Private Care Magazine, Issue 4 - The Royal Marsden

WelcomeIn our fourth edition of Private Care, weproudly introduce some of our world-leadingconsultants and the groundbreaking workthey are doing here at The Royal Marsden.Among them are three consultants based inthe Gynaecology Unit – Dr Susana Banerjee,Dr Alexandra Taylor and Dr Susan Lalondrelle– who are paving the way with new researchand treatments.We can also announce the appointmentof two new consultants to the Urology Unit.Professor David Nicol and Mr Pardeep Kumarare to enhance the Trust’s strong surgical teamby expanding our work into kidney, testicular,bladder and prostate cancers.Our patients are also enjoying their newsurroundings in our refurbished OutpatientDepartment at Sutton, which provides amodern and comfortable environment.Aisha Miah answers some common questionsabout sarcomas and talks about her researchambitions for the treatment of these tumours.Adam Doyle, Director of Private CareIssue 4CONTENTSPRIVATE CARE FEATURES4. GYNAECOLOGYUNIT SPECIAL REPORTThree leading consultantstalk about how their researchinto gynaecological canceris beneting atients8. SOFT-TISSUESARCOMA Q&AAisha Miah, ConsultantClinical Oncologist,discusses soft-tissuesarcomas9. UROLOGY FOCUSWe welcome Professoraid icol and Mr PardeeKumar to the Urology Unit10. SPOTLIGHT ONSKIN AND PLASTICSr Christoher arland andMr Kelvin Ramsey discusstheir cutting-edge workin dermatology andreconstructive surgeryPRIVATE CARE NEWS3. FACILITIES UPDATERefurbishment of theOutatient eartment atutton is now comlete7. RESEARCH UPDATETwo Royal Marsden consultantsare honoured with fellowshis11. THE ROYAL MARSDENCONSULTANT DIRECTORYA handy reference list of theconsultants featured in this issue2 The Royal Marsden Private Care

Hospital newsFACILITIES UPDATESutton refurbishment completeAs part of our continuedrefurbishment programme,we have now completedthe renovation of the PrivateCare Outpatient Departmentat our Sutton site.The refurbished departmentprovides an inviting and restfulenvironment for patients, whilethe natural, modern interioris in keeping with our newfacilities at Chelsea.As well as these aestheticimprovements, we haveupdated the disabled accessand added an extra consultingroom to increase capacity.We have also introducedan interview room wherepatients can talk to nursingstaff in private.Dr Diana Tait, ConsultantClinical Oncologist, said: “Aswell as the improved waitingand consultation areas forpatients, the new facilityprovides me with the bestenvironment in which tocommunicate with patientsand provide them with theirclinical assessment.”The new facility provides me with the bestenvironment in which to communicatewith patients and provide them withtheir clinical assessmentDR DIANA TAIT, CONSULTANT CLINICAL ONCOLOGISTWILTSHAWWARDUPGRADEWiltshaw Ward is to berefurbished in order toincrease the capacity forprivate patients.Eight more inpatientside rooms and adedicated day surgicalarea will be added, andexisting side rooms areto be renovated withfridges, hanging space,at-screen Ts andpatient entertainmentsystems. All rooms willhave en-suite facilities.The proect will run intwo phases to ensurethat only half the wardis closed at any time.The work should becompleted by the endof this year.The upgrade will allowThe Royal Marsden tooer a dedicated servicefor private patientscoming for day surgery,as well as creating anew waiting area withreclining chairs, a coeebar, newspapers,magaines and T.Sarah Crawshaw,Private Care ServiceManager above, saidThis refurbishment willensure that privatepatients have top-classfacilities to enable a morerelaxing hospital stay.”The Royal Marsden Private Care 3

GYNAECOLOGY UNITLeading the wayin cancer careWe speak to three of The Royal Marsden’s consultantsabout their groundbreaking research into thetreatment of gynaecological cancers

Gynaecology focusDr Susan Lalondrellein the CyberKnife suitewith Lead RadiographerHelen TaylorTaylor, Consultant ClinicalOncologist. “The gynaecologicalservice at The Royal Marsdenprovides multidisciplinarycare for patients with anintegrated team approach by thesurgeons, medical oncologistsand clinical oncologists.”Above, from left: Dr SusanaBanerjee, Consultant MedicalOncologist; Dr SusanLalondrelle, ConsultantClinical Oncologist; and DrAlexandra Taylor, ConsultantClinical Oncologists Europe’s largestcancer centre, TheRoyal Marsden offersa complete range of treatment,from surgery and chemotherapyto state-of-the-art radiotherapyusing leading-edge equipment.Our Gynaecology Unit isan excellent example of ourcommitment to providingpatients with access to worldleadingoncologists and thevery best cancer care.Internationally recognisedsurgeons work in partnershipwith the oncologists to providecomprehensive radiotherapyand chemotherapy services.A large research practice alsomeans that patients benefit fromthe latest in drug development,which results in better outcomes.As a result of this approachand the hospital’s internationalreputation, The Royal Marsdenattracts the highest calibre ofmedical and research talent,whose specialist knowledge ingynaecological cancer meansthat our patients receive thebest treatment and care.We are proud to introducethree consultants in theGynaecology Unit – Dr SusanaBanerjee, Dr Alexandra Taylorand Dr Susan Lalondrelle – whoare leading the way with newresearch, treatments and services.“Patients with gynaecologicalcancer often need a combinationof surgery, chemotherapy andradiotherapy to optimise theirtreatment,” says Dr Alexandra“THE AVASTINBREAKTHROUGHIS VERY EXCITINGAND MEANS MORETREATMENT OPTIONSFOR PATIENTS”DR SUSANA BANERJEE, CONSULTANTMEDICAL ONCOLOGISTDr Susana BanerjeeDr Banerjee is a ConsultantMedical Oncologist and MedicalOncology Lead for Clinical Trialsand Translational Research (forGynaecological Cancers) at TheRoyal Marsden. Her researchinterests are the personalisationof patient treatment and targetedtherapies in women’s cancers,and she is leading a researchteam offering a portfolio of PhaseI–III clinical trials for patientswith gynaecological cancers.One of the most promising areasof drug development is in thetreatment of ovarian cancerwith bevacizumab, or Avastin.The drug works by attackingblood vessels that feed cancersand allow them to spread.Clinical trials have shown thatby combining bevacizumab withchemotherapy and continuingit afterwards (maintenance), thetime before the cancer progressescan be increased, as can thesurvival rate for some patientsat high risk of relapse.“This breakthrough is veryexciting and means moretreatment options for patients,”says Dr Banerjee. “Avastin isnow available to patients withovarian cancer as first-linetreatment, and patients withrecurrent disease are offered thisdrug at The Royal Marsden.”Dr Susan LalondrelleDr Lalondrelle, ConsultantClinical Oncologist, specialisesin treating gynaecological andskin cancers using radiotherapy,brachytherapy (internal radiation)and chemotherapy, workingclosely with her colleagues inThe Royal Marsden Private Care 5

Gynaecology focusGynaecologicalcancer facts21women a dayare diagnosedwith uterinecancer in the UK,making this themost commongynaecologicalcancer8in10womendiagnosed withovarian cancerare over the ageof 50 and havebeen throughthe menopauseDr Susana Banerjeein conversationwith a patientother specialties to providecomprehensive cancer care.“The gynaecological team hasa strong research profile,” saysDr Lalondrelle. “In radiotherapy,we offer technical expertise thatis not widely available. We havea large radiotherapy departmentat both Sutton and Chelsea,offering CyberKnife, intensitymodulatedradiotherapy (IMRT),arc therapy, brachytherapy andimage-guided treatments.”As well as treating patientsday-to-day, Dr Lalondrelleand her team are conductingimportant research that willimprove the delivery of cancertreatment. As part of this excitingwork, she is using CyberKnifeto treat recurring cancers thatmay have previously receivedradiotherapy – something thatis not normally possible.“We are always striving tofurther personalise cancertreatment to increase the chancesof cure,” says Dr Lalondrelle. “Inradiotherapy, we are looking atmethods that integrate PET andother imaging into treatment toguide the need for a larger orsmaller radiotherapy dose.“Some cancers are moreaggressive than others, and wecurrently treat them all the same.If we could predict how a cancerwould respond to treatment, wecould individualise the treatmentto give just the right dosage,which could lead to moresuccessful treatments for someand fewer side effects for others.”Dr Alexandra TaylorDr Taylor, Consultant ClinicalOncologist, specialises in thetreatment of gynaecologicalcancers with radiotherapy,brachytherapy andchemotherapy. She has aparticular interest in advancedradiotherapy technologies,including IMRT, image-guidedbrachytherapy and CyberKnife.“This is a unique environmentwhere clinical excellence isexpected and innovation stronglysupported,” says Dr Taylor.“With this infrastructure, it ispossible to rapidly implementnew developments and todevelop clinical research.”Dr Taylor is undertakingresearch into novel applicationsfor these advanced techniquesin gynaecological cancer.This includes a dose escalationstudy with IMRT for cervicalcancer, which allows us toreduce the dose to normaltissues – thereby reducingthe risk of side effects – butdeliver more radiotherapy toselected areas within the pelvis.This allows for a higher dosethan is safe with conventionalradiotherapy, and shouldimprove cure rates.“The Royal Marsden has astrong history of radiotherapyresearch with an internationallyacclaimed radiotherapy physicsteam,” says Dr Taylor. “This hasled to multiple clinical studiesassessing new techniques suchas IMRT and stereotacticradiotherapy with CyberKnife.”Helen Taylor,CyberKnife LeadRadiographer, andDr Alexandra Taylor“IN RADIOTHERAPY,WE OFFER TECHNICALEXPERTISE THAT IS NOTWIDELY AVAILABLE”DR SUSAN LALONDRELLE,CONSULTANT CLINICAL ONCOLOGIST6 The Royal Marsden Private Care

Research newsRESEARCH UPDATEFellowship honour forRoyal Marsden consultantsTwo eminent researchersfrom The Royal Marsdenand The Institute of CancerResearch (ICR) have beenelected to the Academyof Medical Sciences inrecognition of their effortsto defeat prostate cancer.Professor Johann de Bonoand Professor Ros Eelesare among 46 new Fellowschosen this year for theiroutstanding contributionsto the medical sciences.As Honorary ConsultantMedical Oncologist and Headof the Drug Development Unitat The Royal Marsden, andProfessor of ExperimentalCancer Medicine at the ICR,Professor de Bono specialisesin developing new targeteddrugs for prostate cancerpatients. Several of thesedrugs, including the hormonetherapy abiraterone (Zytiga)and the chemotherapeuticcabazitaxel (Jevtana), arenow available to patients afterPhase III trials led by Professorde Bono showed they couldextend life for men withlate-stage prostate cancer.Professor Eeles is HonoraryConsultant in ClinicalProfessorJohannde BonoOncology at The RoyalMarsden and Professor ofOncogenetics at the ICR. Sheand her team have identifiedabout 50 genetic variants thatpredispose men to prostatecancer. Professor Eeles isalso working to integratethis information into patientWe’re making great progress in identifyingmen at increased risk of prostate cancer...I’m pleased that this has been recognisedPROFESSOR ROS EELES, HONORARYCONSULTANT IN CLINICAL ONCOLOGYProfessorRos Eelescare through individualrisk profiling and targetedscreening programmes.Professor de Bono said:“I’m delighted to be awardedthis prestigious Fellowship,which acknowledges the workconducted by our team at TheRoyal Marsden and the ICRin anti-cancer clinical drugdevelopment and improvingthe outcome of patients withadvanced prostate cancer.”Professor Eeles said: “ThisFellowship also reflects onthe hard work and dedicationof my team. Our researchis making great progress inidentifying men at increasedrisk of prostate cancer so thatthey can be offered targetedscreening and tailoredtreatment programmes. I’mpleased that the Academy hasrecognised the importance ofthis type of research.”SUPPORT FOR THREE JOINT RESEARCH PROJECTSVital research work has receiveda boost from a new academicpartnership fund.Three projects have receivedmoney from the Mount VernonChallenge Fund, which supportsjoint research projects betweenThe Royal Marsden, TheInstitute of Cancer Research(ICR) and Mount Vernon CancerCentre in Hertfordshire.The fund follows the launchof an academic partnershipbetween the three organisationsin June 2010. The partnershipwas launched to initiate newopportunities for translationalresearch in both commonand rare cancers, includingradiotherapy research usingCyberKnife, which is installedat both The Royal Marsdenand Mount Vernon.Dr Paul Nathan, Researchand Development Directorat Mount Vernon, said: “TheChallenge Fund demonstratesthe potential from collaborationsbetween our three institutions.The three projects fundedare of the highest qualityand we hope that furthercollaborative projects willbe funded in the future.” Drs Vicky Goh, Sonia Li andAndreas Makris from MountVernon, and Professor MitchDowsett and Ms Janine Salterfrom The Royal Marsden andthe ICR successfully appliedfor funding for their researchproject on volumetric perfusionCT in the assessment of primarybreast cancer. Dr Andreas Makris andProfessor David Miles fromMount Vernon, and ProfessorsIan Smith, Mitch Dowsett andStephen Johnston fromThe Royal Marsden and theICR received funds for theirproject Breast Research UnitsClinical Research Fellow foroptimisation of neoadjuvanttherapy for the treatment ofearly breast cancer. Drs Paul Nathan, Vicky Gohand Anwar Padhani from MountVernon, and Professor MartinGore and Drs Andrew Reynolds,James Larkin, Simon Robinsonand Dow-Mu Koh from TheRoyal Marsden and the ICR weresuccessful in their applicationfor their research into drugresistance, drug sequencingand predictive markers inmetastatic renal cancer.The Royal Marsden Private Care 7

Sarcoma Q&AQ&ASOFT-TISSUESARCOMASDr Aisha Miah, ConsultantClinical Oncologist,discusses the latest researchinto sarcoma treatmentsAfter completing her oncologytraining at The Royal Marsden,Dr Aisha Miah undertook aPhD in advanced radiotherapytechnology and gained furtherexperience in the USA and theNetherlands. Now back withThe Royal Marsden, she offerschemotherapy and radiotherapyfor the treatment of soft-tissuesarcomas and is developing newradiotherapy techniques for limband retroperitoneal sarcomas.“The Sarcoma Unit at TheRoyal Marsden is fantastic,”says Dr Miah. “We have anexcellent clinical and researchteam – everyone has the sameethos in improving patient careand the standards of treatmentand facilities, and is given thesupport to undertake researchand implement new treatments.”What is a sarcoma?It is a cancerous tumour ofthe connective tissue – bone,muscle, nerves, fatty tissue andcartilage – that can occur in anypart of the body. There are morethan 50 types of soft-tissuesarcoma and they are extremelyrare, accounting for about oneper cent of all cancer diagnoses.The causes are mostly unknown.Who do they affect?Sarcomas can affect both sexes.Particular types of soft-tissuesarcoma arise in young patients,but the majority – about two thirds– of those diagnosed are over 50.Dr Aisha Miah,Consultant ClinicalOncologist, speaksto a patientHow are they treated?Surgery is the main treatmentfor most types of soft-tissuesarcoma – often in conjunctionwith radiotherapy. Some typeswill be treated with chemotherapybefore or after surgery. Doctorstake into account the type ofsarcoma, how far it has grownor spread, as well as the generalhealth, fitness and age of thepatient. We believe the outcomeis improved by treatment inspecialist cancer centres suchas our Sarcoma Unit.What are the symptoms?The main symptom is a lumpthat is painless at first, butbecomes painful or sore as itgrows and presses againstnerves and muscles. A lumpcan be anywhere in the body –interestingly, the most commonplaces for a sarcoma to presentare on the buttocks or thighs.What research are youcurrently conducting?We’re taking part in a nationalstudy called VORTEX, lookingat the role of post-operativeradiotherapy in limb sarcomasand whether we can reduce theincidence of long-termcomplications. Internationally,we’re part of the EuropeanOrganisation for the Researchand Treatment of Cancer,and have recently opened theSTRASS trial, looking at the roleof pre-operative radiotherapy inthe treatment of retroperitonealsarcomas. Working closely withmy medical oncology colleagues,we have a number of clinicaltrials for the treatment ofmetastatic soft-tissue sarcoma.I’m also interested indeveloping radiotherapytechniques that improveoutcomes without increasinglong-term toxicity for the patient.This will primarily involveintensity-modulated radiotherapy(IMRT) studies in the use ofpre-operative radiotherapy forlimb sarcomas. Advancedimaging technology anddiagnostic pathology offerthe potential for personalisedtreatments, dose escalationradiotherapy and integratedchemotherapy or biologicalagents with radiotherapy.We hope to improve diseasecontrol while minimising therisk of long-term toxicities forthe patient so that they maintainan excellent quality of life.Soft-tissuesarcomas1%of all cancersare soft-tissuesarcomas,making themvery rare3,000people a yearare diagnosedwith soft-tissuesarcomasin the UK50+types of softtissuesarcoma8 The Royal Marsden Private Care

Urology focusWelcome to twonew urology expertsProfessor David Nicol and Mr Pardeep Kumar join The Royal Marsdenhe Royal Marsden’sUrology Unit hasrecently appointedtwo new consultants.Professor David Nicol andMr Pardeep Kumar are toenhance the Trust’s strongsurgical team by expandingour work into kidney, testicular,bladder and prostate cancers.Professor Nicol, who wasone of the first surgeons inthe world to use laparoscopicsurgical techniques for urologypatients 20 years ago, plans tofocus on kidney and testicularcancers. Before joining TheRoyal Marsden, Professor Nicolwas the Clinical Lead of RenalTransplantation at the RoyalFree Hospital and a ConsultantUrologist at University CollegeLondon Hospitals. He waspreviously Director of Urologyand Renal Transplantation atPrincess Alexandra Hospitalin Brisbane and Professor ofSurgery at the University ofQueensland, both in Australia.He said: “I am delighted tojoin such a well-respectedhospital. I am looking forwardto getting back to combiningmy clinical work with research.”Mr Kumar, who trained inthe UK, has worked in Egyptand, more recently, the USA.He said: “In Egypt, the ratesof bladder cancer are high,so it was a good place to learn,due to the sheer volume ofoperations we were performing.“In the USA, I trained in roboticsurgery and would like to use thatexperience here at The RoyalMarsden. I plan to expand ourwork in robotic surgery forbladders and also start using itfor urinary tract reconstruction.“Not many places in the UKoffer minimally invasive bladderreconstruction, so it will reallyoffer our patients more options,and reduce their hospital staysfrom 16 days to seven.”“IN THE USA, I TRAINEDIN ROBOTIC SURGERYAND WOULD LIKE TOUSE THAT EXPERIENCEHERE AT THE ROYALMARSDEN”MR PARDEEP KUMAR, CONSULTANTUROLOGICAL SURGEONMr PardeepKumar (left)and ProfessorDavid NicolThe Royal Marsden Private Care 9

Skin and plastics focusSpotlight onSKIN AND PLASTICSThe arrival of Dr Christopher Harland and Mr Kelvin Ramsey promises a revolutionin skin cancer care and reconstructive surgery at The Royal Marsdenhe Royal Marsdenis proud to welcometwo world-leadingconsultants: Dr ChristopherHarland, ConsultantDermatologist, and Mr KelvinRamsey, Consultant Plasticand Reconstructive Surgeon.Individually, they are leadersin their respective fields, buttogether, they are combiningtheir expertise to providepatients with the best clinicaland aesthetic outcomes.Dr Harland will focus onthe early detection of skincancer, skin cancer surgeryand laser therapy. Since joiningThe Royal Marsden, he hasbeen undertaking importantcollaborative research with themelanoma team into the toxicityreaction from cancer-relateddrugs – in particular, newertherapies such as vemurafenib.“Not all dermatologists dowhat I do,” says Dr Harland.“The essence of what I do issee, diagnose and treat – allunder one roof.”Meanwhile, as well as hisdaily focus on reconstructionfor breast cancer, head andneck cancer and sarcomapatients, Mr Ramsey is workingon an exciting doctorate inlymphoedema surgery research.Looking at ways to reducethe long-term swelling of thearm following the removal oflymph nodes from the armpit,Mr Ramsey aims to dramaticallyalleviate the long-term effectsof lymphoedema surgery.The technique involves the latestadvancements in microsurgicaltechniques coupled with imagingsystems to identify the lymphaticchannels in the arm, and thenrerouting them into thebloodstream, thus emptyingthe excess fluid and curingthe lymphoedema.“The combination of imagingsystems and surgery issomething that has not beendone anywhere before,” saysMr Ramsey. “If it is successful,it means that we couldpotentially change patients’“THE COMBINATIONOF IMAGING SYSTEMSAND SURGERY ISSOMETHING THATHAS NOT BEEN DONEANYWHERE BEFORE”MR KELVIN RAMSEY, CONSULTANTPLASTIC AND RECONSTRUCTIVESURGEONlives. In the past, they mighthave needed to wear a stockingfor the rest of their life.”Dr Harland and Mr Ramseyrun parallel clinics at The RoyalMarsden. “By working togetherfrom the outset, we are ableto offer patients the best clinicaland aesthetic outcome,” saysDr Harland.“Meeting the patient togetheris so important,” adds MrRamsey. “We can discussany complicated issues andwe gain a greater understandingof how each of us needs toapproach the individual case.The more planning you cando in plastics, the better theoutcome for the patient.”Dr Harland and Mr Ramseywill both also play a major rolein the establishment of an earlydetection unit for skin cancerat our Sutton site.10 The Royal Marsden Private Care

Contact detailsCONSULTANT DIRECTORYGet in touch with the consultants featured in thisissue of Private Care if you would like to makea referral to The Royal MarsdenGynaecology Skin & Plastics UrologyDr Susana BanerjeeConsultant Medical OncologistMA MRCP PhDSpecial interests: ovarian cancer,endometrial cancer, targeted therapyT: 020 8661 3078 or 020 8661 3979drsusanamedsec.banerjee@rmh.nhs.ukDr Christopher HarlandConsultant DermatologistMA MB FRCPSpecial interests: early detection of skincancer, cutaneous drug toxicitiesT: 020 8915 6087 F: 020 8661 3124christopher.harland@rmh.nhs.ukMr Pardeep KumarConsultant Urological SurgeonPhD MB ChB FRCS(Urol)Special interests: bladder and prostatecancer, robotic surgery, diagnostic urologyT: 020 7808 2789 F: 020 7808 2099pardeep.kumar@rmh.nhs.ukDr Susan LalondrelleConsultant Clinical OncologistBM BSc MRCP FRCRSpecial interests: technical radiotherapy(IMRT, IGRT, CyberKnife), brachytherapy,chemotherapy, cervical/uterine/vulval/vaginal cancers, radiotherapy andbrachytherapy for melanoma andnon-melanoma skin cancersT: 020 8661 3272 F: 020 8915 6791susan.lalondrelle@rmh.nhs.ukDr Alexandra TaylorConsultant Clinical OncologistBA MBBS MRCP FRCR MDSpecial interests: gynaecologicalcancer, radiotherapy, brachytherapy,IMRT, CyberKnifeT: 020 7808 2581 F: 020 7808 2258alextaylormedsec@rmh.nhs.ukSarcomaDr Aisha MiahConsultant Clinical OncologistBMed Sci MBBS MRCP FRCR PhDSpecial interests: soft-tissue sarcomas,radiotherapy (IMRT, IGRT, stereotacticradiotherapy including CyberKnife),chemotherapyT: 020 7808 2591 F: 020 7808 2672aisha.miah@rmh.nhs.ukMr Kelvin RamseyConsultant Plastic andReconstructive SurgeonMA MB BChir FRCSEd(Plast)Special interests: microsurgery, breastreconstruction, lymphoedema surgeryT: 020 7808 2208 (NHS),0845 519 9221 (PP)kelvin.ramsey@rmh.nhs.ukProfessor David NicolConsultant Urological SurgeonMB BS FRACSSpecial interests: upper urinary tract(kidney), testicular cancer, retroperitonealmalignancyT: 020 7808 2076 F: 020 7808 2099david.nicol@rmh.nhs.ukFor more information on allour consultants, please visitwww.royalmarsden.nhs.uk/consultantsThe Royal Marsden Private Care 11

Only Royal Marsden Private Care offersexceptional standards of personalised caresupported by the knowledge, expertise andworld-leading approach of The Royal Marsden.Private patients see their chosen consultantthroughout their treatment and receive thefull support of our specialist cancer teamsin exclusive private facilities.Private patientservicesInpatient andoutpatient privatewing and MedicalDay Care Unit;daycare facilities.DiagnosisRapid Diagnosisand AssessmentCentre and ClinicalAssessment Unit;specialist pathologyservices.Surgical theatresand critical careEight state-of-the-arttheatres; the UK’sonly Level 3 CriticalCare Unit for cancer.Imaging servicesExtensive CT andMRI facilities andthe latest PET-CTscanners.The Royal Marsden welcomes NHS and private patients.For more information on our Private Care Service, please call our Private CareCustomer Services Manager on (0)20 7811 8278 (0900 to 1700 UK time)or email private.patients@rmh.nhs.ukFor information on our consultants, please visit www.royalmarsden.nhs.uk