RM Magazine, spring 2013

Life demands excellence

magazine – spring 2013

Making IMRT available to all Inside the Centre for Molecular Pathology Green light for new skin cancer drugs

Advancing treatment for prostate cancer

Our expert team is at the forefront of a golden age of drug discovery and clinical trials at The Royal Marsden

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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 Prostate cancer focus

The researchers and clinicians making major breakthroughs in the treatment of this cancer

18 Research hub How we are developing

personalised medicine in the Centre for Molecular Pathology

20 Fundraising focus

Behind the scenes with The Royal Marsden Cancer Charity’s Community Fundraising Team

22 Radiotherapy

Pioneered at The Royal Marsden, IMRT benefits patients nationwide

Regulars 04 Hospital news 25 PCAG 25 The Friends 26 Fundraising 28 Foundation news 30 Puzzles & prizes

Welcome

Welcome to the spring 2013 edition of RM, the magazine for our staff, patients, carers and Foundation Trust Members.

In this issue, we explore the advances that we are making in the treatment of prostate cancer (page 12). At The Royal Marsden, we are proud to have some of the world’s leading clinicians and researchers in this field. Major breakthroughs have resulted in a golden age of drug discovery and life-extending trials, including pioneering drugs such as abiraterone (page 5) – developed by The Institute of Cancer Research (ICR) and trialled at The Royal Marsden, it is now considered one of the most significant advances in the world in treating late-stage prostate cancer.

The Centre for Molecular Pathology (CMP) is also featured (page 18), following its official opening last November. The CMP brings together teams of clinicians and scientists to accelerate and extend our research in personalised or ‘precision’ medicine. We explain the layout of the centre and how the teams will work together. I am delighted that Professor Mitch Dowsett has been appointed as Head of the CMP, given his unique skills and experience in this field.

Also essential to our future is the continuing support of The Royal Marsden Cancer Charity. Over the past decade, the charity has raised £100 million, funding a variety of major developments. Our new campaign, ten10: a decade of innovation, was officially launched in January with the support of our President, HRH The Duke of Cambridge, who recorded a special video message (page 26).

I hope you enjoy reading this issue of RM, and look forward to a successful year ahead.

Cally Palmer CBE, Chief Executive, The Royal Marsden RM magazine 03

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Left: Dr James Larkin was involved in the trials for two melanoma drugs at The Royal Marsden.

Below: drug triallists Sandra Sayce and Allan Bennett

Hospital News

Advanced skin cancer drugs get NHS go-ahead he National Institute for Health and Clinical Excellence (NICE) has recommended two drugs trialled at The Royal Marsden – vemurafenib (Zelboraf) and ipilimumab (Yervoy) – as NHS treatment options for metastatic melanoma, the most aggressive form of skin cancer.

The two drugs work differently.

Vemurafenib blocks the effects of BRAF, a cancer-causing mutated gene. Half of patients with metastatic melanoma will have this mutation, which drives the cancer’s development.

The second drug, ipilimumab, harnesses the power of the body’s own immune system to fight cancer.

Dr James Larkin, Consultant Medical Oncologist, led the vemurafenib trial and was

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involved with the ipilimumab trial at The Royal Marsden. He said: “The results of these two trials represent the biggest breakthrough in the treatment of melanoma for more than 30 years. The clinical trials have shown a very significant prolongation of life.”

Allan Bennett, 74, from Devon, has been taking vemurafenib for more than a year. “When I arrived at The Royal Marsden to take part in the trial, virtually every treatment option had been tried by my local hospital, and my last round of chemotherapy hadn’t worked at all,” he said.

“I was told there was nothing more that could be done for me, but within the first two months of taking the drug, some nasty swellings on my neck had

dramatically reduced and the cancer that had spread to my lungs had almost disappeared.

“The disease was stable. I was amazed,” Allan added.

“This drug has given me at least an extra year of life, and I feel as though I could go on indefinitely.”

Sandra Sayce, 49, from Ruislip, was first diagnosed with malignant melanoma in October 2001. “By 2005, more lesions had appeared on my legs and eventually they spread to my lungs, liver, lymph nodes and spleen,” she said. “In 2006, I was told that the treatment was not working and that I probably had four months to live. I had a choice – palliative care or to try one more trial.

“The trial at The Royal Marsden was for ipilimumab.

Almost immediately, I knew it

was working,” she added.

“Six years later, the lesions have flattened, no more have appeared and the ones in my liver cannot even be seen on a CT scan. I pinch myself because I know how lucky I am to have been on this trial.”

The trial results represent the biggest skin cancer breakthrough for more than 30 years Dr James Larkin, Consultant Medical Oncologist, the royal marsden

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Hospital news

New abiraterone trial

Striking results for pioneering prostate cancer drug A drug that was already set to transform care for men with advanced prostate cancer also has impressive benefits for men with earlier-stage disease, a new clinical trial has shown.

Abiraterone was approved last year by the National Institute for Health and Clinical Excellence (NICE) for use on the NHS to treat prostate cancer that has stopped responding to standard hormone therapies and chemotherapy.

The recent Phase III trial, carried out at The Royal Marsden, shows that when the drug is given to men with no or mild symptoms before chemotherapy, it can double the time before tumour progression can be detected by a scan.

The benefits for men taking abiraterone were so striking that the trial was stopped early so that all patients in the study could receive the drug. The US Food and Drug Administration has now approved abiraterone, in combination with prednisone, for use in patients before chemotherapy.

The findings are set to pave the way for men to be treated with abiraterone much earlier

in the course of their disease, without having to undergo chemotherapy first.

Some 1,088 men from the UK and elsewhere, who had stopped responding to standard hormone-suppressing drugs but had not received chemotherapy, took part in the randomised double-blind study.

“Abiraterone was initially approved for use in patients who had run out of standard treatment options,” said Professor Johann de Bono, who led the trial. “But this trial shows that if we can give patients the

drug at an earlier stage, we can slow their decline and block their cancer growth for longer.”

Professor Martin Gore, The Royal Marsden’s Medical Director, said: “Here at The Royal Marsden, we have seen first-hand the impact abiraterone has had on our patients with advanced prostate cancer.

Patients are now living longer and with fewer side effects.

“To see the positive impact this is having on patients with early-stage disease is an exciting development in prostate cancer research.”

Abiraterone trial facts

2 in 3

patients with advanced and aggressive prostate cancer showed a decline in prostatespecific antigen (PSA) levels of 50 per cent or more after taking abiraterone 18 months+

20

15

10

5

0

8 months

Those who responded to abiraterone experienced significant benefits – tumour shrinkage, lower PSA levels and a lack of pain – for an average of eight months. For patients whose cancer was driven by the ERG gene – about a third of men – this benefit lasted for more than 18 months In men with no or mild symptoms, abiraterone doubled the time before tumour progression was detected by a scan when the drug was taken before chemotherapy

New Year Honours for our staff

Two Royal Marsden staff have been recognised in the latest New Year’s Honours List. Jan Balyckyi and Audrey Ardern-Jones have been awarded OBEs for services to cancer care and radiography and to cancer genetics nursing care respectively.

As Radiotherapy Service Director and Principal Therapy Radiographer, Jan manages our radiotherapy service and ensures that it complies with all national targets and legislation.

Audrey, who retired from her full-time post as Senior Clinical Nurse Specialist in 2008, is an Associate Lecturer in Cancer Genetics and Chair of The Royal Marsden’s Arts Forum. She joined The Royal Marsden as a research sister in 1993 to set up the UK Genetic Prostate Cancer Study – now a worldwide collaborative research project – with Professor Ros Eeles.

Cally Palmer, Chief Executive of The Royal Marsden, said: “I am delighted that Jan and Audrey, who have both made such a significant contribution to The Royal Marsden’s work as a world-class cancer centre, have been recognised for their outstanding contributions to healthcare.

My warmest congratulations to both of them.”

HRH Princess Alexandra with xxxxxx xxxxxx and xxxxxx xxxxx

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Hospital news

Below: Mr Cyrus Kerawala (third from left) and team during the pioneering surgery. Inset: patient Jez O’Neill

breakthrough in facial reconstruction surgery A Royal Marsden patient has become the first in the world to receive a combined operation for facial reconstruction following head and neck cancer.

Jez O’Neill, 30, underwent the pioneering operation last November to have three standard procedures in one, following the removal of his tumour nearly 10 years ago.

He is now recovering well after having his palate reconstructed, teeth implants installed and a temporary bridge fitted.

Mr Cyrus Kerawala, Consultant Oral and Maxillofacial Surgeon, who designed and performed the surgery, said: “I’m really pleased the operation went so well, as I’ve spent the past

year planning how it would work. The operation required all the clinical teams to combine as we had various people working on different areas during the 12-hour operation.

“Technically, the operation was more precise than the conventional approach because

Patients now have the option of one procedure rather than multiple operations Mr Cyrus Kerawala, Consultant Oral and Maxillofacial Surgeon, the royal marsden

the reconstructed bone had to be fitted into the correct position with millimetre accuracy, so that the implants could be inserted at the same time.

“It’s wonderful that we can now offer patients the option to have one procedure rather than multiple operations over a period of up to 12 months.”

Jez said: “I’ve been totally in awe of the quality of service across the board at The Royal Marsden. The clinical team, the nursing staff and the post-operative support have all been incredible.

“I’m well on the way to recovery now, and I know my quality of life will be greatly improved thanks to Mr Kerawala and the team.”

Integrated Cancer Centre in development

The Royal Marsden and The Institute of Cancer Research (ICR) are working on the development of an Integrated Cancer Centre in order to provide the best treatment through worldleading research.

The centre will allow both The Royal Marsden and the ICR to develop a unified strategy, and to integrate research and clinical practice more effectively. Both organisations are developing a joint venture model for the centre, to be considered by boards in mid-2013.

The aims of the centre include transforming patient outcomes through excellent research and access to the most recent discoveries; ensuring long-term financial sustainability and effectiveness as a worldleading cancer centre; and attracting and retaining the world’s best scientists and clinicians.

In addition, we intend to have a single Research Directorate to ensure a unified direction, led by Professor Alan Ashworth, Chief Executive of the ICR, as Director of Research, and supported by Professor David Cunningham, Director of Clinical Research, and Dr Liz Bishop, Divisional Director of Cancer Services and Research.

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Hospital news

Dr Mike Potter

London Cancer Alliance

Delivering improved cancer services in London n 2011, The Royal Marsden signed up to the London Cancer Alliance (LCA), along with The Institute of Cancer Research (ICR) and 16 other NHS Trusts across west and south London.

The LCA aims to develop more integrated pathways of care for patients, set the direction for improvements in patient experience and outcomes, and develop common data sets to assess our performance. We aim to provide cancer treatment and care in a new way, improve access to screening and diagnostics, and increase the number of patients enrolled in clinical trials to improve cancer

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care across London and our local health communities.

Cally Palmer, Chief Executive of The Royal Marsden, is stepping down from her role as Chief Executive Project Lead for the LCA after leading it through the formation of its management structure and service plan. She hands over to two Independent Chairs, Dr Neil Goodwin CBE and Dame Gill Morgan.

Dr Goodwin has extensive leadership experience in both the public and private health sectors. He has been chief executive of numerous NHS organisations, and was awarded a CBE in 2007 for services to the NHS.

Dame Gill has held a number of senior posts in public health and executive management, including Permanent Secretary of the Welsh Assembly Government. Prior to this, she was Chief Executive of the NHS Confederation.

Dr Shelley Dolan, Chief Nurse at The Royal Marsden, has been appointed as Associate Clinical Director. She will support the Clinical Director, Professor Arnie Purushotham, a Director of King’s Health Partners Integrated Cancer Centre and Professor of Breast Cancer at King’s College London. He is also a Consultant Surgeon at Guy’s and St Thomas’.

award joy for nurse

Elena Ann Murray with a patient

A Royal Marsden nurse has been honoured with a Beacons of Hope Award by the Lymphoma Association after an anonymous nomination.

Elena Ann Murray works in the outpatients department in Chelsea and has been a nurse at The Royal Marsden for 34 years.

“I’m so happy to receive this award – it’s a complete surprise,” she said. “I aim to create a friendly atmosphere in the clinics and to make patients feel at ease.”

The anonymous citation read: “Elena is wonderfully friendly and treats each patient as an individual. She’s completely dependable, entirely selfless [and] always there to support and help those who need her.”

Mr Satvinder Mudan

Two new Divisional Medical Directors

Dr Mike Potter and Mr Satvinder Mudan have been appointed as Divisional Medical Directors.

Dr Potter has taken on the role of Divisional Medical Director for Cancer Services.

He joins Dr Liz Bishop, Divisional Director for Cancer Services and Research and Development, and Jen Watson, Clinical Nurse Director, in providing expert clinical and managerial leadership across the division.

Mr Mudan has been appointed as Divisional Medical Director for Private Care. He will support Adam Doyle, Kate Hall and Louise McNamara in the delivery of the Private Care service.

Both Dr Potter and Mr Mudan will work alongside Dr Tim Wigmore in his role as Medical Director for Clinical Services.

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Hospital news

Diana Higgins, PALS and Patient Information Officer (right), speaks with a patient

UKONS honour

Nurse Consultant voted oncology nursing president Natalie Doyle, Nurse Consultant, Living With and Beyond Cancer at The Royal Marsden, has been voted President of the United Kingdom Oncology Nursing Society (UKONS).

Natalie, who has worked at The Royal Marsden for the past 16 years, was nominated by the society’s board and then voted in by UKONS members. She will hold this prestigious position for the next two years.

“I am delighted to have been elected President,” Natalie said. “This is a very exciting opportunity for me to continue the excellent work of my predecessors, uniting oncology nurses across the country and giving them a voice.”

UKONS represents cancer nurses and cancer nursing across the UK. Natalie believes that she can lead the society in its continued efforts to inspire nurses in this field by supporting their training and development, whether they work in specialist cancer settings, general hospitals or primary care and the community.

As part of the role, Natalie is also involved in the UKONS annual conference and plans to modernise the society’s website.

Also, in an attempt to help nurses to be able to join UKONS and get involved with national activities, members voted at the AGM to repeal the membership fees for 2013–14.

This is an exciting opportunity for me to unite oncology nurses and give them a voice Natalie doyle, Nurse Consultant, Living With and Beyond Cancer, the royal marsden

Natalie Doyle

Patient Advice and Liaison Service

advice by the Bedside T he Royal Marsden’s Patient Advice and Liaison Service (PALS) is now taking its help and advice to the wards.

With PALS by the Bedside, staff are now visiting clinical areas and wards to ensure patients can easily access PALS. Individuals can still visit the Help Centres for information on the services available to them.

“We feel that some patients don’t know what we do or where we are,” said PALS and Patient Information Officer Diana Higgins. “So, as well as advertising our Help Centres and providing contact cards for patients to fill out, we decided to take the service out to the wards.

“People often think PALS just deals with complaints, but we give a lot of support, information and advice on many issues, hold resolution meetings to sort out problems and work with various hospital departments,” she added. “PALS by the Bedside brings what we do into the clinical areas and lets patients know we are here.”

PALS and the Patient Information Service run Help Centres at Chelsea and Sutton

to provide information, support and advice to patients, their families and friends, and the staff involved in their care.

“We have a unique setup here,” said Diana. “We are all health professionals. For example, Rebecca Phipps and I are trained nurses and my other colleague, Jan Graham, is a social worker. We’re also unique in that PALS and our Patient Information Service are combined and based in our Help Centres. Not many other organisations offer this.”

The Chelsea Help Centre is based in the Ambulatory Care Centre, while at Sutton it is to the left of the main entrance, at the top of the ramp. Both are open 9.30am to 4pm, Monday to Friday. Email PALS at patientcentre@rmh.nhs.uk or call Freephone 0800 783 7176.

We bring what we do into the clinical areas and let patients know we are here diana higgins, PALS and Patient Information Officer, THE ROYAL MARSDEN

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Hospital news

Chief Pharmacist to head up national association Royal Marsden Chief Pharmacist Ian Costello has been elected as the new Chair of the British Oncology Pharmacy Association (BOPA).

Ian, who joined The Royal Marsden in 2007, leads BOPA’s Executive Committee and is responsible for developing and supporting the delivery of the association’s strategy over the next two years.

“I’m delighted with this appointment,” he said.

“It’s a real honour to lead our national association and I look forward to the exciting developments and challenges ahead.”

The aim of BOPA is to promote excellence in the pharmaceutical care of cancer patients through education, communication, research and innovation. It is working with bodies such as the Royal Pharmaceutical Society and the UK Oncology Nursing Society in developing and supporting strategies to improve oncology medication pathways and to help patients achieve the best outcome from their treatment.

Ian Costello

Adam Doyle, The Royal Marsden’s Divisional Director for Sutton and Merton Community Services (left), with Paralympian David Weir CBE and Michelle Corin, Musculoskeletal Services Manager, at the opening of the Jubilee Health Centre in Sutton

The Weirwolf opens new health centre in Sutton aralympian David Weir CBE, who won four gold medals at the London 2012 Paralympic Games, recently opened the new Jubilee Health Centre in Wallington, Sutton.

The state-of-the-art centre offers diabetic eye screening, physiotherapy, podiatry and various children’s services, provided by Sutton and Merton Community Services. It is also currently home to two GP practices, a pharmacy and local NHS hospital trusts.

“I was thrilled to be asked to open this fantastic new health centre,” said David, who lives in Sutton. “It’s a real asset for our community and I welcome this improvement to our health facilities and services in Sutton.

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The Royal Marsden’s Divisional Director for Sutton and Merton Community Services, Adam Doyle, was also at the opening. He was joined at the event by Royal Marsden Chief Operating Officer David Probert, Chief Nurse Dr Shelley Dolan and Nicky Browne, Director of Performance and Strategy Implementation.

“We were honoured to welcome David Weir, who played such an important part in the success of the London 2012 Paralympic Games, to open the Jubilee Health Centre,” said Adam. “The integrated healthcare approach is a great development for patients in the community, and provides community

services with much-improved facilities to treat patients.”

As well as being a Paralympian, David – nicknamed ‘the Weirwolf’ – is a regular competitor in the London Wheelchair Marathon, which he won for a record-equalling sixth time in April 2012, matching the achievement of Baroness Tanni Grey-Thompson.

The Jubilee Health Centre is a real asset for the community’s health facilities and services in Sutton David Weir CBE, paralympian

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Hospital news

Staff Awards 2012

The Royal Marsden held its annual Staff Achievement Awards Ceremony in November at the Tower of London.

The ‘Gatsby’-themed evening was a huge success, with colleagues from across the Trust being recognised for their achievements. Congratulations to all who were nominated and to the following award winners: Pursuing Excellence Dawn Smith, Nursery Manager Ensuring Quality Individual: Paulina Markovic, Quality Manager Team: Pathology Quality Leads Driving Efficiency Individual: Claudine Cleaver, Service Improvement Manager Team: Physiotherapy – outpatients, Sutton and Merton Community Services Breaking Boundaries Individual: Emilda Thompson, Senior Research Nurse Team: Professor Mitch Dowsett and team, Academic Biochemistry Developing Potential Dr Khin Thway, Consultant Histopathologist Anything’s Possible Individual: Tina Shaughnessy, Senior Staff Nurse, IV Team

Team: PATCH team Working Together Individual: Lisa Ogden, Specialist Speech and Language Therapist Team: Dr Julia Chisholm, Consultant Paediatric Oncologist, and Amber Conley, Matron, Oak Centre for Children and Young People Outstanding Contribution Individual: Bernadette Knight, Staff Support Facilitator, Psychological Support Team: Lung Unit research team, research nurses and clinical trial co-ordinators Unsung Hero/Heroine Patricia Stanley, Welfare Rights Advisor Outstanding Leadership Caroline Blackburn, Specialist Nurse, Dietetics

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Hospital news

Meeting holistic needs

Mr Kelvin Ramsey in theatre and in shooting action (below)

Sutton to get new West Wing clinical research facility

Funding has been approved to create a new clinical research facility at Sutton.

The Royal Marsden Cancer Charity will fund the £2.6-million project, which will provide a dedicated space for patients participating in clinical trials. In particular, the unit will increase the opportunities for translating early-phase studies conducted in the Drug Development Unit into late-phase research.

“This new unit will enable the transition of earlyresearch findings into largescale trials, which is integral to our National Institute for Health Research Biomedical Research Centre’s strategy,” said Professor David Cunningham, Director of Clinical Research. “The facility will increase the amount of research we can do and improve efficiency.

Although the unit will be an innovative space, it will also be a very comfortable environment for patients.”

The unit will be located in the West Wing of the hospital and will be open by the end of the year.

GB rifle record for surgeon r Kelvin Ramsey, Consultant Plastic and Reconstructive Surgeon at The Royal Marsden, was part of the eight-strong GB long-range rifle shooting team competing in last year’s historic North America series. In their last match against the US and Canada, the team scored a record-breaking 150/150.

“As well as winning against America and Canada, we broke a world record – eight members of the team scoring full marks has never been done before,” said Kelvin.

Selected for Great Britain Cadets at 18, and captain of Cambridge University’s team (earning a blue in the process), Kelvin has since travelled the world representing different England and GB rifle teams.

“Shortly after joining The Royal Marsden, I went to

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the World Long Range Rifle Championships in Australia.

The GB team won, so we’re currently world champions, which is fantastic.”

Kelvin now has his sights set on the 2018 Commonwealth Games in Australia. “It’s only a team of two at the Commonwealth Games, so I’ve got a lot of work ahead of me,” he said. “It’s difficult to combine my work at The Royal Marsden with training and competing, but you can’t turn down the chance to represent your country.”

A new assessment is being launched to help ensure a good patient experience at The Royal Marsden.

The holistic needs assessment is part of an initiative from the Department of Health and National Cancer Action Team (NCAT), and incorporates a person’s physical, psychological, social, spiritual and financial wellbeing. Following an extensive service evaluation, a holistic needs assessment will be offered as part of every cancer patient’s care.

Initially, the assessment will be carried out following diagnosis and on completion of primary treatment.

“Holistic needs assessments could make a huge difference to patients’ overall experience with the potential to improve outcomes by identifying and resolving concerns quickly,” said Natalie Doyle, Nurse Consultant, Living With and Beyond Cancer.

“Undertaking a holistic needs assessment will enable a patient to work with healthcare professionals to address their concerns. It should help the individual to take greater control of what happens to them and support them to self-manage their condition. By giving patients the opportunity to identify their concerns, teams will be able to develop a care plan that is tailored to an individual’s needs.”

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Professor Johann de Bono, senior author of The Royal Marsden’s pioneering research into prostate cancer

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Cancer focus

prostate cancer special

New discoveries helping to extend life The Royal Marsden’s research into prostate cancer is bearing fruit, with new treatments helping to prolong the lives of men with the disease.

We report on the breakthroughs made by our world-leading team

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ajor breakthroughs in prostate cancer research have resulted in a ‘golden age’ of life-extending drug discovery and successful clinical trials at The Royal Marsden.

This includes pioneering drugs such as abiraterone, which is now available on the NHS and was hailed as one of the biggest developments in treating men with advanced prostate cancer (see page 5).

As well as drug development advances, Royal Marsden scientists have designed a blood test that reads genetic changes like a barcode and can pick out aggressive prostate cancers. It assesses changes in the pattern of gene activity in blood cells triggered by a tumour elsewhere in the body. Researchers believe that the test could eventually be used alongside the existing prostate-specific antigen (PSA) test at diagnosis to identify patients who need immediate treatment.

“Prostate cancer is a very diverse disease,” says Professor Johann de Bono, senior author of the study. “Some people live with it for years without symptoms. But for others, it can be aggressive and life-threatening, so it’s vital that we develop reliable tests to tell the different types apart.

“We’ve shown that it is possible to learn more about prostate cancers by the signs they leave in the blood, allowing us to develop a test that is potentially more accurate than those available now and easier for patients than taking a biopsy. Our test picks up signs that a patient is likely to have an aggressive cancer. Doctors should then be able to adjust the treatment they give accordingly.”

Another pioneering cancer trial and subsequent treatment for men with advanced

prostate cancer has shown to significantly improve survival rates by up to 30 per cent.

Royal Marsden patients benefited enormously from the radium-223 chloride drug trial that was closed in 2011 due to its success.

Dr Chris Parker, Chief Investigator of the trial, explained that it was stopped early due to overwhelming evidence showing that the powerful alpha radiation drug worked and improved overall survival rates.

Patients experienced less pain and fewer side effects, and less damage was caused to the surrounding cells as the radiation targeted only the cancer.

One patient who took part in the trial, 64-year-old Ian Moore, says: “When I was diagnosed five years ago, I was told that the cancer had spread to my bones and I had three years to live.

“I tried many different treatments before Dr Parker invited me onto the radium trial.

I didn’t hesitate as I was hopeful it would give me a better quality of life, and it has. I’m so grateful for the opportunity to go on the trial, and am living a good life because of it.” ➜

Our blood test picks up the signs of aggressive prostate cancer Professor Johann de Bono, honorary Consultant in medical oncology

Prostate cancer facts

40,841 men in the UK were diagnosed with prostate cancer in 2009

10,721 men died from prostate cancer in 2010

30%

of men aged 50 will have the disease, though only a small proportion will develop clinically relevant and significant disease

70%

of men aged 70 and above will have the disease

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Cancer focus

Q&A prostate cancer

Mr Alan Thompson, Head of the Urology Unit, explains prostate cancer

symptoms – such as problems passing urine, or back, hip or pelvic pain – with their GP. However, most patients have no symptoms – they are diagnosed following a test to measure the level of prostate-specific antigen (PSA) in the blood.

If the GP suspects cancer, the patient is referred to a urologist, who performs a general examination. This includes a digital rectal examination, during which the size, lumpiness and hardness of the prostate is assessed. If the prostate feels abnormal or if the PSA level is elevated, the patient will undergo a transrectal ultrasound-guided prostate biopsy. If this reveals the presence of cancer, further tests – such as an MRI, bone or CT scan – may be performed.

How is it treated?

What is prostate cancer?

It is a form of cancer that develops in the prostate, a gland that only men have. Usually the shape and size of a walnut, the prostate sits under the bladder and surrounds the urethra, through which men pass urine and semen.

What causes it?

The biggest risk factor is age: there is a very low risk for men aged under 50, with the risk rising with age thereafter. About nine per cent of cases are linked with a family history.

Ethnicity affects the risk too, with black African and Caribbean men in the UK being two to three times more likely than men of white European origin to develop prostate cancer.

How is it diagnosed?

Some patients are suspected of having prostate cancer after discussing their

The best treatment option is determined by the grade and stage of the cancer, as well as the age and fitness of the patient.

Active surveillance is a management option for men with potentially curable cancer who wish to avoid the complications associated with treatment (see page 17).

A radical prostatectomy involves the removal of the whole prostate gland and the seminal vesicles. This is only done in cases where the tumour is fast-growing and needs radical treatment, and patients must be fit enough to undergo the surgery.

External-beam radiotherapy – for example, intensity-modulated radiotherapy (IMRT) – involves the accurate and focused use of a high dose of radiation to the prostate gland and surrounding tissues.

Two types of brachytherapy can also be used to treat prostate cancer. Seed implantation is used to treat localised low- and medium-risk cancer, and involves placing 50 to 100 tiny, low-dose radioactive seeds into the prostate. The seeds remain in the prostate and release their radiation slowly over many months, with relatively minor side effects. Medium-risk patients also have the option of high-dose rate brachytherapy, which involves placing radioactive rods into the prostate.

Other treatments such as high-intensity focused ultrasound (HIFU) and cryotherapy are available as part of clinical trials.

In metastatic disease, hormones and chemotherapy, as well as new drugs such as abiraterone, may be used.

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Cancer focus

Left: Professor Ros Eeles, Honorary Consultant in Clinical Oncology and Cancer Genetics. Top left: Amanda Baxter, Clinical Nurse Specialist. Top right: Dr Chris Parker, Consultant Clinical Oncologist. Above right: Consultant Surgeon Chris Ogden, who peforms prostatectomies using the da Vinci S surgical robot

genetic testing

Identifying men at risk

Understanding the genetic links to prostate cancer has been at the forefront of research at The Royal Marsden for a number of years.

The IMPACT study, led by Professor Ros Eeles, Honorary Consultant in Clinical Oncology and Cancer Genetics, has identified men with a genetic predisposition to prostate cancer due to mutations in the BRCA1 and BRCA2 genes, and offered them the opportunity for targeted screening.

Each year, Professor Eeles sees more than 300 men aged between 40 and 69 who have female relatives with BRCA-type breast or ovarian cancer. She says: “Men who carry the BRCA gene have a higher risk of developing prostate cancer and may be a lot younger than the majority of prostate cancer patients. Men with the BRCA1 gene have about twice the risk of developing prostate cancer, and men with the BRCA2 gene have up to eight times the risk.”

The study, which is being carried out in 60 centres in 19 countries, has helped us develop a programme of early detection for prostate cancer in men with these gene alterations.

Professor Eeles, who also works at our academic partner The Institute of Cancer Research (ICR), has been leading the trial for the past six years and has been pleased with the findings so far.

“We test the men’s PSA levels with a simple blood test once a year,” she says.

“If it is raised, we will follow up with a biopsy.

“As we do not have national screening in the UK for prostate cancer, the men on the trial ordinarily would not have known if they had a raised PSA level. Some in their early 40s were not experiencing any symptoms that would encourage a GP to refer them for further testing had they not been on this trial.”

open access for patients

Pilot aims to reduce the number of routine check-ups

Patients who have a stable PSA level for two years following their treatment will be offered the opportunity to join a new pilot study at The Royal Marsden.

The Open Access Pilot for prostate cancer patients has recently signed up men who are doing well after treatment and are coming to The Royal Marsden for routine check-ups. ➜

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Cancer in focus

Isabel White, Clinical Research Fellow in Psychosexual Practice

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Cancer focus

According to Clinical Nurse Specialist Amanda Baxter, the pilot will help reduce the stress and anxiety that patients often experience when they come back to the hospital for follow-up appointments.

“Patients want to just get on with their lives after successful treatment and don’t necessarily want to keep returning to hospital for routine check-ups,” she says. “Sometimes the thought of coming back can create a lot of tension and anxiety for patients, and can be inconvenient if they are back at work.

“Patients who have had radiotherapy or surgery and are doing well after two years can be invited to join the pilot.”

Following the success of a similar pilot for breast cancer patients, men who live close to one of the hospital sites will be asked to come in for a blood test once a year. A clinical nurse specialist will analyse the results and write to the patients who continue to have a stable PSA level. Those with a raised level will automatically be invited back to the clinic.

“Patients have been really positive about the pilot and welcome the fact that they do not have to keep coming back to the clinic unnecessarily,” says Amanda.

helping ease the side effects Psychosexual therapy after treatment

With more men now surviving prostate cancer, the importance of dealing with the side effects of treatment has never been greater.

At The Royal Marsden, we pride ourselves on not only offering all our patients the most successful treatment plan designed specifically for their needs, but also helping them to manage life after cancer.

As well as guiding patients through the minefield of which treatment to undergo, Clinical Nurse Specialist Amanda Baxter also helps them understand the side effects.

Integrated sexual dysfunction management is offered to those experiencing complex sexual and relationship consequences of prostate cancer treatment Isabel White, Clinical Research Fellow in Psychosexual Practice

“Although newer treatments like our da Vinci S surgical robot, which performs prostatectomies, have reduced the side effects, patients can still experience shortterm incontinence and erectile dysfunction,” she says. “In some cases, the side effects can be permanent. I find that men deal with them much better if they’re told at the start before the problem begins.”

Isabel White, Clinical Research Fellow in Psychosexual Practice, helps patients by providing sexual rehabilitation for them after treatment. She established one of the country’s first psychosexual therapy services dedicated to helping people whose sexual lives and relationships had been badly affected by cancer and its treatment.

“Men with prostate cancer and their partners are offered a sexual health assessment,” says Isabel. “Integrated sexual dysfunction management is offered to those experiencing complex sexual and relationship consequences of prostate cancer treatment.

“I work within the Urology Unit to support and manage men and couples experiencing high levels of emotional distress, those who are not responding to standard drug treatment for erectile dysfunction, and those who have other health issues that are impacting on their sexual recovery.”

Isabel also offers treatment programmes for men with non-erectile dysfunction difficulties such as loss of desire, changes in orgasm, loss of sexual satisfaction and altered masculinity.

Watch and wait

Active surveillance for low-risk prostate cancer patients

Not all men with prostate cancer need treatment. The Royal Marsden has more patients than any other UK centre on its active surveillance programme, which keeps a check on men with low-risk prostate cancer.

“Forty per cent of men with low-risk prostate cancer choose active surveillance rather than immediate treatment,” says Dr Chris Parker, Consultant Clinical Oncologist. “Active surveillance allows us to test their PSA level every six months and conduct an MRI test every two years.

“Two-thirds of our patients on active surveillance will lead normal lives, but a third will need treatment at a later stage. The idea is to avoid unnecessary treatment for men with harmless prostate cancer.” rm

Case study:

Tony McHale, 62 “I’ve recently been diagnosed with prostate cancer, but I’ve been on the IMPACT trial for three years because of my family history. My mum died of breast cancer, and my younger sister was diagnosed with it 10 years ago. She suggested I get tested for the BRCA gene, and I tested positive for BRCA2.

“I was 57 then and just carried on with life as normal.

I was invited to join the trial at The Royal Marsden; if I had not taken part, I would have probably ignored the symptoms and avoided going to my GP. I have options now as my cancer has been detected early. My tumour was of the type which had a high chance of progression unless treated, so without the genetic test, I may not have been treated immediately elsewhere.

“I’m discussing my options for treatment with my consultant and the team. They’ve been fantastic and are really helping me to decide.”

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The top floor will be devoted to research that covers every type of cancer. In two open-plan research labs, tumours will be investigated for new mutations and mechanisms of response to possible new treatments, using samples from patients as well as samples stored downstairs, meaning that new treatments can be tested in real time. In addition, two new teams are being recruited to work on gynaecological cancer and gastrointestinal cancer on this floor.

Part of the histopathology department from The Royal Marsden’s Chelsea site has been moved to the ground floor of the CMP and is now next door to the molecular diagnostics lab – this will speed up the diagnostic treatment process.

The histopathology unit examines patients’ tumours to determine which cancer they have. The molecular diagnostic unit looks at the genetic mutations that can affect treatment options and houses three separate labs, preventing contamination by keeping different processes separate.

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Research

CENTRE FOR MOLECULAR PATHOLOGY

The revolution starts here The new NIHR Centre for Molecular Pathology is now open. Here, we look at the pioneering work that will take place inside the building

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The lower ground floor will store tissue samples, providing researchers with an extensive ‘biobank’ for molecular study and linkage to clinical data. There are 16 freezers, each able to store more than 50,000 tissue samples at -80°C. These tissue banks will effectively allow us to look back in time. When we develop new tests, we need to know how they relate to the outcome of a patient. We can quickly refer to this biobank to determine how our patients that had that sample taken and had that particular marker are doing in the meantime. There are also seminar rooms on this floor, giving staff the space to share knowledge and ideas.

he Centre for Molecular Pathology (CMP) in Sutton is a state-of-the-art facility dedicated to the research of personalised cancer treatment. Bringing together clinicians, geneticists, pathologists and scientists from The Royal Marsden and The Institute of Cancer Research under one roof for the first time, it is set to revolutionise the way we treat cancer.

In the £18.2-million building, scientists are discovering the genes that are important in cancer and in cancer therapeutics. This will ensure that The Royal Marsden remains at the forefront of international developments in targeted therapies for cancer.

Professor Mitch Dowsett, Head of the CMP, says: “We will have several different teams in the CMP and it’s important to bring them together in one area. Under one roof, we now have a molecular diagnostic group working on tests needed immediately for patients, histopathologists supporting that group, and research groups.”

The facility was financed through capital funding awarded by the Department of Health to the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre, The Wolfson Foundation and The Royal Marsden Cancer Charity. rm

It’s important to bring together different teams within the CMP PROFESSOR MITCH DOWSETT, HEAD OF THE CMP

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I’ve worked for The Royal Marsden Cancer Charity for 19 years and don’t think I’ve experienced any two days the same Amanda Heaton, Community fundraising and Development Manager

Clockwise from top left: Amanda Heaton with volunteer Dennis Malone; Janet Tobin encourages young supporters; a volunteer promotes this year’s Marsden March at London Victoria station; Sarah Cassidy takes to the skies to support The Royal Marsden Cancer Charity; braving the chill to raise awareness of The Marsden March

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Fundraising focus

behind the scenes

Community Fundraising Team The Royal Marsden Cancer Charity supports the work of the hospital, raising funds for new buildings, equipment and cancer research – and the daily efforts of the Community Fundraising Team are vital

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rganising a £1-million fundraising walk for thousands of people is all in a day’s work for The Royal Marsden Cancer Charity’s Community Fundraising Team. Every year, the team arranges a wide range of fundraising events with local groups and businesses.

The team is also there for the fundraisers who actively raise money for the charity by taking part in skydives, cycle challenges and marathons. “We also support those who take part in less vigorous activities such as quiz nights, bake-offs and fundraising dinners at home,” Amanda says.

Amanda Heaton, Community Fundraising and Development Manager, and her team are based in the heart of the Sutton hospital site. The bustling office is a regular drop-in for patients, staff and supporters.

“I’ve worked for The Royal Marsden Cancer Charity for 19 years and don’t think I’ve experienced any two days the same,” says Amanda. “Our patients and supporters regularly pop in on their way to clinical appointments with donations or to tell us about their latest fundraising activities, so we’re always busy. Staff also drop by as many of them support the charity.”

Amanda also manages the charity’s corporate sponsors. “They are great supporters and raise considerable sums for the charity,” she says. “We have many companies who raise money for us, so I visit them regularly to support their fundraising.

I recently spent a day travelling to and from a company in Cheltenham for a corporate sponsor pitch, which was successful.”

The team is made up of 10 members of staff and more than 40 volunteers, who are kept busy with The Marsden March, the fundraising 14-mile walk between Chelsea and Sutton. Amanda says: “They are all so dedicated and committed. They donate 12,000 hours a year to us, so a lot of my time can be taken up managing their time effectively.”

Sarah Cassidy, Community Fundraising Executive, co-ordinates the supporters and has gone the extra mile by taking part in an event herself. “I’ve been encouraging our supporters to jump out of aeroplanes, run marathons and trek in exotic locations for years, so I thought it was only fair that I did one myself,” she says. “I did a sponsored skydive and it was absolutely amazing.

“When not jumping out of planes, I support the many fundraisers who have signed up for a challenge. Along with other members of the team, I also go along to the events and cheer them all on. This often involves getting up at 4am on a Sunday morning to travel to the event and set up our Royal Marsden Cancer Charity information tent.”

Janet Tobin, Community Fundraising Executive, spends most of her day encouraging schools, community groups such as the Freemasons and locals pubs to fundraise for the charity.

“My day can start by talking to a head teacher at a local school about fun ways the children can raise money for us, followed by distributing our marketing literature and donation boxes to a local publican and then finishing the day with a presentation at a Rotary Club,” says Janet. “It is always fun and varied.” rm

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Medical physicists test one of the cutting-edge linear accelarators used at The Royal Marsden to deliver intensitymodulated radiotherapy

Optimising diagnostic images for patient swallowing tests using a ‘phantom’

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Radiotherapy

Intensity-Modulated RadioTherapy

Pioneering new techniques in cancer treatment Over the past decade, The Royal Marsden has been at the forefront of research into radiation treatments such as intensity-modulated radiotherapy, which is now set to benefit cancer patients nationwide

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hroughout the past decade, The Royal Marsden and our partner The Institute of Cancer Research (ICR) have been leading the way with research into intensitymodulated radiotherapy (IMRT), an advanced radiotherapy treatment that results in fewer side effects than conventional techniques.

Now, this cutting-edge cancer treatment is to become more widely available to patients throughout the NHS. Last year, Prime Minister David Cameron and Health Secretary Jeremy Hunt unveiled the Cancer Radiotherapy Innovation Fund, a £15-million roll-out of IMRT that could result in almost 8,000 more patients a year benefiting from this treatment. It is thought that one in three cancer patients could ultimately be treated with this type of radiotherapy.

With IMRT, linear accelerators target precise doses of radiation at the tumour. The shape of the radiation beams may change hundreds of times during the treatment. The direction and intensity of the beams also varies, which results in radiation being sculpted in three dimensions around the tumour, minimising the radiation dose to normal tissue.

The first clinical trial of IMRT was conducted at The Royal Marsden in 2007.

The study of 306 women with breast cancer confirmed that it led to fewer side effects than conventional radiotherapy. IMRT is now a routine radiotherapy treatment at The Royal Marsden for some cancer types.

Professor David Dearnaley, Professor of Uro-Oncology and Honorary Consultant Clinical Oncologist, led the trials into IMRT at The Royal Marsden and the ICR. He says: “In the past, radiation side effects limited the total dose that could be given. IMRT targets more precise doses of radiation at a tumour,

Case study:

Geoffrey Rowcliffe, 74 “I was diagnosed with advanced prostate cancer 11 years ago. I had a PSA [prostatespecific antigen] level of over 100, which is extremely high – radiotherapy on The Royal Marsden’s IMRT trial was my only treatment option.

“I was treated daily for seven weeks, then had a course of hormone treatment. My PSA level soon went down, going as low as 0.04. It remains low, and I now see Professor Dearnaley for a check-up once a year.

“I was fortunate to receive IMRT, and I am so pleased that it is to become available to other patients across the country.”

while minimising the impact on surrounding healthy tissue. Sculpting the dose in this way allows higher doses to be directed to the cancer, increasing the chance of cancer cure while reducing the side effects of treatment.

It’s a win-win situation.”

IMRT is particularly beneficial for prostate cancer patients, as it can reach tumours in areas that were previously considered untreatable. It is also especially beneficial for patients with head and neck cancers, as it reduces the likelihood of side effects such as damage to salivary glands, which makes it difficult to enjoy and digest food.

“In 2003, we started a randomised controlled trial at The Royal Marsden, which showed that IMRT maintained saliva gland function and improved symptoms and quality of life of patients with head and neck cancer,” says Professor Chris Nutting, Consultant Clinical Oncologist and the lead investigator on the trial. “The data we gathered from this trial has influenced the roll-out of IMRT from the government, and it is extremely positive that this form of radiotherapy will be much more widely available throughout the NHS.” ➜

IMRT increases the chance of cure while reducing the side effects of treatment.

It’s a win-win situation Professor David Dearnaley, Professor of Uro-Oncology and Honorary Consultant Clinical Oncologist

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20/02/2013 16:36

Radiotherapy

Scientific support

Medical physicists and dosimetrists play a central role in planning radiation treatment for patients, whether via external radiation beams or internally placed radioactive sources (brachytherapy). They also provide consultancy on the design of radiation facilities and the safe handling, storage and disposal of radioactive materials.

Physicists and technologists also work together to enable the accurate analysis of imaging data obtained to show what is happening in a patient’s body – for example, determining metabolic rates or blood flow.

March of the machines

medical physics

Behind our pioneering radiotherapy and imaging work is a dedicated team of specialists in the Joint Department of Physics

Each year, more than 6,000 cancer patients undergo radiotherapy, including IMRT where appropriate, at The Royal Marsden.

Most will be unaware of the vital role that medical physicists, engineers, dosimetrists and technologists play in ensuring their safe and efficient diagnosis and treatment.

Staff in the Joint Department of Physics provide support for the clinical activities of the radiotherapy, radiology, nuclear medicine, ultrasound and MRI and radiation protection advice departments. These individuals often work in the background, calculating measurements and performing quality assurance when the radiotherapy machines are not in clinical use.

“We play an essential role in providing state-of-the-art treatment at The Royal Marsden,” says Margaret Bidmead, Head of Clinical Radiotherapy Physics.

“For example, each patient undergoing radiotherapy treatment has a personalised plan based on data measured from the linear accelerators and acquired from scientific imaging protocols for diagnosis and localisation, delivered in a safe and effective manner.”

Medical physicists are consulted for the specification, procurement and testing of complex and expensive medical equipment such as linear accelerators and scanners.

Crucially, they design and manage quality assurance and maintenance programmes to ensure that the equipment is safe and accurate. Their specialist knowledge is also called on to rectify equipment problems. A large part of a mechanical engineer’s work is to construct test objects and ‘phantoms’ – these approximate the properties of tissue and act as a surrogate for a patient, allowing the team to test and verify dose measurements and troubleshoot any potential issues.

Medical physicists are also involved in research at all levels, such as studying theoretical concepts, developing and testing equipment, and providing physics input to the design of clinical trials of new imaging and treatment techniques. The department also integrates the support of clinical services with the provision of national education and teaching programmes. rm

Above left: Margaret Bidmead, The Royal Marsden’s Head of Clinical Physics.

Left: a radiotherapy dosimetrist plans treatment for a patient

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Hospital groups

PCAG AND THE FRIENDS The new pin and wristband feature the periwinkle in their design

JOIN PCAG AND MAKE A DIFFERENCE

The Royal Marsden’s Patient and Carer Advisory Group is on the lookout for more members. Why not get involved?

The Patient and Carer Advisory Group (PCAG) actively reflects the voices of patients and carers in the planning and delivery of care and services. It is now looking for new members who are keen to represent patients and their carers, and keep the spotlight on their needs.

Charles McGregor, PCAG Chairman, said: “By joining PCAG, you will get the chance to make a difference and help to shape and influence proposals for new services, advise on how to provide information to patients and their families, and highlight areas for improvement.”

One example of a successful hospital service set up by PCAG is the Listening Post. This series of informal sessions held by members allows patients, carers, friends and family to offer suggestions and comments that are then collected to help improve the patient experience.

Other notable successes include dedicated on-street car park spaces for patients receiving chemotherapy in Chelsea, the reduction of chemotherapy waiting times and the appointment of a psychosexual therapist.

“It is up to you how involved you become,” said Charles.

“You can attend our meetings, which take place every two months, or contribute via email or letter. Everyone’s input is valued and listened to.”

More information about PCAG, including the notes of its meetings, is available online at www.royalmarsden.nhs. uk/about/patient-careradvisory-group To join the group or to talk to a member of PCAG, please contact Craig Mortimer in the Quality Assurance Team on 020 7808 2176 or by email at qualityassurance@rmh.nhs.uk

It’s up to you how involved you are...

Everyone’s input is valued and listened to CHARLES MCGREGOR, PCAG CHAIRMAN

Charles McGregor, Chairman of the Patient and Carer Advisory Group

THE FRIENDS OF THE ROYAL MARSDEN, CHELSEA

New charity pin and wristband for The Friends The Friends of the Royal Marsden, Chelsea have launched a fabulous new charity pin and wristband designed to appeal to the charity’s many supporters.

“This has been an exciting development,” said Friends volunteer June Torrance, who has been leading the project.

“A team of our volunteers, including our Honorary President, Countess Cadogan, came up with the idea of using the periwinkle flower, as it is used to prepare two of the medicines used in the treatment of cancer.”

A number of hospital departments were also involved in the project, including marketing, pharmacy and medical photography.

The result is a stunning blue periwinkle pin and contrasting white wristband.

All profits will be used to support the work of The Friends and purchase equipment for The Royal Marsden, Chelsea. The pin costs £2 and the wristband is £1. Both can be purchased at The Friends Shop and from The Friends trolley service and café at Chelsea.

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HRH The Duke of Cambridge provided a personal video message

A decade of innovation at The Royal Marsden Soccer star Jermain Defoe joined staff and patients at the launch of our ten10 campaign

Royal support for charity campaign As our new campaign – ten10: a decade of innovation at The Royal Marsden – gets under way, royal and sporting supporters join in the celebrations RH The Duke of Cambridge has helped to launch The Royal Marsden Cancer Charity’s new campaign by starring in a specially made film. Ten10: a decade of innovation at The Royal Marsden celebrates our achievements over the past 10 years and looks ahead to the next decade and our vision of even greater progress.

The campaign was launched in January at the Oak Centre for Children and Young People, a world-leading facility funded

by The Royal Marsden Cancer Charity. A personal video

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message from HRH The Duke of Cambridge, President of The Royal Marsden, and a visit from England and Tottenham Hotspur striker Jermain Defoe ensured that the campaign got off to a great start.

Over the past decade, The Royal Marsden Cancer Charity has raised £100 million to fund pioneering developments in cancer research, diagnosis, treatment and care. Each month, the campaign will highlight a different project or facility and the impact it has had on cancer treatment, both at The Royal Marsden and across the country.

We are privileged to have the support of HRH The Duke of Cambridge, who recorded a video message endorsing the charity, the new campaign and the amazing benefits the charity brings to the hospital.

Football star Jermain Defoe, whose father sadly passed away at The Royal Marsden last summer, was at the launch, keen to support the new campaign.

Actor Nathaniel Parker, star of The Inspector Lynley Mysteries and a charity supporter, has also narrated a film about ten10.

He travels around the hospital, talking to staff about how to

donate your birthday to help us raise much-needed funds.

To watch the film, visit www.royalmarsden.org/ten10

Please help The Royal Marsden to continue its amazing work as a centre of innovation and help make a difference for people with cancer HRH the duke of cambridge, president of the Royal marsden

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ten10: our focus each month

Every month in 2013, the ten10 campaign will celebrate a different project or facility funded by The Royal Marsden Cancer Charity. Fundraising staff and charity volunteers will visit each project to highlight the work of the charity to staff, patients and visitors.

In January, we kicked off at the Oak Centre for Children and Young People.

The Royal Marsden Cancer Charity raised £16 million towards the centre, which was opened in September 2011 by TRH The Duke and Duchess of Cambridge.

In February, we put the spotlight on the Drug Development Unit. Partfunded by the charity in 2005, it provides a link between discovery, trial and tumourspecific evaluation of drugs, enabling better collaboration between laboratory-based and clinical teams. Nearly 300 patients a year enter Phase I trials at the unit, which opened in February 2005, making it one of the largest in the world.

For details of our projects in focus each month, visit www.royalmarsden. org/ten10 The Royal Marsden’s Drug Development Unit

Getty images

Fundraising

Donate your birthday This year, make your birthday count by donating it to The Royal Marsden Cancer Charity. Join celebrities including Olympic gymnast Louis Smith, Spice Girl Mel C and TV presenter Phillip Schofield and ask friends and family to make a donation instead of buying you presents. It can be the cost of a DVD, the office birthday whip-round or a meal out – every penny will make a difference to people with cancer.

Donating your birthday will help us continue to invest in innovation at The Royal Marsden for the benefit of cancer patients everywhere. To donate your birthday, simply visit www.royalmarsden.org/ten10

Get ready to March!

For a third year, patients and their families and friends will join Royal Marsden staff on The Marsden March, a 14-mile walk between the Chelsea and Sutton hospitals.

Taking part on Sunday 17 March will be 4,000 walkers, raising money for The Royal Marsden Cancer Charity. In addition to our full 14-mile route, there is a shorter option that follows the last five miles of the main route – a popular choice for families and teams of all generations.

Entry is now closed, but you can still show your

support by cheering the walkers along the route or volunteering on the day.

For details of how you can get involved, please visit www.royalmarsden. org/march

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21/02/2013 11:47

foundation News

Governors in the spotlight after nine years of service Four Governors reflect on their time serving the needs of Members and patients at The Royal Marsden

Tony Hazeldine

ince the inauguration of The Royal Marsden as a NHS Foundation Trust in 2004, four Governors have been a constant force in representing the needs of Members on the Trust’s Council of Governors.

In April, Tony Hazeldine (Public, Sutton & Merton), Dr James Laxton (Patient, East Elmbridge and Mid Surrey), Sally Mason (Patient, Elsewhere in England) and Professor Ian Smith (Staff, Doctor) will have served the maximum possible tenure of nine years.

Sam Greenhouse, Head of the Foundation Trust Office, said: “On behalf of the Trust, I would like to thank Tony, Jim, Sally and Ian for their dedication, commitment and support throughout their time as Governors. They have helped to ensure that The Royal Marsden is challenged to maintain its work as a world-leading cancer centre.”

But how has the experience of the past nine years been for our dedicated foursome?

S

Dr James Laxton

What words best describe your time as a Governor?

TH: Pride and rewarding.

JL: Informative and enjoyable.

SM: Privilege, involvement and insight.

IS: Interesting and constructive.

What has been the highlight?

TH: My involvement in the appointment of the Chairman and Non-Executive Directors, the integration of the Sutton and Merton Community Services and the revision of the Constitution following the enactment of the Health and Social Care Act 2012.

JL: It’s been an informative period and I’ve gained an understanding of the workings of the hospital. Being involved in projects such as CyberKnife and endoscopy and in clinical trials of prostate cancer has allowed me to gain a true behind-the-scenes perspective.

SM: The rebuilding of the Chelsea site, following the devastating fire in January

Sally Mason

2008. The Trust Board had the vision to use it as an opportunity to improve and rebuild parts of the hospital.

IS: Revising the Constitution has been an exciting highlight.

How has The Royal Marsden changed during your tenure?

TH: I have seen so many groundbreaking developments in cancer research, diagnosis, treatment and care, including CyberKnife, the da Vinci surgical robot, the construction of the Oak Centre for Children and Young People and the development of personalised treatment for every patient through the Translational Genetics Laboratory and the Centre for Molecular Pathology. The hospital has become even more patientorientated and communitycentred too, with membership involvement through the Council of Governors as a matter of course.

JL: Technological advances over the past 15 years have

Professor Ian Smith

led to drastic improvements in the development of medicine and medical equipment. The Trust has embraced this, resulting in more effective, modern treatments.

SM: The Royal Marsden has become even more outwardlooking with several external developments, including a Chemotherapy Day Care Unit at Kingston Hospital, the provision of Sutton & Merton Community Services and an Acute Oncology Service with local hospitals in southwest London, all of which help to bring the hospital’s expertise closer to patients’ homes. On the research side, The Royal Marsden and The Institute of Cancer Research now have an academic partnership with Mount Vernon Cancer Centre to collaborate on programmes to find new and better ways to treat cancer patients.

IS: It has been a time of change and expansion at both the Chelsea and Sutton sites, with greatly improved facilities for service delivery and research.

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Foundation news

How the new Council of Governors will look

Be a part of the new Council of Governors

The Trust has welcomed the opportunity to review its constitution in light of the Health and Social Care Act 2012. Last December, the Council of Governors approved a reduction in the size and changes to the composition of the Council, enabling it to be more efficient and to reflect the enhanced duties of Governors. Patient subconstituencies have been revised to reflect Local Authority boundaries.

The Trust would like to thank all Governors for their support and contributions.

Their time and input in representing the views of patient, carer and public Members has been vital in the development of the Trust.

A full list of the seats on the new Council is shown to the right, with opportunities to stand in forthcoming elections marked ‘nominations sought’. If you are interested in becoming a Governor and being a part of our new Council, please contact the Foundation Trust Office for further details (see right).

Election timeline

◆ March 2013: nominations open and close ◆ April 2013: voting opens; Members get voting packs ◆ April 2013: voting closes and results are published.

For further information about the election, please call Rebecca Hudson on 020 7808 2844 or Jitendra Patel on 020 7811 8239, or send an email to rebecca. hudson@rmh.nhs.uk

Members’ events Improving services Last November, Chief Nurse Dr Shelley Dolan hosted the Patient, Carer and Public Members Event in Sutton.

Consultant Medical Oncologists Dr Jaishree Bhosle and Dr David Watkins, who work in the Acute Oncology Service, spoke about improving access to care in local hospitals closer to the homes of patients in southwest London.

Attendees also helped to shape the Trust’s local quality improvement indicator as part of the Quality Accounts process for 2013–14. Discussion groups revealed what matters to patients, carers and public members.

Members’ Week Our annual Members’ Week will take place on 4–8 March to encourage more people to become Members. Anyone who joins that week will have the chance to win £50 in John Lewis vouchers. You’ll also be able to find out how to get even more involved – for example, by standing for election to our Council of Governors.

If you, a friend or a family member would like to get involved, please visit www.royal marsden.nhs.uk/membership to complete an application form, or call or email the Foundation Trust office (see below right).

Non-Executive Director steps down

The Reverend Dame Sarah Mullally is to step down from her role as Senior Independent Director and Non-Executive Director of The Royal Marsden after seven years in the role. It follows her appointment as Canon Treasurer at Salisbury Cathedral and Non-Executive Director of Salisbury NHS Foundation Trust in March.

Trust Chairman R. Ian Molson said: “Sarah has been pivotal to the work of the Board and the Council of Governors with her wealth of knowledge of the NHS at both policy and clinical operational levels.

“I would like to congratulate Sarah on her new appointments and thank her for the enormous contribution she has made to The Royal Marsden.”

Patient and Carer ◆ Kensington & Chelsea and Sutton & Merton 3 x nominations sought ◆ Elsewhere in London 2 x nominations sought ◆ Elsewhere in England 2 x nominations sought ◆ Paediatric and Young Adult Stacey Munns ◆ Carer 2 x nominations sought Public ◆ Kensington & Chelsea Dr Carol Joseph ◆ Sutton & Merton nomination sought ◆ Elsewhere in England Ann Curtis and 1 x nomination sought Staff ◆ Doctor nomination sought ◆ Nurse nomination sought ◆ Corporate Support Services nomination sought ◆ Clinical Professionals (AHP & Healthcare Sciences) nomination sought ◆ Clinical Support Staff nomination sought Nominated Organisations ◆ Institute of Cancer Research Cathy Scivier ◆ Cancer Research UK (Charity) Kate Law ◆ Local Authority: Borough of Kensington & Chelsea Cllr Robert Freeman ◆ Local Authority: Boroughs of Sutton & Merton nomination sought ◆ Clinical Commissioning Group 2 x nominations sought

Contact us Freephone 0800 587 7673, telephone 020 7808 2844, email foundation.trust@ rmh.nhs.uk or visit www.royalmarsden.nhs.uk/ membership

Council of Governors meetings Wednesday 6 March 2013, 11am–1pm, Board Room, Chelsea Tuesday 14 May 2013, 11am–1pm, Board Room, Chelsea 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, my husband had radiotherapy for prostate cancer at The Royal Marsden in 2011. We were most impressed with the hospital and my husband felt very privileged to have treatment there.

I am always pleased to see the latest RM magazine and am encouraged to read about the advances made in treating prostate and other cancers. But the article that touched me most was ‘Gems of courage’.

What help this must be for sick children during their treatment. Please keep up this wonderful care.

Many thanks for such an interesting and encouraging magazine, which must be a tremendous help to anyone suffering from cancer.

Mrs Rowena HK Adams

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Fill in your details below when sending in your crossword competition entry. See right for details of our address.

NAME

ADDRESS

PRIZE CROSSWORD Across 1 Snake (5) 4 Saying (5) 7 Villainous (9) 8 Way out (4) 9 Bee house (6) 12 Whirlwind (6) 13 Dry (4) 16 Allowed (9) 18 Trench (5) 19 Demanding (5)

Down 1 Obscure (5) 2 Bicycle basket (7) 3 Prevalent (4) 4 Sudden (6) 5 Fuss (3) 6 Composition (5) 10 Abbreviate (7) 11 Gusto (6) 12 Vacuous (5) 14 Journal (5) 15 Stupefy (4) 17 Furrow (3)

CONTACT DETAILS

Congratulations to Penny Watts, who won 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 closing date for entry is Friday 5 April 2013. 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 Friday 5 April 2013. 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 and 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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14/02/2013 16:43

in the next issue RM brings you the latest hospital updates, research news, inspiring stories and exclusive interviews. The summer 2013 issue is coming soon…

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Breast cancer: our work in focus Report on the third Marsden March

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The role of nurse practitioners

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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 Marie-Thérèse Shepherd – Press Officer For Sunday Lucy Ryan – Editor Marc Grainger – Deputy Editor Catherine Hopkinson – Art Director Mathilda Evans – Account Director 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 2013. 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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21/02/2013 09:47

Up for a challenge?

Are you looking for excitement, new experiences and a real sense of achievement?

Our Challenge Events team can offer you a wide range of adventures, from walks along Hadrian’s Wall, to cycling, marathons to parachute jumps.

The list is (almost) endless.

Email charity@royalmarsden.org or visit www.royalmarsden.org/challenges 1

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Do a parachute jump Trek across the South Downs Take part in the London Triathlon Run a marathon Cycle from London to Brighton

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Registered Charity No. 1095197

20/02/2013 16:32