The London Clinic’s International Newsletter

WELCOME MESSAGE FROM OUR MEDICAL DIRECTOR MR SATYA BHATTACHARYA

A warm welcome to The London Clinic’s first international newsletter. The London Clinic has been the hospital at the heart of the medical community in and around Harley Street since 1932.Patients come to The London Clinic from all over the world. We are proud to treat many patients from the Middle East and other countries, such as the United States, Cyprus, China, Ghana, Togo and Canada amongst others. To make the stay and treatment for our patients as comfortable as possible, we have a

dedicated International Office which provides a centralised service for all of our international patients, their families and companions.

The team look after booking appointments with our leading consultants and organising admissions to The London Clinic.

We have interpreters available to patients seven days a week. All of our interpreters speak Arabic and some additional languages including German, French, Farsi and Turkish. We have also put in place alternative options when interpreters are not available, so that translation services are always provided.

NOVEMBER/DECEMBER 2017

3D PRINTING FOR PERSONALISED ORTHOPAEDIC PROCEDURES AN INCREASING NUMBER OF PEOPLE NEED CORRECTIVE HIP SURGERY BECAUSE THEIR HIP JOINTS ARE CAUSING THEM PAIN AND MOBILITY PROBLEMS. WHEN PATIENTS ARE REFERRED TO THE LONDON CLINIC OUR EXPERT CONSULTANTS TAKE A FRESH LOOK AT WHAT IS GOING WRONG, DIAGNOSE THE PROBLEM, AND CREATE A PERSONALISED TREATMENT PLAN TO HELP PATIENTS GET BACK ON THEIR FEET QUICKLY AND RETURN TO THEIR NORMAL LIVES.

With recent technological advances we are able to provide personalised patient solutions for hip replacement surgery using innovative 3D printing. Advanced imaging techniques (CT and MRI scans) captures the bony anatomy of the hip with great precision and accuracy, computer software then uses this information to create:

3D PRINTED MODELS FOR PREOPERATIVE PLANNING

3D INSTRUMENTAL MODELS, ALSO KNOWN AS PATIENT SPECIFIC

3D PRINTED MODELS FOR PREOPERATIVE PLANNING

Help the surgeon visualise and plan complex hip replacements.

Accurately position the artificial hip.

Aid the reconstruction of massive bone defects of the hip socket.

Professor Alister Hart, a leading consultant in orthopaedic care at The London Clinic, says: “Better imaging, advanced computer software and the emergence of 3D printing has enabled us to make tailor-made solutions for patients. The ultimate goal of personalised orthopaedic hip surgery is to improve the position of the artificial hip. This determines the final leg length, range of motion within the hip joint, and longevity of the implant all of which are very important for ensuring we improve the patient’s mobility and quality of life.”

CONTACT THE INTERNATIONAL OFFICEIf you would like to contact the International team, please do so using one of the following methods:Telephone: +44 (0) 20 3219 3266 Fax: +44 (0) 20 3219 3516 Email: internationaloffice@thelondonclinic.co.uk

WE ARE DEDICATED TO PROVIDING A WORLD-CLASS CANCER TREATMENT SERVICE WHERE CANCER PATIENTS CAN UNDERGO THEIR FULL JOURNEY OF CARE.

Radiotherapists Radiologists

Clinical Nurse

Specialists

Medical Oncologists

Surgeons

Chair of each

Oncology MDT

Pharmacists

Dieticians

Physiotherapists

CANCER CARE at The London Clinic

EXTENDED MDT MEMBERSCORE MDT MEMBERS

MULTIDISCIPLINARY TEAM MEETINGS AT THE LONDON CLINIC At The London Clinic the treatment and care of patients diagnosed with cancer are discussed at our well established cancer Multidisciplinary Team meetings, also known as MDTs. These meetings ensure that all of our patients get the best possible treatment that can be offered for their individual case as discussed and recommended by a group of leading experts. Our MDT members meet on a regular basis to discuss and carefully review each individual case in order to formulate a research based treatment recommendation, tailored to the needs of each patient. The final decision about each patient’s treatment plan is made in consultation between the patient and their consultant.

DEDICATED CLINICAL NURSE SPECIALISTS FOR OUR PATIENTSWe have 30 dedicated clinical nurse specialists (CNS) who provide expert advice relative to specific conditions or treatment pathways. Our CNS are a key point of contact for our patients, they are involved in the co-ordination and organisation of each patient’s treatment programme and work closely with other members of the treatment team.

Our CNS provide an extra layer of expertise to the medical team. These roles have a significant impact on patient care. For example, we have a process whereby the clinical nurse specialist will conduct a pre-assessment of the patient prior to surgery. This early contact with our hospital, and an expert nurse, helps patients to feel less anxious and gives them added confidence in the process. Patients have also derived significant benefit from the role of our breast CNS, who is available from the first consultation through to treatment and surgery as a familiar point of contact and support throughout the process. For example patients receiving radiotherapy find it helpful to discuss any side effects with a CNS after they leave the hospital.

WE TAKE A HOLISTIC APPROACH MANY PEOPLE ARE INTERESTED IN USING COMPLEMENTARY THERAPIES TO HELP THEM COPE WITH CANCER AND THE VARIOUS TREATMENTS THIS ENTAILS. THE LONDON CLINIC HAS A HOLISTIC APPROACH TO CANCER CARE.Complementary therapies are offered to people with cancer, alongside treatment such as surgery, chemotherapy and radiotherapy under the direction of an oncology-trained lead therapist.

AT THE LONDON CLINIC AS WE PROVIDE:

• Pathology laboratory testing • Diagnostic imaging

• Treatment such as chemotherapy, radiotherapy and immunotherapy

• Surgery

We continually reinvest in state-of-the-art equipment and new modalities to treat cancer and provide our patients with the best possible outcomes.

Our complementary therapists work with each patient as a whole person, not just the part of the body with the cancer. Reflexology, aromatherapy massage, Indian head massage, Reiki and spiritual healing are

available for our cancer patients. Complementary sessions are offered to all patients

and everyone receives four free sessions, which can be taken at any point in their treatment or during their recovery.

Patient

INNOVATIONS IN CANCER CARETechnology continues to advance, and so too does our ability to offer more sophisticated procedures and treatments. As part of our charitable status, we are able to reinvest the surpluses we make to offer the best possible treatment options for our patients.

INTRAOPERATIVE RADIOTHERAPY (IORT) FOR COLORECTAL PATIENTS

CYBERKNIFEThe London Clinic offers CyberKnife therapy as an alternative to surgery for complex or inoperable cancer cases. CyberKnife therapy delivers highly-focused beams of radiation from a robotic arm that can be directed from virtually any direction, this is known as stereotactic ablative body radiotherapy. The machine has tracking software that detects any movement of the tumour or patient and automatically repositions the radiotherapy beam in order to minimise damage to healthy tissue. Because of its pinpoint accuracy, CyberKnife allows larger doses of radiotherapy to be delivered, meaning that the patient requires fewer hospital visits. This advanced technology can be used to treat small to medium sized tumours within the lung, digestive system, liver, pancreas and brain and other parts of the body.CyberKnife therapy has many advantages such as: • Treatment is carried out on an outpatient basis

with each session taking a maximum of two hours

• The procedure is painless so there is no need for an anaesthetic

• Treatments are normally concluded in a week or less

PIONEERING THERAPY FOR LIVER CANCERThe London Clinic is one of the few private hospitals that offers Selective Internal Radiotherapy (SIRT), a pioneering treatment used to accurately target primary liver cancer or cancer that has spread to the liver from other parts of the body such as bowel cancer.Millions of tiny radioactive beads (microspheres) are injected into the arteries that supply the cancers and they selectively treat the cancers in the liver. The microspheres block the tumour vessels and they emit radiotherapy directly to the cancers from inside the body. SIRT can also be given in combination with chemotherapy.Patients may benefit from SIRT therapy if their liver cancers cannot be removed by surgery. SIRT can be used to treat secondary tumours in the liver that started in the bowel or spread to the liver from other organs such as the breast or stomach. It can also treat primary liver cancer.

NEW GEL HELPS TO REDUCE SIDE-EFFECTS FOR PROSTATE CANCER PATIENTSThe London Clinic is the first private hospital in the UK to offer prostate cancer patients a new treatment called SpaceOAR. This high-tech hydrogel has been designed to protect patients from the side-effects of radiotherapy that can cause long-term problems such as rectal damage.SpaceOAR hydrogel acts as a spacing gel that is inserted between the prostate and rectum.

After being injected in liquid form, the gel solidifies and temporarily positions the rectal wall away from the prostate during radiotherapy treatment for prostate cancer.

The gel, which is mostly made from water, stays in place for between three and six months, after which it breaks down and is absorbed by the patient’s body. Using the gel, specialists can

target the prostate gland with the knowledge that the risk of damaging the patient’s rectal wall has been significantly reduced.

This advanced therapy:

• Helps destroy microscopic tumour cells that may be left behind at the tumour site

• Limits healthy tissue exposure to radiation

Colorectal IORT is suitable for locally advanced and locally recurrent colorectal cancer patients and can be given as the sole treatment or as a boost

treatment followed by external beam radiotherapy.

Patients are carefully selected in MDTs and are treated by a colorectal surgeon and consultant oncologist. Medical physicists, therapeutic radiographers, clinical nurse specialists and physiotherapists also play a key role in the treatment and recovery of the patient.

THE LONDON CLINIC BECAME THE FIRST HOSPITAL IN THE UK TO PERFORM COLORECTAL INTRAOPERATIVE RADIOTHERAPY (IORT); USING THE INTRABEAM SYSTEM WITH FLAT APPLICATORS.The Intrabeam Radiotherapy System is a mobile irradiation system designed to deliver a single dose of targeted low energy radiation (x-rays) directly to the tumour site immediately after the tumour is surgically removed.

Image reprinted with permission from Augmenix, Inc.

We have carefully designed two extensive patient menus after feedback from patients, advice from dieticians and our suppliers. We have an international chef who ensures our international patients and their visitors can enjoy dishes that are consistent with their culture. Our international chef is more than happy to visit patients and understand their needs and preferences to produce dishes for their specific requirements. During Ramadan, our catering team can provide freshly prepared food to be consumed during the night.

PROVIDING NUTRITIOUS FOOD FOR OUR PATIENTS IS AN IMPORTANT PART OF THE HIGH QUALITY CARE WE PROVIDE.

INTERNATIONAL CHEF

NOVEMBER/DECEMBER 2017

NEW TREATMENT FOR CONDITIONS OF THE BILE DUCT We are the first private hospital in the UK to offer SpyGlass cholangioscopy technology.

This minimally invasive procedure helps diagnose and treat conditions or obstructions of the bile duct, including:

• Benign tumours • Bile duct stones

• Malignant tumours • Pancreatic duct stones

Conventionally endoscopic retrograde cholangiopancreatography (ERCP) is used to help diagnose and treat conditions of the bile ducts. However, if ERCP is unsuccessful or fails to establish a clear diagnosis, patients at The London Clinic can now be considered for SPYGLASS cholangioscopy.

The SPYGLASS cholangioscope is a very thin (3mm) steerable endoscope that has a tiny camera on the end. This allows the consultant to visually examine the inside of the bile ducts.

The biggest impact from SPYGLASS is the improved patient journey. Diagnosis can be given more quickly, treatment more accurately and less invasively than in the past.

TREATING STONESWhen treating stones, the SPYGLASS CHOLANGIOSCOPE can be inserted right up to the stone and, under a direct view, shock waves can be fired through the cholangioscope using electrohydraulic lithotripsy to break them up. Balloons and baskets are then used to remove these fragments.

DEALING WITH STRICTURESWhen diagnosing and treating narrowings (strictures) of the bile duct the endoscopist is able to make a clearer assessment as to whether the narrowing is caused by a benign or cancerous disease by using the SPYGLASS CHOLANGIOSCOPE to inspect the lining of the bile duct. If the cause is benign many strictures can be opened up with balloons or stents.If the stricture might be due to cancer, biopsy forceps can be passed down the cholangioscope which allows direct samples from abnormal areas of the bile duct to be taken. These biopsies will then be sent to our pathologists to help make a clear diagnosis.

ROBOTIC SURGERY ALLOWS OUR CONSULTANTS TO OPERATE WITH ENHANCED VISION, PRECISION AND CONTROL.

At The London Clinic we have specialist surgeons who are able to perform gynaecological, colorectal, hepatobiliary and urological surgery using the advanced da Vinci Surgical System.

This computer-enhanced robot, mimics the surgeon’s hands and wrist movements and enables our surgeons to perform keyhole (laparoscopic) operations with great accuracy.

Robotic surgery is commonly used to treat prostate cancer (radical prostatectomy).

Professor Prokar Dasgupta, Professor of Urology, who has pioneered robotic urological surgery in the UK explains: “Rather than making a big cut on a patient we can achieve the same effect through tiny key holes.

This benefits patients as they have a shorter hospital stay and have less blood loss and pain.

We are able to see the organ we are operating on in 3D, high definition which is beneficial for areas that have a lot of nerves and blood vessels that need to be avoided.”

“One drawback of robotic surgery is we lose our sense of touch, in radical prostatectomy procedures we have overcome this by producing bespoke 3D printed models of the patient’s prostate. By creating a patient specific model the surgeon is able to feel their way around the real prostate when they perform the surgery,” adds Professor Dasgupta.

Image reprinted with permission from Boston Scientific

CONTACT THE INTERNATIONAL OFFICEIf you would like to contact the International team, please do so using one of the following methods:Telephone: +44 (0) 20 3219 3266 Fax: +44 (0) 20 3219 3516 Email: internationaloffice@thelondonclinic.co.uk