Private Care AUTUMN/WINTER 2018
CRUCIAL ADVANCES Pioneering smarter, kinder treatments for gastrointestinal cancers Our one-stop breast clinic arrives in Sutton
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AUTUMN/WINTER 2018
PRIVATE CARE AT THE ROYAL MARSDEN
THE FACTS
9.1/10
scored in the Care Quality Commission’s 2017 inpatient survey
WELCOME As the Managing Director of P rivate Care at The Royal Marsden, I’m pleased to introduce the latest issue of P rivate Care magaz ine. In this edition, we profile the work of our G astrointestinal U nit, and how robotic surgery and smarter, kinder treatments are improving outcomes for patients. W e also hear from Dr Angela G eorge, Clinical L ead for our world- leading Cancer G enetics U nit, and Dr S usana Banerjee, Consultant Medical O ncologist, on how our Mainstreaming Cancer G enetics programme has radically improved testing for breast and ovarian cancer risk. O ur regular Consultant Focus delves into the work of Dr S usan L alondrelle, H ead of Clinical O ncology. Dr L alondrelle is involved in clinical research that focuses on adaptive planning to improve accuracy and reduce toxicity using image- guided brachytherapy, and on how our new MR L inac machine, the first in the U K, could reduce side effects in young women with gynaecological cancer. I hope you enjoy reading the updates and news in this issue. Shams Maladwala Managing Director of Private Care
ON THE COVER Dr Katharine Aitken, Consultant Clinical Oncologist in the Gastrointestinal Unit
600
young inpatients are seen in the Oak Centre for Children and Young People every year
1,700
patients have been treated with stereotactic body radiotherapy since 2011
1st
in the Private Hospital category at the 2017 LaingBuisson Awards
4
weeks to get BRCA gene test results, reduced from 20
35
specialists in our multidisciplinary team meetings
FIND OUT MORE
For referrals and enquiries, call 020 7811 8111 or email privatepatients@rmh.nhs.uk
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U P DAT E
MR LINAC READY FOR ITS FIRST PATIENT
THE FINAL PREPARATIONS are now under way at The Royal Marsden’s Sutton site to treat the first patient in the UK on the Magnetic Resonance Linear Accelerator (MR Linac). The pioneering machine, which combines an MR scanner and linear accelerator, received its CE mark in the summer. A multidisciplinary team is working to ensure
that it is ready for action by autumn 2018. Dr Alison Tree, Consultant Clinical Oncologist, said: “The location of tumours and organs can change; for example, the prostate might move from day to day, depending on the fullness of the patient’s bowel. “Using the MR Linac, we will be able to see affected organs much more clearly than
COUNTING DOWN The MR Linac suite (above); Dr Alison Tree (above right)
before, including constant monitoring during treatment, ensuring we can deliver radiotherapy more precisely. Also, for the first time, we will be able to change the radiotherapy plan each day to account for changes in anatomy, which means our ability to avoid healthy tissue will be better than ever before.” The MR Linac was made possible by a £10-million grant from the Medical Research Council to The Institute of Cancer Research, with additional support from The Royal Marsden Cancer Charity.
TALKING POINTS “At the new onestop breast clinic, women can have all of their tests and receive their results on the same day” Page 6
“Minimally invasive “The Mainstreaming robotic surgery has Cancer Genetics n mero enefit programme has for oesophageal revolutionised BRCA cancer patients” testing in the UK” Page 8
Page 12
“Radiotherapy has an important role to play in the treatment of gynaecological and skin cancers” Page 14
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IN BRIEF ASCO meeting
Our clinicians travelled to Chicago in June for the American Society of Clinical Oncology (ASCO) Annual Meeting, where they presented the latest advances in cancer research and care. A keynote lecture from Professor Johann de Bono revealed findings from the first clinical trial to show the benefits of immunotherapy in prostate cancer, and Dr Susana Banerjee addressed the latest evidence on physician burnout.
Prestigious award
Consultant Medical O ncologist P rofessor Ian S mith has won the 2 0 1 8 W illiam L . McG uire Memorial L ecture Award for his lifelong focus on improving the management of breast cancer. H e is the third Royal Marsden consultant to have won both this priz e and the Brinker Award for S cientific Distinction in Clinical Research, following in the footsteps of P rofessor Mitch Dowsett and the retired P rofessor Trevor P owles.
Team efforts
The Royal Marsden has made a short film, about a young female patient who had fertilitysaving surgery, to illustrate the importance of multidisciplinary teams (MDT) in developing personalised treatment plans and improving quality of care. Up to 35 specialists attend our weekly MDT meetings. Watch the video at royalmarsden.nhs.uk/mdt
PARTY AT THE PALACE HRH THE DUKE of Cambridge, President of The Royal Marsden, represented the hospital at a star-studded dinner at Buckingham Palace this summer to celebrate our fundraising work. Guests included valued supporters of our Oak Cancer Centre Appeal, such as Alan and Jette Parker of Oak Foundation – whose incredibly generous donation
of £25 million has been the largest to date – and members of the Appeal Board. Actors Tom Hiddleston and Olivia Colman and tennis star Grigor Dimitrov also attended, while Kylie Minogue sang for guests. Due to open in 2021, the £70-million Oak Cancer Centre will ensure patients are at the heart of research and will help to speed up the development of treatments to improve survival.
A NIGHT TO REMEMBER The event saw Kylie Minogue perform and HRH The Duke of Cambridge address guests
3D breast imaging could help evaluate aesthetic outcomes New research from The Royal Marsden suggests that imaging equipment commonly used for cosmetic surgery could assist in surgical planning for breast cancer patients. The Royal Marsden is one of only a few U K centres using the V ectra X T three- dimensional imaging system. Miss J ennifer Rusby, Consultant
O ncoplastic Breast S urgeon, led a study that aimed to validate breast symmetry and volume measurements provided by the system, allowing surgeons to better understand the natural changes in shape that occur over time after breast cancer surgery. This will enable them to better prepare patients for what lies ahead.
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U P DAT E
Using big data for diagnosis ROYAL MARSDEN consultants are exploring the latest advances in artificial intelligence (AI) to help diagnose cancer earlier and improve quality of life for our patients. Dr Christina Messiou, Consultant Radiologist at The Royal Marsden, is leading one study in this area, in partnership with Professor Andrea Rockall and Dr Ben Glocker, from Imperial College London. Dr Messiou said: “Unlike CT scans, whole-body MRI scans can detect myeloma in the bone marrow before it has spread, meaning earlier diagnosis. This is particularly important in myeloma because
“Whole-body MRI scans generate a vast amount of data” SMART WORK Dr Christina Messiou
as the disease progresses, it can result in irreparable bone damage. “But the challenge with using whole-body MRI scans is that they generate a vast amount of data – around 1,000 images – which all need to be examined individually by a radiologist. AI removes some of these more laborious tasks.” Professor Rockall, Honorary Consultant Radiologist at The Royal Marsden and Clinical Chair in Radiology at Imperial, said: “Big data is collaborative by its very nature, and this study will draw on expertise from radiologists, physicists, data scientists and computer scientists, as well as the machine learning group at Imperial. We hope AI will not only detect and quantify the amount of disease, but also reduce the time needed for a radiologist to review the entire scan.”
MATCHING PATIENTS TO TREATMENTS Researchers at The Royal Marsden and The Institute of Cancer Research (ICR) are predicting how bowel cancer patients will respond to treatment by looking at circulating tumour DNA in the blood. These small pieces of DNA can be picked up by a simple blood test, also known as a liquid biopsy, which is quicker, cheaper and less invasive than taking a sample of body tissue. In two major studies with the ICR, our researchers predicted which patients would respond to regorafenib and cetuximab, two important treatments for bowel cancer. Khurum Khan (above), Clinical Research Fellow, said: “By analysing the DNA for minute genetic alterations, we can follow the progression of a patient’s tumour. This enables us to select the right treatment for the right patient, at the right time, meaning we avoid unnecessary treatment with a drug we know won’t work, and we can also consider alternative options at a much earlier stage.”
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RAPID RESULTS
Our new one-stop clinic in Sutton provides fast, accurate diagnoses for patients concerned about breast symptoms EXPERT SERVICE A patient has a mammogram in the Sutton RDAC
THE ROYAL MARSDEN’S Rapid Diagnostic and Assessment Centre (RDAC) in Sutton has launched a new one-stop clinic where women with concerns about breast cancer can have all of their tests and receive their
results on the same day, with biopsy results fasttracked to be available just a few days later. As soon as a patient receives a diagnosis, our expert multidisciplinary teams, including oncologists,
radiologists, radiographers, clinical nurse specialists and histopathologists, will devise an individualised treatment plan. Dr Robin Wilson, Consultant Radiologist and Head of the Breast Unit, says: “We carry
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DIAGNOSTICS
out a ‘one-stop’ triple assessment for our patients: an initial clinical examination is followed by ultrasound and, if the patient is over 40, mammography. We then go on to do a needle biopsy if required. “We understand that this is an anxious time for our patients, so we aim to reassure them and make the process as straightforward as possible.”
The multidisciplinary team of surgeons, radiologists and clinical nurse specialists meet three times a week to discuss any breast imaging that is indeterminate and to review all biopsy results. Dr Wilson says: “At these meetings, we ensure that all the results of examinations, imaging and biopsies fit together to make a definite diagnosis so that we can recommend the best course of action.”
FIND OUT MORE
Please contact our Central Referral and Information Line on +44 (0)20 7811 8111 (8am6pm, MondayFriday; 10am-2pm, Saturday) or email privatepatients@ rmh.nhs.uk
BREAST CANCER IN NUMBERS
9,344
patients with suspected breast cancer were referred to The Royal Marsden in 2017-18
OUR EXPERT TEAM
93%
Mr William Allum
Consultant Surgeon Mr Allum specialises in surgery for benign and malignant breast disease and perioperative multimodality trials. He says: “Our multidisciplinary team approach sets us apart. Our world-leading specialists work together to obtain optimal results for our patients.”
Miss Jennifer Rusby Consultant Oncoplastic Breast Surgeon
Miss Rusby specialises in a rapid breast diagnostic service, oncoplastic breast-conserving surgery, nipplesparing mastectomy, and breast reconstruction. She says: “From diagnosis to follow-up, patients can access all the expertise and facilities they need, under one roof.”
Mr Peter Barry Consultant Oncoplastic Breast Surgeon
Mr Barry is a specialist in the early diagnosis of breast cancer, oncoplastic breast surgery, neoadjuvant and perioperative trials, and immediate breast reconstruction. He says: “Our multidisciplinary unit works cohesively to provide a comprehensive service, with rapid access for patients when needed.”
Miss Katherine Krupa Consultant Oncoplastic Breast Surgeon
Miss Krupa specialises in rapid multidisciplinary assessment (MDA) of breast symptoms, surgery for benign and malignant breast conditions, and oncoplastic breast surgery. She says: “Our one-stop clinics provide patients with the peace of mind of fast and accurate diagnosis.”
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of our NHS breast cancer patients are treated within the NHS standard period of 62 days
3,513
patients were treated for breast cancer at The Royal Marsden in 2017-18
95%
of patients receive a same-day diagnosis
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GUT REACTION Developments in treating gastrointestinal cancers are moving fast, with liquid biopsies, robotic procedures and high-tech radiotherapy promising safer, more rapid and effective outcomes for patients THE FUTURE OF TREATMENT for gastrointestinal (GI) cancers is looking promising. The Royal Marsden offers a comprehensive and multimodal pathway of treatment consisting of immunotherapy, chemotherapy, surgery and radiotherapy, with new developments picking up pace. Dr Katharine Aitken, Consultant Clinical Oncologist in the GI Unit, says: “The developments we are working on could be gamechanging. We’re focused on researching smarter, kinder treatments that provide better survival outcomes.” Researchers are investigating different tests that will promote earlier, faster and less invasive diagnosis. One method is to analyse breath samples for a chemical signature linked to GI cancers. The Royal Marsden was involved in the study underpinning this procedure, which was developed by academics at Imperial College London, and has since
appointed a new surgeon, Sacheen Kumar, who is a leader in this field. Experts are also investigating how tumour DNA taken from blood tests could shape more effective treatment. Known as liquid biopsies, these are less invasive than taking a sample of body tissue. A recent study led by The Royal Marsden with The Institute of Cancer Research (ICR) found that liquid biopsies could improve outcomes for bowel cancer patients by predicting which treatment would most benefit a patient (read more on page 5). Dr Irene Chong, Consultant Clinical Oncologist in the Gastrointestinal Clinical Trials Unit, develops biomarkerdriven, proof-of-concept clinical trial protocols based on discoveries made in the laboratory. She says: “We’re discovering new therapeutic targets and biomarkers for oesophageal and rectal cancers through DNA sequencing and functional profiling.”
We have also appointed four new gastroenterologists to the GI Unit, increasing the expertise in advanced endoscopic procedures for those with early-stage cancers and precancerous growths. Robotic surgery Minimally invasive procedures have marked a distinct shift in surgical treatment for GI cancers over the past decade. Mr Asif Chaudry, Consultant Upper GI/ Oesophagogastric Robotic Surgeon, and colleague Mr Myles Smith were the first surgeons in the country to offer robotic procedures for oesophageal cancers.
“We’re focused on smarter, kinder treatments that provide better outcomes”
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GI UNIT
SAFER DOSES Dr Katharine Aitken says clinical teams are researching smarter, kinder treatments
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Mr Chaudry says: “Removing these cancers is extremely complex. Traditionally, we would cut through the muscles of the chest wall and remove part of a rib. In contrast, the minimally invasive approach of robotic surgery has numerous benefits for patients, including less blood loss, less pain and quicker recovery time. “We are also carrying out surgical procedures that use real-time imaging. These involve injecting a fluorescent dye during surgery, which, when viewed under a certain light, glows bright green when it meets cancerous tissue. This means surgeons can isolate the tumour more easily, ensuring cancerous tissue is removed and minimising damage to healthy tissue. “Along with colleagues at the ICR, we are working on techniques that use highenergy light during robotic
procedures to eradicate microscopic cancer cells.” A founding member of the Upper GI International Robotic Association and part of the European minimally invasive oesophagectomy think tank, Mr Chaudry is collaborating with colleagues to design models for how international centres should be carrying out robotic upper GI procedures. He is also leading on the ICONIC trial, which looks at a combination of immunotherapy and surgery for the treatment of oesophageal and gastric cancers. Earlier this year, he performed a world-first procedure on an oesophageal cancer patient who had immunochemotherapy prior to surgery. Radiotherapy advances In one of the largest and best-equipped radiotherapy departments in the UK, Royal Marsden clinicians deliver
ROBOT MASTER Mr Asif Chaudry is designing procedural models to be used across Europe
high-quality image-guided radiotherapy as a routine standard of care for GI cancers. Dr Aitken says: “The dramatic advances in radiotherapy technology over the past 20 years have led to tangible clinical benefits for patients. “Historically, radiotherapy design was much more rudimentary. With modern technology, we can offer much more personalised treatment for GI cancers. Each radiotherapy treatment is mapped on a CT scan, individualising the treatment according to the patient’s anatomy and, where relevant, the movement of the tumour according to the patient’s breathing.” For GI patients, intensitymodulated radiotherapy (IMRT) is used routinely. IMRT shapes radiation so that it can precisely target the tumour, allowing normal tissue to be spared and reducing side effects. The Royal Marsden led the development of this technology, and was the first centre nationally to routinely adopt such treatments for oesophageal and anal cancers. Stereotactic body radiotherapy (SBRT) – also known as stereotactic ablative radiotherapy (SABR) – is the use of multiple small beams to deliver radiotherapy treatment shaped to the size of the tumour. It has been shown to be particularly effective in treating liver metastases where surgery is not feasible, and to treat pelvic reirradiation and oligometastatic disease. Using machines such as CyberKnife and state-of-the-art linear accelerators, our experts are experienced at delivering SBRT, having treated 1,700 patients since 2011.
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GI UNIT
Dr Aitken says: “The advantage of having access to different delivery platforms for SBRT is that we can select the most appropriate machine for the individual patient.” Targeting tumours One exciting prospect is the potential of the MR Linac for GI patients, particularly those with hard-to-treat diseases such as pancreatic cancer (read more about the MR Linac on page 3). This is crucial for a tumour type historically associated with poor outcomes. The Royal Marsden is part of an international consortium for MR Linac research; in GI cancers, this is focusing on its use for pancreatic, rectal, oesophageal and liver cancer.
At diagnosis, a third of patients with disease localised to the pancreas are inoperable, often due to the involvement of surrounding structures such as adjacent blood vessels. Currently, these patients are treated with four to six months of chemotherapy, followed by six weeks of chemoradiation. Data from a laboratory setting suggest that pancreatic cancer cells respond better to higher doses of radiation. Dr Aitken is the consortium’s lead for pancreatic cancer. She says: “Conventional doses of radiation are of limited effectiveness in these tumour types. The challenge is how to give higher doses of radiation safely because of the proximity of the pancreas to organs sensitive to radiation, such as
HIGH PROFILE Dr Irene Chong develops clinical trial protocols based on discoveries in the laboratory
the stomach and the bowel. The MR Linac is the ideal solution.” The MR Linac produces clearer images so clinicians can see exactly where the tumour ‘sits’ in relation to these surrounding structures at the time of treatment delivery. By viewing and adapting radiotherapy plans based on this information, the maximum dose is targeted at the tumour while minimising dosage to healthy tissue. This will enable pancreatic radiotherapy to be given in fewer, higher doses, over a shorter period of time. It is our vision that by combining our expertise, state-of-the-art equipment and research credentials, we can extend, save and improve the lives of more patients diagnosed with GI cancers.
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ALL IN THE GENES The Mainstreaming Cancer Genetics programme has radically improved testing for breast and ovarian cancer risk
GENETIC TESTS ARE essential in cancer care. They can provide information about the cause of the cancer and inform decisions about the best treatment plan. They can also identify relatives of patients who are at increased risk. The Royal Marsden’s Cancer Genetics Unit is a world leader in this field. In 2013, the unit, along with The Institute of Cancer Research (ICR), started an innovative programme to provide faster, more efficient and more patient-centred testing for BRCA1 and BRCA2 genes (which can increase a woman’s lifetime risk of breast cancer to between 70 and 80
per cent and a woman’s lifetime risk of ovarian cancer to 60 per cent) through routine cancer clinic appointments. Mainstreaming Cancer Genetics (MCG) began in the Gynaecology and Breast units at The Royal Marsden, but has now expanded into other tumour types, nationally and internationally. Before the MCG programme, genetic testing for cancer patients was limited and difficult to access. Nationally, only 15-30 per cent of eligible patients would be offered tests for BRCA gene mutations. Testing relied on oncology teams recording an accurate
family history, identifying that the patient met specific criteria, and then referring them to genetics teams. These steps meant that patients were often not referred for testing. Fast, accurate and affordable MCG has simplified the process. Dr Angela George, Clinical Lead for the Cancer
So far, several thousand women have been able to have genetic testing
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GENETICS
Genetics Unit, says: “With our new DNA sequencing technology, we have made a fast, accurate and affordable cancer gene test. We simplified test eligibility and brought testing to patients in the cancer clinic, rather than making them have another appointment with a different team.” So far, more than 2,000 Royal Marsden patients have benefited from the programme, while more than three times as many have been able to be tested, including many women who would not previously have qualified. The new pathway is also much faster: results are received within four weeks, rather than 20. It’s not just beneficial to patients: relatives with BRCA mutations also have the option of having their ovaries removed now or after having children. Clinicians predict that this could prevent 283 cases of ovarian cancer and 77 deaths each year in the UK. Dr Susana Banerjee, Consultant Medical Oncologist, says: “The MCG programme has revolutionised BRCA testing in the UK and affected treatment decisions for women with ovarian and breast cancer. “In ovarian cancer, women with a BRCA mutation are more likely to respond to targeted drugs called PARP inhibitors, such as olaparib and niraparib. These drugs have significantly extended the time before disease progression by almost four times compared to patients on a watch-and-wait follow-up. “It’s not just in the UK where we’re driving change. Our experts are influencing international practice, building clinical relationships and
SPREADING THE WORD Dr Angela George (left) has led on education to train doctors in BRCA testing; Dr Susana Banerjee (below) believes the programme has been revolutionary
developing education programmes to ensure more women undergo BRCA testing and receive results more swiftly.” Global reach MCG-International was launched in 2017 as an international collaboration project to share experiences and good practice in cancer predisposition gene testing. It is now in place in several countries across Asia, Australasia, North America and Europe. Dr George recently travelled to China, leading on education programmes to help train doctors in BRCA testing. She says: “We are aiming to give
women throughout the world faster and more accessible genetic testing, improving cancer outcomes for them and their families.” In addition to providing resources such as videos, a learning toolkit and training checklist, several of the senior nurses at The Royal Marsden are now qualified to deliver genetics counselling. Dr George adds: “By enabling more patients worldwide to access testing, the MCG programme has led to better treatment for cancer patients, and the opportunity to prevent further cancers in carriers and their families.”
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DR SUSAN LALONDRELLE Consultant Clinical Oncologist THE ROYAL MARSDEN’S Head of Clinical Oncology, Dr Susan Lalondrelle, is a Consultant Clinical Oncologist specialising in the treatment of gynaecological and skin cancers. Dr Lalondrelle trained in oncology in South West Thames and was awarded a clinical fellowship at The Institute of Cancer Research (ICR), completing research into the application of advanced radiotherapy technologies in pelvic tumours in 2008. Her research has been presented and published internationally and was awarded the Sylvia Lawler Prize from the Royal Society of Medicine. Dr Lalondrelle continues to be actively involved in clinical
research. She has a particular interest in radiotherapy technologies such as the MR Linac and stereotactic and image-guided adaptive radiotherapy, all with the aim of delivering more focused treatment and reducing toxicity. She is an expert in imageguided brachytherapy, an internal radiation treatment. Her other research focus is the combination of new biological and immunotherapy agents with radiotherapy. Dr Lalondrelle has an ongoing interest in medical education. She is a module leader for the ICR’s MSc Oncology course and an educational supervisor to clinical oncology trainees.
CAREER HIGHLIGHTS 1998 Graduates from the University of Southampton 2003-2010 Undertakes specialist training in clinical oncology in South West Thames 2008 Completes clinical fellowship at The Institute of Cancer Research, which involved research degree in adaptive radiotherapy planning
Q&A 2011 Appointed as a Consultant Clinical Oncologist at The Royal Marsden 2016 Becomes a member of the National Cancer Research Institute’s Gynaecological Clinical Studies Group 2018 Becomes Head of Clinical Oncology at The Royal Marsden
Q What services do you offer at The Royal Marsden? A I provide a holistic approach and specialise not only in radiotherapy but also in chemotherapy, systemic therapies, and brachytherapy for patients with gynaecological and non-melanoma skin cancers. Treatments are often complex and multifaceted, so a multidisciplinary approach is
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C O N S U LTA N T F O C U S
“New radiotherapy technologies have enabled us to provide more efficient, more effective care for patients” even more focused than other radiotherapy techniques, so you can give really high doses to the target with very little damage to surrounding tissue. Q What are the options for skin cancer patients? A Non-melanoma skin cancer is the most common cancer in the UK. We see a large volume of these cases, most of which will be basal-cell carcinoma. As these lesions often appear on the nose, ear and scalp, where surgery can be difficult and leave unsightly scars, radiotherapy is often the preferred option. We can treat these cancers with superficial radiotherapy, which delivers radiation only to the skin rather than deep into the body. We also use brachytherapy to target skin cancers, for larger affected areas that we would not be able to treat using other radiotherapy machines. key. I work closely with surgical and medical oncology colleagues and other health professionals to decide the best treatment for each individual patient. Q What are the latest treatments for gynaecological cancers? A Radiotherapy has an important role to play, and we use the latest equipment to deliver the highest standard of external radiotherapy and brachytherapy. The advantage of brachytherapy is that it is
Q How has research developed in your areas of expertise? A The Royal Marsden is the first centre in the UK – and one of only seven in the world – to install an MR Linac, which combines an MRI scanner with radiotherapy delivery. We are part of an international research consortium – for which I am leading the gynaecological group – that is designing clinical trials on this machine, with the goal of improving outcomes for
patients. For example, my team is looking at how we can use the MR Linac to reduce the side effects in young women treated for gynaecological cancers through more focused, personalised treatments. We’re also investigating how we can use it to deliver stereotactic radiotherapy to an area that has been treated in the past, as this could potentially provide curative treatment that was previously not possible. I’m also the Chief Investigator on the PAPAYA study, which aims to find out whether the addition of immunotherapy will reduce the rate of relapse after curative radiotherapy for women with cervical cancer. Q What does the future of radiotherapy look like? A I am excited and optimistic about the future. The arrival of new technologies in the past decade has enabled us to provide more efficient, more effective care for patients. We’re about to see even more groundbreaking results with the MR Linac, which will allow us to target cancers with greater accuracy. Advances in brachytherapy will mean kinder, smarter treatments for patients along with improved outcomes, and the development of stereotactic therapy will mean patients who previously would have been incurable may be given life-saving treatment.
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As Europe’s largest cancer centre, The Royal Marsden has the expertise, facilities and technology to provide the highest standards of personalised care, and we treat more private patients than any other UK centre. By choosing The Royal Marsden, you are ensuring the best possible treatment and care, at the moment a patient needs it most. Because where a patient goes first really matters.
Life demands excellence
To refer a private patient, contact our Central Referral and Information Line on +44 (0)20 7811 8111 or email privatepatients@rmh.nhs.uk royalmarsden.nhs.uk/private
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