High-tech treatment

Transcription

High-tech treatment
Life demands excellence
magazine – summer 2015
High-tech
treatment
How The Royal Marsden’s
advanced radiotherapy
techniques lead to better
patient outcomes
The pioneering
100,000 Genomes
Project begins
Scientists team up
in the Centre for
Molecular Pathology
l
At The Royal Marsden, we deal
with cancer every day, so we
understand how valuable life is.
And when people entrust their
lives to us, they have the right
to demand the very best. That’s
why the pursuit of excellence lies
at the heart of everything we do.
RM MAGAZINE
l
Executive notes
Contents
12 Advanced technology,
precision treatment
New radiotherapy techniques
mean better patient outcomes
18 In the lab
The teams working in the
Centre for Molecular Pathology
20 Focusing the beam
How BRC funding boosts our
radiotherapy research
22 A day in the life
Meet Dr Lisa Thompson,
Manager of the Molecular
Diagnostics Laboratory
24 Hundreds
and thousands
The Royal Marsden’s role in
the 100,000 Genomes Project
Regulars
04 Hospital news
17 It happened to me
26 Fundraising
28 Foundation news
30 Puzzles & prizes
Cover photograph: Dr Imogen Locke,
Lead for Clinical Oncology at
The Royal Marsden
Welcome
to the summer 2015 edition of RM, the magazine for our staff,
patients, carers and Foundation Trust members.
In this issue, we focus on the work being done in radiotherapy
at The Royal Marsden (page 12). With one of the largest
departments in the UK, we treat, on average, up to 5,000 patients
each year and deliver more than 75,000 treatments. Our new
machine, the Brunel, adds to our 10 linear accelerators and
can deliver all forms of advanced external-beam radiotherapy.
We also look at the official openings of two new facilities:
the Reuben Foundation Imaging Centre and the West Wing
Clinical Research Centre.
In Chelsea, the Reuben Foundation Imaging Centre – funded
by The Royal Marsden Cancer Charity through a generous
donation from David and Debra Reuben – was officially opened
by Simon Stevens, the Chief Executive of NHS England (page 5).
Equipped with two MRI scanners and two CT scanners, it will
help accelerate the pace of new imaging discoveries and benefit
cancer patients for many years to come.
We also welcomed Professor Dame Sally Davies, the Chief
Medical Officer for England, to The Royal Marsden in Sutton to
formally open the West Wing Clinical Research Centre (page 6).
Also funded by The Royal Marsden Cancer Charity, the West
Wing has increased the Trust’s capacity for delivering efficient,
innovative clinical trials in a research-focused setting.
I hope you enjoy reading this issue of RM.
Cally Palmer CBE, Chief Executive, The Royal Marsden
RM MAGAZINE 03
HOSPITAL NEWS
MAGGIE’S COMES TO
THE ROYAL MARSDEN
he Royal Marsden is
proud to announce
that Maggie’s will
be opening a new Centre at
its Sutton site.
The Centre will provide free
practical, emotional and social
support to people with cancer
and their family and friends. It
will further enhance the patient
T
04 RM MAGAZINE
care on offer at The Royal
Marsden and mark another step
forward in the redevelopment
of the Sutton site.
Maggie’s Centres are built in
the grounds of NHS hospitals
and offer people a warm and
welcoming environment, with
qualified professionals providing
a programme of support that has
been shown to improve physical
and emotional wellbeing.
The Centre will be designed
by London-based studio
Ab Rogers Design, with
landscaping by world-renowned
landscape architect Piet Oudolf.
Cally Palmer, Chief Executive
of The Royal Marsden, said:
“Treating people with cancer
is not just about treating their
disease; at The Royal Marsden,
we treat the whole person –
their physical, emotional and
psychological needs. Working
with Maggie’s, to provide a
Maggie’s Centre at The Royal
Marsden in Sutton, will enable
us to extend the level of
non-clinical support in a
beautiful environment.”
A planning application is due
to be submitted in early summer
2015, with the aim to open the
Centre in early 2017.
For more information
about Maggie’s, visit
www.maggiescentres.org
Hospital news
IMAGING CENTRE NOW OPEN
Lucy
Westmore:
Maggie’s
and me
I was diagnosed
with cancer when
an MRI scan revealed a mass
covering the right side of my
body, from my liver to my lower
spine. Professor David
Cunningham at The Royal Marsden
was straightforward and brilliant
when he told me the harsh
reality: that without immediate
treatment, I had months to live.
I knew that medically I could
not be in better hands. But I
felt like I was walking through
a nightmare. I was exhausted
and in pain, my emotions were
all over the place, and my body
was in a state of stress. I knew
I would need a lot of support to
get through the coming months.
I remember walking along the
path to the Maggie’s Centre at
Charing Cross Hospital for the
first time. It felt as if the plants
and trees were guiding me to a
place of recuperation. A lovely
member of staff from Maggie’s
asked if I needed help. I burst
into tears and she gave me the
biggest hug I have ever had. It
was just what I needed.
We sat down with a mug of
tea and I told her my story. She
recommended I start a weekly
relaxation class and from that
point, I never looked back. It’s an
uplifting and happy place to be.
I burst into tears
and received the
biggest hug I
have ever had
LUCY WESTMORE, ROYAL MARSDEN PATIENT
The Reuben Foundation Imaging Centre
has been officially opened at The Royal
Marsden in Chelsea by Simon Stevens,
Chief Executive of NHS England.
Thanks to a generous donation by
the Reuben Foundation, the centre is
equipped with state-of-the-art 1.5T and
3T MRI scanners and two CT scanners.
This will ensure that the Trust remains
at the forefront of cancer diagnostics
and continues to pioneer new methods.
David Reuben and his wife, Debra,
enjoyed a tour of the centre before it
was officially opened. Mr Reuben said:
“We are delighted and proud to support
The Royal Marsden Cancer Charity
in creating the Reuben Foundation
Imaging Centre, which will help
accelerate the pace of new imaging
discoveries and benefit cancer patients
for many years to come.”
The new centre is the final part of
the rebuilding work at the Chelsea
site following the fire there in 2008.
Cate Savidge, CT Superintendent
Radiographer, said: “We are now able
to offer more appointments and new
procedures, extend our interventional
service, and work at the forefront of
technology. It is a pleasure to give the
first-class service our patients deserve.
Patients have commented on how
wonderful the new facility is.”
Opening the centre, Mr Stevens said:
“It is thanks to philanthropy – as well
as an impressive feat of engineering –
that this remarkable imaging centre
was able to go ahead. It is yet another
example of how The Royal Marsden
continues to pioneer new technology
to give cancer patients access to the
latest machines and techniques.”
Survey asks patients’ views on clinical trial involvement
The Royal Marsden’s
Gastrointestinal (GI)
and Lymphoma Unit
has conducted a
survey to investigate
patients’ views of
cancer research and
their reasons for
participating in
clinical trials.
Between August
2013 and July 2014,
patients who had
been approached
about participating
in clinical trials were
asked to complete
a questionnaire. Of
the 249 respondents,
75 per cent said
they would consider
taking part in studies
requiring a research
biopsy, while 78 per
cent would donate
their tissue for
genetic research.
Funded by the
NIHR Biomedical
Research Centre at
The Royal Marsden
and The Institute of
Cancer Research,
the survey found
that the majority of
patients approached
consented to one or
more clinical trials.
Many said this was
because they felt
the trial offered
the best treatment
available. They also
wished to help others
and contribute
to research.
Dr Sing Yu
Moorcraft, Clinical
Research Fellow
in the GI and
Lymphoma Unit,
said: “Recruitment
to clinical trials
can be challenging.
Understanding
patients’ attitudes
towards research
and the factors that
influence their
decision regarding
trial participation
may lead to improved
trial recruitment
strategies.”
RM MAGAZINE 05
Hospital news
UroStation tests begin
Patients at The Royal Marsden have
become the first in the UK to be tested
for prostate cancer using the Koelis
UroStation, a revolutionary new
software platform.
Funded by The Royal Marsden
Cancer Charity, the £100,000
UroStation creates a 3D map of the
prostate. These more comprehensive
and accurate images represent a major
step in the diagnosis of prostate cancer.
Mr Pardeep Kumar, Consultant
Urological Surgeon, explained that
early diagnosis is the key to improving
patient outcomes, so enhancing our
techniques for diagnosing cancer
is hugely beneficial to patients.
He said: “The UroStation allows us to
combine both
ultrasound and
MRI images
in real time,
allowing
pinpoint
accuracy in
needle biopsy
placement.”
One of the
first patients
to undergo
testing was Paul Ashworth (pictured),
who said: “The procedure of taking
a biopsy is not pleasant; however, it
was fantastic to know that Mr Kumar
was going to obtain a sample from
the area of concern. The importance
of this was brought home, as the
sample proved conclusively the type,
stage and aggressiveness of the cancer.
As a result, it was clear I needed a
radical prostatectomy.
“Without the new machine, it would
have been much harder to make the
decision to go ahead, but I’ve since
had a radical prostatectomy with the
da Vinci robot and I’m recovering well.”
06 RM MAGAZINE
The Royal Marsden’s
Dr Nicholas Turner
with Professor Dame
Sally Davies
West Wing to boost research
rofessor Dame Sally Davies,
Chief Medical Officer for
England, has officially
opened the West Wing Clinical
Research Centre at The Royal
Marsden’s Sutton site.
The £2.6-million unit is a dedicated
space for Phase Ib, II and III clinical
trials. Previously, patients on latephase studies were treated in different
departments around the hospital.
Now, they will be seen in one space.
The facility includes five treatment
bays, an on-site laboratory and a
pharmacy room. It is staffed by a
dedicated team incorporating research
nurses, clinical research fellows, trial
co-ordinators, schedulers, a Good
Clinical Practice Compliance Officer,
P
laboratory staff, IV-trained nurses
and a resident pharmacist.
Dr Naureen Starling, Consultant
Medical Oncologist and lead clinician
for the unit, said: “The West Wing
Clinical Research Centre has increased
the Trust’s capacity for delivering
efficient, innovative clinical trials in
a research-focused setting. It is a
modern and comfortable environment
for patients, improving their clinical
trial experience. This is another
example of how we are investing in
our research infrastructure, delivering
personalised medicine and translating
scientific findings into the clinic.”
The facility was funded by legacies
left by generous supporters of The
Royal Marsden Cancer Charity.
Involving patients in centre’s design
Patients had an
active role in
shaping the West
Wing Clinical
Research Centre.
Staff at The
Royal Marsden
ran an internal
competition to
come up with
names for the
five treatment
bays. The 50
entries were
then narrowed
down to five
and taken to
a Patient and
Carer Research
Review Panel,
which voted
for the winning
theme of
gemstones. The
bays are called
Amethyst, Coral,
Jasper, Quartz
and Topaz.
Patients also
helped choose
the 24 treatment
chairs that are
within the unit.
Four types were
chosen and
displayed at the
front entrance
of the hospital.
Visitors, staff
and patients
were asked to
try the chairs
and vote for
their favourite,
with the winning
design being
rolled out across
the unit.
Hospital news
SURGERY GOES SOCIAL
or the first time,
surgeons at The
Royal Marsden
invited the online community
into the operating theatre
as a procedure was live
tweeted as part of Prostate
Cancer Awareness Month.
The operation was
a robotic-assisted
prostatectomy performed
under a general anaesthetic,
using the new da Vinci Xi
robot to remove the prostate
and surrounding tissues.
Two members of The
Royal Marsden’s PR and
Communications team sat
in the operating theatre
F
LIVE TWEETING STATS
Retweets
176
New followers
50
Total reach
1,076,234
and broadcast each step
of the two-hour procedure
on Twitter on behalf of
Mr Erik Mayer, Consultant
Urological Surgeon. Mr
Alan Thompson, Consultant
Urological Surgeon, was
also on hand as the Patient
Advocate and to help
answer any questions
from followers on the social
network using #TRMlive.
Mr Mayer said: “Prostate
cancer is the most common
cancer in men in the UK.
We wanted to raise
awareness of the disease
while also highlighting
one of the treatment options
that involves the latest
technology in prostate
cancer surgery.
“The da Vinci Xi robot
manipulates tissue in the
same way as a surgeon
would when carrying out
open surgery. But, unlike
the surgeon, the robot does
this through tiny holes –
reducing pain and blood
loss, and minimising the
patient’s hospital stay and
recovery time.
“By live tweeting the
procedure, we were able to
demystify what happens
during this type of surgery
and answer questions
from followers.”
The 70-year-old patient
was happy for us to
broadcast his procedure in
order to raise awareness of
the disease and to give other
men an understanding of
what happens in the
operating theatre.
PROSTATE CANCER FACTS
SOURCE: CANCER RESEARCH UK
41,736
men in the UK were
diagnosed with prostate
cancer in 2011
1 in 3
cases are diagnosed
in men aged over 75
84%
of patients diagnosed
in 2010–11 in England
and Wales are
predicted to survive
10 or more years
1 in 8 men
in the UK will get
prostate cancer
during their lifetime
NEWS IN BRIEF
RESEARCH FELLOWSHIP
FOR GI NURSE
Ann Muls, Macmillan Nurse
Consultant in the Gastrointestinal
Unit, is the first nurse at The Royal
Marsden to be awarded a National
Institute for Health Research (NIHR)
clinical doctoral research fellowship.
Ann’s study will look at ways to
predict which patients will have
long-term changes in bowel
function following radiotherapy.
Recruitment will begin later this
year and women diagnosed with
a gynaecological cancer will be
invited to participate.
Ann said: “Pelvic radiotherapy
treatment causes 80 to 90 per
cent of people to have long-term
changes in their bowel function.
This can have a devastating impact
on their quality of life.
“This research will hopefully
give us a predictive marker so
we can inform patients of their
likelihood of experiencing chronic
bowel problems before they
start treatment.”
CHIEF EXEC JOINS TASKFORCE
Cally Palmer, Chief Executive of
The Royal Marsden, has joined an
independent taskforce announced
by NHS England to develop a
five-year plan for cancer services
that will improve survival rates
and save many lives.
The taskforce has been asked
to deliver the vision set out in
the NHS Five Year Forward View,
which calls for better prevention;
swifter diagnosis; and better
treatment, care and aftercare.
It has also launched a programme
to test ways of diagnosing cancer
more quickly at 60 sites in the UK.
Chaired by Harpal Kumar, Chief
Executive of Cancer Research UK,
the taskforce will work across the
entire health system and will
include cancer specialist doctors,
patient groups and charity leaders.
RM MAGAZINE 07
Hospital news
Imaging Clinical
Research Facility
hosts open evening
Patients and their families were
invited to an open evening at
The Royal Marsden and The
Institute of Cancer Research in
Sutton to discover more about
the Imaging Clinical Research
Facility (CRF). The event
coincided with International
Clinical Trials Day in May.
The facility includes three MRI
scanners – two 1.5T and one 3T
– as well as two PET/CT scanners,
and manages a portfolio of
around 100 research studies.
This includes providing imaging
expertise to support early-phase
experimental medicine studies
as well as leading on the
development of imaging
techniques and guided therapies
for improved cancer treatment.
Katherine May, Imaging CRF
Centre Manager, said: “Imaging is
an essential part of cancer care
as it can be used to help diagnose
cancer and to plan surgery and
other treatment options.
“We want to make sure that
our research is focused on the
needs of the patient, so encourage
their involvement in all stages of
the research process.
“By joining The Royal Marsden
Patient and Carer Research
Review Panel, patients can
help with grant applications,
protocol development and
ensure our information sheets
are user-friendly.”
The Imaging CRF is funded by
the National Institute for Health
Research (NIHR). It is one of 19
CRFs in the UK, and the only one
dedicated solely to imaging
research. The NIHR funds CRFs
for experimental medicine to
help speed up the translation
of scientific advances for the
benefit of patients.
08 RM MAGAZINE
The da Vinci Xi surgical
robot in theatre at
The Royal Marsden
SURGICAL SUCCESS FOR
FIRST DA VINCI XI PATIENT
he new da Vinci
Xi surgical robot is
now fully integrated
into the McCarthy Family
theatre suite, enabling more
patients at The Royal
Marsden to experience the
benefits of this revolutionary
surgical system.
Diagnosed with bowel
cancer in February 2012,
58-year-old Rita Hegarty
was referred to The Royal
Marsden a year later. She
was treated with radiotherapy
and, on 29 January 2015,
became the first patient in
England to be treated using
the da Vinci Xi robot. Since
then, the machine has been
used to operate on more than
30 patients, allowing surgeons
to operate with greater
accuracy than ever before.
“I was told the benefits
of the new machine and it
seemed like the best option
for me at that time,” said Rita.
“When you’re dealing with
cancer, you have to trust your
T
consultants. I knew I was in
safe hands with Professor
Paris Tekkis and his team.
“Initially I assumed the
robot would be preprogrammed to perform
the operation. I didn’t realise
that Professor Tekkis would
be controlling the robotic
arms using a console just
a few feet away.
“Being the first patient
didn’t faze me. I hear so
many stories of people
affected by cancer that I
want to help in any way
I can. So, I hope that I’ve
helped surgeons hone
I felt well enough
to walk within
five days – I’m
starting to feel
like myself again
RITA HEGARTY, THE FIRST PATIENT IN ENGLAND
TO UNDERGO SURGERY WITH THE DA VINCI XI
their skills and they can
now go on to save many
more lives with this fantastic
piece of machinery.”
For Rita, the most
remarkable thing about the
experience is how quickly
she recovered.
“I felt well enough to walk
around within five days and
was out of hospital pretty
quickly,” she said. “Also,
because the robotic procedure
is done through keyhole
surgery, I have minimal
scarring and bruising, which
means I’m starting to feel
like myself again.”
Hospital news
ALWAYS EVENTS LEAD TO BEST POSSIBLE CARE
We will always...
1 listen to patients, families and our colleagues
2 introduce ourselves to patients, families and colleagues
3 find out from the patient how they like to be
addressed or called
4 observe careful hand hygiene as it is the most effective
way to prevent and control infection
5 involve the patient and carer in the design of their care
6 ask if patients and families have any concerns or worries
7 explain, and check that you have understood our
explanations
8 ask if a telephone call addressed your needs and
concerns
9 aim to have take-home medication prescribed 24 hours
prior to discharge
10 ensure that the patient and family know who to contact
on discharge
11 ask if patients are happy with the care they are receiving
In its ongoing commitment to safe,
effective and compassionate care, The
Royal Marsden has created 11 ‘Always
Events’. These are events that should
always happen if we are to give the
best possible care to patients.
The idea was inspired by NHS
England’s ‘Never Events’ guidance for
all frontline staff – highlighting things
that should never happen in a hospital.
The new initiative has come from
frontline doctors, nurses and allied
health professionals. The events have
been communicated to all staff caring
for patients and their families.
Dr Shelley Dolan, Chief Nurse at
The Royal Marsden, said: “Always
Events will keep all of us focused
on achieving the best possible care
throughout the Trust.
“It is another example of how we
are always looking at ways to keep
the patient at the heart of everything
we do at The Royal Marsden.”
New targeted treatment for
blood cancer patients licensed
Ibrutinib (Imbruvica), a new blood
cancer treatment, has launched in the
UK following clinical trials in hospitals
including The Royal Marsden.
A once-daily, first-in-class oral drug,
ibrutinib treats relapsed or refractory
mantle cell lymphoma (MCL) and
chronic lymphocytic leukaemia (CLL)
in patients whose disease has returned
following their first treatment.
Previous treatments for relapsed
disease have been limited and are
associated with a number of side
effects. Ibrutinib represents a nonchemotherapy option for these patients.
Dr Claire Dearden, Consultant
Haematologist and Head of Haematooncology at The Royal Marsden, said:
“The use of ibrutinib signals a real step
change in CLL treatment. Historically,
there have been few treatment options
beyond chemotherapy, which may not
be suitable or effective for all patients.
Many of our patients who have taken
part in the trial have responded
extremely well to this new drug.”
Ibrutinib signals a real
step change in CLL
treatment. Many patients
on our trial responded
extremely well to the drug
DR CLAIRE DEARDEN, CONSULTANT HAEMATOLOGIST AND
HEAD OF HAEMATO-ONCOLOGY, THE ROYAL MARSDEN
Schwartz Rounds to encourage staff communication
The Royal Marsden
has introduced
Schwartz Rounds to
encourage staff who
do very different
jobs to talk and
share best practice.
Originally
developed in the
US city of Boston,
Schwartz Rounds
allow staff from all
disciplines across the
organisation to get
together and reflect
on the challenging
and uplifting parts
of their jobs. The
first Schwartz
Round at The Royal
Marsden was held
in February and was
incredibly popular.
Research shows
that staff who attend
Schwartz Rounds feel
they communicate
better with their
patients and
colleagues, feel
less isolated and
more supported,
cope better with
the emotional
pressures of their
work, and get a
better understanding
of how colleagues
think. About 100 UK
Trusts now run them.
Chief Nurse Dr
Shelley Dolan said:
“The invitation to
attend a Schwartz
Round is to
absolutely everyone
in the hospital, as
the experience that
our patients and
their families get at
The Royal Marsden
is the result of
hundreds of people
all working together
to effect the best
care possible.”
Dr Shelley Dolan,
Chief Nurse
RM MAGAZINE 09
Hospital news
Cookbook and nursing manual out now
he Royal Marsden
has launched two
books this spring.
The Royal Marsden
Cancer Cookbook, edited
by Dr Clare Shaw, The
Royal Marsden’s Consultant
Dietitian, navigates through
the facts and myths about
what patients should eat
during and after cancer
treatment. The book helps
those experiencing changes
in body weight, appetite,
the ability to taste and
swallow, or digestion.
PHOTOS: GEORGIA GLYNN SMITH
T
Arts Forum competition open
The Arts Forum photography
competition is once again looking for
your most inspiring and uplifting
photographs. The biennial
competition is open to patients, their
families, carers and staff, with a panel
of external judges deciding the three
best pictures. Shortlisted photographs
will be exhibited at The Royal
Marsden in Sutton and Chelsea.
To enter, email your photo to
Stephen Millward (stephen.
millward@rmh.nhs.uk) with your
name, address and telephone number.
Images must be in JPEG format and
no larger than 1MB. You can submit
up to four digital photos. The closing
date is 7 September 2015, and winners
will be announced at the opening of
the exhibition in October.
10 RM MAGAZINE
Dr Shaw said: “For many,
a diagnosis of cancer leads
them to reconsider their diet
and how it can be improved.
The book will help inspire
people to eat food that will
support and nourish them
during and after treatment.”
The book features more
than 130 beautifully
presented recipes, with
contributions from celebrity
chefs such as Nigella
Lawson, Mary Berry and
Tom Aikens. Published by
Kyle Books, The Royal
Marsden Cancer Cookbook
(RRP £19.99) is available
in all good bookshops as
well as online – with 50
per cent of proceeds going
to The Royal Marsden
Cancer Charity.
The Royal Marsden
Manual of Clinical
Nursing Procedures is
internationally recognised
as the definitive guide to
clinical nursing skills.
Now in its ninth edition,
the manual provides
detailed and evidence-based
guidelines for more than 200
procedures related to every
aspect of a patient’s care.
Published by Wiley, the
manual has three separate
versions: Professional,
Online and Student. Trust
access to the online version
is via www.rmmonline.
co.uk. The professional
and student versions are
available to buy from www.
royalmarsdenmanual.com
Hospital news
MEALTIMES MADE EASIER
n initiative to
help patients
get the most
out of mealtimes has
been developed by The
Friends of The Royal
Marsden, Chelsea,
and Dr Clare Shaw,
The Royal Marsden’s
Consultant Dietitian.
The trial scheme
on Horder Ward sees
volunteers help to
A
prepare patients for their
meal, ensure they are
comfortable, chat to
visiting relatives, and
talk through any eating
difficulties that patients
may be having.
Volunteer Henrietta
Fellowes said: “As well
as lending the ward
nurses a helping hand,
we’ve also had some
wonderful interaction
with patients and their
relatives, who have been
grateful for the support.”
Sarah Briscoe, whose
husband is a patient,
said: “The volunteers
are so helpful. Small
things like knowing how
my husband likes his
soup, and encouraging
him to eat when he’s
having difficulties, have
made a big difference.”
NEW PATIENT SUPPORT PROCESS
FOR BREAST CANCER PATIENTS
Breast cancer patients
at The Royal Marsden
are benefiting from a
redeveloped follow-up
pathway after their
treatment is complete.
The Patient and Carer
Advisory Group (PCAG),
in line with national
organisations, was
aware that many
patients are unsure of
what to do when they
have concerns at the
end of treatment. PCAG
participated in the
development of the
open-access pathway
and provided valuable
input into how end-of
treatment consultations
should be delivered at
the start of the pathway.
During a consultation,
the nurse practitioner
will assess how the
patient is coping,
provide information
about the signs and
symptoms to look for,
and explain how to
contact their team
with any questions or
concerns. A cancer
support worker will also
provide support and
suggest other services.
Fiona McKenzie, a
member of PCAG and
a patient at The Royal
Marsden, said: “Although
most breast cancers do
not recur due to the
success of treatment,
the fear of recurrence
is present for many
patients. It’s important
for us to establish a
good relationship with
the breast care team
from the beginning, so
that we feel supported
and comfortable
enough to contact them
once our treatment
has concluded.”
Patients can call the
open-access line on 020
7811 8114 (9am–5pm) or
email oafu@rmh.nhs.uk
TV stars bring gifts and glamour
to our young patients
Celebrity visitors have been keeping
patients, their families and staff
entertained in the Oak Centre for
Children and Young People.
Strictly Come Dancing’s Janette
Manrara and Aljaz Skorjanec (top,
with young patient Olivia Maloney)
popped in to the hospital to show off
a few dance moves, while comedians
Josh Widdicombe and Adam Hills from
Channel 4’s The Last Leg toured the
Teenage Cancer Trust unit and handed
out copies of their latest DVDs.
And comedian David Walliams (above)
had everyone laughing when he read
out a chapter of his Gangsta Granny
story, before meeting patients in the
centre and giving them each a book.
RM MAGAZINE 11
Radiotherapy focus
OUR RADIOTHERAPY DEPARTMENT
Advanced technology,
precision treatment
The Royal Marsden has one of the UK’s largest radiotherapy departments,
treating up to 5,000 patients a year using a range of techniques
Q&A RADIOTHERAPY
In the past 10 years, research into radiotherapy techniques has transformed
the way we treat patients. Dr Imogen Locke, Lead for Clinical Oncology
at The Royal Marsden, explains
What is radiotherapy?
Radiotherapy uses high-energy
X-ray radiation produced by linear
accelerators to shrink tumours
and kill cancer cells. Radiation is
delivered by a machine outside
the body (external-beam radiation
therapy), or from radioactive material
placed in the body close to the
cancer cells (internal radiation
therapy, also called brachytherapy).
Systemic radiation therapy uses
radioactive substances such as
radioactive iodine that travel in
the blood to kill the cancer cells.
What factors decide the type
of radiation you use?
The radiation therapy prescribed
depends on many factors, including
the type of cancer, its location, how
close it is to normal tissue that is
sensitive to radiation, and how far
into the body the radiation needs to
travel. The type of therapy will also
take into consideration the patient’s
general health and medical history,
location of the cancer, and whether
the patient will be receiving other
types of cancer treatment.
Radiotherapy cures approximately
40 per cent of cancers, and half of
all cancer patients should receive
radiotherapy at some point during
their treatment pathway.
How does radiation therapy
kill cancer cells?
Radiation therapy damages the
DNA of cancer cells beyond repair,
so they stop dividing or die. When
the damaged cells die, they’re broken
down and eliminated by the body’s
natural processes.
How has radiotherapy
technology developed?
The way we treat patients is more
sophisticated now. The evolution of
radiotherapy is based on shaping
the beam of radiation so that it
minimises the damage to healthy
tissue and organs.
Has the way we treat patients
changed over the past few years?
We’ve seen advances with research
into radiotherapy techniques. The
PACE trial, for example, is exploring
the benefit of reducing radiotherapy
sessions from 39 standard treatments
to five delivered with stereotactic
radiotherapy. This would be less
time-consuming for the patient.
The START trial proved it was
as effective to give three weeks of
radiotherapy as it was for five weeks
in breast cancer cases. The next phase
is looking at reducing this further,
with bigger doses for shorter periods.
The FAST trial has completed
recruitment and compared three
weeks with just one week. The
results will be published in the
next couple of years. ➜
The evolution of radiotherapy is based
on shaping the beam of radiation
DR IMOGEN LOCKE, LEAD FOR CLINICAL ONCOLOGY
12 RM MAGAZINE
Dr Imogen Locke, Lead
for Clinical Oncology
RM MAGAZINE 13
Radiotherapy focus
TAILORED TREATMENT: OUR RANGE
OF RADIOTHERAPY TECHNIQUES
IMAGE-GUIDED
RADIOTHERAPY
(IGRT)
Uses a variety of
imaging techniques,
such as X-rays or
CT scans, alongside
radiotherapy. Imaging
confirms the position
of the patient and
the tumour so that
the radiotherapy
beam is targeted
more precisely.
INTENSITYMODULATED
RADIOTHERAPY
(IMRT)
Multiple beams
of radiation of
varying intensity
are used to shape
the radiotherapy
more precisely.
VOLUMETRIC
MODULATED ARC
THERAPY (VMAT)
This is an advanced
method of
radiotherapy first
performed in the
UK at The Royal
Marsden. During
VMAT, the linear
accelerator delivers
radiotherapy in one
or more continuous
arcs to conform the
treatment to the
exact size and shape
of the tumour.
STEREOTACTIC
RADIOTHERAPY
The use of multiple
small beams to
deliver a high
dose in just a few
treatments. It is
delivered using an
IGRT technique on
a linear accelerator
or CyberKnife.
CYBERKNIFE
Delivers stereotactic
radiotherapy, using
a moving couch
and a small linear
accelerator on a
robotic arm to
deliver multiple
beams of radiation
from different angles.
BRACHYTHERAPY
Radioactive sources
are placed inside the
patient’s body.
ADAPTIVE
RADIOTHERAPY
These treatments
are chosen on the
day. The patient
is imaged and the
treatment plan
designed to ‘fit’
the volume to
be treated. For
example, in bladder
cancer, we will
select the plan that
fits the size of the
bladder that day.
HIGH-TECH EQUIPMENT
Our linear accelerators deliver
various radiotherapy techniques
The Trust’s Radiotherapy Department
is one of the largest in the UK, treating
up to 5,000 patients and delivering
more than 75,000 treatments each
year. The multidisciplinary team
includes therapy radiographers,
radiotherapy aides, medical physicists,
engineers and clinical oncologists.
Now, a new linear accelerator has
been installed at The Royal Marsden
in Chelsea, offering patients the most
up-to-date radiotherapy techniques.
The £2.3-million Varian TrueBeam
machine, known as the Brunel, treats
up to 40 patients a day across a variety
of tumour types, including breast, lung,
head and neck, prostate, gastrointestinal
and gynaecological cancers.
The TrueBeam can deliver all forms
of advanced external-beam radiation,
including image-guided radiotherapy
(IGRT), intensity-modulated
radiotherapy (IMRT), stereotactic body
radiotherapy (SBRT) and volumetric
modulated arc therapy (VMAT). This
unit also has the flattening filter free
(FFF) delivery system, which means
the dose can be delivered more quickly.
“Developments in radiotherapy
imaging allow us to target tumours
Top: the Radiotherapy reception in Chelsea.
Above: Sophie Alexander, Senior Radiographer
with sub-millimetre precision,” says
Sarah Helyer, Radiotherapy Services
Manager. “Greater accuracy means
that fewer healthy cells are damaged,
which, in turn, means higher doses
can be given, making treatment more
effective and reducing side effects.”
In total, the Trust operates 11 linear
accelerators across the department.
Additionally, the CyberKnife machine
in Chelsea is used specifically for
stereotactic treatments. The Sutton
department has a Gulmay superficial
radiotherapy machine for the
treatment of skin cancers.
This year, the Trust is replacing the
oldest machine at the Sutton site ➜
Greater accuracy means that fewer
healthy cells are damaged
SARAH HELYER, RADIOTHERAPY SERVICES MANAGER
14 RM MAGAZINE
Cancer focus
The state-of-the-art
Varian TrueBeam
linear accelerator.
Insets, from top:
an X-ray showing
the area to receive
radiotherapy;
setting up the beam
on the control screen;
the view inside the
machine
RM MAGAZINE 15
Radiotherapy focus
Advances in Comparative Evidence
(PACE) study is a randomised clinical
trial that compares stereotactic
radiotherapy treatment to the current
standard treatments of surgery and
conventional radiotherapy.
SHARING PIONEERING
TECHNIQUES
Our new treatment techniques
are adopted nationwide
The Royal Marsden’s new
radiotherapy techniques are often
rolled out across the country, thanks
to its commitment to training and
education. New treatment methods
have been shared with more than half
of the UK’s radiotherapy departments.
“At The Royal Marsden, we thrive
on change and embrace it well,” says
Dr Helen McNair, Lead Research
Radiographer. “We like to try new
ways of doing things for the benefit of
our patients. Radiotherapy studies at
The Royal Marsden have changed the
way cancer patients are treated, not
only here but across the country.”
TRAINING FUTURE
GENERATIONS
We provide professional
development for radiographers
Top: a patient is positioned on the linear
accelerator prior to treatment. Above: Sarah
Helyer, Radiotherapy Services Manager
with an Elekta Versa HD linear
accelerator. This will be known as
the Hawthorn Unit and can deliver
the full range of advanced techniques,
including the FFF delivery system.
CLINICAL TRIALS
We conduct innovative research
into new treatment techniques
Patients at The Royal Marsden have
access to clinical trials for new
radiotherapy treatments, with many
national trials being instigated here.
16 RM MAGAZINE
Our trials are evaluating methods
such as IMRT and IGRT in order to
deliver higher doses to the tumour
while reducing the risk of long-term
side effects. Such trials include
IMPORT HIGH, for patients with
breast cancer, or the HYBRID and
RAIDER trials, which use IGRT and
adaptive radiotherapy in patients
with bladder cancer.
Other trials are looking at reducing
the numbers of treatments that
patients receive. The Prostate
The Royal Marsden’s Radiotherapy
Department prides itself on offering the
best training for the next generation of
radiographers. We support about 70
students over their three- and fouryear courses, as well as radiographers
who are undertaking a Masters.
“Although we support students on
the conventional full-time three-year
BSc course, we also train staff who
are recruited for admin and clerical
work in radiotherapy while they
undertake a part-time degree
programme,” says Sarah Armstrong,
Professional Development Lead.
“The in-service programme allows
people who would like to train to be
a radiographer to work full-time and
receive a salary while they undertake
the part-time four-year BSc.” rm
A patient’s perspective
IT HAPPENED
TO ME
How we deal with
cancer as a family
I was diagnosed with stage 4 lung cancer
in September 2011, and given six months
to live without treatment. But I’m still
here, thanks to The Royal Marsden’s
drug development programme…
Tom McKinley, 38, lung cancer patient
ince testing positive for
an ALK mutation, I’ve
moved from one new
drug to another, but I’ve still
been able to spend valuable
time with my family. Living with
stage 4 lung cancer has had a
huge impact on everyone I love.
I think it’s easier for me to cope
with, as it’s my body and my
fight. For my family, and my
wife Rosy in particular, they
have to contemplate a different
future to the one we expected.
S
I’ve been on many trials with
Dr Sanjay Popat, Consultant
Medical Oncologist, and been
through chemotherapy,
radiotherapy and two brain
surgeries on secondary tumours.
It surprises me how living
with cancer has become a way
of life for us. My family has been
my backbone since diagnosis.
Occasionally, my children –
Wilf, 7, and Esme, 4 – will
innocently belittle it in a way
that I find so uplifting.
Once, at the end of the school
day, my son’s teacher produced
a jar full of staples that had been
used to stitch me up after surgery.
Wilf had taken it to school for
show-and-tell. Another time,
Esme explained proudly to a
friend that my bald patch was
because “Daddy has cancer!”
It made me smile because it
reflected how we deal with
cancer as a family. To them, it is
just something Daddy has. And
aside from The Royal Marsden’s
amazing work, it’s thanks to my
family that I’m still here fighting.
Going from one drug trial to
the next can be difficult. In the
back of your mind, you think the
road will end somewhere. But,
a part of me enjoys my visits to
The Royal Marsden, because Dr
Popat and his team have been
so warm and honest, giving me
as many options as possible.
Last year, the side effects
of the trial I was on were
considered too much. Dr Popat
explained that it was either
chemotherapy or morphine pain
management until another trial
opened. Chemotherapy had
stopped working years before,
so even though there was no
guarantee I’d get another trial,
I opted to wait. Fortunately, it
paid off and I’m now doing
really well on a new trial.
Esme explained
proudly to a friend
that my bald patch
was because
“Daddy has cancer”
Dr Sanjay Popat,
Consultant Medical
Oncologist, says:
“Tom is a remarkable
individual, living with
a diagnosis of advanced
lung cancer with
seeming normality.
He is testament to the
years of scientific and
drug development
advances that have
revolutionised the way
we now treat non-small
cell lung cancer.
“It is only through
a deep understanding
of the biology of his lung
tumour, combined with
the impact of new drugs
and the dedication of
The Royal Marsden’s
Lung Unit team, that
we have been able to
control his tumour
so successfully.
“Tom has undergone
innovative approaches
to molecularly
characterise his tumour,
and accessed the latest
advances in stereotactic
radiotherapy and new
drugs, allowing us
to remain one step
ahead. I hope we can
change the face of lung
cancer to see many
more patients doing
as well as Tom is. We
are just starting to
see this happen.”
RM MAGAZINE 17
Several research teams
populate the top floor
of the Centre for
Molecular Pathology,
including the Systems
and Precision Cancer
Medicine group, led by
Dr Anguraj Sadanandam
(far right)
MEET OUR SCIENTISTS
In the lab
The Centre for Molecular Pathology brings together
world experts dedicated to the research of
personalised cancer treatment. Here, we meet
the teams and their pioneering work
w
The discoveries these teams
are making will ensure that
The Royal Marsden remains
at the forefront of targeted
therapies for cancer
18 RM MAGAZINE
e now know that
patients with the
same type of cancer
may respond differently to the
same treatment. This is due to
differing genetic mutations in
individual tumours and the
patient’s own genetic profile.
Molecular diagnosis uses this
information to tailor treatment
to suit each patient’s needs.
Since opening in November
2012, the £18.2-million Centre
for Molecular Pathology (CMP)
has brought together experts
from The Royal Marsden and
The Institute of Cancer Research
with the aim of revolutionising
the way we treat cancer.
Now, the top floor of the CMP
has been filled with research
teams, investigating tumours for
new mutations and mechanisms
of response to possible new
treatments. The discoveries
these teams are making will
ensure that The Royal Marsden
remains at the forefront of
international developments in
targeted therapies for cancer.
Centre for Molecular Pathology
Systems and Precision
Cancer Medicine
This team, led by Dr Anguraj
Sadanandam, develops ways to
screen patients with colon and
pancreatic cancers to determine
which group of patients is more
likely to respond to a specific
treatment. The aim is that
patients are given a personalised
treatment regimen that works
efficiently on their specific cancer.
Gastrointestinal Cancer
Biology and Genomics
Dr Nicola Valeri leads this
team in the discovery of novel
therapeutic targets and
biomarkers for gastrointestinal
cancers. Their research has three
main aims: studying circulating
microRNAs as predictors or
response in gastrointestinal
cancer patients; using largescale RNAi screenings to
define novel therapeutic targets;
and developing novel preclinical models for drug
testing and studying
mechanisms of resistance.
Clinical Pharmacodynamics
Biomarker
Dr Udai Banerji and his team
study the biological effects of
new treatments on the body.
Patient samples from tumours,
blood and hair are taken before,
during and after treatment
and undergo bespoke tests
to determine how active the
drug is in individual patients.
This is a critical question
when evaluating new anticancer drugs.
created to predict such
mechanisms in cancer cells and
devise rational combinations of
drugs to provide more effective
treatment options.
Cancer Biomarkers
Laboratory
Headed by Professor Johann
de Bono, this team focuses
on circulating biomarkers,
specifically circulating tumour
cells (CTCs), whole-blood
gene expression profiling,
and sequencing of circulating
tumour DNA (ctDNA) in plasma.
The CMP routinely receives
blood samples taken from
patients being treated at The
Royal Marsden, as well as other
hospitals around the world.
Counting the CTCs in a blood
sample gives the clinician an
indication of how a patient is
responding to therapy.
Computational Pathology
and Integrative Genomics
Dr Yinyin Yuan leads this
team, which is investigating
cancer tissue ecosystems and
how selective pressures can
promote cancer development.
Understanding how tumours
adapt to their microenvironment
is key to appreciating how they
grow and spread, and could
direct interventions to alter or
stop the selective pressures
helping to drive their growth. rm
Above: Dr Udai
Banerji leads
the Clinical
Pharmacodynamics
Biomarker and
Drug Evaluation
Pharmacodynamics
teams. Below: Adnan
Khan (left) and
Andreas Heindl
are part of the
Computational
Pathology and
Integrative
Genomics team
Drug Evaluation
Pharmacodynamics
Scientists working in this
group, also led by Dr Banerji,
are studying resistance to
cancer treatments in order to
devise combinations of anticancer drugs that can overcome
specific resistance mechanisms.
Computer algorithms are
RM MAGAZINE 19
RADIOTHERAPY
Focusing the beam
As a Biomedical Research Centre, The Royal Marsden and The Institute
of Cancer Research together receive funding from the National Institute
for Health Research to support our work. Here, we show how advanced
radiation technologies are leading to better patient outcomes
a
t The Royal Marsden,
we are dedicated to
developing advanced
techniques to enhance the
benefits of radiotherapy. Half
of our patients will receive
radiotherapy at some point
during their treatment and it
contributes to the cure of 40 per
cent of patients as a standalone
therapy, or in combination with
treatments such as surgery
or chemotherapy.
Professor Kevin Harrington
is Radiotherapy Theme Lead
for the Biomedical Research
Centre (BRC). He focuses on
how new techniques such as
intensity-modulated radiotherapy
(IMRT) and image-guided
radiotherapy (IGRT) can help
increase cure rates, reduce side
effects and improve functional
outcomes for patients.
“We are currently assessing
the role of IMRT in shaping and
delivering radiation beams more
accurately,” says Professor
Harrington. “This would allow
BRC THEMES
The Royal Marsden’s work
as a Biomedical Research
Centre focuses on eight
research themes, each of
which is spearheaded by
a Theme Leader. The themes
and their leaders are:
20 RM MAGAZINE
us to increase the radiation dose
to a range of different tumour
types, including pelvic, lung
and head and neck cancers.
“A number of studies are also
addressing the issues of using
IMRT as a way of avoiding
damage to normal tissues.
These include assessments
of sparing the heart, salivary
glands and carotid arteries.
The support of the BRC has
been essential to fund
research in delivering these
pioneering techniques.”
Professor Harrington and his
team have also conducted pilot
studies on reducing the number
of fractions of radiotherapy in
breast and prostate cancers.
FAST-Forward, a randomised
Phase III multicentre trial, aims
to identify a one-week, fivefraction schedule of curative
radiotherapy that is at least
as effective and safe as the
UK-standard 15-fraction
regimen used after primary
surgery for early breast cancer.
Cancer Imaging
Dr Dow-Mu Koh
Molecular Pathology
Professor Mitch Dowsett
Cancer Therapeutics
Professor Johann de Bono
Breast Cancer
Dr Nicholas Turner
“This is of great benefit to
patients, as they have fewer
radiotherapy treatments and,
potentially, reduced side effects,”
says Professor Harrington. “It
is also important to the NHS
as it achieves a 66 per cent
cost-saving benefit.”
The Royal Marsden has also
won funding from the Medical
Research Council to build a new
MR Linac, which will be used,
initially, in Sutton for research
in treating tumour types such as
prostate, lung, head and neck,
rectal and pancreatic cancers.
“The MR Linac will use MRI
in place of the standard CT
imaging on our existing linear
accelerator [linac] machines
and allow us to see tumours in
real time during each fraction
of radiotherapy,” says Professor
Harrington. “This will lead to a
significant increase in studies
that we hope will be BRCfunded to evaluate image-guided
radiotherapy across a range
of tumour types.” rm
Prostate
Professor David Dearnaley
Clinical Studies
Professor David Cunningham
Cancer Genetics
Professor Nazneen Rahman
Radiotherapy
Professor Kevin Harrington
NIHR Biomedical Research Centre
Our radiotherapy
trials are of great
benefit to patients,
as they lead to fewer
treatments and,
potentially, reduced
side effects
PROFESSOR KEVIN HARRINGTON,
BRC RADIOTHERAPY THEME LEAD
RM MAGAZINE 21
Multiple genes from several
patients can be sequenced
in a matter of days
As Manager of the Molecular Diagnostics
Laboratory, two days are seldom the
same for Dr Lisa Thompson. But whether
it’s assessing solid tumours in the
laboratory, giving talks to colleagues or
explaining the department’s work to
fundraisers, Dr Thompson is focused on
high-quality diagnostics for patients
22 RM MAGAZINE
Staff profile
A DAY IN THE LIFE
Dr Lisa Thompson
Laboratory Manager,
Molecular Diagnostics
m
y role is to ensure that The
Royal Marsden’s Molecular
Diagnostics Laboratory
provides a comprehensive, specialised
service for haematological malignancies and
solid tumours. We’re not patient-facing, but
what we do in the laboratory helps patients,
and that means a lot to everyone. With
state-of-the-art technology and facilities,
we’re fortunate to be based in the Centre
for Molecular Pathology (CMP) in Sutton.
In sequence
My day starts at 8am with assessments
in solid tumours such as lung cancer,
colorectal cancer and melanoma. In order
to maximise finding genetic changes at low
levels in the tumour, we need to enrich the
tumour cells from which we extract DNA. By
using a microscope, I identify and mark the
tumour-rich tissue on a slide before passing
it to my team for DNA extraction. We use
this approach not only for Royal Marsden
patients, but also to prepare DNA for the
100,000 Genomes Project [see page 24].
Using next-generation sequencing
technology and specialist software, we
look for genetic changes in the DNA that
will have a direct impact in the diagnosis,
prognosis and targeted treatment options
for patients. Multiple genes from several
patients can be sequenced at one time in a
matter of days, rather than the weeks taken
with conventional methods. I report our
sequencing results to the oncologists at
The Royal Marsden and other hospitals
across the country and overseas. We are
also using this technology in the Cancer
Research UK National Lung Matrix Trial.
I next focus on testing an online system
for requesting tests and viewing results. This
will allow clinicians to track sample requests
in real time and to receive alerts when results
become available, improving the standard
of clinical reporting and patient care.
Time for a lecture
Around lunchtime, I sometimes give lectures
on topics such as next-generation sequencing
to pathology staff. Lectures are an important
part of continuing professional development,
and keep staff up to date with advances in
molecular pathology as well as how our
work fits into the patient’s clinical pathway.
Next, I might be back to the laboratory
to take fundraisers on a tour of the facility.
This is a rewarding role, as fundraisers
generously support our work and appreciate
getting an insight into what we do here.
Finally, I go to a lab meeting, at which I’m
updating the team on a new departmental
policy. An important area of my work is
ensuring the laboratory is performing to the
highest level and fulfils the requirements of
the UK Accreditation Service. This involves
making sure that all aspects of laboratory
work is documented and audited and that
there are clear standard operating
procedures and policies in place.
I’m proud to work with an amazing and
dedicated group of people. No day is ever
the same and each one brings different
challenges, which is why I enjoy working
in molecular diagnostics. rm
RM MAGAZINE 23
100,000 Genomes Project
GROUNDBREAKING GENOMICS PROGRAMME
Hundreds and
thousands
The Royal Marsden is part of a new initiative to sequence the genomes of thousands
of people in England. Dr Rowena Sharpe, Assistant Director of the NIHR Biomedical
Research Centre, explains the importance of the 100,000 Genomes Project
The 100,000 Genomes Project is an
ambitious three-year programme to
sequence 100,000 whole genomes
from NHS patients across England
by 2017. Genomics promises
incredible benefits in healthcare
through scientific discovery, and
this study will help to deliver them.
In what way is The Royal
Marsden involved?
The project is the latest element of
our pioneering work in translational
cancer research and personalised
medicine. The Royal Marsden is
part of the West London Genomic
Medical Centre (GMC), along with
the Imperial College, Chelsea and
Westminster, and Royal Brompton
NHS trusts. We’re leading on the
cancer element of the partnership,
collecting and decoding the
genomes from some of the 50,000
cancer patients who are treated
at our Chelsea and Sutton sites
each year, together with patients
from two Royal Marsdenassociated hospitals: Epsom
and St Helier, and Kingston.
Why is genomics so important
in cancer treatment?
Identifying the genomic make-up
of patients and their tumours is
crucial for pinpointing whether
they are eligible for targeted therapy.
The knowledge we’ve gained in
24 RM MAGAZINE
recent years has provided us
with an opportunity to accelerate
our understanding of cancer,
particularly in the area of
personalised medicine.
Which patients will be involved?
There has been an extraordinary
response by patients and their
families wanting to take part in the
project. It is anticipated that about
75,000 NHS patients across England
with cancer or a rare disease –
including some with life-threatening
and debilitating diseases – will be
involved. Recruitment for the cancer
element of the project began in May
2015 to identify and gain consent
from patients and to collect tumour
samples, extract DNA and start the
whole-genome sequencing process.
Can genomics improve the
treatment patients receive?
Research into genomes has already
led to enhanced treatment for our
patients. For example, a mutation
in the BRCA2 gene can trigger a
type of breast cancer as the body
produces faulty proteins and,
ultimately, tumours. Identifying the
BRCA2 gene enables clinicians to
draw up targeted patient treatment
plans and potentially increase the
chances of remission and survival.
The BRCA2 gene and its links
to cancer were discovered 20 years
ago by scientists at The Institute
of Cancer Research, The Royal
Marsden’s academic partner. This
paved the way for genetic testing
and the discovery of treatments
for patients with the faulty gene.
This is just one example. Genetic
research has enabled new and
more precise diagnostic tests,
and will lead to more effective
and targeted treatments to improve
outcomes and reduce side effects
of cancer therapies. BRCA is one
of many genes that are altered in
cancer. The 100,000 Genomes
Project will look at whole human
genomes to identify, in a single
test, the changes that may be
present in many different genes.
What future benefits will we see?
This initiative – and genomics in
general – could transform the future
of healthcare. It could improve
the prediction and prevention
of disease, enable new and more
precise diagnostic tests, and allow
personalisation of drugs and other
treatments to specific genetic
variants. We’re already pioneers
in this field and this project gives
us the opportunity to have an even
greater impact on cancer treatment
and practice in the future. rm
To discover more about the
100,000 Genomes Project or to find
out how you can take part, visit
www.genomicsengland.co.uk
ILLUSTRATION: DALE EDWIN MURRAY
What is the scope of the project?
Genomics
explained
Genomics is the
study of genomes.
A genome is the
complete map of the
DNA sequence of an
organism. The full
human genome,
which comprises
three billion letters,
was completely read,
– or sequenced – in
2003 through the
Human Genome
Project. The project
cost £2 billion and
involved years of
research by scientists
around the world.
Modern technology
now means that
a person’s genome
can be sequenced in
a matter of days, at
a fraction of the cost.
Today’s pioneering
genomics projects
are leading to
dramatic advances
in personalised
medicine, and better
outcomes for cancers
in particular.
RM MAGAZINE 25
THE ROYAL MARSDEN
CANCER CHARITY
Give me five!
This spring, thousands of patients, staff, family and
friends came together for the fifth annual Marsden March
in support of The Royal Marsden Cancer Charity
he sun shone on 22
March as more than 5,500
walkers crossed the finish
line of the fifth annual Marsden
March, a 14-mile sponsored
walk between The Royal
Marsden’s Chelsea and Sutton
hospitals to raise money for The
Royal Marsden Cancer Charity.
This year’s event was started
by Professor Martin Gore,
The Royal Marsden’s Medical
T
26 RM MAGAZINE
Director, whose groundbreaking
work has been supported by
The Royal Marsden Cancer
Charity. Richard and Fred
Fairbrass from pop band
Right Said Fred, who have
walked every year, cut the
ribbon in Chelsea.
The event began in 2011
with 2,000 participants, who
raised more than £800,000.
Since then, it has involved
over 15,000 marchers and
raised almost £5 million.
The Marsden March is a great
way for patients, staff, friends
and family to show their support
or honour a loved one. Money
raised from the Marsden March
helps us to provide the best
possible care and treatment for
people affected by cancer.
As well as Richard and Fred
Fairbrass, there were a number
of other familiar faces among
the walkers this year. Comedian
Tim Vine kicked off the fivemile walk from King George’s
Playing Fields in Lower Morden
before completing the walk
with the rest of the fundraisers.
Newsreader Nicholas Owen
was also there to hand out
medals at the finish line.
Charles Hallatt, Chairman
of Banham, sponsors of the
event, said: “We were honoured
to sponsor The Royal Marsden
Cancer Charity’s Marsden
March. A large number of the
Banham team participated and
raised funds for this vital cause.
“The Marsden March really
brings the community together
to raise funds and awareness
for The Royal Marsden so
that it can keep achieving its
pioneering and life-saving
Fundraising
This year, 5,500 walkers took part in
the fifth annual Marsden March, raising
more than £1.6 million for The Royal
Marsden Cancer Charity. The 14-mile
route between Chelsea and Sutton
took in landmarks such as Putney
Bridge and Wimbledon Common
The atmosphere
was fantastic. I’ll
be signing up for
next year’s march
without a doubt
TALIA GOLDING, ROYAL MARSDEN PATIENT
research to fight this terrible
disease that unfortunately
touches so many of us. We were
delighted to take part and hope
this year sees the largest-ever
fundraising amount to date.”
Amanda Heaton, The Royal
Marsden Cancer Charity’s
Community and Corporate
Fundraising Manager, said:
“A big thank you to everyone
who gave up their Sunday to
take part in another fantastic
day – we saw more walkers
than ever before taking part.
“Early indications are that we
are on our way to exceeding our
fundraising target of £1.6 million
and we hope we can continue
to improve on this figure year
after year. We are so grateful
to all our fundraisers, volunteers
and supporters and look forward
to seeing them again in 2016.”
Talia Golding, a 25-year-old
patient treated at The Royal
Marsden for non-Hodgkin
lymphoma, walked the 14-mile
route on the day. She said:
“The hospital is an amazing
place, with great facilities and
staff. I found out about The
Marsden March while I was
staying in hospital a couple of
years ago and decided I really
wanted to take part.
“This was the first year that
I’ve been well enough to do it
and I really enjoyed the day –
the atmosphere was fantastic.
I’ll be signing up for next year’s
march without a doubt.”
Next year’s Marsden March
takes place on Sunday 13 March.
To find out more, visit www.
royalmarsden.org/march or
email marsdenmarch@
royalmarsden.org
RM MAGAZINE 27
FOUNDATION NEWS
A WELCOME TO...
Professor Dame Janet Husband, former
Medical Director of The Royal Marsden, who
returned to the hospital last year to take up the
position of Non-Executive Director. We speak
to her about her activities in recent years and
how it has been since taking up the role
Janet’s career
highlights
2002
Appointed Officer of
the British Empire for
services to medicine
2003
Appointed Medical
Director of The
Royal Marsden
2004
Becomes the first
female President
of the Royal College
of Radiologists
2007
Awarded title of
Emeritus Professor
of Radiology by The
Institute of Cancer
Research. Appointed
Dame Commander of
the British Empire for
services to medicine
2010
Appointed Chair of
the National Cancer
Research Institute
2014
Rejoins The Royal
Marsden as a
Non-Executive
Director
28 RM MAGAZINE
Research, the Trust’s
academic partner, in 2007,
and retired in the same
year after a career in
diagnostic radiology
spanning nearly 40 years.
Away from The Royal
Marsden, Janet became
the first female President
of the Royal College of
Radiologists in 2004. In
2007, she was appointed
Dame Commander of the
British Empire for services
to medicine and received
an Honorary Doctorate of
Science from the University
of London in 2013.
Janet’s impressive career
also extends to a number of
non-executive appointments
in healthcare, as well as
a six-year service as a
Specially Appointed
Commissioner to The Royal
Hospital in Chelsea and
a spell with Monitor as a
member of the Cooperation
and Competition Panel for
NHS-funded services.
he newest member
of the Trust’s Board
of Directors is
Professor Dame Janet
Husband, who joined us
in June 2014 as a NonExecutive Director following
the unanimous approval of
her appointment by the
Council of Governors.
T
Janet will be familiar to
many staff and patients
as she was formerly The
Royal Marsden’s Academic
Lead in Radiology and was
Medical Director from 2003
to 2006. She was awarded
the title of Emeritus
Professor of Radiology by
The Institute of Cancer
It is a huge
privilege to be
a Non-Executive
Director at The
Royal Marsden
PROFESSOR DAME JANET HUSBAND,
NON-EXECUTIVE DIRECTOR
Foundation news
Clinical Nurse
Specialist Joanna
Stone discussed
her work with
young patients
at a recent
Members’ Event
Between 2010 and 2012,
Janet served as Chair
of the National Cancer
Research Institute.
“My previous roles have
given me a wealth of
experience in many different
settings,” Janet said, “but
a constant theme running
through them all is oversight
of the quality of patient care
and strategies to ensure its
continuous improvement.
This has given me the best
possible background to
take up this role, and to
provide an experienced,
independent voice on the
Board to support its overall
strategic direction.”
In her role, Janet attends
Board sub-committees, the
Quality, Assurance and Risk
Committee, the Audit and
Finance Committee and
Council of Governor
meetings. She has already
had a positive influence
following her return to the
Trust, and has shown her
firm commitment to her new
position by embarking on
hospital ‘walkabouts’ with
Chief Nurse Shelley Dolan
and Chief Operating Officer
Dr Liz Bishop.
“I am very fortunate to
have been able to talk to
patients,” said Janet. “I
have learned that there is
a real culture of caring for
patients as individuals,
which shines through the
whole organisation. This
one-to-one contact is a
powerful tool to help inform
our ideas about how we
can improve patient care.
“I am delighted to have
been appointed as a
Non-Executive Director at
The Royal Marsden. It is
indeed a huge privilege.”
MEMBERS’ EVENT: NURSES
ON THE FRONTLINE OF CARE
The Royal Marsden recently held an event for its members and
Governors to give them an insight into the role of nursing at the
hospital and within the community.
Hosted by Jen Watson, Clinical Nurse Director, the event at
the hospital’s Sutton site was attended by about 50 people.
Dr Catherine Wilson, Head of The Royal Marsden School,
discussed the growing success of the school, while Clinical
Nurse Specialist Joanna Stone spoke about the challenges
she faces working with young patients in the Oak Centre for
Children and Young People.
Ann Duncan, Matron for Smithers, Kennaway, Markus and
Wilson wards, gave an overview of what her role involves,
followed by a presentation about nursing in the community by
Jane Hopping, Integrated Locality Manager for Raynes Park
of Sutton and Merton Community Services.
Jen said: “The event was a great success, with many members
saying they had found out something new. It is really important
that the role of nursing is understood as it is a vital part of the
successful running of the hospital.”
The Trust would like to thank all those who were involved
in the event, particularly the members and speakers who
made it a great success.
If you are interested in attending similar events and are not a
member, please contact Rebecca Hudson on 020 7808 2844.
Keep in touch
Dates for your diary
Annual General Meeting
Tuesday 22 September 2015,
5pm-6.30pm, Chelsea
Governor Focus
Conference
Carer and Patient
Governors Lesley-Ann
Gooden and Colin Peel
represented The Royal
Marsden at the NHS
Providers Governor Focus
Conference in April.
The event brought
together more than 200
governors from acute,
ambulance, community
and mental health trusts
across the country. It
enabled them to share
their experiences and
explore how governors
can be best equipped to
support trusts in delivering
quality healthcare.
Colin said: “I found it
very useful in terms of
content and information.
I had the opportunity to
see what problems other
trusts were facing and
to discuss potential
solutions that would
also benefit our Trust.”
Council of Governors
meeting Wednesday
23 September 2015,
11am-1pm, Chelsea
To attend a meeting, please call 020 7811 8558.
Become a Member and/or
contact your Governor:
telephone 020 7808 2844,
email foundation.trust
@rmh.nhs.uk or visit
www.royalmarsden.
nhs.uk/membership
RM MAGAZINE 29
PUZZLES & PRIZES
Test your wits
Win!
Complete our crossword and you could win £50 in John Lewis vouchers
SUDOKU
2
4
3
4 9
8
4
7
3
7
2
3
Dear RM, When my mother was diagnosed
with breast cancer, our world was turned
upside down, but the process was made
much easier by your wonderful staff. At every
moment after you walk through the door,
you are greeted with warmth and smiles.
I cannot thank the staff at The Royal
Marsden enough. Everyone works so hard,
so it was fabulous to see the Awards article
in RM – they deserve to be rewarded.
Jackie Clark
6
5
8
3 1
5 8
7
9
5
5
7
8
4 7
9
6
3
1
Star letter
4
2
4
6
7
9
8
11
14
12
PRIZE CROSSWORD
55
13
10
13
15
16
17
Fill in your details below when sending in your crossword
competition entry. See right for details of our address.
Across
1 Cereal seed (5)
4 Portion (5)
6 Frozen water (3,4)
8 Underworld (5)
9 Uncertainty (5)
11 Turn upside down (5)
13 African river (5)
14 Faults (7)
16 Rabbit (5)
17 Flying geese (5)
Down
1 Dog (9)
2 Shorten (7)
3 Catches a criminal (5)
4 Beg (5)
5 Bird (3)
7 Provide amusement (9)
10 Raise to a higher standard (7)
12 Publicly denounce (5)
13 Nurseries for birds (5)
15 Light-hearted pleasure (3)
NAME
ADDRESS
POSTCODE
TELEPHONE
30 RM MAGAZINE
Congratulations to Tatiana Roshupkina,
the winner of last issue’s crossword prize.
The lucky winner
of our prize
crossword will
receive £50 in John
Lewis vouchers.
We also welcome
your thoughts on
RM magazine and
love to hear about
your experiences
at the hospital.
The Star Letter
wins £50 in John
Lewis vouchers.
Send your crossword or
letter with your name and
contact details to RM, Press
Office, The Royal Marsden,
Fulham Road, Chelsea,
London SW3 6JJ. The entry
closing date is Tuesday 28
July 2015. See below for
prize draw rules.
PRIZE DRAWS & STAR LETTER TERMS &
CONDITIONS: 1. The Prize Draws and Star Letter
are open to all readers of RM except employees
of the Press Office at The Royal Marsden and
Sunday, who produce RM magazine. 2. The closing
date for receipt of all entries is Tuesday 28 July
2015. Only one entry per person per draw.
3. Responsibility cannot be accepted for entries
that are incomplete, illegible or not received.
Proof of posting is not proof of receipt. No cash
alternative is available and prizes are not
transferable. Value of prizes is correct at time of
going to press. 4. Winners will be notified by post
within 14 days of closing date. 5. The Promoter’s
decision on any aspect of the promotions is final
and binding. No correspondence will be entered
into. 6. The Promoter reserves the right to
substitute a prize of equal or greater value
should circumstances make this necessary.
7. Entry implies acceptance of rules. 8. The
winner of the Star Letter prize of £50 in John
Lewis vouchers is the sender of the best letter
selected by RM magazine. 9. The winner of the
crossword prize of £50 in John Lewis vouchers
will be the first correct entry drawn out of the
bag. 10. The Promoter is The Royal Marsden
Hospital, 203 Fulham Road, London SW3 6JJ.
IN THE NEXT ISSUE
RM brings you the latest hospital updates, research news, inspiring
stories and exclusive interviews. The autumn 2015 issue is coming soon…
●
●
●
News from ASCO
Investing in
continuing education
New Father &
Son fundraising
campaign
FOR THE ROYAL MARSDEN
Rachael Reeve – Director of Marketing and Communications Elaine Parr – Head of PR and Communications
Vicky Hartley – PR and Communications Manager Catherine O’Mara – Senior Press and PR Officer
Claire Borgeat – Senior Press and PR Officer Kelly Smale – Press Officer
FOR SUNDAY
Marc Grainger – Editor Ian Dutnall – Art Director
Madhushri Nadgir – Senior Account Manager Richard Robinson – Group Editor
Matt Beaven – Creative Director Toby Smeeton – Managing Director
RM magazine is published by The Royal Marsden in partnership with Sunday: wearesunday.com
© The Royal Marsden 2015. All rights reserved. Reproduction in whole or part is prohibited without prior permission of the Editor. The Royal Marsden
and Sunday accept no responsibility for the views expressed by contributors to the magazine. Repro by F1 Colour. Printed by Pureprint.
Registered Charity No. 1095197
You can organise your own My Marsden March
event at a time and a place to suit you, your friends
and family. Beautiful countryside, stunning cities or
scenic beaches – the choice is yours. All the money
you raise will go to The Royal Marsden Cancer
Charity to help us build a future beyond cancer.
For more information visit
www.royalmarsden.org/mymarch