Working as a unit
Mr Declan Cahill, Head of the Urology Unit
The Urology Unit at The Royal Marsden combines state-of-the-art technology with world-leading cancer specialists to diagnose and treat patients, providing diagnostic services for patients with prostate, testicular, kidney and bladder cancer symptoms.
“We have transformed the way the urology service is delivered at the Trust to ensure that patients receive the best access to diagnostics, specialist clinicians and leading-edge treatments,” says Mr Declan Cahill, Consultant Urological Surgeon and Head of the Urology Unit.
Speed of referral
The Royal Marsden’s multidisciplinary model ensures a robust and timely diagnosis for patients. The Trust’s Rapid Diagnostic and Assessment Centre (RDAC) at Chelsea is one of the most advanced centres of its kind in the UK. It provides a dedicated space for urology diagnostics including flexible cystoscopy, uroflowmetry and image guided prostate biopsy, which can be carried out in one visit. Diagnostic and surveillance trans-rectal ultrasound and biopsies of the prostate also take place in the RDAC.
We know that a speedy diagnosis is crucial for better patient outcomes, and we also know how worrying it is waiting to get results
“We know that a speedy diagnosis is crucial for better patient outcomes, and we also know how worrying it is waiting to get results,” says Netty Kinsella, Uro-Oncology Nurse Consultant. “We test men for prostate cancer and, in many cases, provide the necessary tests on the same day.”
The Reuben Foundation Imaging Centre, which is on The Royal Marsden’s Chelsea site, is equipped with two state-of-the-art MRI scanners – one 1.5T and one 3T – and two CT scanners. Meanwhile, the Sutton hospital has three MRI scanners – two 1.5T and one 3T – as well as two CT scanners.
“Our advanced scanners enable us to see a patient’s cancer with greater clarity than ever before,” says Cheryl Richardson, Superintendent Radiographer for MRI.
“Clearer images improve our diagnostic ability and allow us to monitor the metabolism of tumours. We can assess if treatments are working and change plans accordingly.”
specialists join the weekly MDT meetings
Personalised treatment plans
The Royal Marsden’s multidisciplinary teams (MDT) develop personalised treatment plans for each patient, improving their experience and quality of care. Up to 35 specialists join the weekly MDT meetings, including surgeons, medical oncologists, radiotherapists, pathologists, radiologists, nurses and allied health professionals.
All major urological surgery is carried out at the Chelsea hospital, including laparoscopic, robot-assisted, endoscopic and open surgery. Consultant Urological Surgeons Mr Erik Mayer and Mr Christopher Ogden, along with Mr Cahill, also offer salvage robotic prostatectomy for recurrent disease.
“People are living longer and this, unfortunately, means that some patients who have not had surgery to remove the prostate do develop a recurrence of their cancer within the prostate itself,” says Mr Mayer.
“We are now able to offer these patients salvage robotic prostatectomy, which takes advantage of the dexterity of the da Vinci Xi surgical robot to deliver the best outcome.” A full range of radiotherapy and chemotherapy is also carried out at both the Chelsea and Sutton hospitals.
The Royal Marsden continues to improve its follow-up services by introducing survivorship clinics and health and wellbeing events.
The Trust also gives patients the opportunity for supported transfer back into primary care for their follow-up care, approximately two years after their cancer treatment.
Netty says: “This means patients can benefit from having follow-up care closer to home and do not need to make unnecessary trips to hospital.”