Clinical Radiotherapy Specialist, Bronwyn Van Blerk
I am a Clinical Radiotherapy Specialist. I am a therapeutic radiographer that has moved into a floor manager role and I support the frontline treatment radiographers with problem-solving.
‘Once a radiotherapy referral is received from the consultant, together with my team, I have to ensure that all relevant information is available to sign off the referral as soon as possible for us to proceed with booking appointments. Working within the cancer services trust is a rewarding experience because we are making a difference in someone’s life. Although work relationships can be difficult at times, it becomes appreciative when you hear the words “thank for helping me through my cancer journey”.
‘Making a difference in the lives of staff and especially patients is the most gratifying part of my job. Within cancer services we embark on a journey with our patients, from the first time they are seen in the clinic to the last day of treatment when they are able to ring the bell to symbolize the end of the treatment pathway. This is the special part of my job!’
Paul Marshall, Radiotherapy Planning Radiographer
“I am a Radiotherapy Planning Radiographer at The Kent Oncology Centre, part of a team of radiographers and dosimetrists working at Maidstone and Canterbury.
“Each patient having radiotherapy has to have an individualised treatment plan and it is our job to prepare these, using a CT scanner specially adapted for radiotherapy, and computerised treatment planning systems. We begin by carrying out a CT scan with the patient lying in the treatment position; this is the first radiotherapy appointment for the patient and many of them are apprehensive so an important part of our job is to explain the procedure and to put them at ease.
“Once the scan is complete, the images are then transferred to a treatment planning computer system where we will mark any organs likely to be affected by the treatment and the oncologist or specialist radiographer will outline the area to be treated. A treatment plan can then be calculated, which ideally gives a high dose to the target area whilst avoiding other organs and structures as much as possible. If the target dose is too low, the treatment will not be effective; however if the target dose is high other organs need to be shielded adequately in order to reduce unwanted side effects.
“This is where teamwork plays an important part and we work closely with the Oncologists and Medical Physicists to get the best possible treatment plan working within strict clinical protocols. Every patient and every target volume is a different size and shape so no two cases are the same; the higher the dose the more complex the plan can be, some can take many hours of work over several days to complete.
“I think the part of my job I enjoy the most is the teamwork. Our role puts us in the centre of things, working with Treatment Radiographers, Physicists, Macmillan Staff, Schedulers, Nurses CNSs, Dieticians and Oncologists to ensure the patients get the best possible treatment.”
Elaine Ellis, Straight To Test Colorectal Nurse
“As part of my role, I will receive a 2 week wait suspected cancer referral from the GP and I will then call the patient within 1-2 days of the patient visiting the GP to take a full history. When I call the patient they are often scared, unsure of what is to happen, so a lot of time is also spent listening and reassuring patients, explaining what is going to happen and when. We are often the first person they speak to at the start of the journey, giving them confidence in us to do the very best for them is paramount.
“The Straight to Test Telephone clinic (STT) enables the patient to continue with their normal life. I can call them whilst at work or wherever suits them and this stops the patient having to take time off work or being in out-patient departments.
“I work in a close team with a wealth of knowledge and experience, making it a happy and educational environment. MTW is a centre of excellence for the cancer pathway and the STT for colorectal is the first STT to be set up and is now influencing other departments within MTW and other trusts. It is lovely to work autonomously and be able to determine the appropriate tests patients require and if a cancer is found, you know the patient was on the correct test and that the journey has begun and usually caught early.”
Helen Vaughan, Macmillan Speech and Language Therapist
“I’m a Macmillan Speech and Language Therapist and I work within Oncology and I’ve been in the role for about two and a half years – but I’ve been with the Trust for 29!
“I work mostly with head and neck cancer patients and I work across the pathway so I see them before they start treatment, at diagnosis, during treatment and then at follow up. I’m here to support them with being able to swallow and communicate effectively. We work as a team with patients to carry out preventative measures so that the muscles involved in speech and swallowing do not seize up and that swallowing is safe. We carry out assessments and then give advice and exercises for voice, jaw, tongue, lip and swallowing as needed. Many of the patients we work with have had surgeries including partial removal of the tongue, floor of the mouth or part of the jaw – so we provide a lot of support in helping them return to swallowing and talking.
In this role you get to meet so many different characters and many are quite anxious and worried when they first come in – but getting to support them week by week and hearing about their recovery is really special. We had a lady in last week who is already back doing her job and able to eat with her family thanks to the teams support, so it’s really heartwarming to be able to make that difference in people’s lives.”
General Porter, Jayne Ansell
“I’ve been a General Porter for about a year now and there’s a lot more to the role than people may think – we don’t just push, pull and smile! We have to collect blood gases, we have to know about units of blood and take them to the wards and we have to deliver samples and be there for any sort of emergency that happens at the hospital, so we are heavily involved with keeping the trust running and caring for patients.
“We work with many cancer patients in our day to day role and very often deliver units of blood or platelets to wards for them so they can be treated as quickly as possible. We are also responsible for taking them to scans such as CT’s and x-rays as well as taking them to oncology for chemotherapy treatment.
“I enjoy having that short relationship with patients and being a small part of their journey. We are joining them obviously at a very emotional and stressful time of their lives so sometimes it is nice to be able to chat with them and try to relax them – a laugh and a joke often goes a long way!
Soni Xavier, Prostate Pathway Specialist Nurse
“My prime duty is to work through the Cancer two week wait (C2WW) prostate pathway to ensure these patients are getting their investigations and procedures done as quickly as possible. The first and main part of the pathway is through me and my challenge is to prepare a safe and smooth way for these patients in the process of cancer diagnosis.
‘The word cancer is scary for many, as we all know most of the cancers are life threatening. But, in the modern era of the technology, new diagnostic and treatment methods, we can treat cancer and cure if we diagnose these in the early stage. Prostate cancer is one of them. This is where my role is more important, by guiding these patients to an early diagnosis will help us start the treatment as early as possible and will have better prognosis.
‘All the team members within the team, this includes the outpatient clinic nurses, doctors, consultants, diagnostic departments, laboratories, pharmacy departments, all these have been working hard and helping us with these patients in the pathway. Teamwork has an important role in the health sector and if you have a good team working with you, the performance standard will always be high. Good teamwork is the slogan behind our success.
When you have new challenges you will find new ways, you will look for new ideas to overcome that situation. To make impossible to possible is the challenge, and that is the daily challenge.”
Jo Priston, Medical Secretary
“I’m a medical secretary and I deal with all incoming new cancer patients and make appointments for those patients after diagnosis, which can include MRI and CT requests and much more. I talk directly to the patients after their diagnosis which can be very difficult as many can understandably be very emotional and anxious and just wanting to get their appointment booked in for as soon as possible.
“The role is extremely important as we are pretty much the first port of call for the patient and a key part of my job is reassuring them that all is in hand and their case is being dealt with. The point in which the patient comes to me is such a critical stage – many of these patients have just been told they have cancer. It can be an incredibly daunting role but it is also so rewarding, as we play a huge role in sending that patient on the correct pathway for treatment.
“When speaking with patients, I often put myself in their shoes and ask ‘how would I be in this position?’ and treat them as I would if it was my own family looking for help with respect, understanding and empathy. I feel like we do make a difference and that people can get off the phone and feel reassured that they are in the right hands. Teamwork plays a massive part of our success – we simply would not function if everyone wasn’t doing their part.”
Hide Yamamoto, Consultant Urologist
“As a consultant urologist my role is to diagnose and treat people who have surgical problems with the urinary tract. I am currently involved in the day-to-day running of the prostate cancer pathway. As one of the highest patient-volume pathways it requires me to work closely with co-ordinators, nurse specialists and our Multidisciplinary Team to ensure that patients are managed correctly and promptly.
“We should be proud that we have set up a high standard diagnostic service for prostate cancer with good clinical outcomes and patient experience.
“Unfortunately it is getting rarer for me to be gifted with the time to tell patients that they have no cancer – a task now granted to my junior colleagues! But it is always rewarding to see patients avoid complications of investigations and treatment as they may have done previously, an indication that we are making progress as a specialty. It is absolutely impossible for the pathway to function and to achieve targets without all members knowing and performing their roles. We communicate well together as team and this in turn, I feel helps simplify the complexities of the pathway for all.”
Emma Ince, Principal Respiratory Physiologist
“I am a healthcare scientist for physiology and I manage a service comprising of three healthcare scientists and an administrator, across the Trust’s two main sites. We assess how well patients’ lungs are working and these tests involve a lot of persuasion and support, as the tests require the patients’ maximum effort and concentration.
“Patients with lung cancer require lung function tests in order to help assess their suitability for radical treatment. This is to assess if a patient has enough lung capacity to have a good quality of life after surgery and as a service, we also provide diagnostic tests for patients with other cancers, this is to ensure that the chemotherapy drugs do not cause any lung damage as they are known to be highly toxic to the lungs.
“I really enjoy the patient interaction – although it can be extremely emotional at times! In the short time that each patient is with the department, I am able to get them to engage and laugh and get to know them. I have a wonderful team, who work tirelessly putting patients at the fore of their day.
“No one individual has the answers to every problem. As a team you are able to look at things from different perspectives and find innovative solutions.”
Consultant Histopathologist, Dominic Chambers
“I spend most of my time looking down a microscope at slides of biopsies and resections which are heavily involved in the diagnosis of cancer. Within the team, we do a large amount of work assessing growth specimens to measure the grade and stage of the tumour to determine if the surgery was successful and then deciding to carry out further molecular tests if necessary.
“Without the cellular pathologists, there is essentially no tissue diagnosis so pathology is pivotal in cancer diagnostic work. We work extremely close with other clinical teams and are very synergistic with radiology who we work with as the diagnostic machine behind cancer services. Radiologists can diagnose things on imaging and that enables them to target which parts to sample for cellular pathology – so radiology are very important to us, as without them, we wouldn’t get a biopsy.
“I feel like recently we have made a huge difference in Cellular Pathology to streamline the service and work better alongside other teams in the process. We have made moves to increase efficiency such as growing our number of specialist biomedical scientists to do the cut up of the specimens and by doing that we are reducing the amount of time consultants spend cutting up specimens, allowing consultants to focus on other areas.
“I enjoy the challenge of making the diagnosis, it’s inquisitive and like solving lots and lots of puzzles every day. I get a huge amount of satisfaction when making a diagnosis and being able to say ‘I know exactly what that is, the patient can now go and get the correct treatment’, which can sometimes be critical for their survival.”
Sarah Jalink, Medical Secretary for Oncology
“My role as a medical secretary means I am the first port of call for new patients referred to oncology. I am responsible for registering patients and booking their appointments, typing clinic letters, chasing appointments in other departments and speaking to patients and their families regarding any problems they have, and trying to find a solution.
“Teamwork plays a very important role in the running of cancer services. I work closely with the consultants and clinic co-ordinator to ensure that patients are seen in clinic, or their queries responded to, in a timely manner.
“It is so rewarding to hear that patients have been cured and discharged from oncology and occasionally the consultants allow me to contact patients with ‘good news’ and it is so lovely to be able to pass it on and hear their reaction, as well as seeing patients ring the ‘end of treatment bell’.
“I feel privileged to work in cancer services with an amazing team of caring people and hope that I can make patients’ journeys a little easier. I try to put myself in their shoes, or imagine it was a family member of mine and treat patients how I would expect to be treated, with empathy, understanding and care.”
Kannon Nathan, Consultant clinical Oncologist
“I am a consultant clinical oncologist who mainly deals with head and neck cancer, gynae-oncology and skin cancers and I am based at the Trust’s Canterbury site which covers the East Kent catchment of patients. I work within a well versed team, at all levels, from administrative staff to surgical clinical colleagues. The key element is communication and we ensure we are on a daily basis with each member of the team respecting everyone and their views and opinions.
“A vital aspect of our job is to ensure the patient is engaged and to manage timely treatment to ease anxiety when they are at their most vulnerable being diagnosed with cancer. As they are on this pathway, their treatment may not be clearly defined until you have all their information which is a concerning time for patients, so it is important at all times to involve them in this, as with their help we can achieve the same purpose. We keep things simple and have named keyworkers and they can put faces to names and we’ve had some great feedback from patients, with them commenting on seeing ‘the team in action and acting as a team’.
“It is great to have an excellent team at Canterbury who help with this tight complex pathway, and all staff in radiotherapy, from reception to planning to treatment, serve their role with aplomb and I’m honoured to be part of that. In head and neck cancer, we really are part of the patient’s journey. I love working in this team, and to ensure the pathway works, is only because the team effort of all staff across the Trust, not one individual, and I love being a part of that.”
Madie Corse, Pathway Navigator
“I am a Pathway Navigator, currently working within the lung team. I have been in post for a year now, starting my time as the Upper GI navigator as part of a secondment. My role allows me to work alongside a large variety of teams; no two days are the same. I work closely with the clinical teams such as respiratory consultants, radiologists, histopathologists, specialist nurses as well as the different administrative teams.
“My role allows me to be a central point of contact for the different teams and for the patients. My contact details are provided to the patients at their initial consultation so that any queries that they may have they can come directly to me, I also find that sometimes patients enjoy having a conversation that does not necessarily have a large amount of clinical knowledge but can offer support and someone to listen to them.
“The aspect of my role that I find most rewarding is helping people and knowing that my advice or reassurance is comforting through possibly the most difficult time in their lives. I also enjoy being able to work so closely with so many people and being able to constantly be able to build new working relationships in order to continue benefitting patients as well as our processes.
‘It is vital to work as one team, this is how the best level of care is delivered to the patient. It’s so important that the patient sees a united team and receives consistent care from every member of staff in every stage of their pathway.”
Sam Austin, Radiotherapy Receptionist
“Radiotherapy reception is a fast paced and ever expanding job role and involves mainly booking in and supporting patients. As the first point of call, we pass on any worries or patient concerns to the appropriate department including Macmillan radiographers, oncology registrars and treatment areas whilst remaining sensitive to the needs of the patient.
“The role is very special, as we are often called upon to be that person who can make a difference and always being helpful, smiley and a shoulder to cry on when needed.
“I really enjoy working in a positive environment, where everybody is supportive of each other; and seeing previous patients return to tell us their good news really is an amazing experience. Each area has specific knowledge exclusive to Radiotherapy; gained through each teams combined years of experience and therefore gives our patients first class treatment.”
Chris Harker, Cancer Data Analyst
“I am based in the Trust’s Business Intelligence team in the role of Senior Information Analyst. My main responsibilities in relation to the cancer waiting times standards cover four areas.
“Firstly, to provide advice in relation to pathway queries to ensure there is a consistent approach across the trust to adhere to national and local guidance. I work with staff in all roles across the cancer services division as well as management and clinical staff from other divisions.
“Second is the validation of the data collected on the trust’s cancer database, Infoflex, which is also used by the four other trusts in the Kent & Medway cancer network. This involves liaising with the Multi Disciplinary teams to ensure that the data is validated. Third is the monthly upload and reporting of the trust’s cancer waiting times data, which has to be complete and accurate.
“The final area is the analysis of the performance and data, providing regular and ad hoc reports internally and externally.
“It is important that everyone involved in patients’ care work together and the provision of information to help to achieve the standards is pivotal to this. As such, I am able to use the knowledge and skills that I have developed over the 10 years that I have been involved with cancer waiting times to provide trusted support to staff at MTW and across the network.”