Many sarcoma subtypes arise in the skin and are sometimes confused for other skin cancers. Pathways are in place for referral from dermatologists to the specialist sarcoma service. While for many patients, treatment of skin sarcoma is often straightforward and successful there are certain uncommon subtypes for which management is much more complex. The London Sarcoma Service has a dedicated expert dermato-oncologist at the centre of our care pathway for patients with skin sarcoma.
Surgeons
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I am a Consultant Dermatologist & Dermatological Surgeon at University College London Hospital (UCLH) with a special interest in skin cancer. At UCLH I established both the Mohs micrographic surgery service and the photodynamic therapy (PDT) service and am also the Dermatologist to the London Sarcoma Service.
At Harefield and Royal Brompton NHS Trust, I run a specialist clinic for heart and lung transplant patients with skin problems. This is a much-needed service since organ transplant patients have a 100-fold higher risk of skin cancer. In addition, I have a special interest in skin problems in other groups of immunosuppressed individuals including those with haemato-oncological disorders such as chronic lymphocytic leukaemia.
I served as the Skin Cancer Lead at UCLH and as the lead for Mohs surgery on the London Cancer Skin Pathway Board for many years. I am an honorary senior lecturer at University College London (UCL).
Professional Affiliations
I am a member of the Royal Society of Medicine, the British Association of Dermatologists, the British Society for Dermatological Surgery and the British Medical Laser Association and am also on the Board of The British Society for Skin Care in Immunocompromised Individuals.
Current cancer research projects
I continue to research alongside my clinical duties and supervise PhD students. I have served on the examining board of the University of London for PhD and Final MB examinations.
Previously I was awarded a Cancer Research UK (CR-UK) Clinical Research Fellowship working at its London Research Institute, as well as the Blizard Institute of Cell and Molecular Science at Barts and The London and the St John’s Institute of Dermatology. For my research on skin cancer I was awarded a PhD by the University of London.
Medical credentials
I began my medical career at the University of Bristol, before moving on to postgraduate studies in Oxford and London, achieving membership of the Royal College of Physicians in 2001.
Since then, I have undertaken extensive specialist dermatology training at some of the UK’s leading hospitals, including Barts and The London and The Royal Free Hospital, as well as completing a dermatological and Mohs surgery fellowship at the University Hospital of Wales’ Welsh Institute of Dermatology.
I am the plastic and reconstructive surgery representative sitting on the University College Hospital (UCLH) skin cancer Multi-Disciplinary Team (MDT). Within this service, I hold weekly clinics and operating lists that include reconstruction for skin sarcoma. In addition, I provide plastic and reconstructive surgery services to colorectal, gynaecology and urology MDTs at UCLH that involve complex abdominal wall and perineal reconstruction. My specialist interest in ‘complex wounds’ allows me to use the latest techniques and innovation to achieve the most optimal functional and aesthetic outcomes.
Oncologists
I completed my clinical training at St Bartholomew’s and University College London Hospitals. I completed a PhD at the Institute of Cancer Research and the Royal Marsden Hospital which looked at the genes that predispose patients to prostate cancer.
I now specialise in the treatment of soft tissue and bone sarcomas using chemotherapy and radiotherapy. I work in the one of the largest sarcoma centres in Europe and I am one of the leading experts in the UK in the treatment of soft tissue sarcoma and bone sarcoma (all body sites except brain) using technical photon and proton radiotherapy. I have pioneered a new innovative practice changing radiotherapy technique in the treatment of soft tissue and bone sarcomas for patients who cannot have surgery. This technique uses the latest technology which allows the delivery of high doses of radiotherapy that can offer long term control for large soft tissue and bone tumours which were previously untreatable with minimal side effects. This technique can be used in sarcomas all over the body but in particular for inoperable intra-abdominal and pelvic sarcomas. This technique is currently under development for a national clinal trial in the UK and internationally (HD Sarc) and is currently only available at UCLH. I also offer re-irradiation for sarcomas that have had radiotherapy previously or have been caused by previous radiotherapy.
I also have a special interest in breast sarcoma including phyllodes tumours and angiosarcoma of the breast. I was one of the main authors in the UK national phyllodes guidelines and lead nationally for improvement outcomes of breast sarcomas.
I am a strong advocate in the holistic care of cancer management with focus on diet, exercise and emotional wellbeing. A diagnosis of cancer can often bring a shock to patients’ lives and therefore a reflection and adjustment on individual lifestyle factors in our busy and stressful lives is critical in comprehensive cancer management. Many diseases in our population are due to the contribution of environment, lifestyle and food choices.
I trained as a Clinical Oncologist in South Africa and was awarded a CESR in Clinical Oncology by the Royal College of Radiologist. I have worked with the London Sarcoma Service at University College Hospital since 2009 and now specialise exclusively in the treatment of sarcomas.
I developed an interest in sarcoma during my training and now specialise in the management of bone and soft tissue sarcomas as well as fibromatosis. I have a special interest in developing the use of advanced radiotherapy techniques for the treatment of sarcomas and to that end I am involved in research funded by the Bone Cancer Research Trust and Cancer Research UK. I have an interest in education and I am involved in teaching both medical students and specialty trainees.
Nurses
I work within the Dermatology Department at UCLH alongside our Lead Consultant for Skin Sarcoma, CNS and Oncology Team. My role is to give continued support for patients pre and post surgery including complex wound care.