Private Care Magazine

Private care Introducing CyberKnife The latest radiotherapy treatment in focus Specialist children's centre now open Improving the lives of young people with cancer

Welcome to Granard House Our refurbished private care facility nears completion

Issue 1 CONTENTS 3. CUTTING EDGE New CyberKnife radiotherapy technology brings pinpoint accuracy to treating patients at our Chelsea hospital

Welcome

As a provider of private care for your patients, we want to ensure that you are aware of the many exciting projects and successes at The Royal Marsden. That’s why we’ve created Private Care, to regularly share news and update you on new developments in cancer care.

In this first issue, you can read about Granard House, our private wing, which will re-open in August. Much work has gone into creating a space that is of the highest clinical standard yet calm, cosy and modern. You can also learn more about our new Centre for Children and Young People. With the second phase well under way, we explain why it will become Europe’s leading centre in paediatric care.

We are very excited to introduce CyberKnife.

As part of our ongoing commitment to providing the very latest in radiotherapy treatments, we’ve recently become one of the first London Trusts to install CyberKnife and began treating patients in July. We also update you on our pioneering research into skin and kidney cancer.

I hope you enjoy reading this first issue.

We welcome your comments and feedback.

Kerensa Heffron, Development Director

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4. GRANARD HOUSE Private Care Service Manager Kate Hall on the exciting re-opening of our refurbished private wing

6. CARING FOR CHILDREN How a pioneering programme at our new paediatric centre will offer young patients new treatments including access to the latest clinical trials

7. STAFF PROFILE Consultant Dermatologist Dr Louise Fearfield on her role and the work of the Rapid Diagnostic Assessment Centre

h o s p i ta l n e w s

facilities UPDate

exPaNDiNG OUR critical care unit Last year, The Royal Marsden opened Europe’s largest and most advanced Critical Care Unit (CCU) for cancer.

Patients will be able to take full advantage of this when we open our private wing.

Our new facility provides the UK’s only Level 3 critical care facility just for cancer patients. The unit will also include dedicated space for adolescent patients.

“The CCU combines our Critical Care team’s expertise with the latest technology, including a state-of-the-art clinical information system,” explains Dr Tim Wigmore, Critical Care Consultant.

The sophisticated IT system will enable patients to be

continuously, safely and efficiently monitored.

These data from patient observations and medical interventions will help shape best practice and research worldwide, as well as enabling specialists to identify the key elements of care that can make a difference to the survival of a critically ill patient.

Part of the new CCU is dedicated to high-dependency care, providing a world-class level of care in a specially designed and staffed unit.

Single isolation rooms, fitted with high-efficiency air purification systems, will also protect high-risk patients and provide the highest infection control standards.

CyberKnife technology comes to Chelsea hospital The Royal Marsden has acquired CyberKnife, the very latest in radiotherapy technology. We are one of the first London Trusts to install the latest model and began treating patients in July.

The machine, based at our Chelsea hospital, will be available to treat patients with prostate, pancreas, liver and other tumours.

Housed in a speciallybuilt bunker lined with radiation-shielding material, CyberKnife works very

CyberKnife's accurate delivery of large doses of radiotherapy means that patients will require fewer hospital visits

differently from most conventional radiotherapy machines. “CyberKnife can track a moving tumour. Lung tumours, for example, aren’t static, they move as patients breathe,” explains Consultant Clinical Oncologist Dr Nick Van As, clinical lead for the CyberKnife project. “X-ray cameras monitor the tumour’s position and sensors monitor the patient’s breathing and reposition the radiation beams so they are delivered with pinpoint accuracy, minimising damage to healthy tissue.”

As CyberKnife technology enables large radiotherapy doses to be delivered with greater accuracy, patients will require fewer hospital visits.

For example, visits for lung cancer patients could be reduced from 30 to three; for prostate cancer patients, visits could drop from 37 to five; and

palliative radiotherapy visits could fall from 10 to one.

“We pride ourselves on being at the forefront of cancer care,” says Cally Palmer, The Royal Marsden’s Chief Executive. “Our radiotherapy services are world-renowned, and CyberKnife will provide us with many exciting

opportunities to continue improving our care for patients who need high-dose radiation treatment, as well as opening up unique research opportunities. It also helps to reaffirm the Trust’s belief in the importance of providing personalised medicine in treating cancer patients.”

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Granard house oPens The ÂŁ6 million modernisation and expansion of Granard House, our private care wing in Chelsea, is nearly complete. Here Kate Hall, Matron and Service Manager for Private Care, talks about the benefits the refurbishment will bring to both patients and staff

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re at f s eu ar e ch

’ve been at The Royal Marsden for 10 years – working with private patients for eight years, as Day Unit Sister from 2004 to 2007 and then as Matron since 2007.

In my time here, I’ve seen many exciting developments such as the opening of The Oak Foundation Drug Development Unit in 2005, one of the world’s largest facilities dedicated to testing new cancer therapies. Then in 2007 our da Vinci Robot arrived, making us the UK’s busiest centre for robotic prostate surgery. We are always looking for ways to improve patient outcome and the patient experience with the latest equipment and techniques.

As part of this ongoing commitment we recognised that Granard House, our dedicated private facility, needed modernisation and renovation. The new facility is now almost complete and we look forward to moving into our new home.

Our Chelsea hospital is a beautiful building with a wonderful heritage which did pose some challenges, for example, because of the building’s age, each room is different. We worked with this, fitting bespoke furniture and using natural materials to create a restful, comfortable environment. By playing to the building’s strengths we have created a unique space with all the advantages of a modern, clinical building while reflecting our unique heritage.

“The challenge was to create a modern working space with interiors that would motivate patient wellbeing” JOANNA HAYDEN, INTERIOR DESIGNER, THE DESIGN BURO

The modernised Granard House will provide a fully air conditioned, comfortable and well-lit environment. Its ward will house 21 single, en-suite private rooms over three floors.

Patients’ needs are at the heart of the rooms’ design, giving them as much control over their environment as possible; rooms are individually temperature controlled and have bedside lighting control. In their rooms patients can access an entertainment system that provides terrestrial and satellite TV channels, including foreign language channels, and wi-fi internet access.

Ward Sister Rebecca Clarke will lead inpatient care, and each of Granard House’s three floors will have a Junior Sister providing day-to-day clinical leadership. There is also a

new lounge specifically for private patients who are being admitted or transported home.

The wing will include the refurbished outpatient suite with modern equipment for minor procedures, new consulting rooms and a comfortable waiting area with refreshments.

Annie Foreman, Day Services Sister, will lead the outpatient service, with Senior Staff Nurse Laura Hitchcock and her team co-ordinating patient care.

I’m proud of the high standard of nursing care that we offer private patients. The new facilities mean we can provide this care in a modern, calm facility dedicated to meeting our patients’ needs and hopefully surpassing their expectations.

Top: the light and airy new outpatients’ reception area.

Above: each single en-suite room has its own individual look and is designed so that patients can easily access entertainment, the internet, and room lighting and temperature controls

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research UPDaTe SEARCHING FOR new TReaTMenTs

Skin cancer drug breakthrough

At The Royal Marsden, we carry out clinical trials of promising new treatments including surgery, chemotherapy, radiotherapy, rehabilitation and nursing. This allows us to give our patients access to both established and emerging treatments in an environment of continuous innovation.

In the last year alone, we recruited more than 4,000 patients to over 450 clinical research projects to help us improve treatment and outcomes for patients here and all around the world.

We work in partnership with the Institute of Cancer Research and work in association with a number of other cancer research organisations and charities.

Clinical trials led by The Royal Marsden have shown that two new drugs improve the survival rates of patients with advanced skin cancer.

Melanoma is now the second most common cancer among 15 to 34 year-olds in the UK. At a meeting of the American Society of Clinical Oncology in Chicago in June, scientists reported that a pill, vemurafenib, appears to give patients a greater chance of surviving. It was tested on a

“This is the most significant advance since the introduction of chemotherapy in the 1970s”

group of 675 patients with advanced melanoma. Another drug, ipilimumab, taken intravenously, is said to give patients extra years of life.

Dr James Larkin (pictured), UK Principal Investigator at The Royal Marsden for the vemurafenib trial, said: “This is great news – two breakthroughs almost at the same time. Both drugs will be very important for patients with advanced melanoma.”

Professor Martin Gore, Medical Director at The Royal Marsden, agreed, adding: “There is a very long way to go, but this is the most significant advance in the treatment of skin cancer since the introduction of chemotherapy in the 1970s.”

grant funds study on new kidney cancer therapies The Royal Marsden is part of European research group the PREDICT Consortium which has been awarded a €5.8million grant to identify ways to develop more effective and personalised therapies for kidney cancer.

“Currently, once kidney cancer or renal cell carcinoma (RCC), has spread, the mortality rate is higher than in other cancers.

It’s notoriously hard to treat,” explained Dr Charlie Swanton, the

project’s lead scientific consultant. “PREDICT has identified that RCC has no existing reliable biomarkers [chemicals or proteins that indicate cancer activity] for determining individual patient treatment,” he said. “By recruiting participants for the PREDICT trials, The Royal Marsden is starting the important process of identifying a biomarker and we hope this approach will be relevant to other cancers where no biomarkers exist.”

leading the way in chilDren’s cancer care Our new £18 million Centre for Children and Young People (CCYP) in Sutton offers a modern, age-appropriate environment with state-of-the-art technology, which will build on our status as one of Europe’s leading children’s and teenage cancer centres.

“Over the last decade, the overall cure rate for children with cancer has risen to 75 per cent; unfortunately advances beyond this have reached a plateau,” says Professor Andrew Pearson, 2 The Royal Marsden Private Care 6

Medical Director of Cancer Services. “We plan to challenge this and improve the lives of every child affected by cancer.” Not only will the centre be able to treat more inpatients and daycare cases, but once completed, it will house a world-leading drug development programme. “We’re focusing on a ‘bench-to-bedside’ theme,” he continues, “ensuring our young patients benefit from new cancer treatments and drugs developed in our laboratories.”

rM e sp ee ao rp clhe

Staff Profile

Dr Louise Fearfield Consultant Dermatologist “I’m really proud to be the first physician to take on this new role of Consultant Dermatologist at The Royal Marsden,” says Dr Louise Fearfield, who is based at the Rapid Diagnostic Assessment Centre (RDAC) at our Chelsea hospital.

Louise trained at Oxford University and St Thomas’ Hospital, qualifying as a doctor in 1992. Her first dermatology post was at the Chelsea and Westminster Hospital and at The Royal Marsden, where she completed her thesis on prognostic factors in melanoma.

After seven years as a consultant at the Royal Berkshire Hospital, Louise was then appointed Consultant Dermatologist and

an honorary consultant at The Royal Marsden.

“The RDAC is an exciting development for the hospital,” explains Louise. “It means that when a private patient is referred for suspected skin cancer, it’s possible that they can be seen within 24 hours, and all private patients are seen within a week of receiving their referral.”

The speed and efficiency of diagnosis and treatment is something Louise and her team are proud of. “We carry out a ‘See and Treat’ system wherever possible,” she says. “This accessible system is fast and efficient; a patient with skin lesions will be examined and a biopsy taken on the day,

“The Rapid Diagnostic Assessment Centre means that patients referred by their GP for suspected skin cancer can be seen within a week of receiving their referral” if needed. Results will then be processed as rapidly as possible, generally within a week. If a patient is diagnosed as positive for melanoma, we have a team of world-renowned plastic and melanoma surgeons and oncologists to deal with any treatment going forward. You couldn’t be in a better place.”

The new skin facilities at the centre include state-of-the-art technology such as a dermatoscope (a device to

examine an area of skin in detail), and a camera that exposes damage beneath the skin’s surface. This enables skin lesions to be viewed in a magnified way, which greatly aids diagnosis and monitoring.

“The RDAC will take us to the next level in skin diagnostics,” says Louise. “There are many exciting new developments on the horizon that will help to increase the speed and accuracy of diagnosis.”

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“As a world-renowned centre of expertise, our vision is to contribute to global improvement in the effective treatment of cancer while providing treatment and care of the highest quality ” Cally Palmer CBE, Chief Executive

Private patient services: Inpatient and outpatient private wing and Medical Day Care Unit; daycare facilities.

Diagnosis: Rapid Diagnosis and Assessment Centre and Clinical Assessment Unit; specialist pathology services.

Surgical theatres and critical care: Eight state-of-the-art theatres; the UK’s only Level 3 Critical Care Unit for cancer.

Imaging services: Extensive CT and MRI facilities and the latest PET-CT scanners.

For more information on our Private Care Service, please call: our Private Care Customer Services Team on (0)20 7808 2956 (0900 to 1700 UK time) or (0)20 7808 2063 (Arabic language only), or email private.patients@rmh.nhs.uk For information on our consultants, please visit: www.royalmarsden.nhs.uk