Life demands excellence
magazine – winter 2013
Theatre royal HRH The Duke of Cambridge pays a unique visit to The Royal Marsden’s surgical suite
Lung cancer focus: improving outcomes Our advances in targeted treatment Training tomorrow’s clinical experts
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. Thatâ€™s why the pursuit of excellence lies at the heart of everything we do.
Contents 12 Lung cancer focus
How one of the world’s most common cancers is meeting its match at The Royal Marsden
17 A royal visit
HRH The Duke of Cambridge scrubs up for theatre at the Chelsea hospital
20 Research matters
Paving the way for new treatments with molecular pathology breakthroughs
22 A day in the life
Meet Specialist Registrar Hazel Lote, an expert clinician of the future
Regulars 04 Hospital news 24 Fundraising 27 The Friends 28 Foundation news 30 Puzzles & prizes
Cover photograph: HRH The Duke of Cambridge with Consultant Urological Surgeons Mr Alan Thompson and Mr Pardeep Kumar
Welcome to the winter 2013 edition of Rm, the magazine for our staff, patients, carers and Foundation Trust members. Our President, HRH The Duke of Cambridge, recently visited the theatre suite and the CyberKnife machine at our Chelsea hospital. it was a pleasure to have the opportunity to show him a glimpse of the complex and pioneering surgery that takes place on a daily basis at the hospital. We are grateful for the Duke’s support for our patients and the work of The Royal marsden. a key part of the success of The Royal marsden is the contribution made by our junior doctors. Our registrars spend four years rotating around different units, working with some of the world’s most respected oncologists. Their role is vital to the high standard of treatment and care that we take such pride in providing at The Royal marsden. The fact that so many young doctors in training stay with us demonstrates the commitment they have to the Trust and our patients. it has been a busy end to the year for The Royal Marsden Cancer Charity. We were delighted to have the support of fashion designer Ralph Lauren, whose sale of Pink Pony products throughout the next 12 months will be donated to the charity. Our charity golf day was, once again, a great success and we were thrilled to welcome Tim Henman to the event, following his support at Rally Against Cancer this summer. i hope you enjoy reading this issue of Rm.
Cally Palmer CBe, Chief executive, The Royal marsden
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THE ROYAL MARSDEN PLAYS PIVOTAL ROLE IN QUEST FOR PERSONALISED MEDICINE he Royal Marsden is about to embark on Phase II of the Stratified Medicine Programme (SMP), following the success of the first phase of this pioneering national project. Launched in 2011 by Cancer Research UK, the SMP is the most ambitious programme of its kind in the UK and has achieved international recognition as a significant step towards individually tailored molecular medicine for NHS cancer patients. The initial phase was a twoyear pilot study that recruited 9,000 patients with breast, bowel, lung, prostate, ovary or melanoma skin cancer. Each participant had tissue samples taken from their tumours and a wide range of DNA tests performed quickly and for a fixed cost, to assess whether this strategy could be implemented across the NHS. As a leading centre for molecular diagnostics – the area of pathology concerned with detecting genetic abnormalities, such as mutations, that can help with the diagnosis, treatment or monitoring of a patient’s disease – The Royal Marsden was
chosen as a Cancer Research UK clinical hub (hospital) and a technology hub (laboratory). Phase II of the SMP will be led by Dr David Gonzalez de Castro, Head of Molecular Diagnostics at The Royal Marsden. It will focus on non-small-cell lung cancer (NSCLC) patients as a model where the molecular stratification of NSCLC – which has always been considered as one disease when, in fact, it encompasses multiple molecular genetic subgroups – can have great potential for novel therapeutic interventions that otherwise would not be available to these patients. In addition, thanks to the Biomedical Research Centre (BRC) funding and the facilities
Today, we can give our patients access to a wider array of therapies and clinical trials than ever before DR DAVID GONZALEZ DE CASTRO, HEAD OF MOLECULAR DIAGNOSTICS AT THE ROYAL MARSDEN
in the NIHR Centre for Molecular Pathology (CMP), the team is now developing molecular stratification of many other cancer types, applying translational research that can have an effect on patients in a short timeframe. Dr Gonzalez de Castro said: “The initial phase of the programme has just finished and we have been able to achieve the main objective of performing a whole panel of molecular tests in the specified time in more than 90 per cent of patients. This is by far the highest figure nationally, and we have only been able to achieve it thanks to the outstanding effort and commitment that the Molecular Diagnostics team has put into this project.” As one of only three technology hubs within the SMP, The Royal Marsden is able, for the first time in the UK, to routinely study a multitude of molecular markers in cancer patients. This means that we can achieve stratified medicine for cancer patients in the NHS, improving patient outcomes and making the UK an attractive prospect for groundbreaking clinical trials. Dr Gonzalez de Castro said: “This is revolutionary – only three years ago, it was common for cancer patients to have to wait four weeks or more to have one single molecular test performed, and a significant number of patients were missing out on the huge potential of targeted treatment. Today, we can perform a panel of five or more tests within 10 to 15 days on the NHS, in time to inform the clinical management of our patients and giving them access to a wider array of therapies and clinical trials than ever before.”
15,000 The Molecular Diagnostics team has performed more than 15,000 molecular tests in 3,000 cancer patients, of which two-thirds were patients of The Royal Marsden
90% During Phase I of the Stratiﬁed Medicine Programme, The Royal Marsden performed molecular tests on tumour samples within the speciﬁed time in more than 90% of patients
The Royal Marsden can perform a panel of ﬁve or more molecular tests within 10 to 15 days on the NHS
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International children’s trial launches
Dr David Gonzalez de Castro, Head of Molecular Diagnostics at The Royal Marsden
A trial to find the best chemotherapy regimen for children and young adults with recurring or resistant neuroblastoma has opened at The Royal Marsden. Researchers on the Phase II BEACON neuroblastoma trial will also investigate whether blocking the growth of new blood vessels supplying the tumours can enhance this treatment. Neuroblastoma is the most common childhood tumour occurring outside the brain, and there are around 100 children diagnosed with the cancer each year in the UK. Despite the number of children surviving neuroblastoma rising from 17 per cent in 1971 to 64 per cent today, the aggressive form of the disease is still hard to treat successfully. Neuroblastoma is dependent on the creation of new blood vessels, and this study will establish whether bevacizumab (Avastin), which inhibits blood vessel growth, can enhance the chemotherapy regimen. Professor Andy Pearson, who leads the Paediatric Drug Development team at The Royal Marsden and is lead researcher on the study, said: “There’s an urgent need to develop new drugs that can be fast-tracked into frontline therapy. The aim is to develop treatment for each individual patient, so that we can target each tumour more precisely.” In total, 120 patients will be treated at six different UK paediatric oncology sites, including The Royal Marsden. RM MAGAZINE 05
Two former Royal Marsden cancer specialists have been awarded the 2013 Pride of Britain Lifetime Achievement Award. Professors Trevor and Ray Powles, who are identical twins, worked at The Royal Marsden for more than 30 years before retiring in 2003. Professor Trevor Powles was Head of the Breast Unit, and Professor Ray Powles, his younger brother by 20 minutes, was Head of the former Leukaemia and Myeloma Unit. The Lifetime Achievement Award was awarded to the professors for their work in treating people with cancer and in the international field of cancer research. The annual Pride of Britain awards ceremony celebrates the achievements of truly remarkable people and is the biggest national event of its kind in the UK, with an audience of around seven million viewers. ITV sent cameras to The Royal Marsden to interview Professor Ian Smith, Head of the Breast Unit, who worked closely with Professor Trevor Powles. The interview was shown before the professors received their award in October. Professor Smith said: “I am delighted that Trevor and Ray have been given this national award. During their careers at The Royal Marsden, their dedication, compassion and focus to improve treatments and find cures for their patients, and their contribution to research, was invaluable.”
Pride of Britain toP award for cancer sPecialist twins
Professor ian smith, Head of the Breast Unit at the royal Marsden, being interviewed for the Pride of Britain awards 2013
the two professors receive their awards from Prime Minister david cameron and host carol Vorderman
this photograph: Professor ian smith, Head of the Breast Unit at the royal Marsden, being interviewed for the Pride of Britain awards 2013. Below left: Professors trevor and ray Powles receive their awards from Prime Minister david cameron and host carol Vorderman. Below: the two professors Professors trevor (left) and ray Powles with with the the Prime Prime Minister Minister
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Dr Nicholas Gough, Specialist Registrar in Palliative Medicine, in conversation with a nurse on Bud Flanagan Ward
Training camp top spot for Royal Marsden fellow
TRAINING THE DOCTORS OF THE FUTURE he Royal Marsden delivers a comprehensive and supportive training programme for its trainee doctors, according to a new survey. The National Training Survey, carried out by the General Medical Council, found that our junior doctors working in departments including anaesthetics and palliative medicine received
Training and inspiring the future generation of consultants is vital DR ORLA LACEY, CLINICAL LEAD FOR TRAINING AT THE ROYAL MARSDEN
good training in all areas. Dr Orla Lacey, Clinical Lead for Training at The Royal Marsden, explained that training our junior doctors is a hugely important part of The Royal Marsden’s work as Europe’s leading cancer centre. She said: “We always strive to ensure that doctors training with us grow in confidence so they can provide efficient, safe and compassionate care for patients. I consider training and inspiring the future generation of consultants to be vital.” Dr Jayne Wood, Head of Palliative Medicine, said: “Our trainees are well supported by the whole team both in and out of hours, and report a good experience with regards to intensity of work. As the educational and clinical
supervisors, we ensure that the trainees meet us on a regular basis from a training perspective and also through twice-weekly consultant-led ward rounds. The training at The Royal Marsden provides wide clinical experience related to cancer as well as managing some of the most complex palliative care patients.” Dr Nicholas Gough, a Specialist Registrar (SpR) in Palliative Medicine, said: “Trainees are well supported by consultants who are aware that we will be the consultants of tomorrow. I am in the third year of my four years’ training and have received a lot of time and advice from consultants. “I have also been offered opportunities to get involved with projects that will support me when I become a consultant.”
A Royal Marsden fellow was part of the winning team at this summer’s National Institute for Health Research (NIHR) Experimental Medicine Training Camp, which focused on the skills needed for developing a programme of research. Dr Alexandra Pender, a clinical research fellow for The Royal Marsden and The Institute of Cancer Research, was partnered with multidisciplinary research trainees to develop a hypothetical £5-million, ﬁve-year programme to set up a Making People Healthier Research Unit. The main theme of the bid was identifying modiﬁable risk factors to personalise obesity treatment, and included the following six themes into different areas of obesity research: metabolic characterisation; paediatric health; nutrition; community engagement; bariatric surgery; and PROMS (Patient Reported Outcome Measures). Dr Pender’s team prepared a full written proposal, a ﬂyer and a presentation for submission, and met with experts to discuss their ideas. Each group presented to a panel of NIHR professors. Dr Pender’s team came top at the end of the weekend. Dr Pender said: “The proposal partly focused on patient and public engagement in health research, an area in which I’ve had no previous experience. The experience of writing a successful proposal will be useful when submitting future funding applications for research at The Royal Marsden.”
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far left: dr francesco sclafani of the gastrointestinal and Lymphoma Unit. Left: dr naureen starling, associate director of clinical Research
ReseaRch identifies gene that deteRmines tReatment Response he identification of individual tumour characteristics could be used to predict how well patients with early-stage rectal cancer will respond to treatment, according to new research. The eXPeRT-C trial, developed and co-ordinated by the gastrointestinal (gi) and Lymphoma Clinical Unit at The Royal marsden, recruited 165 patients from 15 european centres to evaluate the addition of the drug cetuximab to chemotherapy and radiotherapy for early-stage rectal cancer. a retrospective analysis of this trial discovered that a tumour suppressor gene known
as TP53, also known as the genome guardian, may have a role in determining how well patients respond to cetuximab. TP53 is normally responsible for controlling the rate of the proliferation of a cell and should ensure that the cell dies if it becomes abnormal. TP53 is known to be non-functioning in about 50 per cent of colorectal cancers, potentially leading to a reduced response of tumour cells to treatment. The research demonstrated that patients in the eXPeRT-C trial whose tumours had a normally functioning TP53 gene seemed to have a significantly better survival when they were
treated with cetuximab, on top of standard chemotherapy and radiotherapy, than when treated with chemotherapy and radiotherapy alone. Dr Francesco Sclafani of the gi and Lymphoma Unit at The Royal marsden presented the results of this research at the 2013 eCCO Congress in
If confirmed, these findings will have implications for the treatment of other types of cancer Dr Francesco sclaFani, Gi anD lymphoma Unit, the royal marsDen
amsterdam. He said: “if confirmed, these findings will be of considerable relevance to colorectal cancer treatment and will have implications for the treatment of other types of cancer. This research will likely trigger further research to evaluate the previously unexplored role of TP53 as a mediator of response to cetuximab in colorectal cancer.” Cetuximab is used to treat patients with metastatic colorectal cancer whose tumour cells do not harbour a mutation of the KRaS gene. This new research identifies that the positive effect of cetuximab in patients with a normally functioning TP53 gene appears to be independent of KRaS status. Dr naureen Starling, associate Director of Clinical Research at The Royal marsden, said: “This research represents a valuable contribution towards developing personalised medicine in gastrointestinal cancers. The identification of biomarkers that predict response or resistance to targeted drugs is a really important research avenue. “The identification of TP53 gene status as a potential marker of response to cetuximab therapy in early-stage rectal cancer represents a step forward in the biomarker field of research and one we hope will be confirmed in future validation studies.” Dr Sclafani’s research was funded by the national institute for Health Research (niHR) Biomedical Research Centre (BRC) at The Royal marsden, which is the only BRC dedicated to cancer. Read about the BRC’s pioneering work on page 20.
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ROBERT TIFFANY WARD DUE TO RECEIVE REVAMP
for Private Care, said: “The standard of care and treatment we provide at The Royal Marsden is world class, and it is important our Private Care facilities reflect this. We want our patients to feel comfortable and relaxed in their surroundings. We always appreciate feedback and a lot of work has gone into the plans to make sure we are taking people’s comments on board.” Work on Robert Tiffany Ward will begin before the end of 2013 and is expected to be complete by the end of 2014. It follows completion of the extensive refurbishment of the Private Care facilities at the Chelsea site.
Robert Tiffany Ward, The Royal Marsden’s private patient ward in Sutton, is to undergo a £2.9-million refurbishment. The ward, which includes the Private Care Medical Day Unit (MDU), has not been updated
since the 1990s, but plans are in place to create a fantastic modern facility, including 11 inpatient rooms with en-suite facilities on the ward and 17 treatment chairs in the MDU. The new facility will be light and bright, and each
inpatient room will be fitted with the latest entertainment systems and will provide a private space for patients to receive treatment, recuperate and see their visitors. Louise McNamara, Divisional Nurse Director
We want patients to feel comfortable and relaxed in their surroundings LOUISE MCNAMARA, DIVISIONAL NURSE DIRECTOR FOR PRIVATE CARE AT THE ROYAL MARSDEN
ROYAL MARSDEN SCORES TOP MARKS IN HOSPITAL INSPECTIONS Sutton
The privacy, dignity and wellbeing given to patients
he Royal Marsden has scored highly in the recent Patient-led Assessments of the Care Environment (PLACE), an annual mandatory inspection. Patient assessors are required to inspect the care environment and to score standards of
The condition, appearance and maintenance of buildings
cleanliness, food, privacy, dignity and wellbeing, and the condition, appearance and maintenance of buildings. PLACE inspections were introduced in April 2013, with results reported publicly to help drive improvements in the care environment and to show how
hospitals are performing nationally. Both Sutton and Chelsea posted excellent results. Dr Shelley Dolan, Chief Nurse, said: “We pride ourselves on our excellent care and treatment, but it’s also crucial that our patients are treated with dignity, receive privacy and
good food, and that a high level of cleanliness is maintained.” The Trust’s catering facilities also scored highly in mandatory annual inspections carried out by local environmental health officers. Both the Sutton and Chelsea sites scored a maximum five stars under the local authority Scores on the Doors rating scheme. Gary Burkill, Head of Facilities, said: “Receiving the high PLACE scores and five stars for our annual catering assessment is testament to the hard work and dedication of our staff.” RM MAGAZINE 09
Chief Nurse honoured with EONS Award
Dr Shelley Dolan, Chief Nurse at The Royal Marsden, has been honoured with the European Oncology Nursing Society (EONS) Lifetime Achievement Award at the 2013 European Cancer Congress in Amsterdam. Dr Dolan qualified as a nurse in 1980 and specialised in Intensive Therapy Unit (ITU) nursing, and moved into specialist cancer ITU at The Royal Marsden. As Nurse Consultant in Critical Care, Dr Dolan worked on the development, design and opening of the largest Critical Care Unit for cancer patients in the UK. She was appointed as Chief Nurse in June 2007. More recently, Dr Dolan has taken on the role of Associate Clinical Director in the London Cancer Alliance and is playing a key part in transforming cancer services in London and the UK in the NHS. Cally Palmer, The Royal Marsden’s Chief Executive, said: “This award marks an outstanding personal and professional contribution made by Dr Shelley Dolan to the field of oncology nursing. It is a significant achievement and one Shelley should be proud of.”
REHABILITATION AND THERAPIES SERVICE FOR PATIENTS IN THE COMMUNITY atients can now benefit from Royal Marsden rehabilitation and therapy services in the community. While many patients receive these services as an outpatient, for some it is appropriate to be seen by staff at home. Some services, such as physiotherapy and occupational therapy, can be provided in the community, usually for a period of six weeks after discharge. Patient Patricia Dickie was diagnosed with cervical cancer in 2001. Despite being successfully treated at The Royal Marsden, she developed lymphoedema – swelling in the tissues beneath the skin that occurs when lymph fluid can’t drain away – in both her legs following radiotherapy. Patricia said: “My legs were very swollen and it really affected my quality of life. I was seen by staff in the
lymphoedema clinic but Jill Cooper [Head Occupational Therapist at The Royal Marsden] also came to my house. She was fantastic. I was having problems with my bathroom because of my lymphoedema and following a knee replacement operation. She helped organise a special bath lift for me. “I think of The Royal Marsden as a bit like a duvet. You get wrapped up in this wonderful care, where you get made to feel like you are the only patient they have, so to get this support – not
Royal Marsden care goes beyond our four walls JILL COOPER, HEAD OCCUPATIONAL THERAPIST AT THE ROYAL MARSDEN
only in the hospital but also at home – was great. My quality of life is much better now and I am very grateful.” Patricia has also had physiotherapy at home and is set to come to the hospital’s lymphoedema clinic, where therapists will help manage her swelling with a special bandage treatment. Jill Cooper said: “We are very proud of the service we provide to patients. For some, coming into the hospital is just not possible. It’s vital that we can provide some services in the community, especially as we are now seeing more and more people living with cancer. Royal Marsden care goes beyond our four walls.” For details of rehabilitation and therapy services, call 020 7808 2830 (Chelsea), 020 8661 3090 (Sutton) or visit www.royalmarsden.nhs.uk
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Help us beat ﬂu
The Royal Marsden has launched its 2013 campaign (see below) to encourage staff to get the ﬂu jab. Inﬂuenza is a highly contagious acute viral infection that affects people of all ages. Most people recover in a week or two, but ﬂu can cause serious illness, especially in the very young, the elderly and those with underlying chronic health problems. Flu epidemics occur mainly in the winter and can result in disruption to healthcare services. It is vital that Royal Marsden staff are vaccinated in order to protect staff, their families and patients, who can be particularly vulnerable to ﬂu.
The NHS also offers the jab to members of the public. Those who can get it free of charge include: ◆ pregnant women; ◆ anyone with a long-term condition such as diabetes, asthma, kidney disease or heart or chest problems; ◆ anyone undergoing medical treatment who may have a compromised immune system; ◆ anyone with a neurological condition such as multiple sclerosis or cerebral palsy; and ◆ anyone over the age of 65. Staff wishing to receive the jab should call Occupational Health on 020 7808 2139 for Chelsea and 020 8661 3003 for Sutton. Patients should speak to their GP.
This Morning presenter Phillip Schoﬁeld meets Ward Sister Nikki Holloway during ﬁlming at The Royal Marsden
STAR TURNS AT THE ROYAL MARSDEN ollywood actor Samuel L Jackson and television presenter Phillip Schofield filmed at The Royal Marsden in September as part of a week-long special for ITV’s This Morning to promote male cancer awareness. This Morning has joined forces with the male cancer awareness campaign One For The Boys, which Mr Jackson is chairing to raise money for The Royal Marsden Cancer Charity’s scanner appeal. The series aims to show the importance of visiting your GP and early diagnosis. As the country’s leading cancer centre, The Royal Marsden was delighted to be involved to raise awareness and highlight the work being carried out at the hospital. Filming took place on Burdett Coutts Ward, where Mr Jackson met two patients who are in remission. Testicular cancer patient Carl Taylor, 21, and 54-year-old Mark Etherton, who is recovering from prostate cancer, spoke about their
Be a flu fighter this year and get the FLU JAB Protect yourself, your family and vulnerable patients
Flu clinics start on 1 October 2013 in Chelsea and Sutton
All staff can have the flu jab for free this winter. For more information contact Occupational Health on 020 7808 2139 for Chelsea and 020 8661 3003 for Sutton.
experiences and the importance of going to your GP if you notice any unusual changes with your body or any symptoms or signs. Carl said: “It was incredible being interviewed by him. We had a good laugh and we even ended up following each other on Twitter. It was also good to support The Royal Marsden.” Mr Schofield interviewed Brenda Shepperd, a volunteer for The Royal Marsden Cancer Charity. She spoke about her husband Eric, who died from bowel cancer after being reticent to visit his GP when he developed crippling stomach pains. Both guests interviewed Ward Sister Nikki Holloway about the ward, the patients and her job, before meeting two inpatients who spoke about the excellent care they had received and the high quality of food provided. The episodes were shown on This Morning on 7 and 8 October, the first instalments in a week-long series of programmes on male cancer awareness and early diagnosis. RM MAGAZINE 11
LUNG CANCER SPECIAL
Treatment advances with patients at heart
Lung cancer is one of the most common cancers in the UK and can have a poor prognosis. However, through a combination of collaborative working and innovative new treatments, The Royal Marsden’s Lung Unit is improving outcomes for patients
Q&A LUNG CANCER
Dr Mary O’Brien, Head of the Lung Unit, explains the causes, symptoms and treatments of lung cancer
How common is lung cancer?
Excluding non-melanoma skin cancer, lung cancer is the second most common cancer in the UK. Around 42,000 people are diagnosed with the disease in the UK each year.
What are the symptoms?
Symptoms may include a persistent cough, or a change in a cough a patient has had for a long time; shortness of breath; bringing up phlegm with signs of blood in it; or an ache or pain when breathing or coughing. Loss of appetite, loss of weight and fatigue are also signs.
What can cause lung cancer?
The majority of cases in the UK – about 86 per cent – are caused by tobacco smoke. Cases in non-smokers can be attributed to risk factors such as a family history of lung cancer; exposure to radon gas in the environment; exposure to materials such as asbestos in the workplace; and air pollution, including second-hand smoke.
How is it diagnosed?
A GP may refer a patient with suspected lung cancer to a hospital, where they will be diagnosed via X-ray or CT scan.
The diagnosis is confirmed via a biopsy, usually performed by bronchoscopy (a look inside the airways via the insertion of a flexible tube known as a bronchoscope), with the patient under local anaesthetic. The earlier a cancer is picked up, the easier it is to treat and the more likely it is that the treatment will be successful. Therefore, it is important that you go to your GP as soon as possible if you notice any worrying symptoms.
What are the different types of lung cancer?
The main types are small-cell lung carcinoma (SCLC), which is also known as oat-cell cancer, and non-small-cell lung carcinoma (NSCLC). Mesothelioma, which is a cancer affecting the outer lining over the lung, is also treated by lung cancer doctors.
How is it treated?
The most common treatments are surgery, chemotherapy and radiotherapy, used either alone or in combination. Surgery is normally used to treat NSCLC, while chemotherapy or radiotherapy is preferred for SCLC. A patient’s treatment and outcome will
depend on the stage (how advanced it is) and type of the cancer.
Are we making any progress in the treatment of lung cancer?
Yes. We have now learned that there are many different types of lung cancer and that some have particular targets that are proving extremely responsive to new drugs. Lung cancer is one of the best examples of progress from personalised medicine and treatment, where targets have been found on the cancer cell. Highly active drugs have now been developed to treat these cancers.
What about in the earlier detection of lung cancer?
Work is ongoing to help identify those patients at the greatest risk of developing lung cancer – particularly the risk for smokers. Research is being done that will enable smokers to document their own exposure and measure their own risks. Looking forward a few years, strategies for screening patients who are at high risk will be explored. Smokers who have accumulated at least 40 ‘pack years’ [a pack year is the equivalent of one packet of 20 cigarettes per day for one year] are in this group. ➜
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Dr Mary O’Brien, Head of The Royal Marsden’s Lung Unit
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This photograph: Consultant Clinical Oncologist Dr Merina Ahmed oversees a patient’s treatment. Right: Dr Jaishree Bhosle, Consultant Medical Oncologist (right), chats with Clinical Nurse Specialist Karon Payne
Lung cAncer fActs
people were diagnosed with lung cancer in 2010 – about 115 new cases a day
of lung cancer cases are attributed to smoking
1 in 5
of UK cancer deaths is caused by lung cancer
8 in 10
of lung cancer cases occur in people aged 60 or over
of lung cancer patients survive for five or more years
AdvAnces in treAtment
How new radiotherapy techniques and clinical trials at The Royal Marsden are improving patient outcomes
The Royal marsden has always taken a different approach to lung cancer, aiming for curative treatment plans for patients wherever possible. Historically, patients who presented with this disease often received a poor prognosis, and treatments offered would be palliative. Surgery remains the main treatment option for early-stage lung cancer, often followed by chemotherapy. However, a significant proportion of lung cancer patients are not suitable for surgery – for example, they may not be fit enough – in which case, stereotactic radiotherapy, including CyberKnife, is a viable alternative. The Royal marsden was one of the first centres in the UK to offer stereotactic radiotherapy treatment, pioneering it from 2009. it allows us to administer extremely high doses of radiation to the tumour with pinpoint accuracy. The advantage of stereotactic radiotherapy is that even patients with poor lung function – for
example, those with emphysema – can be treated successfully in this way. Stereotactic radiotherapy is delivered via multiple radiation beams instead of just a few. We are able to aim precisely at a tumour from a number of different angles, enabling us to give a high dose of radiation to the tumour, but a much lower dose to surrounding normal tissue. “The difficulty for a clinical oncologist treating lung cancer is that the lung is a moving target,” says Dr merina ahmed, Consultant Clinical Oncologist. “This presents us with a challenge, but we have methods for overcoming movement with the use of breath-hold and tracking techniques. On a linear accelerator, a patient will hold their breath for about 20 seconds while we administer treatment, which they do five or six times per treatment cycle. “This allows us to reduce toxicity to the lung and, by combining it with new radiotherapy techniques such as arc therapy, we can reduce the side effects further. “Over the past few years, for stage 3 lung cancers, we have moved towards combination treatment consisting of
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For some patients, we can now discuss more than one treatment option Dr Jaishree Bhosle, consultant meDical oncologist
chemotherapy and radiation simultaneously, which has seen better cure rates. This form of treatment is more toxic, however, and patients need to be fit enough to tolerate the intensity of treatment, and also require careful monitoring from the team here. “Looking to the future, i am really excited to be setting up trials that aim to increase longevity for people with metastatic disease. The trials will look at stereotactic radiotherapy in conjunction with new drug treatments, with the hope that together they will increase life expectancy.” Dr Jaishree Bhosle, Consultant medical Oncologist, is also positive about recent changes in the treatment for lung cancer. “There has been a significant leap forward in the treatment of advanced non-small-cell lung cancer over the last few years through revolutionary developments in drug treatment,” she says. “The Royal marsden, as part of Cancer Research UK’s Stratified medicine Programme, is now able to test for genetic mutations in a patient’s lung cancer, allowing for targeted treatment [see page 4 for more details]. We are one of a handful of centres in the world that
can offer every lung patient a personalised approach to treatment, thanks to these successful research programmes. Through our trials, patients with advanced disease are living longer and often with fewer side effects than in the past. “it is great that, for some patients, we can now discuss more than one treatment option and have other treatments for when they are needed. Some of the new drugs are taken in tablet form, which allows patients to have fewer appointments at the hospital and has different side effects to conventional chemotherapy. For some patients, this means that they are able to continue working, go on holiday and enjoy time with their friends and family, rather than spending time at the hospital.”
Lung cancer patients benefit from double the expertise through our collaboration with The Royal Brompton Consultants and nurses in The Royal marsden’s Lung Unit are working hand in hand with partner hospitals, particularly The Royal Brompton in Chelsea, to ➜
Mr Hatton has been coming to The Royal Marsden since July 2013 for treatment for early-stage lung cancer. He says: “It’s a really simple procedure to use the breath-hold device. At first, I thought it might be quite tough to hold my breath on and off throughout each course of radiotherapy, but it is actually quite easy to do – it doesn’t hurt and it isn’t uncomfortable. “The type of radiotherapy I need has required me to come in every day for a few weeks at a time, but each session of radiotherapy is only about 15 minutes long. I am very pleased with the treatment I have been receiving at The Royal Marsden.” Dr Merina Ahmed, the Consultant Clinical Oncologist who is treating Mr Hatton, says: “Mr Hatton is doing really well with his stereotactic radiotherapy treatment, and I am pleased to say that his prognosis for the future looks good.” RM magazine 15
Dr Sanjay Popat, Consultant Medical Oncologist
This streamlined approach to treatment and care utilises the skills of two specialist trusts for the maximum benefit of the patient DR SANJAY POPAT, CONSULTANT MEDICAL ONCOLOGIST
provide the best possible expertise, treatment and care to patients. Through this partnership, patients benefit from the expert care of two world-leading acute trusts. The Royal Brompton specialises in treating patients with lung disease and The Royal Marsden specialises in cancer, and this joined-up approach employs the skills and knowledge of both sets of specialists. “As part of the cross-site partnership between the two hospitals, members of The Royal Marsden Lung Unit attend the various multidisciplinary team meetings [MDTs],” says Dr Sanjay Popat, Consultant Medical Oncologist at The Royal Marsden. “During these sessions, the results of patients who have been diagnosed with lung cancer are discussed, and treatment
is agreed. If a patient requires surgery, as many lung cancer patients do, that decision is made during an MDT. At a further MDT between the two hospitals, we discuss the results of surgery and whether the patient would benefit from more treatment. If further treatment is required, such as radiotherapy, chemotherapy or a combination of both, this is administered and managed by our team.” Joint clinics are held between clinical oncologists and medical oncologists, who look after The Royal Marsden’s radiotherapy patients and chemotherapy patients respectively. “This works extremely well,” says Dr Popat. “If a patient in clinic is being treated with chemotherapy, under me for example, and I think radiotherapy may be needed as well or instead, I have
direct access to one of our clinical oncologists, such as Dr Fiona McDonald. With the patient, we can map out the new treatment plan during that clinic, rather than the patient needing to come back to a separate clinic.” A key role within the MDT is that of our nurses. Karon Payne, Clinical Nurse Specialist (CNS) in the Lung Unit, says that all parts of the team, across both trusts, are in constant discussion to ensure that patients are on the right track. “I am in clinics almost every day, do ward rounds to see patients who have been admitted, attend our MDTs and liaise with our medical colleagues in the community to ensure that our patients continue to have the best possible care outside of the hospital,” she says. “We work really well as a team; everyone is looking out for our patients and has their best interests at heart. We’re always discussing and exploring the options of possible trials suitable for patients. “The Royal Marsden is one of just a few centres in the world that offers patients tests for genetic mutations in their cancer, which results in more targeted treatment. There is huge progress being made in this area and, due to treatments that are more appropriate for an individual’s cancer, we are seeing better outcomes for patients.” Radiotherapy is also a treatment option for lung cancer, with stereotactic radiotherapy provided to many patients at The Royal Marsden. “This type of treatment is a great example of partnership working between us and The Royal Brompton,” says Dr Popat. “For a lung cancer patient to receive stereotactic radiotherapy, a special type of preparation needs to be done to the lungs. At The Royal Brompton, a patient will have tiny gold seeds, known as fiducial markers, placed into their tumours, so that radiographers and clinical oncologists at The Royal Marsden know exactly where to deliver this radiotherapy. This streamlined approach to a patient’s treatment and care, by utilising the skills of two specialist trusts, provides the maximum benefit to the patient and the best possible outcome.” rm
16 RM MAGAZINE
Hospital Royalnews visit
Chelsea surgical unit welcomes HRH The Duke of Cambridge The Royal marsdenâ€™s President donned scrubs and witnessed the pioneering surgery we perform during a unique visit to the hospital
hrh the Duke of Cambridge in the Wolfson Surgical Suite with Consultant Urological Surgeon Mr Pardeep Kumar RM magazine 17
urgery at The Royal marsden received a royal reception in november as our President, HRH The Duke of Cambridge, visited the Chelsea hospital. after being greeted by Chief executive Cally Palmer and medical Director Professor martin gore, The Duke ‘scrubbed up’ and was escorted into the surgical unit by Dr Tim Wigmore, Divisional medical Director, and Clinical Service Lead for Theatres nick Bultitude. During the visit, the Duke witnessed two ongoing operations, something he had never done before. He met Consultant Plastic Surgeon mr Stuart James and his team to observe a DieP flap breast reconstruction, and Consultant Urological Surgeon mr Pardeep Kumar and his team to witness an open partial cystectomy and ureteric reimplantation – the removal of a tumour in the bladder. mr James said: “a DieP flap breast reconstruction is the gold standard in breast reconstruction surgery, and it was an honour to have the Duke witness part of today’s operation. The Duke showed great interest in the procedure, and the benefits that this surgery will have for our patient.”
mr Kumar said: “The Royal marsden offers one of the most comprehensive ranges of bladder reconstruction surgeries in the country. The Duke was fascinated by the procedure and its intricacies. it was a privilege to talk him through the surgery and its benefits.” The Duke also visited the hospital’s CyberKnife radiotherapy machine. Dr nick Van as, Clinical Lead for CyberKnife, said: “CyberKnife is an exciting development in radiotherapy and allows us to deliver high-dose radiation while minimising dose to normal tissue. The Duke was very interested to learn about the benefits, find out how the machine is operated, and see the robotic arm in motion.” Cally Palmer, said: “We were delighted to welcome our President back to the hospital in Chelsea this afternoon, to see our theatre suite and CyberKnife. We are very grateful for the Duke’s support for our patients and for the work that we do at The Royal marsden. it was a pleasure to have the opportunity to show him a glimpse of the complex and pioneering surgery that takes place on a daily basis at the hospital.” rm
18 RM magazine
Opposite page, clockwise from top left: HRH The Duke of Cambridge watches an operation; The Duke meets Senior Staff Nurse Resurrection Palomo, Operating Department Practitioner Ricardo Bonocore and Nick Bultitude, Clinical Service Lead for Theatres; observing bladder surgery with surgeon Mr Pardeep Kumar; The Duke and Dr Nick Van As in our CyberKnife suite This page, clockwise from top left: viewing via a surgical microscope; some of The Royal Marsdenâ€™s surgical team at Chelsea; The Duke is greeted by Medical Director Professor Martin Gore and Chief Executive Cally Palmer; The Duke with Dr Tim Wigmore; Dr Nick Van As and CyberKnife patient Frederick Corbett with The Duke; Mr Stuart James explains breast reconstruction surgery RM magazine 19
Research: the key to future treatment The Royal marsden and The institute of Cancer Research Biomedical Research Centre receives niHR funding to support our pioneering work. Here, we find out how our molecular Pathology theme helps to provide targeted treatment for our patients
20â€‚ RM magazine
Biomedical Research Centre
I look for research that will ultimately improve the outlook for cancer patients
olecular pathology has become a key factor in how we treat our patients. The Royal Marsden, together with The Institute of Cancer Research (ICR), is the UK’s only National Institute for Health Research Specialist Biomedical Research Centre (BRC) dedicated solely to cancer. Over the past 10 years, research work on targeted molecular diagnostics and the concept of personalised medicine has helped us to tailor treatment to individual patients, rather than take a ‘one-size-fits-all’ approach. Professor Mitch Dowsett is Head of the Centre for Molecular Pathology and Molecular Pathology Theme Lead for the BRC. He says: “We test the molecular characteristics of a tumour to identify mutations in the DNA that are responsible for the development of cancer. This is irrespective of where the tumour originates, so our work often crosses across all tumour units within The Royal Marsden and The Institute of Cancer Research.” A total of £62 million in funding is shared among the eight BRC research themes over a five-year period. “As Theme Lead, I have several opportunities a year to bid for funding,” says Professor Dowsett. “In IN FUTURE ISSUES... We will highlight the work of six other key Biomedical Research Centre themes and the role of their leads: CANCER THERAPEUTICS Professor Johann de Bono BREAST Dr Nick Turner PROSTATE Professor David Dearnaley CLINICAL STUDIES Professor David Cunningham CANCER GENETICS Professor Nazneen Rahman RADIOTHERAPY Professor Kevin Harrington
PROFESSOR MITCH DOWSETT, HEAD OF THE CENTRE FOR MOLECULAR PATHOLOGY
Left: Professor Mitch Dowsett, Head of the Centre for Molecular Pathology (CMP). From top: Professor Dowsett with CMP colleagues; with Dr David Gonzalez de Castro, Head of Molecular Diagnostics; outside the CMP building
the last meeting, four of my projects were supported. These covered molecular pathology work in gastrointestinal, breast, prostate and paediatric cancers. “The breadth and amount of work we do in molecular pathology is growing continuously as access to targeted treatments becomes more widespread. The BRC funding is essential to this work. “As Theme Lead, I look for research that will ultimately improve the outlook for cancer patients. There is no point in us pushing forward trials that will not have an impact on improving the patient outcome. “Even though I may be supporting a prostate molecular study, the finding may eventually be helping a patient with a different type of cancer.” FORMAT trial The FORMAT trial was among the most recent molecular pathology projects to receive BRC funding. It opened in October 2013 to patients with gastrointestinal cancer – specifically upper GI patients with gastric, pancreatic and oesophageal tumours. Up to 200 patients will be recruited over two years. Dr Naureen Starling, Consultant Medical Oncologist, who is leading the trial, says: “We have a pragmatic approach and will only be testing for up to 20 gene mutations and translocations [where genes combine]. This is to ensure that when patients test positive for a mutation or translocation, we can offer them a licensed drug or drug-development trial. “The trial is designed with the sole purpose of improving the patient outcome. We have no interest in the more exploratory testing of a very large number of gene mutations and then not offering a treatment option for the patient.” rm RM MAGAZINE 21
Talking to a patient about their prognosis gets easier with experience
Specialist Registrar Hazel Lote’s day includes multidisciplinary meetings to discuss patients’ treatments; a check on her lymphoma patients; a clinic to see up to 10 outpatients; and meetings with senior consultants in the Gastrointestinal Unit
22 RM magazine
A DAY IN THE LIFE
Dr Hazel Lote Specialist Registrar
s soon as I decided to specialise in oncology, I knew I wanted to come to The Royal Marsden. I’d done my initial training at various London hospitals, but as a trainee doctor here, I am working with some of the most respected cancer specialists in the country, if not the world. The learning curve is incredible. I am now in year two of my four-year Specialist Registrar (SpR) training, and rotate to a different tumour type every six months. So far I have worked in the Lung Unit under Dr O’Brien and Dr Bhosle, and in the Urology, Skin and Gynaecology units under Professor Gore, Dr Larkin, Dr Pickering and Dr Banerjee. Rotating every six months to different tumour types has given me the foundation to work out where I would like to specialise. Clinical experience It’s also important to learn about more than one malignancy as new therapies and therapeutic targets are increasingly applicable across tumour types. I have just moved to lymphoma and gastrointestinal (GI) malignancy, and am now working under Professor David Cunningham, Dr Chau, Dr Rao, Dr Watkins and Dr Starling. My day generally starts early with the multidisciplinary meeting (MDT), which is attended by colleagues from the GI team across all clinical disciplines. Clinical and medical oncologists, surgeons and radiologists all discuss the best way to proceed with a patient’s treatment. After MDT, I pop up to Bud Flanagan Ward to check on my lymphoma patients. The Senior House Officer on duty is
ward-based and gives me updates on my patients throughout the day, but I still like to check in first thing to see if all is well and to ensure that the pharmacy knows what drugs my patients require. I generally start my clinic at 9.30am and see around eight to 10 outpatients who have come for their check-ups in a morning. In the patient consultation, I outline the next steps in their treatment and answer any questions. Patient skills Talking to a patient about their prognosis is a particular skill and it gets easier with experience. If it is poor, for example, I make sure a Clinical Nurse Specialist (CNS) and a family member are present to give the patient the support they need. In the afternoon, I often attend meetings with the GI unit’s senior consultants, clinical fellows and research nurses. Here, we outline the current and upcoming trials so that we can offer the most effective and latest treatments to patients. The senior consultants are incredibly supportive and really encouraging. As an SpR, I need to get involved in research. Most SpRs take a couple of years out before the end of the four years’ training to do a PhD or master’s. I am still exploring my options at the moment. My day usually finishes at about 6pm. I am on call three weekends every six months in addition to being on call overnight on many weeknights. I love the patients and the variety of the job. There is so much going on in research and drug development, too, and I really want to be a part of this future. rm
RM MAGAZINE 23
The royal Marsden CanCer ChariTy
Golfers putt on a show at charity golf day
Pink Pony partnership High fashion has come to The Royal Marsden, with Ralph Lauren joining forces with The Royal Marsden Cancer Charity. Mr Ralph Lauren has long been recognised for his early leadership in the fight against breast cancer. Since 2000, his eponymous luxury brand, Ralph Lauren, has carried a Pink Pony range of clothing, with a percentage of proceeds going to cancer charities in the US and the UK. From October 2013, a year-long Pink Pony partnership was formed with The Royal Marsden Cancer Charity. As a result, 25 per cent of the retail price of Pink Pony products sold in UK Ralph Lauren stores, within Harrods and online at www.ralphlauren.co.uk will benefit The Royal Marsden Cancer Charity. Harper’s Bazaar magazine also collaborated with Ralph Lauren for The Royal Marsden’s benefit, hosting an exclusive online handbag auction. A unique Pink Pony Soft Ricky bag, lined in a stunning one-off pink, was auctioned for the charity. The bag was presented to the highest bidder at a glamorous event at the Ralph Lauren New Bond Street store, and the winning bid was donated to The Royal Marsden Cancer Charity.
From left to right: Tony lewis, Tim henman, alasdair haddon-Paton and Walter swinburn teed off in support of The royal Marsden Cancer Charity
ormer British tennis number one Tim Henman joined leading bankers and charity supporters at the annual Royal Marsden Cancer Charity City Challenge Golf Day at Sunningdale Golf Club. Tim, who took part in Rally Against Cancer earlier this year at The Queen’s Club, is a scratch-handicap golfer, so was more than happy to lend his sporting skills once again to the charitable cause. On the day, Tim played with Tony Lewis, a current patient at The Royal Marsden, before joining the other teams for lunch and prize-giving. Delighted to continue his support of The Royal Marsden Cancer Charity, Tim said: “Rally Against Cancer was a great event and opportunity to raise money for a fantastic cause. The Royal Marsden makes such a difference to so many people. I was pleased to support it once more, particularly on the golf course!” Tony, who has supported the City Challenge Golf Day for the past 12 years,
was thrilled to be part of another marvellous event, boosted by the attendance of such a high-profile celebrity golfer. “Tim was a fantastic representative for Great Britain on the tennis court,” said Tony. “He is also a fantastic golfer, and put many of us to shame with a spectacular round! “With his help, we managed to raise over £70,000 this year, and hope to continue raising funds for such a marvellous hospital.”
24 RM MAGAzIne
“Doing a trek along the Great Wall of China was a great way to raise money for The Royal Marsden and their wonderful work”
Denise van Outen walks the Great Wall of China Radio and television presenter Denise van Outen has raised more than £16,000 for The Royal Marsden Cancer Charity by walking the Great Wall of China. Denise took on the challenge after promising her best friend Tamara Edwards, and Tamara’s family, that she would walk with them to raise money for The Royal Marsden, where Tamara’s dad, Michael, was treated for leukaemia. He sadly passed away last year. The idea came to Denise when
Michael’s wife, Christine, revealed how devastated she was that she and her husband had never made their dream trip together. The childhood sweethearts had been saving all their lives to travel in their retirement, so Christine was heartbroken to have never had the chance to walk along the Great Wall with Michael. Denise pledged to do it in memory of him. “I felt it was something positive to do and would give everyone a focus,” said
Denise. “Doing this trek along the Great Wall of China was a great way to raise money for The Royal Marsden and their wonderful work.” In September 2014, The Royal Marsden Cancer Charity is organising its first exclusive trek along the Great Wall of China. For details on how to sign up and follow in Denise’s footsteps, visit www.royalmarsden.org/ great-wall-of-china-trek
RM magazine 25
THE ROYAL MARSDEN CANCER CHARITY
Help us make our next Marsden March the biggest yet ver the past three years, more than £3 million has been raised by 10,500 walkers by taking part in The Marsden March. The 2014 event will be the biggest one yet, as 5,000 walkers take to the streets between Chelsea and Sutton. Registration for The Marsden March 2014 is now open and will close on 17 January, unless places fill up before then. With only 4,000 places in the 14-mile walk and 1,000 in the five-mile option, space is limited, so sign up early to avoid disappointment. Amanda Heaton, Community and Corporate Fundraising Manager, said the event is a great chance for everyone connected to The Royal Marsden to come together. “For the past three years, The Marsden March has surpassed all expectations and generated huge levels of
enthusiasm for the charity from staff, patients, former patients, and their friends and family. “Last year, even the rain didn’t dampen our spirits. I’m really looking forward to an even bigger, better event in 2014.” There are two options for those wishing to take part. There is the 14-mile walk from our Chelsea hospital to our Sutton hospital, and the familyfriendly five-mile route between King George’s Playing Fields in Merton and The Royal Marsden in Sutton. At the finish line, there will be a party with live music, children’s entertainment, a barbecue, and various stalls and activities. All the funds raised go directly to The Royal Marsden Cancer Charity, which supports the work of The Royal Marsden. To take part, visit www. royalmarsden.org/march
Katherine Jenkins joins Royal Marsden runners in the Royal Parks half marathon Welsh mezzo-soprano Katherine Jenkins joined more than 90 other runners raising money for The Royal Marsden Cancer Charity in the Royal Parks Foundation Half Marathon. The 13-mile race took place in London’s four Royal Parks: Hyde Park, Kensington Gardens, St James’s Park and Green Park. Katherine said: “A friend of mine has a granddaughter who’s been recently diagnosed with cancer and is being looked after by the wonderful staff at The Royal Marsden. Many families are touched by cancer, including my own, and that is why I wanted to help. I’m proud to have taken part in the Royal Parks Foundation Half Marathon with the team from The Royal Marsden, and to help continue the good work this truly outstanding hospital undertakes.” 26 RM MAGAZINE
The Friends at Sutton celebrate 50 years of service The Friends have recently completed 50 years of volunteering and fundraising in our Sutton hospital. They formally marked the occasion by launching a range of merchandise that went on sale during a day of celebration in September. Records of expenditure only date from 1974, but since then, The Friends at Sutton have provided almost £4.5 million for amenities, equipment, furniture and furnishings for the wards and many departments. The Friends comprise about 185 volunteers, providing numerous services across the hospital. a particular point of pride is the number of years that so many of the volunteers have devoted to the hospital. For example, elizabeth Jayne is a former Chairman of The Friends and is the longest-serving volunteer, having volunteered at Sutton for almost 42 years. Congratulating The Friends on their 50th anniversary, elizabeth said: “The hospital
has grown enormously and the work and support of The Friends has expanded with it. “The organisation is very different now, and the size of the funds and scope of the contribution The Friends of Sutton make is so important to the hospital. i have enjoyed helping and hope to continue to be a volunteer.”
Dates for your diary The Annual Carol Concert at Holy Trinity Church, Sloane Street, is on Tuesday 3 December at 6.45pm. This year, The Friends have also joined with The Royal Marsden for the Celebrate a Life event on Thursday 12 December. For details and to book these events, visit the Friends Office, Chelsea.
the friends at sutton’s longest-serving volunteer, elizabeth Jayne (right), with a colleague
The Friends at Chelsea shop update
Volunteers Olivia deyong and naomi dawson in the friends shop
The Friends shop has recently undergone some minor refurbishment, to make it brighter and give customers easier access to the merchandise. Olivia Deyong is one of the many volunteers who run the shop. She is responsible for the buying side of the business and has a good eye for spotting great new ideas for gifts and cards
for all occasions. The gifts range from lavender bags and toiletry bags to chinaware, candles and lots more. Olivia has also introduced a selection of new confectionery, while making sure that the shop is always stocked with the old favourites. “Time is so precious,” says Olivia. “Why look elsewhere when you can find it all
here? And the best thing is that all the profits of items bought at The Friends shop go to The Royal Marsden.” Another volunteer, Naomi Dawson, has been busy selecting this year’s Christmas card selection. Her choice of cards can be found in The Friends shop, The Friends Café and at the hospital, courtesy of The Friends’ trolley service. RM magazine 27
Meet the Governors Our Council of governors has a pivotal role to play in representing the interests of members, the public and partner organisations across the health community. governors are also important in providing feedback about the Trust, its vision and its performance to the constituencies and the stakeholder
Dr Carol Joseph, Public Governor Carol is the Public governor for the Kensington and Chelsea constituency, and is now in her third year of office. as Lead governor, Carol’s main responsibility is to contact monitor, the healthcare regulator of nHS Foundation Trusts, in exceptional circumstances where concerns are expressed by fellow governors about the way the Trust is managed. However, given the excellent ratings of the Trust’s performance, Carol does not think this responsibility is likely to be utilised in the foreseeable future. Carol also stated that
elected governors all aim to be as effective and representative as possible in their constituent roles and in the activities they carry out for the Trust. She said: “We are all totally committed to the success of this hospital and to supporting the excellent work of the Board and its Chairman.”
We are all committed to the hospital’s success and to supporting the excellent work of the Board and its Chairman
organisations that either elected or appointed them. We will be featuring our governors in Rm so you can learn more about them individually. We start with Dr Carol Joseph, our recently appointed Lead governor and Public governor for Kensington and Chelsea, and Carer governor Lesley-ann gooden.
Lesley-Ann Gooden, Carer Governor Lesley-ann is one of two Carer governors for The Royal marsden, and was recently re-elected to serve for another three years. a qualified counsellor and life coach, Lesley-ann cares for her husband, malcolm, who is a patient at The Royal marsden. Her mother also received excellent treatment at the hospital. “Being surrounded by compassion and empathy made it easy for me to consider running as Carer governor,” she says. “i wanted to give something back and make a difference.” Lesley-ann is also on the Trust’s Patient and Carers advice group (PCag), is a volunteer assistant for the
Patient advice and Liaison Service (PaLS), and belongs to The Friends of The Royal marsden, Chelsea. “From my roles in the Trust, i’ve a good understanding of the hospital and its community, which helps me as a governor,” she said. “The Royal marsden is a place where people can feel safe. it’s a pleasure to represent my fellow carers.”
Being surrounded by compassion and empathy made it easy for me to consider running as Carer Governor
28 RM magazine
What it means to be a Foundation Trust
Annual General Meeting update
This year’s Annual General Meeting took place on 25 September in the Julian Bloom Lecture Theatre in Chelsea, and was a wellattended event. After a welcome by R. Ian Molson, The Royal Marsden’s Chairman, Chief Executive Cally Palmer summarised the Trust’s performance of the past year, and particularly noted how the hospital has provided half a million episodes of care, and that there have been 20,000 new patient referrals. The Chief Executive also highlighted the excellent results from the recently implemented Friends and Family Test and the Patient Environment Action Team inspections. The success of running Sutton and Merton Community Services, opening the Centre for Molecular Pathology (the only Specialist Biomedical Research Centre for cancer) and the development of the London Cancer Alliance were also discussed. Financial Director Alan Goldsman confirmed that the Trust has met all of its financial and quality targets set by Monitor, before Medical Director Professor Martin Gore gave an informative talk on ‘What is important in cancer care?’. Dr Theresa Wiseman, the Trust’s Strategic Lead for Health Service Research, then gave a talk highlighting two new pilot schemes run by The Royal Marsden for patients with prostate, breast, colon and gynaecological cancers who have finished treatment and need support in the community.
MeMbers’ event update dr tim Wigmore, divisional Medical director and Consultant in Critical Care and anaesthesia
he Trust held its annual Quality account members’ event on 27 november in Sutton. Hosted by associate Chief nurse Susan aitkenhead, the event focused on establishing our quality improvement priorities for 2014/15. Those who attended helped shape the Trust’s local quality improvement indicator as part of the Quality accounts process. Discussion groups highlighted
the issues that matter most to patients, carers and the public we serve. members also heard from Divisional medical Director and Consultant in Critical Care and anaesthesia Dr Tim Wigmore, who presented on ‘First do no harm: The Royal marsden’s Patient Safety initiatives’. Our next members’ event will be held in February 2014 at our Chelsea site. Details will be sent to members in due course.
Dates for your diary Council of Governors meeting Tuesday 3 December 2013, 11am–1pm, Board Room, The Royal Marsden, Fulham Road, Chelsea
Members’ event Late February 2014, The Royal Marsden, Fulham Road, Chelsea. For more details, contact rebecca. email@example.com To attend these events, please contact the Foundation Trust Office.
The Royal Marsden was one of the first hospitals in the country to become a Foundation Trust. While the Trust is still part of the NHS, it is independent from the Department of Health and is directly accountable to its service users. One requirement of being a Foundation Trust is to have Members that consist of patients, staff and the wider public. The benefit of becoming a Member is that you have greater involvement in the management of the hospital. Members are also represented by their elected Governors, who have a duty to hold the Board of Directors to account and help shape the strategic direction of The Royal Marsden. Membership is free, and allows Members to: ◆ have a greater say in how services are run; ◆ stand for Governor; ◆ elect others as representatives on the Council of Governors; ◆ receive regular updates about The Royal Marsden and its services; ◆ tell the Trust about the needs and expectations of the local community; and ◆ attend the AGM and exclusive Members’ events.
Keep in touch
Become a member and/or contact your governor: Freephone 0800 587 7673, telephone 020 7808 2844, email foundation.trust @rmh.nhs.uk or visit www.royalmarsden. nhs.uk/membership RM magazine 29
PUZZLES & PRIZES
Test your wits
Complete our crossword and you could win £50 in John Lewis vouchers SUDOKU
7 2 5 9 1 4
7 4 5 2
2 5 4 6 3 9 2
Dear RM, Having read the recent issue of RM, I thought I would let you know how interesting it is to read about the research work carried out by the various teams at the hospital. It’s fascinating to see how research progresses to treatment, and heartening to see the advances being made. Even though I am not local to the area, I believe it is important to see the inspiring work being carried out at The Royal Marsden as this will beneﬁt patients throughout the country. Yours faithfully, Gillian Dastey, Lancashire
1 6 3 9 6 3 6 1 7 3
Fill in your details below when sending in your crossword competition entry. See right for details of our address. NAME
Across 1 Birds (5) 4 Ordinary (5) 6 American state (7) 8 Sharpen (4) 9 Done openly (5) 12 Beneath (5) 13 Urge (4) 15 Announce (7) 17 For transferring liquid (5) 18 Water in a desert (5) Down 1 Dog (9) 2 Fastened (7) 3 Marine animal (4) 4 Vegetable container (3,3) 5 Cooker (3) 7 God’s little helpers (5,4) 10 Anticipates (7) 11 Bring into existence (6) 14 Nothing (4) 16 Bounder (3)
Congratulations to P Davidson, the winner of last issue’s crossword prize.
The lucky winner of our prize crossword will receive £50 in John Lewis vouchers. We also welcome your thoughts on RM magazine and love to hear about your experiences at the hospital. The Star Letter wins £50 in John Lewis vouchers. Send your crossword or letter with your name and contact details to RM, Press Office, The Royal Marsden, Fulham Road, Chelsea, London SW3 6JJ. The entry closing date is Monday 20 January 2014. See below for prize draw rules. PRIZE DRAWS & STAR LETTER TERMS & CONDITIONS: 1. The Prize Draws and Star Letter are open to all readers of RM except employees of the Press Ofﬁce at The Royal Marsden and Sunday, who produce RM magazine. 2. The closing date for receipt of all entries is Monday 20 January 2014. Only one entry per person per draw. 3. Responsibility cannot be accepted for entries that are incomplete, illegible or not received. Proof of posting is not proof of receipt. No cash alternative is available and prizes are not transferable. Value of prizes is correct at time of going to press. 4. Winners will be notiﬁed by post within 14 days of closing date. 5. The Promoter’s decision on any aspect of the promotions is ﬁnal and binding. No correspondence will be entered into. 6. The Promoter reserves the right to substitute a prize of equal or greater value should circumstances make this necessary. 7. Entry implies acceptance of rules. 8. The winner of the Star Letter prize of £50 in John Lewis vouchers is the sender of the best letter selected by RM magazine. 9. The winner of the crossword prize of £50 in John Lewis vouchers will be the ﬁrst correct entry drawn out of the bag. 10. The Promoter is The Royal Marsden Hospital, 203 Fulham Road, London SW3 6JJ.
30 RM MAGAZINE
in the next issue RM brings you the latest hospital updates, research news, inspiring stories and exclusive interviews. The spring 2014 issue is coming soon…
Research: the role of patient input School of Nursing: training the cancer nurses of tomorrow taffAwards:this S year’s winners
For the royal Marsden Rachael Reeve – Director of Marketing and Communications Elaine Parr – Head of PR and Communications Naomi Owen – PR and Communications Manager Belinda Lock – Senior Press Officer Catherine O’Mara – Senior Press Officer Sukhie Deol – Press Officer For sunday Lucy Ryan – Editor Marc Grainger – Deputy Editor Ian Dutnall – Art Director Bryony Bromfield – Senior Account Manager Matt Beaven – Creative Director Toby Smeeton – Managing Director RM magazine is published by The Royal Marsden in partnership with Sunday: sundaypublishing.com © The Royal Marsden 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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