RM M A G A Z I N E AUTUMN 2021
A CARING CAREER How we help nurses like Heather on the children’s and young people’s wards to learn new skills Our innovative work in cellular therapies A focus on fitness: preparing patients for surgery
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.
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EXECUTIVE NOTES
CONTENTS 4 Bulletin What’s happening around The Royal Marsden 12 Presenting progress Showcasing notable research breakthroughs in the US 16 A day in the life On the job with Junior Sister Heather Jones 18 Infused with potential The Royal Marsden is at the forefront of cellular therapies 21 It happened to me Amy Sutton on her journey with acute lymphoblastic leukaemia 22 Fitness first How we ensure physical and mental readiness for treatment 24 Strength in diversity Different backgrounds matter in developing cancer research 28 A novel solution A cheap, simple gel could boost the effects of radiation therapy 30 Puzzles and prizes Test your wits and win a prize with our crossword 31 Stay in touch Your comments on social media, plus hospital contacts
WELCOME to the autumn 2021 edition of RM, the magazine for our staff, patients, carers and Foundation Trust members. In this issue, we look at how we have expanded our work in cellular therapies over recent years. The Royal Marsden is one of the approved NHS centres in the UK to offer CAR-T cell
therapy, an emerging treatment option for some patients with blood cancer, and we run clinical trials using other types of cellular therapies for patients with solid tumours (see page 18). Our research continues to identify and develop new, innovative cancer treatments for patients worldwide. Our clinicians recently presented research at the American Society of Clinical Oncology conference, which was held virtually again this year. You can read about a selection of these studies on page 12. One of our patients recently celebrated being given the all clear from oesophageal cancer. I’m pleased to say he is now the first patient in the UK to be be declared cancer free following a robotic oesophagectomy, showing the impact of pioneering new ways to treat cancer (see page 5). In this issue, you can also read about the work of our prehabilitation team, helping patients get fit for surgery and make a good recovery, ensuring the best outcome and quality of life (see page 22).
ON THE COVER Heather Jones, Junior Sister Some photographs in this issue were taken prior to the COVID-19 pandemic and may not reflect current social distancing and PPE guidelines
Dame Cally Palmer, Chief Executive, The Royal Marsden
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B U L L E T I N W H AT ’ S H A P P E N I N G A R O U N D T H E R O YA L M A R S D E N
Centre takes shape
THE OAK CANCER CENTRE, currently being built at The Royal Marsden in Sutton, is taking shape, with the curved façade now recognisable. The construction team has reached the fourth storey and the project is on track to complete at the end of 2022. By bringing together over 400 staff under one roof, this state-of-the-art research and treatment facility will help us accelerate the development of new treatments and diagnose more cancers at an earlier stage. With floor-to-ceiling windows, it will also mean patients can be cared for in a bright and peaceful environment. The Oak Cancer Centre has been made possible thanks to supporters of The Royal Marsden Charity. To help raise the final millions needed, visit royalmarsden.org/appeal
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PIONEERING PROCEDURE Robotic surgeon Mr Asif Chaudry (left) and patient Mark Howell
? DID YOU KNOW? Director of The Royal Marsden School, Dr Rebecca Verity, has been awarded a Professorship from the University of East Anglia
All-clear for robotic surgery patient FIVE YEARS AFTER undergoing the UK’s first robotic oesophagectomy operation, Royal Marsden patient Mark Howell has been given the all-clear. The 51-year-old plumber had the pioneering surgery – performed by Consultant Surgeon Mr Asif Chaudry using the da Vinci Xi surgical robot – in 2016, after being diagnosed with oesophageal cancer. He also received a split course of chemotherapy. The da Vinci Xi, funded by supporters of The Royal Marsden Cancer Charity, gives surgeons greater precision in their work by providing a magnified, threedimensional view inside a patient’s body. The surgeon also controls
the robotic arms, which can grip scissors and other instruments and provide greater accuracy when performing operations. Mark said he was thrilled to be the first to be cured of oesophageal cancer by the pioneering surgery. He added: “I consider myself very lucky that the timing was right for me to have the robotic operation. I recovered much quicker than I would have with the traditional open surgery.” Since then, Mr Chaudry has carried out 100 robotic oesophagectomy procedures at The Royal Marsden and has helped train robotic surgeons in cancer centres across the world to perform the technique. RM magazine 5
VOLUNTEERS MAKE A GOOD CALL
Shielding and lockdown measures have left some homebound cancer patients feeling lonely and isolated. Now, as part of our Telephone Befriending and Supportive Listening service, these patients are invited to be matched with a trained volunteer, who calls every week for a chat. Edie Cleary, 83, was diagnosed with secondary breast cancer just months after her husband, Michael, died. She said: “The impact of my husband’s death along with the dreadful experience of lockdown have honestly been harder to deal with than the cancer. It’s been incredibly lonely, so my weekly calls have been really helpful.” Volunteer Janet Barton (above), 62, said: “I’ve known family and friends who have had cancer, so I know it can be a lonely and frightening time. It’s been an outlet for me, too – like so many, I’ve missed social connections from normal, everyday life.”
Want to know more? If you’re a patient interested in the befriending service, ask your Clinical Nurse Specialist for more information.
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A NEW HOPE Researchers are aiming to make immunotherapy work for brain cancers
Brain cancer breakthrough COMBINING IMMUNOTHERAPY WITH an experimental cancer drug could offer a new way of treating some patients with aggressive brain cancers, according to early results from the Phase 1 Ice-CAP trial, led by researchers from The Institute of Cancer Research, London, and The Royal Marsden. Two of the first 10 patients treated for glioblastoma on the trial responded to the immunotherapy drug atezolizumab in combination with ipatasertib, a new precision drug. It was particularly effective for patients with defects in the PTEN gene. Study leader Dr Juanita Lopez, Consultant Medical Oncologist, said: “Until now, immunotherapy has not worked for brain cancer. But by uncloaking the disease using ipatasertib, we could make some brain cancers vulnerable to atezolizumab.”
Royal Marsden patient Hamish Mykura, 59, was diagnosed with glioblastoma in 2018 and joined the trial after traditional treatment, including chemotherapy and radiotherapy, stopped working. More than two years on, he has no visible cancer. He said: “Having the opportunity to take part in a clinical trial has been terrific. I now feel cautiously optimistic about the future. The cutting-edge science that has informed my treatment and care is truly remarkable – it’s astonishing that I’m still here.”
“By uncloaking the disease, we could make it more vulnerable”
BULLETIN
New system makes radiotherapy as easy as ABC
Workshops aim to boost patients’ confidence LOOK GOOD FEEL BETTER is holding confidence-boosting virtual group workshops to help cancer patients combat the visible side effects of their treatment, from hair and eyebrow loss to brittle nails and dry skin. Hosted online by trained experts, each session provides participants with a safe, welcoming and fun environment to learn new skills and techniques. Most importantly, they also provide a vital opportunity to chat, share experiences and feel supported at such a challenging time. The workshops are free of charge and cover a range of themes, including Hand & Nail Care, Hair Loss, Scalp Care & New Growth, Chair Yoga and Skincare & Grooming for Men.
LOOKING GOOD The online workshops help cancer patients to feel themselves again
Want to know more? Visit lookgoodfeelbetter.co.uk/ workshops
? DID YOU KNOW? Mr Theo Nanidis and Dr Anna Hurley were awarded the “Best Presentation” prize by the British Association of Plastic, Reconstructive and Aesthetic Surgeons for their paper that focuses on a novel way to calculate the available volume of tissue from a patient’s thigh for use in breast reconstruction.
The radiotherapy team has introduced the newest version of a device that helps patients to hold their breath during treatment to the lungs, and controls the Linac beam switching on and off. Funded by The Royal Marsden Cancer Charity, the Elekta Active Breathing Control Device (ABC 3.0)™ helps regulate the patient’s breathing so that large doses of radiotherapy can be delivered in fewer treatment sessions, with excellent accuracy and lower doses to the surrounding tissue areas. When the patient is in ‘breath hold’, the area of disease and surrounding organs can be seen more clearly on a CT scan. This enables precise definition of the area for treatment. John Wooley (above), 84, has secondary bowel cancer affecting his lungs, and was the first patient to use the ABC device. He said: “The staff put me at ease and explained why they needed my lungs to be so still during treatment. My side effects were much better this time. I’ve had 20 years since my first cancer diagnosis. I told the team I want another 16 so I can get my letter from the Queen!” RM magazine 7
PROSTATE CANCER DRUG COMBINATION SHOWS PROMISE
Men with particularly aggressive prostate cancers can be treated more effectively by combining an existing targeted medicine with a new experimental drug, according to a study led by Professor Johann de Bono, Director of the Drug Development Unit. Results from the IPATential150 study, published in The Lancet, suggest that a combination of abiraterone and ipatasertib can block two of the cancer’s growth signals at once in men whose tumours lacked the PTEN gene. Peter Hartley (above), 68, a patient on the trial, said: “When I was first diagnosed with advanced prostate cancer in 2015, they told me there was nothing they could do and I would only have two to three years left. This was before I joined Professor de Bono’s research trial. “For the past three years, I’ve been given a new lease of life. Being on this trial has been nothing short of a miracle. I’ve had no side effects and my quality of life is fantastic.”
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CT IN THE COMMUNITY Some people may be offered a lung scan following an assessment
Free lung checks in Sutton PAST AND CURRENT smokers in Sutton are being invited for a free NHS lung health check in a drive to diagnose lung conditions – including cancer – earlier. With one of the highest mortality rates for lung cancer in west London, Sutton is one of 23 places across England to run the NHS England Targeted Lung Health Check programme. The lung checks begin with a telephone assessment. Those deemed to be high risk will be invited for a low-dose CT
scan of the lungs in a mobile scanner based in the Tesco car park in Cheam. Dr Richard Lee, Consultant Physician in Respiratory Medicine at The Royal Marsden and the programme’s Joint National Clinical Lead, said: “When lung cancer is caught sooner, we have a much better chance of being able to treat it successfully. “It’s thanks to a collaborative effort that we’re able to mark this milestone, which will ultimately help us save more lives.”
Our commitment to our patients We have developed a patient experience commitment with help from patients, carers, members of the public and staff. The patient experience refers to how the process of receiving care feels for patients, relatives and carers. A positive patient experience is defined by the Department of Health as “getting good treatment in a comfortable, caring and safe environment, delivered in a calm and
reassuring way; having information to make choices, to feel confident and in control; being talked to and listened to as an equal; and being treated with honesty, respect and dignity”.
Want to know more? Read our patient experience commitment at royalmarsden.nhs.uk/ patient-experience-commitment
BULLETIN
Patients to benefit from new pain-relief system THE PAIN MANAGEMENT team has launched a new implantable drug infusion system to help patients control the pain that is commonly associated with cancer and improve their quality of life. The device consists of a small pump that is inserted under the patient’s skin to store pain relief
“This is all about improving patients’ quality of life”
medication and dispense it at regular intervals. Dr Matt Brown, Consultant in Pain Medicine, has led the development and implementation of this new service, establishing The Royal Marsden as one of the lead UK centres for this type of pain management within the newly established National Cancer Pain Network. He said: “This is all about improving patients’ quality of life and functional levels. By using this pump, we can deliver medication directly into the patient’s spinal
fluid, where the pain nerve receptors are located. We can use smaller doses of targeted pain medications often without the side effects experienced from taking stronger oral painkillers. With this service, The Royal Marsden now offers a pain treatment that was previously only available at leading cancer centres in Europe and North America.” EASING PAIN Dr Matt Brown has led the launch of the new service with international pain fellow Dr Saweda Cuthbert
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IN BRIEF
can build a better understanding of the underlying cause of many conditions, which will hopefully help us to predict them and improve how we tailor treatments and care.
Additional resources for collaborative meetings The Royal Marsden’s weekly Adult Psychological MDT meetings now include a wider range of specialised roles, including art therapists, counsellors, psychologists, psychotherapists, mental health nurses and a psychiatrist, making them one of the unique ways in which The Royal Marsden ensures that patient safety and quality of care remain at the heart of the services we provide. Clinical Lead of the Adult Psychological Support Service, Dr Justin Grayer (above), says: “These meetings are an opportunity for us to collaboratively reflect on our work, hear different perspectives and discuss more complex cases.”
New professorships awarded by the ICR
Three Royal Marsden members of staff have been awarded personal Chairs by The Institute of Cancer Research (ICR). Congratulations to Dr Nick van As, Medical Director and Consultant Clinical Oncologist; Dr Ian Chau, Consultant Medical Oncologist; and Dr Michael Hubank, Head of Clinical Genomics, on being awarded the title of Professor.
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Q&A: GENOMICS Natalie Percival, The Royal Marsden’s Divisional Nurse Director and Chief Nurse of the North Thames Genomic Medicine Service (GMS) Alliance, discusses how genomic medicine is changing healthcare Q What is genomics? A Genomics is the study of an organism’s complete set of genetic information, including genes and DNA. It looks at how this information interacts and how that affects the organism. It’s different from genetics, which looks at how a single gene is passed between generations and how variations in this gene may influence certain health conditions. New technology now enables
us to ‘read’ a genome more accurately and quickly than ever before, meaning we have more opportunities to use this information to help our patients. Q How will genomics improve care for patients? A Genomic medicine has the potential to enable us to diagnose rare conditions more quickly and personalise treatment for people with inherited conditions and cancer. Through research, we
“I believe genomics is the future of healthcare”
Q What are the aims of the North Thames GMS Alliance? A It aims to work with all healthcare providers, patients and the public to build trust and support the safe, effective and efficient use of genomics. Its priorities include developing training opportunities for NHS teams in our areas and creating pathways that identify more people with certain genetic conditions and cancer patients at risk of severe side effects from some treatments. We’re also working with patients, carers and the public to identify the needs and concerns of the local community, ensuring their views are represented in all the decisions made by the alliance. Q How did you come to be involved in the alliance? A I’m passionate about change, and I believe genomics is the future of healthcare. When the alliance launched earlier this year, I was really excited to join the team. As Chief Nurse, I work with incredible nurses and midwives every day to develop and embed pathways that will enable genomics to improve care for patients. I support nursing colleagues and the wider multidisciplinary team to feel confident in bringing genomics into their practice.
BULLETIN
Campaign puts spotlight on lung cancer in ‘never smokers’ BRENDA, 64 NON-SMOKER SYMPTOMS: PERSISTENT COUGH DIAGNOSIS: STAGE IV LUNG CANCER
Brenda isn’t alone. Unfortunately, 57% of lung cancers aren’t diagnosed until stage IIIb or IV. Symptoms can include a persistent cough, breathlessness, recurrent chest infections, back or shoulder pain, hoarseness or swelling in the face or neck. If you see persistent or unexplained symptoms, please consider a CXR or referral on the Lung Cancer Pathway.
For more information: lungcancerseethroughthesymptoms.uk
Regd. lung cancer charities
TWO LUNG CANCER patients who are being treated at The Royal Marsden have created a striking new campaign to raise awareness of the disease in ‘never smokers’. More than 57 per cent of lung cancer patients in the UK are diagnosed at stage 3 or 4 (UKLCC 2020 Early Diagnosis Matters), once cancer has spread. So patients Jenny Abbott and Debra Montague, who founded the charities EGFR Positive UK and ALK Positive UK respectively, teamed up with the Ruth Strauss Foundation to urge GPs and healthcare professionals to act on lung
SEEING THROUGH The campaign photos by Rankin show lung cancer patients who have never smoked, including Brenda (left), who is a patient at The Royal Marsden
cancer symptoms, regardless of a person’s smoking history or age. Jenny says: “Incidences of lung cancer in people who have never smoked are increasing. The fact that so many are diagnosed with late-stage disease suggests that it is under-recognised by GPs.” The See Through the Symptoms campaign also features photographs taken by renowned photographer Rankin, who lost his mother to lung cancer in 2005. The images capture nine never smokers who were diagnosed with stage 4 lung cancer.
Rainbow badges reflect inclusivity
The Royal Marsden has welcomed NHS rainbow badges. They reflect our support for LGBT+ people, including staff, visitors and patients, and are a sign of our commitment to inclusivity. Each staff member who wears a badge has signed a pledge, declaring their understanding of the badge initiative and their advocacy for LGBT+ people. If approached about sexuality or gender issues, we will actively listen and provide advice or signpost to support, as appropriate. These badges are small, but they can make a big impact. We hope the badges will encourage LGBT+ people to be their true selves with healthcare professionals, ensuring that they have the best possible experience at the Trust. Every single person deserves the same access to healthcare, and the NHS rainbow badges are one way of showing that The Royal Marsden is welcoming of everyone.
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PRE SEN T ING PROGRE SS We highlight the notable research breakthroughs showcased by our experts at the recent American Society of Clinical Oncology Annual Meeting 12 RM magazine
ASCO
IN JUNE, EXPERTS from The Royal Marsden presented the results of their pioneering research to a global online audience at the American Society of Clinical Oncology (ASCO) Annual Meeting, the world’s largest cancer conference. Thousands of cancer researchers and clinicians, patients and press attended the virtual event to learn about the latest advances in oncology. With our researchers presenting across a range of topics and multiple tumour groups, The Royal Marsden continues to hold an international reputation for revolutionising the way we provide cancer treatment and care.
ENCOURAGING RESULTS Mr Aadil Khan’s review highlighted the benefits of vascularised lymph node transfer
Breakthrough treatments for oesophageal cancer There was positive news on the benefits of two immunotherapy treatment options that have shown significantly improved long-term survival rates for patients with advanced oesophageal cancer. The results of the CheckMate 648 study, led by Consultant Medical Oncologist Dr Ian Chau, suggest a breakthrough that could transform treatment for this incurable disease. The global randomised Phase 3 study enrolled 970 patients with previously untreated, unresectable advanced, recurrent or metastatic oesophageal squamous-cell carcinoma. It found that patients who received immunotherapy treatment – either nivolumab and chemotherapy, or nivolumab with ipilimumab – survived longer overall than those who received chemotherapy alone. “After decades of little progress in using chemotherapy for oesophageal cancer, this study
“We’ve found two new immunotherapy treatment options” RM magazine 13
has found not one but two new treatment options using immunotherapy to extend life for these patients,” says Dr Chau. “The clinically meaningful improvements in survival of the two treatment regimens highlight immunotherapy’s impact on cancer care and should bring new therapeutic options to a group of patients that are often diagnosed when their disease has already spread. This could have a practicechanging impact for patients globally in the future.”
“This could be key to the development of a targeted brain cancer treatment”
A PATIENT’S PERSPECTIVE Roy Norwood, 76, oesophageal cancer patient
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EXTENDING LIVES Dr Ian Chau (above); Dr Juanita Lopez (right)
Early promise for targeted brain cancer drug Dr Juanita Lopez, Consultant Medical Oncologist, presented encouraging early results from a Phase 1 trial called BAL101553 that could lead to the first-ever targeted brain cancer treatment. Results showed that two of the first 20 patients treated for glioblastoma, a highly aggressive type of brain cancer, responded to the targeted drug lisavanbulin. Researchers from The Royal
“I was diagnosed with oesophageal cancer in 2019 and was told about the trial running at The Royal Marsden. I didn’t have to think about whether or not I would go on it because I didn’t have any other options. “The treatment has gone really well, and my doctor has been pleased with the way I’ve
Marsden found that the treatment was particularly effective in patients with a high expression of a protein called EB1, with two of the three EB1-positive patients showing a long-lasting response to the drug. One patient’s tumour shrank by more than 90 per cent. “We are in a new era of personalised medicine, with markers in cancer cells offering vital clues to what treatment could target an individual’s disease,” says Dr Lopez.
responded. Last summer, after a year of treatment, I was told I was cancer free, which was more than I could have ever hoped for. The disease came back a few months later, but I’m still on treatment and have a good quality of life. I consider myself very lucky, as without the trial I wouldn’t be here.”
ASCO
“We believe that our findings from this trial could be a key step in the development of the world’s first targeted brain cancer treatment, offering hope to some patients with aggressive glioblastoma. People with brain cancer have very poor survival rates and lack treatment options, so this could be a welcome addition to our limited arsenal of tools to combat the disease.” A step forward for advanced melanoma treatment Professor James Larkin, Consultant Medical Oncologist, presented promising results from the Phase 2 C-144-01 trial, which showed that lifileucel, a tumour-infiltrating lymphocyte (TIL) therapy, could stop or reverse the progression of advanced melanoma. More than a third of patients on the trial responded well to this innovative type of cellular immunotherapy, which uses the patient’s own T cells to fight cancer. “These results show that TIL therapy could offer sustained benefits to some patients with advanced melanoma that can improve over time, which could provide a new treatment for people who currently have no other options,” says Professor Larkin. “Along with potentially extending patient’s lives, this one-off treatment also means less time in hospital compared to treatment with other immunotherapies.” Promising surgery cuts lymphoedema swelling A meta-analysis conducted by the plastic and reconstructive surgery team reported that vascularised lymph node transfer (VLNT)
“TIL therapy could benefit patients with no other options”
reduces swelling and the risk of infection in patients who develop lymphoedema following cancer treatment, and significantly improves their quality of life. VLNT is a microsurgical procedure that reconstructs lymphatic function by taking tissue containing lymph nodes (a lymph node flap) from an unaffected part of the body and transplanting it into the affected limb. Data from 581 patients and 31 studies from 15 countries showed that excess limb volume reduced by 40 per cent in patients who had undergone VLNT in the upper limb and by 34 per cent for those with lower-limb lymphoedema. “Our review is the first to quantify the potential therapeutic benefit of VLNT in reducing both limb volumes and the risk of infection in patients with lymphoedema after cancer treatment,” says Mr Aadil Khan, Consultant Plastic Surgeon and joint senior author for the study. “We are encouraged by the findings of our meta-analysis and are currently developing a randomised clinical trial to formally evaluate the benefit this technique might bring to patients with lymphoedema.” RM
NEW POSSIBILITIES Professor James Larkin presented news on TIL therapy
A PATIENT’S PERSPECTIVE Paul Nicholson, 37, glioblastoma patient on the BAL101553 trial
“When I was diagnosed with glioblastoma in 2017, my estimated life expectancy was just over one year. My initial treatment with radiotherapy and chemotherapy didn’t work, so it was a huge relief to join this trial at The Royal Marsden. “I was told there was a five per cent chance the drug would work. But three years on, my scans are still looking good, and my cancer has shrunk by more than 90 per cent.”
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A DAY IN T HE L IF E OF
HE ATHER JONES JUNIOR SISTER
I’VE BEEN CARING for teenagers and young adults in The Royal Marsden’s Teenage Cancer Trust Unit (TCTU) – part of the Oak Centre for Children and Young People (OCCYP) – for nearly eight years. Ever since I was three years old, I knew I wanted to be a nurse. My grandmother was treated at The Royal Marsden, so I grew up hearing what a special place it is. I successfully applied for the Junior Sister Development Rotation Programme after working my way up from a band 5 staff nurse role to become a senior staff nurse. It’s a new 15-month programme that helps nurses to progress in their COURSEWORK AND CARE Heather is gaining experience in a senior nursing position while supporting junior staff to care for young patients
careers by bridging the gap between the roles of senior staff nurse and ward sister, enabling us to build experience before taking on more senior roles. Janine Shearing and Rosie Formella, who are also nurses in the OCCYP, are enrolled on the programme, too. All three of us will be working on our usual wards for nine months and then will rotate around McElwain Ward and the children’s Day Care Unit. Varied role I work a four-day week, which consists of two dedicated programme days – one for
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A D AY I N T H E L I F E
learning and development and one for management – as well as two days on the TCTU. The learning and development days are quite structured and give me time to complete courses in coaching and enhanced leadership, for example. I also shadow staff in the Children and Young People’s Unit, such as the safeguarding teams or the haematology matron, who I normally wouldn’t have much contact with. The aim is to develop a better understanding of how the department and the hospital operate, because thinking about the bigger picture is important for a more senior position. My management days, on the other hand, are incredibly varied. Sometimes I am completely officebased, which can involve managing rotas, budgeting, completing incident reports and monitoring mandatory training. At other times, I’m on the ward supporting the team. For example, I often help new joiners settle in by working shifts alongside them or sign off new skills for junior staff, such as canulation. I’m also there to do things like debriefing when something challenging happens with a patient or managing appraisals and monthly reviews. Ward support Our participation means that the ward sisters for children’s and young people’s services have additional support, as they would usually be responsible for the tasks we do on management days. It’s great that we can ease their workload –
“The programme takes me out of my comfort zone so I can learn new skills”
particularly during the past year, which has been so challenging. For example, I’ve helped ensure that my ward is on top of the latest restrictions and guidance, and provided extra emotional support to staff, patients and their families. The team, including the unit sisters and practice educators, have been a great help while I complete the programme. I’m looking forward to the next phase when I’ll have the chance to work on the two other units. It will take me out of my comfort zone so I can learn new skills. I’m incredibly grateful to The Royal Marsden for providing this new opportunity for senior nurses – it’s wonderful to work somewhere that values career progression for its staff. RM RM magazine 17
SUPPORTING PATIENTS Dee Moloney, Clinical Nurse Specialist
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CELLULAR THERAPIES
INFUSED WITH POTENTIAL Using the body’s immune cells to target cancer, cellular therapies are showing great promise – and The Royal Marsden is at the forefront CELLULAR THERAPIES ARE emerging forms of immunotherapy that harness the power of T cells – a key infection-fighting immune cell – to target both blood cancers and solid tumours. These complex therapies use a technique known as adoptive cell transfer, in which the patient’s own T cells are harvested to be grown or modified in a laboratory to boost their ability to attack cancer, before being given back to the patient. The Royal Marsden’s cellular therapy programme has grown significantly since we treated our first patient in 2019. To support this expansion, we have set up the Cancer Biotherapeutics Unit and upgraded our stem cell and cellular therapy laboratory. Today, we are one of the NHS’s approved centres for chimeric antigen receptor T-cell (CAR-T) therapy and have treated more than 20 patients with NHS-approved CAR-T products since December
“We’re trialling CAR-T therapy in plasma cell myeloma patients”
2019. We are also set to use other pioneering cellular therapies, including tumour-infiltrating lymphocyte (TIL) therapy and T-cell receptor (TCR) therapy in clinical trials. CAR-T therapy In CAR-T therapy, T cells are isolated from the patient’s blood using an apheresis machine, in the similar way that stem cells are harvested before a transplant. They are modified to produce proteins called chimeric antigen receptors that allow them to recognise and lock onto cancer cells, and these CAR-T cells are then reinfused into the patient’s bloodstream. This promising treatment is approved on the NHS for patients with relapsed diffuse large B-cell lymphoma and relapsed mantle-cell lymphoma (a rare type of non-Hodgkin lymphoma), as well as patients aged up to 26 with relapsed B-cell acute lymphoblastic leukaemia. “The three CAR-T products currently available on the NHS target the CD19 antigen biomarker,” says Dr Emma Nicholson, a Consultant Haematologist who leads on the development of cellular
EMERGING POSSIBILITIES Dr Andrew Furness is researching cellular therapies in solid tumours
therapies for blood cancers in the Cancer Biotherapeutics Unit. “A clinical trial is due to open soon that will target a marker called BCMA and will recruit patients with plasma cell myeloma who aren’t able to have stem cell transplants.” Patient support Patients who undergo CAR-T therapy are supported by a multidisciplinary team of doctors, nurses, psychologists, allied health professionals, pharmacists, and Critical Care Unit (CCU) and palliative care specialists. “Our patients have relapsed disease, so waiting up to a month for their personalised CAR-T product to be manufactured is a stressful time for them and their families,” says Dee Moloney, RM magazine 19
CELLULAR THERAPIES
A PATIENT’S PERSPECTIVE
a Clinical Nurse Specialist who focuses on cellular therapy treatments. “We offer bridging therapy – such as further chemotherapy, radiotherapy or steroids – as a means of keeping their disease under control until they can receive CAR-T therapy. “Patients may also require CCU support, so we have an excellent team who monitor, treat and help them recover after the infusion.” Solid tumours Beyond CAR-T therapy, additional approaches are being explored against solid cancers, including TIL and TCR therapy. In particular, there have been promising results in clinical trials for patients with advanced melanoma for whom standard immunotherapy has been unsuccessful. With this treatment, part of the tumour is surgically removed in order to harvest T cells that are naturally capable of infiltrating the cancer. These are then activated and grown in large numbers before being reinfused into the patient. Dr Andrew Furness, a Consultant Medical Oncologist who is leading on cellular therapies in solid tumours for the Cancer Biotherapeutics Unit, says: “TIL therapy appears to offer the potential for durable control for a proportion of patients with advanced melanoma whose disease appears resistant to standard approaches. “We are now looking to extend this therapy to patients with other tumour types, including advanced lung and head and neck cancers, at an earlier stage in their treatment.” What the future holds This year, led by Dr Furness, The Royal Marsden will open its first trial of TCR therapy for patients with a rare type of sarcoma. Like CAR-T therapy, TCR therapy involves modifying T cells 20 RM magazine
Kevin McNulty, 71
with a receptor so they recognise specific targets in a patient’s tumour. Meanwhile, the Cancer Biotherapeutics Unit will continue to explore how effective cellular therapies are in treating blood cancers and solid tumours. It will focus on whether we should be using cellular therapies as a first-line treatment, understanding why some patients experience adverse side effects, and how to select patients who will have the best response. RM
PROMISING APPROACH Dr Emma Nicholson is leading the development of cellular therapies for blood cancers
How do cellular therapies work? The patient’s T cells are harvested from the bloodstream or tumour
These T cells are modified in a laboratory to enhance their ability to recognise and attack cancer cells The modified T cells are then infused back into the patient via an intravenous drip
“I had CAR-T therapy to treat my diffuse large B-cell lymphoma last year. I was diagnosed with stage 4 disease in 2019 and had been through two lots of chemotherapy when I was told it was not working. I was at my lowest ebb. Without treatment, it was predicted I’d last a couple of months. “I’d never heard of CAR-T therapy when the doctors first mentioned it. It sounded like science fiction compared to my previous treatments, but I had run out of options. After speaking to Dr Nicholson about the process, it was an easy decision to go for it. “I went to The Royal Marsden in Sutton to have my T cells taken from my blood using an apheresis machine in early May. I had some holding treatment to keep me going for the month while I waited for my cells to be modified and infused back into me. “I was in hospital in Chelsea for a month following the infusion – and for a few of those days, I was in the CCU. But on day 28, a scan showed I was clear of disease. I could not be more grateful.”
IT HAPPENED TO ME
I’VE BEEN LOOKED AFTER BY THE ROYAL MARSDEN FOR 24 YEARS. NOW I’M FINALLY LEADING A NORMAL LIFE Amy Sutton, 33, leukaemia patient
and started my own business as a hatter. At this stage, I had a lot of complications and severe side effects, including malabsorption and malnutrition, as a result of years of intensive treatment. I weighed just 33kg and was incredibly weak. I needed help getting up from chairs or out of cars. I had intensive physiotherapy and, to build up my strength and increase my weight, I was introduced to Dr Darina Kohoutova and the Gastrointestinal and Nutrition Team service (GIANTs) in 2019. They’ve had a huge impact
“I was incredibly weak, but the nutrition team had a huge impact on my recovery”
I WAS FIRST diagnosed with acute lymphoblastic leukaemia (ALL) at three years old. When I was eight, I was referred to The Royal Marsden after it was discovered I had ALL for the third time, as well as a tumour in my brain. I needed radiotherapy and chemotherapy to get me into remission and to prepare me for a bone marrow transplant.
The procedure was a success, but it took me ages to fully recover. I was then diagnosed at 15 with chronic myeloid leukaemia and again aged 29. Both led to further treatment and two more bone marrow transplants. Despite this, before my fifth diagnosis, I had 12 really positive years when I was cancer free. I met my fiancé, Carlos, got a degree in costume design
on my recovery. They helped me to get the nutritional supplements I needed, and recommended that I have a feeding tube inserted into my stomach and take medication that helps break down fats. Within months, I had more energy and began to feel stronger. I reached a healthy weight and could eat solid foods – and this April, I had my feeding tube removed. I’ve even taken part in two challenges this year to raise money for The Royal Marsden Cancer Charity, including walking 15 miles around my local area for The Banham Marsden March. I’ve now been in remission since October 2018. Although I’m still working with the GIANTs team to manage the side effects, the cancer has gone, I’m leading a normal life – and Carlos and I plan to get married in a lighthouse in Scotland next year. RM
Professor Darina Kohoutova
Lead of GIANT service “It has been a real joy to get involved, together with our specialist dietitian Catherine Fleuret, in Amy’s treatment. Amy was diagnosed with severe malnutrition and a feeding tube was inserted for almost two years. Improving her nutritional status was limited by severe bile acid malabsorption, so it was important to find the right balance of medication, nutrition via gastrostomy and oral diet. Amy’s weight increased by 13kg and her gastrointestinal symptoms improved dramatically, so her tube was removed in April. It has been a privilege to work with Amy and to see her flourish. We wish her and Carlos the very best for their future.” RM magazine 21
WHEN A CANCER patient needs surgery, it’s important that they are fit and healthy enough to withstand the physical rigours of the procedure and ensure the best outcome. The Royal Marsden’s prehabilitation service encompasses a range of therapies and medical support to put high-risk patients in the strongest position to be considered eligible for surgery. This means we can avoid cancelling or postponing their operations and enables them to recover more quickly. Our upper gastrointestinal (GI) team has implemented SUMMIT, a multidisciplinary meeting where surgeons, anaesthetists, physiotherapists, dietitians, psychologists and anaemia nurses come together to make a full physical assessment of patients. This involves considering any existing medical conditions, such as diabetes, anaemia or high blood pressure. “We know these can affect patient outcomes, so identifying them with enough time to take action and control them is vital,” says Dr Susanna Walker, Consultant Anaesthetist and Clinical Lead for Surgical Prehabilitation Pathways.
FI T NE S S FIRS T Our prehabilitation service works with patients to ensure they are physically and mentally ready to undergo cancer treatment such as surgery 22 RM magazine
Personal plan The team devises a prehabilitation treatment plan, which can include help from dietitians and physiotherapists, guidance to reduce smoking and alcohol consumption, and psychological support. In the first year of the programme, postponements of upper GI surgery decreased by 60 per cent. But the benefits for patients continue after surgery. “Patients who are properly prehabilitated can take a more active lead in their rehabilitation,” adds Dr Walker. Adrian Fautly is an exercise therapist who receives referrals from the physiotherapy team. He works with patients one-to-
P R E H A B I L I TAT I O N
one and in group classes, and makes weekly calls to check their progress and keep them motivated. He also offers virtual fitness classes and video guidance. “If someone is very inactive when they go through treatment – which a lot of people are because of the side effects – their physiology will change dramatically,” Adrian explains. “Then, when considered for surgery, their recovery is likely to be severely affected because of the significant level of deconditioning and muscle weakness. Our work is about reducing any further deconditioning, but the key thing is to ensure they’re fit for surgery.” The key challenge for patients is motivation. “People are worried that with low energy, any kind of exercise is going to be taking more of that energy away,” Adrian says. “Actually, that isn’t the case: it will help to release energy.” Eating well Crucially, physical activity must go hand in hand with nutrition to give the patient the greatest benefit. Natalie Harris, a Senior Specialist Dietitian working on prehabilitation,
“If someone is inactive during treatment, it affects their recovery”
HEALTH CONSCIOUS Adrian Fautly (left); Natalie Harris (above left) and Dr Susanna Walker (above) are part of our prehabilitation service
says: “Growing evidence supports the work of dietitians to prepare cancer patients before – and optimise them during – treatment with good nutrition, particularly before surgery. “It can be difficult for patients to know how to make the best food choices when faced with a new and rapidly changing set of symptoms and circumstances, so having the support of an expert in nutrition and cancer is highly valued.” Alongside this, a psychological wellbeing team helps patients to cope with their diagnosis, motivate themselves and learn techniques to improve their mental health. In the future, the prehabilitation team hopes to broaden the service to all cancer patients. “More and more people are surviving cancer,” says Dr Walker. “Prehabilitation provides people with the knowledge and autonomy to help themselves in the long run.” RM
A PATIENT’S PERSPECTIVE Lynda Nash, 65 “I was diagnosed with oesophageal cancer in 2019. As a smoker with diabetes and COPD [chronic obstructive pulmonary disease], I was considered high risk and not fit enough for the operation. But I was determined that cancer wouldn’t take me. “Everyone at the hospital was marvellous – they helped me get fit enough for surgery. I gave up smoking and started the exercise programme. It was hard, but I kept going for my grandchildren. “I had my operation in January 2020, and the team are still there for me. I’m not diabetic any more, and I still do my exercises regularly.” RM magazine 23
S T R ENG T H IN DIVERSI T Y It’s vital that The Royal Marsden listens to the opinions of people from different backgrounds when developing cancer research and our services. Here, three patients tell us why they got involved
ANY PATIENT, CARER or member of the public can get involved in helping us to improve the research we undertake and the services we deliver at The Royal Marsden. Our patients and their carers know better than anyone what it is like to receive cancer treatment and the impact of side effects on their quality of life. Their input provides valuable insight that helps researchers and health professionals understand what matters most to people affected by cancer, challenges and shapes their decisions, and ensures we design research that is easier for patients to understand 24 RM magazine
and services better tailored to their needs. Sex, age, race and ethnicity all play important roles in how different types of cancer and treatments affect people. So it’s vital that we get feedback from people from varied backgrounds to reflect the true breadth of lived experience. The more diverse our patient and public involvement groups are, the greater the impact we can have on new cancer treatments and improved care for everybody.
Della “When I was diagnosed with breast cancer 10 years ago, I was shocked as I thought only white people got cancer. The experience opened my eyes to the lack of awareness of the disease within my community and the need for better representation everywhere, from clinical trials to charity marketing materials. Diversity in research and service design is vital to ensure treatment and care are tailored to everyone’s needs. For example, side effects from drugs can vary based on characteristics like gender and ethnicity, so the more people they’re tested on the better. I’ve also struggled to find a prosthesis to match my skin tone, which highlights the need for more inclusion in clinical design.”
PAT I E N T I N V O LV E M E N T
How can I get involved? There are several ways to contribute to our research and service delivery:
Kierran “There are a lot of benefits for people like me to be involved in shaping research. As an ethnic person, I’m less likely to find a donor, especially at my age, as I was diagnosed with leukaemia at 21. Also, it would have been good to know someone like me was on the back end. If I can survive it with the support that I had, then I think I should pass that on. Survivors should be part of the process to help others get to the finish line.
• Attend patient and public engagement events such as open days • Join a group such as the Patient and Carer Advisory Group to contribute to our services delivery • Become a member of the Patient and Carer Research Review Panel and contribute on research proposals and documents • Become a member of one of our Trust committees or a research co-applicant and collaborator You can do one or more of these things and change your mind at any time. We’ll provide training and support, and we’ll reimburse your travel and other out-of-pocket expenses.
“If we don’t talk about our cancer experiences, our needs won’t be met”
Want to know more?
Eshant “Everyone’s bodies are different, so the more people that get involved in research studies, the more data doctors will have when developing treatments. Patient involvement can also help tailor services to ensure they’re accessible for everyone. I’ve been part of a committee where I would provide feedback on things like leaflets or event marketing to make them more patientfriendly. This could be making sure a variety of people are represented in the images or checking the language is appropriate and not too aggressive or patronising.” RM
To find out more, email patientsinresearch@ rmh.nhs.uk to help us shape our research and patients.engagement @rmh.nhs.uk to support service delivery. You can also get involved online via our new platform, Cancer Patients’ Voice (patients-voice. cancerbrc.org)
RM magazine 25
to eat cake, get crafty or play some games – all to support The Royal Marsden Cancer Charity. By hosting a Marsden Morning, you’ll be helping us to build the new Oak Cancer Centre, which will speed up the development of life-saving treatments and help diagnose more cancers at an earlier stage, when treatment is more likely to be successful.
Back by popular demand, Anya Hindmarch’s ‘Be A Bag’ service has relaunched with six new designs in support of The Royal Marsden Cancer Charity. The ‘Be A Bag’ collection is available online and in The Village Hall, the centre of our Charity Trustee Anya Hindmarch’s new Village on Pont Street. Originally inspired by a present Anya gave to one of her closest friends, a washbag printed with a newborn’s passport photo, the service uses pioneering digital technology to allow people to personalise bags with photographs of their fondest memories or loved ones. The collection, made using an innovative new cotton-canvas feel fabric created from recycled plastic bottles and finished with leather trims, includes tote bags, a mini crossbody, washbags and a framed clutch. The Royal Marsden Cancer Charity will receive a £10 donation from the sale of each tote and cross body bag, and a £5 donation from each washbag and clutch.
Want to know more?
Want to know more?
Sign up for your free kit today at royalmarsden.org/morning
For more information, visit anyahindmarch.com
MARSDEN MORNING COULD YOU HOST your own Marsden Morning and help build hope for cancer patients? On Friday 22 October we are launching our first ever Marsden Morning, and we want you to get involved! Invite your friends, family or colleagues
Eat cake, get crafty or play games with friends to support our Charity 26 RM magazine
Photograph: Getty Images
Beautiful keepsake in the bag
T H E R O YA L M A R S D E N C A N C E R C H A R I T Y
Out of this world
We’re excited to announce that Spacemasks.com have renewed their support for The Royal Marsden Cancer Charity for a third year. To date, the partnership has raised £20,000 for the Oak Cancer Centre appeal. Spacemasks are self-heating eye masks to combat tiredness and stress. Within minutes of putting on a Spacemask you will feel it warm up and help you relax.
Want to know more? For every box of exclusive rosescented Spacemasks sold, £1 is donated to the Charity. Visit spacemasks.com
Making Celebrate a Life extra special CELEBRATE A LIFE is our annual carol service in December when supporters make a donation to have a star decoration named for someone special and hung on the Christmas trees outside the hospital. Last year, due to the pandemic, we were not able to be together. Instead, we held the event virtually and raised over £112,000. Roma Sharma, Celebrate a Life Supporter, said: “I
attend this service each year in memory of my father and brother. This service means a lot to me and it’s my chance to thank The Royal Marsden for giving me more time with my family. I am so pleased we could still take part last year despite the restrictions.” This year we are planning to make the service even bigger by holding in-person events at Chelsea and Sutton, as well as livestreaming the event online so that anyone
can take part. We will also have the digital tree on our website again so that supporters can see the star that they name on the digital tree if they are unable to attend the events. The Sutton event is on 7 December, the Chelsea event on 9 December and both will be livestreamed.
Want to know more? To name a star for someone special, please visit royalmarsden.org/star
Contact The Royal Marsden Cancer Charity Telephone 020 7808 2233 Email charity@royalmarsden.org Visit royalmarsden.org Registered Charity No. 1095197
Let your memories light up London This December, thousands of beautiful white roses will light up Mayfair’s Grosvenor Square as part of a light installation to remember those we have lost this year and to raise funds for The Royal Marsden Cancer Charity. Anyone can make a donation in person or online to have a white rose dedicated to someone, creating a beautiful and touching display of white lights and a peaceful, stunning way to commemorate those lost. The event is supported by Claridge’s hotel and The Connaught. The idea for the garden came from Charity Trustee and designer Anya Hindmarch, and fashion creative and writer Camilla Morton, in memory of the late production designer and art director Michael Howells. RM magazine 27
RADIOTHERAPY BOOST Dr Navita Somaiah
A NOVEL SOLUTION The BRC is trialling the use of a cheap, simple gel to boost the effects of radiation therapy in breast cancer RESEARCH FUNDED BY the NIHR Biomedical Research Centre (BRC) at The Royal Marsden and The Institute of Cancer Research (ICR), London and pharmaceutical firm KORTUC Inc is investigating whether the common antiseptic hydrogen peroxide can enhance the cancer-killing effects of radiotherapy in breast cancer patients. Of the two million patients affected by breast cancer worldwide, 60-80 per cent are diagnosed with locally advanced disease. This can cause debilitating symptoms that affect their quality of life. For these patients, radiotherapy 28 RM magazine
with or without hormone therapy is often more appropriate than chemotherapy or surgery. Finding a simple, inexpensive way to improve the effectiveness of radiotherapy would therefore be highly beneficial for patients and health services around the world. Hydrogen peroxide plays a vital role in normal cellular processes, but at higher concentrations could make tumour cells more sensitive to radiation therapy. Hydrogen peroxide breaks down into molecular oxygen in tumours, thereby potentially overcoming radiation resistance due to oxygen starvation. Dr Navita Somaiah, a Consultant
Clinical Oncologist at The Royal Marsden and a Clinician Scientist at the ICR, led a Phase 1 trial to test injecting a gel solution of hydrogen peroxide directly into breast tumours before radiotherapy, and found it to be safe and well tolerated. The effectiveness of this method is now being evaluated in a randomised, controlled Phase 2 trial called KORTUC, involving 184 patients at six UK centres – The Royal Marsden; Beatson West of Scotland Cancer Centre; The Christie; Royal Cornwall Hospital; Addenbrooke’s Hospital, Cambridge; and University Hospitals of North Midlands – with plans to expand to India. The aim is to apply for licensing of the treatment in the UK at the end of the trial. Radiotherapy is one of the world’s most widely used cancer treatments, with most oncology centres having access to it in some form. As about 40 per cent of breast cancer patients worldwide are from Brazil, Russia, India and China – all countries with rapidly expanding radiotherapy resources – this safe and simple intervention could have a huge impact around the globe. The gel is cheap and easy to produce and store, and doesn’t require state-of-the-art equipment to use – so, if approved, it could be quickly rolled out worldwide, including in low- and middleincome countries. And if it is proven to be effective in breast cancer, the intervention could be quickly evaluated for use with other challenging diseases, such as head and neck cancers, cervical cancer and soft-tissue sarcomas. RM
What is the Biomedical Research Centre?
The National Institute for Health Research-funded Biomedical Research Centre for cancer is a partnership between The Royal Marsden and The Institute of Cancer Research, London. It supports the rapid translation of leading-edge cancer research from the laboratory and into a clinical setting. Find out more at cancerbrc.org
F O U N DAT I O N N E W S
MEET THE GOVERNOR
Dates for your diary Board of Directors meeting 28 September Annual General Meeting 28 September Council of Governors meeting 4 October Board of Directors meeting 8 December Council of Governors meeting 13 December
OUR COUNCIL OF Governors has a pivotal role to play in representing the interests of members (patient/ carers/public and staff), the public and partner organisations across the health community. Dr Banan Osman was elected as a Public Governor in May 2021.
Q Tell us briefly about yourself. A I am the youngest child of a banker and a heavily involved housewife. My mother was passionate about charity and effecting change in her community. I’m now a mother to a ninemonth-old baby girl and am currently in my final year in urology training in Surrey to become a Consultant Urologist. I’m a teaching Faculty member of the Royal College of Surgeons England and an Honorary Clinical Tutor for the Severn School of Surgery. I’ve also held the position
“Joining the Council is a great opportunity to use my experience”
of Assistant Director of Training for surgical specialities at the Sudanese Medical Association international training school.
Q What is your connection with The Royal Marsden? A In 2011/2012, I worked as a Sarcoma and Plastics junior doctor at The Royal Marsden, during which time I was appointed as a Surgical Doctor Trainee Representative in the Junior Doctors’ Forum. I’ve also been a volunteer with the Friends of The Royal Marsden since 2017. Q What made you decide to stand for election to be a Governor? A The past year has been an example of change and adaptation, as well as a challenging period for the NHS. The excellence in care provided by The Royal Marsden is something I am passionate to see continue despite the challenges, and I am eager to contribute by supporting the Trust in this role. Joining the Council of Governors is a great opportunity to use my experience to support the Trust.
For details of these meetings, please call 020 7808 2844 or email corporate governance@ rmh.nhs.uk
Keep in touch
COUNCIL BOUND Dr Banan Osman (above) returns to The Royal Marsden as a Public Governor
Call 020 7808 2844 or email trust. foundation@rmh. nhs.uk. Contact your Governor by email at governors@ rmh.nhs.uk
Become a member To sign up and become a member, visit royalmarsden. nhs.uk/ membership or call 020 7808 2844 to request a membership form RM magazine 29
PUZZLES & PRIZES
PRIZE CROSSWORD The lucky winner of our prize crossword will receive a £50 John Lewis & Partners gift card. Send your crossword with your name and contact details to RM, PR and Communications Team, The Royal Marsden, Fulham Road, Chelsea, London SW3 6JJ. The entry closing date is Wednesday 27 October 2021. See below for prize draw rules. Summer 2021 crossword solution Across 2 Abandoned 6 Ego 7 Haddock 8 Aviary 9 Ales 11 John 12 Badger 16 Pit prop 17 Oak 18 Necklaces Down 1 Arena 2 Abolish 3 Abhor 4 Dodo 5 Dukes 10 Lagoons 11 Japan 13 Aspic 14 Rakes 15 Ural Congratulations to Sheila Bailey, the winner of the summer 2021 issue’s crossword prize. 1
2
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15 z
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AUTUMN 2021 PRIZE CROSSWORD ENTRY FORM Fill in your details below when sending in your crossword competition entry. See above for details of our address. NAME ADDRESS
POST CODE TELEPHONE
30 RM magazine
THE TEAM
Try the fiendishly tricky numbers puzzle – it’s just for fun
FOR THE ROYAL MARSDEN
4 3
1 8 8 4
5 4 7
5
7 7 9 2 8
1 4 2 9 6 5 1 7 9 7 2 3 6 5 4
CROSSWORD CLUES
5
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SUDOKU
Across 1 Stroll leisurely (5) 4 Mix (5) 6 Pod used for flavouring (7) 8 Large open spaces, often peaty (5) 9 Lightly fry (5) 11 Long, pointed, protruding teeth (5) 13 Narrow passage between buildings (5) 14 Dish, mainly of rice (7) 16 Easy to understand (5) 17 Endow or provide with a quality (5)
Down 1 Instrument for measuring height (9) 2 Ground-dwelling monkeys (7) 3 Part of a roof (5) 4 Groups of musicians (5) 5 Long fish (3) 7 Type of gas used for welding (9) 10 Not fastened (7) 12 Indian lute (5) 13 Dwelling (5) 15 Take legal action (3)
Rachael Reeve Director of Marketing and Communications Abby Samuel Head of PR and Communications Morwenna Darby Senior PR and Communications Manager Catherine O’Mara Senior PR and Communications Officer Francesca Vitale Senior PR and Communications Officer Georgia Tilley Senior PR and Communications Officer Emma Dowse Senior Case Studies Officer Orla Anandarajah PR and Communications Assistant
FOR SUNDAY Marc Grainger, Zoë Phillimore Editors Helen Chadney, Kirtey Verma Sub-Editors Robert Hearn Senior Designer Emma Franklin Group Account Director Richard Robinson Content Director Sam Walker Creative Director Toby Smeeton Managing Director
PRIZE DRAW TERMS AND CONDITIONS
RM magazine is published by The Royal Marsden in partnership with Sunday: wearesunday.com
1. The Prize Draw is open to all readers of RM except employees of the Press Office at The Royal Marsden and Sunday, who produce RM magazine. 2. The closing date for receipt of all entries is Wednesday 27th October 2021. Only one entry per person per draw. 3. Responsibility cannot be accepted for entries that are incomplete, illegible or not received. Proof of posting is not proof of receipt. No cash alternative is available and prizes are not transferable. Value of prize is correct at time of going to press. 4. Winners will be notified by post within 14 days of closing date.
© The Royal Marsden 2021. All rights reserved. Reproduction in whole or part is prohibited without prior permission of the Editor. The Royal Marsden and Sunday accept no responsibility for the views expressed by contributors to the magazine. Repro by F1 Colour. Printed by Geoff Neal Group.
5. The Promoter’s decision on any aspect of the promotions is final and binding. No correspondence will be entered into. 6. The Promoter reserves the right to substitute a prize of equal or greater value should circumstances make this necessary. 7. Entry implies acceptance of rules. 8. The winner of the crossword prize of a £50 John Lewis & Partners gift card will be the first correct entry drawn out of the bag. 9. The Promoter is The Royal Marsden, Fulham Road, London SW3 6JJ.
S TAY I N T O U C H
COMMENT, LIKE, SHARE Join the conversation on Twitter @royalmarsden and @royalmarsdenNHS Facebook @royalmarsden, @royalmarsdenchelsea and @royalmarsdensutton Instagram @royalmarsden Twitter
Facebook Jane Race You guys are absolute superstars! You looked after me so nicely when I was an outpatient at Bud Flanagan many years ago. Mark Harp Batches of Harp Tales books went to the children’s wards at The Royal Marsden Sutton last week. Huge thanks to Harrison, the hospital arts team and The Royal Marsden Cancer Charity. I hope the families on the ward enjoy! Jackie Kelly The wonderful Royal Marsden x x
Laura Theodossy @laura_theodossy A few members of the @trmeducation team came together today to raise money for @royalmarsden. It was hot but a lovely walk through London. Well done!
Nichols and Sons Tree Surgeons Today we have delivered some toys, magazines, art supplies and sports equipment to the Oak Centre within The Royal Marsden Sutton. The work they do here is absolutely amazing and we hope the children have a lot of fun with them [above].
Bill Turnbull @billtu Big question – can I get out of here and home in time for kickoff? Thanks for everything, @royalmarsdenNHS
The Royal Marsden School @RoyalMarsdenSchool Members of our team have raised over £700 for The Royal Marsden Cancer Charity. Thank you to all our supporters!
sarahwhiteac @sarahwhiteac The children (and their parents!) were very excited to send their art work and messages to @dukeandduchessofcambridge, it was a great way to lift their spirits! #playspecialist
STAY IN TOUCH WITH THE ROYAL MARSDEN CANCER CHARITY
CONTACT THE FRIENDS OF THE ROYAL MARSDEN, CHELSEA
CONTACT US CALL THE ROYAL MARSDEN, CHELSEA
020 7352 8171
CALL THE ROYAL MARSDEN, SUTTON
020 8642 6011
VISIT US ONLINE royalmarsden.nhs.uk WANT TO WORK AT THE ROYAL MARSDEN? Visit jobs.royalmarsden.nhs.uk READ RM MAGAZINE ONLINE royalmarsden.nhs.uk/ rm-magazine
CONTACT THE ROYAL MARSDEN HELP CENTRE For confidential chat, support and information, call
0800 783 7176
020 7808 2233
CALL US
CALL US
or visit royalmarsden.nhs.uk/ your-care/royal-marsdenhelp-centre
EMAIL US charity@royalmarsden.org
EMAIL US friendsroyalmarsden @gmail.com
For general feedback, compliments, concerns or complaints, send us a message royalmarsden.nhs.uk/ contact-us/get-in-touch
VISIT US ONLINE royalmarsden.org Registered Charity No. 1095197
020 7352 3875
VISIT US ONLINE formc.uk Registered Charity No. 222613
Look out for the winter 2021 issue of RM – coming November 2021 RM magazine 31
Write your Will for free Give back to the future
Writing or updating your Will can feel like a big decision, which is why The Royal Marsden Cancer Charity has a simple and free service that can help you. We hope that once you have included your loved ones, you’ll be inspired to leave us a gift in your Will – although there is no obligation to do so. Your gift can help fund our life-saving research that will make a vital difference to cancer patients long into the future.
To sign up visit royalmarsden.org/freewill or call 020 7808 2233 Registered Charity No. 1095197