Support Line: 0800 002 9002
General Enquiries: 01223 870008
  »  Events News  »  London Kidney Cancer Patient Day 2014

London Kidney Cancer Patient Day 2014

by | Feb 10, 2015 | Events News

12th November 2014, Hotel Ibis Styles, Southwark, London.
This was the fourteenth patient day organised by the Kidney Cancer UK for English and Welsh patients and their families. Although the turnout was not as good as for previous patient days, the event was a resounding success; more than 30 delegates came along to learn about the management and treatment of kidney cancer directly from health professionals and experts.
Mike Powell, broadcast journalist, presenter, and reporter for BBC news (TV and radio), chaired the event. Mike is also a kidney cancer survivor, having been diagnosed with a tumour on his left kidney in 2010. Mike had a partial nephrectomy at a local military hospital and is now free from kidney cancer, although he was diagnosed with an unrelated brain tumour last year.
For a copy of the corresponding slide presentation, please click on the titles below:

The role of the Clinical Nurse Specialist and holistic needs assessment
David Cullen, Lead Nurse Renal Cancer from the Royal Free Hospital in London, opened the day with an interesting presentation on the role of a Clinical Nurse Specialist (CNS), and a new initiative that is being brought in for nurses called holistic needs assessment. He started off by saying that the role of a CNS varies depending on the hospital, and there are a lot of inequalities in the level of support provided by CNSs. The level of support is dependent upon the skills, experience and knowledge base of the nurse, and inconsistencies result due to amount of training and the skills sets of each individual; it takes many years to train and develop CNS skills sets.
David went on to discuss the poor National Cancer Patient Experience survey results due to disjointed services across London; London Cancer is trying to address this and improve patient experience by centralising services and coordinating scans with oncology appointments.
David concluded his presentation by talking about some new initiatives that he is involved with at the Royal Free. The National Cancer Survivorship Initiative is a partnership between NHS England and Macmillan to improve ongoing services and support for people living with and beyond cancer. Information Prescriptions provide up-to-date and accurate information from the NHS and patient organisations about various conditions, treatment options and local care services. Holistic Needs Assessment is a validated tool to assess and plan personalised care at different points in the treatment pathway. This will become mandatory in the NHS next year. Treatment Summaries are forms that the patient can carry around with them to summarise all the treatment they have had or are currently taking. These will improve the flow of information between the hospital and the GP.
Saved by a robot – a patient story
Greg gave a very uplifting presentation about his kidney cancer journey. Greg was diagnosed with kidney cancer after his 8-year old son accidentally kicked him in the groin while playing! He went to his GP with pain in his groin, which was still evident a week later. His GP referred him for an ultrasound scan, which diagnosed a mild varicose vein, but after 2 months his groin still hurt. He was then referred to a urologist and after more scans he was diagnosed with a golf-ball sized tumour on his kidney; until then he had felt fit and well, with no signs or symptoms.
Greg’s urologist specialised in robotic surgery, so he had a partial nephrectomy using robot-assisted surgery (RAS). Unlike traditional laparoscopy (key hole surgery), RAS gives a 3D image of the area being operated upon, and the movement of the robotic arms is in the same direction as the surgeon’s arms (in laparoscopy, the movement is opposite to the surgeon’s movement). This allows for good control and precision. Greg’s surgeon also had an ultrasound probe, which could be inserted into the body to identify the exact location and boundary of the tumour. Diathermy (heating) was used to mark out the tumour area to be removed, along with a 5 mm margin of healthy tissue. This improved precision and helped to preserve healthy kidney tissue.
Patient support
Lee Marriott-Dowding, Team Leader – Patient Support for Kidney Cancer UK, highlighted the areas where the Fund can provide support for patients and their families, such as the Kidney Cancer Careline, the online patient forum, patient information, kidney cancer patient days, local support groups, and the patient grant scheme. She then touched upon areas where the Fund is representing kidney cancer patients, such as Patients Involved with Nice (PIN), the International Kidney Cancer Coalition (IKCC), and National Voices. She ended by highlighting the 2012 National Cancer Patient Experience Survey (NCPES) results, which showed that provision of understandable, written information is essential to enable patients to become active participants in their treatment and care.
Advanced kidney cancer today: current treatment options
Dr Louise Lim, Medical Oncologist from Barts Health in London, gave a very interesting presentation about the current drug treatments for advanced kidney cancer, and the ongoing research to find new and more effective cancer drugs.
Current systemic drug treatment for advanced kidney cancer is mostly targeted therapies, such as sunitinib (Sutent), pazopanib (Votrient), and axitinib (Inlyta), which target a protein called VEGF. The VEGF protein is increased in kidney cancer cells. VEGF inhibitors can increase survival to about 30 months. In the past 5 years, researchers have discovered that the immune system plays a pivotal role in the development of cancer, and are beginning to understand how to manipulate it. This has led to the development of immunotherapies, such as anti-PD-L1 and anti-PD-1, which enhance the anti-tumour activity of T-cells (immune cells), potentially leading to long-lasting responses. Barts Health is about to start a randomised phase III clinical trial of nivolumab versus sunitinib in treatment naïve patients (patients who have not received drug treatment for their kidney cancer) very soon. There is also a trial planned combining a VEGF inhibitor with a PDL-1 antibody as first line treatment for renal cell carcinoma. Dr Lim talked about this being a very exciting area of research at the moment.
Dr Lim continued by discussing the results of clinical trials with targeted therapies to prove their effectiveness and safety. She discussed the results from the COMPARZ trial, which reported no difference between the effectiveness of sunitinib and pazopanib. However, in the PISCES trial, pazopanib was preferred by 70% of patients over sunitinib, mainly because the patients generally felt better, had less fatigue, and less hand and foot syndrome while on pazopanib. She then talked about second line treatments and the results the AXIS-1 trial, which compared sunitinib with axitinib; overall survival was better for axitinib and the side effect profile for each drug was similar, although there were more hand and foot side effects and rashes with sunitinib, and more diarrhoea with axitinib. RECORD-1 compares everolimus with placebo; everolimus is an mTOR inhibitor with a different mechanism of action than VEGF inhibitors, such as sunitinib and pazopanib. Compared to placebo, everolimus extended progression free survival from 1.8 months to 4.9 months. Everolimus and axitinib are both used as second line treatments; however, they have not yet been compared in a randomised clinical trial.
Dr Lim finished by mentioning that a biomarker has not yet been identified for kidney cancer, because it has been discovered that kidney tumours are very heterogeneous in terms of protein expression (potential biomarkers) and the tumours are very complex. This needs to be taken into account when treatment is planned.
Interventional radiology for the treatment of kidney tumours
Dr Rowland Illing, Consultant Interventional Radiologist from University College Hospital in London, gave an interesting explanation about his work with image-guided intervention. This involves inserting a needle into a tumour to ablate (destroy) it using very high or very low temperatures, while using CT imaging to guide the needle into position. Usually, ablation is used for elderly or unfit patients, or those who are not willing to have an operation. It can only be used for small renal masses, usually less than 4 cm in size. NICE have issued guidelines for two ablative techniques; cryoablation and radiofrequency ablation (RFA).
Dr Illing prefers to biopsy his patients prior to treatment so that he is knows what he is dealing with. This is not usually done for kidney cancer patients, and might lead to a change in the management of this type of cancer.
Dr Illing then went on to show the results of two recent studies using cryoablation to treat renal tumours; both studies were successful with recurrence rates of 1.7% and less than 1%, and success with a single session of 94% and 98%, with no effect on renal function. Results with RFA are not as good, with recurrence rates in the order of 5.5%. This is because the treatment area is more difficult to visualise in RFA since there is no ice ball surrounding the tumour.
Dr Illing finished by explaining the main limitation of ablation, which is surgical access to anterior tumours. Research is ongoing to determine whether this can be overcome by using functional imaging. Also, he mentioned the SURAB clinical trial, which is comparing active surveillance (6 months observation) with ablation.
Dietary considerations for kidney cancer patients
Rachel Nandy, Specialist Dietitian at the Royal Free Hospital in London, closed the day with a presentation about healthy eating for cancer patients. She talked about the role of food in the development of cancer as being very complex, and the scientific evidence base linking diet and cancer is not convincing. She went on to say that a healthy diet is unique to each individual, and what is healthy for one person may not necessarily be so for another. She mentioned the eat well plate as a guide for healthy eating, described a healthy diet, and a healthy weight (body mass index, BMI), and then continued by talking through each food stuff (starchy food, fibre, fat, fruit and vegetables, salt, sugar, alcohol) in turn to explain their function in the body and give a healthy eating guide. She finished her presentation by talking about food labelling, supplements, functional foods (pro- and prebiotics, plant stanols and sterols), and the importance of being active for a healthy lifestyle.

<a href="" target="_self">Malcolm Packer</a>

Malcolm Packer

Malcolm is Chief Executive Officer at Kidney Cancer UK and Kidney Cancer Scotland and has worked with the charity in various capacities for over 15 years.