Researchers from NHS Lothian and the University of Edinburgh have conducted a clinical study to investigate the extent to which cancer and cancer treatment affects COVID-19 immunity.
Blood samples were taken regularly from over 760 consenting patients, most from Southeast Scotland, who were receiving routine treatments for cancer.
The samples were then tested for signs of an immune response to COVID-19 using an antibody test.
The study is the largest of its kind in the world with the first patients being recruited in May 2020, just months after the United Kingdom experienced its first lockdown.
Dr Peter Hall, Consultant Medical Oncologist at Edinburgh Cancer Centre, said: “Treatments such as chemotherapy can affect the immune system, so it was really important for us to understand the effects of COVID-19 on people undergoing anti-cancer treatment.
“We now have a better understanding of how the virus affects these patients in the short and long-term, and to what extent the vaccine had an impact on their antibodies.
“It’s very reassuring to see that most cancer patients can go ahead with their treatments without fear of excessive risk from COVID-19, and that vaccination offers an effective means of protection.”
The study found that COVID-19 infection rates in patients with cancer largely mirrored those of their local population and that treatment type did not impact the rate of their antibody response.
It also concluded that vaccination was effective in protecting people with cancer from COVID-19.
Dr Hall continued: “More research is needed, but this was an important step in understanding how people receiving anti-cancer treatment are impacted by the virus.
“It’s also another example of NHS Lothian and the University of Edinburgh working collaboratively to understand how best to care for some of the most vulnerable patients.”
You can read the Scottish COVID Cancer Immunity Prevalence Study in full in The Oncologist.
A kidney cancer drug has been accepted for use within NHS Scotland and across the UK thanks to an international study, with NHS Lothian and Edinburgh University leading the UK part of the trial.
The treatment, pembrolizumab, is an antibody delivered intravenously as an immunotherapy to reduce the chances of a relapse after kidney cancer surgery.
Thanks to the research, the Scottish Medicines Consortium (SMC) has advised that the drug will now be made available to treat eligible adults with renal cell carcinoma (RCC).
In Scotland, about 1000 patients are diagnosed with RCC each year, and the incidence of the disease has been increasing over time.
Surgery carries the hope of cure if disease is caught early, but about a quarter to half of patients who undergo a nephrectomy (whole or partial kidney removal) have disease recurrence at different sites within three to five years of this.
RCC is generally resistant to chemotherapy and radiation therapy so, until now, there have been no additional treatments that reduce this risk of relapse.
The study showed that, for patients with a raised risk of relapse, pembrolizumab reduced the risk of kidney cancer coming back by a about a third and there are early indications that this is leading to patients living longer.
This has led to the SMC recommending the drug for NHS use and the first non-trial patients are now receiving this new treatment in Edinburgh.
Dr Stefan Symeonides, Senior Lecturer at the University of Edinburgh and Oncology Consultant at the Edinburgh Cancer Centre, said: “Research continues to explore which people might benefit most from this treatment, as pembrolizumab is not always effective or suitable for every patient.
“However, this represents a significant breakthrough in the treatment of kidney cancer as confirmed by UK approvals from the SMC in Scotland and NICE in England and Wales, as well as its incorporation in treatment guidelines from the European Society for Medical Oncology (ESMO).
“Approval of pembrolizumab is welcome news to many RCC patients, who otherwise had no treatment options available to them to prevent or reduce the risk of relapse of the cancer following nephrectomy.”
Local healthcare workers at the Western General Hospital in Edinburgh have been honoured for their exceptional work at a prestigious ceremony.
Sponsored by NHS Lothian Charity, the annual Celebrating Success Awards 2022 are nominated by fellow healthcare workers across the organisation.
Thomas Faulkner, Specialist Biomedical Scientist at the Western General Hospital won the Young Achiever award for going the extra mile in everything he does.
Although in the very early stages of his career, Thomas has played a huge part in the implementation of a new system and training in the laboratory. His team praised him for his dedication, commitment, energy, passion and enthusiasm.
Thomas said: “I’m very grateful to everyone who has nominated me. I was not expecting it so very happy that I’ve won.”
The Visible Haematuria One Stop Clinic Team at the Western General Hospital won the Best Example of Quality Innovation and Productivity Award.
The clinic is a collaboration between the Urology & Radiology department and Quality Improvement Support Team. It has greatly improved the patient experience and significantly reduced the time from referral to diagnosis for patients with urgent suspicion of cancer as well as the number of visits they make.
The Team said: “We’re very surprised but very thankful to have won this award.”
Calum Campbell, Chief Executive, NHS Lothian, said: “It is fantastic seeing staff being able to come together again and celebrate in person.”
Bringing new hope to patients with the help of specialised nurses
Scotland is leading the way with an innovative service for secondary breast cancer patients.
The Patient Trials Advocate service, (PTA) is the first of its kind in the UK, and it’s bringing fresh hope to those with the incurable cancer by introducing them to clinical trials which can help to improve outcomes and extend life.
The initiative has been developed by charity Make 2nds Count which campaigns to raise awareness of, and fund research into, secondary breast cancer – a form of the disease which kills 1000 women in the UK each month but remains largely unknown.
Also known as metastatic, advanced or stage IV breast cancer, it is a cancer that has spread beyond the breast to other parts of the body and can be treated but not cured. On average there are around 35,000 patients in the UK currently living with this form of the disease.
There is evidence that early access to innovative new treatment options can improve the outcomes of men and women with secondary breast cancer and the new, bespoke service, the first of its kind in the UK, sees specialist nurses support patients and link them up with clinical trials.
The PTA scheme covers Scotland in its entirety through nurses based in Edinburgh, the Borders and the Highlands. Patients have an initial one-to-one, hour-long phone consultation with one of the nurses who can advise about clinical trials and answer any queries, search for suitable trials and support patients in discussing them with their clinician.
“We know that many secondary breast cancer patients have never had a conversation with their clinician about clinical trials and we want to empower them to change that through our PTA service,”says PTA nurse Vivienne Wilson, a senior research nurse at Edinburgh’s Western General Hospital.
“We want to ensure that every patient with secondary breast cancer has the knowledge and the opportunity to discuss trials as part of their treatment pathway.
“I’m delighted that the Patient Trials Advocate service is now being expanded to include the whole of Scotland. I’ve been working with Make 2nds Count for over a year now and I think this service really is one of a kind. I enjoy the opportunity to talk to many secondary breast cancer patients, sharing my knowledge with regards to available trials and guiding them to explore their options.”
Since the service piloted last year more than 100 patients have been supported. Of those, 100% backed the initiative and 95% said they would talk to their clinician about the possibility of accessing clinical trials.
One of those who knows only too well the benefits of a clinical trial is Edinburgh mum-of-four Lesley Stephen. Diagnosed with stage IV breast cancer out of the blue in 2014, the disease had already spread to her lungs, liver and bones.
Two years later she was told she had run out of treatment options. But she subsequently got the chance to take part in a clinical trial and is still living with the disease six years later.
Lesley says: “I had undergone 18 months of treatment, which was unsuccessful, when I heard of a friend who was taking part in a clinical trial. That inspired me and gave me hope that there just might be another option.
“I researched potential trials myself, which was not easy, and I realised that there was a lack of awareness. But because of the trial I took part in, I have had another six years of life I never expected to have. This just shows why the patient advocacy service is so important. People need to know that there perhaps, is another possibility out there for them.”
Make 2nds Count was founded by mum Lisa Fleming, 38, of Edinburgh, who had no previous breast cancer diagnosis, warning signs or lump when she was told she had secondary breast cancer.
Her aim is to support patients and families, educate and raise funds for research into the disease. So far the charity has raised more than £1million.
To find out more about the Patient Trials Advocate service visit:
New equipment is helping NHS Lothian to provide “first class treatment” to cervical cancer patients in the South East of Scotland.
Cervical cancer is the most common cancer in women under 35 and around eight women are diagnosed with cervical cancer each day in the UK.
The new brachytherapy kit, from Elekta, allows the delivery of a high dose of radiation directly into the tumour and minimises damage to the surrounding healthy tissue.
Brachytherapy is a form of internal radiation therapy which targets the cancer directly.
Dr Mark Zahra, Consultant Clinical Oncologist & Clinical Lead for Radiotherapy at Edinburgh’s Cancer Centre, said: “This kit will help us to continue to provide first class treatment to patients with cervical cancer.
“It gives us more options than our previous brachytherapy equipment as it can treat larger tumours and expand the dose of radiation to the tumour, whilst protecting the normal organs.
“The Elekta kit is used alongside image-guided technology to really tailor treatment to the patient’s anatomy and needs and minimise the long-term health effects of radiotherapy.
“Together we expect these technologies to have a real impact on patients’ cure rates and comfort.”
Edinburgh Cancer Centre has used image-guided brachytherapy for gynaecological cancers for over 10 years and is the first in Scotland to use Elekta technology. The technology will now be routinely used for all eligible patients in the South East of Scotland with gynaecological cancers.
Dr Zahra continued: “Edinburgh Cancer Centre is a leader in innovative treatments and progress such as this could not have been possible without a huge team effort.
“We strive to provide the best possible care we can and share our research and learning to help improve outcomes for patients everywhere.”
Over 99% of cervical cancers are caused by HPV. HPV is very common and four out of five people in Scotland will have it at some point in their lives.
HPV vaccines are offered to all S1 pupils and can prevent around 75% of cervical cancer cases. Alongside the vaccine, it’s vital to attend cervical screenings (smear tests) when invited.
Experts from Universities of Edinburgh and Glasgow will receive funding from Cancer Research UK to conduct ground-breaking work as part of a chain of research hubs around the UK.
The £12 million investment over the next five years will be used to accelerate the Cancer Research UK Scotland Centre’s work into diagnosing and treating cancers which are among the most prevalent in Scotland, including bowel cancer, mesothelioma, liver cancer and brain tumours.
The Scotland Centre, comprising scientists from Edinburgh and Glasgow, has been chosen as one of just seven locations to secure funding in the latest review of the Cancer Research UK Centres network of excellence.
Understanding cancer
The work taking place in Edinburgh includes Professor Malcolm Dunlop and colleagues studying the faulty genes that underpin bowel cancer. Prof Dunlop’s team is aiming to understand how our genes influence the risk of developing the disease and the chances of surviving it.
Professor Steve Pollard and his team are developing potential new treatments for the most common type of brain tumour in adults, known as glioblastoma multiforme.
Professor Ian TomlinsonCo-Director, Cancer Research UK Scotland Centre, said: “This investment will give us the tools we need to deliver high quality research which will make the biggest difference for patients.
“It means we will be able to further develop our work in translational research – getting cutting edge discoveries from the laboratory to patients and learning as much as possible from patients to initiate new research.
Dr Iain Foulkes, Executive Director of Research and Innovation, Cancer Research UK, added: “This past year proves, more than any other, the value of investing in science and medical research, and what can be achieved with collective focus and collaboration.
“Just like science is our route out of the pandemic, science is our route to beating cancer. Despite the impact of the pandemic on the charity’s income, we are funding some of the best and most promising research in Scotland to help more people survive.”
A £13 million investment has transformed services for blood cancer patients across South East Scotland at the newly opened Edinburgh Haematology Centre.
Located at the Western General Hospital, the centre has been rebuilt, expanding and improving day ward facilities, and enabling a major service redesign to enhance the range of treatments on offer.
Now patients can benefit from intensive chemotherapies and innovative treatments, such as outpatient bone marrow transplants saving them up to a three week stay in hospital. A new relatives’ suite and buddy beds also help to better support inpatients.
The majority of funding (£12.3 million) was gifted by a private donor, who wishes to remain anonymous, to significantly improve the experience at the centre for patients, carers and staff.
“This was an amazingly generous donation which will benefit patients and staff for many years to come”, explains Dr Peter Johnson, a Consultant Haematologist who led on the refurbishment.
“The vision was to create a welcoming, calm, clinically excellent and aesthetically pleasing environment that would help patient wellbeing and was representative of the quality of healthcare being delivered. We are extremely grateful to the donor for this exceptional donation.”
NHS Lothian, and its official charity – Edinburgh and Lothians Health Foundation (ELHF), worked with patients and staff on the redesign and to develop an inspirational arts and therapeutic design programme.
A series of bespoke artworks and installations made by specialist artists and makers are displayed throughout the centre, helping to create a sense of calm and visual interest.
Jane Ferguson, Director of Edinburgh and Lothians Health Foundation explains: “We can’t thank the donor enough for their generous charitable donation, which has enabled us to take forward creative and innovative techniques to enhance and really elevate the space.
“Being diagnosed with a serious illness is a traumatic experience so we wanted to create an environment that was warm and comforting and would help reduce some of that anxiety and stress. The end result is truly beautiful and the difference in experience for patients now and in the future will be transformational.”
Fiona Smith, Senior Charge Nurse of Haematology Day Treatment added: “The changes have really made a huge difference. Care is much more than treatments and medicines.
“Being able to provide privacy and a calming environment helps to relax patients and having more space and cutting-edge equipment helps us to do our job even better.”
Neil Clifton is one of the patients benefitting from the new centre. He recently received a stem cell transplant as an outpatient for treatment of Myeloma. He says: “It really doesn’t feel like going into a hospital anymore. The centre is much brighter and more pleasant.
“Having a private room for my treatment in the day unit really helped to make me feel safe and comfortable and being able to receive it as an outpatient is much more convenient.”
The Edinburgh Haematology Centre forms part of a wider masterplan at the Western General Hospital site to improve patient services including significant investment in cancer care and facilities.
NHS Lothian also has a vision to build a new Regional Cancer Centre at the hospital site designed to be a world leader for cancer research and innovation.
New prostate cancer treatment available at Edinburgh Cancer Centre is first in Scotland
Men in the South East of Scotland may now be able to access a new treatment for prostate cancer, which is available at the Edinburgh Cancer Centre, Western General Hospital.
The Edinburgh Cancer Centre (ECC) is the first in Scotland to offer High–dose-rate brachytherapy (HDR-BT) for treatment of prostate cancer.
It was successfully introduced by NHS Lothian earlier this year and is now being made available to suitable patients across the South East of Scotland.
Prostate cancer is the most common cancer among Scottish males affecting 1 in 10 men. With more than 3,000 men diagnosed every year this figure is only expected to increase.
But, with early detection and improved treatments, survival rates are also increasing. Radiotherapy is commonly used to cure prostate cancers and increasing the radiation dose in treatments has shown to improve long-term cancer control.
The HDR-BT service at the ECC offers an additional treatment approach to deal with aggressive but localised prostate cancer. It allows a higher dose of radiation to be targeted directly into the prostate gland in a safe and controlled way. This minimises radiation exposure to surrounding normal tissue and thereby reduces potential side effects.
The new treatment is being offered alongside existing radiotherapy treatments at the Edinburgh Cancer Centre, expanding the range of treatment options on offer.
Dr Aravindhan Sundaramurthy, Consultant Clinical Oncologist at the Edinburgh Cancer Centre explains: “We have been successfully delivering low-dose-rate brachytherapy (LDR-BT) for prostate cancer with over 1000 men throughout Scotland benefitting from the service. However, men with more advanced or aggressive disease would not be eligible for LDR-BT on its own.”
“The start of the new HDR-BT service opens a very important therapeutic option for men with high-risk prostate cancer features. It brings together the skills and expertise of staff across our radiotherapy, oncology and anaesthetic teams to deliver another treatment option.”
He said: “I would strongly encourage anyone who is offered this treatment to go for it. It was a very smooth process and the care I received from the NHS was absolutely first class. I was looked after every step of the way and I knew that I was in the best possible hands for my treatment.”
This HDR-BT service is a collaborative effort involving radiotherapy nursing, prostate clinical oncologists, anaesthetics, therapeutic radiographers and oncology physicists. It is currently being offered at the Edinburgh Cancer Centre for suitable patients within the South-east Scotland Cancer Network with an aim to expand the service to other patients across Scotland.
A new £6.2 million Renal Dialysis Unit has opened in Edinburgh serving patients from the north and west of the city. Located at the Western General Hospital, the state-of-the art facility is designed to meet projected rising demand for dialysis services, while being more comfortable and welcoming for patients.
It will ensure patients who need kidney dialysis have access to the latest equipment in modern, bright and spacious surroundings.
The new building replaces a smaller unit, which was over 30 years old, and very cramped. It has increased the number of dialysis stations from 9 to 12. Now up to 72 patients can be treated in the unit.
Dialysis involves filtering waste products and excess fluid from a patient’s blood when their kidneys stop working properly. The most common form of dialysis, haemodialysis, takes on average four hours per session and is typically carried out three times a week.
Dr Caroline Whitworth, Consultant Nephrologist explains: “Patients can expect to spend between 12 and 18 hours per week on dialysis so having a welcoming, peaceful and comfortable place to do dialysis is really important.
“We’re already seeing the positive impact this fantastic new facility is having on patients and staff. The clinical areas is as light and airy as possible, but also more peaceful, giving patients a much better experience. The unit will be a great benefit for patients for years to come.”
Bill Aitken, a renal patient, started experiencing symptoms of kidney failure in his early 30s. An avid football player he first noticed that something was wrong when his fitness started to deteriorate. He has been a patient with NHS Lothian for over 25 years. He says: “I’ve been in and out of treatment at both the Royal and the Western General. This feels light years away from the previous unit.
“It’s very nice and bright and has cracking views out the window to Edinburgh Castle and the Old Town. When we’re dialysing, we’re there for a long time so it makes a huge difference to be doing it in modern, pleasant surroundings.”
The Renal Dialysis Unit is one of several new projects at the Western General Hospital to transform services and create more space, comfort and privacy for patients. It was funded by NHS Lothian Capital Investment, constructed by Robertson Construction on behalf of RMF Health, and designed by HLM Architects.
David Cairns, regional managing director, Robertson Construction Central East, said: “The new renal unit is one of several projects we have delivered at the Western General Hospital, on behalf of RMF Health, over the last 2 years whilst the hospital has remained a live environment. We’re also progressing a number of other projects with RMF Health which will provide first class facilities for the hospital.”
The capital development team worked closely with NHS Lothian’s official charity, Edinburgh & Lothians Health Foundation, to integrate creative enhancements of the environment into the design, helping to ensure that the unit was not only clinically functional but also aesthetically pleasing.
Jane Ferguson, Director of Edinburgh & Lothians Health Foundation, explains: “The involvement of our Arts in Health and Wellbeing team from the start of this project really demonstrates the importance that NHS Lothian has placed on art and design as an essential part of their capital projects.
“They recognise how much of an impact the environment and surroundings can have on patient and staff wellbeing. We were delighted to work together to take forward creative and innovative ways to enhance the space, and I think the end result is a welcoming, restful environment which creates privacy, distraction and diversion while patients receive treatment.”
