Urology Unit: for healthcare professionals

The Royal Marsden leads nationally and internationally on solutions to improve the patient experience in living with and beyond urological cancers.

Our service

We have improved the way in which urology services are delivered through the expansion and transformation of the existing pathway. If your patient does have urological cancer, they will have access to leading-edge treatments and cancer specialists renowned for their clinical experience.
 
We provide diagnostic services for patients with prostate, testicular, kidney and bladder cancer symptoms. And have the facilities and expertise to diagnose both common and complex cases.

Referrals 

Symptoms of possible urological malignancy of any type are seen in weekly clinics in Chelsea. The Royal Marsden will accept any referral where there is a suspected urological malignancy. Tertiary referrals or those requesting a second opinion are welcome from not only London and the South East, but nationally and internationally.

Speed of referral to diagnosis

Our ‘one-stop model’ ensures more robust and timely diagnosis for patients. We provide a dedicated space for urinary tract imaging with ultrasound, X-ray and flexible cystoscopy carried out in one visit, often giving patients their results the same day and avoiding unnecessary visits.

Diagnostic and surveillance trans-rectal ultrasound and biopsies of the prostate are carried out in the Rapid Diagnostic and Assessment Centre (RDAC), or in the outpatients department in Chelsea.

The Royal Marsden has a comprehensive range of staging modalities including high resolution CT (including PET CT), MRI (including diffusion sequencing), ultrasound, endoscopy and nuclear medicine imaging. We have a close working relationship with the adjacent Royal Brompton Hospital which enables full specialist assessment of any cardio-thoracic issues related to diagnosis and treatment.

Access to personalised treatment plans

Streamlining of the diagnostic pathway ensures our multidisciplinary teams can develop a personalised treatment plan for each cancer patient improving the patient experience and quality of care. 

All major urological surgery is carried out at The Royal Marsden in Chelsea which has comprehensive facilities for laparoscopic, robot-assisted, endoscopic and open surgery, as well as HIFU (High Intensity Focused Ultrasound) for prostate cancer. The Royal Marsden also offers salvage robotic prostatectomy for recurrent disease using the very latest in surgical robotic equipment, the da Vinci Xi system.

Radiotherapy is carried out at both the Sutton and Chelsea hospitals. Radiotherapy techniques include conformal (CFRT) intensity modulated (IMRT), image guided radiotherapy (IGRT) and stereotactic body radiotherapy (SBRT). Chemotherapy is also carried out at both hospitals as well as at the William Rous Unit at Kingston Hospital.

The Royal Marsden has a long history of treating complex and rare tumours. We can offer reconstructive surgery such as the formation of neo-bladders and continent urinary diversions to those suitable for the procedure. The Urology Unit works collaboratively with other surgical specialities such as Plastic Surgery, General Surgery and Gynaecology. The department is also an approved training centre.

Multidisciplinary meetings are held weekly both at a local level and as a joint specialist urology multi-disciplinary team. We aim to deliver the highest quality care with sensitivity, compassion and discretion, using a holistic approach and giving continuity of care.

Patient experience post treatment

We are continuing to improve our follow-up services by introducing survivorship clinics, health and wellbeing events and transfer of care to primary care when safe and appropriate.
 
We are giving patients the opportunity for supported transfer back into primary care for their follow-up care, approximately two years post their cancer treatment.  This means patients can benefit from having follow-up care closer to their home and they don’t need to have unnecessary trips to hospital. We recommend that practice nurses lead the follow-up programme of patients with clear triggers for rapid re-access to secondary care if necessary. 

To support our primary care colleagues, this model will include the development of a discharge care plan and information pack for healthcare professionals and improved education and support for patients prior to transfer of care. The service will be offered when clinically appropriate and on a case by case basis.

Research

The Royal Marsden has a major commitment to research, and works with The Institute of Cancer Research at the Chelsea and Sutton sites. The Urology Unit is carrying out research into screening and genetic profiling of men with a significant family history of prostate cancer and in black men who are at an increased risk of prostate cancer. Together we are working on developing molecular targeted therapy and translational research to develop tissue, serum and other tumour markers.

There are also a number of chemotherapy and radiotherapy trials on-going within the Urology Unit. These include STAMPEDE which recently showed that early chemotherapy improves the survival of men with advanced prostate cancer, Checkmate 025 trial which has revealed that the immunotherapy drug nivolumab has the potential to improve treatment for advanced kidney cancer and the CHHiP trial which is giving fewer but higher doses of radiotherapy to men with prostate cancer.