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Transforming Oncology
Show #282 - Date: 1 Nov 2020

References from the show:

Dr Penny Kechagioglou
Chief Medical Officer, Genesis Care

Social Prescribing NHS

Dr Penny Kechagioglou
Categories: Conventional Medicine, Integration & the NHS, UK Doctors & Clinics
Keywords: integrative oncology, breast cancer, private treatment, immunotherapy, radiotherapy, exercise




Robin Daly: Hello and welcome to another ‘Yes to Life’ show on UK Health Radio. I’m Robin Daly, regular host for the show and founder of the UK charity ‘Yes to Life’, which has been helping people with cancer to learn about and utilize integrative medicine to help them through and beyond their illness for the last 15 years.

The last two ‘Yes to Life’ shows have consisted of samplers from each of the sessions of the two weekends of our recent online conference ‘Your Life and Cancer 2020’. I’m delighted to say the event was attended by some oncologists and one of these, the chief medical officer of Genesis Care – Dr. Penny Kechagioglou, was kind enough to say some very complimentary things about the conference on social media. So I invited her to come on the show and explore changing attitudes towards lifestyle and complimentary medicine, and the way forward for oncology in the UK.

Robin Daly: Dr Penny, it’s an absolute pleasure to have you on the ‘Yes to Life’ show, I’ve been looking forward to today enormously. We’ve not spoken before, but you attended our recent online conference ‘Your Life and Cancer 2020’, following which you posted some very supportive comments on social media – simultaneously asking your colleagues to consider if they’re looking at their patient’s needs in a holistic way and if there’s more that they could do. So, thank you very much for that and welcome to the show.

Dr Penny Kechagioglou: Thank you Robin. I thoroughly enjoyed the two weekend events that you organized, bringing together patient experts and also specialists talking about integrative medicine and integrative oncology. I was very impressed by the high caliber of the speakers and the content, which I very much believe in. And hence my posts later on, to encourage my fellow colleagues to consider holistic medicine.

Robin Daly: Excellent. So I definitely want to hear more about your thinking on that, but first I wondered if you’d mind telling us a bit about yourself. Oncology is a highly demanding profession, and you’re in a top position. What drew you to medicine and to oncology in particular, and what do you attribute your success in this field to?

Dr Penny Kechagioglou: Sure, so my name is Penny Kechagioglou. I am a consultant clinical oncologist in Coventry at the University Hospital of Coventry and Warwickshire, and I specialise currently in breast cancer.

I decided to become a doctor and go into medicine because I wanted to become an oncologist to help cancer patients have a better life, and also work with researchers to be able to offer new therapies to beat cancer. So I wanted early on to become an oncologist, and I’m very proud that I’ve managed to achieve that – and working in one of the biggest university hospitals in the country in terms of integrative oncology. I think it’s an aspect that I have learned through the other part of my role, which is the chief medical officer at Genesis Care UK, a private oncology provider, where we offer integrative oncology and conventional treatments within the same location and of treatments.

Robin Daly: This early interest you had in oncology, is this through a personal experience, or what drew you to it?

Dr Penny Kechagioglou: My interest came from a family event. I lost my brother quite early on in his life when he was a teenager by a rare form of cancer. And the learning points from then, for me as a young child, was the lack of information that families and people with cancer, especially children, receive in terms of what is available – what support is out there and how can the patient have a good quality of life, even in a terminal stage.

And that put me really to read about oncology and have the passion to practice it as a lifetime job. I see it not as a job, but as part of who I am, and my patients belong to my extended family really.

Robin Daly: So, maybe the last part of that question about how you’ve been so successful has to do with that aspect of your relationship with your patients.

Dr Penny Kechagioglou: Yes, I think so. I owe my success really to my patients that have helped and encouraged me to continue doing what I do. And also the people I work with, cancer and oncology is a multi-disciplinary specialty. I work with nurses and with other types of clinicians and healthcare professionals, and that is also very, very important – the role of allied health professionals, other than doctors, in the management of cancer patients.

Robin Daly: You mentioned you work both in private medicine and in the NHS, I’m often contrasting and comparing the strengths and the weaknesses of the US healthcare system and our NHS, different things seem possible under each and they each have their own strengths and weaknesses. So there you are, working with both public and private models of care, what would you say about the merits of each system?

Dr Penny Kechagioglou: It’s a great privilege to work in the public and private sector, and as you say, Robin, they both compliment patient care. A brilliant example is during the COVID-19 pandemic, when the independent sectors stepped in to help with elective cancer operations, so that patients who needed an operation to remove the cancer would actually do it while the NHS focused on treating COVID-19 patients. So you can see immediately a collaboration between the public and the private sector, and how one compliments the other.

Robin Daly: Just as in the US there’s more integration in their insurance-based system, presumably because patients like it and it’s cost-effective, in the UK private health care is ahead on integration, can you tell us what’s on offer? You’d mentioned that Genesis has a much more integrative approach. What’s on offer there?

Dr Penny Kechagioglou: We know that only 40% of oncology providers in the world have got integrated medicine under the same roof, so combining complimentary and mainstream treatments, and this is what Genesis care does really well.

In the UK, for example, we have 14 centres which specialise in oncology care. We offer radiotherapy, chemotherapy and diagnostic services in the same clinic or centre. We have medical exercise facilities and also wellbeing consultants who can offer patients complimentary therapy, such as relaxation, acupuncture, reflexology, nutrition and advice. So patients come in for treatment, but they also feel that they are receiving holistic treatments as well. They leave the centre having a great experience and it doesn’t feel like such a painful event to have treatment for cancer anymore. It feels like they have experienced an unpleasant event, but they were left with good mental health in one way and also physical health by becoming stronger through exercise.

Robin Daly: So, very important. This is a little taste of taking things into their own hands and contributing towards our own wellbeing.

Dr Penny Kechagioglou: Absolutely. And if you take the feedback from our patients, they talk about having that sense of control and also the power to be able to do something for themselves and not being always dependent on what the clinical doctor says in diet, nutrition and lifestyle. It is under the control of those patients, and actually having a focus and seeing consistent improvements in their health – losing weight, increasing their muscle mass, feeling much better, having a better quality of life – enables them to go through difficult treatments, such as chemotherapy, but also have better clinical outcomes long-term.

Robin Daly: That’s brilliant. It’s not to say there aren’t complimentary therapies on offer at many NHS oncology units. But it’s noteworthy that they’re quite circumscribed in their offerings and as far as I’m aware they’re all charitable initiatives of one kind or another, i.e. the NHS themselves hasn’t provided these, they’ve been set up usually by some cancer patient or parent or whatever and have ended up with a unit at the hospital, which is providing some of those kinds of services. I wonder, is it a source of frustration to you not to be able to offer your NHS patients more?

Dr Penny Kechagioglou: I think the NHS is specializing in a lot of areas and oncology is not the main specialty, there are other acute specialties as well, so we need to be mindful of that. It’s very natural that the NHS can only offer those services through collaboration. And if you see what Genesis Care has done, we have also collaborated with Penny Brohn UK, which is one of the biggest cancer charities, to be able to offer to our patients those complimentary and wellbeing therapies. I think you can only do that and achieve the best outcome through collaboration. And as you say, the NHS does have the facilities, but not under the same roof. We could refer patients to several charities around Coventry, for example, that run forums and exercise groups, but the benefit of Genesis care is that they contain all those services in the same place – for ease of the patients really.

Robin Daly: That’s very important. Because if it requires too much effort for a patient who’s very ill and is challenged on many levels – psychologically, emotionally, and physically – to go around searching out services from all around the area – that’s a quite a big ask, isn’t it?

Dr Penny Kechagioglou: You’re absolutely right. And I think that what’s missing overall, in the UK at least, is some sort of collection of those services in a website where patients can actually go and find what they need and where to find what they need, because different patients may have different needs throughout the cancer journey.

Some patients may need more exercise to get the strength, some patients need nutrition advice, some need psychological advice. So where do they get all that information and where can they go out and get them from?

Robin Daly: Well, a couple of suggestions for everyone listening is that our own website has a directory which has a lot of people who specialise in supporting people with cancer in a lot of different fields. Also, social prescribing is coming up fast these days and that’s available through a GP, who actually point people towards services that are local to them. So both those may be of use to people.

It was fantastic that you were at our event, I’m not sure how many sessions you were able to attend, but were there any particular highlights that stood out for you?

Dr Penny Kechagioglou: Yes, there were. I really liked the message that came out from those events, and in particular we are not talking about replacing mainstream medicine or oncology with integrative medicine, we are talking about integrating the two, and this is an important message. For me, it’s very important that we champion the integrative oncology aspect, and we have certain champions in the country who can actually make that movement grow and make it more standard practice.

When a consultant sees a patient in clinic, or in the multidisciplinary team, how do we ensure that integrative oncology is part of the consultation and patients can get full care – holistic care as we call it. This is my vision, this is what I want to see going forward. And it was discussed, including undergraduates, targeting the undergraduate curriculum, ensuring that research is done with prospective review of the patients that have undergone integrative oncology treatments, making sure that the outcomes were recorded and are published so that people can be more aware, clinicians and patients alike.

Robin Daly: A hugely important part of that is, as you say, somebody championing the cause, otherwise it never becomes even an acceptable concept that people should do such a thing. That’s why I’m particularly pleased to be talking to you today, because you’re in an influential position and you’re right behind this concept. You will be creating the space for other people to say, ‘Hey, maybe this isn’t such a bad idea’, which really needs to happen as soon as possible.

The two weekends were targeted at slightly different groups of people, the first one was targeted at people that are brand new to integrative medicine and I’m pleased to say that a significant proportion of the people who came were exactly in that position. Although of course, the quality of the speakers attracted lots of other people as well, who just wanted to hear the speakers. But I think a third of them were new to integrative medicine and we kept it pointed firmly towards them and didn’t get carried away with complexity, but it’s quite a steep learning curve for people when they first come across the possibility of helping themselves in all these ways. We were at pains to point out to people that you don’t have to know it all today, you can find your way – and there are ways to be helped to do that as well. But were there any kind of particular messages from that first weekend that you picked up on?

Dr Penny Kechagioglou: Yes, I like very much the fact that there is some evidence behind integrative oncology, that’s important for clinicians who always base their practice on clinical evidence. A lot of people do not know that actually there have been small studies, for example, if we take mistletoe therapy in pancreatic cancer, you know that there have been studies or there are currently studies ongoing showing that quality of life has significantly improved versus best supportive care in that very difficult to treat cancer. So it’s important to understand and learn and be open-minded as clinicians and actually there is some evidence behind those treatments. They are not just experimental treatments, and it’s very important is to listen to the voice of the patient. And even if the evidence is not extensive, if the patient outcomes are better, if the patient quality of life improves, I think that’s a fantastic outcome. If we can offer that for the patients, we should be very proud and happy to do that.

So my message from the first weekend was about keeping it simple and looking at what we can change now. For example, what I have changed over the last few months since working very closely with Penny Brohn, is that I’ve started thinking about how to replenish essential vitamins after chemotherapy treatments for patients. So I offer a vitamin D test for every patient before they go into a patient initiated follow-up, to ensure that their vitamin D levels are adequate because we know that low vitamin D levels can increase the risk of breast cancer, and that’s a very simple thing that we can do – all of us.

Robin Daly: I think that’s so important, what you just said – that many of the things we’re looking at, in and of themselves, are tiny. They’re not expensive. They’re not even time consuming often, but they can all add up to a big difference. You know, surprisingly small things can add up to a big difference, when a few of them are put together.

So, great to hear you say that, and, again, it’s kind of the business of being open-minded is what you were talking about, which is so important when a patient comes up saying, ‘I’m interested in doing mistletoe treatment’. Well, as you say, there is some evidence for mistletoe treatment, and there’s plenty of evidence that it’s not dangerous and not likely to be harmful. So to be supportive of that person doing the mistletoe treatment is hugely important for that person, that they actually feel they are doing this with the blessing of their oncologist, as opposed to, ‘I’m going to do it behind their back sort of thing anyway’, or, ‘I’m going to be put off’ – one or the other.

I think what you’re saying is right. If you’ve got a situation where you’re looking at something with the evidence there to some extent, there’s not a risk to the patient and you know that it’s safe, I think the endorsement is so important for the general morale and again, feeling that they’re doing something to help themselves for those patients.

Dr Penny Kechagioglou: I absolutely agree, and for the patient to feel that they have the support from the oncologist means a lot. We often don’t see that, but actually, if the patient feels that they’re doing something without the oncologist approving it, that increases the anxiety, and it’s not fair for the patients. So if they’ve chosen to follow integrative medical oncology, I think we should be supportive. As you say, as long as what they are doing does not cause harm. So that’s where our clinical role should play, rather than blocking them in pursuing those treatments.

Robin Daly: And I don’t think anybody’s expecting oncologists to become experts in some areas they’re not. Obviously they’ve got masses of expertise in what they do, and that’s plenty enough to be going on with, but it’s good if there are experts out there in lots of these other approaches. But I feel like oncologists, what would be a great use to them would be somewhere they could go to and quickly find out that, yes, there’s a reasonable amount of evidence and yes, it’s safe – without having to study for hours to do that. I don’t know if there is such a thing at the moment, but it feels like we could do with it.

Dr Penny Kechagioglou: I think we could do it, you’re absolutely right. And again, it’s working in collaboration, it’s knowing who the right people to approach are, and obviously those experts in the event that you organized Robin, demonstrated that. There are a lot of people out there with fantastic knowledge and experience for those therapies that we as oncologists can draw knowledge from.

Robin Daly: Yes, so this is where the dialogue is so important. One of the things that we’ve been aware of ever since we started ‘Yes to Life’ is that the most important thing and the thing that’s the hardest to get to happen – is dialogue. And that when there’s dialogue, there’s understanding, there’s ground to meet on. All of this is a benefit to patients rather than being in the firing line between two groups of people that are sort of arguing at arm’s length, without ever talking to each other and that’s a very difficult situation indeed for patients to be in.

Dr Penny Kechagioglou: Yes. And I think with your help the dialogue has already started, so I’m very positive that we can do more in the future collectively.

Robin Daly: Fantastic. The second weekend we sort of put the foot on the gas a little bit, and we started producing material that was more aimed at people who’d already embraced integrative medicine and they were really wanting to find out some more.

It was a bit more involved, a bit more complex. I have to say that plenty of the people who were new to integrative medicine did come along, even though we warned them that it was going to be like that. And I think they were able to take it in the spirit of, ‘Well, all this is doing is showing me that the field is quite wide and there’s lots of avenues I could pursue in the future sometime’. As long as it didn’t scare too many of them off, that’s always the concern with the complexities and things. But it was interesting, again, I think the audience was very appreciative, there was lots of great dialogue. The experts, as you say, came up with the goods every time – I wasn’t disappointed in any of the speakers. Was there anybody who stood out for you in that second weekend?

Dr Penny Kechagioglou: I really loved the nutrigenomic talk and I never realized how much theory and science is behind the foods that we eat, and definitely my target after my weekend was to go and read more. But I think that’s an area which I find particularly interesting and it’s very individual again, and you could talk about personalized treatments for patients. We should be looking at what is the right nutritional balance for our patients. How can we enable them and provide support and signposting to the right people to get the right balance in their lives? And we had stories from patients with advanced cancer that they live years because they follow, together with mainstream treatment, certain lifestyles – which they enjoy, have control of and feel good about.

Robin Daly: Yes, it was a very interesting session. It’s not something I know a huge amount about either, but I’m wanting to find out more. I thought that would be good subject matter for another radio show sometime. But yes, it’s fascinating what’s going on – it’s quite cutting edge. But it does point to the huge differential in the success of treating one person and treating another, doesn’t it, or a diet with one person or another, any of these things. It begins to show you how individual we actually are and that ‘a one size fits all’ approach doesn’t do it.

Dr Penny Kechagioglou: It definitely doesn’t do it. It’s not just how our bodies individually work, but also we are predisposed to certain conditions. We also have already existing conditions, some people have diabetes, for example, and nutrition has to be a very important aspect of their lives, but also quite specific. So we cannot give the same advice for every patient, we have to look at the patient holistically. Again, a collaboration between the clinician who knows about those conditions and what the patient needs, and the integrative clinician, will bring the right outcome for the patient.

Robin Daly: I think it’s interesting that in a way conventional medicine has focused its efforts largely on killing and removing cancer, with many notable successes. On the other side complimentary and lifestyle medicine has, in the main, been looking to support health and wellbeing – so it has vast insights into the effects of nutrition and sleep and exercise, et cetera. To me these look like two sides of the same coin. Some people have dismissed one side entirely and they’ve got away with it, but I suspect that many, many more actually suffer hugely as a consequence of dismissing one of the two sides of that coin. I wondered how you see it.

Dr Penny Kechagioglou: I absolutely agree. Mainstream oncology care and integrative complimentary care for oncology, they go hand in hand. With cancer we know fast, specific treatments that have been approved and are evidence-based that we use as clinicians and we use them with confidence. But we know that complimentary therapies can also make those mainstream treatments more effective, so combining the two we can actually have a better outcome than we thought we would.

There is evidence, for example, for traditional Chinese medicine, that when combined with chemotherapy in lung cancer it has been shown that it increases overall survival versus chemotherapy alone. So there is evidence of a synergistic effect and that is very important. As clinicians we cannot ignore that, we always strive to give patients the best possible outcomes and therefore we should be able to consider all available treatments and offer the tools to the patients, because we often again forget that the choice of the patient is very important.

I personally have seen a lot of patients, for example, who went with one side, either alternative medicine or with mainstream alone. And that’s a choice, but we have a duty as clinicians to offer those choices, and both of them, to the patient.

Robin Daly: Well, I love to hear that, it’s fantastic. I think some of the greatest things in integrative medicine, I feel, come from these kind of synergistic effects, and more and more of them are being uncovered these days. Between some kind of simple natural approach – maybe it’s a supplement or something, or maybe it’s heat or oxygen – combined with absolutely standard care, changes the outcome, often quite substantially. And this is an amazing thing when a simple intervention like that can make such a difference to a treatment that we already have, and we know how to do it.

I think that’s the area with the biggest potential for improving the results of cancer treatment, just by these simple combinations, and I would love to see that happening. It needs, as you’re saying though, some kind of open-mindedness that hasn’t existed before. For example, medicinal mushrooms are used routinely in hospitals in the East with chemotherapy because of what it does to help people’s immune systems, but there’s no consideration of using mushrooms in hospitals here. It’s just like, ‘We don’t do that’. Something needs to change quite fundamentally for that to be able to happen, even though they’re very cheap, they’re very safe and they are very effective too.

Dr Penny Kechagioglou: Absolutely, I agree. And I think it will come Robin, and we’ve seen more and more clinicians coming together to implement and advocate for those treatments. So I think it will come, but it’s coming in slowly. The key here is also the data collection, so, following up those patients who have had integrative oncology and reporting on those outcomes. That is what’s going to change and also drive the culture change for clinicians to see over time that yes, indeed, those patients who follow integrative oncology have better outcomes. I think any change in health policy or the work that we do has to be driven by those patient outcomes and data.

Robin Daly: I understand. Well, let’s roll on and get that data. In recent years we’ve seen new developments in hospital treatments. I’m interested from your experience, which of these are you most excited about and which do you believe are bringing the most benefit to people with cancer? That’s both in the short term and in the longer term.

Dr Penny Kechagioglou: I will speak about radiotherapy specifically. I think radiotherapy is a treatment that can actually cure cancer and it’s the second treatment after surgery that can treat cancer just on its own, with no surgery at all.

But over the years radiotherapy has changed, it has evolved. For example, a few months ago we gave three weeks or four weeks of radiotherapy to breast cancer patients. Now we have reduced the number of fractions into five, because we found a new machine that can actually give the equivalent outcomes to patients over a week versus four weeks, which is a fantastic change for patients to have the treatment completed in one week. That makes a huge difference to their lives.

Also, with the newest techniques that we’re using in radiotherapy, we see a lot fewer side effects. I can see in every single tumor type that radiotherapy has evolved immensely, and not just the technique, but also the number of fractions that we treat – which has improved survival, improved quality of life and can also be useful for patients who have cancer that has metastasized. And we see excellent outcomes long-term in those patients receiving radiotherapy.

Robin Daly: Well, that’s interesting. You surprised me there coming in with a very old treatment that you think has improved a lot. I was expecting to start talking about targeted therapies and things. Could you just tell me a couple of things about the radiotherapy? I assume that the patients are receiving a lower dose of radiation overall, is that true?

Dr Penny Kechagioglou: The patients receive the same dose overall, but it has become more targeted, going into your point about targeted therapies. Radiotherapy has become more targeted and that is the key, the dose hasn’t reduced. In fact, it has increased and that’s the key. So we know which tumours are most likely to respond to radiotherapy and we try to escalate that dose. We try to escalate that using the right machines and the right techniques on limiting the dose to the normal tissues and focusing the radiation to the tumor, using techniques such as breath hold. So ‘deep inspiration breath hold’ in breast cancer, or abdominal compression, and simple techniques that the patients can control themselves by counting the breath, for example, and we can achieve better outcomes with lower toxicity.

Robin Daly: That’s really interesting to hear. Is there anything else that’s a recent development that you feel is making a lot of difference for patients?

Dr Penny Kechagioglou: Yes, there’s a new, well it’s not new anymore, but there’s a new generation of chemotherapies called immunotherapies. We have seen immunotherapies making a huge difference for melanoma cancer patients, for example, and we are increasingly using immunotherapy for other tumor types, such as lung cancer, breast cancer and bladder cancer. What they do is basically potentiate the system to be able to fight cancer, and we have seen some long-lasting outcomes with patients living for years with metastatic melanoma, for example, and they have changed completely the biology of the disease. So I think that category of drugs I would consider as revolutionary.

Robin Daly: Right. Well, certainly you hear a lot about it and you hear some good success stories as well, so it’s nice to have you confirm that.

Okay, exercise, funnily enough it’s sort of come in from left field. It appeared from nowhere as something that might be good for people who have cancer. They were all told to stay in their beds for weeks before, but suddenly it was, ‘Come on out of there. You’ve got to do some exercise. In fact, you could do it while you’re having your chemo’. A very different thing. But as I say, it’s come in from left field in a way, it wasn’t there within complimentary medicine and it wasn’t there in orthodox medicine either. It just seemed to appear from nowhere, through research, I suppose. As a result, it’s made great inroads. It’s still not common enough in the UK that oncologists are recommending it to people, I feel, considering how great the benefits are. But it’s certainly had far less resistance than say, ideas about nutrition, where there’s a huge gap still between a functional medicine practitioner’s advice for nutrition and one you might receive at the hospital.

It’s quite interesting, the thing that it’s been appearing in that way. I feel like it’s been a bit of a Trojan horse and it’s allowed a lifestyle approach into mainstream medicine much more easily, because there was not any kind of history to it. Is that your view of it or how do you see it?

Dr Penny Kechagioglou: It’s interesting, your point about exercise, because one of the main complaints of patients during chemotherapy and radiotherapy, and actually after that when there’s some viral stage, is fatigue, and there is science behind exercise and exercise-based evidence that it combats fatigue. It’s something that everyone can do without any expense, they just need to come out of the house. So do 30 minutes of walking, brisk walking, six times a week. That is the recommendation and it’s as simple as that. The effects of that on its own are huge, not just in speeding up the metabolism and reducing fat, which we know can cause cancer, but also releasing those important hormones, which makes you feel good, makes you feel stronger and more positive, in combination. Also, in the contact with nature.

So it’s caused so many good effects, exercise, and people are worried now at the pandemic stage that they can’t do any of that because they can’t socialise, but actually 30 minutes of outdoor walking on a path that you know, and you can do that with another person from your household, this is therapeutic.

Robin Daly: Yes, it is fantastic isn’t it? It’s completely free and you can do it yourself. It’s really an excellent addition, because it’s not just a minor difference. It can, as you say, have a major impact in many, many areas of your treatment and outcome. So from what you’re saying earlier, you’re clearly optimistic that integration in the UK is not only possible it’s going to happen, am I right?

Dr Penny Kechagioglou: I am very optimistic. And I think those events that you organised Robin, we need to have more of those.

Robin Daly: We will.

Dr Penny Kechagioglou: We need to invite more mainstream clinicians to participate and network with other people who are experts and learn from them. Because I think there is a knowledge gap and hence why, oncologists in particular, haven’t taken on that practice or they’re still not offering it to their patients. There is a knowledge gap, which we need to fill in and that’s our duty.

Robin Daly: Well, hopefully you can help us in getting your colleagues along to our next event, we’d love that of course. It’s been fantastic to have some of them at that this event, but of course we want lots because we want to have the biggest impact possible. I know that our audience, of course, is largely people who have cancer or their relatives or their supporters, and they would desperately love their oncologists to understand why they want to do these things and actually it’s for real, it can make a real difference. It would be hugely important to them to have the support their oncologist saying, ‘Yes, that sounds like a good idea’. So I really hope you’re right. Of course, we’re pushing all the time for this change to happen in the UK – can’t come soon enough as far as we’re concerned. So, really appreciate having your support for what we’re doing, it means an awful lot to us and so hopefully we will see big change very soon.

Dr Penny Kechagioglou: That’s excellent. Well, happy to support you in the future as well. Thank you, Robin and well done for everything that you do, and I’m very, very happy to have met you and definitely we need to grow that movement.

Robin Daly: Fantastic. Thank you very much, Penny. Have a good day, bye.
Dr Penny Kechagioglou: You too, bye.

Robin Daly: Such a joy to speak to a top expert about the issues at the heart of our mission at ‘Yes to Life’, and to be met with such open-minded enthusiasm and the desire to create new ground and improve the outcomes and experience of those going through cancer treatment. This is exactly what we’ve been working for all these years and an incredible outcome for ‘Your Life and Cancer 2020’. I’m looking forward enormously to working with Dr Kechagioglou, and meeting more of her colleagues who are open to integration.

Also, ‘Yes to Life’ has an innovative fundraiser in December, an online dinner. It costs just £10 to join in and there’s going to be spectacular entertainment, stars, prizes, and loads of fun, all in a great cause. It’s on the 10th of December and you can book your place on the ‘Yes to Life’ website. That’s: yestolife.org.uk Just click events.

Thanks so much for listening today. Hope you found it interesting and will want to join me again next week for another ‘Yes to Life’ show on UK Health Radio. Goodbye.

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Radio show transcript edited by Kathy Martin, Literary Transcript Editor