Private Care SUMMER 2022
A SPECIALIST IN SARCOMA Mr Dirk Strauss brings his unique expertise to Cavendish Square Stars of surgery: in theatre with our skilled surgeons
SUMMER 2022
OUR INTERNATIONAL SERVICE
THE FACTS
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different nationalities among our patients
WELCOME As the Managing Director of Private Care at The Royal Marsden, I’m pleased to introduce the latest issue of Private Care magazine. In this issue, you can get an insight into our highly skilled surgical team – who are the focus of a Channel 4 documentary series this summer – and we introduce the latest appointments to our roster of world-leading consultant surgeons. Miss Rachel O’Connell, Consultant Oncoplastic Breast Surgeon, is now seeing private patients in Sutton and at Cavendish Square, while Mr Omer Karim, Consultant Urological Surgeon, is treating private patients in Chelsea. You can also read about how Dr John Williams is leading a team of pain experts at our private patient facility at Cavendish Square, and how they strive to provide a bespoke pain management service for each patient. Our front cover features Mr Dirk Strauss, one of our leading consultants in the Sarcoma Unit and Skin Unit. His clinic at Cavendish Square offers diagnosis and treatment, with diagnostic imaging tests available onsite that can provide results on the same day. Read more about his career to date in our Consultant Focus feature. I hope you enjoy this issue.
15%
of our private patients are from outside the UK
26 members of staff in our international team
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languages spoken by our international team: Arabic, French, Mandarin and English
FIND OUT MORE
Shams Maladwala Managing Director of Private Care
For referrals and enquiries, call +44 (0)20 7811 8111 or email privatepatients@rmh.nhs.uk
ON THE COVER Mr Dirk Strauss, Consultant Surgical Oncologist and General Surgeon
Some photographs in this issue were taken prior to the COVID-19 pandemic and may not reflect current PPE guidelines
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U P DAT E
ROBOTICS MILESTONE FOR LEADING SURGEON A ROYAL MARSDEN SURGEON has passed the rare milestone of conducting the same robotic surgery procedure more than 2,000 times – a figure that, it is thought, fewer than one per cent of surgeons reach. Mr Declan Cahill, Head of Urology and Consultant Urological Surgeon, achieves world-leading results for
robotically assisted radical prostatectomy for cancer margins, precision and recovery post-surgery. The procedure involves the removal of the prostate gland and some surrounding tissues in men with advanced prostate cancer. Mr Cahill, who first performed a laparoscopic radical prostatectomy in 2003 and has
WORLD-CLASS RESULTS Mr Declan Cahill
been using robotics exclusively since 2009, said: “The follow-up evidence collected from my patients shows that, each year, outcomes improve. That includes survival rates, improved continence and potency and fewer complications. “Robotics has enabled me to give patients curative surgical options with fewer side effects.”
TALKING POINTS “The hospital’s robotics team is multi-specialised and very well equipped” Page 7
“As surgeons, we are a part of a multidisciplinary team of professionals who all play a valued part”
“Pain is unique to each patient. Therefore, we strive to provide a bespoke service” Page 12
“Sarcoma is a rare and specialised cancer that is treated at very few hospitals across the country” Page 15
Page 10
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IN BRIEF NIHR accolade Professor Christopher Nutting has been appointed as a Senior Investigator by the National Institute for Health and Care Research. Professor Nutting has an international reputation for his research and clinical work in the treatment and management of several types of cancer, including head and neck, thyroid and thoracic.
FAST-TRACKING Amy O’Reilly says patient questionnaires could speed up treatment
Cancer exhibition
The Royal Marsden has supported the curation of the Science Museum’s new exhibition, Cancer Revolution: Science, innovation and hope, which explores the past, present and future of how cancer is prevented, detected and treated. It features personal accounts from our staff and patients, and highlights innovations pioneered by the hospital, such as The Royal Marsden Cancer Charity-funded robotic surgery.
Research prize Consultant Medical Oncologist Professor Nicholas Turner, who specialises in the treatment of breast cancer, has won the 2022 Pezcoller Foundation-EACR Translational Cancer Researcher Award. Professor Turner received the award in recognition of his work developing new therapies for breast cancer and using liquid biopsy tests to deliver more precise treatments for patients.
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PATHWAY TO FASTER CANCER DIAGNOSIS A NEW REFERRAL pathway developed by Royal Marsden researchers aims to speed up diagnosis and reduce anxiety for patients with suspected head and neck cancer. In pathways for other suspected cancers such as prostate and lung, patients may have a scan before being seen in the clinic. But due to the various types of cancer seen in the head and neck region, there’s no single test or procedure to assess everyone referred. The EVEREST-HN trial will investigate whether assessing each patient’s risk before they are seen by a specialist will improve outcomes. Trial Manager Amy O’Reilly said: “We’ll ask patients across 52 centres to complete an electronic questionnaire
about their symptoms before being seen by a specialist, who will determine how they should be managed based on their individual risk. “This could mean that high-risk patients have targeted investigations arranged before being seen in the clinic to ensure that treatment starts urgently if they have cancer. It could also mean lower-risk patients are reassured sooner that it’s unlikely they have cancer, while avoiding unnecessary tests and appointments.” EVEREST-HN is supported by the International Centre for Recurrent Head and Neck Cancer (IReC), thanks to funding from The Royal Marsden Cancer Charity and the National Institute for Health and Care Research (NIHR).
U P DAT E
Artificial intelligence could boost patient surveillance ARTIFICIAL INTELLIGENCE (AI) could help predict the recurrence of lung cancer earlier, according to results from the OCTAPUS-AI study. In a world first, Royal Marsden researchers compared different machine learning (ML) models using data from more than 600 non-small-cell lung cancer (NSCLC) patients to find out which algorithm most accurately identified those at risk of recurrence following curative radiotherapy. ML is a type of AI that allows software to automatically predict outcomes. Dr Richard Lee, Consultant Physician in Respiratory Medicine, Champion for Early Diagnosis and the study’s Chief Investigator, suggests that this technology could be used to detect recurrence earlier in high-risk patients, enabling them to receive further treatment sooner. For those with a low AI BREAKTHROUGH Dr Sumeet Hindocha sees AI helping to detect recurrence in high-risk cancer patients
risk of recurrence, it could mean fewer follow-up scans and hospital visits. Dr Sumeet Hindocha, Clinical Oncology Specialist Registrar and study lead, said: “Right now, there is no set framework for the surveillance of this patient group. This study is an exciting first step towards developing a model to help guide the monitoring of these patients based on their individual risk of recurrence. Next, we’ll test our models using imaging data alone and in combination with clinical data.” This Early Diagnosis and Detection Centre study, in collaboration with Imperial College London, is supported by the National Institute for Health and Care Research Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research, London, and The Royal Marsden Cancer Charity.
JOINT BREAST RESEARCH TEAM WINS TOP AWARD
A team from The Royal Marsden and The Institute of Cancer Research, London, has won one of the world’s most prestigious science awards for work that has transformed treatment for patients with breast cancer. The researchers were named winners of the Team Science Award by the American Association for Cancer Research, which recognised their “seminal translational discoveries in breast cancer research that have led to significant improvements in diagnosis and treatment”. Professor Stephen Johnston (above), Head of The Royal Marsden’s Breast Unit, said: “The close working relationship between our scientists and clinicians facilitates this effort and allows advances from basic research to reach patients quickly. “By targeting the right treatment to the right patient at the right time, we’ll deliver better and more effective care.”
For referrals and enquiries, call +44 (0)20 7811 8111 or email privatepatients@rmh.nhs.uk
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WELCOME TO THE TEAM Introducing the latest appointments to our roster of world-leading consultant surgeons
Miss Rachel O’Connell Consultant Oncoplastic Breast Surgeon After completing training at The Royal Marsden, Miss Rachel O’Connell is now seeing private patients in Sutton and at Cavendish Square. As a Consultant Oncoplastic Breast Surgeon, Miss O’Connell is passionate about providing women with the best possible cosmetic appearance while successfully removing the tumour during breast cancer surgery. Improving the cosmetic outcome after breast cancer surgery was the focus of her MD research degree at The Royal Marsden and The Institute of Cancer Research, London, which she completed during her surgical training. Miss O’Connell has also completed an Oncoplastic Breast Surgery Fellowship at The Royal Marsden. Oncoplastic surgery involves removing the tumour while minimising changes in the
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“Having a good cosmetic outcome is really important psychologically for many women, and something I strive to achieve with each patient” appearance of the breast. She says: “We know that the majority of women do very well after breast cancer treatment, which usually involves surgery and may also involve chemotherapy and radiotherapy. For this
A FOCUS ON AESTHETICS Miss O’Connell’s techniques limit changes in the appearance of breasts during cancer surgery
reason, having a good cosmetic outcome is really important psychologically for many women, and something I strive to achieve with each patient.” Miss O’Connell’s expertise allows her to help more women reach that point in several
N E W C O N S U LTA N T S
ways. She deploys surgical techniques that maintain the shape of the breast as much as possible – for example, removing tissue containing the tumour and replacing it with tissue taken from folds around the breast area, known as a perforator flap reconstruction. Miss O’Connell also works closely with colleagues in the multidisciplinary team to offer each woman who needs a mastectomy the reconstruction that’s best for them. She performs implant-based reconstruction and works with other plastic surgeons on reconstructive surgery using tissue taken from the abdominal wall. Mr Omer Karim Consultant Urological Surgeon Mr Omer Karim, a Consultant Urological Surgeon, will be treating private patients in Chelsea. Having undergone robotic surgery training in 2004, he is one of the UK’s first robotic surgeons. Mr Karim studied at Charing Cross Hospital Medical School, completed postgraduate research at the Johns Hopkins Hospital in the USA, and trained in robotic surgery in Paris. He has since helped set up robotic programmes across the UK, including at St Mary’s Hospital in London, Wexham Park Hospital in Berkshire and Queen Alexandra Hospital in Portsmouth. Specialising in prostate and kidney cancer, Mr Karim is passionate about sharing his expertise in robotic surgery and is regularly asked to teach surgeons in the UK. He has also taught internationally, including in
“Robotic surgery offers patients many benefits, as it often means less trauma and improved recovery compared with traditional techniques” centres across South Africa, Kuwait, Turkey and India. He is an expert in robotic partial nephrectomies, a surgical technique that aims to remove the cancer while sparing as much of the normal kidney as possible, so helping the patient retain kidney function. Mr Karim said: “I am very excited to join The Royal Marsden as it is a highly prestigious institution and, thanks to funding from
A SHIFT IN APPROACH Mr Karim has shared his expertise in robotic procedures with surgeons around the world
The Royal Marsden Cancer Charity, has a world-renowned robotic surgery programme. “Robotic surgery offers patients many benefits, as it often means less trauma and improved recovery compared with traditional techniques like open or laparoscopic keyhole surgery. The hospital’s robotics team is multi-specialised and, with access to three da Vinci surgical systems, very well equipped. I look forward to bringing my skills to the team.”
For referrals and enquiries, call +44 (0)20 7811 8111 or email privatepatients@rmh.nhs.uk
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SUPER SURGEONS IN THE SPOTLIGHT Our skilled surgeons are among the best in the world – and a new documentary is shedding light on their lifesaving roles
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SUPER SURGEONS
AS A CENTRE of excellence for cancer, The Royal Marsden sees patients referred to us from hospitals across the UK for highly complex surgical procedures using state-of-theart technologies, such as The Royal Marsden Cancer Charityfunded da Vinci Xi robot. But our patients can only benefit from these hi-tech devices and pioneering techniques thanks to the skills of our surgeons. Our surgical team has been under the spotlight for almost a year, with a documentary crew filming a three-part series at the hospital. Coming soon to Channel 4, the primetime series follows eight Royal Marsden patients with advanced or relapsed cancers who are preparing for innovative surgery.
AS SEEN ON SCREEN Professor Vinidh Paleri operates on a patient
Building relationships The production team at Wonderhood Studios started filming last September. Patients were approached via their clinical teams to ask if they were willing to share their experience and appear on camera. Embedded with the clinical teams, the crew adhered to the hospital’s strict infection control procedures while researching and filming. They also built close relationships with the patients, whose consent was sought right up until the series was complete.
Will Littleboy, 50, who appears in the series, was referred to Professor Vinidh Paleri, Consultant Head and Neck Surgeon, after his local hospital in Norfolk told him that he needed a total laryngectomy (complete removal of the voice box) to remove his laryngeal cancer. The operation would have left him needing an artificial valve to speak and unable to breathe through his nose. Fortunately for him, there was another option. “I was so relieved when Professor Paleri suggested a procedure that could leave me cancer free and with the ability to speak using my own voice box,” he says. “Taking part in a documentary that celebrates taking on and beating cancer seemed to be the best way to highlight the expertise and exceptional surgical talent at this extraordinary hospital. “It has been a pleasure to work with compassionate, enthusiastic and respectful film-makers who have allowed my story to be told. Hopefully, it will inspire others to have the courage to put their trust in these amazing clinicians.” Professor Paleri says: “The filming was a fascinating experience and, on a personal level, I enjoyed it far more than I expected to. I liked the way the film crew followed the patients on every aspect of their journey at The Royal Marsden.
For referrals and enquiries, call +44 (0)20 7811 8111 or email privatepatients@rmh.nhs.uk
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documentary being filmed. Yet for me, the biggest stars are the patients who allowed themselves to be filmed – an incredible act of bravery and kindness.” Mr David Nicol, Chief of Surgery, says: “This was a fantastic opportunity to showcase the innovative work of our surgical teams. We gave the crew unprecedented access to our work to ensure a true reflection of what happens here every day.”
“As surgeons, we are a part of a multidisciplinary team. Our colleagues include nurses, speech and language therapists, dietitians, junior doctors and anaesthetists, among countless other professionals who all play a valued part and have been pivotal in the process of this
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THEATRE FOCUS Top: Mr Dirk Strauss (centre) midsurgery. Above: Ms Marielle Nobbenhuis puts on surgical PPE
Surgical showcase As well as Professor Paleri, four other surgeons feature across the three episodes: Ms Marielle Nobbenhuis, Consultant Gynaecological Surgeon, Mr Andrew Hayes and Mr Dirk Strauss, both Consultant General Surgeons in the Sarcoma and Skin units, and Mr Ricky Bhogal, Consultant Hepatobiliary Surgeon. “I think, to the outside world, cancer is different,” Mr Bhogal says. “Unless you have
MELISSA FERNANDES E LEMOS 45, uterine leiomyosarcoma patient under the care of Ms Nobbenhuis “When I was asked about filming for the documentary, I thought it would be one good thing that I could do to help others. I was diagnosed late and thought sharing my story could help other women. I think everyone is busy with work and families, and women in particular give so much more time to others than to themselves.”
SUPER SURGEONS
“I hope my story will inspire others to put their trust in these amazing clinicians” experienced it as a patient or through family, friends or work, you don’t have a real picture. Hopefully, this documentary will give people a glimpse of what it is like for cancer patients who are making really difficult decisions about their lives. “I hope the audience will recognise how special The
Royal Marsden is and how all of us working here are striving to find patients a curative option or a treatment that will give them extra quality of life.” Professor Paleri adds: “We all know early diagnosis is key, and we hope anyone watching with any unusual symptoms will go and get checked out. “But also, we want people to watch the documentary and know that if cancer comes back, it is not time to give up – there are treatments available, there are trials available. There is hope.”
ON THE ROTA
Mr Andrew Hayes Sarcoma and skin specialist
Professor Vinidh Paleri Head and neck specialist
Ms Marielle Nobbenhuis Gynaecology specialist
Mr Dirk Strauss Sarcoma and skin specialist
A STITCH IN TIME Mr Andrew Hayes applies a suture at the end of surgery
Mr Ricky Bhogal Hepatobiliary specialist
For referrals and enquiries, call +44 (0)20 7811 8111 or email privatepatients@rmh.nhs.uk
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UNIQUE TO EACH PATIENT Our Cavendish Square centre offers private patients world-class expertise and a multidisciplinary approach to the treatment of cancer-related pain
“PAIN IS A deeply personal and emotive experience that is unique to each patient,” says Dr John Williams, who has led The Royal Marsden’s pain management service for more than 25 years. “Therefore, we strive to provide a bespoke service to each one.” A highly experienced consultant who trained in anaesthetics and pain control in London, Oxford and Baltimore, USA, before joining The Royal Marsden, Dr Williams and his colleagues run clinics at our Cavendish Square centre to
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help private patients cope with painful side effects of cancer. Here, patients with a referral for a pain management review are offered a full assessment at their first appointment. Pain can be divided into two types: acute, which is generally short-lasting, such as pain after surgery; and chronic, which presents for longer than a few months. The pain management team uses a biologicalpsychological-social approach to managing acute and chronic pain that results from cancer. Our experts aim to provide
QUALITY OF LIFE Dr John Williams leads a team that is expert in reducing cancer pain
support, advice and treatment to address all these areas, leading to reduced pain, improved quality of life and rehabilitation. “With improved cancer treatments, many people are living longer with cancer,” says Dr Williams. “Our goal is to improve the quality of the experience by focusing on pain and symptom control. “I’ll form an opinion about what I think is causing the pain and make a plan about the best way to treat it. I see myself as a central hub, with access to different options of pain control.”
PA I N M A N AG E M E N T
RAY SULLIVAN Patient, 62
BESPOKE SERVICE Dr Williams’ team offers access to several pain control options
One such option that has developed hugely in the past few years is interventional treatment. A patient may benefit from a nerve block, an epidural, or more advanced techniques such as implanted pain-relieving pumps or spinal cord stimulators. As part of The Royal Marsden’s particular approach, our neurosurgeons will join the pain clinic’s mutidisciplinary team meeting, where these advanced interventions and neurosurgical techniques for intractable pain are discussed. “What is unique about The Royal Marsden’s pain service at Cavendish Square is the open line of communication with the oncologists and surgeons at the hospital, and with other teams such as the physios or psychologists,” says Dr Williams.
“Our aim is to be a ‘pain-free’ hospital”
“Everything is linked through our electronic patient records, so we know what is going on for the patient in all areas of their treatment and care. “The aim of the team is to make The Royal Marsden a ‘pain-free’ hospital, where we address and treat any pain problems a patient might have.”
OUR PAIN MANAGEMENT OPTIONS Drug treatment Simple drugs such as paracetamol and codeine or stronger opioids such as morphine, oxycodone and fentanyl patches Physiotherapy Supports physical issues around pain management and rehabilitation Psychology Supports emotional issues around living with pain
“I was diagnosed with cancer of the tonsil, which affected areas in my neck and throat. I was fortunate: my cancer was diagnosed fast, and I received exemplary treatment and care at The Royal Marsden. “Due to the position of my cancer, I needed to undergo an intense course of chemotherapy and radiotherapy following surgery. At times during my treatment, I was in severe pain, which could only be controlled with strong morphine medications that required me to be admitted to hospital. “Dr Williams and his team were so patient and kind during what was a difficult time for me. As an outpatient, I was seen at Cavendish Square. It’s a peaceful setting with state-ofthe-art facilities and clinicians who are leaders in their fields. I was almost able to forget I was in a hospital when I was here, safe in the knowledge I was receiving the best treatment and care available. “I am off all pain medication now – something I am incredibly proud of. Within six months of my diagnosis, I was given the all-clear.”
Support services Acupuncture and occupational therapy Interventional treatments Such as pain control via neuro or spinal surgery
For referrals and enquiries, call +44 (0)20 7811 8111 or email privatepatients@rmh.nhs.uk
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MR DIRK STRAUSS Consultant Surgical Oncologist and General Surgeon
MR DIRK STRAUSS is a Consultant Surgical Oncologist and General Surgeon in the Sarcoma Unit and Skin Unit, with a special interest in surgery for limb, retroperitoneal and intra-abdominal sarcomas. Before joining The Royal Marsden in 2008, he trained as a general surgeon in South Africa. He underwent further specialist training in upper gastrointestinal surgery at St Thomas’ Hospital in London and surgical oncology at The Royal Marsden. Before his full-time consultant appointment, he carried out a combined research and clinical fellowship in Surgical Oncology at The Royal
Marsden, culminating in several peer-reviewed publications and presentations in the fields of oncology, sarcoma and melanoma. Mr Strauss actively participates in clinical trials in the UK and Europe and has a principal investigator role, as well as sub-investigator roles, in the Sarcoma Unit. He is the National Coordinator for the European Organisation for the Research and Treatment of Cancer’s (EORTC) STRASS 2 study, and is a member of the EORTC’s Soft Tissue and Bone Sarcoma Group, as well as the British Association of Surgical Oncology and the Connective Tissue Oncology Society.
CAREER HIGHLIGHTS 1989 Graduates in Medicine from University of the Free State, South Africa 2001 Completes Fellowship of the College of Surgeons of South Africa 2002 Graduates with Master of Medicine, specialising in General Surgery, from Stellenbosch University, South Africa 2008 Obtains Fellowship of the Royal Colleges of Surgeons 2008-09 Research and clinical fellowship at The Royal Marsden’s Sarcoma and Melanoma Unit
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2010 Appointed as Consultant Surgeon at The Royal Marsden 2010-22 Joins Connective Tissue Oncology Society, British Association of Surgical Oncology, the British Sarcoma Group and the Transatlantic Australasian Retroperitoneal Sarcoma Working Group 2018 Appointed Chairman of the Local Therapy Committee of the European Organisation for the Research and Treatment of Cancer’s Soft Tissue and Bone Sarcoma Group
Q&A Q What services do you provide at The Royal Marsden’s Cavendish Square centre? A My focus is mainly the initial diagnosis of soft-tissue tumours and sarcoma, as well as treatment. I run initial assessment consultations and, if required, we have diagnostic imaging tests available onsite that can provide results the same day. At Cavendish
C O N S U LTA N T F O C U S
“We have learned how to adapt the surgery and treatment of each sarcoma sub-type to provide a personalised approach”
Square, we also have treatment rooms available. This means we can carry out a biopsy if it is required, or excisions of cysts or skin lesions where appropriate. Q How has the treatment of sarcoma changed over your career? A Sarcoma is a rare and specialised cancer that is treated at very few hospitals across the country. As it is so uncommon, not many
healthcare professionals have expert knowledge about it. Since I began working in this field, it has become clear that the best outcomes for patients with this type of cancer are those who are treated in specialist centres. Therefore, we concentrate on the treatment and management of these patients in specialist multidisciplinary units like we have here at The Royal Marsden. Sarcoma is an umbrella term for a variety of soft-tissue cancers; the behaviour, risks and management of each one of these sub-types are different. Over the years, we have learned how to adapt the surgery, treatment and management of each of these sub-types to provide a personalised approach to each patient’s diagnosis in order to achieve the best outcomes. Q What areas of research are you involved in? A One of my specialist areas
is retroperitoneal, or abdominal, sarcoma. Although surgery is usually successful in treating these tumours, patients often go on to develop recurrence in the same place or elsewhere in the body. One of my research studies is the STRASS 2 study, which is looking at whether giving chemotherapy before surgery for high-grade sarcomas lowers the risk of the cancer coming back in the future. Q What does the future hold for sarcoma patients? A The research themes in sarcoma at the moment involve looking at how to improve long-term outcomes for patients by using chemotherapy or other systemic treatment options to see if we can lower the risk of recurrence. We are also looking at how we adjust our surgical and radiotherapy treatments to make functional and quality-of-life outcomes better for patients.
For referrals and enquiries, call +44 (0)20 7811 8111 or email privatepatients@rmh.nhs.uk
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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