Janet Hanwell Clinical Nurse Specialist, Oak Foundation Drug Development Unit

The patients we see in the Oak Foundation Drug Development Unit (Oak DDU) have advanced cancers that have become untreatable with other standard therapies. By the time someone attends our ‘new patient’ clinic in Sutton, they have already been through a lengthy journey as a cancer patient.

It is my role as a Clinical Nurse Specialist (CNS) to give patients information about the complexities of new drug trials and to support their participation in them. It’s an exciting, diverse role that is unique to The Royal Marsden, and combines hands-on care with co-ordinating Phase I clinical trials.

Our unique relationship with The Institute of Cancer Research (ICR) and the pharmaceutical industry enables our patients to access early-stage trials. Our remit is translational research – translating science from the laboratory into treatments to benefit patients.

It’s an exciting, diverse role that is unique to The Royal Marsden, and combines hands-on care with co-ordinating Phase I clinical trials.

Covering all bases

I work three days a week alongside two other CNSs. I start each day at about 8am when I check messages, then the rest of my day is usually spent between clinics and meetings and on the phone to patients and other healthcare services such as hospices, GPs and district nurses. Patients travel from all over the UK to come to the Oak DDU, so making sure they are well supported where they live is important.

I am a core member of the multidisciplinary team (MDT) that meets every Wednesday morning to discuss our 60-plus patients. This is a chance for clinical colleagues to offer their professional opinion and agree the next stage of each patient’s treatment. As a CNS, I provide a holistic perspective, which often promotes discussion about patients’ symptoms and psychological and social aspects of care.

Keeping in touch

After the MDT meeting, I head straight to one of our two weekly outpatient clinics. A large part of my role is building up a relationship with the patient. It’s vital that they feel they can talk to me. Drug development is a team effort and the patient is central to this.

All our trial patients come to the Oak DDU for their treatment and regular check-ups. During the afternoon, I hold telephone clinics with patients at home who may require ongoing support and assessment. I’m often asked to see more complex situations on the ward by the nursing team. We tend to get to know our patients really well as the trial protocols require them to come in weekly for check-ups.

It is an exciting time in drug development. Our improved understanding of the molecular basis of cancer has led to a focus on targeted therapies, which means we are now seeing some good-quality, life-extending treatments.