Life demands excellence
magazine â€“ summer 2012
More grants for our pioneering research Understanding the role of genetics Top nutrition for our young patients
Head and neck care in focus How The Royal Marsden is leading the way in the treatment of head and neck cancer patients
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 Focus on head and neck cancer Meet the team who lead the way in the treatment of head and neck cancer
20 Genetics research The Translational Genetics Laboratory is set to pioneer personalised medicine
Regulars 04 Hospital news 22 Day in the life 24 Fundraising 27 PCAG 27 The Friends 28 Foundation news 30 Puzzles & prizes
to the summer 2012 edition of RM, the magazine for our staff, patients, carers and Foundation Trust Members. In this issue, we explore the advances that The Royal Marsden is making in head and neck cancer (page 12), and examine the techniques and treatments that are making a real difference to patients’ lives. We also take a look at recent breakthroughs in the fields of prostate, skin and kidney cancers (pages 4–11), and spend a day in the life of Shirley Moore, our catering supervisor and a key member of our children’s centre team (page 22). Finally, I am delighted to announce that we have exceeded our fundraising target of £1 million for our second Marsden March (page 24). We are still receiving generous donations and I look forward to updating you in the next issue.
Cally Palmer, Chief Executive, The Royal Marsden
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Cancer Research UK
landmark research into tumour variation atients with advanced kidney cancer at The Royal Marsden have taken part in a breakthrough study which suggests that taking a sample from just one part of a tumour may not give a full picture of its ‘genetic landscape’. In the first-ever genome-wide analysis of the genetic variation between regions of the same tumour, scientists from Cancer Research UK, led by Professor Charlie Swanton, analysed samples from patients of Dr James Larkin, Consultant Medical Oncologist at The Royal Marsden. They found that about two thirds of gene faults were not shared
across other biopsies from the same tumour. “This study has shown significant molecular changes between parts of the same tumour,” said Dr Larkin. “We have also seen differences between primary kidney tumours and cancer cells that have spread to other organs.
The findings may be relevant to how we treat kidney cancer Dr James Larkin, Consultant Medical Oncologist
“The molecular changes that drive the growth of the cancer once it has spread may be different from those that drive that of the primary tumour. “The idea of personalised medicine is to tailor treatments to suit individual patients, so the findings may be relevant to how we treat kidney cancer patients.” The research, published in the New England Journal of Medicine, revealed that there were more differences than similarities between biopsies from the same tumour at the genetic level. The next step will be to understand what is driving this diversity in different cancers and to identify the
key driver mutations that are common throughout all parts of a tumour. The researchers compared the genetic faults in samples taken from different parts of four separate kidney tumours, and also from sites where the cancer had spread to other organs. This allowed them to identify 118 different mutations – 40 of which were ‘ubiquitous mutations’ found in all biopsies, 53 ‘shared mutations’ that were present in most but not all biopsies, and 25 ‘private mutations’ that were only detected in a single biopsy. The findings could explain why using single biopsies to identify biomarkers, to which personalised cancer treatments can be targeted, has not been more successful and also points to a way forward for treatment.
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Vemurafenib launches in UK emurafenib, a lifeextending pill for advanced melanoma patients that has been developed with the help of The Royal Marsden and The Institute of Cancer Research (ICR), is now available in the UK. Vemurafenib is the first personalised treatment that has been shown in clinical trials to increase survival time for patients with a specific BRAF gene mutation. The European Commission has now licensed vemurafenib for adults with this mutation whose cancer is inoperable or has spread. Research led by Professor Richard Marais at the ICR found that the mutated BRAF gene drives cancer development in about 50 per
cent of malignant melanomas. Vemurafenib, taken as four pills twice a day, is designed to block this cancer-causing form of the BRAF gene. In clinical trials led in the UK by Dr James Larkin at The Royal Marsden, patients treated with vemurafenib lived an average of 13.2 months compared with 9.6 months for patients who received standard chemotherapy. They were also 8.8 times more likely to respond to vemurafenib than to standard chemotherapy (48.4 per cent versus 5.5 per cent). The incidence of malignant melanoma is increasing in the UK, with about 10,000 people diagnosed and 2,300 deaths a year. It is the second most common cancer in people aged 15–34 in the UK.
In trials led by The Royal Marsden and The Institute of Cancer Research, vemurafenib extended life for patients with advanced melanoma
Royal Marsden scores ‘excellent’ rating Case study:
Charlie Sain-LeyBerry-Gray, 23 “Two weeks after having a mole removed from under my right arm, I was told I had malignant melanoma, which had spread to my liver and every vertebra in my back. “I was referred to The Royal Marsden, where I was told that surgery and chemotherapy were not an option due to the spread of the cancer – but that I could be eligible for vemurafenib, if I was one of the 50 per cent of people whose melanoma had the BRAF mutation. I was tested and was eligible, so started on the trial immediately. “Before the trial, I had terrible back pain due to the tumours on my vertebrae. One week after starting the treatment, this completely went. I’ve even been able to begin running again. “I’m a lot more optimistic about the future now. I know it’s still serious, but I’ve seen the results of the new drug – I really believe that it ‘understands’ my cancer and how to tackle it. I’m taking it step by step – another drug might be developed next year that could take my treatment to a further level. “I can’t thank The Royal Marsden enough – Dr James Larkin and his team have given me options I didn’t think I had.”
The Patient Environment Action Team (PEAT) has rated The Royal Marsden NHS Foundation Trust as ‘excellent’ for the fifth year in a row. The PEAT inspectors scored the Trust as being ‘excellent’ for the overall hospital environment, the levels of privacy and dignity given to patients, and the quality of food, as well as the levels of cleanliness and infection prevention and control.
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Team Science Award
Global award win for cancer drug success multidisciplinary team from The Royal Marsden and The Institute of Cancer Research (ICR) has won a prestigious global award for its success at taking new cancer drugs from concept to patients. This is the first time the American Association for Cancer Research (AACR) Team Science Award has been won by a team from outside the USA. The AACR said its decision was based on “the tremendous impact this team has had in preclinical and clinical studies of cancer therapeutics”. The team members are from the Cancer Research UK Cancer Therapeutics Unit at the ICR, which discovers
Professor Johann de Bono
boost for prostate research Professor Johann de Bono from The Royal Marsden and The Institute of Cancer Research (ICR) will collaborate with other leading prostate cancer researchers in a $10-million global effort to drive the development of personalised treatment for this disease. In April, Stand Up to Cancer, the Prostate Cancer Foundation and the American Association for Cancer Research announced the formation of a ‘Dream Team’, drawn from five leading prostate cancer clinical research
The ‘Dream Team’ will drive the development of personalised treatment
Photography: AACR/Phil McCarten
new drugs, and the Drug Development Unit at The Royal Marsden and the ICR, which progresses drug candidates into clinical trials. The AACR highlighted the team’s world-leading discovery of 16 innovative drugs over the past six years, and the progression of six of these drugs into Phase I clinical trials. The close collaboration between the scientists and doctors has enhanced our ability to translate basic scientific research into new personalised cancer medicines. This award is a great endorsement of the academic drug discovery and pioneering development model and the impact this has had on the lives of cancer patients.
centres in London and the USA. Along with Professor de Bono, the team also includes Dr Gerhardt Attard from The Royal Marsden and the ICR. Over three years, the team will drive the development of personalised treatment by scanning the genomes of patients with advanced metastatic cancer. They will look for gene alterations that are more common in patients who respond to therapies, as well as alterations in patients who develop resistance to the drugs. The aim is to identify a panel of biological markers that doctors can use to target treatments to their patient. Professor de Bono said: “I am thrilled to be part of this collaboration, to make a real and lasting difference to men with advanced prostate cancer.” The project is scheduled to start mid-2012 with the first clinical trials in early 2013.
The multidisciplinary team accepts the AACR Team Science Award
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The future of diagnostics
Breast radiotherapy research wins grants Staff working at The Royal Marsden and The Institute of Cancer Research (ICR) have been awarded research grants for three projects that aim to address aspects of the long-term consequences of breast radiotherapy
Import-IGRT Professor Phil Evans, Professor of Medical Radiation Physics at the ICR, has been awarded an Efficacy and Mechanism Evaluation grant of £250,000 over two and a half years from the Medical Research Council. Dr Emma Harris (above), Principal Radiotherapy Research Physicist at The Royal Marsden, is the chief physicist and co-author of the study. Currently under way, this study investigates whether image-guided radiotherapy (IGRT) is effective in reducing the volume of tissue treated to a high dose, and will identify the consequent reductions in risk to normal tissue compared with the standard radiotherapy technique.
HeartSpare Dr Anna Kirby (above), Consultant Clinical Oncologist at The Royal Marsden, has been awarded a National Institute for Health Research (NIHR) Research for Patient Benefit grant of £250,000 over three years. Although radiotherapy is highly successful in treating breast cancer, the heart is very sensitive to this treatment. This study will assess two potentially simple techniques that reduce the dose of radiation to the heart. The ultimate aim is to reduce the after effects of radiotherapy in the hearts of breast cancer patients by making heartsparing treatment available to all UK women.
Benefit versus risk in breast radiotherapy Dr Ellen Donovan (above), Principal Clinical Physicist at The Royal Marsden, has been awarded an NIHR Healthcare Scientist personal fellowship grant of £180,000 over three years. Using new technology, we can deliver radiotherapy in more sophisticated ways and improve the accuracy of the treatment. This project aims to understand and quantify the differences between IGRT and standard radiotherapy techniques so that the new, more accurate methods may be used to minimise the harm done by ionising radiation to tissues away from the treated area.
Plans have been approved for a new Diagnostics Suite, located on the fourth floor of Granard House. The suite, due to be complete by mid2014, will offer patients all diagnostic services within one centre, meet future demand and enhance our research programmes. Two new MRI scanners will be installed by spring 2013, followed by two CT scanners. The Royal Marsden will be one of just a few centres to have both a 3T and a 1.5T scanner in one location. Both machines are being funded by donations to The Royal Marsden Cancer Charity. The 3T MRI scanner is generally available only in research or private centres. It will offer superb diagnostic image quality, especially when scanning small fields of view; shorter scanning times in certain protocols, therefore increasing capacity; and personalised treatment planning. The new 1.5T scanner has increased diagnostic capabilities, range, comfort and image quality. The co-location of the two scanners ensures that all patients requiring an MRI scan will be offered the most appropriate scanner. Two new PET/CT scanners will also be installed in a new facility at Sutton this September, making The Royal Marsden the largest NHS provider of PET/CT scanning in the UK.
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Safeguarding Children and Adults Leads Scott Pollock and Anne Howers
Sourcing ethical foods
ANOTHER CATERING COUP he Royal Marsden catering department has won the Good Food on the Public Plate Award for the third year in a row. The award highlights public sector organisations in London that provide meals that not only taste good, but also benefit the environment, are ethically sourced and provide good value. Rosie Boycott, Chair of the London Food Board, congratulated the hospital for its use of organic milk, British pork and free-range eggs. “We pride ourselves on serving food that is nutritious for our patients and staff but also ethically sourced,” said Gary Burkill, Head of Facilities at The Royal Marsden. This is the latest in a long line of awards in recognition of the hospital’s catering staff, practices and food sourcing.
The Royal Marsden has already been honoured with a Compassion in World Farming Good Chicken Award and three Good Egg Awards for its catering excellence. At a reception at Clarence House hosted by HRH The Prince of Wales, the Soil Association commended the hospital for serving fresh, local and organic produce. Individual catering staff members at The Royal Marsden have also been recognised for their commitment to nutrition and patient welfare. In 2009, Shirley Moore, who works in the Oak Centre for Children and Young People (OCCYP) as Paediatric Catering Supervisor, won a News of the World Children’s Champions Extra Award. Read all about Shirley’s work on page 22.
We pride ourselves on serving food that is nutritious for our patients and staff but also ethically sourced GARY BURKILL, HEAD OF FACILITIES
PUTTING SAFETY FIRST The Royal Marsden is working hard to raise awareness of child and adult abuse, and to ensure that staff are aware of what to do if they suspect someone is being harmed. All staff are offered training to spot the signs and indicators of abuse to make sure potential abuse is reported and prevented from reoccurring. To bring this area to the fore, the roles of Safeguarding Children and Adults Leads
have been created, with Anne Howers, Head of Children’s and Family Services for Sutton and Merton Community Services, and Scott Pollock, Discharge/Vulnerable Adult Lead, in these roles for children and adults respectively. Anne and Scott will support Trust staff in liaising with partner agencies that work with vulnerable adults and children in order to protect these members of society.
Over 1.5 million viewers tune in to watch Horizon
April saw the screening of the BBC Horizon documentary ‘Defeating Cancer’, ﬁlmed at The Royal Marsden last summer. The documentary focused on the ‘benchto-bedside’ approach to cancer medicine that The Royal Marsden pioneers, as well as looking at some of the state-of-the-art technologies used to treat patients. Medical Director Professor Martin Gore said: “It’s a welcome reminder that The Royal Marsden is on the frontline, working hard to make things better for our patients. It also demonstrates that our achievements involve all of us. Absolutely everyone contributes.”
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A grand musical gift for the chapel
Senior Physiotherapist Sarah Crighton
Spring into Action
New one-stop-shop for diet and exercise advice The Royal Marsden’s new Spring into Action clinic aims to help cancer patients gain a better quality of life by providing specific advice on diet and exercise. Sarah Crighton, Senior Physiotherapist, explains: “We want to fill the gap for patients who have side effects during and after treatment – such as fatigue, weight issues and a reduced sense of wellbeing – and make sure patients are aware of the benefits of a healthy lifestyle. Most patients strive to get back to doing something they did easily before treatment. We can help
them achieve this and give them the confidence to deal with life during and after cancer.” The clinic allows patients at both sites to self-refer for a one-off, informal 45- to 90-minute appointment with a dietician
We want to make sure patients are aware of the benefits of a healthy lifestyle sarah crighton, senior physiotherapist
and/or a physiotherapist. It is open to patients at any stage of diagnosis and treatment. “We also find local exercise opportunities and dietary support to empower people to continue independently,” explains Sarah. Following their appointment each patient receives an agreed action plan and a telephone consultation after three months to review their progress. To book an appointment please contact the Therapy Department quoting ‘Spring into Action’ on 020 7808 2811 (Chelsea) or 020 8661 3028 (Sutton).
Through the wonderful generosity of a private donor and the efforts of The Friends of The Royal Marsden, Chelsea, there is a new grand piano in the chapel. This will ensure our continued success as a venue for a variety of music events, which, in the past, have included chamber organ, violin and song recitals. Over the past few years, the chapel has welcomed young musicians from the Oratory School and students from the Royal College of Music. One memorable performance was given by Megumi Nagae, a former Royal College of Music violinist and now our resident musician, who performed Max Bruch’s Violin Concerto No.1 in G minor with pianist Tom Blach in a packed chapel. Audrey Arden-Jones, Chair of the Arts Forum, said: “We are grateful to the talented musicians who play for free, giving so much pleasure to others, and we are indebted to the hard work of the organiser, chaplain Alistair McCulloch, and the team from the Arts Forum.”
The new grand piano in the chapel
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Zero landfill target
The nine GP Education Days have attracted almost 100 attendees each session
GP Education Day success ow in its third year, The Royal Marsden’s GP Education series of quarterly one-day seminars and online learning opportunities continues to be a success, contributing directly to GPs’ professional knowledge on cancer diagnosis and treatment. The Royal Marsden has held nine GP Education Days since September 2009, covering most tumour types, with almost 100 GPs attending each session. The most recent event, on 27 April, was chaired by Miss Jenny Rusby, Consultant Breast Surgeon, and Mr Alan Thompson, Consultant Urological Surgeon, both from The Royal Marsden. Speakers focused on the screening, diagnosis, treatment and management of breast and prostate cancers.
In line with government objectives, we are helping to build relationships between primary and secondary care by educating GPs on the value of prevention and early diagnosis – recognising cancer signs and symptoms and referring patients at the right time. To ensure our Education Days remain relevant and engaging for GPs, we are planning more interactive, case-led sessions to help us further understand the problems faced in primary care and allow us to offer expert secondary care advice. We also work with Cancer Research UK, the Department of Health and the British Heart Foundation to bring in outside speakers for the events. We produce video highlights of each
Education Day, which are made available to all GPs via www.doctors.net.uk, while a quarterly e-bulletin informs GPs of the latest news and general information on specific cancers. The next GP Education Day is in August at Chelsea’s conference centre and will focus on skin cancer and lymphoma.
We are helping to build relationships between primary and secondary care by educating GPs
Plans are under way to reduce the amount of landfill from The Royal Marsden’s Chelsea site to zero by sending our non-recyclable material to an energy-fromwaste (EfW) plant to be converted into energy for the local area. We currently recycle 95 per cent of our total nonclinical waste, including all paper, plastics and glass. Confidential waste is either shredded before recycling or disposed of via a specialised contractor. The remaining five per cent that can’t be recycled goes to landfill. The Trust is now in discussions with our waste contractor to redirect this waste to an EfW plant. Alan Goodfield, Environmental Waste Manager, said: “Being able to reduce our landfill waste to zero and produce heat and electricity for the local area would be a great result.”
of our total non-clinical waste is recycled
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Refurbishments in Sutton
Refurbishment work has now been completed in the Rapid Diagnostic and Assessment Centre (RDAC), Robert Tiffany Ward and Radiotherapy Department at our Sutton site. The renovations include a more open waiting area, more modern units, new windows and a more accessible reception area. Plans are also under way to create a new clinic room.
The David Adams Leukaemia Appeal is hosting its annual Grace Ball at the five-star Jumeirah Carlton Tower Hotel, Knightsbridge, on Saturday 10 November. Guests will enjoy a champagne reception, followed by dinner and dancing to a live band, and other entertainment including auctions, magicians, caricaturists and a casino. Money raised will be donated to The Royal Marsden Cancer Charity. Early-bird tickets can be purchased for £100 before 10 October; the full price is £120. Tables of 10 or 12 are available. The ticket price includes a reception drink, three-course dinner and a half bottle of wine. For more information, or if you have prizes to offer for the raffle or would like to sponsor a future event, call 020 8891 2221, email liz@davidadamsleukaemia appeal.org or visit www.davidadams leukaemiaappeal.org
London Olympics 2012
the olympic torch sets pulses racing Olympic fever reached The Royal Marsden when the iconic Olympic Torch was proudly showed off to staff and patients by one of the London 2012 Olympic Torchbearers. Alex Richardson, a fundraiser and supporter of The Royal Marsden Cancer Charity, is one of the 8,000 Torchbearers for the London 2012 Olympic Torch Relay. Staff, patients and visitors in the Oak Centre for
Children and Young People, the Playhouse Day Nursery and Oak Drug Development Ward were delighted to see the torch first hand. Alex said: “It is an honour to be selected to carry the torch for my fundraising work for the hospital so it seemed fitting to show it off to everyone here. It was lovely to bring smiles to patients’ faces when they had their photo taken with the torch.”
Charlie Lustman and Vina Jarrett, Main Reception Supervisor
charlie’s inspiring visit
US singer-songwriter and cancer survivor Charlie Lustman made time to visit The Royal Marsden in Chelsea on a whistle-stop tour of London in February. He talked to patients and performed songs that he wrote after diagnosis, treatment and recovery from osteosarcoma in his upper jaw. “Mine is the story of a survivor who lost his jaw to cancer and found his voice,” said Charlie. “The Royal Marsden is a place where they say life demands excellence, and they definitely deliver on this.” Staff were delighted to welcome him to the hospital. “Charlie is an inspirational example of life beyond cancer,” said Lynne Hopwood, Assistant Chief Nurse (Operations). Charlie recently completed a 28-city tour of the USA and also performed in Kenya for World Cancer Day.
Young patient Riley Siddell and his mum hold the Olympic Torch
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head and neck cancer special
Meet the Head and Neck Unit team Introducing the clinicians who are pushing the boundaries of research and treatment of head and neck cancers
Q&A head and Neck cancer Dr Kate Newbold, Consultant Clinical Oncologist, talks about cancers that occur in the head and neck
notice a persistent ulcer, a sore throat or an earache; in the voice box, hoarseness may be the first symptom; in the sinuses, patients may notice a nasal discharge or a blocked nose. Patients will commonly notice a lump in the neck, which will be a lymph node to which the primary cancer has spread.
Who does it affect?
Men are affected more than women, and it usually affects people over the age of 60; however, we are increasingly seeing cases in younger patients as a result of HPV.
How common is it?
It is the seventh most common site of cancer, with about 7,000 new cases diagnosed every year in the UK.
How is it treated?
It depends on where the tumour arises. Essentially, cancers of the mouth and sinuses are treated initially with surgery, then, in some cases, by a combination of chemotherapy and radiotherapy after the operation. Tumours of the throat and larynx are treated with radiotherapy alone, or in combination with chemotherapy. Sometimes surgery to the larynx is required. We can achieve cure rates of over 90 per cent in early-stage tumours with surgery or radiotherapy alone, and 50–70 per cent in more advanced-stage disease with a combination of modalities.
What are head and neck cancers?
These are cancers that arise in any region of the head and neck, excluding the brain. Most commonly, they arise in the mouth, throat and larynx (voice box), but we also treat cancers of the ears, nose, eyes and sinuses. The most common type of cancer in the head and neck is squamous cell carcinoma.
What causes head and neck cancers?
Smoking tobacco is a major cause of squamous cell carcinoma. This risk is increased when associated with heavy alcohol intake. We are also increasingly seeing cases of head and neck cancer caused by the human papilloma virus (HPV).
How is it diagnosed?
Symptoms vary, depending on where in the head and neck it arises. The patient may
Is any interesting research being carried out at The Royal Marsden?
The Head and Neck Oncology Unit has just been awarded a five-year Cancer Research UK programme grant, which is a huge success and very exciting. There are three streams of research. I will lead the first, developing functional imaging (MRI and PET) techniques to define the biological characteristics of tumours, with the aim to tailor radiation and drug therapy to the individual patient. The second, led by Dr Kevin Harrington, will continue the development and investigation of tumourselective radio-sensitisers that target the radiation-induced DNA damage response. And the third, led by Dr Chris Nutting and Dr Shreerang Bhide, will define predictors of the radiation response in acute- and latereacting normal tissues and in tumours. ➜
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reconstructive surgery A three-dimensional approach to facial reconstruction
Rachel Johnson, 31 “In 2009, shortly before I was due to get married, I felt a pain in my shoulder, then my neck swelled up. I had a laparoscopy and a biopsy, which revealed it was cancer in my nose that had spread to my neck. “Chemotherapy and radiotherapy were not enough to beat it, so I had a section of my neck removed. I had side effects from the treatment and surgery that everyone could see. I suffered with acne and sores on my neck, and found it hard to look at myself in the mirror. “I had to stay strong. My goal was my wedding, which we postponed until 2010. I also had my young son Dejaun to think about. “I had great support from my family and my husband Dwayne. We were warned that the treatment would affect my ability to conceive, but against the odds, we have had a second little boy, Roshaun.”
In the past year, The Royal Marsden has been using advanced technology to plan the details of reconstruction surgery for head and neck cancer patients prior to entering the operating room, moving on from the traditional ‘freehand’ approach used by other hospitals. Pioneered by Mr Cyrus Kerawala, Consultant Maxillofacial Head and Neck Surgeon at The Royal Marsden, the process uses data from patients’ staging CT scans to make three-dimensional models of the bones of their skull. These models allow Mr Kerawala to plan where he will make any bony cuts before the patient reaches the operating table. They also even allow him to accurately determine the shape and amount of bone that he will need to use to reconstruct his patients and so decide which part of the body it would be best to harvest bone from. “Previously, we would harvest bone from the lower leg, pelvis or shoulder blade on a ‘best-guess’ basis,” says Mr Kerawala. “We now use the models as a guide to help us decide on a tailored approach for each patient. The models allow us to understand with great accuracy the size and shape of the bony defect that surgery will produce. As a result, we can plan where to harvest bone from and can even decide how we are going to shape that bone before we get into the operating theatre. Before, much of that decision-making had to take place during the operation.”
dimensional model rather than a flat picture of a CT makes it much easier for us to explain what will happen during their operation.” The next stage is to incorporate teeth implants into the initial operation. “Most head and neck patients having part of their jaw removed and reconstructed would have the operation to remove the cancer, and then, six months later, undergo further surgery to insert implants to replace their teeth,” explains Mr Kerawala. “Soon, with the aid of our new models, we will be performing both operations together. The benefits to the patient will be immense, as it will reduce the number of operations, so they’ll be fully rehabilitated much sooner.”
Three-dimensional models help us decide on a tailored approach for each patient Mr Cyrus Kerawala, Consultant maxillofacial Head and Neck Surgeon
Mr Cyrus Kerawala, Consultant Maxillofacial Head and Neck Surgeon
The new pre-operative planning also allows surgeons to be much more time-efficient. “Each operation can last about 10 hours, so anything that reduces this has obvious benefits for the patient,” says Mr Kerawala. “Patients have benefited by getting a more accurate result, and using a three-
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Jamie Wood, 19, amateur boxer
“In September 2010, I was diagnosed with Ewing’s sarcoma, a rare form of bone cancer, in my right sinus. I was really shocked. I was 17, incredibly fit from training and was just about to enter the Amateur Boxing Association’s championships. I didn’t think cancer would affect someone like me. I just had a headache that would not go away. “I am a really determined person so, when I was referred to The Royal Marsden, I just said, ‘Right, let’s get on with the treatment so I can get back to boxing.’ I had eight courses of chemotherapy over four-day periods, with a three-week gap between each course. “In February 2011, I had my palate removed, along with eight front teeth and my right sinus. A plastic palate and teeth were put in as a temporary measure and I then had another eight doses of two-day chemotherapy treatments. “In November, I had the big reconstruction operation with Cyrus. At my initial meeting with him, he said he would use my leg bone for the reconstruction. I was really against it as you need your legs all the time for boxing, so there would be no way I’d be able to box. He discussed the possibility of using my shoulder blade, and that’s what we agreed. “He took a little piece of bone out of my shoulder blade and used it to make a palate. It is incredible and looks completely normal. I am so pleased that he managed to avoid using my leg bone as I don’t know what I would do without boxing. “As soon as my chemotherapy finished last August, I was back in training. I have always dreamed of taking part in the Olympic Games and to become a world champion one day, and I now have a clear road ahead of me to achieve this.”
Mr Kerawala on Jamie
“Jamie was a very unusual case as he was both young and keen to pursue a professional boxing career. We discussed the possible sites from which to harvest bone to reconstruct his top jaw and, with the help of his three-dimensional model, we ultimately agreed that his left shoulder blade would be best, both in terms of the size and shape that we needed, and the impact it would have on his boxing. This made the operation more complicated than usual as, after removing
the cancer, we had to move Jamie onto his front so that we could get access to his back. “At first, most patients have difficulty walking after the more standard transplant of bone from leg to jaw, but in Jamie’s case, as he was a fit young man, he was able to quickly build up the muscle around his shoulder blade with exercise.” ➜
Jamie Wood had reconstructive surgery on his palate at The Royal Marsden as part of his recovery from cancer in his sinus
A little piece of bone from my shoulder blade was used to make my palate... It is incredible Jamie Wood, Royal Marsden patient
RM magazine 15
Cancer in focus
a great deal of previous treatment,” said Dr Harrington. “Under those circumstances, we’d expect that the average response rate to chemotherapy alone might be as low as single digits, and the average survival would be between three to four months. In our study, this had been prolonged to an average of seven months, albeit not in a randomised trial. “Based on the results, we’re now recruiting patients with advanced head and neck cancer to a randomised Phase III trial, in which all patients will receive chemotherapy and half will also receive Reolysin. We are extremely excited about this progress.”
Dr Kevin Harrington, Consultant Oncologist
A new drug to target head and neck cancers shows promise in trials
Dr Kevin Harrington, leader of The Institute of Cancer Research (ICR) Targeted Therapy Team and Consultant Oncologist at The Royal Marsden, is conducting studies of a new drug based on a naturally occurring human virus. It is hoped that the drug, RT3D, could boost the effects of two standard chemotherapy drugs in some cancer patients, according to early-stage trial data. RT3D, also known by the trade name Reolysin, is based on a harmless virus found in almost all adults’ respiratory and gastrointestinal tracts. It has the ability to grow in – and kill – certain types of cancer cells, but does not grow in normal cells. Head and neck cancer patients had the best response rates to a Phase I study, so they were targeted in a Phase II study at The Royal Marsden and St James’s University Hospital, Leeds. Cancers shrank for about one third of the patients who could be evaluated, and disease stabilised for a further third. For one patient, all signs of cancer disappeared. “These are impressive response rates in patients whose cancers had grown despite
Our patients showed impressive response rates... We are extremely excited by this progress DR Kevin Harrington, Consultant Oncologist
Essential nutrition Nutrition is vital in the rehabilitation of patients after treatment. Natalie Harris, Senior Specialist Dietitian, starts working with head and neck cancer patients as soon as they have been diagnosed to help prepare them for what they will experience during their treatment. She says: “I drip-feed them information so they know what to expect. A side effect of radiotherapy is a dry mouth and difficulty swallowing, which can make eating hard for patients.” Some patients are artificially fed through a tube following surgery or treatment and work their way up to eating normally. Natalie says: “Different people require different levels of support, but I generally see patients every other week for a couple of months. Most are eating after six months, but foods such as steak and bread can still be difficult at this stage.”
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Dr Chris Nutting, Consultant Clinical Oncologist
New studies aim to improve cure rates and preserve patients’ quality of life
One of the most significant advances in cancer treatment for head and neck patients at The Royal Marsden and The Institute of Cancer Research (ICR) has been the PARSPORT trial – the use of intensitymodulated radiotherapy (IMRT) to minimise the side effects from radiation therapy. The randomised trial allowed one or both parotid glands to be spared, maintaining saliva production; something that could not be achieved with conventional radiation therapy. Dr Chris Nutting, Consultant Clinical Oncologist and the designer and lead investigator of the trial, says: “Every year, 550,000 people worldwide are diagnosed with head and neck cancers, of which 250,000 would benefit from IMRT treatment. “Most head and neck cancers have a good chance of long-term cure, but the side effects can affect patients’ quality of life.
Our research is looking at ways to minimise the impact that treatment can have on their lives. Following the success of our trial, every eligible head and neck cancer patient in the UK is to be offered IMRT.” A second IMRT trial, COSTAR, which follows on from the success of PARSPORT, is currently under way. Dr Nutting says: “COSTAR looks at how standard radiotherapy for parotid gland cancer may cause damage to the inner ear and hearing loss. IMRT shapes both the beam and the dose of radiation to match the shape of the tumour. This allows us to target the radiation beams at the cancer more accurately, reducing the risk of damaging surrounding healthy tissue.” The Royal Marsden is also recruiting for the third trial, ART DECO, which looks into giving the maximum doses of IMRT for cancer of the larynx or hypopharynx (upper part of the oesophagus). “The main aim of this study is to see if it is possible to improve cure rates of these cancers by increasing the dose of radiotherapy, while avoiding damage to healthy tissue,” explains Dr Nutting. “Previously, surgery would have been standard for the patients with cancer in the larynx, but in the past year, we have pushed larynx preservation rates from 60–70 per cent to 95 per cent. “Quality of life is a critical part of treating head and neck cancers as it can be so visual. Patients’ main concerns are preserving their senses, voice and swallowing ability. We work hard to achieve successful treatment and preserve quality of life for all our patients.” rm
Head and neck cancer
550,000 people are diagnosed with head and neck cancers each year worldwide
250,000 of those would benefit from IMRT treatment
most common cancer in the UK
new cases of oral cancer are reported each year in the UK
2,300 new cases of larynx cancer are reported each year in the UK
RM magazine 17
Surgical voice restoration after laryngectomy
Location of tissue vibration for voice
Tracheoesophageal puncture and voice prosthesis Trachea and air from lungs
Justin Roe, Research Speech and Language Therapist
“I was diagnosed with throat cancer in 2006. I had been a heavy smoker but had given up two years before. I had radiotherapy and chemotherapy, but the cancer returned four years later. “I needed to have my voice box removed and was given six weeks to decide if I wanted to go ahead, so I reluctantly agreed. I was very frightened, but the speech therapist really prepared me for the operation. He put me in touch with another patient who had undergone the same procedure, which put my mind at ease. “After the operation, it was not too bad as I knew what to expect. I have very strong willpower, so I just got on with my therapy and I was saying a few words within a few weeks. I was taught how to breathe through my stomach while covering the stoma in my neck. It improved every day and I can now hold a conversation. “I consider my life to be quite normal now. I attend a clinic every three months. People look at me differently because of the way I speak and the stoma in my neck, but I don’t let it worry me.”
Illustration: John See
John Alden, 67
18 RM MAGAZINE
Head and neck cancer: speech therapy
Restoring the power of communication
A key element of rehabilitation from head and neck cancers is speech therapy. We meet one of the therapists who help patients to cope with the after effects of their condition
peech and language therapy plays a vital role in rehabilitating patients with head and neck cancers. A common concern among patients is the effect that the cancer, treatment or surgery may have on swallowing and communication. Justin Roe, Research Speech and Language Therapist, explains that he and his colleagues work with patients before, during and after treatment to ensure that they can achieve a good quality of life. The Speech and Language Therapy team treat a range of patients, from those who require extensive surgery – such as a laryngectomy (voice box removal due to cancer) – to those who need radiotherapy and chemotherapy. “We like to see patients before they start radiotherapy or have surgery, to help them prepare for the side effects they will experience,” explains Justin. “Some people may already be having difficulties, and we can provide help and advice on our first meeting. We also explain how the treatment itself may affect their ability to communicate and swallow. We discuss with patients how we plan to work with them to improve their ability to eat, drink and speak. “At The Royal Marsden, we also provide an On Treatment Clinic for patients to access once a week during their radiotherapy. This incorporates our multidisciplinary approach to treating patients and includes clinical nurse specialists and dietitians. “Improved chemoradiotherapy techniques have meant that people may not require extensive surgery. The side effects associated with selective and more targeted radiotherapy are less severe, but it still takes a lot of work
to get them rehabilitated. This work starts before treatment, and we provide patients with exercises to prepare the swallowing muscles for the immediate and long-term side effects of radiotherapy.”
Speech therapists use a number of methods to assess swallowing ability, including a videofluoroscopy (an X-ray of swallowing) and Fibreoptic Endoscopic Evaluation of Swallowing (FEES), in which a nasendoscope with a small camera on the end is passed through the nose and into the throat. With these assessments, therapists can see which muscles are working and which need exercises to improve swallowing. “People improve at different times after their treatment,” Justin says. “In my research capacity, I use a range of measures. These include videofluoroscopy to see how people having radiotherapy swallow before their treatment starts and then up to a year after it. “As part of my five-year research fellowship,
We specialise in surgical voice restoration and support patients who have had their voice boxes removed to communicate effectively again Justin Roe, Research Speech and Language Therapist
I am looking at the potential benefits of intensity-modulated radiotherapy (IMRT) on swallowing. We are fortunate at The Royal Marsden to have a state-of-the-art KayPentax Digital Swallowing Workstation to analyse swallowing function in detail.” Laryngectomy patients have significant changes to overcome, says Justin: “Our speech therapists specialise in surgical voice restoration (SVR) techniques and work closely with our multidisciplinary colleagues to get the best outcome for patients. Before they have their surgery, we will explain to them, and their families, what impact surgery will have on their communication and swallowing. We also arrange for them to meet a patient who has been through the surgery and recovered following intensive rehabilitation. “After their surgery, we aim to get people eating and drinking again. Because they have had their voice box removed, we also look at options to get people speaking again. Normally this will involve SVR, where we place a special valve in the throat called a voice prosthesis. We teach people to use this so they are able to speak with their families and get back to work. We encourage people to be as independent as possible. However, we are always available to help people who may have difficulty with their valves.” Justin says that many patients are signed off after their five-year cancer check-up. However, laryngectomy patients are likely to remain in touch with the speech therapists for life, as they will always need access to expert advice and support, given the permanent changes to their communication abilities. rm
RM magazine 19
TRANSLATIONAL GENETICS LABORATORY
Making personalised medicine a reality The Royal Marsden’s new initiative will help us to understand the role of genetics in why people develop cancer, and usher in a new era of individually tailored treatment plans
he Royal Marsden, with our academic research partner The Institute of Cancer Research (ICR), is committed to the development of personalised medicine – tailoring treatment plans to individual needs. The new Translational Genetics Laboratory, a groundbreaking initiative led by Professor Nazneen Rahman, will provide testing to investigate how the genetic make-up of an individual affects why they develop cancer and what treatment will be most appropriate for them. The £1.16-million project, which will be funded by The Royal Marsden Cancer Charity, will focus on patients being treated at The Royal Marsden. Once established, it will then support genetic testing for cancer patients elsewhere in the UK, uniquely providing test results and recommendations for how they should be used in the clinic.
Reading the genetic code
Professor Rahman explains: “Genes are the instructions that make our bodies work, including instructions on when cells should grow or stop growing. A faulty gene can cause a cell to grow uncontrollably, invading normal tissues, and we call this a cancer. Previous research has already identified nearly 100 genes that can increase the risk of cancer occurring. “Our work in this new project will involve setting up a new laboratory with the latest state-of-the-art sequencing technology. This will allow us to read the genetic code in thousands of patients, quickly and affordably, from a simple blood test.” Genetic testing is not only helpful for people with cancer, it can also potentially
provide vital information for their relatives, who may be at risk of cancer and could benefit from screening. “Currently, cancer gene testing is severely restricted,” says Professor Rahman. “Hundreds of women with ovarian or breast cancer are not eligible for NHS testing of BRCA genes, despite their proven benefit in cancer management and mortality reduction. “Many of these restrictions are due to the expensive, laborious testing methods used previously. The new sequencing technology that we will use in the Translational Genetics Laboratory is much easier, faster and cheaper and will revolutionise clinical practice in the area of genetics.” By 2014, Professor Rahman hopes to be able to offer genetic testing for all ovarian and breast cancer patients at The Royal Marsden, as well as for many other cancer patients. The ultimate aim is for genetic testing to be available for all cancer patients as a matter of course. “This is an immensely exciting time for genetics within cancer medicine – the speed at which the technology and its application is moving makes extraordinary progress a reality,” says Professor Rahman. “Previously we were trying to run; suddenly, due to the new technologies, we are able to fly. It’s a fantastic opportunity that will make a real difference for patients and their families.” rm
This is an immensely exciting time for genetics within cancer medicine PROFESSOR NAZNEEN RAHMAN, HEAD OF GENETICS
20 RM MAGAZINE
Research in focus
Professor Nazneen Rahman will head up the work of the Translational Genetics Laboratory
Shirley and her team work in the Oak Centre for Children and Young People, providing freshly cooked meals. Shirley gets the young patients in the Play Room involved in fun food projects, such as decorating biscuits, and takes time to ask what the children want to eat
I always check that the patients have eaten and, if not, I will cook whatever they want to get them eating. Iâ€™ve had some very unusual requests
22â€‚ RM magazine
a day in the life
Paediatric Catering Supervisor, Oak Centre for Children and Young People Shirley Moore
ood nutrition is a vital part of a child’s recovery from cancer, but treatment normally affects the taste buds and makes eating difficult. I have a team of seven and it’s our job to ensure that all the patients are eating well. This can be a challenge, but I love spending time with the children and getting them excited about food.
My day starts at 9.30am. We have two kitchens in the Oak Centre for Children and Young People (OCCYP): one in the McElwain Ward and one upstairs in the Teenage Cancer Trust Unit. We offer food to order for all our Day Care patients from 10am until 6pm, and a morning and afternoon snack trolley for the 32 inpatients in the OCCYP. I’m really proud that all the food is freshly cooked. I do most of it with one of my team, Johnny Heusner. Lunchtimes can get hectic, but are fun. I once served 18 meals in eight minutes while also on the phone to Day Care! I always check that the patients have eaten their lunch and, if not, I will cook whatever they want to get them eating. I’ve had some very unusual requests – one patient craved Brussels sprouts six times a day; another couldn’t decide between a beef burger and a chicken burger, so I made him half-and-half.
Food and fun
The first thing children usually go off is chocolate – the chemotherapy makes it taste metallic – and they crave salty foods like
crisps. I try to get them to eat things they’ve never had before so they won’t have anything to compare it to. It’s also important to keep up their calorie count, so we offer milkshakes and rich meals such as macaroni cheese. If a young patient is not eating, I contact the dietitians, who speak to the family and then advise me. I can usually encourage them; I keep meals small, and I’m a dab hand at ‘smiley face’ dinners with broccoli fangs! After the lunchtime rush, I pop into the Play Room and School Room. I work closely with the staff in both, including the nursing staff, and always help out at parties and themed days. I taught the children to make pancakes on pancake day – it was lovely to see them take ownership of their work.
Like a family
We like to cook a roast dinner on Sundays. The children all sit together – it’s like a home from home. We become a family, which is why it’s such a wonderful place to work, but it’s hard not to get too attached. My working day should finish at 6pm, but I rarely leave at that time – if someone hasn’t eaten and asks for a different meal, I can’t resist making it for them. Some families have asked if they can adopt me when they leave and have offered to set me up in a ‘granny flat’ at the bottom of their gardens! And one child who started at pre-school after treatment wouldn’t eat the food the school cooked, so the staff had to pretend that I was a chef in their kitchen. rm
RM magazine 23
The royal marsden cancer charity
24â€‚ RM magazine
Taking on cancer together This year’s Marsden March was a huge success, with thousands of supporters making the 14-mile journey between our Chelsea and Sutton hospitals he Royal Marsden Cancer Charity’s second Marsden March – a 14-mile sponsored walk between the Chelsea and Sutton sites, took place on Sunday 11 March 2012. The event has already exceeded its fundraising target of £1 million for The Royal Marsden Cancer Charity.
Bigger and better
This year, we had almost double the number of walkers, with 3,000 completing the 14-mile route and 700 walking the five-mile route. Walkers came from as far afield as Shanghai and the Netherlands, and from around the UK, including Derby, Liverpool, Cambridge and Plymouth. Our youngest walker on the five-mile walk was aged just four months old, and our eldest was 85. This year, we were again joined by actors Nathaniel Parker and Larry Lamb and singer Richard Fairbrass, who all took part in the 14-mile walk. Brit-nominated classical singer Camilla Kerslake also walked the five-mile route and sung at the after-party, while newsreader Nicholas Owen started the five-mile route.
Staff members who walked the 14-mile route included Chief Executive Cally Palmer; Professor Martin Gore, Medical Director; Gary Burkill, Head of Facilities; David Probert, Chief Operating Officer; and 36 colleagues at Sutton and Merton Community Services. Thank you to all of this year’s walkers and our 234 volunteers, corporate supporters and entertainers who made the day such a great success. If you’d like to watch a film that captures the atmosphere of the event, see more photos and find out how to get involved in next year’s event, visit www. royalmarsden.org/march
We’re marching for The Royal Marsden as a team in celebration of life and hope, and to say thank you claire vines, Marsden March supporter
RM magazine 25
LONDON MARATHON 2012
Running stars Well done to the 80 runners who took part in the London Marathon on Sunday 22 April, in support of The Royal Marsden Cancer Charity. This year, we also received an extra five places from The Princes Charities Forum, due to our role as one of the charities of TRH The Duke and Duchess of Cambridge and Prince Harry. So far, our London Marathon runners have raised £118,500. Amanda Heaton, Fundraising and Community Development Manager for The Royal Marsden Cancer Charity, was delighted at the number of runners supporting the hospital’s charity. “I have such huge respect for these amazing people who are willing to dedicate themselves to months of training and then endure the challenging event
itself, all for the benefit of others,” said Amanda.“By taking part, these fundraisers are helping us enhance and develop the world-class cancer treatment and care The Royal Marsden already offers to thousands of people. “My team and I were there on the sidelines, cheering ourselves hoarse in support of them all. It was a fabulous day.” One runner, Phill Davis, ran to say thank you to the hospital, who treated his wife when she was diagnosed with breast cancer in April 2010. “We have been so impressed by The Royal Marsden. I am very grateful for the care and dedication shown by all the staff, so I took the opportunity to repay their support by running the marathon to raise money for The Royal Marsden Cancer Charity.”
Running and cycling events Want to take part in one of The Royal Marsden Cancer Charity’s challenge events? For details, visit www.royalmarsden.org
1 August London to Paris Cycle 28 August Land’s End to John O’Groats Cycle 1 September London Stadia Trekathon 2 September London Ride of Champions Cycle 16 September to Brighton Cycle 24 London 26 RM magazine 22 September Parachuting day
leap to A challenge
On bank holiday Monday 7 May, 23 supporters took part in a special parachuting day in support of The Royal Marsden Cancer Charity. This event has been so popular that we have arranged a second later in the year on Saturday 22 September. Places are free; all we ask is that you can raise a minimum amount of £395 sponsorship in return for your jump. To join our team in September, call Sarah Cassidy on 020 8770 0279 or email firstname.lastname@example.org.
Pcag and the friends chelsea
The Friends of The Royal Marsden The Friends of The Royal Marsden, Chelsea were delighted to present Professor David Cunningham with a cheque for £119,209. This was the proceeds from the Cura Ball, for which we were one of the chosen charities to benefit. The money will be used to directly fund Professor Cunningham’s
Mandie Adams McGuire (right) with Governor Anita Gray
research into bowel cancer and personalised treatment. “Personalised medicine is the identification of genetic abnormalities and then applying specific drug treatment to them,” said Professor Cunningham. “This is one of the most important areas for research in cancer in the next five years.”
Stepping down after four years at the top Mandie Adams McGuire, Chairman of the Patient and Carer Advisory Group (PCAG), is to step down after four years at the helm. Mandie has been involved in fundraising for The Royal Marsden for more than 20 years, following the death of her first husband, David, from leukaemia. The Royal Marsden prolonged David’s life by two years. She formed the David Adams Leukaemia Appeal Fund, and when the PCAG was set up eight years ago, she saw it as another way to give back to the hospital. “During my time as Chairman, we’ve seen the Trust appreciate the needs, concerns and feedback of patients and carers more and more,” says Mandie.
Working with the Trust, PCAG has been able to bring about some real improvements mandie adams mcguire, chairman, pcag
“Working together with the Trust, PCAG has been able to bring about real improvements. I was keen to help establish The Listening Post – a project that helps patients and carers to meet PCAG members to feed back informally about the Trust. “The lobbying of Commissioners to retain pancreatic surgery at The Royal Marsden was also important. It would have been terrible for the Trust and our patients had we lost this service, given the potential implications.” Mandie said she’s been lucky to have the support of a great team, especially her former ViceChairman, Kate O’Callaghan, who sadly passed away in April this year. “Kate was a very active member of the group; it was incredible the time she gave to the hospital, to The Listening Post and many other projects. When we visited her in hospital, shortly before she died, she told us to get cracking, that there was still so much work to be done. That was typical of Kate, always thinking about how she and others could give back to the hospital.”
Wendy Crabb, Chairman of The Friends, Chelsea, presents the cheque to Professor David Cunningham
A very special party The Friends Summer Drinks Party will be held on Thursday 14 June at The Royal Hospital, Chelsea. Countess Cadogan will host the event, which promises to be very special indeed. We are fortunate to have sponsors Strutt & Parker on board, and all proceeds will go to The Royal Marsden Cancer Charity. If you would like to attend, please contact The Friends office. Call 020 7352 3875 or email email@example.com.
RM magazine 27
Members’ event: you’re invited
We hope you can join us at our next Members’ event on Thursday 19 July at 5.30pm at our Chelsea site, hosted by Chief Operating Officer David Probert. Members will have the opportunity to learn about the work that goes into developing new treatments, from the scientific bench to the patient’s bedside. Attendees will have the chance to tour the CyberKnife Unit, which was featured in the recent BBC Horizon documentary ‘Defeating Cancer’, and will be reaching its one-year anniversary at the Trust this summer. Consultant Medical Oncologist Dr James Larkin, and Consultant Clinical Oncologist Dr Nick Van As, who both featured in the documentary, will be guest speakers at the event. All Members are welcome at this free event, although booking is essential. For further details, or if you would like to attend, please contact the Foundation Trust Office.
Public Governor Ann Curtis (right) with Governor Hilary Bateson
Food for thought
In the spotlight
and the Membership. It’s vital we listen to the Members to make sure the hospital remains a centre of excellence.
The Public Governor for Elsewhere in England, who was elected for a second term this year, tells us why her role as a Governor is crucial
How has The Royal Marsden developed from being a Foundation Trust during your time as Governor? It’s gone from strength to strength. With the new CyberKnife and the Da Vinci S robot, together with the research and development into new drugs, the hospital is at the cutting edge of UK cancer care.
Tell us a bit about yourself I’m retired and married with two daughters who live abroad: one in Denmark and another in Australia. I try to visit them and my three granddaughters whenever I can. Why did you decide to stand for election to be a Governor? When a young friend was being treated at The Royal Marsden, my husband and I became Members. My husband suggested I stand for Governor when we were invited to do so by the Trust. What is a Governor’s role? We are the voice of The Royal Marsden Membership. We are also the link between the hospital’s Board of Directors
What are your aims as a Governor for the next year? To understand both the government’s new Health and Social Care Act and how the Trust can adapt to our economic restraints, yet still deliver excellence to all patients. Why should people become Members? So that we hear the good and not-so-good comments from patients and carers to help The Royal Marsden continually improve its care.
In February, the Trust held a Members’ event in Sutton, at which Consultant Dietitian Dr Clare Shaw spoke about the importance of diet and nutrition during the different stages of a patient’s pathway, as well as the initiatives that the Trust takes to ensure patients receive the right food at the right time (read more about the Trust’s awardwinning food service on page 8). The event also offered attendees the opportunity to quiz Medical Director Professor Martin Gore and Interim Chief Nurse Dr Liz Bishop on quality issues in the Trust, ranging from the training that junior doctors receive to the importance of infection control. Members were also asked for their input in setting the Trust’s quality targets for 2012–13 by voting on their priorities.
And the winners are...
At our annual Members’ Week in February, we offered £50 of John Lewis vouchers to a lucky person selected at random from those who joined that week. Congratulations went to Amanda Joubert. At the last Members’ event, those attendees who had referred a friend or relative to join the Trust as a Member went into a prize draw to win John Lewis vouchers. Congratulations to David Warner and Freda Freedman.
28 RM magazine
RM11_PG28-29_Foundation news_des5.indd 33
Working for our Members
my year as a governor Dr Carol Joseph reflects on her first year as Public Governor for Kensington and Chelsea lthough I had no connection with the Trust before becoming a Governor, my immediate family, like many others, has been affected by cancer, so I was aware of its reputation as a leader in cancer treatment. Since becoming a Governor, I’ve recognised how the role is key when collaborating with the hospital’s board in the governance and development of the Trust and its activities. I am conscious of the need to increase membership of the Trust and have signed up new Members at various events. Please support the hospital by becoming a Member! My husband Kim and I also took part in this year’s Marsden March. It was a great day. I also signed up several new Members, including two local policemen, a bookseller and a cake maker. I’m now retired, but my background as a consultant epidemiologist, which involved handling large sets of health data, has come in useful in helping the Quality Accounts team to prepare this year’s
Your Governors at a glance Patient Governors ◆ Paediatric and Adolescent Stacey Munns ◆ South West London Anita Gray, Fiona Stewart, Edward Crocker, Raelene Salter ◆ East Elmbridge & Mid-Surrey Dr James Laxton, Chris Pelley ◆ Greater London Dr Geoff Harding, Hilary Bateson ◆ Elsewhere in England Sally Mason, Vikki Orvice Carer Governors Lesley-Ann Gooden, John Preston, John Howard Public Governors Kensington & Chelsea Dr Carol Joseph ◆ Sutton & Merton Tony Hazeldine ◆ Elsewhere in England Ann Curtis ◆
Staff Governors Doctor Professor Ian Smith ◆ Nurse Lorraine Hyde ◆ Other clinical professional Nina Kite ◆ Non-clinical Kim Andrews ◆
Dr Carol Joseph and husband Kim Howell at this year’s Marsden March
Quality Account Report. This document contains many statistics that need to be presented in a clear manner for both professionals and public alike. Helping to shape the report’s content has been a very rewarding experience. Being a Governor has been extremely satisfying – I have made new friends, got involved locally in health-related activities and learned more about the
Make your vote count
In June, ballot papers will be sent to eligible Patient Members for two seats on the Council of Governors for the South West London constituency, and one for the East Elmbridge and Mid-Surrey area. If you have received ballot papers, please vote for your preferred candidate(s) to represent you at the highest level in the hospital, and return the form by the closing date of Thursday 5 July.
pioneering clinical and research work carried out at the Trust. I feel privileged to be able to represent Members and support the remarkable work of this world-class hospital.
Dates for your diary Members’ event 19 July 2012, 5.30–7pm, Chelsea Council of Governors meetings 11 September 2012, 11am–1pm, Cripps Lecture Theatre, Sutton Annual General Meeting 26 September 2012, 5pm, Education and Conference Centre, Stewart’s Grove, Chelsea
Nominated Governors ◆ Institute of Cancer Research Cathy Scivier ◆ Primary Care Referrer Dr Chris Elliott ◆ South West London Cancer Network Alison Hill ◆ West London Cancer Network vacant ◆ London Borough of Kensington & Chelsea Councillor Robert Freeman ◆ Sutton & Merton PCT Dr Martyn Wake ◆ Croydon PCT vacant ◆ NHS Kensington & Chelsea Mable Wu ◆ Surrey PCT vacant ◆ Cancer Research UK (charity) Kate Law ◆ University Partner vacant If you have any questions or would like to become a Member, call the Foundation Trust Office on 0800 587 7673 or email firstname.lastname@example.org RM magazine 29
RM11_PG28-29_Foundation news_des5.indd 34
#E3638 Level: Easy
9 4 2 6
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PUZZLES 6& PRIZES 6
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Test your wits 5 4
5 8 9 7 2 Complete our crossword 8 2 4 5 and you could win a £50 John Lewis voucher A
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Dear RM, I am writing to sing the praises of The Royal Marsden because of the fantastic way they took care of my wife after she was diagnosed with a sarcoma. The skill, dedication and total professionalism were absolutely fantastic and a reﬂection of the way the nursing and auxiliary staff care about their patients. Nothing was too much bother for them. When walking into The Royal Marsden during my visits, I could not help but feel the positive, calm and happy environment that pervades the building, such is the ethos of The Royal Marsden. If you could bottle it and pass it on, I am sure people visiting every hospital would feel more at ease. Yours very sincerely, Peter Ruddick
1 8 7 4 B
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Across 1 Hanker (5) 3 Endures (5) 6 Decimal unit (3) 8 Conundrums (7) 9 Garret (5) 10 Dull pain (4) 13 Long drama (4) 14 Commence (5) 17 Green vegetable (7) 18 Novel (3) 19 Nursemaid (5) 20 Synthetic fabric (5) Down 1 Abominable snowman (4) 2 Serviette (6) 3 Indolent (4) 4 Choice (9) 5 Sibling (6) 7 Good food (9) 11 Time of year (6) 12 Gentle Greek breeze (6) 15 Untrusting (4) 16 Long-necked bird (4)
Congratulations to Malcolm Churchill, who won last issue’s crossword prize.
The lucky winner of our prize crossword will receive £50 of John Lewis vouchers. We also welcome your thoughts on RM magazine and love to hear about your experiences at the hospital. Star Letters win a £50 John Lewis voucher. Send your crossword or letter with your name and contact details to RM, Press Office, The Royal Marsden, Fulham Road, Chelsea, London SW3 6JJ. The closing date for entry is Tuesday 17 July 2012. 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 Tuesday 17 July 2012. Only one entry per person per draw. 3. Responsibility cannot be accepted for entries that are incomplete, illegible or not received. Proof of posting is not proof of receipt. No cash alternative is available and prizes are not transferable. Value of prizes is correct at time of going to press. 4. Winners will be notiﬁed by post within 14 days of closing date. 5. The Promoter’s decision on any aspect of the promotions is ﬁnal and binding and no correspondence will be entered into. 6. The Promoter reserves the right to substitute a prize of equal or greater value should circumstances make this necessary. 7. Entry implies acceptance of rules. 8. The winner of the Star Letter prize of £50 of John Lewis vouchers is the sender of the best letter selected by RM magazine. 9. The winner of the crossword prize of £50 of 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 autumn 2012 issue is coming soon…
ocus on the work of the F gynaecological unit ews from the annual ASCO N meeting in the USA The latest research updates
For The Royal Marsden Rachael Reeve – Director of Marketing and Communications Elaine Parr – Head of PR and Communications Belinda Payne – Senior Press Officer Catherine O’Mara – Senior Press Officer Marie-Thérèse Shepherd – Press Officer For Sunday Lucy Ryan – Editor Marc Grainger – Sub Editor Catherine Hopkinson – Art Director Lindsay Barrett – Account Director Matt Beaven – Creative Director Toby Smeeton – Managing Director RM magazine is published by The Royal Marsden in partnership with Sunday: sundaypublishing.com © The Royal Marsden 2012. 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.