Each year, there are approximately 55,200 new cases of breast cancer in the UK.
People with breast cancer face a host of different treatments including chemotherapy and radiotherapy. For the majority of people facing a breast cancer diagnosis, surgery to remove the cancerous tumour is their primary treatment, with people either undergoing breast-conserving surgery or a mastectomy.
IGHI is home to a team of staff who are skilled and passionate about their roles. Our talented people are the reason we’re able to tackle some of the most pressing global health challenges through cutting-edge innovation.
We’re giving you the chance to get to know our staff a little better and learn about what motivates them in their roles, who inspires them and what they like to get up to outside of IGHI.
Meet Lily Roberts, a teaching fellow at the NHS Digital Academy. Learn more about her role and how Lily supports the next generation of digital leaders in health.
There are several facets to my role. Predominantly, I am the first point of contact for participants of the year-long NHS Digital Academy (NHSDA) PGDip programme and advocate for optimum student experience. I provide participants mostly with technical, academic, or pastoral support. I enjoy the latter the most as it allows me to connect with individuals on a personal level, and understand the barriers to their engagement and how I can support them further.
Throughout the year I collaborate with the wider team to make improvements to the programme based on participant feedback which we collect for each module. We also assess the participants many times throughout the year. I am in charge of coordinating the marking teams and, more often than not, I get involved with marking myself.
My NHSDA colleagues would maybe say something like responsive, organised and kind. Whereas those in my office might say bonkers and surprisingly sassy!
It feels like a lifetime ago, but I was taught to play both piano and organ by my very talented late granny from age seven, and at 14, I achieved a Grade 8 Distinction in both. I have dark memories of being made to practise every day to earn my pocket money and the adoration of my granny. Somehow, I still enjoy playing (and love my granny) today. My favourites for the piano are Beethoven’s Pathétique Sonata and Chopin’s Nocturnes.
I find certain traits of the people around me inspirational; my older sister Florence is a police officer and I think she’s really brave (and crazy). My granny can reel off hours of stories from years and years ago and I’m always in awe of that (how much of it is true we will never know!).
My partner inspires me to be confident in myself and to invest in stocks (he’s an accountant – previously I would have said Bitcoin, but that word is banned from our house). And working at IGHI I am inspired every day by my incredibly clever colleagues who are always producing really interesting work.
Probably teleportation? I really miss my family and friends over in New Zealand and would love to be able to head over for a weekend here and there, pop into my favourite cafes, go for a swim at the beach, visit the New Zealand sheep. I’d then teleport straight back to our office in St Mary’s Hospital on Monday at 9 am with some Whittakers chocolate for my colleagues.
I have quite a few! I enjoy true crime podcasts. I haven’t yet found one which matches the perfection of Serial, Season One but I’m a loyal listener of My Favourite Murder and All Killa No Filla. I’ve always had a sweet tooth. Much to my delight I’ve found apple crumble can be adapted to a relatively wholesome breakfast choice. I’ve also got a slight addiction to buying activewear. I’m one of those people who wears activewear even when they’re not exercising, but you never know when you’ll need to run from something (I clearly listen to too many true crime podcasts!).
By Mr Daniel Leff, Consultant in Oncoplastic Breast Surgery at Imperial College Healthcare NHS Trust and Reader in Breast Surgery at Imperial College London
I became curious about surgery as a speciality in my final year of medical school training at Imperial. In my early post-graduate years, I finally decided upon a career in surgery when I witnessed the direct impact it had on improving patient outcomes. I relished the technical challenge of balancing the cancer surgery on one hand, with the need for high-quality aesthetic outcomes on the other.
IGHI is fortunate to have so many inspiring women who play an important part in shaping our work. Not only have they influenced our legacy since the launch of the Institute in 2010, they’re also leading the way forward in delivering our latest innovative research.
For Women at Imperial Week, and with International Women’s Day around the corner, we’re highlighting 10 women in different roles across IGHI. We spoke to them to find out a bit more about what motivates them, and the future they’d like to see for women in the workplace. (more…)
Nobody should have their quality of life limited by hearing loss. But if your hearing started to deteriorate, would you know?
Hearing loss can remain undetected and untreated for a long time. But if identified early and treated effectively, those with hearing loss can continue to communicate with the world around them and have meaningful experiences in all aspects of their life. This is one of the major messages that this year’s World Hearing Day is focused on, under the theme “hearing for life”. (more…)
It was Christmas time three years ago when Amy experienced a stroke. Amy was enjoying her retirement, having spent her career working in publishing. But the stroke took away her independence, paralysing her left arm such that she needed full-time care. This isn’t an uncommon outcome: some 80% of people experience difficulty using their arms after a stroke.
Amy spent the next four months in hospital, the beginning of a long road to recovery.
“The rehabilitation I received in hospital mainly focused on walking, but it was my hand that I really needed help with,” she says.
“And I wasn’t told that if I didn’t use my hand that I would lose function of it.”
When Amy returned home she needed full-time care and regular rehabilitation sessions. But with an overstretched health system burdened by an ageing population, Amy wasn’t able to access the recovery support she required at home.
“I was glad to get out of hospital, but I couldn’t get the help I needed and felt very hard done by,” she says. “I had to take charge of my own recovery.”
Amy joined a local network called LEGS (Local Exercise Groups for Stroke), a charity that offers physiotherapy-led rehabilitation for stroke survivors. It was here that she met Ella Gibbs and Gianpaolo Fusari from our Helix Centre, who were working on a solution to help people like Amy.
“Stroke is the leading cause of disability in the UK, so we were really motivated to work in this area and find out where we could use design to make a difference to people’s lives,” says Gianpaolo, senior designer at Helix, an innovation lab for healthcare.
“We wanted to learn more about what happens both in the hospital and in the community, so we shadowed teams of therapists on wards, linked up with various charities and also observed rehabilitation sessions in the home environment.”
It was the latter scenario where Gianpaolo realised there was a major gap to be filled.
“We followed early-support discharge teams, the therapists who go to people’s homes five days a week for 45 minutes to do intensive therapy,” he says.
“It’s a really great service, but only about 20-30% of eligible people receive it because there aren’t enough therapists to go around.”
The team ran workshops with patients and healthcare professionals to further flesh out people’s needs after stroke and better understand their feelings. It became clear that the lack of help at home was a real roadblock in people’s recovery.
“People felt unsupported after their formal rehabilitation programmes ended,” says Ella, physiotherapist and clinical researcher. “They were afraid to do some exercises at home for fear of injuring themselves. And they didn’t have any way of monitoring their own progress. The same goes for the therapists, who couldn’t see whether their patients were sticking to their exercises between sessions.”
Evidence suggests that stroke survivors need to perform hundreds of exercise repetitions every day to recover the function of their affected limbs. But even for those fortunate to be eligible for support at home, typical therapy sessions simply aren’t long enough to achieve those kinds of numbers. So rather than looking for an unlikely solution in these narrow windows, the Helix team began to focus on life outside of therapy. They wanted to help people help themselves – empowering them to take charge of their own recovery.
“There’s increasing emphasis on this self-management aspect of treatment for people with longer-term conditions,” says Jennifer Crow, an occupational therapist at Charing Cross Hospital who has been working with Helix on the project.
“Because people aren’t going to get a therapist’s help every time they need to do something. There simply aren’t enough of us. I believe self-management has to be the way of the future.”
Working with some 200 patients and healthcare professionals like Amy and Jennifer, the Helix team created a digital tool – OnTrack Rehab – that enables self-management of stroke recovery.
This platform couples a smartwatch app with tailored coaching to help people own their rehabilitation journey at home. The app works like a step counter. It tracks minutes of arm activity through an algorithm developed specifically for stroke survivors, whose arm movement differs from healthy individuals’.
“That’s the ‘secret sauce’ of our innovation,” says Gianpaolo.
The device displays these minutes to the user, alongside a daily goal and what they achieved the previous day. The app also sends the user tailored messages – depending on how active they are – to motivate and encourage them.
“It’s great – it reminds you to use your hand,” Amy says. “I think you need constant reminding that it’s there and needs to be used. I think it’s helped me to be more aware of that.”
Earlier versions of OnTrack showed users much more information. But testing sessions showed that people found it overwhelming and difficult to make sense of.
“What really struck me was how the Helix team really listened. Not just to us, the therapists, but to the patients as well,” Jennifer says. “Throughout this project they’ve always taken on board our suggestions, so that the next time we see them, they’ve made appropriate iterations. So much other research is done without any prior consideration of patients’ actual needs, which is so important.”
OnTrack shares the activity data it gathers not only with the users themselves, but also with their therapists. This offers a window into what happens between therapy sessions. The OnTrack team also uses this information to provide regular, tailored coaching sessions, which the therapists consult on.
By motivating people to better engage with their rehabilitation at home, OnTrack hopes to complement therapists. And ultimately, reduce the need for therapy sessions, which are in scarce supply.
Results from a pilot study in 2018 with 10 people showed an average increase in activity of 20%, which equates to roughly an extra hour of arm activity per day. While promising, the team can’t be sure that this improvement was due specifically to OnTrack. That’s why they’re now carrying out a more robust feasibility study with a larger number of patients and an independent evaluation.
Despite the years of research and development so far, it’s still early days for OnTrack. The team has more to do to refine the product and its features. They also need to demonstrate its impact on rehabilitation outcomes at scale. But if trials support its use, Gianpaolo has high hopes for the platform.
“In the short term, we want to see how it can integrate with NHS practice, becoming part of the services offered to stroke survivors here and hopefully in other countries in the future,” he says. “We also want to explore whether we can adapt OnTrack for rehabilitation in other areas. For example people living with Parkinson’s disease.”
The OnTrack team is excited for the road ahead and to helping many more people like Amy recover from stroke.
This work has received funding from the NIHR Imperial Biomedical Research Centre. Read about other Helix work here.
On a basic level, all humans really need to survive is air, water, food and sleep. We need to sleep every night to give our body important R&R, among many other things. And research has shown how getting a good night’s sleep is crucial for our mental health and wellbeing.
When we sleep well, we’re more likely to have greater concentration, be in a better mood and get things done. In contrast, when we don’t, we can really see and feel the opposite effect. While we all have a poor night’s sleep from time to time, we know that people in prison and forensic mental health hospitals in the UK struggle more than most. Yet sleep has seemingly stayed off the radar and isn’t prioritised in these areas.
That’s why we believed it was important to get together and tell people in these settings about the importance of sleep. We also wanted to inform our brand-new research proposal on managing sleep problems better in secure environments.
Our research group originally came together after the Forensic Aspects of Sleep: Research and Development conference in Middlesbrough. We applied for and won around £10,000 from the NHS Research Capability Funding to establish a new cross-disciplinary forensic research group.
The resulting team is a collaboration between Tees, Esk Wear Valley (TEWV) NHS Foundation Trust, University of York and Imperial College London. People in our group have varied professional and lived experiences, including psychiatry, clinical academia, sleep, senior psychiatric nursing and service users. We’ve met five times in the last year in a medium secure hospital in Middlesbrough, where we recently held an event to engage the public about sleep.
On 21st January 2020, we ran a half-day forensic sleep public engagement event within the secure grounds of the forensic psychiatric hospital. We wanted to increase awareness of the importance of sleep to TEWV staff, but also to include as many voices as possible in taking our work forward to inform our research.
The event brought together patients, clinicians, senior managers and commissioners. We set up four different areas that people were free to explore. These were: 1) our research group’s journey so far, 2) how we measure sleep, 3) why sleep is important and 4) Imperial’s ‘People’s Research Café’ to inform our next steps.
The Café gives people the chance to meet researchers and exchange ideas on projects, and it was the first time it had been run in a secure environment. Both patients and staff really engaged with this activity. Once they relaxed, and got going, they couldn’t wait to tell us about issues related to getting a good night’s sleep in the hospital and how we could use research to improve patients’ sleep. One of the main issues raised was the amount of noise. Noises ranged from the window slats being opened every hour at night for safety checks, to staff talking at night unaware their voices echoed down the corridor.
We expected there to be numerous barriers to conducting this event in the secure hospital because of the hospital security regulations. But thanks to considerable prep work and discussions with the security staff, many things we anticipated could raise problems weren’t an issue. For example, pens were counted before and after the event, we used sticky Velcro rather than Blu Tac to reduce security risks and we all had to be escorted within the setting.
The feedback from the attendees and our team shows the event was a huge success. Everyone said the event was helpful for learning something new about sleep, with people describing it as “informative”, “engaging” and “interesting”. Reflecting on the event, Dr Amanda Perry from the University of York said, “Talking to patients and staff over coffee was an opportunity to share ideas, worries and challenges in relation to the management of sleep in secure environments. Everyone I spoke to had a vested interest in making sleep better for all patients in this environment.”
Dr Anne Aboaja, Forensic Psychiatrist at TEWV NHS Foundation Trust and Forensic Sleep Research Group lead said, “The People’s Research Café experience was successful, and it was great to learn about this methodology.”
We will now collate everything we learnt from the People’s Research Café into usable data to inform our research grant proposal. We’re currently writing a commissioned piece of work on the topic of sleep in mental health settings for the journal BJPsych Advances and conducting a scoping review on sleep interventions for the same setting. Our protocol is under review at JBI Evidence Synthesis.
We also hope to hold a similar in the future but covering multiple smaller research projects in one go. We’re excited about the next steps in this relatively new field and will continue to work with patients and staff so that what we do is informed by and tailored to their needs.
Dr Lindsay Dewa is a Research Associate in IGHI’s Patient Safety Translational Research Centre
IGHI is home to a team of staff who are skilled and passionate about their roles. Our talented people are the reason we’re able to tackle some of the most pressing global health challenges through cutting-edge innovation.
To mark our 10th anniversary this year, we’re giving you the chance to get to know some of them a little better and learn about what motivates them in their roles, who inspires them and what they like to get up to outside of IGHI.
Meet Marianne Knight, the Director of Operations for our Hamlyn Centre for Robotic Surgery. Learn more about her role in helping run the day-to-day activities of the Centre.
It’s estimated that one in four adults will experience a mental health problem in any given year. Despite this, there remains a stigma attached to opening up and speaking about our mental wellbeing.
Today, we’re marking Time to Talk Day, encouraging us all to have a conversation about how we’re feeling. We asked four experts at IGHI about their experiences, insights and advice on speaking up about mental health.
Cancer survival is improving and today, half of people diagnosed will survive their disease. This is thanks to research. Research that’s guiding governments to change their policies, underpinning awareness campaigns and educational initiatives, turning discoveries into treatments and prevention measures.
But there’s still much to be done to help more people survive, by catching the disease earlier and developing better treatments.
This World Cancer Day, and as part of our celebrations to mark IGHI’s 10th anniversary this year, find out how our researchers are working to make that happen. Join us in exploring some of our projects that could lead to better detection, diagnosis and treatment of cancer.
We’re helping to prove the potential for artificial intelligence to improve breast screening.
IGHI is part of a collaboration – including DeepMind and Google Health – which is training computers to identify tumours in mammograms using a technique called machine learning. The team’s recent study, published in Nature, found that their AI system was as good as doctors at picking up cancers – and in some cases even outperformed them.
Breast screening involves taking x-ray images, or mammograms, of breast tissue which are then analysed by human experts. While screening continues to help save lives by picking up cancers earlier, sometimes tumours are missed. It can also lead to unnecessary treatment for tumours that wouldn’t have gone on to do any harm. That’s why our researchers are examining whether artificial intelligence could reduce the rate of error in the analysis of breast screening, and ultimately improve the management of breast cancer.
“We hope this work could minimise the burden of breast cancer in the UK and internationally,” says Mr Hutan Ashrafian, study author and IGHI scientific advisor. “Not only that, but we also believe this system has the ability to support clinicians by freeing up resources and allowing them to spend more time with patients.”
Our researchers are working to make brain tumour treatment more precise, with the assistance of a bespoke intelligent robotic platform.
Researchers led by Dr Stamatia Giannarou from our Hamlyn Centre are integrating a number of imaging techniques and robotic instruments to develop a system that can more accurately characterise brain tumour tissue, and distinguish this from surrounding healthy tissue. In doing so, not only could the platform enable more accurate diagnosis, but it could also guide treatment decisions and help surgeons remove more of the cancerous tissue.
Brain tumours are very difficult to treat and survival remains stubbornly low. Surgery is the mainstay of treatment for many brain tumours, but being surrounded by delicate tissue makes the procedure particularly problematic. Surgeons can’t afford to remove too much tissue or risk serious side effects, yet remove too little and the treatment will be ineffective. Giannarou’s system hopes to change this.
“I’m passionate about contributing to a highly challenging research area, where we need significant advances in robotic vision to be able to navigate challenging and dynamic environments like the brain,” she says.
We’re launching a new project to guide the development of tools that are designed to support GPs’ decisions when managing patients with suspect cancer.
Cancer risk tools are algorithms that combine certain risk factors – like age and smoking status – with tell-tale symptoms to work out the probability of a person being diagnosed with cancer within a specific timeframe. Many patients present with symptoms that could indicate cancer, so these tools assist GPs in their decisions on who to investigate and refer.
Dr Olga Kostopoulou, research lead from our NIHR Patient Safety Translational Research Centre, will be investigating how these algorithms interact with GPs’ clinical judgment. She’ll be assessing things such as user trust and control, and looking at other concerns from GPs which could influence their decisions for urgent referral.
“The project aims to provide empirical evidence on these issues,” says Dr Kostopoulou. “And, in doing so, contribute to the currently expanding knowledge base about how such tools should be designed and introduced in clinical practice.”
IGHI researchers are developing an imaging tool that they hope could detect or diagnose changes in cancer that has spread, or metastasised.
Endoscopies are a commonly used investigative technique, which traditionally relies on white light to image tissue inside the body. Prof Dan Elson from our Hamlyn Centre is testing out a different type of endoscopic imaging, called Polarization- and Multispectral-resolved Endoscopy. This uses different properties and wavelengths of light to reveal more information about tissues than is possible with traditional techniques, which can essentially only capture what the naked eye can see.
Prof Elson is investigating whether this type of imaging could help detect and characterise metastases in the tissue that lines the abdomen (peritoneum). For this work, they’re collaborating with the PIPAC trial that’s testing out a new treatment for advanced bowel cancer.
“The PIPAC trial is a good setting for us because the team regularly performs biopsies which we can image in the operating theatre,” says Prof Elson. “We also have the opportunity to image in vivo at different phases of treatment, potentially in the same patient.” Ultimately, doing so could help guide decisions in the clinic.
Scientists at our Hamlyn Centre are developing an imaging system based on fluorescence that could help guide breast-conserving surgery. 
They’re using a fluorescent dye that could help highlight differences between healthy and cancerous tissue, and a special camera system that can image these characteristics. The researchers hope this work could make the treatment more accurate by enabling surgeons to see tumours during surgery, reducing the likelihood of cancerous tissue being left behind.
“By making it easy for the surgeon to see both the location of the tumour and the extent to which it invades, our goal is to eliminate the risk that women require further surgery as the first operation did not remove all of the tumour,” says Clinical Research Fellow Dr Martha Kedrzycki, who is recruiting patients onto a trial that’s testing the system. “This technology could also be extrapolated for use in other cancers, aiding surgeons by highlighting targeted tissues.”