There were celebrations all round for ADVOCATE - ADVancing radiOtherapy teChniques as A Team - the FAST clinic team (Northern Ireland Cancer Trials Network (NICTN) and Northern Ireland Cancer Centre (NICC) who were winners of two Northern Ireland (NI) Health Care Awards hosted at Stormont hotel in October. The first award received was winners for the best collaboration between clinic, academia and industry. Following this, the team were presented with overall winner!
The ADVOCATE initiative is a great example of research and service working together for the benefit of patients. The key driver for this collaboration was to enable men in NI the opportunity to participate in local, national and international prostate cancer clinical trials, which deliver world-class radiotherapy.
The FAST clinic is an innovative research procedural clinic set up in 2015 at the Northern Ireland Cancer Centre, a partnership between the NI Cancer Trials Network, the NI Cancer Centre Radiotherapy Department and ProEx Prostate Cancer Centre of Excellence (Queen’s University Belfast). The FAST clinic has enabled patients with prostate cancer the opportunity to access advanced image guided radiotherapy techniques through prostate cancer clinical trials, reducing radiotherapy from 39 treatments to only five (known as SABR).
For some clinical trials, SABR treatments require the insertion of gold fiducial markers and a peri-rectal spacer prior to radiotherapy. Fiducial Marker implantation in the prostate gland improves the visibility of the target whilst the spacer system reduces unwanted radiation dose to the bowel by up to 70%.
A collaborative multi-professional team, led by Professor Suneil Jain (Co-Director of the ProEx Prostate Cancer Centre of Excellence) set up the FAST clinic, with the aim to provide high quality radiotherapy research and educate the radiotherapy department in preparation for introducing SABR as a standard of care. Regular meetings were organised during the set-up process to ensure the service was introduced in a robust, safe and controlled manner. The first clinic took place in December 2015. Since 2015, 145 patients have had Fiducial Markers inserted and 66 patients have had a spacer device inserted.
Through innovative clinical trials, the clinic has provided an excess of 100 patients with access to advanced image-guided radiotherapy, significantly reducing the traditional treatment protocol from 39 sessions to just five sessions using Stereotactic Ablative Body Radiotherapy (SABR).
The expertise developed in these trials has now extended to standard care, enabling an additional 226 patients to receive prostate SABR radiotherapy in a five-fraction regimen. This shift to SABR has led to a substantial reduction in treatment fractions by approximately 87%, for these patients. As a result, the department has increased treatment capacity ensuring that more cancer patients can access radiotherapy in a timely manner.
The FAST Clinic continues to play a critical role in advancing cancer treatment through research and innovation, directly benefiting patient care.
The FAST clinic and the implementation of SABR was only achievable with the development of a large multi- disciplinary Belfast Health and Social Care Trust group closely partnered with Queen’s University Belfast (ProEX) and commercial companies such as Boston Scientific. Performance and efficiency of this clinic has demanded an ongoing collaborative approach working across professional, departmental and institutional boundaries.
Furthermore, the partnership of the Consultant Clinical Oncologists, NI Cancer Trial Network-Clinical Research Radiographers, Brachytherapy Radiographers, Treatment Radiographers, Specialist Radiographers, Physicists, Clinical Research Fellows and Treatment Planning Technicians has enabled 145 patients to enrol in world-class radiotherapy trials receiving leading-edge advanced radiotherapy.
The knowledge and skills gained by the team in the FAST clinic will be utilised as a foundation to advance radiotherapy techniques for prostate cancer patients across Northern Ireland. The clinical knowledge and skillset developed have now been transferred from the research setting into standard of care practice.
Congratulations to the team and all involved!
From left to right: Sarah-Jane Flynn (Urology site Specialist Radiographer, NI Cancer Centre); Stacey Conway (Lead Clinical Research Radiographer, NI Cancer Trials Network); Grace Totten (Clinical Research Radiographer, NI Cancer Trials Network).
From left to right: Grace Totten (Clinical Research Radiographer, NI Cancer Trials Network), Sarah-Jane Flynn (Urology site Specialist Radiographer, NI Cancer Centre), Stacey Conway (Lead Clinical Research Radiographer, NI Cancer Trials Network) Michelle Tennyson (Chief AHP NI) and Ann Keen (Former Labour Health Care Minister)