Women’s health

Innovation is key for breast cancer care

Consultant Oncoplastic Breast Surgeon Giles Davies discusses Cromwell Hospital's leading-edge services for breast cancer patients

Innovation is key for breast cancer care
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What is your role and speciality at the Cromwell Hospital?

I am a Consultant Oncoplastic Breast Surgeon, offering patients breast cancer surgery and reconstruction. I’m the director of breast surgery at the Cromwell, so I sit on the hospital’s medical advisory board and run the surgery side of the unit, and I am also chair of the cancer board.

How is the Cromwell Hospital leading innovation in cancer treatment, and what new technologies and developments can you tell us about?

In particular, there have been two or three main developments over the past couple of years. One has been our partnership with GenesisCare, a US-based radiotherapy organisation, which has brought us innovative precision radiotherapy services. These include stereotactic radiotherapy, which is a guided radiotherapy for hard-to-reach areas, and MRI-guided radiotherapy services. Our precision radiotherapy involves using novel coils, which are little markers that can show the site of a tumour, allow us to remove them within one-millimetre accuracy. We are the biggest unit in London for this kind of surgery. 

We also have one of the biggest cancer multidisciplinary units in London’s independent sector, enabling us to oversee and review the quality of the cancer treatments we provide. The membership of that team includes not just doctors, but also specialists, palliative care nurses, clinical nurse specialists, holistic practitioners, pharmacists – a wide spectrum of people that all provide valuable input into a patient's care. 

We are also piloting an innovative symptom-tracking app, which monitors patients continuously, allowing us to have remote oversight of a patient’s symptoms during and after treatment. For example, I recently performed a mastectomy and reconstruction on a 38-year-old and, using the app, I can see how well she is sleeping. I can also stay informed that her pain levels are going down or if she registers a high temperature. If there are any changes then I am alerted by the app, which is very comforting for patients to know during their recovery and boosts their confidence.  

I am currently leading a telemedicine suite as well, which is a development from our remote patient interactions during the Covid lockdowns. The Cromwell already has a large international patient base, and video consultations allow us to meet these patients before they travel to London, to understand their needs, and perhaps to arrange for initial tests to be carried out locally. I have carried out telemedicine consultations with patients in Ghana and Nigeria, and I have seen a patient from India with early breast cancer. We sourced specialised chemotherapy for her in Karachi, which wasn't routinely available. Subsequently, she visited us for surgery and further radiotherapy before returning home, and we followed her up her aftercare in Karachi remotely from the Cromwell.

I have also given remote training to a breast surgeon in Ghana, based on a patient she referred to me, because we also have the ability to communicate and train through the telemedicine suite. I think this model is going to only continue, with collaborative networking for professionals and remote care for patients before and after they come to the Cromwell, allowing us to share our expertise and enhance the overall quality of care. 

Can you explain the typical patient journey and treatment steps – such as making their first appointment, testing, diagnosis, treatment and aftercare? 

We are very fortunate at the Cromwell in that we have all our services on one site. Many other hospitals have fragmented services, where patients might receive surgery in one place, radiotherapy in another and reconstruction elsewhere, for example. We offer everything under one roof and are able to provide continuity of care from our multidisciplinary team. Our patient feedback indicates that this is an important factor in the treatment journey.

Whenever we see new patients, we always have the capacity for one-stop imaging and biopsy, so if a patient arrives with breast lump, for example, we can offer them imaging and biopsy immediately. Rapid diagnostic services are the key, particularly for breast cancer. Imaging results are usually received within hours, so patients will have a good idea of what's going on almost immediately. Tissue biopsies are sent to a laboratory, and we communicate those to patients within 48 hours, often sooner. This fast turnaround leads to treatment starting quickly too.

Following treatment we provide extensive aftercare to support patient recovery. We have a holistic care team that includes physiotherapists, nutritionists and psychotherapists, all of which are very important in breast cancer care. The counselling services are pivotal, because when you see a consultant and receive a diagnosis of cancer, you may have questions that don't arise immediately or a patient may not have their own support around them. Our counselling services are housed in the mews section of the Cromwell – with traditional coach houses and a cobbled street – which provides quiet and reflective surroundings. 

The average age of our breast cancer patients is 48, so we are treating people who are still young, who want to return to work, to their families and the things they enjoy. To help with this, we also offer a Pilates-based clinical exercise programme following surgery, which is important for the psychological benefits of exercise and reducing the side effects of treatment, as well as focusing on general health and fitness. 

Can patients come to you at any point in their journey, such as for cancer recovery support?

Very much so. Not only do we see patients at the start of their journey, we also welcome those who may be seeking a second opinion, right through to people who are literally finishing their treatment elsewhere and requiring aftercare. 

Patients that haven’t been treated at the Cromwell can access our rehabilitation services, such as physiotherapy and counselling, and our clinical exercise programme is also available to all, wherever they are being treated. For example, our GenesisCare radiotherapy unit has its own holistic package, with a gym and supportive therapies, including reflexology and acupuncture, that they might not have tried before and that could work for them as part of their rehabilitation. 

If you are concerned about your health, or have received a cancer diagnosis and are considering private treatment, contact Cromwell Hospital to learn more about your options: call +44 (0)20 7460 5700 or visit www.cromwellhospital.com/oncology

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