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RM M A G A Z I N E SPRING 2020

PERFECT MATCH

Twins Kareece and Kameeka’s stem cell transplant story Our personal approach to caring for young patients Inside the forthcoming Oak Cancer Centre


EXECUTIVE NOTES

CONTENTS

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.

4 Bulletin What’s happening around The Royal Marsden 12 It happened to me Shiona Ramage shares her melanoma treatment journey 13 Future vision A look at our plans for the new Oak Cancer Centre in Sutton 16 A day in the life With Dr Rob Dowse, Paediatric Haemato-oncology Consultant 18 Treatment on trial We meet the team behind the acoustic cluster therapy trial 20 A special bond Pioneering stem cell transplants in the treatment of blood cancers 25 Tailor made The NIHR Biomedical Research Centre’s work on breast cancer 26 Fundraising News from The Royal Marsden Cancer Charity 28 Foundation news Updates from our Foundation Trust and Governors 30 Puzzles and prizes Test your wits and win a prize with our crossword

WELCOME to the spring 2020 edition of RM, the magazine for our staff, patients, carers and Foundation Trust members. Late last year, we were delighted to receive planning permission for the Oak Cancer Centre, our new stateof-the-art facility in Sutton. On page 13, you can discover how the building will be laid out, which departments will be included, and the difference the new centre will make for patients and their families. At The Royal Marsden, we have one of the largest stem cell transplant centres in Europe, and a specialist paediatric team supporting our young patients and their families through treatment. On page 20, we focus on the work of this multidisciplinary team with some of our patients. Some of our readers may have seen media coverage earlier in the year regarding children’s cancer services, and NHS England’s decision to mandate co-location of paediatric intensive care with specialist children’s services. You can read more about our response to this decision on page 6. I hope you enjoy this issue.

31 Stay in touch Your comments on social media, plus hospital contacts

Dame Cally Palmer, Chief Executive, The Royal Marsden ON THE COVER Young patient Kareece Stone-Small (left) with her twin sister and stem cell donor Kameeka

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B U L L E T I N W H AT ’ S H A P P E N I N G A R O U N D T H E R O YA L M A R S D E N QUALITY OF CARE Inspectors noted the kindness shown by staff to patients

? DID YOU KNOW? Over 70 per cent of front-line Royal Marsden staff – one of the highest rates in London – were vaccinated against flu this winter, thanks to a series of ‘jabathon’ events and a team of peer vaccinators.

LAST DECEMBER, thousands of beautiful white roses lit up Mayfair’s Grosvenor Square as part of a light installation to support The Royal Marsden Cancer Charity. Thanks to those who dedicated an illuminated white rose – either in person or online – the Ever After Garden raised an incredible sum of money, which will help to make a difference to the lives of people affected by cancer. Antonia Dalmahoy, Managing Director of the Charity, said: “We are so grateful for the generous support of designer Anya Hindmarch and journalist Camilla Morton, Grosvenor Britain & Ireland, Pancommunication and all partners for driving forward such an amazing project.”

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Photograph: David Parry

City of light

We’re a ‘beacon of outstanding practice’ THE ROYAL MARSDEN has retained its ‘outstanding’ rating as a Trust and ‘outstanding’ rating for being well led, following inspections by the Care Quality Commission (CQC) in September and November 2019. Inspectors commented on the collegiate and supportive culture, strong teamwork, and the quality, kindness and compassion of care given to patients across both Chelsea and Sutton. Professor Ted Baker, England’s Chief Inspector of Hospitals, said: “The Royal Marsden NHS Foundation Trust is a beacon of outstanding practice. It was outstanding overall before, but has improved by achieving outstanding in four of the main categories that the CQC rates.

It is a well-run centre of excellence in the study and treatment of cancer and is known worldwide for the work that it does.” Dame Cally Palmer, Chief Executive of The Royal Marsden, said: “I would like to thank and congratulate all the staff of The Royal Marsden for the exceptional quality of care they deliver for patients every day, which is reflected in the CQC’s rating of outstanding for the Trust overall. “This is a fantastic result for The Royal Marsden and especially for our patients, who can have confidence that they are receiving the very best treatment and care, and supporting us to improve survival for patients worldwide through research and innovative practice.” RM magazine 5


BULLETIN

LEADING ON PATIENT EXPERIENCE The Royal Marsden has been ranked among the top NHS trusts in England for patient experience for children and young people, according to recent results published by the Care Quality Commission. Nearly 100 parents, carers, children and young people at the Oak Centre for Children and Young People took part in the 2018 Children and Young People’s Patient Experience Survey, which covered 129 acute and specialist NHS trusts. One hundred per cent of paediatric patients felt they were well looked after while in hospital, and The Royal Marsden scored above average in a number of areas including pain management, experience on the hospital ward and communication with staff. Parents and children felt staff were friendly, and treated them with dignity and respect. Eamonn Sullivan, Chief Nurse at The Royal Marsden, said: “We are extremely proud of these results, which are a true reflection of our values.”

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Paediatrics under review

Prostate study to test genes

PUT TO THE TEST Professor Nicholas Turner

SPECIALIST CARE The Oak Centre for Children and Young People

? DID YOU KNOW?

THE ROYAL MARSDEN is working with partners and stakeholders to evaluate options for the co-location of a specialist cancer service with paediatric intensive care and other children’s services, in line with a recent decision by the board of NHS England. We see this as an opportunity to build on the high-quality, research-focused and safe service we offer, which is supported by our patients and their families. There is currently no hospital in south London that provides both specialist children’s cancer services and paediatric intensive care on the same site. However, our Oak Centre for Children and Young People ensures

that our young patients receive the very best treatment and care, providing access to clinical trials to improve survival, expertise in oncology, and modern, age-appropriate facilities. The Care Quality Commission recently assessed the Trust as ‘a beacon of outstanding practice’, and rated our children’s service as ‘good’ for Safety and ‘outstanding’ for Caring. Patients and families consistently rate us as one

This is a chance to build on the service we offer

of the best centres in the country for patient experience. We believe that a proposal that retains The Royal Marsden’s cancer expertise, life-saving research, modern facilities and accessible location for the population we serve will continue to provide the best clinical outcomes and patient experience. The evaluation of options will take six to 12 months, and any changes in configuration are likely to take up to five years to achieve as they will involve significant investment from the NHS. In the meantime, our service will continue to provide the highest-quality research, treatment and care for our young patients.

Liquid biopsies show the bigger picture A NEW ‘LIQUID BIOPSY’ test can identify rare mutations in breast cancer, which may enable patients to access effective treatment more quickly in the future. Professor Nicholas Turner, Consultant Medical Oncologist at The Royal Marsden and Team Leader at The Institute of Cancer Research, London, presented findings from the plasmaMATCH trial at the San Antonio Breast Cancer Symposium in Texas in December 2019. The trial tested more than 1,000 patients for mutations in tumour DNA shed into the bloodstream, and found specific weaknesses that could be targeted with drugs.

Professor Turner said: “Liquid biopsies can quickly give us a bigger picture of the mutations within multiple tumours throughout the body, getting the results back to patients accurately and faster than we could before. “This matters a lot in terms of making decisions, particularly for those with advanced breast cancer who need to be put on new treatments quickly.”

“The test can get results to patients faster than before”

Congratulations to The Royal Marsden’s Catering departments at Chelsea and Sutton, which have maintained their five-star ratings following unannounced food hygiene audits from the local authorities’ environmental health officers.

A team at The Royal Marsden and The Institute of Cancer Research, London (ICR) is aiming to find out why men of African and Caribbean descent are diagnosed with prostate cancer at twice the rate of the overall UK average. Researchers will be testing the genes of men of African and Caribbean descent to see if they can learn to predict prostate cancer risk, and find better ways of diagnosing and treating the disease. The leader of the PROFILE study, Professor Ros Eeles, Honorary Consultant in Clinical Oncology and Oncogenetics at The Royal Marsden, and Professor of Oncogenetics at the ICR, said: “We believe the secret may lie in changes in the DNA passed on through generations and inherited by men from their parents. But the only way to find out for sure is to do a study like this one, with enough participants to be able to see the bigger picture. “Picking up the disease early, when it is easier to treat, is crucial to improving survival rates. Finding new genetic clues to prostate cancer could also lead to new approaches to treatment.” RM magazine 7


BULLETIN

Welcoming our new nursing associates

REAL WORLD RESULTS A study led by Dr Alison Reid, Consultant Medical Oncologist at The Royal Marsden, has assessed the ‘real world’ experience of two standard treatments for prostate cancer – abiraterone acetate plus prednisone, and enzalutamide – in more than 200 patients. After 12 months, results from the AQUARIUS study found that patients experienced less fatigue and cognitive impairments with abiraterone acetate plus prednisone than with enzalutamide. Dr Reid, the UK Principal Investigator for the study, said: “As more drugs impact the treatment landscape for patients, information regarding the patient experience on these treatments is needed. “While pre-existing medical conditions and medications might mandate choosing either abiraterone acetate or enzalutamide over the other, patients frequently have a choice between the two drugs. “This trial gathered patient-reported outcomes prospectively in a real-world setting about what it was like to take these medications, and the results hold important information that may inform the decisions of patients and doctors about which of these drugs to select for future treatments.”

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THE ROYAL MARSDEN’S first fully qualified nursing associates are now in post. This new role was introduced across the NHS following a public consultation by Health Education England in 2015, which identified a gap in skills and knowledge between healthcare assistants and registered nurses. The first nursing associate trainees began joining courses in 2017. The aim is to bridge the gap and help the NHS meet the changing health needs of patients. Nursing associates are registered and regulated by the Nursing & Midwifery Council. Their role is to support rather than substitute for

LIFE’S WORK Cally Palmer has been Chief Executive of The Royal Marsden for 21 years

DBE honour for Chief Executive CALLY PALMER, Chief Executive of The Royal Marsden NHS Foundation Trust, has been awarded a DBE for services to cancer medicine in the 2020 New Year Honours. Cally has worked for the NHS for her entire career. In her 21 years as Chief Executive, she has worked tirelessly to improve the quality of cancer treatment, care and research. Cally has also been National Cancer Director for NHS England, leading the implementation of the National Cancer Strategy, since 2015. Cally said: “I feel incredibly fortunate to work for the NHS and to be surrounded by

brilliant teams making great strides in progress for people affected by cancer. My role is simply to enable them, and all our staff, to do what they do best. “We’ve seen exceptional and very significant advances in our knowledge and understanding of research, treatment and survival outcomes in the time I’ve been at The Royal Marsden. It is a joy and a privilege to be able to make these improvements for the benefit of patients in the NHS and worldwide through groundbreaking research.”

Room to relax Staff in the Outpatients Department in Chelsea are enjoying a refurbished staff room that has been generously funded by The Friends of The Royal Marsden, Chelsea. With a fitted kitchen, seating area and soft furnishings, the room is

big enough for all staff to relax in during their breaks. Shona Sobande, Outpatients Administration Manager, said: “We are thrilled. The team can now take their breaks and prepare and eat meals in a lovely environment with all mod cons.”

NEW ROLE Nursing Associate Aya Sy-Nicholls

registered nurses, freeing them up to focus on more complex clinical care. The role will also offer a progression route into graduate-level nursing. One of our first nursing associates, Aya Sy-Nicholls, works in the Oak Centre for Children and Young People. She says: “I was a nurse in the Philippines, but when I moved to England, I didn’t have the relevant qualification to nurse, so I became a healthcare assistant. “Training to become a nursing associate allows me to use my skills and experience, and is a step towards potentially doing a degree to become a registered nurse in England in the future.”

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FAST FACTS The Marsden Manual

10th

edition of The Royal Marsden Manual of Clinical Nursing Procedures – the ‘Marsden Manual’ – is due to be launched this summer

350+

evidence-based clinical procedures related to every aspect of care are featured

17

years – the length of time that Sara Lister, Head of Psychological and Pastoral Care at The Royal Marsden, has co-edited the Manual

100+

contributors from The Royal Marsden help to produce the Manual alongside their usual roles

2018

saw the launch of the first Royal Marsden Manual of Cancer Nursing Procedures RM magazine 9


BULLETIN

IN BRIEF

Dr Christina Messiou, Consultant Radiologist (above, left), has won the 2019 Royal College of Radiologists-NIHR Outstanding Clinical Radiology Researcher Consultant award, which recognises the contribution that clinical radiologists make to research. A handful of Royal Marsden staff who worked over Christmas were invited to a special party in November alongside HRH The Duke of Cambridge, President of The Royal Marsden, and HRH The Duchess of Cambridge. The event was filmed as part of the BBC1 documentary A Berry Royal Christmas.

Teenage therapy room

A new therapy room is open at the Oak Centre for Children and Young People (OCCYP), thanks to a supporter of The Royal Marsden Cancer Charity. Darren Swain’s daughter Emma was treated at the OCCYP, and the new therapy room has been decorated in her favourite fuchsia pink in her memory. It is available to 16- to 24-year-olds for treatments including reflexology, massage and aromatherapy.

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Above and Beyond, Clinical

Q What are the side effects of CAR-T therapy? A The major side effect is cytokine release syndrome, which is a complication when a large number of immune cells are highly activated. It can be mild with fever and headaches, but can progress to blood flow instability, multiple organ failure and neurological toxicity.

Consultant’s award

Royal recognition

THE WINNERS

immune response – that are central in controlling tumour growth.

Q&A: CELLULAR THERAPY Consultant Haematologist Dr Emma Nicholson explains how advances in immunotherapy using CAR-T cells are offering more treatment options for cancer patients Q What is cellular therapy? A Cellular therapy is a type of immunotherapy treatment. The treatment requires the patient’s T cells – immune system cells – to be taken from the blood in a procedure called apheresis. A new receptor called a chimeric antigen receptor [CAR] is introduced into the T cells, which, following the infusion of the CAR-T cells back into the patient, binds to a protein on the

cancer cells and kills them directly. Q How can this be used to treat cancer? A The immune system has a key role in controlling the growth of tumours in the body. However, tumours have developed multiple mechanisms to escape and evade recognition by the immune system. T cells are important effector cells – activated cells that defend the body in an

“The therapy has shown effectiveness in some lymphoma patients who are resistant to standard chemotherapy”

Q Which patients can benefit from this treatment? A In the past year, we have been recruiting patients with relapsed or refractory diffuse large B-cell lymphoma [DLBCL] to a randomised clinical trial using CAR-T cells. The therapy has so far shown effectiveness in patients with multiply relapsed DLBCL who are resistant to standard chemotherapy and have limited treatment options. We are now treating patients with relapsed/refractory DLBCL at The Royal Marsden and hope to expand to other indications in the future. Q What future research is going to be carried out into CAR-T treatment? A This is a very active area of research. At The Royal Marsden, we are opening a study using donor gamma delta T cells to treat relapsed or refractory acute myeloid leukaemia.

JO STONE, Lead Nurse for Children and Young People, has been a nurse for more than 25 years. She is described by her colleagues as a role model, and by her patients and their families as an “angel”.

Above and Beyond, Non-clinical SARAH HELYER, Radiotherapy Services Manager, is as an exceptional leader in a department judged by the CQC to be excellent. She is heavily involved in developing new technology to continually improve patient treatment and care.

Working Together THE BREAST UNIT OPEN ACCESS TEAM has transformed the delivery of care for women with breast cancer, enabling them to move on from active treatment to supported self-care.

Excellence in Education YIWEN HON, Knowledge Resources Manager, supports staff and students in academic and research work, delivering excellent teaching sessions and helping people understand complex information.

Driving Transformation and Innovation

Celebrating our staff WE WERE PROUD to celebrate The Royal Marsden’s exceptional staff at our annual Staff Achievement Awards, held in November 2019. Chief Executive Dame Cally Palmer said: “I would like to congratulate the winners on their outstanding contributions and achievements, as well as all those who were nominated for an award.” At the start of the evening, she told staff: “Tonight is a time to

DR JOANNE DRONEY, Consultant in Palliative Medicine, is a highly respected, compassionate and focused clinician. The palliative care research programme has grown significantly under her leadership.

celebrate your achievements over the past year, which have been exceptional, all for the benefit of cancer patients and their families. You all should be very proud.”

Lifetime Achievement

A NIGHT TO REMEMBER Mr Des Barton (above left) and Mary Woods (above) were honoured with Lifetime Achievement Awards at the 2019 Staff Achievement Awards

MR DES BARTON, Consultant Gynaecologist Oncologist, is one of the most published authors in his field. He is enormously dedicated, going the extra mile to provide the very best treatment for patients and training for junior colleagues.

MARY WOODS, Nurse Consultant in Lymphoedema, has worked at The Royal Marsden for 40 years, and is recognised across the UK and internationally for her expertise in cancer care rehabilitation.

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IT HAPPENED TO ME

THE CARE I RECEIVE FROM THE MELANOMA TEAM IS FANTASTIC AND I’M LIVING LIFE TO THE ABSOLUTE FULLEST Shiona Ramage, 49, melanoma patient

immunotherapy drugs, ipilimumab and nivolumab. Unfortunately, I suffered autoimmune hepatitis as a side effect of the treatment, and had to spend three weeks as an inpatient to get it under control. On the plus side, when I was well enough, I could pop out to the King’s Road in Chelsea – a bit of retail therapy worked wonders! When Professor Larkin eventually discharged me, he joked it was for the health of my bank account! Although the immunotherapy treatment had to be stopped, it gave me some benefit and I was clear for six months until, in December 2017, a small tumour was found and I had to start a new treatment

“When I was well enough, I could pop out to the King’s Road – a bit of retail therapy worked wonders!”

IN JUNE 2016, at 45 years of age, I went to get a mole on my back checked out and was diagnosed with melanoma. My life changed forever. I had no idea about the journey that lay ahead of me. I underwent a wide local excision to remove tissue around the original mole site, and after scans showed the cancer had spread to some lymph nodes, I had a full axillary dissection to remove 20 lymph nodes. 12 RM magazine

That’s when I was referred to The Royal Marsden, under the care of Professor James Larkin. At the time, I was confused about why I was being referred to a specialist cancer hospital when I was effectively clear of cancer – but it turned out to be the best decision as, just weeks later, a scan showed a small tumour on my brain. Professor Larkin recommended that I start a combination of two

combination of debrafenib and trametinib. This has reduced the size of the tumour on my brain and kept the rest of my body clear. Two years on, and my latest scan showed good results. I feel very fortunate to be treated by the fantastic melanoma team at The Royal Marsden. The care I receive is outstanding, and the research they do to develop new treatments is at the forefront of medical science and developments globally. I’m now living life to the absolute fullest, having lots of laughs, travelling the world and fundraising for The Royal Marsden Cancer Charity. I also write a blog – shomelanoma.com – to raise awareness and share my experience to help other patients living with melanoma. RM

OAK CANCER CENTRE

Professor James Larkin

Consultant Medical Oncologist “Shiona is amazing – she is full of beans and I’ve been personally struck by her energy. She is effectively living a normal life, which is fantastic considering that a decade ago, someone in her situation would have faced a very poor prognosis. “Not only is Shiona experiencing first-hand the importance of research, but she is also tireless in her fundraising to help us find out why some patients with advanced melanoma respond to immunotherapy while others don’t. “Thanks to research, around half of advanced melanoma patients today will survive for five years or more, when just a decade ago this figure was only one in 20. Shiona is a shining example of the improvement in the outlook for patients with this disease, and it’s a joy to see her living life to the full.”

LEADING THE WAY The Oak Cancer Centre will replace some of the current facilities at Sutton with modern spaces

FUTURE VISION Due to open in 2022, our new Oak Cancer Centre will provide a world-leading hub for excellence in research and patient care > RM magazine 13


OAK CANCER CENTRE

PLANNING HAS BEEN approved for our new state-of-the-art building in Sutton, the Oak Cancer Centre. The planning application received an unprecedented level of public support, with more than 100 positive comments submitted to Sutton Council, including many from our patients. The centre, which is due to open in 2022, will replace

MEDICAL DAY UNIT Second floor By locating the Medical Day Unit on the second floor, patients will be able to enjoy peace and quiet while receiving chemotherapy in spacious, modern surroundings with lots of natural light.

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some of the more dated facilities and infrastructure in our Sutton hospital with modern, purpose-built spaces. Bringing more than 400 of the world’s best clinical researchers together under one roof, it will help us to save more lives by diagnosing cancer earlier, and to speed up the development of new treatments.

To date, The Royal Marsden Cancer Charity has raised £60 million of a £70-million target to make the Oak Cancer Centre possible. It is named in recognition of Oak Foundation, which has donated £25 million – the largest gift ever received by the Charity. With building work due to begin in the summer, here’s a look at the ambitious plans for the new facility.

REMOTE CONSULTATION

RESEARCH

Lower ground floor The lower ground floor will contain ultra-modern remote consultation rooms, moving with advancements in digital technology to help patients avoid repeated trips to the hospital. Link bridges on the ground and first floors will connect the Oak Cancer Centre to the main hospital building for ease of access.

First, second and third floors These floors will bring together 400 researchers currently dispersed across the Sutton site in spaces designed to encourage communication across different tumour specialities. This will enable them to share their latest findings and innovations with other research colleagues, and help accelerate the development of new treatments.

CENTRE FOR URGENT CARE

OUTPATIENTS

Second floor Patients becoming acutely unwell will have a state-of-the art facility where they can be assessed and treated without needing to be sent to a local A&E department. This will ensure patients can be seen quickly by experts who have a detailed knowledge of their disease and treatment.

Ground floor By consolidating the Outpatients Department on a single level, patients will be able to undergo blood tests, see their consultant and collect a prescription without having to visit different floors. For patients who are elderly, frail or feeling unwell, this will make their visit easier and shorter. The design allows for spacious waiting areas where families can sit together. RM

RAPID DIAGNOSTIC CENTRE Lower ground floor By housing a Rapid Diagnostic Centre here and utilising the latest technology, we will be able to diagnose more cancers at an earlier stage when treatment is more likely to be successful. A brand-new endoscopy suite, located alongside the Rapid Diagnostic Centre, will also help to improve early diagnosis.

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A D AY I N T H E L I F E

A DAY IN T HE L IF E OF

DR ROB DOWSE PA E D I A T R I C H A E M A T O - O N C O L O G Y C O N S U LT A N T HAEMATO-ONCOLOGY covers a range of cancer types, including acute and chronic leukaemia, lymphoma and myeloma. I focus on paediatrics, working in the Oak Centre for Children and Young People in Sutton. My days are quite varied, but I’m usually at the hospital by 8am. After checking my emails and having a quick coffee, I go down to the clinical team handover. Colleagues who were on duty overnight speak about any patients who needed additional treatment. Often we have inpatients staying for a stem cell transplant, a critical period of time when they need to be closely monitored through intense treatment. Personal service Each week, a consultant is ‘attending’ for paediatric haematooncology. This means you’re in charge of the ward and look after any new patients who come in. If I’m attending, I make sure I know about all the current patients and any ongoing issues I need to keep an eye on. We have a ward round with the stem cell transplant team later in the morning, where my colleagues and I visit every patient to assess their care and treatment, and speak to their families. 16 RM magazine

“Research is critical for pioneering the best treatment and care”

Depending on the day, I might then go to the Centre for Molecular Pathology (CMP), where samples from our patients are often taken for analysis. Two or three weeks after a stem cell transplant, a blood sample is analysed in the laboratory to see whether the donor cells are growing and making new cells. Four weeks after the transplant, we do another test to see where the new cells are originating from. If the transplant has engrafted successfully, these should be from donor cells. I work closely with the pathology teams, and while visiting the CMP I may analyse samples through the microscope. It’s amazing to have such a fantastic facility on our doorstep, and patients really do benefit from us being an NIHR Biomedical Research Centre. It’s also hugely beneficial to have such a close working relationship with The Institute of Cancer Research, London, which is just next door. I’m actively involved in clinical research and am the principal investigator on a number of trials. We liaise closely with the research team, with meetings every week. Research is critical for pioneering the best treatment and care, especially in paediatric haematooncology, where we’ve made huge strides over the past few decades in understanding the complexities of these types of cancers and developing effective treatments. Tailoring treatment We have multidisciplinary team meetings throughout the week. Personalised cancer care is at the heart of our approach, with every patient receiving a unique treatment plan. These meetings are a chance to regularly discuss, agree and update treatment, and are attended by a range of experts including medical oncologists, radiotherapists,

HANDS ON Thyone uses physio methods such as manual therapy and acupuncture to help improve cancer patients’ quality of life

pathologists, radiologists, nurses and allied health professionals. Over lunch, I catch up with the team on the wards. Communication is a really important part of the job; we’re a close-knit team and patients really benefit from this holistic type of care. In the afternoon, I might have a clinic in our outpatients department, where we talk through

BUILDING RELATIONSHIPS Dr Dowse gets to know patients and their families well over the course of their treatment

results and treatment plans or just have a general discussion about how patients are doing. We work closely with colleagues at St George’s University Hospitals NHS Foundation Trust, where our patients travel if they need the support of an intensive care unit. If we have patients there, I’ll travel to see them and their families, check on their condition and work with our St George’s colleagues to provide the best treatment and care. For patients with these tumour types, we’re hoping to cure the disease. We really build a relationship with patients and their families over the years we see them. It’s this part of my job that is incredibly rewarding, when our patients can finish treatment and get back to living ‘normal’ lives. RM RM magazine 17


CLINICAL TRIAL TEAM

TREATMENT ON TRIAL Acoustic cluster therapy uses microscopic clusters of bubbles and liquid droplets to enhance the delivery of chemotherapy drugs to tumours. We meet some of the team involved in trialling this innovative new treatment – and the first patient in the world to receive it – at The Royal Marsden

Sumita Gurung, Lead Trial Nurse Mark O’Leary and Nigel Bush, Physicists Dr Nina Tunariu, Consultant Radiologist Professor Udai Banerji, Deputy Director of the Oak Drug Development Unit

“This new therapy could improve the effectiveness of simultaneously administered routine chemotherapy drugs by better targeting the tumour, reducing exposure to the rest of the body, and hopefully lowering the rate and severity of treatment side effects. “My role is to bridge the pre-clinical and clinical drug discovery work by leading on the design and co-ordination of this Phase I trial. It’s exciting to be involved in this unique project, and we’re lucky to have this opportunity through working in collaboration with scientists at The Institute of Cancer Research, London and Phoenix Solutions, which invented the technology.”

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“Every project needs imaging, but this trial is unique as it uses advanced imaging in the actual delivery of treatment. My role in the process is performing the ultrasound examinations, choosing a suitable lesion for treatment and ensuring that same lesion is targeted every time the acoustic cluster therapy is delivered. “Once the patient is receiving their chemotherapy, I use the ultrasound probe to identify the lesion in the patient’s liver; the microbubbles and droplets are then administered, and I can visualise the microbubbles in the tumour on screen. “I work with the patient and the team to keep the patient relaxed, which is particularly important at this stage of treatment – ensuring the lesion remains targeted while the ultrasound frequency output is changed to activate the clusters in the microbubbles. “I’m currently supervising and training sonographers in the team so that more staff will be able to operate the ultrasound equipment in this clinical trial setting.”

“We are responsible for preparing the ultrasound system for use with the patients and leading the process that delivers the acoustic outputs from the imaging machine. “The ultrasound process is made up of three phases, which must be kept to specific timings. The first is a localisation phase; this allows the radiologist to refamiliarise themselves with the patient and identify the target lesion before the clusters are administered. We then switch to activation mode, which optimises the ultrasound output to bring about the conversion of the injected microbubblemicrodroplet clusters into large bubbles within the lesion. We observe the ‘wash in’ of the clusters to the lesion, then a fixed

time after that, we switch to enhancement mode, where the imaging ultrasound is supplemented by an additional beam at a much lower frequency. “These lower-frequency waves cause the activated bubbles in the tumour blood vessels to vibrate, potentially increasing the permeability of the vessel walls and leading to more of the chemotherapy drug being delivered to the cancer cells in the imaged tissue.”

“This treatment is all about timing, so communication is key”

Karen Childs, patient

Karen was the first patient to receive this state-ofthe-art treatment as part of a Phase I clinical trial. She was being treated for secondary cancer in her liver but sadly died in January. Before the trial, she said: “This trial is an exciting step for the hospital and a huge step for patients.

“It’s an absolute privilege to be looking after patients on this clinical trial. It’s the first live, active trial I’ve been assigned to, and my key responsibilities include preparing and monitoring both the patient and the treatment. “The microbubble drug supply is collected from the research hatch, which I then prepare by mixing together a powder and liquid – these are the microscopic clusters of bubbles and droplets that are then administered to the patient at a specific point while they are receiving their standard chemotherapy; this process is repeated three times during each visit. Delivering this treatment is all about timing and co-ordination, so communication among the team is absolutely key.” RM

It really would make a big difference to patients’ lives if side effects could be reduced in the future using more targeted treatments like this.” Her sister Julia says: “Karen made a brave decision to go on the trial and we got to see the amazing work at The Royal Marsden. She felt safe and supported and made the most of her Royal Marsden chapter.”

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STEM CELL TRANSPLANTS

A SPECIAL

SISTER ACT Kameeka (right) donated stem cells to her twin Kareece

BOND The Royal Marsden has been pioneering stem cell transplants in the treatment of blood cancers for more than 45 years, and the specialist team at our Oak Centre for Children and Young People supports more than 20 patients and their families through the intense process each year

FIFTEEN-YEAR-OLD SISTERS Kareece and Kameeka Stone-Small have a special connection that surpasses even that of being twins. Four years ago, Kareece was diagnosed with acute lymphoblastic leukaemia (ALL). But after two years of treatment at The Royal Marsden, and just as the girls were about to start secondary school, their mum Lorette was given the devastating news that Kareece had relapsed and would need a stem cell transplant (SCT). Fortunately, the family had been tested when Kareece was diagnosed, and Kameeka was already known to be a sibling match. >

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STEM CELL TRANSPLANTS

“A sibling match is usually preferred, but we can search internationally for donors” match will be identified. A sibling match is usually the preferred donor, but if this is not available, we’re able to search international registries to identify a matched unrelated donor as an alternative. “In the event that there is no good unrelated donor, an alternative donor source will be used – usually an umbilical cord donation, or occasionally a parent, known as a haploidentical transplant. “We also need to achieve the ideal disease status to get the patient into transplant. The optimal state in acute leukaemia is MRD [minimal residual disease] negative, which means there is no detectable disease after treatment. Once we reach that status, we get the patient into transplant as soon as possible.”

Lorette says: “The team had already tested all of the family just in case, so we could move quite quickly. In a way, we were the lucky ones as I knew Kameeka was a good match. Not everyone has that, which must be awful. I am forever grateful to her because without her, we would not have Kareece.” Pioneering treatment Their story is just one example of The Royal Marsden’s world-leading work in stem cell transplantation in adult and paediatric patients, and highlights how identifying a well-matched donor increases the chances of a positive outcome. In 1973, we became one of the first cancer centres in Europe to 22 RM magazine

carry out an SCT (also known as a bone marrow transplant). Today, the Trust is one of the largest SCT centres in Europe, carrying out more than 200 transplants every year. Despite tremendous advances in chemotherapy drugs in the intervening years, the SCT remains one of the most effective strategies to successfully treat some types of high-risk blood cancer. The specialist clinical team in our Oak Centre for Children and Young People (OCCYP) comprises three paediatric transplant consultants, a clinical nurse specialist and a clinical fellow, supported by a multidisciplinary team of allied health professionals. The OCCYP is one of 12 specialist

paediatric transplant centres in the UK, and our consultants work closely with other national experts to help decide the best course of treatment for patients across the country. Dr Caroline Furness, Consultant Paediatric Haematologist and Lead for Paediatric SCT, explains that SCTs – which replace damaged stem cells with healthy ones – are most commonly undertaken to treat diseases such as ALL and acute myeloid leukaemia (AML). “The process is very complex,” she says. “As soon as a patient is identified as needing a transplant, we send off blood tests to establish their tissue type and, in parallel, test family members to see if a sibling

FAMILY MATTERS Finding the best donor match is key to success, says Dr Caroline Furness (right), so all of Kareece’s close family were tested, including her mother Lorette (centre)

Making a match The decision to undertake an SCT is never taken lightly. It is usually only performed in patients with high-risk disease where there is a significant chance of relapse, or when a patient relapses despite standard chemotherapy treatments. Careful assessment of the need for an SCT is essential due to the potential for side effects. Dr Furness says: “Although a transplant is potentially curative, it can also cause complications such as unusual or severe infections, or graft versus host disease [GvHD].” GvHD occurs when the incoming donor immune system recognises the host (patient) as ‘foreign’. It can be an acute problem during the initial transplant admission, leading to skin rash, diarrhoea and liver dysfunction; or can become a

more chronic issue, with long-term effects on quality of life. “The severity of GvHD can be related to the degree of donor match, which is why we focus on getting the best possible donor for our patients via high-resolution donor typing,” says Dr Furness. “Over the past 20 years, through better matching and supportive care, we have improved our patients’ overall outcomes. We now need to work on improving the treatment of transplant-related complications and GvHD. “We have been expanding our team so we can run more research into these side effects. We opened three trials in the past year and hope to expand on that this year. We also recently recruited a research nurse, so we have the team in place to support more patients on clinical trials.” Patients undergoing an SCT can often be in hospital for anything from a few weeks to a few months. Even when they are discharged, the side effects can trigger numerous >

STEM CELL TRANSPLANTS: 5 KEY STAGES 1 Testing A series of tests is carried out to assess the patient’s health. Transplants tend to be more successful in people who are generally healthy, despite their underlying condition –

2 Harvesting

EXPERT CARE Clinical Nurse Specialist Innie Johnson is part of the dedicated paediatric team

Stem cells are harvested in three main ways from donors: from blood using a cell-separator machine; from bone marrow under anaesthetic; or from donated cord blood –

3 Conditioning High doses of chemotherapy (sometimes with radiotherapy) destroy existing bone marrow cells and any residual cancer cells in preparation for infusion –

4 Infusion A day or two after conditioning finishes, the stem cells are infused into the patient’s bloodstream –

5 Recovering The patient stays in hospital for four to six weeks while the stem cells attach to the bone marrow and start producing new blood cells RM magazine 23


STEM CELL TRANSPLANTS

A PARENT’S PERSPECTIVE Sarah Shelley, mum of 15-year-old patient Niamh

overnight stays at our shared care hospitals or, in some cases, back at the OCCYP. Patients come in for weekly check-ups for up to six months following a successful SCT, then with decreasing frequency for five years. They also attend our long-term follow-up clinic for monitoring of growth, puberty and heart, lung and kidney function. Innie Johnson, Clinical Nurse Specialist, says: “I look after the families through what is likely to be one of the most difficult times of their lives. The parents are juggling jobs, caring for other family members and, of course, looking after their unwell child. “The OCCYP is a safe and welcoming environment where we offer support for children and 24 RM magazine

their families from play specialists, psychologists and teachers. Most of their care can be provided within the OCCYP and in collaboration with their local hospitals.” It is this level of care, combined with The Royal Marsden’s SCT expertise, that has led to Kareece’s recovery. Lorette says: “She is doing brilliantly now. She is possibly underdeveloped for her age, but she is here and alive. The team at The Royal Marsden were, and continue to be, amazing.” As for Kareece, she says she is grateful to her sister Kameeka, but received more than just her twin’s stem cells from the transplant. “Since the SCT, I can no longer eat peanuts, celery or raw carrots – I managed to get Kameeka’s food intolerances, which is weird!” RM

NEXT STEPS Dr Furness and her team are now running more research into the side effects of SCTs to help improve patients’ quality of life

“Niamh is busy studying for her GCSEs in the summer, 14 years after she became the youngest patient ever to have a stem cell transplant at The Royal Marsden. She was only 20 months old when she was diagnosed with acute myeloid leukaemia, so she has absolutely no memories of being a patient here. “Her dad Christopher and I were in such shock when she was diagnosed as she was never sick. Bizarrely, she has never been sick since and, aside from her checkups at The Royal Marsden, she never needs to go near a doctor. “Shortly after she was diagnosed, I pretty much moved into the old children’s centre with her for months. It was a really difficult time, as I had my four older children at home being cared for by family. I don’t know how we did it, but we got through it. The staff were amazing and looked after us all. We are so grateful to The Royal Marsden.”

DOING WELL Now 15, Niamh underwent an SCT as an infant

TAILOR

MADE The development of personalised breast cancer treatment is key to improving survival rates

A KEY AIM of the Biomedical Research Centre’s (BRC) Breast Cancer theme is to capitalise on developments that have already been made by identifying new approaches to predicting individual patient outcomes and discovering new targeted treatments. Researchers at The Royal Marsden and The Institute of Cancer Research, London (ICR) are aiming to transform breast cancer management by designing innovative biomarker-driven trials at critical points along the patient pathway. Following recent results, clinicians are now able to identify the molecular differences between tumours to help provide the best treatment for individual patients. A recent study – co-led by Professor Mitch Dowsett, BRC Breast Cancer Theme Lead; Professor Ian Smith, Consultant Medical Oncologist at The Royal Marsden; Professor Judith Bliss of the ICR; and Professor John Robertson at the University of Nottingham – analysed samples from the POETIC (perioperative endocrine therapy – individualising care) trial and aimed to identify which patients would benefit sufficiently from endocrine therapy to need no further treatment.

Results from the study are leading to patients being given treatment before the tumour is removed to see how it responds, rather than just taking a biopsy. Professor Dowsett (pictured, centre) says: “Accurately identifying mutations and other abnormalities is critical to our understanding of the causes of cancer. Our work in patients with the most common form of breast cancer showed that identifying mutations accurately required more than one biopsy of the type usually used for diagnosis. “Our current focus is now on oestrogen-responsive breast cancer and on identifying the key biologic effects of drugs that withdraw oestrogens just prior to surgery.” Last year, scientists at The Royal Marsden and the ICR led a study to develop a personalised ‘liquid biopsy’ that could detect the return

of breast cancer nearly 11 months earlier than hospital scans. “We hope that in five to 10 years’ time, we will be able to conduct a blood test post-surgery that will detect whether there is circulating tumour DNA present,” says Professor Dowsett. “In patients where there is no circulating tumour DNA detected, further treatment won’t be necessary. In the 20-30 per cent where micrometastasis is detected, we can treat this early. This is our greatest hope for improving survival rates.” RM

What is the Biomedical Research Centre?

As a Biomedical Research Centre (BRC), The Royal Marsden and The Institute of Cancer Research, London receive funding from the National Institute for Health Research (NIHR) to support our groundbreaking work. RM magazine 25


T H E R O YA L M A R S D E N C A N C E R C H A R I T Y

Funding research

EVER PRESENT The Belderson family and their supporters walk every year

Marching in memory THE 10TH BANHAM Marsden March promises to be a fantastic event, with thousands of walkers coming together on Sunday 3 May to raise money for The Royal Marsden Cancer Charity. This year, every step our walkers take will help us build the Oak Cancer Centre, our new state-of-the-art facility in Sutton, which is set to open in 2022. Find out more on page 13. Sharon and Lee Belderson will be walking the 15-mile route with their

“It’s always such a lovely day walking with so many other patients and families” 26 RM magazine

son Lewis and daughters Bethany and Tiffany, in memory of their son and brother Billy, who died in 2013 from a brain tumour. After being diagnosed in 2010, Billy was treated at The Royal Marsden and walked the inaugural Marsden March in 2011. He also took part in the following two events, and his family have continued the tradition. Sharon said: “Billy never missed a Marsden March when he was alive, and we will carry on taking part in this great event for as many years as we can in his memory. It’s always such a lovely day walking with so many other patients, families and members of staff. We can’t wait!”

Want to know more? Spaces are limited, so go to royalmarsden.org/march to sign up

Since it was launched in 2014, the Lady Garden Foundation has raised more than £1 million to fund research into gynaecological cancers at The Royal Marsden. More recently, it has funded Clinical Research Fellow Dr Lucy Dumas, whose work focuses on gynaecological cancers in older women, who make up a large proportion of patients affected by this tumour type. Working alongside Dr Susana Banerjee, Dr Dumas is investigating current standards of care for older patients, and has found that these women may be less likely to receive certain treatments. She has also carried out research to understand how muscle quality – which can differ between older and younger patients – relates to survival. Last October, the foundation held its biggest-ever gala at Claridge’s in Mayfair. Hosted by Lady Ainslie, the event raised over £400,000 and welcomed 200 guests including Dame Joan Collins, Katherine Jenkins and Sarah, Duchess of York.

Want to know more? Visit ladygarden foundation.com

BE IN THE RUNNING CAPITAL IDEA Sign up now for the Royal Parks Half Marathon in London

Paying tribute Following the death of sports journalist and Royal Marsden patient Vikki Orvice in February last year, her family and friends hosted a gala evening at Lord’s Cricket Ground in London in November to celebrate her life and raise money for The Royal Marsden Cancer Charity. Ian Ridley, Vikki’s husband, said: “It was an astonishing, uplifting night to celebrate Vikki’s life. I was overwhelmed by the love and generosity, both financial and of spirit. “There were so many tributes to such an amazing woman and I’m delighted we could raise over £100,000 in Vikki’s memory for The Royal Marsden Cancer Charity – a cause that was very close to her heart.”

Cycle challenge RUNNING EVENTS RAISED almost £900,000 for The Royal Marsden Cancer Charity last year, including almost £540,000 from the Virgin Money London Marathon and Royal Parks Half Marathon. If you’ve ever fancied running for the Charity, you can now sign up for the 2020 Royal Parks Half Marathon and take on one of the most beautiful runs in London in October. There are plenty of other opportunities for everyone from novice runners to seasoned athletes. Rachel Johnston, Senior Community Fundraising Events Executive, said:

“We have places in a huge number of events, or you can choose to enter yourself and raise money for us. Our team will support you with a fundraising pack and advice, and we have cheering points at many big events. We would love to welcome any runners with their own places to run for the Charity and be part of Team Marsden.”

Want to know more? Find out how to enter the Royal Parks Half Marathon and many other events at royalmarsden.org/events

Contact The Royal Marsden Cancer Charity Telephone 020 7808 2233 Email charity@royalmarsden.org Visit royalmarsden.org Registered Charity No. 1095197

Former England cricket captain Sir Andrew Strauss visited The Royal Marsden last autumn as part of a cycling challenge to raise money for the Ruth Strauss Foundation. Sir Andrew set up the foundation after his wife Ruth passed away from ALK-positive lung cancer in December 2018, aged 46. He met Professor Sanjay Popat and Dr Fiona McDonald from the Lung Unit, who are leading research into the ALK gene in lung cancer, and James Brokenshire MP, who was treated for the disease at The Royal Marsden. RM magazine 27


F O U N DAT I O N N E W S

MEET THE GOVERNORS

Dates for your diary Board of Directors meeting 25 March 2020

Two Governors discuss their aims and roles at the Trust

Council of Governors meeting 1 April 2020 Board of Directors meeting 9 June 2020 Council of Governors meeting 1 July 2020

THE RIGHT PLACE Assessment teams visited various hospital areas

PATIENTS ASSESS THE HOSPITAL Dr Ann Smith, Public Governor, Elsewhere in England

Dr Smith joined the Council of Governors in April 2018, three years after retiring from The Royal Marsden, where she worked as a Consultant Clinical Scientist. She said: “One of the most fascinating parts of being a Governor is gaining a different perspective on how the Trust operates. When you are working here, the focus inevitably tends to be on your role, which in my case was Head of the Stem Cell Transplant Laboratory. Becoming a Governor has enabled me to gain an understanding of how the Trust functions as a whole, and I can really appreciate the bigger picture now.” Dr Smith has joined the Membership and Communications Committee 28 RM magazine

and Nominations Committee, as well as participating as a panel member for Local Clinical Excellence Awards for Trust consultants. She has also used her academic links to reach out to potential members among University of Surrey students. “Having members reflecting the cross-section of our community is key to ensuring we are capturing a representative range of views,” she said. “I really enjoy continuing to be involved with the Trust as a Governor. It is an opportunity to learn, to contribute to the Trust and to represent members.”

“As a Governor, I can really appreciate the bigger picture now”

Dale Sheppard-Floyd, Carer Governor

Dale was elected to the Council of Governors in May 2019, three years after her husband was diagnosed with prostate cancer. She said: “My husband David and I became members around the time he was undergoing radiotherapy, as we wanted to be more involved with the work of The Royal Marsden. After listening to a presentation by Governors at a members’ event in early 2019, I decided to apply for election. “I am now retired; my previous background was in nursing and health visiting, including teaching and management, so learning about more recent advances in healthcare at The Royal Marsden has been a particularly valuable part of this experience.

“In addition to attending Council meetings, I have joined the Patient Experience and Quality Account Committee with a view to developing a better understanding of what constitutes quality care, and an overall view of the hospital environment as experienced by patients, their families and visitors. “I’m also looking forward to taking part in a series of clinical visits at both hospital sites, which will give me the opportunity to speak to patients and staff and help me understand the front-line issues.”

“Learning about recent advances in healthcare has been so valuable”

AS PART OF OUR programme to continually improve our services, the Trust invited members and Governors to take part in its annual Patient-led Assessments of the Care Environment (PLACE) in 2019. Over two days, several teams of assessors toured both hospital sites, including wards, communal areas, medical day units, radiotherapy departments and external areas. They assessed how the environment supported the provision of care – such as privacy and dignity, food, cleanliness and general building

maintenance – and supported people with a disability or dementia. Member Maria Odone took part in the Sutton assessments. She said: “We were very impressed with what we saw, especially how the food was prepared and tasted. The Royal Marsden is such a wonderful hospital; I enjoyed the opportunity to participate in this process.” Patient Governor Maggie Harkness said: “Our group started at Granard House in Chelsea. All the staff were very welcoming, even during their busy working day. The

wards were neat, tidy, clean and orderly. The dedication of the staff was really evident to see.” PLACE comments and observations are used to help the Trust to continue to pursue excellence in all that we do. Thank you to all the assessors for their support, enthusiasm and time – we could not do PLACE without you.

Want to know more? The PLACE results will soon be available online at royalmarsden.nhs.uk

WELCOME RETURNS The Council of Governors has unanimously approved the reappointment of The Royal Marsden’s Chairman, Charles Alexander, for a second three-year term. Ian Farmer, NonExecutive Director and Chair of the Audit and Finance Committee, has also been reappointed by the Council of Governors. Charles said: “It is an honour to be invited to serve a second term. The Royal Marsden is

forward-looking, innovative in research, with best-in-class care and important investment plans. In short, it is outstanding.” Dr Carol Joseph, Public Governor and member of the Nominations Committee, said: “Governors gave their full support to both reappointments. The Royal Marsden is extremely fortunate in having such high-calibre and highly dedicated people helping to run this amazing hospital.”

To attend any of these meetings, please call 020 7808 2844 or email corporate. governance@ rmh.nhs.uk

Keep in touch To contact your Governor, email governors@ rmh.nhs.uk or telephone 020 7808 2844

Become a member To sign up and become a member, visit royalmarsden. nhs.uk/ membership or call 020 7808 2844 to request a membership form

RM magazine 29


PUZZLES & PRIZES

PRIZE CROSSWORD The lucky winner of our prize crossword will receive a £50 John Lewis & Partners gift card. Send your crossword with your name and contact details to RM, PR and Communications Team, The Royal Marsden, Fulham Road, Chelsea, London SW3 6JJ. The entry closing date is Tuesday 5 May 2020. See below for prize draw rules. Winter 2019 crossword solution Across 2 Particles 6 ABC 7 Primula 8 Eiffel 9 Opal 11 Mace 12 Belize 16 Iceberg 17 SOS 18 Sapphires Down 1 Crane 2 Pacific 3 Rupee 4 Iris 5 Small 10 Priests 11 Mails 13 Elgar 14 Easel 15 Mesh Congratulations to Mrs Malar Kumar, the winner of the winter 2019 issue’s crossword prize. 1

2

6

3

4

5

7

9

8

11

12

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15

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SPRING 2020 PRIZE CROSSWORD ENTRY FORM Fill in your details below when sending in your crossword competition entry. See above for details of our address. NAME ADDRESS

POST CODE TELEPHONE

30 RM magazine

S TAY I N T O U C H

SUDOKU

THE TEAM

Try the fiendishly tricky numbers puzzle – it’s just for fun

FOR THE ROYAL MARSDEN

8 1 2 5 1 6 4 2 5 3 6 8 4 7 5 7 6 9 4 7 2 1 8 5 3 5 4 1 3 7 6

CROSSWORD CLUES Across 1 Magic word (11) 6 Worn by baby for dinner (3) 7 They may put 6ac on (7) 8 Corn (5) 9 Large raptor (5) 11 Indian state (5) 13 Foot-operated lever (5) 15 Dried grapes (7) 16 Also known as (1,1,1) 17 For ladies, in the past, to ride (4,7)

Down 1 Contains photos (5) 2 Small wild mammals (7) 3 Boat (5) 4 Italian poet (5) 5 Passage in a church (5) 10 Duck (7) 11 Land measurements (5) 12 Female servants (5) 13 Sat for an artist (5) 14 Goes in front (5)

PRIZE DRAW TERMS AND CONDITIONS 1. The Prize Draw is 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 Tuesday 5 May 2020. 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 prize 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 crossword prize of a £50 John Lewis & Partners gift card will be the first correct entry drawn out of the bag. 9. The Promoter is The Royal Marsden, Fulham Road, London SW3 6JJ.

Rachael Reeve Director of Marketing and Communications Elaine Parr Head of PR and Communications Abby Samuel Senior PR and Communications Manager Catherine O’Mara Senior PR and Communications Officer Hannah Bransden Senior PR and Communications Officer Francesca Vitale Senior PR and Communications Officer Orla Anandarajah PR and Communications Assistant

FOR SUNDAY Marc Grainger Editor Mark Wheeler Art Director Sian Purdy Designer Jenny Hogan Account Director Richard Robinson Content Director Sam Walker Creative Director Toby Smeeton Managing Director

COMMENT, LIKE, SHARE Join the conversation on Twitter @royalmarsden and @royalmarsdenNHS Facebook @royalmarsden, @royalmarsdenchelsea and @royalmarsdensutton Instagram @royalmarsden Twitter

Facebook

Steve Duffy @MrSteveDuffy Really proud of the @HarrisSutton1 choir members who sang Christmas carols at the @royalmarsdenNHS this morning [right]. They sang brilliantly. Wonderful to get such fantastic comments from staff and patients. A lovely morning! Lisa Randles @LisaLalo The RMH paediatric nurses are incredible human beings! Huge thanks to all of you and a very happy Christmas! Larry Lamb @larrylamb47 Surely that’s [patient Izzy being home for Christmas] a Christmas gift to everyone!!

Noreen Ann Dillon Mr Barton and Mr Butler jointly performed very extensive surgery on my sister 5 years ago. Despite their best efforts she had secondaries and did not survive very long post-op. Will remember their great kindness to us as a family always. x The Magnificent Marsden Making life-changing magic yet again!! Thank you all!! Eamonn Sullivan @CNEamonn Immensely proud, humbled & a little emotional! This rating is a testament to our brilliant people @royalmarsdenNHS – the dedication and care they deliver every day

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Michelle Woodland My late husband and dad have their star on the tree. Amazing surgeons [and] staff at this wonderful hospital. I donate every year and next year I’m going to the concert Music for The Marsden which is raising money for this wonderful charity. Keep up the good work. xx

Eleanor Wood @elliewood07 Celebrate a life, beautiful service as always, never forgotten, memories always treasured and sorely missed. Thanks for giving us hope @royalmarsden #celebratelife #royalmarsdenhospital #missed #christmas [above]

STAY IN TOUCH WITH THE ROYAL MARSDEN CANCER CHARITY

CONTACT THE FRIENDS OF THE ROYAL MARSDEN, CHELSEA

CONTACT US CALL THE ROYAL MARSDEN, CHELSEA

CONTACT THE ROYAL MARSDEN HELP CENTRE

RM magazine is published by The Royal Marsden in partnership with Sunday: wearesunday.com

020 7352 8171 CALL THE ROYAL MARSDEN, SUTTON

0800 783 7176

020 7808 2233

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© The Royal Marsden 2020. 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 Geoff Neal Group.

VISIT US ONLINE royalmarsden.nhs.uk

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EMAIL US charity@royalmarsden.org

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VISIT US ONLINE royalmarsden.org

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020 8642 6011

WANT TO WORK AT THE ROYAL MARSDEN? Visit jobs.royalmarsden.nhs.uk READ RM MAGAZINE ONLINE royalmarsden.nhs.uk/ rm-magazine

For confidential chat, support and information, call

For general feedback, compliments, concerns or complaints, send us a message royalmarsden.nhs.uk/ contact-us/get-in-touch

020 7352 3875

Look out for the summer 2020 issue of RM – coming June 2020 RM magazine 31


Write your Will for free

Registered Charity No. 1095197

Give back to the future

Writing or updating your Will can feel like a big decision, which is why The Royal Marsden Cancer Charity has a simple and free service that can help you. We hope that once you have included your loved ones, you’ll be inspired to leave us a gift in your Will – although there is no obligation to do so. Your gift can help fund our life-saving research that will make a vital difference to cancer patients long into the future. To sign up visit royalmarsden.org/freewill or call 020 7808 2233

Profile for The Royal Marsden

RM Magazine - Spring 2020