered by a multidisciplinary team
of experts through interactive case studies, panel discussions and clinical lectures. Attendees will have the opportunity to network with other GPs and meet many of our consultants.
Fully briefed
Dr Nick Van As, a Consultant Clinical Oncologist at The Royal Marsden who has been involved with our GP Education Days from the start, believes that primary-care providers should be aware of the latest information on cancer treatment and care. “It is vital that GPs are fully briefed and up to speed on the latest developments in cancer diagnosis, screening, treatment and follow-up care,” says Dr Van As, who has spoken at and chaired a number of sessions at the GP Education Days. “During the course of each Education Day, GPs are encouraged to ask questions, discuss issues with their colleagues and offer their professional opinions.” Medical and technological advancements can happen quickly in oncology, he adds. “This was highlighted at a recent event where GPs had overestimated the risk of colonoscopy for the patient. With the benefit of recent figures – which showed that from 2010 to 2012, the risk of serious complications during colonoscopies fell from 0.13 per cent to 0.04 per cent – our consultants were able to reassure GPs that colonoscopy, which is frequently used to diagnose bowel cancers, was an effective and safe procedure.”
The Royal Marsden’s engaging events in the GP Education Series have proved a hit, attracting more than 600 GPs since 2009
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GP Education Series
The GP Education Series also provides a chance for The Royal Marsden to learn from GPs, so we can assist them in providing better care for their patients. For example, they have told us that they need better access to clinical trial and referral information, so we have developed our new online GP hub to bring this information together.
Making an impression
Dr Javier Salerno, a GP from Croydon who has been attending the GP Education Days since they started in 2009, says he would encourage all GPs to attend these events. “I have been impressed by the engaging teaching skills, motivation and enthusiasm among the consultants to educate and inform us on the signs and symptoms to look out for in the early stages of cancer, and the management of patients with cancer that we can hopefully cure – if caught early enough.” Another interesting element to the sessions, he says, is being informed about the latest advances in diagnostics and therapeutic management of cancers. “This is particularly beneficial when I’m talking to a patient in my surgery who may have cancer. I have found the diagnostic services at The Royal Marsden to be fantastic, and if a patient does find they have cancer, the advantage is they are already in the right place for prompt treatment.” Dr Salerno also values the opportunity to learn about the latest research being carried out at The Royal Marsden, and the access GPs are given to the latest articles in oncology journals, with which they can further their knowledge and understanding of a topic. “There have been huge advances in survival rates in oncology over the past five to 10 years, which is very exciting,” he says. “Prognosis overall has improved dramatically.” Dr Salerno is able to pass on the expertise he gains at the GP Education Days to final-year medical students at other hospitals, such as St George’s in south London, where he teaches. He says: “I also share knowledge gained with consultants in Lima, Peru, where I originally come from.” rm RM MAGAZINE 19
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WOMEN IN RESEARCH
Making their mark
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The Royal Marsden is committed to promoting the role of women in research. Here, we profile five women who are making a valuable contribution for the benefit of cancer patients
he Royal Marsden and The Institute of Cancer Research (ICR) are working towards achieving the Silver Award from the Athena SWAN Charter – which promotes women in science, technology, engineering, medicine and mathematics – by 2016. This effort follows the announcement in 2011 by Professor Dame Sally Davies, the UK’s Chief Medical Officer, that the National Institute for Health Research (NIHR) expects to shortlist for Biomedical Research Centre (BRC) and Biomedical Research Unit funding only medical schools that have achieved at least this standard. The Royal Marsden and the ICR represent the only specialist BRC for cancer in the UK. We have a proud history of supporting and championing women in medical research, with several female clinicians leading studies and trials and developing new treatments. These five women are all making valuable contributions to our pioneering research.
Her work has received funding for a clinical trial of the use of abiraterone – a drug developed at The Royal Marsden and the ICR that has transformed prostate cancer treatment – in ovarian cancer. “I am passionate about treating women who have gynaecological cancers,” says Dr Banerjee, a consultant at The Royal Marsden for two years. “There is an urgent need to improve treatments and survival. This can be achieved by clinicians, scientists and patients working together.” A recognisable figure on the international cancer research stage, Dr Banerjee has an impressive catalogue of awards and accolades. As well as regularly presenting her research at international meetings, Dr Banerjee is a Key Opinion Leader for the European Society of Medical Oncology’s forum Women 4 Oncology, which aims to build a network of female oncologists and help them access leadership positions.
“One of my key aims is to mentor the next generation of women in oncology and research and to be a positive role model,” she says. “Opportunities are certainly available for women to be leaders in their field. You need to be determined and not just expect things just to fall into your lap. It is important that women help and support each other.”
DR AISHA MIAH
Consultant Clinical Oncologist, Sarcoma Unit
Dr Miah developed an interest in research as a trainee in the Head and Neck Unit, where she undertook a PhD in Clinical Oncology under Professors Chris Nutting and Kevin Harrington. “What really inspired me was the patient-centred, ‘can-do’ attitude,” she says. “I felt encouraged by senior clinicians to pursue research – and this is still the case. During my time in the
DR SUSANA BANERJEE
Consultant Medical Oncologist and Research Lead, Gynaecology Unit
“It is an exciting time to be working in cancer research and to be part of the revolution improving treatment for women with gynaecological cancers,” says Dr Banerjee. “The latest technologies and knowledge of molecular biology means that it is becoming possible to deliver precision medicine and offer personalised treatment.” Dr Banerjee is the Chief Investigator for several clinical trials, and is working with scientists at the ICR to increase the understanding of genetic and molecular abnormalities to help develop better treatments for women with gynaecological cancers. Her research includes developing treatments for ovarian cancer patients with a BRCA gene mutation. Drugs called PARP inhibitors have shown exceptional results.
This photograph: Dr Aisha Miah. Opposite page: Dr Susana Banerjee
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Research
Opportunities are certainly available for women to be leaders in their field. You need to be determined and not just expect things to fall into your lap DR SUSANA BANERJEE, CONSULTANT MEDICAL ONCOLOGIST
Head and Neck Unit, I worked on local and national clinical trials, which provided me with excellent experience to develop a research programme in my current post.” Since joining the Sarcoma Unit in 2011, Dr Miah has developed the radiotherapy research programme, participating in a Phase III study evaluating the role of pre-operative radiotherapy in retroperitoneal sarcomas, and joining with colleagues from other institutions to look at the benefits of pre-operative radiotherapy in specific histological subtypes. “I have been grateful to BRC funding avenues for project grants for our smaller studies, which will help me to develop a larger portfolio of clinical trials and seek research grants to support the Sarcoma Research Unit,” says Dr Miah. “Sarcoma is a rare cancer so it is essential we collaborate with national and international centres to recruit patients to Phase II/III studies.”
Dr Miah praised the guidance within the unit from Research Lead Professor Ian Judson and the multidisciplinary approach to both research and the treatment of patients. “My aim is to continue to pursue the development of future clinical studies,” she says. “Helping to improve treatments and improving the quality of life for patients drives me.”
DR THERESA WISEMAN Strategic Lead, Health Service Research
Dr Wiseman is responsible for research projects that improve care for patients living with and beyond cancer, especially those in the community. Her priority is ensuring that research makes a difference to practice. “My role is about looking at the experience of patients and developing services and interventions to address these experiences.” Dr Wiseman came to The Royal Marsden in 2011 looking for a more strategic role. ➜ RM MAGAZINE 21
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“My previous job was a joint post as Senior Lecturer/Research Fellow at King’s College London and Guy’s and St Thomas’ NHS Foundation Trust,” she says. “I wanted to become involved with building clinical research capacity and to be right at the coalface in terms of making a difference.” Since her appointment, a number of important health service research projects have been implemented. “One of our projects is working with Prostate Cancer UK and Macmillan Cancer Support to put in place pathways that ensure a seamless transition of care from hospital to the community,” she says. “We are also part of A Survivorship Action Partnership, helping to improve care and support for prostate cancer survivors.” Dr Wiseman is sharing her expertise at national and international levels. A member of the UK-based group Consequences of Cancer and its Treatment, she is also part of the international faculty for the Australian and New Zealand Urogenital and Prostate Cancer Trials Group, and in 2014 will be a keynote speaker at the Cancer Nurses Society of Australia annual conference.
Female sexual difficulties do not get the same research attention as those experienced by men DR ISABEL WHITE, CLINICAL RESEARCH FELLOW
DR ISABEL WHITE
Clinical Research Fellow, Psychosexual Practice
Dr White, who works closely with Dr Wiseman, established one of the UK’s first psychosexual therapy services dedicated to helping people whose sexual lives have been affected by cancer and its treatment. Her research focuses on the clinical assessment and management of sexual difficulties through the development of patient self-report questionnaires (PROMS) and interventions to improve sexual recovery. She says: “There is a need to raise the profile of the sexual consequences of cancer treatment as an important component of rehabilitation and after-care service provision. I particularly want to develop interventions that will make a difference to women’s sexual recovery and adjustment after cancer. “Female sexual difficulties have not been given the same clinical or research attention as those experienced by men, and this gender inequity needs to be challenged. We are about 10 to 15 years behind in female sexual morbidity research compared with male sexual dysfunction, and this research area requires greater investment if we are to make significant progress.”
Clockwise from left: Miss Fiona MacNeill, Dr Theresa Wiseman and Dr Isabel White
Dr White is currently working on several initiatives, including a study with colleagues in the Northern Gynaecological Cancer Centre, Gateshead, to develop a psychological intervention for women experiencing sexual difficulties after gynaecological cancer. She is also collaborating with colleagues at the University of Surrey on an internet-based support programme for men experiencing sexual and urinary difficulties after prostate cancer.
MISS FIONA MACNEILL
Consultant Surgeon, Breast Unit
A Breast and Reconstructive Surgeon, Miss MacNeill has always had an interest in breast cancer research. It began during her time as a Clinical Research Fellow in The Royal Marsden’s Breast Unit with Professor Trevor Powles, who retired in 2003, and working in the research laboratories with Professor Mitch Dowsett, who is now Head of the Centre for Molecular Pathology. Developing new surgical techniques is a major focus. Miss MacNeill and her surgical
colleagues have been key in the development of oncoplastic breast surgery – combining the best cancer and plastic surgery techniques to maintain the breast’s appearance. She says: “It isn’t always possible for surgeons to spend a lot of time in the lab, but by working in close partnership with scientists and other colleagues, there are many opportunities to be involved in innovative and important research.” Miss MacNeill continues to work with Professor Dowsett and Professor Ian Smith, Head of the Breast Unit, in clinical trials. Together, they found that significant changes take place in the proteins of a breast cancer tissue sample within 30 minutes after its removal from a patient and before its arrival in the laboratory, where it is preserved for further analysis. Miss MacNeill, who was responsible for collecting the tumour samples in the operating theatre, adds: “This collaborative study led to an important scientific paper, which will influence how we design future trials that rely on examining cancer-tissue biopsies.” rm
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Hospital groups
THE FRIENDS AND PCAG
Friends win garden awards The Friends of The Royal Marsden, Chelsea received two awards at the London Gardens Society’s annual Trophy Presentation Evening in October. The Friends won the Small Garden category in the London Hospitals Garden Competition and were also awarded a certificate of excellence for their patios, window boxes, containers and hangingbasket displays. Andrew McElwee, who volunteers for the Friends and is soon to retire to Dorset, said: “I am so pleased to have received these awards on behalf of the Friends of The Royal Marsden. I have been looking after the gardens and floral displays in Chelsea for seven years. “It is really gratifying to see nursing staff eating their lunch in some of the garden areas, or patients and their families sitting out in the summer months.”
Spirit of Summer Fair
Friends volunteer Andrew McElwee (left) receives the trophy and certificate from Nicholas Evans, Deputy Master of the Worshipful Company of Gardeners
Jacquie Gulbenkian, Chairman of the Friends of The Royal Marsden, Chelsea, said: “We are absolutely delighted to have won the small gardens category and be recognised for excellence. Andrew, one of our wonderful volunteers, looks after all the gardens and plants at Chelsea and comes to the hospital about twice a week. His efforts bring a smile to the faces of staff, patients and visitors – for which we are enormously grateful.”
Initiative cuts waiting time for chemotherapy outpatients Thanks to a redesign of the chemotherapy service at The Royal Marsden, more patients are experiencing shortened waiting times. Figures from April to October 2013 show that 87 per cent of patients received
chemotherapy within three hours of arriving at hospital – a significant improvement on 69 per cent in October 2011. Members of The Royal Marsden’s Patient and Carer Advisory Group (PCAG) have been working hard with the
Trust to encourage the seamless delivery of chemotherapy to outpatients. PCAG’s concerns helped pave the way for a Trust initiative, led by Professor Ian Smith, to redesign its chemotherapy service by better preparing drugs ahead of appointment times and improving the scheduling of chemotherapy. PCAG also set the Trust a standard of no more than 20 per cent of patients waiting over three hours and no more than five per cent waiting over five hours for chemotherapy. In December 2011, 24 per cent of patients waited between three and five hours for their chemotherapy and six per cent waited over five hours. New figures show that these
The Friends of The Royal Marsden have been appointed as official charity partner for the 2014 Spirit fairs, starting with the Spirit of Summer Fair on 14–17 May at Olympia London in Kensington. The fair is an event for stylish living and will be presenting an exciting collection of boutiques – all chosen by an expert team and approved by House & Garden magazine for their quality and originality. On offer will be interior and decorative accessories, fashion, children’s clothing, summer gifts and gourmet food and wine. You can receive 15 per cent off the ticket price by quoting MARSDEN when booking Visit www.spiritofsummerfair.co.uk or call 0844 412 4623 by 13 May 2014 to book, and make an optional £3 donation with your ticket purchase to Friends of The Royal Marsden.
statistics have fallen to 11 per cent and two per cent. PCAG believes that the development of a two-stop process – wherein patients have blood tests and clinic appointments one day, followed by treatment the next – has also improved the patient pathway. It is now calling on the Trust to review general prescription management, including how to further streamline the time it can take to fill prescriptions for chemotherapy patients. Charles McGregor, Chairman of PCAG, said: “Important work remains to be done to enhance the patient experience in these two areas, but PCAG members are pleased with the Trust’s achievements to date.”
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Carol West (top left) is a Healthcare Assistant on Oak Ward, where patients take part in clinical trials. Her job includes preparing patients for the trials and liaising with doctors and nurses. It also requires a sensitive touch
I don’t think I would be able to do my job well if I was detached CAROL WEST, HEALTHCARE ASSISTANT
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Staff profile
A DAY IN THE LIFE
Carol West Healthcare Assistant, Oak Ward
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hen I am not at work, I miss it so much. I have worked at The Royal Marsden for 16 years in this role, first in outpatients and now on Oak Ward, and it has become such a large part of my life. As a Healthcare Assistant, it is my job to support the nurses and doctors. Oak Ward is dedicated to patients who are on clinical trials; some stay overnight, others come in as daycare patients. It is always very busy as we have the capacity to run up to 30 drug trials at any one time. When I tell people I know outside work that the patients I look after are receiving experimental drug treatment, they assume it must be a depressing place to work – but that could not be further from the truth. We have such good fun on the ward and the patients are absolutely amazing. A helping hand My day starts at 8am, when I join the handover meeting with the clinical staff. Every patient who is coming in that day is discussed, so we all know what is expected of us for the day. As part of the strict protocols for being on a trial, the patients need to have their blood pressure, height and weight checked at every appointment. Some also need to have an ECG (a test to record the rhythm and electrical activity of the heart). I am responsible for carrying out these checks and helping patients complete any paperwork connected with the trial. I also escort patients to their scans and organise the blood-sample forms for the nursing staff. The nurses and doctors here are incredible
and so knowledgeable. When patients ask me complex medical questions, I find a nurse or doctor to answer them – and I joke to the patients: “Do I look clever enough to be a doctor?” Throughout the day, I take drinks to the patients. One lady we had in recently was supposed to be going on an exotic holiday but she was unable to travel, so to cheer her up I made a fruit juice with sugar around the top of the glass so it looked like a cocktail. It made her smile, which was lovely. Care and compassion Most people love to have a bit of banter but I can spot the body language if they want to be left alone, and I totally respect that. Every month or so, patients need to have scans, which can show if the drug trial is working for them. They are always particularly nervous on this day, and I can tell what they are here for before they say anything or I look at their chart – their faces say it all. Recently, a patient came in all quiet and sombre-looking, so I worked quietly around him. After about an hour, he said: “What’s wrong? You are never so quiet, Carol.” That, to me, was an indication he wanted to chat. Over the years, I have learned to deal with the emotions of working with cancer patients. A lot of people tell me not to get too attached, but I can’t help it – and I don’t think I would be able to do my job well if I was more detached. I am a great believer that if you look after people, they will look after you. It’s all about teamwork here on Oak Ward and that is what makes The Royal Marsden so special. We are like one big family. rm
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THE ROYAL MARSDEN CANCER CHARITY
High-tech cards help attract new investors
The O2 provides fundraising boost to The Royal Marsden
The Royal Marsden Cancer Charity has been sharing its message with some of the world’s savviest investors, as part of a relationship with the Sohn Conference Foundation. The foundation, which is dedicated to supporting innovative initiatives to cure and treat paediatric cancer, held the second Sohn London Investment Conference in October at the London Marriott Hotel Grosvenor Square. In what is believed to be a first for a charity, The Royal Marsden Cancer Charity gave a ‘TV in a card’ to every delegate. A new animated film with the card explored the impact of The Royal Marsden’s pioneering work and the innovations that could be funded with further investment. Representatives from the Sohn Conference Foundation later visited the hospital, where they heard a presentation about the latest developments in paediatric research by Professor Stan Kaye. They also presented the Trust with a donation of £150,000 to benefit further work in paediatric cancer. To watch the animated film online, please visit www.royalmarsden.org/videos
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Fundraising
he Royal Marsden Cancer Charity has joined forces with The O2 and its ticketing platform AXS.com in a groundbreaking three-year charity partnership. Whenever customers purchase tickets through AXS.com to events at The O2, they will be encouraged to support the charity by making a donation. Rebecca Kane, General Manager for The O2, said: “We are constantly innovating at The O2 and this charity partnership represents another first for the venue. We are delighted to be supporting such an important and inspiring charity. “More importantly, the partnership will allow The O2 to raise significant awareness and funds for The Royal Marsden Cancer Charity, allowing The Royal Marsden to continue to provide
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world-class care for cancer patients, and act as a global leader in cancer research.” The O2 welcomes more than eight million visitors a year, which will give the charity access to a captive and engaged audience, opening up new opportunities for fundraising and raising awareness. Cally Palmer, Chief Executive of The Royal Marsden, said the partnership was an exciting opportunity for the charity: “The O2 is a leading international brand and we are pleased to be coming on board as an official charity partner. Their support will enable us to take our work forward in many key areas of cancer diagnosis, treatment and research – supporting our work in personalised and translational cancer medicine. I look forward to shaping a successful partnership over the coming years.”
‘Donate your birthday’ campaign success he Royal Marsden Cancer Charity’s ‘Donate your birthday’ initative – which was part of the wider ten10 campaign – has officially come to an end after a year of successful fundraising. A number of celebrities donated their birthdays, including Sir Paul McCartney, Ian Wright, Dermot O’Leary, Jimmy Carr, Sue Perkins, Rita Ora, Nathan Sykes of The Wanted and Jonny Bairstow. Each would tweet a link to The Royal Marsden’s Just Giving page around the time of their birthday, to raise awareness of the charity and encourage donations. The initiative was launched by the charity at the start of 2013 to mark its 10th year – having raised more than £100 million to date – and the next 10 years of innovation and cancer treatment. Many of the celebrities’ tweets were retweeted in huge numbers. Within an hour of Sir Paul’s posting, The Royal Marsden Cancer Charity’s Twitter feed went into a frenzy, with almost 800 retweets and a number of donations. Ozzy Osbourne (pictured above) also took part and got 500 retweets. “I was delighted and honoured to support the Donate your birthday campaign for The Royal Marsden Cancer Charity,” said Ozzy. “It is a great charity to help and a cause close to my heart.” In total, the celebrities’ tweets led to hundreds of donations and raised thousands of pounds. The general public did even better, raising more than £20,000.
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I’m using my bday (tomorrow) to raise money for @royalmarsden! Give a gift and donate to help cancer patients here http://shrd.by/A8Ttyn@OfficialOzzy
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FOUNDATION NEWS
MEET THE GOVERNORS
In the second edition of our series profiling The Royal Marsden’s Governors, we meet Staff Governor Maureen Carruthers and Patient Governor Dr Peter Lewins.
Maureen Carruthers, Staff Governor Maureen was elected as Staff Governor representing the Trust’s nurses in July 2013. As a Matron for the Palliative Care Unit, Maureen has worked at The Royal Marsden for more than 15 years. She decided to stand for election to help improve communication between nursing staff and the Council, and to continue to ensure nurses’ voices are heard at management level. “I have worked with a wide range of staff, from clinical and non-clinical to senior and junior, and think I can bring a strong clinical and unique perspective to the Board,” said Maureen. “It is important that the views of the Trust’s nursing
staff are represented, especially junior staff who can feel quite removed from hospital management. This is something I feel passionate about and I hope I will be able to bridge this gap and ensure that their views, concerns and suggestions are put forward and heard. “I am incredibly proud to work at The Royal Marsden and I am excited about my new role as one of the Staff Governors. It is a new challenge for me and one that I am embracing. “There has been a lot to get to grips with, but it has been really interesting to learn about the workings of the Council of Governors and the impact it has on the hospital.”
Dr Peter Lewins, Patient Governor Peter is one of the two Royal Marsden Patient Governors (for Elsewhere in London) and was elected to this role in April 2013. After being diagnosed with a rare form of leukaemia and retiring as a GP on medical grounds, Peter – whose father, Norman, is also a Royal Marsden patient – decided to stand for election. He said: “As a patient and a GP with 24 years’ experience, I felt I could contribute to improving patients’ experience at the hospital – especially end-of-life care, which was an area of special interest to me during my career.” Peter is also interested in GP education and
improving communication with GPs and patients. Peter said: “As well as being Patient Governor, I am involved with a number of groups within the Trust, such as the Patient and Carer Advisory Group and the Arts Forum. I took part in an event for Coordinate My Care, the end-of-life patient record programme, aimed at training GPs. One hundred and fifty GPs came along and it was very successful. “I am hoping to help integrate the two worlds of the hospital and the GPs. This should lead to an improved understanding on both sides and lead to better care of patients before, during and after their contact with the hospital.”
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Foundation news
At this Biomedical Research Centre event, Members will have the chance to tour the Centre for Molecular Pathology
MEMBERS’ EVENT: JOURNEY OF A TUMOUR SAMPLE ver wondered what happens to a tumour sample once it has been taken from the patient? This April, Members can follow its journey on a special behindthe-scenes tour. Testing patients’ tumours is a vital part of determining what treatment(s) a patient will benefit from. Using information gained from these tests, clinicians can
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then decide whether there is an appropriate NHS treatment, or whether there is a drug trial the patient could be enrolled on. The Members’ event, set to take place in Sutton on Monday 28 April from 2pm to approximately 4.30pm, will begin with a presentation about the Trust’s Centre for Molecular Pathology (CMP). This will explain the centre’s importance
in testing tumour samples – and how that links with drug trials and drug development at the Trust’s Drug Development Unit. After the presentation, Members will go on a tour of the CMP’s pathology and molecular diagnostics laboratories, followed by a visit to the drug discovery laboratories of The Institute of Cancer Research (ICR).
Board of Directors meeting Wednesday 26 March 2014, 2pm–4pm, Board Room, The Royal Marsden, Fulham Road, Chelsea
Council of Governors meeting Wednesday 14 May 2014, 11am–1pm, Board Room, The Royal Marsden, Fulham Road, Chelsea
Dates for your diary Council of Governors meeting Wednesday 5 March 2014, 11am–1pm, Board Room, The Royal Marsden, Fulham Road, Chelsea
To attend any of these events, please call 020 7811 8558.
Rowena Sharpe, Assistant Director of The Royal Marsden and ICR NIHR Biomedical Research Centre, said: “It will be a very interesting tour for Members. Many people know what happens in a hospital but few will know what happens to a tumour sample once it has been taken from a patient. The journey of a tumour sample spans many areas, including pathology and molecular diagnostics, and the tests carried out there help us to determine the best form of tailored treatment for each individual patient. “Not only will Members get a tour of these areas, they will also have the process explained to them so they can get a better understanding of why facilities like the CMP are so important to cancer research at The Royal Marsden and The Institute of Cancer Research.” If you would like to attend or for further details, please contact Rebecca Hudson at rebecca.hudson@rmh.nhs. uk or call 020 7808 2844.
Keep in touch
Become a Member and/or contact your Governor: Freephone 0800 587 7673, telephone 020 7808 2844, email foundation.trust @rmh.nhs.uk or visit www.royalmarsden. nhs.uk/membership RM MAGAZINE 29
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PUZZLES & PRIZES
Test your wits
Win!
Complete our crossword and you could win £50 in John Lewis vouchers SUDOKU
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Star letter
Dear RM, I was referred to The Royal Marsden in Sutton by my GP after several PSA checks and a biopsy. I later agreed to active surveillance after being diagnosed with prostate cancer. In September 2013, after a further biopsy, MRI scan and CT scan, I commenced 37 radiotherapy treatments. There is not praise enough for the care I have received over the past three years. At whatever level, from reception staff to nurses and doctors, everyone was efficient, discreet, human and even humorous on occasion – thank goodness! Peter Harris
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Fill in your details below when sending in your crossword competition entry. See right for details of our address. NAME
PRIZE CROSSWORD
Across 2 Dog (5,4) 6 Period of history (3) 7 Personal attendant (7) 8 Covers with metal (6) 9 Festival (4) 11 Member of the clergy (4) 12 Shakespearean character (6) 16 Avoiding (7) 17 Receptacle (3) 18 One who opposes (9) Down 1 Inexpensive (5) 2 Spanish city (7) 3 Girl’s name (5) 4 Bird (4) 5 Crowd actor (5) 10 Gymnastic entertainer (7) 11 Great fear (5) 13 Brass instrument (5) 14 Child minder (5) 15 Country (4)
ADDRESS
CONTACT DETAILS
Congratulations to Pat Moore, the winner of last issue’s crossword prize.
The lucky winner of our prize crossword will receive £50 in John Lewis vouchers. We also welcome your thoughts on RM magazine and love to hear about your experiences at the hospital. The Star Letter wins £50 in John Lewis vouchers. Send your crossword or letter with your name and contact details to RM, Press Office, The Royal Marsden, Fulham Road, Chelsea, London SW3 6JJ. The entry closing date is Monday 31 March. See below for prize draw rules. PRIZE DRAWS & STAR LETTER TERMS & CONDITIONS: 1. The Prize Draws and Star Letter are open to all readers of RM except employees of the Press Office at The Royal Marsden and Sunday, who produce RM magazine. 2. The closing date for receipt of all entries is Monday 31 March. Only one entry per person per draw. 3. Responsibility cannot be accepted for entries that are incomplete, illegible or not received. Proof of posting is not proof of receipt. No cash alternative is available and prizes are not transferable. Value of prizes is correct at time of going to press. 4. Winners will be notified by post within 14 days of closing date. 5. The Promoter’s decision on any aspect of the promotions is final and binding. No correspondence will be entered into. 6. The Promoter reserves the right to substitute a prize of equal or greater value should circumstances make this necessary. 7. Entry implies acceptance of rules. 8. The winner of the Star Letter prize of £50 in John Lewis vouchers is the sender of the best letter selected by RM magazine. 9. The winner of the crossword prize of £50 in John Lewis vouchers will be the first correct entry drawn out of the bag. 10. The Promoter is The Royal Marsden Hospital, 203 Fulham Road, London SW3 6JJ.
30 RM MAGAZINE
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IN THE NEXT ISSUE RM brings you the latest hospital updates, research news, inspiring stories and exclusive interviews. The summer 2014 issue is coming soon…
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Research: opening of the West Wing The latest news from The Royal Marsden School Fundraising news round-up
FOR THE ROYAL MARSDEN Rachael Reeve – Director of Marketing and Communications Elaine Parr – Head of PR and Communications Naomi Owen – PR and Communications Manager Belinda Lock – Senior Press Officer Catherine O’Mara – Senior Press Officer Sukhie Deol – Press Officer FOR SUNDAY Lucy Ryan – Editor Marc Grainger – Deputy Editor Ian Dutnall – Art Director Bryony Bromfield – Senior Account Manager Matt Beaven – Creative Director Toby Smeeton – Managing Director RM magazine is published by The Royal Marsden in partnership with Sunday: sundaypublishing.com © The Royal Marsden 2014. All rights reserved. Reproduction in whole or part is prohibited without prior permission of the Editor. The Royal Marsden and Sunday accept no responsibility for the views expressed by contributors to the magazine. Repro by F1 Colour. Printed by Pureprint.
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2014 March
My Marsden March Organise your own Marsden March any time, anywhere: www.royalmarsden. org/mymarch
6 April
Brighton Marathon Have you got your own place? Why not run for us? Visit www.royalmarsden.org/run
13 April
Virgin Money London Marathon Have you got your own place? Why not run for us? Visit www. royalmarsden.org/run
Get involved
June
Have fun and raise money for The Royal Marsden Cancer Charity. To find out about all the ways you can get involved and help make a difference to people with cancer, please visit www.royalmarsden.org/do-something
Jump for us Take part in a memorable parachute jump. Visit www. royalmarsden.org/jump
25 May
Bupa London 10,000
South Downs Trekathon Trek 26 miles across the beautiful South Downs. Register by 9 May at www.royalmarsden. org/trekathon
We have guaranteed places, so join our team. Register by 25 April at www. royalmarsden.org/run
June
Special occasion giving Your special occasion can also raise money for The Royal Marsden. Find out how at www.royalmarsden. org/special
September August
Great Wall trek
Sponsor a day
Walk the Great Wall of China with us. Register by 27 June at www. royalmarsden.org/china
Make our day by sponsoring a day that’s special to you – www.royalmarsden.org/day
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17 May
12/02/2014 11:06