First proton beam therapy patient treated at The Christie
The proton beam therapy centre at The Christie is proud to announce that it treated its first patient in December 2018. The team are delighted to reach this key milestone and plan to treat more patients in the new year.
End to end testing
Following ProBeam applications training, the radiographers have been testing out the gantries. The team has been delivering proton beams and taking scans and X-ray images of anatomically realistic phantoms. The phantoms are designed to replicate human anatomy and to safely test out the hardware and software of the ProBeam system. The end-to-end testing period has allowed the radiographers to review their working practices and develop detailed documents that will inform their practice when treating patients.
New complementary therapist for proton beam therapy starting January 2019
The proton beam therapy (PBT) department would like to welcome Peter Sandy, senior complementary therapist to the team.
Peter brings over 10 years’ experience in clinical hypnotherapy with a special interest helping people with anxiety and phobia issues. He has taught hypnotherapy at Diploma level and helps train Christie staff stress management techniques.
Peter has been a member of the complementary therapy and wellbeing team at The Christie since 2013 supporting patients through various emotional issues ranging from managing anxiety, panic attacks and phobia issues, breathing problems, pain issues and insomnia. Peter also works within the smoking cessation and alcohol support team helping patients to overcome addiction problems.
Peter describes how the complementary therapy role will support PBT patients and staff.
"Anxiety is a natural feeling we all experience. However, at times of stress it can affect people in ways that become overwhelming both physically and mentally. For example, some patients may find the idea of wearing a special mask to help ensure accuracy during treatment a difficult and stressful thing to cope with resulting in higher than normal anxiety.
"A big part of my role is to help our patients to feel more relaxed and calm and assist them to find ways to cope with any challenges when under the care of the proton beam therapy centre at The Christie. I look forward to starting in January and offering talking therapies like hypnotherapy, massage and aromatherapy, continuing to learn about protons and last but not least, how to enhance the complementary therapy service."
Senior health play specialist
The proton beam therapy (PBT) department would like to welcome Charlotte Cooper, a senior health play specialist, to the team. Health play specialists (HPS) work with children and young people who are in hospital, attending as an outpatient or in the community. Play can be used as a therapeutic tool to help children understand and cope with their treatment.
Charlotte has described her experiences since joining the department.
“I have worked in haematology and oncology for 19 years and qualified as a HPS in 2002. Since then, I have been involved in developing and leading a radiotherapy play preparation service, working closely with the wider multi-disciplinary team. I have published two service evaluations evaluating the impact of play preparation for children receiving radiotherapy and reducing sedation for nuclear medicine imaging. I also bring experience in teaching, leadership and effective multi-professional working.
“I am a member of the national association of health play specialists (NAHPS) and I am active in promoting the role of the health play specialist nationally.
“We aim to develop a strong evidence base for the importance of HPS in the healthcare setting, which will ultimately benefit patients and their families.
“Although proton beam therapy will be challenging for children I am looking forward to equipping and using the playroom to start preparing and supporting them through play. Developing a range of therapeutic and playful interventions will reduce any anxieties, helping as many as possible to manage their treatment awake with the full support of everyone involved.
“There is such a positive atmosphere as you walk around the PBT centre and a strong commitment from everyone involved making such a specialised and challenging treatment the best experience it can be for the patients and families. I am thrilled to be involved so thank you to everyone for making me welcome and I look forward to what the future holds for PBT and our lovely new health play specialist team here at The Christie.”
Radiographers on the proton team recently attended a five-day training course. A trainer from Varian passed on their extensive knowledge of the entire proton beam therapy system to the team. The team spent time in the classroom learning about the software and hardware involved in treating proton patients.
The radiographers also then had the opportunity to experience some hands-on learning by working on Gantry 1. Training involved using the treatment table, moving the gantry, delivery of proton beams, and getting to grips with the imaging systems.
The practical element of the training allowed the radiographers to experience the sights and sounds of the ProBeam system, which will be invaluable as we move ever closer to treating our first patient.
Varian Users Meeting UK 2018
Members of the proton beam therapy team had the opportunity to attend the Varian Users Meeting conference 2018. Radiographers, physicists, dosimetrists and technologists attended the conference and presented on a range of topics. Topics included treatment delivery, plan robustness and optimisation, mitigating organ motion and systems implementation in proton beam therapy.
“It has been exciting to present on the national stage and show the delegates all the hard work that the team has been doing leading up to the first patient”, said James Donnelly, superintendent radiographer.
The proton team would like to thank the hosts from the Queen's Oncology and Haematology, Hull for hosting an exciting and informative event.
Proton day unit
The proton day unit is designed for paediatric patients who require general anaesthetic. The highly experienced nurse-led unit is where patients will recover after proton beam therapy (PBT) and radiotherapy. It is located on the first floor of the PBT centre with access to the CT and MRI scanners and the treatment gantries so patients can be transferred quickly and safely onto the unit after their scan or treatment.
The unit consists of four bays including one isolation bay. Patients will enter the day case unit from the specialised paediatric waiting areas.
When the day unit is open, paediatric patients receiving radiotherapy who require general anaesthetic will have their planning CT scan in the PBT centre. The day unit team will be supporting the recovery and assessment of these patients. This is an excellent opportunity to utilise the space and resources of the PBT centre.
The opening of the unit signifies we are another step closer to treating the first proton patient.
Proton charity sky dive
This month, therapy radiographer Lucy Davies participated in a charity sky dive – jumping from a plane at 11,000 feet.
Lucy said of her sky dive: “Having never done anything like this before, the sky dive was an exhilarating experience that I will never forget. My highlight of the sky dive was the sensation of freefalling through the sky at approximately 120mph, not to mention seeing the beautiful views over the Lakes as I parachuted back down to the ground. There was a sense of unity and exuberance throughout the day as there was many others who were also participating in a sky dive for The Christie Charity.
“The money I have raised will be allocated to The Christie Charity Proton Patient Fund, which will directly support our patients’ experience whilst they are undergoing proton beam therapy treatment.”
You can help Lucy Davies raise money for this great cause by donating up to the 17 October directly to her fundraising page: https://www.justgiving.com/fundraising/lucysdavies
On 10 September, our first paediatric clinic was held in the proton beam therapy centre. The clinic saw new, current and previous radiotherapy patients for review. Paediatric oncologists led the clinics but were supported by key workers, paediatric nurses, health play specialists and clinical support workers. It was delightful to see our patients and their families using the new facilities and getting their positive feedback on the clinic areas and the proton beam therapy centre.
With more clinics planned in the future, the proton beam therapy centre will continue to open up to more and more patients as we move closer to treating our first patient in autumn 2018.
NHS England Chief Executive visit
NHS England Chief Executive Simon Stevens takes a tour of The Christie's new high energy proton beam therapy centre, meeting staff and patients.
Simon Stevens and Imran Patel (Consultant Clinical Scientist) in front of Gantry 1
First measured Bragg peak on ProBeam
The physics and engineering teams are currently hard at work commissioning Gantry 1 and Gantry 2. The teams are working to measure, understand and test the performance of the ProBeam system. This will ensure the system is safe, reliable and fit for clinical treatment delivery.
One of the first measurements the teams looked at on Gantry 1 tested how the dose changes as a beam of protons passes through a water tank. The measured dose curve clearly showed the first Bragg peak seen at the proton beam therapy centre.
A Bragg peak shows when radiotherapy – whether that’s traditional photon radiotherapy or proton beam therapy – is at its strongest. As a proton beam passes through the body or the physics water tank, it delivers its maximum dose at a precise depth with little or no dose deposited beyond this point.
In proton beam therapy, the treatment is planned so that the Bragg peak occurs precisely at the site of the tumour. This means the treatment planning team can minimise the dose to healthy tissue – reducing long-term side effects – or safely increase doses to tumours, depending on the clinical need.
Measuring this first Bragg peak was an exciting development, marking the transition from planning and theorising to delivering real dose and treatment beams.
Welcome to our new diagnostic radiographer
The proton beam therapy department would like to welcome Amal Salah, a diagnostic radiographer, to the team. Diagnostic radiographers use X-rays, ultrasounds, MRI scans or other imaging technology to look into your body.
Amal has described her experiences since joining the department.
“As a diagnostic radiographer starting in radiotherapy, my new role was a challenging experience at first. Previously, I have had very little experience in radiotherapy or proton beam therapy. During my time as a diagnostic radiographer, I specialized in MRI after completing my Master’s degree in Advanced Medical Imaging.
“The biggest challenge I have faced in my new role as a pre-treatment radiographer in proton beam therapy has been understanding the difference between the diagnostic and therapeutic radiography processes. Additionally, the idea of using MRI scans to help plan radiotherapy treatment is a fairly new one, and this has meant new challenges and unique requirements.
“I am currently designing a presentation to teach therapeutic radiographers more about the process of MRI scanning and to help them learn the theory behind MRI.
“Thanks to both my academic and clinical backgrounds, I am also able to assist with scan optimization. This means we can produce the highest quality images, and these are essential for planning radiotherapy treatment.
“I will continue to embrace the challenges faced in my new role as part of the proton beam therapy team and value the opportunity to learn and evolve as a radiographer.”
Over the last year, The Christie has been working in collaboration with the digital agency Corporation Pop® and mobile application Xploro® to create a unique patient information experience aimed at 8-14 year olds.
The aim of the app is to reduce anxiety by increasing the patient’s knowledge of proton beam therapy in a fun and interactive way. One of these methods is allowing the patient to design their own avatar who will then guide them through the various stages of treatment
Picture Copyright: Corporation Pop
The app has also been designed to answer any questions a child might have about their treatment or the facilities available at The Christie. It will be pre-populated with answers from medical staff and content from CLIC Sargent and Bone Cancer Research Trust.
It is being partly funded by Innovate UK and the Social Tech Trust and will feature a range of content unique to The Christie.
We have had a great response from children at our engagement days and we can’t wait to see the finished product and the impact that it will have on a child’s treatment experience.
Picture Copyright: Corporation Pop
Proton beam therapy patient accommodation
The Christie has been working with Staycity to provide accommodation for out of area patients during their course of proton beam therapy.
Staycity is located in Piccadilly, close to Manchester Piccadilly Train Station. Staycity is an ‘aparthotel’, meaning each apartment comes furnished with fully equipped kitchens, separate bedrooms and living area on one level. Families who have accommodation at Staycity will have access to a designated lounge and communal areas.
Where accommodation is provided, The Christie will provide a free shuttle service between the accommodation and the proton beam therapy centre for the duration of your treatment.
For further information, please visit the Staycity website.