Patients of primary bone cancer, their families and supporters of the Bone Cancer Research Trust are well aware of the need for early diagnosis and appropriate management of sarcomas.
In the United Kingdom, there are currently no designated modules on the undergraduate medical curriculum on sarcomas, and fewer than 20 designated centres treating sarcoma patients. Even in the designated sarcoma centres, only a few students get the opportunity to see sarcoma patients and work with experienced sarcoma clinicians. This results in many medical students graduating with little or no knowledge of sarcomas and even after graduation, the opportunities, time and desire to learn more about sarcomas are scarce.
To address this problem the RLBUHT team (Dr Emily Robinson, Ms Jennifer Doran, Prof Arpan Guha and Mr CR Chandrasekar) in Liverpool have been conducting a National Sarcoma Awareness Project since 2013, funded by the Bone Cancer Research Trust.
The project aims to introduce sarcoma awareness, education and resources to medical students and Junior Doctors. Funded fellowships incentivise top students and doctors to sarcoma and allied specialities early in their career, with the hope that they will carry forward the research beacon to find a cure for sarcomas.
More than 1000 students and young doctors have been educated by the project and 20 top young doctors have been able to work with sarcoma clinicians through the funded fellowship programme in London, Liverpool, Leicester, Oxford, Birmingham, Manchester, Glasgow, and Edinburgh.
We caught up with Dr Tom Oliver to hear about his experiences of the Sarcoma Awareness Project
WHAT INSPIRED YOU TO APPLY FOR THE SARCOMA AWARENESS PROJECT FELLOWSHIP PROGRAMME?
Prior to my sarcoma fellowship, I was a junior doctor in an oncology centre. In the preceding months, I had witnessed the physical and psychological toll cancer had had on patients, their families and healthcare professionals.
Despite this, I had never encountered a patient with sarcoma. With little medical school teaching and no previous exposure, sarcoma had taken on a rarefied form in my mind. The sarcoma awareness project was an opportunity too great to pass up.
HOW DID YOUR EXPERIENCE OF SARCOMA CARE COMPARE TO YOUR OTHER EXPERIENCES IN ONCOLOGY?
I spent a week at the Sarcoma Unit at the Chelsea site of the Royal Marsden Hospital. Sarcoma care was less formulaic than other oncology subspecialities, with greater emphasis on the individual clinician’s acumen. It only accounts for 1% of annual cancer diagnoses and a small cohort means less trials on which to base guidelines.
In combination with the heterogeneity seen in the pathology, sarcoma is a particularly challenging disease to manage. I shadowed many members of the multidisciplinary team during my fellowship and found the puzzling, sometimes enigmatic, nature drew in some of the most inquisitive and compassionate individuals I have met.
WHAT DID YOU NOTICE ABOUT THE SARCOMA UNIT IN PARTICULAR?
The research ethos of the Marsden particularly stood out. The Sarcoma Unit had dedicated clinical research personnel who ran separate clinics for patients across multiple trials. I was even able to complete a small research project of my own during the fellowship. A desire for constantly evolving, innovative practice drove the team to deliver optimum patient care.
WHAT DO YOU THINK THE FUTURE HOLDS FOR SARCOMA CARE? DO YOU HAVE ANY IDEAS ABOUT HOW IT COULD BE IMPROVED?
Despite great ambition, there is work to be done. UK bone sarcoma mortality rates have remained unchanged over the last 25 years. Guidance is often based from trials without a control arm, too.
We must build on the current awareness campaigns. A sarcoma medical school curriculum could be drawn up, equipping all graduates with the ability to adequately detect and investigate suspicious soft tissue and bony masses. Similar efforts should be extended to GP training. Alternative clinical aids, such as a mobile app on managing soft tissue or bony masses would further standardise care for these patients.
It is an exciting time to be involved in sarcoma. Ambitious, new research, driven by highly motivated scientists and clinicians, points to a bright future indeed.
The Bone Cancer Research Trust has committed to funding the National Sarcoma Awareness Project for a further two years in 2016 and 2017.
If you are a final year medical student or F1/F2 doctor interested in taking part, please contact firstname.lastname@example.org with your name, designation and email contact. You will receive free e-learning resources and a link to the online questions .
The top scoring participants will be given the opportunity to take part in funded short term clinical fellowships at a regional sarcoma centre to further their knowledge on sarcomas.