RM Magazine, summer 2013

Life demands excellence

magazine – summer 2013

Interventional radiology, 24/7 An expert approach to managing pain Rally Against Cancer at The Queen’s Club

Teamwork success Meet the teams offering pioneering treatment and expert care in our multidisciplinary Breast Unit

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.

RM MAGAZINE

Executive notes

Contents 12 Breast cancer focus

How a multidisciplinary approach is improving treatment and survival rates

18 A day in the life Superintendent Radiographer Nancy Layt on life at the Rapid Diagnostic and Assessment Centre

20 Pain management

Breaking down recovery barriers with The Royal Marsden’s Pain Management team

23 Interventional radiology’s 24hr service An innovative new service offering round-the-clock, minimally invasive treatment

Regulars 04 Hospital news 24 Fundraising 27 The Friends 28 Foundation news 30 Puzzles & prizes

Welcome

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

In this issue, we explore the advances that we are making in the treatment of breast cancer, the most common women’s cancer in the UK (page 12). The Royal Marsden’s approach is to provide the most comprehensive, joined-up care we can. Our multidisciplinary clinical teams work hand in hand with their research colleagues to deliver a personalised treatment pathway, tailored for the individual patient.

It is important that our patients’ care and treatment is underpinned by effective pain management, and the quality of this service was highlighted in our recent inspection by the Care Quality Commission (page 7). The Pain Management team is critical to the wellbeing of patients and ensures optimal quality of life by taking an integrated approach that links patients with their consultants, nursing teams and GP throughout their treatment (page 20).

Finally, we review the Rally Against Cancer event at the Aegon Championships, held at The Queen’s Club (page 24). We were delighted to work with British doubles tennis player Ross Hutchins, who is being treated for Hodgkin lymphoma at The Royal Marsden, and with the Lawn Tennis Association (LTA) and The Queen’s Club on this event. We are incredibly fortunate to have the support of Ross and the LTA, as well as other world-class tennis stars and celebrities.

The event raised over £250,000 for The Royal Marsden Cancer Charity.

I hope you enjoy reading about our progress and the latest news, and I look forward, with you, to the rest of the summer.

Cally Palmer CBE, Chief Executive, The Royal Marsden

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HOSPITAL NEWS Research in the Drug Development Unit laboratory

As well as living longer, I have also had a wonderful quality of life IAN LISTON, ACTOR AND DRUG TRIAL PATIENT AT THE ROYAL MARSDEN

Ian Liston

DDU DRUG TRIALS HELP EXTEND LIFE EXPECTANCY Royal Marsden patient who has taken part in seven drug trials in eight years has spoken about the importance of the hospital’s Drug Development Unit (DDU).

Actor Ian Liston, who has prostate cancer, was referred to The Royal Marsden after being told conventional treatment was no longer working. He was one of the first patients to be treated at the then newly opened DDU. Mr Liston, 64, said: “I was only being offered palliative care by my local hospital so I knew The Royal Marsden’s DDU was my only chance for living longer.

“I started on a bone-flare study and moved on to many different ones, including abiraterone. Men on abiraterone are supposed to live four to six months longer and I was on it

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for 44 months. More recently, I was on a PARP inhibitor drug trial for 30 months.

“I have been lucky that when one drug trial stopped working for me, another one has opened up.

“As well as living longer, I have also had a wonderful quality of life and have been able to work throughout my treatment.”

Mr Liston, who appeared in Star Wars Episode V: The Empire Strikes Back and many popular TV plays and series, was diagnosed with prostate cancer in 2003 and has a family history of cancer.

He said: “I discovered I carried the BRCA2 mutation in January 2010 and am now on a genetic study as well at The Royal Marsden.

“I will keep trying whatever I can so I can carry on with my life. I always believe that there will be something else out there when one drug stops working.”

Professor Johann de Bono, Honorary Consultant in Medical Oncology at The Royal Marsden and Professor in Experimental Trial patient care in the DDU

Cancer Medicine for The Institute of Cancer Research, said: “Ian has responded really well to a lot of the trials, and it is thanks to patients like him that we are able to research these new drugs. There’s still a lot of work to do in drug development but we’re making major strides.”

Hospital news

AGGRESSIVE PROSTATE CANCER GENE FOUND esearchers at The Royal Marsden and The Institute of Cancer Research (ICR), London, have identified that men with prostate cancer and an inherited gene mutation have a worse form of the disease and should be considered for earlier treatment.

The BRCA2 gene is linked to hereditary breast cancer, as well as prostate and ovarian cancer.

Now scientists say that as well as being more likely to get prostate cancer, men with BRCA2 are also more likely to develop aggressive tumours and have the poorest survival rates.

The study, published in the Journal of Clinical Oncology, shows that doctors should consider treating men with prostate cancer and BRCA2 sooner, rather than waiting to see how the disease develops.

About one in every 100 men with prostate cancer will have the BRCA2 mutation and may benefit from immediate surgery or radiotherapy, even if their disease is at an early stage and classified as low risk.

Prostate cancer can grow extremely slowly or very quickly, making it hard to predict in the early stages. However, researchers say men with prostate cancer and the BRCA2 mutation should be treated early

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and aggressively because their tumour is more likely to spread.

Researchers led by Professor Ros Eeles, Honorary Consultant in Clinical Oncology at The Royal Marsden and Professor of Oncogenetics at the ICR, found prostate cancers spread more quickly and were more often fatal in men who had inherited BRCA2 than in men without the faulty gene.

The team studied the medical records of hundreds of prostate cancer patients, including 61 men with BRCA2, 18 men with the similar BRCA1 mutation, and 1,940 men with neither mutation.

Patients with BRCA2 were significantly less likely to survive their cancer, living an average of 6.5 years after diagnosis, compared with 12.9 years for non-carriers. They were also more likely to have advanced disease at the time of diagnosis.

Prof Eeles said: “It is clear from our study that prostate cancers linked to inheritance of the BRCA2 cancer gene are more deadly than other types.

“It makes sense to start offering affected men immediate surgery or radiotherapy, even for early-stage cases that would otherwise be considered low risk.

“We won’t be able to tell for certain that earlier treatment can benefit men with inherited cancer genes until we’ve tested it in a clinical trial, but the hope is that our study will ultimately save lives by directing treatment at those who most need it.”

Professor Ros Eeles

PALS advice service receives positive user feedback

In a recent voluntary user survey, patients, carers and visitors to The Royal Marsden Patient Advice and Liaison Service (PALS) Help Centres all responded that they would recommend the service.

One hundred per cent of respondents stated that the Help Centres were easy to find, they felt that they were listened to by staff members, their queries were dealt with in a timely manner and they were happy with their experience, including response and outcome. All respondents commented that they felt they were treated with respect and dignity.

One respondent said: “The PALS team at The Royal Marsden have been an enormous help, guiding me with referral information and other information including leaflets on travel.

They were supportive in listening and offering advice.”

Jan Graham, PALS and Patient Information Officer, said: “The team is delighted with the fantastic feedback.

The PALS team work very hard to ensure that our visitors are given the best possible information during their treatment.”

Thank you to everyone who took part in the survey.

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Hospital news

Advanced bowel cancer

NEW DRUG TRIAL SHOWS POSITIVE RESULTS FOR ELDERLY PATIENTS A new trial involving Royal Marsden patients with advanced bowel cancer has shown the importance of treating people over the age of 70.

The Royal Marsden prides itself on offering patients the best treatment and care, regardless of their age, and the results of the Phase III AVEX trial prove that elderly patients with advanced bowel cancer can benefit from treatment to the same degree as younger patients.

The results of the trial, led by Professor David Cunningham, Director of Clinical Research and Head of the Gastrointestinal Unit at The Royal Marsden, in

Bowel cancer facts

115

people each day are diagnosed with colorectal cancer in the UK

The disease is responsible for

16,000

deaths a year It mostly affects people over the

age of

65

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conjunction with pharmaceutical company Roche, were presented at this year’s Gastrointestinal Cancers Symposium in San Francisco. The trial revealed that the drug bevacizumab (trade name Avastin), in combination with another drug, capecitabine, can extend the time that people aged over 70 live without their previously untreated advanced bowel cancer worsening by up to four months, compared to if they were treated with just capecitabine alone. Older patients were also able to tolerate treatment without experiencing any new side effects.

Professor Cunningham said: Professor Cunningham’s trial showed benefits for elderly bowel cancer patients

“Improving outcomes in older patients with cancer is a high priority for clinicians and the AVEX trial provides evidence that such trials are feasible and can have a positive impact on patient care. The results of the AVEX trial show that in patients over the age of 70 who have advanced bowel cancer, chemotherapy with capecitabine and bevacizumab is a valuable treatment option which is well tolerated and can be administered as an outpatient.”

Avastin is already used to treat advanced breast cancer, colorectal cancer, ovarian cancer, lung cancer and kidney cancer.

Professor David Cunningham

Improving outcomes in older patients with cancer is a high priority PROFESSOR DAVID CUNNINGHAM, DIRECTOR OF CLINICAL RESEARCH AND HEAD OF THE GASTROINTESTINAL UNIT AT THE ROYAL MARSDEN

Hospital news

ADVANCED PROSTATE CANCER PATIENTS ARE LIVING TWICE AS LONG

Our new PET/CT scanners will benefit both patients and researchers

SUTTON SCANNING FACILITIES DOUBLE he Royal Marsden has increased its scanning services at its Sutton site, with the opening of the PET/CT Centre. The new facility, co-funded by The Royal Marsden and The Institute of Cancer Research (ICR), now includes two state-of-the-art PET/CT scanners. They will complement the two CT and three MRI machines currently operational in Sutton.

Bernadette Cronin, Deputy Director, Clinical Services, said: “Since The Royal Marsden installed its first PET/CT scanner 10 years ago, the use of this modality for routine diagnosis, follow-up and support of Phase I, II and III research trials has increased substantially, from 500 to 3,500 examinations every year.

“The new unit has not only doubled our capacity at Sutton to allow us to scan more patients more efficiently, but it has also brought us up to the latest level in technology. We can now offer our patients and

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our research teams the absolute best standard of care.

“These two new scanners at Sutton, along with a third PET/ CT scanner at our Chelsea site, make The Royal Marsden one of the largest NHS providers of PET/CT scanning in the UK. This, in conjunction with the ICR PET Radiochemistry Facility located in the Erigal Cyclotron Building on the Sutton site, ensures that we continue to lead on innovation in this field.”

The new unit has doubled our capacity at Sutton, allowing us to scan more patients more efficiently BERNADETTE CRONIN, DEPUTY DIRECTOR, CLINICAL SERVICES, THE ROYAL MARSDEN

Following the introduction of a range of novel therapies, striking new analysis reveals that Royal Marsden patients with advanced prostate cancer are living with the disease, on average, for more than twice as long as a decade ago.

The research, conducted by a team from The Royal Marsden and The Institute of Cancer Research (ICR) and published in European Urology, found that new treatments are having such an impact that the system doctors use to predict how long patients will live is to be revised.

The team studied data from 442 UK patients across 32 clinical trials and two extended-access drug programmes at The Royal Marsden since 2003. Four out of five (78 per cent) patients received docetaxel-based chemotherapy, which was approved for use on the NHS in 2005. Almost half (49 per cent) received abiraterone, a targeted prostate cancer drug

discovered at the ICR and trialled at The Royal Marsden, and approved for use in the NHS last year. Three other novel therapies – enzalutamide, cabazitaxel and radium 223 – were used to treat a small minority of patients.

The research showed that a patient with incurable, castration-resistant prostate cancer receiving a novel targeted therapy will live for around 41 months on average, an increase from an average of 13–16 months in the era before docetaxel-based chemotherapy.

Professor Johann de Bono, Honorary Consultant in Medical Oncology at The Royal Marsden and Professor of Experimental Cancer Medicine at the ICR, said: “This analysis highlights the benefits we are seeing from new treatments for men with advanced prostate cancer.

Men are living for much longer with this form of the disease than they did a few years ago.”

Care Quality Commission report

Royal Marsden patients feel “safe” and consider clinicians to be “experts in their fields”, according to the recently published Care Quality Commission (CQC) report. This feedback was matched by the glowing report filed by the CQC after an unannounced inspection at both Sutton and Chelsea sites. The Trust was compliant with the six standards and there were no concerns raised by the CQC. Dr Shelley Dolan, Chief Nurse, said: “This is a reflection of how dedicated staff at The Royal Marsden are to achieving the best experience for patients. I am thrilled our patients made such positive comments about the overall care and treatment we provide.”

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Hospital news

The Royal Marsden’s education series puts GP wheels in motion

Patients from across London and the south east are benefiting from The Royal Marsden’s GP Education Series. The programme of events for GPs was launched in 2009 and has been attended by more than 400 GPs, with thousands more accessing the online learning resources at Doctors.net.uk.

The series comprises a programme of one-day and half-day interactive seminars covering different aspects of cancer diagnosis, treatment and research relevant to GPs. Webcasts of the events are available online thereafter.

The programme is delivered by a team of experts through interactive case studies, panel discussions and clinical lectures. GPs also have the opportunity to network with colleagues and meet Royal Marsden consultants.

Results from last year’s seminars and through Doctors.net.uk show a real impact on GPs’ clinical practice, benefiting patients.

In March, the Trust held a breast and prostate cancer education day for GPs. Feedback revealed that 100 per cent of them will make a change to their clinical practice.

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From top: Peter Andre meets Nurse Sara Al-Khaldi, young patient Sofia Raulinitis and Consultant Surgeon Mr Chris Ogden

Hospital news

The effects of the Francis Report Peter Andre’s Cancer Diaries

TV STAR PETER ANDRE FILMS SERIES AT THE ROYAL MARSDEN elevision star Peter Andre has filmed a five-part cancer series at The Royal Marsden for ITV’s daytime show This Morning.

The reality television star and singer returned to The Royal Marsden, where his older brother Andrew was treated for kidney cancer, to help raise awareness about the treatment and advances in cancer care at the hospital.

The series, entitled Peter Andre’s Cancer Diaries, focused on surgical innovations, chemotherapy, radiotherapy, palliative care and fundraising. The first episode – on surgery – was aired on 15 May. The Royal Marsden opened its doors to the cameras, which filmed patients and staff in surgery, the Oak Centre for Children and Young People, radiotherapy at Sutton and the Horder Ward at Chelsea.

In the first episode, patient Jacqui George agreed to be filmed during her breast reconstruction surgery with Mr Paul Harris. She said: “I was quite nervous about doing the filming at first, but I was really keen to help show off the work of The Royal Marsden. Mr Harris’s reconstruction surgery has given me such a boost after I was told years ago by another hospital that there was nothing more they could do for me. I really hope the footage of

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my operation offers other women with breast cancer the confidence to ask for more options at their local hospital, or to come to a specialist centre like The Royal Marsden.”

The episode also followed patient Peter Latham, whose prostatectomy was performed

by Mr Chris Ogden using the da Vinci S surgical robot.

Peter said: “When I was asked to take part, there was no question of me not doing it.

I was happy to promote the work of The Royal Marsden.”

I was really keen to help show off the work of The Royal Marsden JACQUI GEORGE, ROYAL MARSDEN PATIENT

In the first episode, Peter Andre said he felt privileged to spend time with the surgeons at the hospital and witness the latest techniques being used to treat cancer. He added: “The future looks good and I’m blown away by it.”

The second episode followed three-year-old Sofia Raulinitis, who has been receiving chemotherapy treatment for acute lymphoblastic leukaemia (ALL). The third programme showed 14-year-old James Shaw receiving his first radiotherapy treatment for a brain tumour.

The final two episodes highlighted the important work of our palliative care team and the support they provide to both patients and their families, and the role of The Royal Marsden Cancer Charity.

The impact of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the subsequent 2013 Francis Report is being felt across the NHS. The Royal Marsden has an excellent reputation for delivering high standards of patient treatment and care. However, along with other NHS Trusts, the report’s recommendations are being taken very seriously. Over the next 12 months, Royal Marsden patients, their families and our staff will benefit from the NHS-wide changes as a result of this review.

The Royal Marsden is committed to robust scrutiny and continuous improvement of all functions. From the Board through to the wards, the Francis Report has been scrutinised to ensure that effective and timely learning is applied throughout The Royal Marsden.

The Trust’s Management Executive has gone through the 290 recommendations, particularly those that apply to provider Trusts.

In many areas, The Royal Marsden is already compliant. However, where there is the opportunity to improve or develop services, or where there is a new recommendation, there will be a Trust-wide action plan to implement changes led by Cally Palmer, Chief Executive at The Royal Marsden.

The first episode showed The Royal Marsden’s surgeons at work

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Hospital news

Advanced nurse practitioners

NURSING STAFF SKILLS INCREASE he scope and skills of nursing staff expand constantly as their roles and responsibilities increase.

The role of the advanced nurse practitioner (ANP) demonstrates how highly experienced nurses are building on their skills and pushing the boundaries of nursing.

In 2012, The Royal Marsden appointed four ANPs: Jon Knox in the Plastic Surgery Unit, Chelsea; Rebecca Martin in the Urology Unit, Chelsea; Jorn Rixen-Osterbro in the Head and Neck Unit, Chelsea; and Samantha Wigfall at the Haematology Unit, Sutton.

Advanced nurse practitioners provide strong clinical leadership

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for nursing teams and bridge the gap between nurses and junior doctors. Along with classic nursing skills, ANPs can take a comprehensive patient history, carry out physical examinations, and use their expert knowledge and clinical judgment to identify the potential diagnosis, refer patients for investigations where appropriate and, in some cases, make a final diagnosis.

They can also determine and instigate treatment pathways, including the prescribing of medicines, and refer patients to appropriate specialists, ensuring that continuity of care is effective and based on best practice.

Liz Bishop, Divisional Director of Cancer Services

and Research and Development at The Royal Marsden, said: “Advanced nurse practitioners are extremely important as they bring with them a different set of skills and a lot of acute and/or oncology experience to the table. They enable continuity of clinical care for the patients, helping to ensure that they receive the best care and that they are discharged from hospital in a timely and safe manner.

“They are diligent in assessing patients, prescribing medicines and providing support to both nursing teams and doctors. Their knowledge of a working hospital is important and they often don’t have the same theatre or clinic commitments, allowing them

to be more present on the wards and accessible to the nursing teams. This has a positive impact on the patient and the staff experience.”

Feedback from staff and patients about the ANP team has been extremely positive, and a formal audit on their impact is planned in the near future.

Advanced nurse practitioners bring with them a different set of skills and experience LIZ BISHOP, DIVISIONAL DIRECTOR OF CANCER SERVICES AND RESEARCH AND DEVELOPMENT, THE ROYAL MARSDEN

From left to right: Advanced Nurse Practitioners Jon Knox, Rebecca Martin and Jorn Rixen-Osterbro

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Hospital news

Research committee gets new lead After chairing The Royal Marsden and The Institute of Cancer Research Committee for Clinical Research for more than six years, Professor David Dearnaley has stepped down from the role to focus on developments in the Biomedical Research Centre Prostate Theme.

He is succeeded by Dr James Larkin, Consultant Medical Oncologist.

Professor Dearnaley has led on many aspects of the development of the research portfolio and governance structures, and has helped to ensure that research has been scientifically robust, of a high calibre and well managed. He has enabled both institutions to deliver their clinical research portfolio in a challenging financial and regulatory climate.

His leadership, expertise and support over a long period of substantial change and in clinical research and development has been crucial.

FLYING START FOR NEW FRIENDS AND FAMILY TEST The Royal Marsden has made a successful start to a new government initiative that gives patients the opportunity to rate their care. The Friends and Family Test is designed to make the comparison between NHS hospitals quick and easy.

Since February, all inpatients have been asked to fill in a short questionnaire when they are discharged, which asks, “How likely are you to recommend our ward to friends and family

if they needed similar care or treatment?”

The results will be reported online monthly and made available to patients, so they can compare hospitals and identify the trusts that provide the best care. Wards within hospitals, as well as the Trust as a whole, can also be compared.

In the first month, The Royal Marsden scored 4.9 out of 5 overall, with seven wards hitting the 5/5 mark.

Richard Schorstein, Matron, Medical Day Unit, said: “We are proud to provide world-leading cancer care, but we also want to know what we can do to make the patient experience even better. It’s great news that we’ve got off to such a positive start and we will continue to work hard to maintain, and improve, these initial scores.”

See the results in the service quality and excellence section of www.royalmarsden.nhs.uk

Entries open for Arts Forum photography competition

Yosemite National Park, the 2012 winner by Chris Sargent

The Royal Marsden Arts Forum is calling for entries from patients, families, carers and staff for its annual photography competition. Shortlisted photographs will be exhibited in the hospital and the best three pictures, selected by external judges, will receive a prize.

You can submit up to four JPEG-format photos (each maximum 1MB) to stephen.millward@rmh.nhs.uk.

Please include your name, telephone number and address. The closing date for submissions is Saturday 31 August. The winners will be announced at the opening of the photography exhibition in the autumn.

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Clockwise from top left: Dr Nicholas Turner with MDU Sister Sally Attridge; Professor John Yarnold and Dr Anna Kirby; Mr Gerald Gui; Anne McLoughlin; Professor Ian Smith

Cancer focus

breast cancer special

A team approach to world-class care as breast cancer survival rates improve, we talk to some of the multidisciplinary team of experts at The Royal marsden’s Breast Unit

Q&A breast cancer

Professor Ian Smith, Head of the Breast Unit, answers the key questions What is breast cancer?

Breast cancer arises when cells within previously normal breast tissue mutate and start to grow in an uncontrolled way. initially, this causes a lump but cells can also spread through the bloodstream to the bones, liver or lungs and grow in these sites. This is called secondary or metastatic cancer. it is increasingly apparent that breast cancer is not one single disease but consists of several different subtypes, each of which responds best to its own specific treatment.

What are the causes of breast cancer?

most breast cancers are sporadic and are caused by random mutations within a gene. The risk increases as you get older – breast cancer occasionally affects young women, but it is more common with age. about 10 per cent of patients have a significant family history of breast cancer or ovarian cancer. Some of these patients have inherited a mutated gene, especially BRCa1 or BRCa2.

What should you look for?

Breast cancer is increasingly diagnosed through mammographic screening in women over 50 without any symptoms or signs.

Otherwise, the most common presenting feature is a painless lump (breast cancer can occasionally present with pain, but this is

rare). in more advanced cases, there may be skin dimpling, swelling or inflammation.

Why are survival rates improving?

earlier detection and better treatments after diagnosis are improving survival rates. also key is the development of ‘adjuvant medical therapies’ given immediately after surgery to mop up microscopic cells that may have spread through the bloodstream to other parts of the body, before they can do harm. more than eight out of 10 people survive breast cancer beyond five years. more than three-quarters survive it beyond 10 years. it’s thought that around 550,000 people are alive in the UK who have had a diagnosis of breast cancer.

Could you tell us about treatment?

The key word is teamwork, with surgeons, clinicians, radiotherapists and nurses working hand in hand with radiologists and pathologists. in addition to surgery and radiotherapy, we have many effective drugs including hormone-blocking agents (tamoxifen and aromatase inhibitors), chemotherapy and targeted therapies, such as trastuzumab (Herceptin). Targeted therapies are becoming widely available and we are heading towards personalised therapy, with specific treatments tailored for the individual patient. The future looks increasingly positive. ➜

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Cancer focus

RISK-REDUCTION STRATEGIES TO BENEFIT HIGH-RISK WOMEN

Radical mastectomy techniques are helping to dramatically lower the chances of getting breast cancer

CASE STUDY:

Emma Parlons

“Before I discovered I had the BRCA gene, I had no idea what it was. I didn’t know that this one faulty gene would mean I was over 80 per cent more likely to get breast cancer and 40 per cent more likely to get ovarian cancer in my lifetime.

“When I found out, I was horrified.

Aged 37, I felt as if I had been cursed with a death sentence. I was an emotional wreck.

“When I met Mr Gui at The Royal Marsden, he had such an amazing manner, I knew immediately that I was in the right hands. By January 2009, I had prepared myself to have a double mastectomy with immediate breast reconstruction.

I felt that I was saving my life — for my children, my husband, my parents and, of course, for myself.

“I had reduced my risk to around two per cent.

Six weeks after surgery, I was back to normal life, but without the fear of breast cancer.”

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Some women carry a gene that predisposes them to getting breast cancer. The most recognised of these are BRCA1 and BRCA2, which are thought to account for five to 10 per cent of all breast cancers.

Women who are identified as being at high risk may consider preventive options, and one of the most effective – albeit the most drastic – methods is a prophylactic, or risk-reducing, mastectomy.

A prophylactic mastectomy is a surgical procedure to remove one or both breasts in order to prevent the development of breast cancer. This reduces the likelihood of high-risk women getting the disease from 80 per cent to just one to two per cent – a figure lower than the breast cancer risk in the general population. This treatment gained worldwide attention in May this year when movie star Angelina Jolie revealed that she had undergone the procedure.

“As surgeons, we are careful not to ‘over-treat’ a woman with breast cancer by radical surgery,” says Mr Gerald Gui, Consultant Surgeon at The Royal Marsden.

“However, appropriate consideration must also apply to preventive surgery in a woman who is at high risk of getting breast cancer.”

There are many factors to consider when deciding on a risk-reduction strategy. We support and encourage women to take the time they need to talk to their doctor and family members, not only about surgery but also the different ways to lower risk, such as active surveillance and an overall approach to healthy living. The role of chemoprevention of breast cancer by drug medication is an evolving area in this high-risk predisposition group.

“At The Royal Marsden, we operate a multidisciplinary approach to treatment,” Mr Gui continues. “If a woman is considering risk-reducing surgery, she will benefit from the detailed input of our genetics team, clinical psychologists, clinical breast nurse specialists and our active support group.”

Breast cancer

women and 400 men are diagnosed with breast cancer each year – that’s about 137 people a day – making it the most common cancer in the UK of women with breast cancer are still alive five years after diagnosis

women will be diagnosed with breast cancer in their lifetime

of breast cancers are diagnosed in women aged 50 and over

Above: Consultant Surgeon Mr Gerald Gui is a specialist in performing riskreducing mastectomies.

Above right: Dr Nicholas Turner, Honorary Consultant Medical Oncologist, speaks with a patient

Cancer focus

CASE STUDY:

Kim Mawby

TARGETED THERAPIES: THE FUTURE OF BREAST CANCER TREATMENT

New drugs and targeted treatments are breaking chemotherapy boundaries

Chemotherapy is an important treatment for women with breast cancer. However, it can come with side effects. The Royal Marsden is aiming to develop new targeted treatments for breast cancer that may not have the same side effects.

Significant targeted treatments have come into use at the clinic in the past year. Most are for patients with metastatic breast cancer and, with these new treatment options, we are making advances in how long people live with advanced breast cancer, as well as improving their quality of life.

One drug that will be available towards the end of 2013 or in early 2014 has real potential to transform the treatment of women with HER2 metastatic breast cancer, say Professor Stephen Johnston, Consultant Medical Oncologist, and Dr Nicholas Turner, Honorary Consultant Medical Oncologist.

“T-DM1 targets chemotherapy to the HER2-positive cancer cells and spares the normal cells in the body,” says Dr Turner.

“Studies partly run at The Royal Marsden show that T-DM1 is better tolerated than standard chemotherapy – and more effective.

“In the Breast Unit, we are pioneering drugs such as T-DM1 and developing other drugs for different types of breast cancer.

We aim to take drugs developed for the treatment of advanced cancer and look at how to bring them to patients with primary cancer in a bid to increase the cure rates.” ➜

T-DM1 has real potential to transform the treatment of advanced breast cancer DR NICHOLAS TURNER, HONORARY CONSULTANT MEDICAL ONCOLOGIST

“I was first diagnosed with breast cancer four years ago. In December 2010, I learned that my cancer had spread into my chest wall and my lungs, and wasn’t curable.

“I met Professor Ian Smith and Dr Nicholas Turner, who gave me some options: I could either start another course of chemotherapy, or go onto a new trial for T-DM1. With no treatment at all, I would have had around six months to live.

“I started on the T-DM1 trial in December 2010, and it was the best decision I have ever made. Nine weeks after the first treatment round, a scan showed that my cancer was undetectable.

Since then, I have this treatment every three weeks, and the cancer stays at bay.

“Apart from feeling a bit tired on the day of treatment, I really don’t suffer any side effects at all.

I am just so lucky: I have two young children, I work, and I feel well.”

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Advanced Nurse Practitioner Anne McLoughlin runs the open access follow-up scheme for patients who have finished hospital treatment

Cancer focus

Consultant Clinical Oncologist Dr Anna Kirby

Kirby, Consultant Clinical Oncologist and lead researcher. “All left-breast cancer patients treated in the UK could potentially benefit from this research.

“The technique has proved popular with patients, in comparison with more traditional external breathing-controlled treatments, as patients feel they have some control over it.”

OPEN ACCESS FOLLOW-UP CARE PROVIDES LASTING SUPPORT

The Royal Marsden’s support programme for patients after treatment

NEW RADIOTHERAPY TRIALS

Research into reducing course length

A new clinical trial has opened at The Royal Marsden to identify whether a one-week course of curative radiotherapy is as beneficial as the current UK standard of three weeks. The FAST-Forward multicentre trial aims to establish if a five-day course can become standard treatment for patients.

The new trial is recruiting 4,000 patients randomised to receive five or 15 daily doses of radiotherapy to the whole breast or post-mastectomy chest wall.

“Lower overall doses given in five sessions reduce the temporary skin soreness and fatigue common after radiotherapy, and are much more convenient for patients,” says Professor John Yarnold, Lead Investigator.

HEARTSPARE STUDY

Reducing radiation doses to the heart in breast cancer patients

The HeartSpare Study is investigating methods of reducing doses of radiation to the heart when breast cancer patients receive radiotherapy. The aim is to lower the risk of heart disease, which patients can sometimes experience years after treatment.

“Holding the breath for 20 seconds during radiotherapy treatment is a simple technique and is proving to be an effective tool in reducing doses to the heart,” says Dr Anna

Since 2010, The Royal Marsden’s open access follow-up programme (OAFU) has supported patients when they have completed their treatment. Their normal routine is not disrupted by regular hospital appointments; instead, quick access to the breast care team is available when needed.

Evidence shows that there is no advantage to regular hospital follow-ups for well women after breast cancer.

“Three months after a patient has finished treatment, they have an appointment with me, or one of the other specialist nurses in the team,” says Advanced Nurse Practitioner Anne McLoughlin, who runs the scheme.

“We talk about diet, exercise, any lifestyle changes that might need to be made and any side effects of treatment.

“Patients will have an annual mammogram. They are often pleased to have come to the end of their hospitalbased treatment as it can be a long and challenging process. It is important that patients know what will happen now and who to contact if they need help or support.

“If I feel a patient should be seen back in clinic because of any symptoms she is experiencing, an appointment will be offered within seven days.” rm

At the end of hospital-based treatment, it is important that patients know what will happen now ANNE MCLOUGHLIN, ADVANCED NURSE PRACTITIONER

RM MAGAZINE 17

In this job, it is important to have empathy and understand how patients are feeling NANCY LAYT, SUPERINTENDENT RADIOGRAPHER

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Clockwise from top left: Nancy performs a mammogram; with a patient in the clinic; catching up with Consultant Radiologist Dr Robin Wilson; assessing scans with colleagues

Staff profile

A DAY IN THE LIFE

Nancy Layt Superintendent Radiographer

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s a specialist Superintendent Radiographer, I am part of a very busy team at the Rapid Diagnostic and Assessment Centre (RDAC) at the Chelsea hospital. I perform ultrasound breast scans with fine-needle aspirations and diagnostic biopsies under ultrasound or mammographic guidance as well as mammograms. We have a similarly expert team of specialist radiographers based at our Sutton site.

My working day starts at 8am each morning. However, I always make sure that I’ve checked through my patient list the night before. This helps me to feel more prepared for the hectic day ahead.

The first patient I see is normally someone who is due to have breast surgery that day. I use ultrasound or mammographic imaging to guide wires to where the lump is, so that it is easily found by the surgeon during the operation.

I also work closely with our consultants based in the RDAC, assisting with procedures such as diagnostic vacuum and excision biopsies. Normally, lumps are removed in theatre, but small, noncancerous lumps can be removed in a minor procedure in the RDAC.

Busy schedules

During the day, I may also work with a radiographer who is undergoing training.

Radiographers are constantly training both in-house and externally, and it is lovely to watch members of your team do well and come up through the ranks.

My lunch is generally eaten on the go, and often during lunchtime, the team will

meet to review cases and decide which patients need to be called back for more investigations. The afternoon is then spent in our one-stop breast clinic, where we see women who have come to us with a breast lump or other symptoms that need a diagnosis.

For many women, the lump turns out not to be cancer and they can be reassured and sent back to their GP for follow-up care. For some, however, it is cancer and this is obviously an upsetting and difficult time for them.

A personal approach

In this role, it is important to have empathy and understand how patients are feeling.

I sometimes think, “How would I feel if I woke up one morning with a lump in my breast?” Diagnostic testing can sometimes be a little uncomfortable, so good communication is very important – especially as you don’t know how a woman is feeling or how she is processing what she is going through.

I have been working at The Royal Marsden since 1989 at both Chelsea and Sutton and have seen a lot of changes over the years. It is a lovely place to work and I have always felt supported. I feel very fortunate to have had the opportunity to become a specialist Superintendent Radiographer, working with such a good team and caring for our wonderful patients.

There is always administrative work to be done at the end of the day, and it is important to ensure that I am on top of it all. My days can be long and I am on my feet most of the time, but I love my job. rm

RM MAGAZINE 19

Top: the Pain Management team. Above: Consultant Dr Paul Farquhar-Smith runs the service at Sutton. Right: Dr John Williams heads up the Pain Management team.

Opposite page: Clinical Nurse Specialists Laura Dopson and Suzanne Chapman speak with a patient on Ellis Ward

Pain management

PATIENT CARE

A personalised approach to tackling pain The Royal Marsden has an integrated method of managing pain that results from cancer, with the aim of improving patients’ quality of life

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or some people, pain can be a challenging side effect of cancer and its treatment. At The Royal Marsden, it is managed by a specialist team to ensure that patients have access to high-quality pain relief whenever they need it.

The focus of the hospital’s Pain Management team is to ensure a good quality of life for patients – taking an integrated approach to managing pain by linking with their consultants, nursing teams and GP throughout their treatment.

The team – which consists of two consultants, two registrars, three clinical nurse specialists, a consultant acupuncturist and a PA – has been led by Dr John Williams, Consultant Anaesthetist, for the past 16 years. “Patients may need access to highquality pain relief before, during and after their cancer treatment,” says Dr Williams.

“Pain management plays a significant role in the overall health and wellbeing of our patients. We don’t want to see patients in pain. We strive to provide the best quality of life for patients in conjunction with their cancer treatment. Getting pain under control is very important and we offer an excellent service here at The Royal Marsden.”

Pain can be caused by a variety of things, including the tumour infiltrating or putting pressure on nerves and bones, or as a side

We don’t want to see patients in pain, so we strive to provide the best quality of life for patients DR JOHN WILLIAMS, CONSULTANT ANAESTHETIST AND HEAD OF PAIN MANAGEMENT

RM MAGAZINE 21

Pain management

effect of radiotherapy, chemotherapy or surgery. To combat such pain, the team offers five types of treatment: drug therapies, physical therapy, psychological medicine and nerve blocks (epidurals), as well as complementary therapies such as massage.

The therapy given is determined by the type and level of pain.

The Pain Management team is a proactive and visible presence around the hospital. In addition to making daily ward rounds to ensure that those who have just had surgery are not in pain, they train nurses on the wards to spot the signs of a patient in pain and explain how to help.

The team also works closely with the Palliative Care Unit. The units convene once a week for a joint multidisciplinary team (MDT) meeting to discuss patients and the most appropriate treatments.

Outpatient support

The team runs an outpatient clinic once a week in both Chelsea and Sutton hospitals.

Consultant Dr Paul Farquhar-Smith runs the Sutton service. There is no waiting list at either hospital – urgent cases are seen daily.

As part of its drive to ensure the service meets patients’ needs, the Pain Management team recently ran an evaluation-screening programme for pain control. Funded by a National Institute for Health Research (NIHR) grant, it showed the importance of integrating pain control as a part of normal care. The team is also looking into making it even Dr John Williams at the weekly joint multidisciplinary team meeting

easier for patients to contact them – via a smartphone app or by using secure email or Skype – to discuss symptoms or worries.

CLINICAL NURSE SPECIALISTS

The role of a clinical nurse specialist is vital within the Pain Management team

Clinical nurse specialists (CNSs) build relationships with patients that remain throughout the treatment and beyond.

The help and advice they provide is an essential part of patient care.

As the three CNSs on the pain team, Laura Dopson, Suzanne Chapman and James Aylett cover both Chelsea and Sutton hospitals. They undertake daily ward rounds with clinicians to see inpatients and review those who have been referred to the weekly pain outpatient clinics. They also advise patients over the phone or by email.

In addition, Laura, Suzanne and James assess patients attending appointments for radiotherapy treatment or scans, thus ensuring that all patients have access to the pain service. They also spend time training nurses on the wards in pain management, and publish articles and poster-based presentations both nationally and internationally.

Laura has worked at The Royal Marsden for three years. She said: “Our aim is to get a patient’s pain under control so that they can enjoy a better quality of life.

“It is a very rewarding job, especially as we follow patients through their treatment and beyond. It is great to see them improve and become pain-free. It is a basic thing, but it makes such a difference to their everyday lives and that of their families. It’s important to be there for them whenever they need advice or support.” rm

We follow patients through their treatment and beyond. It is great to see them improve and become pain-free LAURA DOPSON, CLINICAL NURSE SPECIALIST, THE ROYAL MARSDEN

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CASE STUDY:

Denis Brennan

When diagnosed with throat cancer in 2012, Denis started a six-week course of daily radiotherapy treatment.

After four weeks, the pain in his throat and mouth was made worse by an ulcer and he was admitted to hospital for eight days. Here, the Pain Management team suggested morphine patches, before helping Denis to come off them and use other methods of pain control.

“The team was so helpful and supportive,” says Denis. “They would do anything they could to help. After leaving hospital, I phoned for help, guidance, support and sympathy.

Nothing was too much trouble.”

Denis still has a dry mouth and gets bouts of hiccups (which he hopes acupuncture will stop), but his sense of taste is returning and he has started to put on weight and do gentle exercise. He is still regularly in touch with the Pain Management team.

Interventional radiology

This is a really important service that will maximise the clinical benefit for our patients DR NICOS FOTIADIS, CONSULTANT INTERVENTIONAL RADIOLOGIST

Above: Joy Nwaneri and Dr Nicos Fotiadis

INTERVENTIONAL RADIOLOGY

A 24-hour service A groundbreaking collaboration means an improved interventional radiology service for patients

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atients are now benefiting from a new 24-hour call-out interventional radiology service. The innovative new service is the result of a collaboration between The Royal Marsden and two other hospitals: Chelsea and Westminster NHS Foundation Trust and The Royal Brompton and Harefield NHS Foundation Trust.

The treatments used are minimally invasive and are often performed under local anaesthetic. They include life-saving embolisations, chemo-embolisation (when anti-cancer drugs are administered directly to the tumour through its blood

supply) and urological and biliary stent insertions to unblock obstructed kidneys or for the relief of jaundice.

There has always been an interventional radiology service at The Royal Marsden but, in the past, if a patient required the service out of hours or at weekends, they would have had to be transferred to Chelsea and Westminster Hospital or be taken to theatre.

The collaboration means there is now a nine-person on-call team working between The Royal Marsden, The Royal Brompton and Chelsea and Westminster hospitals.

They have honorary contracts allowing them to work on all sites, treating patients in situ.

“This is a really important service that will maximise the clinical benefit for our patients,” says Dr Nicos Fotiadis, Consultant Interventional Radiologist.“The new on-call team can come to the acutely unwell patients and treat them when they need it, without delays or transfers.

“Interventional radiology is a cuttingedge speciality, delivering drugs directly inside the tumour with fewer side effects and without damage to nearby normal tissues. Many conditions that once required surgery can now be treated less invasively, with less pain and a quicker recovery time.”

The on-call team consists of a consultant radiologist, an interventional radiology nurse and a radiographer. They treat cancer patients at The Royal Marsden, patients with cardiovascular diseases at The Royal Brompton and patients with a wide range of diseases at Chelsea and Westminster.

“The patient experience is always at the heart of everything we do here,” says Joy Nwaneri, Interventional Radiology Sister at The Royal Marsden. “By working in collaboration, the patient will benefit from a seamless on-call service, which means we will come to them when they need us.” rm

RM MAGAZINE 23

The Rally Against Cancer lineup (from left to right): Michael McIntyre, Eddie Redmayne, Sir Richard Branson, Tim Henman, Ross Hutchins, Andy Murray, Jimmy Carr, Jonathan Ross and Boris Johnson

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Fundraising

Rally Against Cancer serves up a great day Andy Murray, Tim Henman and other tennis stars join celebrities to raise money for The Royal Marsden Cancer Charity ally Against Cancer, an all-star doubles exhibition match held at the Aegon Championships at The Queen’s Club in London on Sunday 16 June, has so far raised an incredible £250,000.

The match saw Andy Murray and Tim Henman triumph over Andy’s coach Ivan Lendl and world number six Tomas Berdych. They were joined on court by Boris Johnson, Jimmy Carr, Michael McIntyre, Sir Richard Branson, Jonathan Ross and Eddie Redmayne.

Rally Against Cancer was the idea of British tennis star Ross Hutchins, who has been treated for Hodgkin lymphoma at The Royal Marsden since December 2012. “Ever since I was diagnosed, I wanted to to raise money for The Royal Marsden to thank them for their kindness,” he said. “It’s an unbelievable place that helps thousands of people in situations similar to mine.

“I’d had the idea of a tennis event and was approached by Tournament Director Chris Kermode and the team at the LTA [Lawn Tennis Association], who suggested doing something after the final of the Aegon Championships. I thought it was a great idea, so I asked Andy, and straight away he said he was up for it. Tim, Ivan, Tomas

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and all the other celebrities also said ‘yes’ immediately, which was fantastic. It was a really great day, and all for a charity that obviously means a lot to me.”

The match concluded a week of support for the charity by the Aegon Championships, The Queen’s Club and the LTA. A proportion of ticket sales for the finals day was donated, along with £10 for every ace served during the tournament and proceeds from a week-long raffle.

Andy Murray donated the £73,000 prize money from his Aegon Championships victory to the charity in recognition of the work the hospital has done for his friend Ross. There was also a wave of support online: record numbers of people visited the charity website, the hashtag #rallyagainstcancer was ➜

I’m really pleased we could raise so much money so the charity can continue its amazing work ANDY MURRAY, WORLD NO 2

RM MAGAZINE 25

Fundraising

trending on Twitter, and 250,000 people watched our Never Expect video featuring Ross on YouTube, making it the most shared and most watched video in the UK for 48 hours.

The event also had the support of HRH The Duke of Cambridge, The Royal Marsden’s President, who unfortunately could not attend but sent a personal letter to thank all concerned for supporting such a good cause.

“We were delighted that Ross and the Aegon Championships were able to host this exciting event in support of The Royal Marsden Cancer Charity,” said Cally Palmer, Chief Executive of The Royal Marsden. “We are fortunate to have a huge amount of support. It means so much to the charity, the hospital and our staff and enables us to continue to provide world-class cancer care for our patients. I would like to personally thank Ross and the Aegon Championships team, the LTA and The Queen’s Club for making it happen.”

Andy Murray continued his support by sporting the name of The Royal Marsden Cancer Charity on his sleeve during Wimbledon. He said: “The sleeve patch was just a small way I could show my support for Ross and The Royal Marsden and continue to raise awareness.”

This is a great idea and a great cause. It was huge fun to play on the Centre Court at The Queen’s Club again TIM HENMAN, FORMER WORLD NO 4

26 RM MAGAZINE

Go online for more To find out more about Rally Against Cancer, see the match highlights, read the message of support from HRH The Duke of Cambridge, watch the Never Expect video featuring Ross Hutchins or make a donation, please wisit www.royalmarsden.org/ rally-against-cancer

Hospital groups

THE FRIENDS Sutton Friends support new accommodation for patients

Actress Sheila Hancock (centre) with fellow Summer Drinks Party guests Paul Gulbenkian and William Bortrick

THE FRIENDS OF THE ROYAL MARSDEN, CHELSEA

Summer party celebrations The Friends of the Royal Marsden, Chelsea returned to the Chelsea Gardener for their annual fundraising Summer Drinks Party in May. Hosted by Honorary President Countess Cadogan and generously sponsored

We are thrilled that so many of our own Friends, volunteers and staff support us enabling us to raise even more money JACQUIE GULBENKIAN, CHAIRMAN, THE FRIENDS OF THE ROYAL MARSDEN, CHELSEA

by estate agent Strutt & Parker, the event attracted more than 400 guests, including actresses Sheila Hancock and Charlotte Ritchie.

A jazz band, stilt walkers and living statues entertained guests, while the raffle was a huge success, raising necessary funds that will go directly to supporting The Royal Marsden.

Friends Chairman Jacquie Gulbenkian (featured, right) said: “Every year, this fundraising event just gets better. We are thrilled that so many of our own Friends, volunteers and hospital staff support us, enabling us to raise even more money for The Royal Marsden in Chelsea.”

WELCOME TO THE NEW CHAIRMAN JACQUIE GULBENKIAN The Friends of the Royal Marsden, Chelsea are pleased to announce the appointment of Jacquie Gulbenkian as Chairman.

Jacquie will take over from Wendy Crabb, while Co-Vice Chair Sally Robotham is retiring.

Reflecting on the work of Wendy and Sally, Jacquie said: “Both have done a fantastic job and we’re delighted that they’re staying as committee members.”

An area of Compton House, at the front of The Royal Marsden in Sutton, is being refurbished to provide a two-bedroom flat that will accommodate two different patients and their partners, or one family, from May 2013.

Until recently, patients who were due to undergo a bone marrow transplant were required to remain in hospital for a seven-day course of chemotherapy prior to the surgery. The new facility will allow patients who live too far away from the hospital to travel in on a daily basis to stay on site, in a home-from-home environment.

“The accommodation will enable patients to live as normal a life as possible at that stage of their treatment,” said Kim Davis, Matron, Haemato-oncology Unit.

The project is being funded by the Friends of The Royal Marsden, Sutton, who are contributing towards the cost of furniture and furnishings, and the Kay Kendall Leukaemia Fund, which is funding the building alterations. In addition, the family and friends of Marie Brown have generously donated £8,000 towards the building alterations.

RM MAGAZINE 27

FOUNDATION NEWS

OUR NEW COUNCIL OF GOVERNORS

Following recent elections, we are pleased to announce the new Council of Governors

Council of Governors

Board of Directors

Chairman: Ian Molson

Chairman: Ian Molson

Patient Governors (8)

Carer Governors (2)

Public Governors (4)

Staff Governors (5)

Appointed Governors from stakeholder organisations (6)

Kensington & Chelsea and Sutton & Merton: Joyce Herve, Maggie Harkness, vacant Elsewhere in London: Fiona Stewart, Dr Peter Lewins Elsewhere in England: Vikki Orvice, Simon Spevack Paediatric and Young Adults: Stacey Munns

Carer: Lesley-Ann Gooden, Duncan Campbell

Sutton & Merton: Janet Mountford Kensington & Chelsea: Dr Carol Joseph Elsewhere in England: Ann Curtis, Robert Shearer

Doctor: vacant Nurse: vacant Clinical Professional (AHP and Healthcare Sciences): Richard Keane Clinical Support Staff: vacant Corporate Support Services: Bernadette Knight

The Institute of Cancer Research: Cathy Scivier Cancer Research UK (charity): Kate Law Kensington & Chelsea: Cllr Robert Freeman Sutton & Merton: vacant Clinical Commissioning Group x 2: vacant

ollowing a reconfiguration of the Council of Governors, the recent round of elections was the biggest since the Trust became a Foundation Trust in 2004.

Deborah Tarrant, Director of Workforce and Corporate Affairs, has responsibility for the Foundation Trust Office and was delighted to see such a high number of Members stand as candidates for Governor seats.

“I’d like to thank all the nominees and everyone who

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28 RM MAGAZINE

voted,” she said. “We look forward to working with all the Governors to ensure members’ views are represented at the highest level in the Trust.”

Deborah also thanked the outgoing Governors – Hilary Bateson, Dr Geoff Harding, John Preston, Dr James Laxton, Sally Mason, Tony Hazeldine, Professor Ian Smith, Kim Andrews, Edward Crocker, Liz Coyne, John Howard and Nina Kite – for their dedication and contribution to the Council through their respective time as Governors.

Among other duties, the Trust’s Board of Directors is responsible for determining the strategic direction. The Council of Governors works alongside the Board and has enhanced statutory duties that took effect on 1 April 2013, as a result of the Health and Social Care Act 2012. One such duty is to represent “the interests of the Members of the Trust as a whole and the interests of the public”.

You can contact your Governor through the Foundation Trust Office.

By-election to the Council: don’t forget to vote We are holding a by-election for the vacant seats on the Council.

Voting opened on 9 July, when voting packs were sent to eligible Patient Members of The Royal Marsden who live in Kensington & Chelsea and Sutton & Merton. The byelection also includes the vacant staff seats as detailed in the structure chart (left).

If you have received ballot papers, please vote for your preferred candidate to represent you at the highest level in the hospital and return the form by the closing date of 29 July.

For further information on how you can become a part of the Trust’s new Council of Governors, please contact Rebecca Hudson on 020 7808 2844 or Jitendra Patel on 020 7811 8239 or send an email to rebecca.hudson@rmh.nhs.uk

Date

Action

9 July 2013

Voting opens; voting packs despatched to Members

29 July 2013

Voting closes

30 July 2013

Results published

Foundation news

Quality Account: making your priorities for improvement count

Royal Marsden Governor marches on

Royal Marsden Governor Simon Spevack took part in this year’s Marsden March, and even the rain couldn’t dampen his spirits.

Simon took part in the five-mile walk along with family members. “It was not the best of weather, but that did not dampen the party atmosphere,” he said.

Simon and his family were touched by the messages that others had pinned to their backs, such as “I am walking for the hospital staff that looked after me” or “I am walking for my nan, aunt, mum or dad”.

En route, Simon and his family were spurred on by supporters.

They raised £750 and pledged to do even better next year.

Dates for your diary Council of Governors Meeting Thursday 12 September 2013, 11am–1pm, Board Room, Chelsea The Royal Marsden Annual General Meeting Wednesday 25 September 2013, 5pm, Julian Bloom Lecture Theatre, The Royal Marsden, Chelsea To attend, please email malvin.sayle@rmh.nhs. uk or call 020 7808 2259.

YOU’RE INVITED Members’ Event: Developing Patient Care We hope you can join us at our next Members’ Event on Monday 22 July 2013 at 5pm at our Chelsea site.

Attendees will have the opportunity to tour our new MRI department (phase 1) as part of the Imaging Centre, which is due to be completed next year.

Guest speakers will include Consultant Radiologist Dr Gina Brown (above), who will talk

about how imaging is changing the way the hospital delivers its services and is improving patient care, and Dr Theresa Wiseman, Strategic Lead for Health Service Research.

Everyone is welcome to attend this event, but you will need to be registered as a Member. You can join on the day – please contact Rebecca Hudson in the Foundation Trust Office (see below right) for more information.

Nancy Hallett joins the Board as a Non-Executive Director A new Non-Executive Director has been appointed to the Trust’s Board of Directors. As part of their statutory duties, the Council of Governors approved the appointment of Nancy Hallett, who brings a wealth of experience, skills and knowledge to the Board.

As in the previous three years, Governors have scrutinised and contributed to the content of the Trust’s Quality Account, which will form part of the Annual Report.

Governors routinely review information prepared for inclusion in the Quality Account. Based on their involvement and the feedback received from Members and other patients and carers, they have chosen priority quality issues.

The Trust strives to improve the presentation of data each year to make the Quality Account more succinct, interesting and readable. This year, Governors have seen a considerable improvement in the layout of the information, making it easier to read and digest. The Council has endorsed the key priorities for improvement as set out in the Quality Account.

To receive a copy of the Annual Report, which contains the Quality Account, please contact the Foundation Trust Office from August.

Keep in touch Become a Member or contact your Governor: Nancy, who started her career as a cancer nurse and worked at The Royal Marsden, recently retired as Chief Executive of Homerton University Hospital Foundation Trust.

Nancy took up office on 1 April 2013.

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

RM MAGAZINE 29

PUZZLES & PRIZES

Test your wits

Win!

Complete our crossword and you could win £50 in John Lewis vouchers SUDOKU

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Star Letter

Dear RM, I was diagnosed with breast cancer 10 years ago and was delighted to have breast reconstruction 18 months after my diagnosis.

Before my operation, I was invited to a pampering afternoon and given a beauty goody bag to take home. The afternoon was so unexpected and a great boost before my operation with Mr Paul Harris.

I have so much to thank The Royal Marsden for.

I always look forward to receiving RM magazine.

I have learned so much over the years, especially about how advanced procedures have become and the clinical trials taking place. It fills me with confidence for the future.

Lynn Quinn

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

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Across 1 Shortens (11) 6 Insect (3) 7 End of the day (7) 8 Choose by voting (5) 9 Celestial bodies (5) 11 Trivial (5) 13 Conceals (5) 15 Connected (7) 16 American government department (1-1-1) 17 Feeling awkward or ashamed (11) Down 1 Belittle (5) 2 Bird (7) 3 Riding competition (5) 4 Thoughts (5) 5 Indications (5) 10 Kidnaps (7) 11 Holy book (5) 12 Beer (5) 13 Tentacled animal (5) 14 Pottery fragment (5)

CONTACT DETAILS

Congratulations to Verity Landon, who won last issue’s crossword prize.

30 RM MAGAZINE

The lucky winner of our prize crossword will receive £50 in John Lewis vouchers.

We also welcome your thoughts on RM magazine and love to hear about your experiences at the hospital.

The Star Letter wins £50 in John Lewis vouchers.

Send your crossword or letter with your name and contact details to RM, Press Office, The Royal Marsden, Fulham Road, Chelsea, London SW3 6JJ. The closing date for entry is Friday 23 August 2013. See below for prize draw rules.

PRIZE DRAWS & STAR LETTER TERMS & CONDITIONS: 1. The Prize Draws and Star Letter are open to all readers of RM except employees of the Press Office at The Royal Marsden and Sunday, who produce RM magazine. 2. The closing date for receipt of all entries is Friday 23 August 2013. Only one entry per person per draw.

3. Responsibility cannot be accepted for entries that are incomplete, illegible or not received.

Proof of posting is not proof of receipt. No cash alternative is available and prizes are not transferable. Value of prizes is correct at time of going to press. 4. Winners will be notified by post within 14 days of closing date. 5. The Promoter’s decision on any aspect of the promotions is final and binding and no correspondence will be entered into. 6. The Promoter reserves the right to substitute a prize of equal or greater value should circumstances make this necessary.

7. Entry implies acceptance of rules. 8. The winner of the Star Letter prize of £50 in John Lewis vouchers is the sender of the best letter selected by RM magazine. 9. The winner of the crossword prize of £50 in John Lewis vouchers will be the first correct entry drawn out of the bag. 10. The Promoter is The Royal Marsden Hospital, 203 Fulham Road, London SW3 6JJ.

IN THE NEXT ISSUE RM brings you the latest hospital updates, research news, inspiring stories and exclusive interviews. The autumn 2013 issue is coming soon…

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Spotlight on our new research strategy Sir William Rous Unit five years on The latest treatments for the after effects of radiotherapy

FOR THE ROYAL MARSDEN Rachael Reeve – Director of Marketing and Communications Elaine Parr – Head of PR and Communications Naomi Owen – PR and Communications Manager Belinda Lock – Senior Press Officer Catherine O’Mara – Senior Press Officer Sukhie Deol – Press Officer FOR SUNDAY Lucy Ryan – Editor Marc Grainger – Deputy Editor Catherine Hopkinson – Art Director Mathilda Evans – Account Director Matt Beaven – Creative Director Toby Smeeton – Managing Director RM magazine is published by The Royal Marsden in partnership with Sunday: sundaypublishing.com © The Royal Marsden 2013. All rights reserved. Reproduction in whole or part is prohibited without prior permission of the Editor. The Royal Marsden and Sunday accept no responsibility for the views expressed by contributors to the magazine. Repro by F1 Colour. Printed by Pureprint.

You don’t have to wait until next year to walk in support of The Royal Marsden Cancer Charity. Simply start your own Marsden March event – and march any time, anywhere.

Find out more at www.royalmarsden.org/ mymarch