Simply Oncology (John McGrane & Michael Rowe)

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Welcome to the Simply Oncology podcast!
Dr John McGrane and Dr Michael Rowe are clinical oncologists who want to make all parts of cancer care as easy to understand as possible.
We discuss our 2 streams of podcast;
1) Fundamentals series - Breaking cancer care to basic learning blocks. For patients, students and anyone with an interest in cancer.
2) In the Clinic series - A more focused discussion on more clinical aspects of delivering cancer care. For anyone working in healthcare treating cancer patients. 

Thanks for listening

John & Mike

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In this episode Dr John McGrane and Dr Michael Rowe discuss what cancer is in basic terms.

We discuss some of the causes of cancer and the common treatment types for cancer.

We hope you enjoy.

John & Mike

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In this episode we are joined by Dr Mike Osborn a clinical psychologist working at the Royal United Hospital, Bath.
Dr Osborn helps patients with cancer on how a cancer diagnosis can impact them and how they may expect to feel. He shares his experience and insights after years of working with cancer patients and has some valuable tips that may help patients, families and carers.
“Cancer doesn’t just affect cells, it affects families”.

We hope you enjoy

John & Mike

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In this episode we are joined by Dr Toby Talbot a consultant oncologist who has been heavily involved in modern immunotherapy through his  work with melanoma trials. He treats skin, sarcoma and lung cancer and is discussing what immunotherapy is as a cancer treatment.
We discuss how this new cancer therapy is different to chemotherapy and how it is sometimes used with other treatments.
Immunotherapy has been a major change to improve outcomes for patients in many cancer types.

We hope you enjoy.

Mike & John

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In this episode we talk to Dr Nicky Thorp to look at the work of the Royal College of Radiologists in supporting development of oncology services.
Nicky Thorp is the Medical Director of Professional Practice for Clinical Oncology at the Royal College of Radiologists (RCR).
In this episode we discuss Nicky's role in the RCR, how the RCR is supporting oncology and what challenges and opportunities are happening in oncology currently.

'The RCR is not a building of brick and mortar. It is the members and fellows that make up the RCR'.

We hope you enjoy.

John & Mike

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In this episode we explore the impact of a cancer diagnosis through a patients eyes and story. We talk to Anna Ridley who was diagnosed with cervical cancer in 2018 and treated with chemotherapy, radiotherapy and brachytherapy.

She talks about her cancer diagnosis and how one of the most difficult times was telling her family the news.  She also dealt with some major challenges along her treatment journey.

She talks about how she stayed positive and kept moving forwards through her treatment and beyond. 

She highlighted that the isolation after treatment in follow-up during COVID made her realise the importance of having a support network around you.
She tells the importance of continuing to do the things that give you some joy - be it gardening, exercise, walking or anything that's positive for you.

We were amazed and moved by how honest, brave and eloquent Anna's story is.

We hope it helps you or a loved one.

John & Mike

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Clinical nurse specialists (often called a CNS) are a key member of every cancer patient's care. They are often the person co-ordinating where patients are in their treatment pathway and help patients and families better understand their treatment and care.
Today we talk to Debbie Victor who has over 15 years experience as a clinical nurse specialist.
She talks us through the role of the clinical nurse specialist and when and how patients should get in touch.
"there is no such thing as a stupid question especially if it is weighing on your mind".

We salute the CNSs and hope you see how valuable they are with this episode.

Enjoy 

John & Mike 

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In the Clinic episode aimed at doctors and nurses with an interest in cancer care. We discuss the INTERLACE trial in cervical cancer.

The INTERLACE trial led by Dr Mary McCormack was presented in ESMO 2023 and looks to shape oncological treatment of cervical cancer in the locally advanced setting.

We talk to Dr Gemma Eminowicz who has worked with Dr Mary McCormack over the last 10 years on the INTERLACE trial.

We discuss the 8% overall survival gain at 5 years from the addition of an extra 6 weeks of chemotherapy in INTERLACE . 

We also tackle some of the apparent issues around INTERLACE.

Gemma has delivered a real tour de force on the INTERLACE trial and the background of cervical cancer treatment.

We hope you enjoy.

John & Mike

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In this episode we look at the KEYNOTE A-18 trial in cervical cancer with Dr Gemma Eminowicz. 

This trial was presented by Dr Domenica Lorusso at ESMO 2023 and published in The Lancet in March 2024.
https://doi.org/10.1016/S0140-6736(24)00317-9

This trial took a high-risk group of patients receiving chemoradiation for cervical cancer and they were randomised to placebo vs 2 years of pembrolizumab.

The 2 year follow up results showed progression free survival benefit of 11%  in favour of 2 years of pembrolizumab (68% vs 57 %) with a Hazard Ratio of 0.7. 

Now we have 2 major trials (KEYNOTE A-18 and INTERLACE) in this chemoradiation space for cervical cancer we look at the similarities and differences between the trials.

Where does this point to our new standard of care in cervical cancer?

We hope you enjoy

John & Mike


(ENGOT-cx11/GOG-3047/KEYNOTE-A18)

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Calling all oncology SpRs and their trainers!!
The FRCR part 2 exam is a rite of passage every clinical oncology trainee in the UK has to complete to become a consultant.

We talk to Dr Paul Hatfield (lead examiner) and Dr Alison Stillie (senior examiner) and find out what they want to hear during the exam.

We also hear about how to prepare and what to expect on the day.
We find out how much work the examiners do to make the exam fair and balanced.

If you are going to sit the FRCR part 2 exam at some stage or your are involved in teaching or supervising oncology SpRs the this episode is a must!!!

We hope you enjoy

John & Mike

Please check out the info provided by the RCR in the link below.

https://www.rcr.ac.uk/exams-training/rcr-exams/clinical-oncology-exams/frcr-part-2b-oncology-co2b/frcr-part-2b-oncology-co2b-advice-for-candidates/ 

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Back again with our 2nd episode looking into the dreaded FRCR part 2B exam.

We have our 2 examiners - Dr Paul Hatfield (lead examiner) and Dr Alison Stillie (senior examiner) giving out more pearls of wisdom about how to prepare and how to approach the part 2B exam.

We also discuss what advice consultants and supervisors should be giving candidates and what the benefits of being an examiner are.

This is a must listen episode for any clinical oncology SpR or supervising consultant.

"Make every day at work a learning day" when preparing for the exam.

We wish everyone involved in the the exam good luck and hope there are some pieces of info in the episode that can help.

Good luck

John & Mike

Please see below a link to info from the RCR about how to prepare for the exam.
https://www.rcr.ac.uk/exams-training/rcr-exams/clinical-oncology-exams/frcr-part-2b-oncology-co2b/frcr-part-2b-oncology-co2b-advice-for-candidates/

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In this episode we speak to Dr Karin Purshouse, current Chair of the National Oncology Trainee Collaborative for Healthcare Research. 
We hear about the origins of the organisation and how it has expanded since 2019, with registrar representation in all regions in the UK.
NOTCH excels in running national multicentre retrospective cohort studies, generating real world evidence with international impact. The value is particularly evident in rare/difficult to study tumour sites/patient groups or where randomised control data is unlikely to ever be generated.
Participation offers trainees tangible experience in research as well as invaluable networking opportunities with like-minded, research active registrars and consultants around the country. 
NOTCH are currently looking for interested trainees to join the Board, no prior experience is necessary.
Project proposal submissions are welcome through out the year, expressions of interest are also encouraged as the NOTCH team has a wealth of experience in helping set up and run successful multicentre projects. 
Visit www.uknotch.com for more information and to join the mailing list. 

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“Just because you make it look easy doesn't mean it is easy for you.”
Stress, burnout, resilience and emotional fatigue. These are phrases that have become part of NHS life.
In this episode we discuss the impact of this with psychologist Dr Mike Osborn for Royal United Bath Hopsital.
We talk about telltale signs and the impact this can have on ourselves and patients.

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Part 2 of 2 of our managing stress when delivering cancer care theme.
Here we talk again to the excellent Dr Mike Osborn. We discuss what we can do to help actively recognise and manage some of the impact of stress and emotional fatigue.
‘What advice would a friend give you about how you are managing stress?’.

We need to take care of ourselves as we take care of others.
Enjoy!!!
John & Mike

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Not every older patient is frail and not every frail patient is old.

The incidence of cancer goes up rapidly in the older age groups with a big jump in incidence in the over 75 age group. We are treating increasing numbers of older patients with increasingly complex therapy.
This is often called a 'Silver Tsunami'.

We talk to Dr Nicolo Battisti  - A medical oncologist - who is Clinical Lead of the Senior Adult Oncology Programme at the Royal Marsden Hospital and president of SIOG - the Society of Geriatric Oncology.

We discuss the impact of frailty on cancer therapy for older patients and how to assess frailty in patients.

This is part 1 of 2 of an excellent session!!

Enjoy

Mike & John

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Part 2 of our Cancer in the elderly and assessing Frailty.
We talk to Dr Nicolò Battisti about what measures we can take to set up frailty assessment.

Great tips and advice.
Enjoy

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Dr Nicolo Battisti is the president of the Society of international geriatric oncology and a medical oncologist at the Royal Marsden Hospital.
He shares his thoughts and wisdom on how we can help our older patients and their carers recognise signs of frailty and how to tackle them.

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To day we focus on the big 3 side effects of hormone manipulation in prostate cancer:
-Hot Flushes
-The 5 Ps of Fatigue
-Sexual Function
We talk to British Association or  Urological Nursing trustee and nurse specialist Debbie Victor on strategies to manage these side effects.

This is aimed at helping patients help themselves so feel free to share with anyone you know having hormone therapy for prostate cancer.

We hope this is useful.
John & Mike

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Hormone therapy is a key part of prostate cancer treatment. Removing access to testosterone starves prostate cancer and can cause a 'manopause' or male menopause symptoms.

We discuss this with clinical nurse and BAUN trustee- Debbie Victor.
We look at the impact of this on prostate cancer patients and what positive steps patients can take to tackle these side effects themselves.

We hope you enjoy.

Mike & John

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In this episode we discuss CDK4/6 inhibitors with Professor Mark Beresford, Clinical oncologist and chair of UK Breast cancer Group.

Mark shares his knowledge on why we are giving these drugs to patients with breast cancer and what patients can expect on them.
This is a really big group of patients and we hope this is useful for supporting them.

We hope you enjoy

John & Mike

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Approximately 15% of all lung cancer happen in non-smokers!!

We talk to Dr Tom Newsom-Davis a medical oncologist who specialises in lung cancer about this very specific group of lung cancers.
Tom is chair-elect of the British Thoracic Oncology Group and shares his experience of treating non-smoking related lung cancers and their driver mutations - EGFR, ROS-1 and ALK.
This is a fascinating discussion and Tom is such an engaging person to talk to.

If you have lungs you can get lung cancer.

Enjoy

John & Mike

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This episode is hoping to show patients and the public that non-smoking lung cancer is a very real and very different type of lung cancer to smoking lung cancer.
We discuss the great work that charities like Ruth Strauss foundation, Ros Wonders and EGFR UK do to support this patient group.

Pollution may play a part, vaping may play a part.

Dr Tom Newsom-Davis Chair-elect of the British Thoracic Oncology Group shines a light on this area of lung cancer.

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Approximately 1 in 10 metastatic prostate cancer patients develop osteoporotic fractures.
Whilst treatment for prostate cancer has meant patient are living longer we have to make sure they are also living better.
Testosterone removal, Androgen receptor targeted agents and steroids can all reduce bone strength.

We talk to Dr Xue-Yan Jiang who is part of a group preparing guidelines for bone health through the Royal College of Radiologists and British Association of Urological Surgeons.
We hope you enjoy.

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In recent years we have seen a marked change in the landscape of treatment for endometrial cancer.
This has been driven by understanding the different molecular subtypes of endometrial cancer.
POLE - with an excellent prognosis
MMR deficient - with good prognosis and option for immunotherapy
No Specific molecular profile - intermediate outcome and work still to be done
P53 mutant - with a poorer outcome

Dr Angela George from the Royal Marsden Hospital has a specialist interest in genomics and shares her expertise and knowledge on this fascinating area of gynaecological cancers.

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Chemotherapy is scary and we want to make it less scary for patients. Simple.

We talk to senior chemotherapy nurse Rachel Bryce from University Hospital Plymouth - she is also Macmillan lead systemic anti-cancer therapy (SACT) lead and UKONS SACT representative -  about what patients can expect and what to look out for expect on chemotherapy.

We think this is great discussion that could be used for anyone new to or dealing with chemotherapy.

We hope you enjoy.
John & Mike 

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Radiotherapy is one of the silent workhorses of cancer treatment yet has very little coverage in the media.
In this episode we talk to Amy Warnock one of our treatment radiographers about what to expect during radiotherapy and she talks through what will happen on the day to day basis of radiotherapy.

We hope you enjoy.

John & Mike

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We talk again to Gynae-oncology specialist  - the excellent -Dr Gemma Eminowicz from UCL hospital. Gemma also played a key role supporting Dr Mary McCormack in delivering the INTERLACE trial.

We talk about updates from ESMO and IGCS on cervical cancer.
Gemma discusses her Quality of Life data she presented from INTERLACE and of course we discuss the exciting KEYNOTE A18 data.

We hope you enjoy.

John & Mike

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After a great overview of cervical cancer highlights we now go back to gynae cancer specialist Dr Gemma Emminowicz for insight on endometrial cancer highlights.

KEYNOTE B21- looking at adding pembrolizuamb in the adjuvant setting

DUO-E - looking at durvalumab and olaparib in the metastatic setting

The horizon for antibody drug conjugates in endometrial cancer.

We hope you enjoy

John& Mike

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Join us as we talk with Benson Fayehun, a passionate advocate for addressing health inequalities. Benson is the Founder and President of the Relief for Human Suffering Foundation, a U.S.-based public charity, and the UK Head of Oncology Business Unit at MSD*.

In this episode, we delve into how factors like poverty, socio-economic status, language, and more often have a greater impact on cancer care outcomes than the treatment itself.

This thought-provoking conversation highlights some of the systemic challenges in healthcare and opens the door to critical themes we plan to revisit in future episodes.

We hope you enjoy.

John & Mike

* This is not a MSD endorsement and we acknowledge that many pharma companies are interested in this area.
This episode is not sponsored by MSD.

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Join us in this episode where we look at the treatment landscape in ovarian cancer.
We talk to Dr Shibani Nicum and Dr Rebecca Bowen who both specialise in the treatment of ovarian cancer.
They both lead the UK Gynae Trials Group (GTG) group and are involved in running the excellent UK Gynae-oncology Meeting (UKGOM).
We look at the use of PARPi, Bevacizumab (Avastin) and new targets in ovarian cancer.

This is a rapidly changing environment and this is an excellent overview by Shibani and Rebecca.

We hope you enjoy.

John & Mike

ps- With exclusive update on the date of next years UKGOM meeting

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Join us as we discuss the frontline therapy of metastatic hormone sensitive  prostate cancer with Professor Alison Birtle.
Alison has been involved in many of the key trials in urological cancers and shares her take on selecting patients for triplet therapy.
We also look at the factors that affect treatment choices for our mHSPC pateints.
This area has changed so much in recent years and Alison brings those changes to life in this episode.

You hope you enjoy!
John & Mike

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Join us for our second discussion with Professor Alison Birtle on metastatic prostate cancer.
This time we look at mCRPC. What are our choices after first line therapy.
We discuss;
-PARPi and BRCA testing
-Docetaxel re-challenge
-Cabazitaxel
-Patient Support

This is a real tour de force by Alison.
We hope you enjoy.
John & Mike

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This week the Simply Oncology podcast goes global!

Over 80 % of the world population is living in low or middle income countries.

In this podcast, we're hopefully going to try and cover what is global oncology, what some of the challenges that low middle income countries are facing in terms of delivering cancer care.
We also touch on how clinicians in the UK might be able to cooperate and contribute to improving Cancer care globally, and to do this, we are delighted to welcome Dr Susie Stanway to the podcast. 

The scale if the issues is HUGE and Susie talks us through some thoughts on what may help and how we can get involved.

A truly humbling episode

John & Mike

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Join us for part 2 of our excellent review of high grade brain tumours with Professor Anthony Chalmers.
We look at the role of PARPi and the challenges with new therapies in high grade gliomas.
We discuss tumour treatment fields, vaccine trials and immunotherapy in brain tumours.
We also hear Prof Chalmers wish list for helping advance research in brain tumours.
We hope you enjoy!

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Join us today as we discuss high grade brain tumours with internationally recognised expert Professor Anthony Chalmers.
Part 1 of 2 and we discuss implications of new molecular profiling on prognosis and treatment options in high grade brain tumours.
We look at some recent changes in radiotherapy volumes and doses in brain tumours.
We also discuss challenges in treatment of high grade brain tumours and the impact of steroids in high grade brain tumours alongside surgery, chemotherapy and radiotherapy.

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Join us as we discuss all things prostate radiotherapy with Dr Alison Tree. 
Alison is synonymous with all things prostate radiotherapy and is superb at setting the scene for prostate cancer.

Based at The Royal Marsden Hospital, and The Institute of Cancer Research, Dr Tree has played a key role in several major prostate radiotherapy trials. These include working alongside Professor Nicholas Van As in the PACE trial portfolio and also working on the PIVOTAL Boost trial.

She has special interest in MR-guided prostate radiotherapy (the PRISM trial), boosting dominant intra-prostatic lesions (the DELINEATE trial) and hypofractionation in prostate cancer.

Alison Tree is an amazing speaker on the subject of prostate radiotherapy and we are sure this will be of of interest to anyone interested in prostate cancer or radiotherapy.

This episode contains everything we could want to know about the current position of prostate radiotherapy and future directions of travel.

Enjoy

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Join us for this episode of Simply Oncology where we discuss how to become an oncologist.

Oncology is always a forward thinking and progressive speciality and this involves training and developing training people to meet that challenge.

We talk to Dr Louise Hanna who is an oncologist who treats gynaecological cancers at Velindre Hospital in Cardiff. She is also the Medical Director, Education and Training (MDET) for the Royal College of Radiologist (RCR).

We discuss the appeal of becoming an oncologist.

The skills needed to deliver and co-ordinate cancer care.

How you can find out more if you are interested in becoming an oncologist.

An unmissable episode if you are interested in a career in oncology.

Enjoy!

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Join us in this week as we discuss anal cancer with Dr Rebecca Muirhead.

Based at Oxford University Hospital, Dr Muirhead has played a key role in the adoption of IMRT in anal cancer. She is part of the ACT and PLATO trial group and shares her insights from these trials with us.

We discuss the principles of escalation and de-escalation in the PLATO trial to match the risk of the disease.

Rebecca also very elegantly discusses the pros and cons of re-irradiation in anal cancer to try to regain control of anal caner symptoms in patients where cancer returns.

Enjoy!

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Join us for this special episode of the Simply Oncology Podcast.

We have special guest Dr Tom Roques who is the Vice-President of the Royal College of Radiologists and lead for Clinical Oncology.

Tom speaks candidly and clearly on ; 

- the challenges facing oncology

- the opportunities AI may bring in oncology

- the clinical oncology model

- the role of the RCR in shaping UK oncology

Enjoy

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Burnout in oncology and throughout healthcare is a major issue.

An ESMO survey conducted in young Oncologists in 2013-2014 revealed 70% of young oncologists in Europe were impacted by burnout. 

25% of oncologists surveyed were thinking of a change of career and 38% of leaving the profession. All this at a time of needing more oncologists! 

Join us in this 2 part episode where we join the superb Professor Susana Banerjee.

She discusses the issue of burnout and the excellent work done by the ESMO Resilience Task Force  on this critical issue.

Professor Banerjee is an internationally renowned medical oncologist at The Royal Marsden Hospital treating and researching gynaecological cancers.

She has been heavily involved in the ESMO Resilience project and looking for strategies for dealing with the huge problem that is burnout in oncology.

We hope you find this as useful as we have!

https://www.esmoopen.com/article/S2059-7029(24)01403-0/fulltext

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Join us in this second part of discussing resilience and burnout and oncology with Professor Susana Banerjee.

In our last episode we looked at the ESMO Resilience Taskforce and what institutions should do to improve resilience.

In this episode we discuss what can help us on an individual level.

A lot of it comes down to a feeling of job satisfaction.

That can be having some variety to maintain interest and keeping the parts of the job that we value at our core.

Susie shares some personal views that echo this view in this episode.

We hope you enjoy.

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Join us for this episode focusing on the role of radiotherapy in the treatment of bladder cancer. We talk to leading bladder radiotherapy expert Professor Ananya Choudhury.

Ananya is passionate about all things bladder cancer related and discusses her views on bladder preservation and radiotherapy.

She makes a strong case for bladder radiotherapy in muscle invasive bladder cancer versus surgery and we review the evidence.

We also talk about the use of 'plan of the day' and on set imaging in radiotherapy.

This is a fascinating insight from a world expert in bladder cancer.

We hope you enjoy.

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Join us for our second part of our discussions with the excellent Professor Ananya Choudhury where we discuss the option of bladder preserving treatment in muscle invasive bladder cancer.

In this episode we hear Ananya's views on new Antibody Drug Conjugate trials being used as an alternative to radiotherapy in a bladder 'preservation' strategy.

She is clear that this is experimental only at this stage and does not meet any true definition of bladder preservation in her view.

A fascinating and enjoyable discussion around all aspects of muscle invasive bladder cancer.

Enjoy 

Role that ADCs may have on bladder preservation.

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Join us for this Simply Oncology podcast episode on Health Inequites in the UK with Dr Olubukola Ayodele.
🎙️We discuss the challenges in delivering equitable cancer care across all patients in the UK.
🎙️we hear a recent report stating that black women with breast cancer have 30%higher mortality than equivalent Caucasian women in theUK!
🎙️This is not just an issue for low and middle income countries!

We need to Mind the Gap and Bridge the Gap.

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Join us for the 2nd part of our discussion with Dr Olubukola (Bookie) Ayodele on health inequities in cancer care.

We look at potential steps to promote health equity.

Bookie introduces the concept of 'Cultural Competency' in helping health professionals discuss the very challenging topic that is cancer.

We hear how biological difference in blood results can play role in excluding black patients from certain chemotherapy trials.

We think about the stepwise change and education needed to make healthcare more accessible to all.

Enjoy

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Join us for the first part of this 2 part masterclass in breast radiotherapy.

Breast radiotherapy is a major component of breast cancer treatment. It forms a large part of all radiotherapy delivered across cancer centres.

After removal of a breast tumour radiotherapy is offered to reduce the chance of local relapse of the cancer.

We talk to Professor Mark Beresford who is chair of the UK Breast Group about how breast radiotherapy has gone from 5 weeks of treatment to 1 week.

We talk about side effects and when we offer an extra radiotherapy boost to the area the tumour was.

We also discuss radiotherapy for reducing the risk of disease in the axilla (armpit) and the current surgery versus radiotherapy debate for that area.

This is a must listen for anyone wanting to learn more about breast radiotherapy.