Background An Oncology Health Centre was established in January 2000 at the Princess Royal Hospital (East Hull), and a second Centre opened in 2002 at Castle Hill Hospital (West Hull) (Hull and East Yorkshire Hospitals NHS Trust).

The aims of the Oncology Health Centres are:

• to prevent psychological distress,
• to improve quality of life,
• to deliver evidence-based psychological interventions equitably for patients in Hull, the East Riding of Yorkshire and North Lincolnshire,
• to provide support and supervision for staff,
• to offer local and national training programmes, and
• to create an infrastructure for internationally competative research.

Clinical work

Patients who are receiving, or who have received, treatment for cancer locally are welcome to use the Centre, as are their relatives. They can drop in to the Centres Monday-Friday (9am-5pm) or attend by appointment.

We offer information, support, practical help (including welfare rights) and the opportunity to discuss any matter of concern. In addition, patients are given the opportunity to learn various evidence-based, self-help techniques, for example cue-controlled relaxation and visualisation, in order to minimise treatment side effects and to enjoy as good a quality of life as possible during and after cancer treatment.

Patients who are experiencing a clinically significant difficulty (e.g. an adjustment disorder, depression, a fear of needles, medical procedures or hospitals, or inadequately controlled side effects) are seen by a clinical psychologist or a specialist behavioural oncology nurse. A range of evidence-based psychotherapeutic interventions is used, including adjunctive psychological therapy and hypnotherapy.

In a consecutive period of 12 months, 1,524 new patients attended the Centres. This represents approximately two out of every three people with cancer in our catchment area. Seven hundred and thirty eight were referred by health care professionals in the hospitals or in the community, and 788 attended without an appointment (i.e. as 'drop ins'). Currently, approximately 260 patients and relatives attend each week, and the number continues to increase. Many more patients access the service by telephone.

A recent audit of all patients attending during a period of one week in 2006 found that men and women, with all types of cancer, from all sociodemographic backgrounds, attended the centres. Unlike previous studies which have reported that 70-80% of patients accessing support services in the UK are white, middle class women with breast cancer, this was not the case in this audit.

• 44% of patients accessing the service were male.
• The Townsend Deprivation index (a measure of socio-economic deprivation) showed that 66% of the patients came from the three most deprived quintiles (22% from the most deprived quintile).
• Twenty-two percent had breast cancer, 21% had colorectal cancer, 16% had lung cancer, and 8% had prostate cancer. Patients with the full range of cancer diagnoses attended.

Audits of patients, relatives and referrers have indicated very high levels of satisfaction with the service.

Research

The research strategy is to collaborate with clinicians and basic scientists.

Funded by various sources, including the Medical Research Council, the Cancer Research Campaign, the HTA Programme, the NHS R&D Executive and Dimbleby Cancer Care, current studies include:

• biopsychosocial studies of breast, colorectal and brain cancer,
• psychosocial aspects of cancer screening,
• the evaluation of different models of providing psychosocial care, and
• the evaluation of the effects of complementary interventions on quality of life.

Clinical trials:

1. A randomised, controlled, clinical trial of the effects of reflexology on quality of life (including mood, adjustment, function, coping and patient satisfaction), neuroendocrine mediators and host defences in women with early breast cancer (180 patients; funded by NHS R&D Cancer Programme).



2. A randomised, controlled trial of the relative effects of relaxation therapyand guided imagery, alone and in combination, on host defences, mood, adjustment, quality of life and patient satisfaction in patients with colorectal cancer (150 patients; funded by Cancer Research UK).



3. A pragmatic, randomised controlled trial of the effects of live relaxation on mood, coping, and quality of life (LIVEREL) (156 patients; funded by Endowments).



4. A feasibility study of relaxation therapy plus autohypnotherapy (HYPREL) for patients with thoracic cancer undergoing radiotherapy (funded by Dimbleby Cancer Care).

Teaching

Conferences, study days, and occasional lectures on various aspects of psychosocial aspects of cancer are organised from time to time under the auspices of the Institute of Rehabilitation.

• Members of the Oncology Health Centres staff contribute to various undergraduate and postgraduate programmes (University of Hull; Hull York Medical School).
• Attachments are offered to Specialist Registrars in various specialties, including Medical Oncology, Palliative Medicine and Liaison Psychiatry.
• Students from various disciplines, including nursing and clinical psychology, spend periods of time on clinical placement.
• Regular clinical supervision is offered to local Macmillan Nurses, specialist nurses and others.

Staff

Director

Professor Leslie G Walker

Deputy Director and Senior Lecturer (Behavioural Oncology)

Dr Donald M Sharp

Clinical Psychologists

Dr Emma J Lewis (Dimbleby Cancer Care)

Dr Mark J Stein

Clinical and Research Nurse Specialists (Behavioural Oncology)

Mrs Julie Bateman

Ms Fiona Braid

Mrs Claire Hebblewhite

Mrs Teresa Hope

Ms Jeanette Jackson

Mr Michael Lines

Mrs Mary B Walker (Senior Nurse)

Assistant Nurses (Behavioural Oncology)

Mrs Debbie Gosling

Mrs Tricia Gollins

Welfare Rights Officer

Mr Ian Miller

Secretaries

Mrs Karen Fraser

Ms Claire Levesley

Awards The Centres were commended in the Northern and Yorkshire Region Modernisation Award 2001 and in the National Health and Social Care Awards 2002 (Department of Health).

Key Publications

• Walker L G, Walker M B, Heys S D, Ogston K, Miller I, Hutcheon A W, Sarkar TK and Eremin O (1999). The psychological, clinical and pathological effects of relaxation training and imagery during primary chemotherapy. British Journal of Cancer, 80, 262-268.
• Walker L G, Walker M B and Sharp D M (2003). The organisation of psychosocial support within palliative care. In M Lloyd-Williams (Ed). Psychosocial Issues in Palliative Care. Oxford University Press, Oxford. ISBN 0-19-851540-5.
• Walker L G, Walker M B and Sharp D M (2003). Psychosocial oncology services for women with breast cancer. Update in Urology, Gynaecology and Sexual Health, 8, 25-32.
• Walker L G, Green V L, Greenman J, Walker A A, and Sharp D M (2005). PNI and Chronic Malignant Disease: Cancer. In Irwin M and Vedhara V (Eds) Human Psychoneuroimmunology (PNI). Oxford University Press. ISBN0198568843.
• Walker LG, Walker AA, Walker MB and Sharp DM (2007). Relaxation, visualisation, and hypnotherapy. In Barraclough J. Enhancing Cancer Care: Complementary, Expressive and Supportive Therapies in Oncology. Oxford, Oxford University Press.

Enquiries to:

Professor L G Walker
Director
Institute of Rehabilitation and Oncology Health Centres
215 Anlaby Road
Kingston upon Hull
HU3 2PG
United Kingdom

Email: l.g.walker@hull.ac.uk
Telephone: +44 1482 675046
Fax: +44 1482 675636.

© 2002-2008 AAWalker and LGWalker