The CONVERT trial has shown that the use of modern radiotherapy techniques is reducing side effects in small cell lung cancer patients - Professor Corinne Faivre-Finn

Corinne Faivre-Finn, Professor of thoracic radiation oncology and honorary consultant clinical oncologist 

Professor Corinne Faivre-Finn

I attended the international ASCO Cancer Conference this summer, where I was delighted and privileged to present the results of the CONVERT clinical trial that myself and colleagues from The Christie, the UK and around the world have been working on for nearly a decade. CONVERT is the largest study ever completed in this group of patients.  

The aim of CONVERT was to establish a standard combination of chemotherapy and radiotherapy in small cell lung cancer that hasn’t spread. Before this study it was unclear whether having radiotherapy once or twice a day helped more patients survive for longer and what level of side effects was expected with modern radiotherapy techniques.

Around 550 patients from around the world were split into two groups, one group received radiotherapy twice a day over three weeks (standard treatment) and the other once a day at a higher dose over six and a half weeks (experimental treatment). All patients also had chemotherapy. 

Colleagues from The University of Manchester, The Christie, around the UK, France, Spain, Belgium, Netherlands, Poland, Slovenia and Canada compared survival and side effects for both groups. The first patient was enrolled in the study in April 2008 and the last patient in November 2013. 

We found that small cell lung cancer patients live longer and with fewer side effects than previous studies.

The length of survival in both groups was similar with 56 per cent of patients who had radiotherapy twice a day surviving for two years compared with 51 per cent of those given it once a day. Importantly, the majority of side effects from radiotherapy were similar in both groups. 

Compared to previous studies, we found that half the number of patients than expected experienced complications that required a stay in hospital. This reduction in side-effects is likely to be due to the use of modern radiotherapy techniques.

We are very pleased that our results are providing robust evidence on the best way to treat small cell lung cancer that hasn’t spread outside the chest. Based on our findings, twice–daily radiotherapy with chemotherapy should continue to be considered the standard of care, as once-daily radiotherapy did not prove that survival improved compared to the standard twice-daily treatment. However, given the similar results in both groups it is reasonable to offer once daily radiotherapy if twice daily treatment cannot be delivered due to either patients or the hospital’s preference. Patients can now plan their treatment with their doctors according to what works best for them and their hospital.

Although the trial will still be following up patients for five years, the results are already changing clinical practice within the UK and internationally. We have received many testimonies from patients who are very grateful to be alive several years after receiving treatment. 

There have been too many people involved in CONVERT to thank them all individually, but this trial was a fantastic international collaboration that could not have achieved its results without the dedication, commitment and support of countless colleagues.  The study was funded by Cancer Research UK and was developed with, set-up and co-ordinated by the Manchester Academic Health Science Centre Clinical Trials Unit which is based here at The Christie.

More information about the CONVERT trial is available here.

For further information about Professor Corinne Faivre-Finn visit her consultant profile.

The power of small gestures - Graham Lamb

Graham Lamb, Cook Team Manager at The Christie

Graham Lamb

Small gestures can make a big difference - a simple smile and a thank you go a long way. As a member of the catering team at The Christie, we know this only too well, and will always go the extra mile to help our patients. 

What we do is a very important part of the patient experience, but working in a place where everyone has been touched by cancer can be even more rewarding.

That’s one of the reasons why The Christie has set up a serious of monthly meetings for its staff to discuss their feelings and to share their experiences. These meetings are called Schwartz Rounds and I was delighted to have been asked to give a presentation at one recently. The theme of the discussion was the ‘The Power of Small Gestures’. 

At first I struggled to think about what I should speak about. But then I started to think about what we in the catering department actually do on a day-to-day basis and how our department makes a difference to patients, visitors and staff. We do some pretty impressive things and we also understand the power of small gestures.

Every day we come to work and do our jobs but never take the time to appreciate how much hard work, care and dedication we put in, and it is only by reflecting on and talking about it through the Schwartz Rounds that we have the chance to stop and do that, which is quite an eye opening thing to do, and is also very cathartic.

Most people don’t realise how often we are asked to visit patients on the wards when they have specific dietary requirements, or because their treatments or personal preferences mean they can’t always find meals to suit their palate. We often tailor menus to suit individual patients and revisit them every couple of days to plan the meals for the following period. Simply by doing this we find patients are more open to discussing their meals and in some cases, when their preferences may seem a little strange, they feel more comfortable  speaking to us rather than the ward staff because often they haven’t considered the possibility that we can provide alternative choices outside of the standard menu.

Through visiting a ward we get to see a patient over a period of time. It’s very rewarding to see a noticeable improvement in a patient , especially those who are eating properly again through our input. The flip side of this is that it can be very upsetting in a small number of cases to see a patient continue to deteriorate, despite the best efforts of all the doctors and nurses, and of course our own team that works so hard to find choices of food that the patient will want to eat.

Simply by discussing and planning their meals with us, patients feel included and empowered and are more inclined to try and eat their meal because they have had an input into it. 

Through communicating, encouraging and involving the patients we know that we go the extra mile to offer the best service. It is always appreciated by the patients and when they say “thank you”, that gesture always makes what we do worthwhile, no matter how tiring the day has been, we focus on that gesture.

One example of how the catering team has gone the extra mile for patients was when a very poorly patient in the last days of life wanted to get married. We got a call at 11am that morning to say the wedding was taking place at lunchtime and could we provide a wedding buffet, including a wedding cake, to be served at 1pm. How could we refuse a request like that! 

So we pulled together as a team with all the usual mayhem going on around us and managed to deliver a wedding buffet as well as a cake with chocolate balloons, hearts and the couples’ names iced onto the cake. 

Knowing that we had done something so special for someone in their dying days was hugely rewarding and we know that most patients really appreciate that. It’s equally rewarding when the efforts we go to are recognised by our colleagues with a simple thank you – the power of small gestures really can make a big difference, but are all too easily overlooked!

Most people only see the ward service or the restaurant service and don’t appreciate what goes on behind the scenes to ensure those services are delivered on time. For example we serve around 1,500 meals per day to patients and staff, all freshly prepared and cooked on the premises. No microwave meals like a lot of hospitals serve to patients! It’s essential that we send the patient trolleys out to the wards on time and ensure the restaurant service is set up and ready to go each day. We often have buffets to do for meetings and the odd wedding breakfast to provide as well, so team work is essential.

So our days can be interspersed with ups and downs, positive and negative gestures, however, as always, a positive gesture from a patient cancels out anything negative about the day, making our jobs even more worthwhile, and giving us a great deal of job satisfaction. Working at The Christie and helping our patients really is a special experience. 

The Christie is like a jigsaw and we all make up that jigsaw, no matter what job we do. We all form part of that jigsaw and if any piece is missing, the jigsaw can never be completed. Each piece of the jigsaw is also like one of those small gestures, and without the thousands of small gestures everyday, our Christie jigsaw would be incomplete! 

This year’s Christie Will Week is more popular than ever - Caroline Harrington

Caroline Harrington, Partner, Furness Evans Solicitors 

Caroline Harrington

Like many people in the North West I’ve experienced the amazing staff at The Christie so it’s my pleasure to help fundraise so they can continue with their fantastic and necessary work.
  
Furness Evans is based in Cadishead and prides itself on being a local firm for local people. 

Our aim is to make our clients feel valued and know they can rely on us during difficult times.  

Cadishead has a strong community spirit and this was one of the reasons I chose to move to Furness Evans nearly four years ago.   

The people of Cadishead, Irlam and surrounding areas are extremely generous people and like nothing better than rallying around to help out. I believe this is one of the reasons why this year’s Christie Will Week is more popular than ever. 

To increase awareness of this year’s Make a Will Week I placed a small article in the local free magazine and the response has been overwhelming. I know I shouldn’t be surprised as it’s always been clear to me how generous the local community is but nevertheless I have been overwhelmed by the response.  

Make a Will Week enables me to draft wills free of charge, which in turn means my clients are free to donate my fee to The Christie.  

In light of this, I’m extending my availability to the following week and would urge people to prepare a will and help The Christie.  

Many people put off making a will – some feel it is tempting fate, that they don’t have enough money for it to be worthwhile or simply that they don’t know what is involved. 

Having a will is invaluable – it ensures your money is dealt with how you would want it to be and helps those left behind deal with the estate with your guidance.  

It’s such a good feeling to know that our firm is helping to make a difference.  During Make a Will week, I’ve been inspired and touched to hear people’s experience of The Christie.  

Even if the outcome wasn’t what they wanted, the facilities have been described as amazing with the level of care and support provided by the staff described as life affirming. It is a facility that we all hope we will never need to make use of but is there should we or one of our loved ones need to.  

I have to stop writing now as my phone has just rung - someone has nipped in to make an appointment for Make a Will Week! I hope to see you too – please feel free to give me a call or pop into our office to make an appointment.  

The Christie charity is a very inspirational place to work and is full of people who want to make a difference - Louise Stimson

Louise Stimson, Head of Fundraising, The Christie charity

Being a Manchester girl I am so proud to be the Head of Fundraising at The Christie charity. Friends and family members have passed through The Christie doors at one point or another, which made me more determined to work here.  

I am so pleased to be part of a much loved Manchester institution that helps so many people.

At The Christie charity we raise funds to provide services for patients that go above and beyond what the NHS is able to provide. Whether we are funding the art room or big construction projects such as the forthcoming Integrated Procedures Unit, our primary concern is ensuring that patients are able to receive the best treatment and care possible.  

When I started in my role a year ago, in September, I remember being really excited to work here. Meeting my team and other colleagues only reaffirmed that I had made the right move. The charity is a very inspirational place to work and is full of people who want to make a difference. I see this passion from our staff on a daily basis.

One of my first duties when I started was to host the ‘Walk of Hope’ at Tatton Park. Meeting so many inspirational people in one evening was quite overwhelming but it left such a positive impression on me.  

Walking through the corridors in the hospital and seeing patients being helped by our hospital staff reminds me why I’m here and constantly reignites my passion for raising those much needed funds.

People have many different reasons for fundraising for us, they might be receiving treatment here or might have been a patient themselves in the past. We also have lots of fundraisers who are the friends or relatives of someone who has been treated by The Christie. I hear wonderful stories from our supporters all the time about the excellent treatment and care they have had from the doctors and nurses.

Our supporters raised an amazing £15.9 million last year which is the most we have ever raised. It makes me so proud to head up this successful fundraising team which, through the money raised, makes such a huge difference to the lives of Christie patients.

This year we have introduced a number of exciting new events, one of them being the Fire Walk in March which definitely caught our supporters interest. As it was so popular we are hosting another one next March so sign up quick! As I’m not a runner or a cyclist, this event enabled me to participate in one of our sporting challenges. It was certainly nerve wracking to be the first person to walk across the coals that evening but I’m so glad to have taken part. My next challenge will be the Great North Swim next year and I will be starting my training soon!

We are a very fortunate charity as we have so many active supporters, but we need that support more than ever. We have exciting and ambitious plans for the future.

We want to be able to continue to bring more of the world’s leading cancer experts and their teams to Manchester as part of our academic investment plan focusing particularly on six identified themes - lung cancer, radiation therapy, haematological oncology, women’s cancer, melanoma and personalised/stratified cancer therapy.

We also plan to bring more state of the art innovative equipment to The Christie, including a revolutionary MR Linac scanner enabling experts to deliver more targeted, personalised and advanced radiotherapy for our patients.

We are also raising £4.8m to build an Integrated Procedure Unit. This development is needed to match demand for day case medical procedures such as minor surgery and endoscopies, which are all increasing. This will enable a patient’s treatment to be less fragmented across the site.

Our fundraising continues this year for a dedicated research room on our new proton beam therapy centre, and it is wonderful to see the build progressing so fast on the site. This year we will also be raising funds to replace the outdated patient entertainment system with a hospital wide, multi-media entertainment and information system. Our vision is that this will be a mobile ‘in-flight’ style infotainment service for both inpatients and outpatients.

We will be launching a new fundraising campaign in the autumn which I know will inspire more and more people to get involved with the charity. I can’t say much more about it at the moment but it’s all very exciting!  We are also so pleased this year to be able to announce that we are the official charity partner for the 2017 Great Manchester Run. We will have the partnership for the next three years and it also involves the introduction of a new half marathon on the same day! Soon we will also be announcing a new event that we will be hosting in March 2017 at Beetham Tower in Manchester City centre. Watch this space!

One thing I’ve learnt in this job is that there are always lots of great things going on at The Christie and lots to do to make sure we can fund them, but I know that my team and I wouldn’t have it any other way. It’s an absolute pleasure to do what we do and I’m very lucky to do this job.