primrose oncology clinical research unit

The Primrose Oncology
Clinical Research Unit

About the Primrose Unit | Our research projects | Why we need your support | How to support us



Receive our quarterly lifestyle research updates Email:

The Primrose Oncology Unit was built in January 1996 following a successful appeal from the local community. Bedford 's first purpose built outpatients Oncology facility was born, located in the grounds of Bedford Hospital, serving both the Hospital and the surrounding community.

The Primrose Unit is now the centre for the development of multidisciplinary cancer strategies, patient information strategies, clinical oncology research and rapid access palliative intervention on support. Six hundred and twenty new patients with cancer are seen each year – a three-fold increase over 5 years. We have evolved a second hand "portacabin" to a well equipped a £3.5 million new cancer unit. The Unit provides daily chemotherapy facilities co-ordinated through 4 chemotherapy clinics per week. Staff also run a further six general out patient clinics per week.

Joint clinics are run in conjunction with Head & Neck Consultants, Plastic Surgeons and Gynaecologists. Within five and a half years we are proud to claim The Primrose Unit has become one of most efficient, cancer units in the UK. This has been achieved on the background of the rapidly increasing workload.

core clinical research team has been created, led by Professor Thomas entirely self funded entirely from commercial, lottery and charitable sources. A full report of our research can be found in the Primose Research update.

Translational research projects have been established via the appointment of Dr Naderi, a Medical Oncologist who also runs a Lab in Cambridge University. Four health economics studies run jointly with economics department at Cranfield University. Two Qol, breast cancer studies have linked with Hull University . A further double blind randomised study (NCRN adopted) also teams up with the Cranfield, statistics unit. A PhD student (Nichola Davies) is joint supervised and funded by Dr Thomas and Sarah Morgan at Cranfield University. Madeleine Williams is the research manager and Anne Willis is the NCRN funded trials nurses.

We are now recruit 38% of patients into home grown, NCRN or commercial trials annually. A source of funding in addition to the 100k raised form Dr Thomas leading a team in the London Marathon each year. All team members, including our receptionist, participate in clinical research and have presented work in international meetings each year.

We now have a very active research unit, specialising in quality of life, information and lifestyle research. For a complete update of our research activity can be found in our 2009 update

We are also now in a privileged position to have patient support groups, radio-stations and TV local newspapers, publishing glowing reports about our service. Internationally the staff have been awarded a number of high profile prizes. Thank-you letters and donations are streaming in and written complaints have decreased from two per month to two in the last 18 months. These accolades not only improve self-esteem of all staff, they improve moral and patient confidence. A number of specific strategies have helped to achieve these standards, not only to improve the well-being of patients, but have ensure a cost efficient considerable service for the Hospital.

Services (also see our services):-

Chemotherapy day case facility
Outpatients offices

Specialist Urology services

Diagnostic services - biopsy, ultrasound

The Clinical Research Unit

Specialist head & Neck follow up clinics

More spacious comfortable accommodation for patients and carers during treatments including some day beds.

Increased office and counseling space for Macmillan nurses and support staff.
A resource and information centre.

Hospital palliative care office and co-ordination centre

Specialist nurses offices

A conference and telecom

Title	Publication: Journal & date	Key improvements
Patient’s preferences for video recorded information. Effect of age, sex & ethnic group.	Thomas R, Deary A, D. Stockton, N DeZeeuw . The Euro J Cancer Care. 1999; 8 83-86	We learnt from patients how they want information and discovered deficits in our service.
Patient information satisfaction following a diagnosis of cancer.	Deary A, Thomas R. Annuls of Oncology. 1999, 9, S4, p143.	This is initial survey showed that patient were dissatisfied
Anxiety & Depression - Effect on patient’s preferences for info.	Thomas R, Brown C, Stockton D. Anns of Onc 9, S4, pp 141.	Poor information is associated with Anxiety and depression
Epo for anaemia & qol in patients undergoing chemotherapy	H Thomas, R Thomas, K McAdam, S ESMO , Nice 2002.	Epo improved anaemia and qol
Epoeitin: Attitudes of community and hospital nursing staff.	A Deary & R Thomas. EJC. Vol.35. Suppl.4. p.30 (ab. 92).	Epo use is well accepted by nursing staff
Do patient's want the same information as the GP?	Kaminski E, Deary A, Thomas R. EJC. 1997. 33, S8, 1391.	Most but not all and may frighten some.
Patient preferences for a breast care nurse specialist.	Shingler G, Smith S, Thomas R. EJC. 1997. Vol. 33, S8, 1397.	Accepted greater responsibilities of breast care nurses
Patients attitudes to a bespoke filofax information system.	Kaminski E, Balusu R, Thomas R. EJC. 1997,. 33, S8, 1401.	Highly acceptable
Patient information: A new structured information package.	DeZeeuz N, Bulusu R, Thomas R. EJC. 1997. 33, S8, 1400	Feed back from patients helped us design this file
Where do patients seek additional information after a diagnosis?	Shingler G, Bulusu R, Thomas R. EJC. 1997. Vol. 33, Sup8, 1426.	Interesting insight into patient behaviour – word of mouth
Why Oncologist should provide a web site for their patients.	L Dalton and R Thomas. The EJC. 1999 35. S4. p.46 (ab. 164).	Uncontrolled internet sites. We developed cancernet.co.uk
Forewarned is forearmed – preparatory information on video cassette for chemotherapy & radiotherapy - a randomised trial.	Thomas R, Daly M, Perryman B, Stockton D. EJC 36 (2000) 1536-43. JCO 1999 ASCO): 1570 and EJC.;35. S4. 275	We developed, then evaluated an information film, free at Bedford distributed nationally by Cancer Bacup.
Developing and evaluating a regional information strategy.	R Thomas, C.Lockery. EJC 2001 vol 37, supp.2 pp 62	This review summarised our information strategies
Lyphpoma Chemotherapy – an audit of neutrpenia, dose intensity, and gcsf use in the UK	R Thomas, J.Sweetman, P Hoskins. EJC 2001 vol 37, supp.2 pp119	Showed the lack of maintaining dose intensity in the UK with gcsf
Adjuvant UK breast cancer Chemotherapy – audit of neutrpenia, dose intensity & gcsf.	R Thomas and R Leonard. EJC 2001 vol 37, supp.2 pp61	Showed the diverse choice of regimens and lack of maintenance of dose intensity
Lessons Learnt from Raltitrexed – QA, Patient Education and Intensive Supportive Drugs	R.J. Thomas, M. Williams, J. Garcia-Vargas Clinical Oncology (2003) 00:1-6	For colorectal cancer - Showed how to optimize tolerability, now AstraZeneca guidelines
Examining quality of life issues in relation to endocrine therapy for breast cancer.	Robert Thomas. American Journal of Clinical Oncology 2003. Vol. 26, No. 4, p S40-44	Showed the importance of letting patients have greater input into their management.
RTO1 (MRC)	National publication	Conformal Rxt better
Viktor study (MRC)	National Publication	Trial stopped - cardiac morbidity
Measuring information strategies – developing an information satisfaction questionnaire	Thomas R, Kaminski E, Stanton E and Williams M. EJCC, 2004, 13, 65-70.	This questionnaire is now used internationally to measure patient satisfaction to information
Giving patients a choice improves qol: A multi-centre, investigator-blind, RCT of letrozole v anastrozole	R. Thomas, S. Godward, A. Makris, D. Bloomfield, A.M. Moody, M. Williams. Clinical Oncology (2004) 16: 485-491.	Qol and tolerability can be improved by giving patients a choice.
Patient Information materials in Oncology: Are they needed and do they work?	Thomas R, and H Thorton. Clinical Oncology 1999;11: 225-231.	This review helped us understand the available literature and improve our service
How to deal with the complexities of patient consent?	Robert Thomas. Pulse Clinical pp42-43 Dec2003.	This review helped us re-write our consent sheet.
The changing face of informed consent	R Thomas. B Journal of Can Man. Summer 2004 Vol. 1 No. 1.	This review also helped us re-write our consent sheet.
What are the costs of not using rhEPO to treat anaemia in cancer.	R Thomas. Focus on anaemia in cancer. 2002, 3, 2, pp52-53.	This review identified the most cost effective patients for epo
NICE guidance on supportive and palliative care – Implications for Oncology Teams.	Dr R Thomas and Professor Alison Richardson. Clinical Oncology (2004) 16: 420-424.	Summarised the NICE guidelines for oncologist
The NICE guidance on supportive and palliative care.	R Thomas and Prof A Richardson. B J CM2004. 1. 3	Summarised the NICE guidelines for managers
Anaemia fatigue and Epoeitin in Oncology	R Thomas. British Journal of Cancer Management. April 2005.	A summary of the evidence helped us write the epo guidance
PET saves man	R Thomas, M Williams & S Old. BJCM 2004 Vol. 1 No. 1	Highlighted the advantages of PET in colorectal oncology
Information – Local policies or a national strategy?	Thomas R, British Medical Journal, 1999, vol 318. page 462	Comment on the importance of give local info for local patients
The Role of an Italian Volunteer Organisation.	F. De lorenzo, R. Thomas,. L. 1998. Health communications.	Evaluated the Italian translation of our patient information film.
An open randomised trial of second-line endocrine therapy in breast cancer: comparison of the letrozole and anastrozole.	C. Rose, O. Vtoraya, A. Pluzanska, N. Davidson, M. R. Thomas, S. Johnson, et al. EJC 39 (2003) 2318-2327	This head to head comparison suggested letrozole has some advantages in terms of response.
Dietary advice combined with a salicylate mineral and vitamin supplement (CV247)- a phase II study	R Thomas, M Blades, M Williams Nutrition & Food Science. 2005 35 ,6, 436-451.	One of the first studies to suggest dietary intervetion after cancer may affect progression
Avastin saves the day	R Thomas, A Eldin, BJCC, 2006, vol.2,no.2, 20-21	Interesting case report on the use of Avastin
Erbitux the new team player	Y Habba, R Thomas, D Skipper, M Rees, BJCM Jan 2006	Highlights a potential new role for erbitux
Complementary & alternative medicine- evidence online	J Richardson, K Pilkington R Thomas, BJCM 2005, 2;2,10-14	Reviewed the evidence for CAM therapies often taken by patients
Can we move to a paperless information system?	A Deary, R Thomas, M Williams ESMO 2005	Evaluated the attitudes & costs of an online only system
Patients in trials are more satisfied with their received info	R Thomas, M Williams ESMO 2005	Reassures patients they are well informed in clinical trials
Phase 111 study of gemcitabine and capecitabine for pancreas	National publication	Help understand the chemo responsiveness of pancreatic ca.
Can switching to letrozole improve hot flushes, qol and patient preference	R Thomas, L Walker, C Marshall, San Antonio breast cancer conference 2005 & ESMO Istanbul 2006	This study, with Hull & Cranfield Universities highlights the qol benefits of changing to letrozole
Adjuvant breast cancer drugs – blockbusters or bankrupters	R Thomas, J Green, M Callam. BJCM Jan 2006	Reviewed evidence & cost of Rx for our health economics study with Cranfield University
Cost effectiveness of adjuvant exemestane	R Thomas, M Williams, J Glen ECCO 2007 and Nottingham Breast conference 2007
Cost effectiveness of adjuvant arimidex	R Thomas, M Williams, J Glen - ongoing
Cost effectiveness of adjuvant taxotere	R Thomas, M Williams, J Glen - ongoing
Can switching to exemestane improve hot flushes, qol and patient preference	R Thomas, L Walker, C Marshall, ECCO 2007 - ongoing	This study, with Hull & Cranfield Universities highlights the qol benefits of changing to exemestane
Double blind randomised trial of CV247 v sodium salicylate in men with indolent prostate cancer	R Thomas, M Williams etc - ongoing	NCRN trial designed at Bedford. completed and being analysed.

We learnt from patients how they want information and discovered deficits in our service.