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Please take me home

James Cummings tells us why Clatterbridge is close to his heart

Patients rate the centre as one of the best in the country Win a meal for four at Frankie Dettori’s restaurant


Read about our plans to build a new cancer centre in the heart of Liverpool We’ve changed our name Chemotherapy at home Olympic torch bearer



Contents 04 James Cummings’ story 06 Clatterbridge plans to expand into Liverpool New name and identity for the Trust 08 Care when you need it most Free relationship counselling 09 Charlie’s Olympic wish 10 We’re beating the bugs

This is the second edition of our new look C3 magazine. The first edition was well received with lots of positive comments on the new look and content, so thank you for taking the time to contact us with your feedback.

3C’s. Centre, Clinic, Charity. The new financial year, starting in April, has given us the opportunity to review our commitment to providing the best cancer care to the people we serve. The Trust is in a strong position, which will help us face our upcoming challenges with confidence. Our recently published strategic plan outlines what we want to achieve over the next five years and emphasises our commitment to service re-designs, new developments and research. I am very proud of our excellent performance, the expertise, dedication and commitment of our staff never ceases to impress me - and once again we have been rated among the best performing Trusts in the country by the Care Quality Commission. Read more about this on page 13. We are however continually looking at ways to enhance the quality of our services. Your feedback is essential if we are to improve. It is always good to receive compliments, but particularly valuable to hear suggestions for improvements or hear about your experiences when they could be better. Information about how patient feedback has prompted a review into appointment waiting times can be found on page 13. From 1st April the Trust changed its name to The Clatterbridge Cancer Centre NHS Foundation Trust - you can read more about this on page 6 and 7 along with details of our plans to expand The Clatterbridge expertise into central Liverpool. This is a very exciting time for the Trust and a once in a generation opportunity to enhance our research profile and oncology innovations. I’d like to take this opportunity to welcome our new Non-Executive Director to Clatterbridge. Alison Hastings joined us earlier in the year and we are sure her media expertise will be a great asset to us in maintaining our regarded reputation during the potential forthcoming period of change. Details of her appointment can be found on page 14. Andrew Cannell Chief Executive



Taking chemo closer to patients

12 It’s all in the planning 14 Media expert joins board Trust performance 15 Foundation Trust Governor Laurie Black Elections news


16 Clatterbridge offers complex prostate treatment 17 Investing to improve


18 Meet Dr Arthur Sun Myint Bowel cancer facts 19 1,000 reasons to celebrate 20 Charity News 21 Research round up 22 Upcoming events 23 Puzzle page and recipe 24 Your views


A PATIENT’S JOURNEY A hospital ward can mean a lot of different things to different people, experiences which inherently connect a person to the staff and surroundings for the rest of their lives. 33-year-old James has, and always will have, a special place in his heart for the staff on Sulby ward after they shared one of the most important days of his life with him, and helped him through his most difficult time. Four years ago James’ life was turned upside down when he was diagnosed with an aggressive form of cancer. With his health starting to deteriorate, the Skelmersdale man married his childhood sweetheart on the ward as his prognosis was uncertain. This is his story: In December 2007, James Cummings woke up with excruciating stomach pain. The 28-yearold had previously been to his GP with similar pains but his doctor couldn’t be certain of the cause. His doctor scheduled a hospital scan and the results revealed that he had a tumour, and there was a 90 per cent chance it was malignant. James said: “I was devastated; the word cancer just terrified me, especially as we had only just lost my girlfriend’s mum to it six months earlier. I just didn’t know how I was going to tell my family, it came as a complete shock. I was 28 and healthy, I couldn’t take it in.” Within two weeks James was booked in for surgery to remove the tumour, which was a rare case of adrenal gland cancer, usually associated with the bowel. He was told that as his tumour was small the operation would be quite straightforward. However, when James was admitted to The Royal Liverpool University Hospital for surgery in February 2008, the day before his 29th birthday, he was dealt another

terrifying blow; the tumour had rapidly grown to more than 17cm in just two weeks. With the growth now too big to operate on, James was told that he needed to undergo chemotherapy and radiotherapy at The Clatterbridge Cancer Centre immediately if they were to have any hope of surgery in the future. James said: “My mum slept by my bedside that night, it was all a blur. I couldn’t stop crying - it just didn’t feel real at all. I woke up on my birthday in agony not knowing what my future held, or even if I had one.” In March 2008, James and his girlfriend of nine years, Laura, were told that his cancer was so aggressive that if the current combination of chemotherapy and radiotherapy didn’t work, he would only have two weeks to live. Hearing the devastating news, the childhood sweethearts, who had become engaged before James’ diagnosis, decided to get married at the hospital. The Clatterbridge Reverend performed the ceremony on 11th March 2008 around James’s hospital bed on Sulby Ward, with close family present. James said: “I don’t remember my wedding, I was on so much morphine and so poorly it’s all a bit of a haze. All I could think of was my little girl, Molly. She was only 18-monthsold at the time and I knew if I didn’t make it she wouldn’t remember me. It should have spurred me on but it sent me into a blind panic and I started having anxiety attacks. I couldn’t look at her. My heart felt like it was breaking every time I did. We were given the option to freeze my sperm as the treatment could make me permanently infertile. I couldn’t bear the thought of leaving Laura on her own with one child and to be honest I had little to no hope that I was ever going to recover.” Fortunately, the treatment did start working


In sickness and in health James Cummings has shared both with the staff at Clatterbridge

and by July the tumour had shrunk to half its size and James was strong enough to undergo the 12-hour surgery to successfully remove it. James continued to undergo chemotherapy after the operation to ensure all of the cancer cells had been diminished, and on Christmas Eve he was told he was well enough to go home and spend time with his family before continuing with his ongoing treatment in the New Year. Unfortunately 2009 was not the year of recovery and celebration as planned. In August James was told that he had secondary lung cancer and would need to go through daily radiotherapy for eight weeks again before another gruelling 12 months of chemotherapy. James said: “After getting the news I don’t think I could have coped if it wasn’t for the staff at Clatterbridge. Obviously it was the medicine and treatment that got my body through it all but to be honest I don’t think I would have survived if it hadn’t been for them. They refused to let me ever believe I wouldn’t get better and spent hours talking to me and supporting me. Whatever they get paid is not enough, they literally saved my life. I am still really close to them especially Dr Ali who has been there every step of the way, I cannot praise him enough.” James is still undergoing scans every three months to monitor his recovery. But he has more than overcoming cancer and enduring four years of turmoil and treatment to celebrate now as he and his wife Laura, who is a care worker for the elderly, have just found out that they are expecting their second child. James who is now a stay-at-home dad, said: “I never thought I’d get to see Molly go to her first day of school, let alone get the opportunity to be a dad again. We’re over the moon, and for the first time in a long time, the future is something that really excites me.”

James and Laura on their wedding day

Cummings family of four, soon to be five

C3 | The Clatterbrige Cancer Centre Magazine





An exciting proposal to develop a £95m comprehensive cancer centre adjacent to the new Royal Liverpool Hospital site is under discussion by local commissioners. The plans would see Clatterbridge’s main services move from its current location in Wirral to a new purpose built facility in Liverpool. All inpatient beds will be transferred to the new purpose built centre in Liverpool, with outpatient clinics, outpatient radiotherapy and chemotherapy and proton therapy remaining at the Wirral site for Wirral and West Cheshire cancer patients. The development plans are being welcomed by clinicians, who see this as a ‘once in a generation’ opportunity to transform cancer services in our region. Being located adjacent to the new Royal Liverpool University Hospital and in such close proximity of the University of Liverpool will increase our potential to participate in pioneering cancer treatment trials, whilst the close location to an acute hospital and ready access to Intensive Treatment Units and critical care services will help improve care for our

most vulnerable patients. Dr Nicky Thorp is clinical lead for the new development, she said: “This is a huge reconfiguration of cancer services, and something I am certain will benefit all cancer patients in our region. Clatterbridge’s potential to progress and develop world class cancer services can be realised with these plans. Clinicians in Wirral and Liverpool are very excited by the opportunities and conveniences this development will offer, with the ultimate ambition of improving the cancer experience for our patients.” Chief Executive Andrew Cannell added: “76% of our patients live north of the River Mersey. We made a move to address this obstacle last year when we expanded our radiotherapy service and opened a radiotherapy facility on the Aintree Hospital site in Liverpool. The success of that centre and the benefits that it has brought to patients has helped us appreciate the impact this new development will bring to our services. We are not closing the centre in Wirral and moving to Liverpool. Services in Wirral will remain,

1. The Clatterbridge Cancer Centre - Wirral 2. The Clatterbridge Cancer Centre - Liverpool (Aintree) 3. The Linda McCartney Centre - The Royal 4. The Countess of Chester 5. Southport Hospital 6. Halton Hospital 7. The Marina Dalglish Centre - Aintree 8. Broadgreen Hospital 9. The Liverpool Women's Hospital 10. St Helens Hospital 11. Clatterbridge Cancer Centre at the Royal Hospital

SEFTON ST. HELENS The Clatterbridge Cancer Centre - Liverpool The Marina Dalglish Centre - Aintree


St Helens Hospital Broadgreen Hospital

The Linda McCartney Centre - The Royal The Liverpool Women's Hospital


The Clatterbridge Cancer Centre - Wirral Halton Hospital

The Countess of Chester

2018 Southport Hospital

1. The Clatterbridge Cancer Centre - Wirral 2. The Clatterbridge Cancer Centre - Liverpool (Aintree) 3. The Linda McCartney Centre - The Royal 4. The Countess of Chester 5. Southport Hospital 6. Halton Hospital 7. The Marina Dalglish Centre - Aintree 8. Broadgreen Hospital 9. The Liverpool Women's Hospital 10. St Helens Hospital 11. Clatterbridge Cancer Centre at the Royal Hospital

SEFTON ST. HELENS The Clatterbridge Cancer Centre - Liverpool The Marina Dalglish Centre - Aintree


St Helens Hospital Broadgreen Hospital

The Linda McCartney Centre - The Royal The Liverpool Women's Hospital Clatterbridge Cancer Centre at the Royal Hospital


The Clatterbridge Cancer Centre - Wirral Halton Hospital

and the majority of Wirral and West Cheshire patients will still be able to attend the Wirral centre for outpatient treatment. What we are doing is taking an opportunity to build on the current reputation of Clatterbridge as an excellent hospital and transform it into a world class facility.”

The Clatterbridge Cancer Centre - Wirral The Clatterbridge Cancer Centre - Liverpool The Linda McCartney Centre - The Royal The Countess of Chester Southport Hospital Halton Hospital The Marina Dalglish Centre - Aintree Broadgreen Hospital The Liverpool Women’s Hospital St Helens Hospital



The Clatterbridge Cancer Centre - Wirral The Clatterbridge Cancer Centre - Liverpool The Linda McCartney Centre - The Royal The Countess of Chester Southport Hospital Halton Hospital The Marina Dalglish Centre - Aintree Broadgreen Hospital The Liverpool Women’s Hospital St Helens Hospital The Clatterbridge Cancer Centre at The Royal Liverpool Hospital


WHAT THE PLANS MEAN: • New purpose built cancer centre in Liverpool, adjacent to The Royal Liverpool Hospital • Ready access to non oncology specialists and critical care beds to improve care for acutely unwell patients • Seamless pathways with surgical teams • Enhanced Research and Development opportunities with better integration between the Liverpool University and Cancer Research Centre


The Countess of Chester



• The Clatterbridge Cancer Centre in Wirral will close • Clatterbridge will merge with The Royal Liverpool Hospital


To provide the best cancer care to the people we serve.


The decision was made to change our name following formal consultation prompted when feedback was received that the word ‘oncology’ was confusing to our patients. Advice was sought from patients, public and staff, and we received more than 500 formal responses to the consultation. 66% were in favour of changing our name to: The Clatterbridge Cancer Centre NHS Foundation Trust. By changing our name we hope to make clear to the public and our patients that our core purpose is cancer expertise and the service they receive is being provided by Clatterbridge cancer specialists. To support our new name, we have also introduced a new corporate design style to help distinguish our services further. The new style is bold and striking and creates closer

links to the Trust’s name which will help us achieve a stronger local identity. The main aspect of the design is essentially made up of three C’s to represent Clatterbridge Cancer Centre. The outer C remains constant representing the stability and permanence of the Clatterbridge ethos and professionalism throughout its various clinic, centre and charity applications. The middle C is made up of the void or white C. The inner C represents the Centre and its Charity. We have a clear picture of our fundamental purpose and our role in contributing to the health of the population we serve. Our new vision summarises these obligations and our mission outlines the key attributes of service delivery that we shall measure ourselves against.

To improve health and wellbeing through compassionate, safe and effective cancer care. The Clatterbridge ethos sets us apart from other healthcare providers and this ethos is derived from the organisational values which our staff subscribe to. These values are fundamental to the culture of the organisation and guide the behaviours we exhibit in caring for our patients, both current and future.


• Putting people first • Achieving excellence • Passionate about what we do • Committed to our future • Always improving our care

• The radiotherapy centre on the Aintree hospital site will close • Our eight chemotherapy clinics will close

C3 | The Clatterbrige Cancer Centre Magazine




Care when you need it most Support services at the Trust make up a vital part of the cancer care we provide. From a chaplaincy service to benefits advice - we aim to offer professional or personal assistance with any problems that cancer and its effects may have brought into a patient’s life.

Meet two members of this vital team: Julian Hampton-Matthews and Margaret Foulkes. They make up the oncology social worker service. Being diagnosed with cancer is both frightening and distressing for the person and their family and friends. Nearly half of people with cancer (49%) say they experience depression as a result of their cancer diagnosis and more than four in ten (45%) say that the emotional aspects of cancer are the most difficult to cope with compared to physical effects. Julian and Margaret provide support and advice to patients attending the hospital either as an inpatient or outpatient and provide social and emotional support to the whole family. Margaret has particular expertise in working with families and children with social care needs. She offers practical advice and skills for parents in how to communicate a cancer diagnosis to their children. She told us: “Often parents are more worried about their children and the effects of their illness on the family, rather than their own needs. It can help if they

Free relationship counselling Not talking to each other? Arguing about money? Want to leave? Hitting out? Macmillan Cancer Support has teamed up with Relate to offer free relationship advice


know their children have someone to talk to or if they can be given advice on what to say and how to explain what is going on. I offer practical support too, by liaising with schools or providing letters for examination boards. But it’s totally the patient’s choice whether they want to access this support. They decide if they would like to talk to me, or if they would like an appointment for their children.” Julian added: “Being treated for cancer can leave people feeling tired and weak or in pain. The frequency of treatment can limit what people can practically do, and surgery can affect people’s physical strength and mobility, either temporarily or permanently. A once healthy person who has never needed support from social carers can suddenly find themselves reliant on others to help with basic daily chores like shopping and food preparation. Similarly, people who are already in the social care system - vulnerable adults, or people with drug and alcohol problems need additional support to address the effects of cancer. We’re on hand to ensure that these patients get the appropriate support from for cancer patients living in Cheshire and Manchester. Relate offers advice, relationship counselling, sex therapy, workshops, mediation, consultations and face-to-face support. As the country’s largest provider of relationship support, every year they help over 150,000 people.

Charlie’s Olympic Wish

social services when they return home. “We liaise with outside and voluntary organisations on behalf of the patients, but it’s not just the patients who fall within the category for social care needs – carers can also be vulnerable and need support too. Research has shown that 38% of cancer carers spend more than 30 hours caring each week. Caring for someone along the cancer journey can have enormous impact on someone’s emotional well-being. Carers can neglect their own lives to some extent, losing touch with friends or giving up opportunities. Relationships can also be strained at times. “Cancer is perceived as a ‘health’ issue, rather than a ‘health and social care’ issue. A cancer diagnosis can be life changing for everyone involved, and in some instances the change is permanent, this will inevitably impact on a person’s social needs too.” If you, or a friend or family member have social care needs as a result of a cancer diagnosis contact your nurse or radiographer for advice on what help is available.

ONLINE FORUM While our expert staff endeavour to provide all the information that patients need to support them through their treatment, patients will often benefit from sharing their experiences with other patients. There is limited scope for this to happen during busy treatment clinics. Therefore we are developing an online forum on our website which will help patients and their families to get this peer to peer support.

For more details visit: or telephone 0161 872 0303

Charlie Witter from Whitegate, Cheshire was just 12 years-of-age when he suddenly became ill and his physical appearance changed significantly; he started to lose his hair, put on weight and found it difficult to hold anything without shaking. An MRI scan showed that he had a benign brain tumour, which was fortunately removed in 2007. But in February 2011 a MRI scan revealed what the family had been dreading; he had another large brain tumour. Charlie was referred to Dr Husband at Clatterbridge where he underwent five weeks of life-saving radiotherapy. During this time Charlie was not only having to cope with the anxiety and side-effects that accompany treatment - he was also revising for his GCSEs. Despite going through such a difficult time Charlie managed to sit every one of his exams and achieved top grades in all of them. Charlie’s mum, Karen, says, “He’s such an amazingly positive young man and has never let his treatment, daily medication or condition stop him from living life as normal as possible. His experience was made so much easier by the staff at Clatterbridge who have been excellent, they all have a great sense of humour and really put us at ease. They could not have made us feel more comfortable.” Since completing his treatment Charlie and his friends and family have been determined to raise as much money as possible for Clatterbridge by setting up Charlie’s Wish and have already raised over £5,000. In recognition of Charlie’s excellent exam results and his fundraising success Karen nominated Charlie to be one of the official 2012 London Olympic Torchbearers. “I nominated Charlie to carry the flame through a Coca Cola competition and we put the application on Facebook so we got lots of ‘likes’ on the page. Lots of people voted for him and I think he must have had the most votes in West Cheshire and Chester.” Charlie has beaten thousands of nominees and has been chosen to run a 300m stretch with the Olympic flame on 30 May! Charlie added: “It is very exciting, I have always watched the Olympics and I’m looking forward to the track events. I’ve told a few of my friends and they’ve all said they will come and watch me on the day.” Charlie’s Olympic run will be held in the Shrewsbury area and will be broadcast across the globe. To support Charlie’s Wish visit

SPOTLIGHT ON GIVING There are so many ways to support The Clatterbridge Cancer Charity, from donating by text to joining our weekly lottery. Rob from Hoylake donates to the charity through a monthly Direct Debit: “Donating through

a Direct Debit was really easy to set up and a great way to support Clatterbridge. Giving regularly helps the charity to plan for the future and I know it is making a real difference to the lives of local cancer patients.”

If you would like to set up a Direct Debit visit

C3 | The Clatterbrige Cancer Centre Magazine





Our PALS officer is here to listen to any comments concerns or complaints you have, and we make every effort to take action where we can to benefit our patients. This can range from formal complaints which we have a duty to investigate - to small suggestions that might help others. During 2011/12 we received eight PALS comments about the environment at the Trust. One was from an unhappy patient who found there was nowhere to place toiletries while having a shower on Conway ward. In response to this our Estates Team are looking to install shelving in all shower areas. We received just 14 formal complaints in 2011/12:

Beating the bugs

Hygienic hospitals are vital for keeping our patients, their visitors and staff as safe as possible. Infections are mostly caused by bugs or germs called bacteria that occur naturally all around us. They also live on our skin, in our mouths and noses. Whilst most of them don’t do us any harm, when we are unwell or frail due to illness or after an operation, our bodies’ natural defences are weaker, so more care is needed to protect us. The Trust is set infection control targets each year to continue to drive down the number of hospital acquired infections. For 2011/12 we had two targets:


Subject of Complaint


Treatment and Care


Staff attitude


Clostridium difficule:

MRSA bacteraemia:



Due to the high standards of infection control in the Trust we met this target by having only eight cases in 2011/12. Many of our patients are particularly vulnerable to this infection due to their disease and treatment so this is a great achievement for our brilliant infection control team.

In the summer we had our first case of MRSA in seven and a half years, so unfortunately we didn’t meet our target of zero. But a detailed review of the case identified that this solo case was not caused by any failings in our infection control arrangements.

Discharge Arrangements


Any complaint is thoroughly investigated. To date no further action was taken once we had responded to the complaints made.

Taking chemo closer to patients A pilot scheme is underway to assess the feasibility and benefits of delivering outpatient chemotherapy treatments away from a hospital setting. Clatterbridge delivers chemotherapy treatments in collaboration with eight district hospitals across the Merseyside and Cheshire region. In providing these clinics we are able to deliver chemotherapy much closer to the patient’s home and feedback received positively reinforces this option as a huge benefit to them. The ‘Clatterbridge in the community’ pilot is set to take this approach one step further, by offering the option to receive your chemotherapy treatment at a GP surgery, or even at your own home. Leading the project is Chief Pharmacist Helen Clark, she told us: “We started recruiting patients for this project in February. We will be

inviting 60 patients to join the pilot so we can follow their experiences and learn from them. There is already a lot of research and evidence which points towards the advantages of receiving chemotherapy outside of the hospital setting, and now this is an opportunity for our patients to experience those advantages. We want to offer patients the choice of having their chemotherapy in a setting that is most suitable for them, to give them the best experience. The information we get from this pilot will help us design services for patients in the future.” Experienced chemotherapy nurses from Clatterbridge are carrying out the study using suitable patients and carefully selected chemotherapy regimes. If you are receiving chemotherapy and are interested in finding out a bit more about the project, please speak with your chemotherapy nurse who can give you more details.

PURPOSE BUILT MOBILE HEALTH CLINIC One of our main strategic objectives for 2012/13 is to widen this pilot to also include the use of a purpose built mobile health clinic where our nurses can deliver chemotherapy as close to where patients live as possible in a safe environment. This is aimed to ensure the best patient experience possible.

C3 | The Clatterbrige Cancer Centre Magazine



Phase 3


It’s all in

the planning

Today, advances in radiotherapy treatment mean it is now a standard treatment option for a wide range of malignancies. And with the help of technologic advances in X-ray production and improvements in imaging and computer-based treatment planning – clinicians are increasingly dependant on radiotherapy capabilities in the fight against cancer. We want to take a closer look to find out just how the doctors and radiographers know how much or how little radium to use for each patient and how they decide where to ‘aim’ the radium beams. Once a patient has had accurate measurements of their exact position recorded by a CT scan, the pictures are fed into a computer and the science behind the magic begins ….. during the following two weeks consultants and radiographers work together using computerbased treatment planning systems to produce intricate, individualised treatment plans for every patient.

Phase 1 Consultants review the pictures taken by scanning machines to decide the precise area to be treated. This process can take up to four days depending on the complexity and position of the tumour and involves working closely together with the diagnostic department and planning radiographers to ensure the most effective and safe plan. The dose and number of treatments are based on the recommendations by NICE, however they are locally modified by the clinician to meet with a patient’s needs and desired treatment outcome. Once the consultant is confident in the prescription, they will ‘outline’ the area to be treated using computer planning software and this complete image is saved for the next phase.

The next and final phase before the plan is ready is called Dose Calculation. This is an electronic process where the images and plan generated in the previous phases are translated using computer planning software into numbers or ‘doses’. These numbers are then quality checked by another set of radiographers and saved as the treatment plan for that patient. The data is transferred into a format that can be read by the treatment machines, and then the treatment radiographers access the details using the computers on the treatment sets when the patient attends their first appointment.

Phase 1: The consultants use the planning systems to outline the area (shown in red)

Phase 2 The image is then passed onto the planning radiographers who determine the safest and most effective way of delivering the radiotherapy to the ‘outlined’ tumour site. This will be decided based on the location of the tumour and whether it is close to other structures or organs. There are standardised techniques and angles to use, but the majority of plans are individual to the patient. A pair of radiographers plan which direction the radiotherapy ‘beam’ will enter and exit the patient’s body, all plans are prepared in the presence of two professionals for quality assurance. A final quality check by a senior radiographer is conducted before the plan is signed off and sent to the Dose Calculation department.

The yellow, red and green lines indicate the direction which the radiotherapy beam will travel.

Richard Heathcock is a Pre-treatment Advanced Practitioner. He has worked in the radiotherapy planning department for eight years. “There is a massive difference in how we plan radiotherapy now – and it’s all due to the advances in diagnostic equipment. CT scans, MRI scans and PET:CT scans provide us with more information so we can tailor treatments more precisely, and ultimately improve outcomes for our patients. Every radiography student learns how to plan a treatment, but it’s not a job that is suited to everyone. You need to be very analytical and precise and have an ‘eye’ for complex planning. There are 11 full time radiographers working in the planning department, and last month we planned just under 450 patient treatments!! That’s a lot of plans! We have to work very closely with the consultants whose time is split between treatment planning and their clinic commitments so at times delays can be caused when we are unable to co-ordinate time to review decisions. But what we can’t do in this process is rush, because that’s when mistakes are made. So having a lot of patience helps in this role too. “We work very closely with the Physics department and are fortunate at this Trust to work with four different planning systems, offering us a diverse range of software to plan intricate and complex treatment plans. Just last month the Trust invested £265,000 in upgrades to planning software. With the technology we have available to us, I’m confident our patients are getting the best possible treatment for their diagnosis. And that’s something that makes our job worthwhile.”

C3 | The Clatterbrige Cancer Centre Magazine 13



Media expert joins Board Alison Hastings has joined the Board for a three-year term bringing a wealth of media and reputation management experience with her to help raise the Centre’s profile nationally and internationally. Alison started her career as a journalist at the age of 18 and by the age of 29 was Editor of the Newcastle Evening Chronicle. After a number of years in the world of regional press, during which she was appointed to the Press Complaints Commission,


FEEDBACK FROM PATIENTS HAS PROMPTED A REVIEW INTO PATIENT APPOINTMENT WAITING TIMES. Following a cancer diagnosis, we know waiting for a treatment appointment date can create anxiety. A national target of 62 days is set, and from the point of GP referral all patients should start their treatment within that time. We consistently deliver against this national target as we appreciate that delays to starting treatment can add additional stress at an already difficult time. Out-patient clinic appointment waiting times can occur for a number of reasons. For example, more patients can be added to the list at short notice to ensure they are not waiting longer than 62 days, or consultations can take longer than scheuled as it is important that the doctor discusses and explains a patient’s diagnosis and treatment thoroughly. It is equally important however for patients to expect to be seen for their appointment as close as possible to the appointment time which is designated to them. We acknowledge this isn’t always the case at the moment. We are therefore embarking on a review of outpatient waiting times to improve this situation.


she then went on to set up her own media consultancy business. Today she has 28 years experience and is currently the BBC Trustee for England, Vice President of the British Board of Film Classification and a Media Consultant. Alison said: “I am delighted to be joining the Board of such a well-respected and well-loved cancer centre. As much of my media work is based in London it will be immensely rewarding to be able to help contribute to such a worthwhile service locally.”

Top of the league! The Care Quality Commission’s inpatient and outpatient surveys for 2011 rate The Clatterbridge Cancer Centre as one of the best performing Trusts in the country. The Trust received the highest ratings in areas including cleanliness, waiting lists and planned admissions, confidence and trust in doctors and nurses, patients feeling they were involved in decisions about their care and patients reporting that they were treated with dignity and respect. The survey is aimed at understanding what patients think about the care and treatment they receive and is crucial to improving the quality of care delivered by the NHS. Director of Nursing and Quality Helen Porter said:


PAST EXPERIENCES HELP US BUILD OUR FUTURE Laurie Black tells us why he became a Foundation Trust Governor Hello, my name is Laurie Black and I am a publicly elected Foundation Trust Governor. My family is, and has been, around the NHS for many years. My wife was a theatre sister and devoted her working life to the NHS and our daughter works at the Royal Orthopaedic Hospital in Birmingham. I spent 30 years in New Zealand working within the hospital system supplying and commissioning equipment for laundry services and learned a lot about hospital Boards and patient care. About 15 years ago I was diagnosed with prostate cancer. After hormone therapy treatment the cancer became more aggressive and I was recommended to have surgery at The Countess of Chester. I was referred to Clatterbridge for extensive radiotherapy after my surgery and I was introduced to my Consultant Dr Ibrahim. It was then that my outlook on cancer changed. He was so understanding and helpful - all of a sudden it wasn’t a burden

anymore. Everything was explained to me and made so easy and my treatment was a great success. I thought: ‘If that’s the way they do things, I want to be a part of it’ and that’s why I became a Foundation Trust Governor. I hope I can influence both sides of the coin as a Governor. It’s an opportunity to have input into strategic decisions but I also hope to share my cancer experience with other male patients. I’m a people person, I like to meet and talk with people and hopefully I can help a few other patients who need advice.


Elections we need your support The Council of Governors was established to represent your views and ensure that cancer services are developed in a way that reflects the needs of local people. The Governor election process for 2012 started in May. This year we will be holding elections in four public constituencies and one staff constituency. If you are interested in becoming a Governor or learning about their role within the Trust, contact Andrea Leather on 0151 482 7799.

Make your vote count If you decide becoming a Governor is not for you, you can still take part by voting. Voting is important because it’s your chance to vote for the candidate you think will best represent your views and be accountable to you, the member. Below is a timetable of dates to look out for: 12th June – nominations pack circulated 27th June – closing date for nominations 17th July – voting packs circulated (if required) 6th August – closing date for election 7th August – results report to the Trust and successful candidates notified

Dates for your diary: Public Council of Governors meeting Monday 9th July - 5.30pm Monday 12th November - 5.30pm Annual Members Meeting Thursday 27th September – 7pm

C3 | The Clatterbrige Cancer Centre Magazine 15



Investing to improve Our investment to ensure the best possible environment at The Clatterbridge Cancer Centre continues. Current work on the main entrance, reception and corridors is underway and set to be complete by June 2012. This will include new ceilings, lighting, furniture including reception desks, decoration, flooring, heating and improved signage. There will also be a full refurbishment of the tea bar sitting area.

Clatterbridge offers complex prostate treatment The Brachytherapy team at the Trust introduced a new treatment technique for prostate patients in March when they treated their first patient using Ultrasound Guided High Dose Rate Brachytherapy (HDR). Brachytherapy is a form of cancer treatment where a radiation source is placed directly inside the body within pre-inserted catheters. In the case of prostate brachytherapy, the catheters are inserted into the gland at specific locations calculated using a computer planning system. The total dose is given to the prostate in about 10-15 minutes and as the radiation is delivered from inside the prostate, the healthy normal tissue nearby gets a much smaller dose of radiation reducing the likelihood of long term side effects. Chris Lee, Consultant Clinical Scientist and Head of Brachytherapy physics said: “HDR prostate brachytherapy is an extremely beneficial and state-of-the-art addition to our existing brachytherapy service and is suitable for patients with intermediate and high-risk disease.” The team at Clatterbridge will be using the technique initially as a ‘boost’ in combination with traditional external beam radiotherapy but will also be investigating the use of the technique as a sole treatment. As well as the proven clinical benefits of the technique, patients will also benefit from shorter overall treatment times compared to a standard radiotherapy course – just 16 visits as opposed to 32. In addition, these shorter times will also help to free


Dr Eswar and Chris Lee

up valuable radiotherapy treatment machine appointments. Chris added: “We have been using brachytherapy as a treatment modality at the Centre for many years but using high dose rate brachytherapy for the prostate is a novel approach to the treatment option. The technique is widely available in America and Canada, but only a few centres in the UK are able to offer this complex treatment to patients. We were fortunate to receive a generous donation of £20,000 from the Wirral & North Cheshire Prostate Cancer Support Group enabling us to purchase an integral component of the equipment necessary to implement the service, so on behalf of the team, I would like to say a huge thank you to them for their support.”


ACUTE ASSESSMENT As part of our ongoing ward refurbishment programme we are building a new acute assessment unit. If a patient becomes suddenly unwell due to their disease or treatment, this unit will bring together a dedicated environment with specially trained staff and specialist equipment to ensure they receive the best possible care.

C3 | The Clatterbrige Cancer Centre Magazine 17



BOWEL CANCER Bowel cancer is a growth created by an abnormal and uncontrolled division of cells that start in the bowel wall as a polyp, which can take many years to develop.


Dr Arthur Sun Myint Consultant Clinical Oncologist Specialist in bowel and breast cancer He joined Clatterbridge: In 1980 as a Specialist Registrar in Clinical Oncology and was appointed Clinical Scientist for the Medical Research Council in 1983. He enjoys: Portrait and landscape painting - as an accomplished artist he has exhibited oil and water colours in his home country of Burma since 1964.

He also: Was the first oncologist to introduce ‘contact radiotherapy’ in the UK when he set up


the first service in 1993 at Clatterbridge and helped design the new ‘Papillon’ treatment machine. He is now the course director for the ‘Papillon’ technique, training other UK and international cancer centres. He will be named as President of the International Contact Radiotherapy Society in 2013. He said: My father was a doctor in my home country of Burma and my attention was drawn to oncology when my mother was diagnosed with breast cancer. I am the longest serving consultant at Clatterbridge. I have worked here for 32 years. I can attribute much of this success to the staff I work with. They are very dedicated; nothing is too much trouble for them which makes my job a lot easier. It’s almost like working in a ‘family business’ which for me is almost the case as my daughter is training to be an oncologist and is working here too. I am keen to ensure patients are involved in decision making when it comes to their treatment prescription and what I enjoy most about working here is the patient environment which supports this.

1,000 reasons to celebrate The Clatterbridge Cancer Centre Liverpool celebrated its first birthday on February 14th


What are the symptoms?

• Bleeding from the back passage (rectum) or blood in your stools • A change in normal bowel habit • A lump can be felt in your abdomen or rectum • A straining feeling in the rectum • Pain in your abdomen or rectum • Anaemia (low red blood cells) See your GP if you have any of the above symptoms


What causes bowel cancer? There are no definitive reasons as to what causes bowel cancer but there are four areas that should be taken into account when assessing the risk: age; family history; diet (lifestyle) and history of inflammatory bowel disease.


How common is bowel cancer? Bowel cancer is the third most common cancer in the UK. About 1 in 20 people will develop bowel cancer in the UK.


How is it diagnosed? An investigation of the large bowel using a camera within a tube or X-ray images of the bowel after fluid containing barium is inserted via the rectum. National screening programmes are also in place for detecting bowel cancer in its early stages improves the chances of a cure.


How is it treated? Traditionally, surgery is the main method of treatment. More advanced cancers may need radiotherapy or chemotherapy or both to kill off cancer cells before surgery. Alternative treatments to radical surgery are being developed all of the time and Clatterbridge offers a specialist treatment by Dr Myint called ‘Papillon’ – which is a form of contact radiotherapy to treat early small rectal cancers.

The centre has proved a huge success with patients and has met its targets for the first year by routinely treating 100-110 patients every day. Centre Manager Julie Fenlon said: “We’ve treated just over 1,000 Merseyside patients last year, that’s 1,000 less patients travelling the long distance to Clatterbridge in Wirral. That adds up to a lot of miles and a lot of money saved for them and their families! We have chemotherapy clinics in every district hospital in this region; we have our centre in Wirral and now this centre which means we are delivering cancer treatments much closer to patients’ homes.”

Patient Christine Finney from Widnes is receiving radiotherapy treatment for breast cancer at the centre and was there to celebrate the special day. She added: “Starting treatment for cancer is extremely daunting. I was worried about all of it. But the staff have been wonderful. They really explained everything, anytime I was worried I knew I could call or pop in and they would see me. This centre couldn’t feel less like a hospital, it’s a lovely, friendly and brilliant place, and I trust them completely.” Thanks to Costco, Liverpool for their kind donation of a delicious birthday cake and treats to help celebrate the special occasion.

Thank YOU! The Clatterbridge Cancer Charity has raised a life-changing £1.2million in the last 12 months. This amazing achievement wouldn’t have been possible without your support so to say thank you we’re holding a free Supporters’ Reception at the fantastic Leaf café on Bold Street, Liverpool, on Monday 18th June and we’d love you to come along.

This informal evening will allow us to celebrate our successful year with the people who made it possible … YOU! As well as telling you all about our exciting plans for the next year there will be live entertainment, the opportunity to take part in our fun quiz and the chance to experience the sophisticated atmosphere of this quirky teashop, it’s sure to be a fun night! If you’d like to attend this special evening please ring the Charity team on 0151 482 7948.

C3 | The Clatterbrige Cancer Centre Magazine 19



Research round up

Angry Swans When local rowing coach and dedicated fundraiser Peter Little sadly died in February 2008 following a three year battle with prostate cancer, his friends and family were determined to continue his charitable legacy by raising money for Clatterbridge. As his youngest son Antonee explained: “Angry Swans is a multisport club created as a tribute to a man, a dear friend, and a role model who in his life raised over £150,000 for charity. In addition to his fundraising, he also provided opportunities, notably with disadvantaged and disabled children. He always taught us to help those less fortunate than ourselves so we are continuing his good work.” In the last four years the Angry Swans have been joined in their fundraising by many of Peter’s friends, who all share the same enthusiasm to do a little to help to make others’ lives better. They have so far raised over £13,000 for a variety of good causes including more than £5,000 for Clatterbridge in the last 12 months. Members range in ability from tenacious beginners all the way through to international athletes, taking part in various events including the Southport Dragon Boat Race,

stages of the Tour of Britain cycling race, Southport Mad Dog 10k, cycling Coast2Coast across Britain, Liverpool Marathon, Liverpool Triathlon and the forthcoming Le Mans 24 Hour Cycle Race. The group is now hoping to double it’s fundraising total. To support the Angry Swans in their fundraising, challenge them to a sporting event or for more information about raising money in memory of a loved one give us a ring on: 0151 482 7948 or email fundraising@ Keep an eye out for cyclists and runners all over the North West in their distinctive orange, black and white shirts.

FREEDOM OF THE CITY Wednesday 8th February 2012 was a momentous day for Liverpool Cancer Research UK Centre, with over 160 guests attending a special event at Liverpool Town Hall to celebrate the presentation of their Scroll of Admission to the City’s Freedom Roll of Associations and Institutions. The prestigious award was being given in recognition of the Centre’s groundbreaking research and cancer awareness work in the community. The Lord Mayor of Liverpool, Councillor Frank Prendergast presided over the ceremony, which took place in the Council Chamber. Testimonies were given by Dr.

Academic Unit of Oncology


FLY FOR CLATTERBRIDGE Make 2012 your leap year by joining us at our third Skydive Sunday of the year and take part in an exhilarating 10,000ft tandem skydive! Imagine standing at the edge of an open doorway in an aircraft flying at 10,000ft. You lean forward with only the outline of distant fields below, the noise of the engines and wind ringing in your ears. Letting go you fall forward into the clouds, diving through the


air as you freefall at 120mph. As the canopy opens, peace and quiet surrounds you and you begin your tranquil parachute descent from a mile up before steering yourself back down to the centre of the drop-zone below. If you want to experience the thrill of a lifetime call the Charity Team on 0151 482 7948. There is a £50 registration fee to guarantee your place and a minimum sponsorship to raise in order to complete the jump for free.

The Centre continues to actively support the development of the Academic Unit of Oncology. We recognise the importance of academic leadership and see it as an excellent opportunity to strengthen our relationship with the University of Liverpool. The Academic Unit is led by Professor Dan Palmer (Chair of Medical Oncology) and will seek to attract external research funding from the National Institute for Health Research (NIHR), local and national charities, as well as from pharmaceutical industry collaborations. The Trust has recently invested in a number of research posts to support the development of an early phase trials portfolio. This work will be conducted by the Liverpool Early Drug Development Unit (LEDDU), which is a collaboration between Clatterbridge, the University of Liverpool and the Royal Liverpool and Broadgreen University Hospital. We have also committed to fund a Chair of Radiation Oncology, Senior Lecturer and Senior Physicist to further strengthen the Academic Unit.

Kumar, Prof Sir Howard Newby (University of Liverpool) Andrew Cannell (The Clatterbridge Cancer Centre), Derek Campbell (NHS Merseyside), Jon Hayes (Merseyside and Cheshire Cancer Network), Tony Bell (Royal Liverpool Hospital), patient representatives Dennis Helsby and Bernie Singleton, and Profs Dan Palmer and Paula Ghaneh spoke about the future plans for the Centre. Following presentation of the Freedom Scroll and the signing of the register, the Centre’s Pledge to the City to fight cancer through research, training cancer professionals of the future, and through working with local people to help them understand, avoid and overcome cancer was declared.

Chief Executive Andrew Cannell at the ceremony

10TH ANNIVERSARY OF THE MERSEYSIDE AND CHESHIRE CANCER RESEARCH NETWORK The Merseyside and Cheshire Cancer Research Network (MCCRN) celebrates its 10th anniversary in 2012. The MCCRN is one of 32 networks that make up the National Cancer Research Network (NCRN) whose purpose is to provide the infrastructure to improve the speed, quality and integration of research. The NCRN also has the primary aim of increasing the number of cancer patients recruited into research and over the past 10 years has earned a world-class reputation for increasing participation into clinical trials. Over the past decade the MCCRN has co-ordinated and supported the recruitment of over 14,000 patients into high quality cancer studies. Their recruitment has been commended nationally and has increased year-on-year with 18.7% of cancer incident cases in 2010/11 being recruited to studies.

C3 | The Clatterbrige Cancer Centre Magazine 21



EVENTS CALENDAR Mersey Tunnel 10K 10 June One of Liverpool’s most unusual races, this point to point 10k takes you underneath the famous River Mersey via the Kingsway Tunnel. With Merseyrail providing free train travel to and from the start and finish line for runners all you have to worry about is the bit in between! Liverpool Triathalon 1 July Now in its fourth year, the Liverpool Triathlon is on track to grow to over 2,000 participants. With three distances on offer, from Super-Sprint to Olympic, the Liverpool Triathlon provides a great setting for people of all ages and abilities to take up the triathlon challenge. Clatterbridge Bike Ride 16 September Our first ever bike ride offers cyclists a 50 or 100 mile route starting in Southport. Passing through Lancashire it includes many of the major highlights of the region including the beautiful Forest of Bowland National Park. Chester Marathon

Mersey Walk of Hope 26 October After last year’s successful Mersey Walk of Hope, the moonlit walk along Liverpool Waterfront is back and this year it’s going to be bigger and better! For more information or to register for any of these events get in touch on 0151 482 7948 or email fundraising@


Parcs, ur conference’ took place at Centre The 9th annual ‘Find Your Sense of Tumo Trust er Canc age Teen the by ed erence host Nottingham earlier this year. The conf advice. and ort supp for ther toge e com s year sees young people aged 14-25

Cream of Butternut Squash Soup Ingredients Oil 2 tbsp Onion, chopped 1 medium Butternut squash 1 medium Chicken stock or vegetable stock 4 cups Salt and pepper to taste Low fat milk or milk alternative ½ cup

(Serves 6 people)

Cheshire le from across the Merseyside and “This year we took five young peop different the ss discu to gned which is desi Cancer Network to the conference image, late body on s topic ded inclu Talks hip. aspects of treatment and survivors climb Swarner, the first cancer survivor to effects, fatigue and fertility, with Sean ded. atten who all to talk nal Mount Everest, giving an inspiratio

Colourful, easy to make and delicious soup with a good source of vitamin A. Use double cream instead of milk to increase calories, and increase protein content by adding a handful of red lentils.

ing the l question and answer session allow “The conference also included a pane and nosis diag late on s focu a questions with young people to ask professionals . nosis diag to time what can be done to improve the rtunity to g people who attended had the oppo “It wasn’t all talk though - the youn In the us! to kind very was her weat luckily the experience the on-site activities and Saturday night was the that say to fair is it and t nigh evening there was a disco each ding this in all the years that I have been atten simply the best night I have known an opportunity for is h whic , case Show the red featu conference. Saturday night also ence. To te performance and entertain the audi each city/unit to put on a three minu ils go to www. enta ce eren conf the of rest the and get a better idea about what this ge of the conference. where you can see foota rience, ing and for some a life changing expe “The conference is informative, entertain same the had le to meet others that have it allows potentially isolated young peop look will we and it loved le peop g Our youn experience and to build peer support. s website and yteen Jimm the to go se plea year, next forward to taking another group see for yourself what it is all about.”

Method 1. Roast the butternut squash for a sweeter flavour - cut the squash in half and scoop out the seeds. Wrap in foil and roast in a 200 degree oven for 1 hour or until tender. 2. Scoop out the squash with a spoon and put contents in a saucepan. 3. Heat the oil and cook onion, stirring often for about 3-5 mins until translucent. Add to squash. Add broth and bring to boil. 4. Puree soup in batches in a blender or use the hand held blender in the saucepan. 5. Add milk or cream, salt and pepper. Heat through but be careful not to let boil. Serve with crusty bread or speciality bread.

David Wright Teenagers Teenage Cancer Trust Lead Nurse for ts Adul g Youn and

Clatterbridge dietician Kathryn Parr shares another of her delicious recipes

BOX WISE Can you place the three-letter groups in the boxes so neighbouring boxes always make a six-letter word, like PAR-DON or DON-ATE? We’ve placed one group to start you off. 1













Answers on back page




Support your cancer centre

7 October

An exciting new route has been developed for the Chester Marathon 2012 incorporating Chester’s iconic landmarks, covering 17 miles in England and 9 miles in Wales.

Recipe of the month

Find yourself a sense of tumour!

Please debit my credit / debit card, number

I would like to help ‘The Clatterbridge Cancer Charity’ by donating: £100




Other £

Direct Debit*

*If you tick this box, the Charity team will be in touch to set up your Direct Debit.

Look good, feel better Look Good…Feel Better helps women cancer patients in the most practical and positive way. They hold free skincare and make-up workshops to help combat the visible side effects of cancer treatment and, in turn, boost confidence and wellbeing. For more information call into the Macmillan Information Centre near to the main reception desk or visit Call to book a place on your nearest workshop: Monthly on a Tuesday in the Countess of Chester Hospital (01244 364 948) and weekly on Mondays in The Linda McCartney Centre, Royal Liverpool Hospital (0151 706 3720)

(maestro only)

I would like to know more about ways I can support the Charity

Tick if you do not want a receipt and help us reduce costs

I enclose a cheque/postal order made payable to “The Clatterbridge Cancer Centre”

Name: Mr / Mrs / Miss / Ms / Dr Address:

Start date

Expiry date

Issue No. (maestro only)

Security code (last three digits on reverse) In making this donation I do not intend that my wishes for its uses should impose a Trust. Signed: Date:


Telephone: E-mail: Thank you – your donation will now make an even greater contribution to our work. There are so many ways to get involved, find out more at: / 0151 482 7948 Or call into our charity office at Clatterbridge

If you are a UK taxpayer, we can receive an extra 25p for every £1 you donate. Gift Aid it? I am a UK tax payer and would like ‘The Clatterbridge Cancer Charity’ to reclaim the tax on any of the donation I have made in the last six years and all future donations as Gift Aid donations until I notify you otherwise. To qualify for Gift Aid, I understand that the amount of income and/or capital gains tax I pay must be at least equal to the amount claimed on my donation in the appropriate tax year (6 April one year to 5 April the next)

Send To: Charity office, The Clatterbridge Cancer Centre NHS Foundation Trust, Clatterbridge Road, Bebington, Wirral CH63 4JY Charity No 1051727

C3 | The Clatterbrige Cancer Centre Magazine 23



We know that there is amazing work going on in the hospital everyday – if you have a story you would like to share or if you want to tell us about your experience or the experience of a loved one, please get in touch. Looking forward to hearing from you… Vicki Head Communications Manager E: T: 0151 482 7583

STARr Lette

Caring Clatterbridge

It is now 24 years since I first came to Clatterbridge, I have had five cancers - all different ones and Clatterbridge is the greatest! My granddaughter has chosen to support Clatterbridge’s charity when she takes part in a run in May because you have looked after me so well. Your new magazine is great, you can see all the caring faces again - they stick in your mind. God bless all your staff, Clatterbridge is the only place I want to go. Rita Foster, Southport I would just like to thank all staff involved in the recent peer review process for their time and commitment in this process. National Cancer Peer Review is a quality assurance programme for NHS cancer services which involves self-assessment and professionally conducted reviews by external teams against nationally agreed “quality measures”. Several teams underwent Peer Review and overall reports show the trust did very well! Thank you all! Kate Smith Head of Clinical Governance One year at Clatterbridge Cancer Centre Liverpool has gone by so fast – it was good to look back and appreciate what we have achieved on our 1st birthday on 14th February. I just want to thank all the past and current patients treated at the centre for their support – you all make our job a pleasure! Julie Fenlon Centre Manager


Hoylake’s new Frankie’s New York Italian restaurant, a collaboration between celebrity chef Marco Pierre White and champion jockey Frankie Dettori, is giving away a three-course meal with wine for four people to the writer of next issue’s Star Letter. The 155-seater restaurant offers an Italian-American influenced menu, specialising in fresh pastas, steaks, seafood, burgers and handmade pizzas, while its stylish bar area offers a full range of cocktails, wines and beers. R4 AL FO A ME MARCO ITE AT H EW PIERR NKIE’S FRA YORK NEW LIAN ITA

Diagnostic Radiographer Hilary Moore has been awarded with an illustrious award in recognition of her commitment to always putting her patients first. Hilary was chosen as 2011’s Radiographer of the Year for the North West and received her prize at a glittering ceremony at the House of Commons in London.

Email your letter to or post to Vicki Head, The Clatterbridge Cancer Centre, Bebington, Wirral CH63 4JY by 31st July to be in with a chance of winning this prize. Please include your name, address and telephone number. The winner will be announced in the Autumn edition of C3 magazine.

We recognise the importance of your experience as a patient and those of your family and friends. If you have any compliments, concerns or complaints please contact: Sue Relph, Patient Experience Manager on: 0151 482 7927 or sue 24

Box wise answers: 1. Sch, 2.Eme, 3.Tic, 4.Unc 5. Ool, 6. Ket, 7. Lad, 8. Mot, 9. Tle, 10. Les, 11. Ser, 12.Ifs

Well done Hilary!

C3 - The Clatterbridge Cancer Centre Magazine  

The Clatterbridge Cancer Centre Magazine