The Royal Marsden

A day in the life: Dr Rob Dowse, Paediatric Haemato-Oncology Consultant

Haemato-oncology covers a range of cancer types, including acute and chronic leukaemia, lymphoma and myeloma. I focus on paediatrics, working in the Oak Centre for Children and Young People in Sutton.
Dr Rob Dowse

Dr Rob Dowse

My days are quite varied, but I’m usually at the hospital by 8am. After checking my emails and having a quick coffee, I go down to the clinical team handover. Colleagues who were on duty overnight speak about any patients who needed additional treatment. Often we have inpatients staying for a stem cell transplant, a critical period of time when they need to be closely monitored through intense treatment.

Personal service

Each week, a consultant is ‘attending’ for paediatric haematooncology. This means you’re in charge of the ward and look after any new patients who come in. If I’m attending, I make sure I know about all the current patients and any ongoing issues I need to keep an eye on. We have a ward round with the stem cell transplant team later in the morning, where my colleagues and I visit every patient to assess their care and treatment, and speak to their families.

Depending on the day, I might then go to the Centre for Molecular Pathology (CMP), where samples from our patients are often taken for analysis. Two or three weeks after a stem cell transplant, a blood sample is analysed in the laboratory to see whether the donor cells are growing and making new
cells. Four weeks after the transplant, we do another test to see where the new cells are originating from. If the transplant has engrafted successfully, these should be from donor cells. I work closely with the pathology teams, and while visiting the CMP I may analyse samples through the microscope.

It’s amazing to have such a fantastic facility on our doorstep, and patients really do benefit from us being an NIHR Biomedical Research Centre. It’s also hugely beneficial to have such a close working relationship with The Institute of Cancer Research, London, which is just next door.

I’m actively involved in clinical research and am the principal investigator on a number of trials. We liaise closely with the research team, with meetings every week. Research is critical for pioneering the best treatment and care, especially in paediatric haematooncology, where we’ve made huge strides over the past few decades in understanding the complexities of these types of cancers and developing effective treatments.

Tailoring treatment

We have multidisciplinary team meetings throughout the week. Personalised cancer care is at the heart of our approach, with every patient receiving a unique treatment plan. These meetings are a chance to regularly discuss, agree and update treatment, and are attended by a range of experts including medical oncologists, radiotherapists, pathologists, radiologists, nurses and allied health professionals.

Over lunch, I catch up with the team on the wards. Communication is a really important part of the job; we’re a close-knit team and patients really benefit from this holistic type of care. In the afternoon, I might have a clinic in our outpatients department, where we talk through results and treatment plans or just have a general discussion about how patients are doing.

We work closely with colleagues at St George’s University Hospitals NHS Foundation Trust, where our patients travel if they need the support of an intensive care unit. If we have patients there, I’ll travel to see them and their families, check on their condition and work with our St George’s colleagues to provide the best treatment and care.

For patients with these tumour types, we’re hoping to cure the disease. We really build a relationship with patients and their families over the years we see them. It’s this part of my job that is incredibly rewarding, when our patients can finish treatment and get back to living ‘normal’ lives.

Dr Rob Dowse, Consultant Paediatric Haematologist