A unique training programme for a new breed of cancer care doctors is underway at The Christie in Manchester, an international center of excellence in cancer care.
Three supportive oncology fellows have been recruited to support the development of a new service at The Christie for cancer survivors with complex problems requiring specialist interventions. This new type of cancer care doctor will help to prevent and manage the adverse effects associated with cancer and its treatment.
The supportive oncology service at The Christie has been developed to improve the quality of life for the growing number of patients living with cancer for an extended period.
The service supports around 2,000 patients each year. It is the first of its kind in the world to combine a wide range of support services, including psychological support, pain and symptom management, medication optimization, occupational therapy, and end-of-life care.
Other services provided through supportive oncology include dietary advice, endocrinology for the hormonal side effects of cancer treatment, cardio-oncology and access to a specialist senior adult oncology team for patients with high levels of frailty.
The first of the three supportive oncology fellows to start at The Christie is Dr Ahmed Aboelnaga. He will be joined by Dr Savannah Thirza and Dr Erdem Kolemen by the end of the year.
Dr Ahmed Aboelnaga said: “I am thrilled to have been recruited to this new fellowship and to be one of the first of a new type of cancer care doctors working to improve the quality of life for cancer survivors with complex needs.
My initial medical training was in Egypt, but I have worked in several countries and was a GP in Huddersfield most recently. The Christie has a worldwide reputation, so I feel fortunate to be here. While working in oncology in Saudi Arabia, we often asked for a second opinion from The Christie.
“Both of my parents in Egypt had cancer, and that has influenced my approach to this role, wanting to do everything possible to support patients to overcome the challenges of treatment throughout their whole cancer journey, not just providing end-of-life care.
“I hope I will be able to apply what I have learned as a GP and bring a slightly different perspective to discussions in the team about the best way to care for patients.”
The fellowship for each doctor lasts 12 months; during this time, they will do three rotational placements lasting four months.
The first placement will cover acute oncology (managing acute problems relating to cancer or cancer treatment), toxicities management (problems caused by cancer treatments), and inpatient care.
For the second placement, the fellows will work with the supportive care team, in enhanced supportive care clinics and with the palliative and end-of-life care team.
The third placement will cover psychological medicine, endocrinology, and the senior adult oncology service.
During the first three days of each placement, the fellows will shadow experienced consultants and then work more independently with patients. The fellows will also spend around 20% of their time on a research project.
When the training for the first three fellows is complete, The Christie expects them to spread best practice internationally and plans to recruit three new fellows to take their place.
The fellows will help The Christie deliver higher quality patient care, including staffing a daily pain clinic for patients, supporting the early discharge of patients, and providing ongoing remote care once patients are recovering at home.
The fellowship is part of a national pilot program aiming to develop core competencies in the new field of supportive oncology among doctors working throughout the whole cancer care continuum. Each fellow will develop knowledge and skills in symptom control, management of side effects of cancer treatments, psychological support and complex pain management.
The fellows will study a new national supportive oncology curriculum developed by the UK Association of Supportive Care in Cancer (UKASCC) with support from the Royal College of Radiologists.
As the population of patients living with cancer rises, so does the need for formal, funded supportive oncology services. This model can increase patients’ quality and length of life, and improve both physical and psychological symptoms, while reducing hospital admissions and saving the NHS money in the long-term.
It is great news to see the first clinical fellows starting their training programme. This new generation of doctors working in cancer care will play a vital role for the NHS and patients, and we look forward to watching it grow.”
Dr Tom Roques, Vice President, Royal College of Radiologists
Initially, this will be studied by the three Christie fellows and a fellow recruited at The Clatterbridge Cancer Centre in Liverpool. Several other cancer hospitals have also taken an interest and are hoping to recruit additional doctors to study the new supportive oncology curriculum.
Health Minister Andrew Gwynne MP visited The Christie recently to find out more about the new supportive oncology service.
Dr Richard Berman, Consultant in Supportive Oncology and Palliative Medicine at The Christie and a leading international expert who has worked with NHS England to redesign supportive care services, said: “There is still a misconception that a cancer diagnosis, and especially an advanced cancer diagnosis, means that there’s no hope, but more and more people are now living good lives with and beyond cancer.
“The Christie was the first cancer center worldwide to launch a supportive oncology service. Our aim is to help patients live well for as long as possible.
“Along with our colleagues at Clatterbridge, we are thrilled to have recruited the first-ever supportive oncology doctors worldwide. The three doctors are a strong team with complementary overlapping skill sets, including a GP, a general medic and an oncologist. They already have an excellent understanding of the principles of supportive oncology and are passionate about its role in cancer care now and in the future.
“Advances in treatments mean that the number of people surviving cancer will increase. Taking a person-centered and holistic approach to care ensures we’re giving patients the best possible life.
“Timely access to supportive oncology not only improves patient care but can save the NHS money.”
Supportive oncology has developed in response to the changing demographics of cancer. Half of people diagnosed with cancer in England and Wales now survive their disease for ten years or more and live, on average, almost six times longer after their cancer diagnosis than was the case 40 years ago. Macmillan estimates that there will be 5.3m living with cancer by 2040 (around 1 in 14 of the population).
Patients who may be living with advanced or ‘incurable’ cancer for 15 years or more can have complex psychosocial care needs along with practical, financial and employment challenges. Cancer survivors also cope for decades with the life-changing side effects of treatment.
