Winner

The Teenage and Young Adult Cancer Service – Yorkshire and Humber

by Leeds Teaching Hospitals NHS Trust

This is the first, and currently only, peripatetic service in the UK supporting teenagers and young adults (aged 13-24) with cancer. It provides age specific care and the access to peer group support that is so important, ensuring every patient has a choice in where he or she is treated, at one of seven designated centres in the region providing care as close to home as possible.

Charitable support has enhanced quality in the regional Principal Treatment Centre (PTC) and a large regional Designated Centre and the service has developed an expert team in the care of young people, alongside the disease-specific expertise to treat their illness.

The percentage of referrals increases each year, reflecting the value our peers recognise that we add. The PTC is a leading centre in recruitment to clinical trials, with its own active research programme, and hosts many visits from others wishing to replicate what the team has achieved.

Judges’ comments

Highly commended

Innovations in the delivery of Stereotactic Ablative Radiotherapy (SABR) for inoperable non-small cell lung cancer in the Leeds Cancer Centre

by Leeds Teaching Hospitals NHS Trust

Stereotactic Ablative Radiotherapy (SABR) is the precise delivery of high doses of radiation in a small number of treatment fractions. There is considerable evidence supporting it as superior to conventional radiotherapy for the treatment of medically inoperable non-small cell lung cancer (NSCLC). 

SABR requires specialist imaging and treatment technology, along with increased expertise, to be delivered safely and effectively. Leeds Cancer Centre has treated more than half of all inoperable NSCLC patients in the UK and has continued to develop the treatment technique. It is the first centre in the world to deliver SABR treatments with Volumetric Modulated Arc Therapy (VMAT) and was the first to clinically introduce Elekta’s high-dose-rate ‘Flattening Filter Free’ technology. 

The team continues to share its SABR knowledge and expertise with other clinical professionals throughout the UK. As well as providing mentoring for new centres in start-up, in October 2012 the team hosted the 3rd Leeds SABR study day, combining scientific, medical and technical teaching with practical, hands-on workshops for over 70 participants. 

Commended

HeartSpare: reducing the risk of heart disease from breast radiotherapy

by The Royal Marsden NHS Foundation Trust

Breast radiotherapy halves the risk of breast cancer returning but may lead to long-term heart damage. But because of a lack of resources and staff training, ‘heart-sparing’ radiotherapy techniques are extremely limited. 

The team pioneered the use of a simple, inexpensive technique (voluntary breath-hold or VBH) to reduce the amount of heart tissue exposed to radiation during breast radiotherapy. Breathing in pulls the heart away from the radiotherapy beam and a randomised study demonstrates that our technique is as reproducible and as effective as the current gold-standard technique, which uses a £50,000 device and requires disposable mouthpieces at £100 per radiotherapy course.

The success of our initiative is evident by the fact that other radiotherapy centres are now implementing the VBH technique, which has proved to be as effective, simpler and markedly more cost-effective than the alternative.

Finalists

Carcinoma of Unknown Primary team, Royal Free London NHS Foundation Trust

by Royal Free London NHS Foundation Trust

The Carcinoma of Unknown Primary (CUP) team at the Royal Free was created in response to NICE guidance, following an earlier pilot service that identified significant needs.

These were: only a small proportion of patients are true CUP cases, so the focus needed to be on the work-up phase; most referrals came from the acute admissions units so close liaison with them was essential; most referrals were based on imaging results, highlighting the key role of radiologists; and referral teams did not distinguish between patients with suspected cancer and those with acute problems related to known cancer or its treatment.

The service has improved assessment time and patient experience, and reduced the time in creating a management plan, the number of investigations, length of stay and costs.