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UHDB surgeons leading the way for gynaecological cancer treatment

Mr Anish Bali

University Hospitals of Derby and Burton is leading the way nationally as a provider of life-saving surgery for patients with gynaecological cancers.

The Royal Derby Hospital is one of the top centres in the UK for laparoscopic “keyhole” surgery in gynaecology and also for ultra-radical open surgery for patients with advanced ovarian cancer.

State-of-the-art robot-assisted surgery has also been used in theatres to perform keyhole surgery since 2015, with this technique being especially effective in gynaecology for patients with womb and cervical cancers.

UHDB has pioneered the use of ultra-radical surgery and is now one of the most established centres anywhere for the comprehensive surgery, which can be used to treat patients with advanced ovarian cancer and involves all visible cancer tissue being removed, including from other surrounding organs.

The Trust has become one of the biggest training centres nationwide for keyhole surgery in gynaecology, with around 250 laparoscopic hysterectomies performed each year and consultants from up and down the country attending on-site training sessions on the specialty.

Mr Anish Bali, Divisional Director for Women’s and Children’s and Consultant Gynaecology Oncologist, said: “We are very proud of our position as one of the most established centres around for both advanced laparoscopic and advanced open surgery in gynaecology. The ongoing development of these specialties and the use of our robotic platform to perform keyhole surgery have really helped improve the recovery time for these patients, whilst ultra-radical surgery has been found to dramatically improve the prognosis of our patients with ovarian cancer. We are now one of the biggest training centres for both of these specialties and are delighted to be playing our part in finding the most effective surgical interventions to help more women beat this terrible disease.”

The Gynaecology Cancer Centre at the Royal Derby Hospital is supported by four surgical oncologists, two clinical/medical oncologists, three clinical nurse specialists and dedicated pathologists and radiologists. 

Around 250 laparoscopic hysterectomies took place at UHDB in the last year – 120 of which were for womb cancer cases – whilst keyhole surgery was used in theatres for approximately 25 patients with cervical cancer during the same period.

Most womb cancers present at an early stage and can be treated using keyhole surgery, which involves surgeons making several small incisions, instead of one large wound, and has a number of benefits over traditional open surgery, with patients spending less time in hospital and recovering quicker.  

Royal Derby Hospital patient Annie Ray was diagnosed with Stage 1 womb cancer in January 2017 and, after initially having to rearrange her procedure because of illness, she underwent laparoscopic surgery at the Royal Derby Hospital in March 2017.

Thankfully, the operation was a success and, following several regular check-ups over the next two years, Annie was last week given the fantastic news that she was completely cancer free.

She said: “I initially went to hospital because I thought I had polyps, so it was extremely scary to find out I had cancer. The whole surgery flew by in the blink of an eye; one minute I was being prepared for surgery and the next it was the following day and I was going home. I’m just so grateful and it feels absolutely amazing to have been given the all clear. Mr Bali is my saviour and all of the staff I came across were fantastic, I can’t fault anyone for anything. I was so lucky that we caught it when we did as I would’ve never known. Getting checked really did save my life, so I’d recommend all women visit their GP if they have any symptoms.”      

The Royal Derby Hospital became one of the first centres nationwide to offer ultra-radical surgery for patients with advanced ovarian cancer five years ago and has established this specialty since then, with around 40 procedures taking place in the last year. 

The comprehensive surgery takes several hours to complete and involves all visible cancer tissue being removed, including from other surrounding organs like the spleen and liver.  

Patient Karen Clegg was diagnosed with advanced ovarian cancer in October 2016 after initially visiting her GP with irritable bowel problems.   

After three rounds of chemotherapy, in February 2017 she spent three weeks in hospital after having ultra-radical extensive surgery, which involved her having a hysterectomy and having her gallbladder and spleen removed during an 11-hour operation.

Karen underwent further chemotherapy last year after receiving the news that a small part of the cancer had returned and she is now receiving ongoing treatment at the Royal Derby Hospital. 

She said: “Ovarian cancer is very aggressive but sadly, it hides in plain sight, so it’s so important to catch it early. Any woman that has even the smallest inkling that something isn’t right should go to see their GP. It was a kick in the teeth to hear that the cancer had come back but I’m lucky that it is much smaller than before and hasn’t entered any of my major organs. Ultra-radical surgery is definitely not for the faint-hearted but I can’t praise my surgeons, Mr Viren Asher and Mr Anish Bali, enough, as they were magnificent. I have had some pretty dark days but everyone at the Royal Derby Hospital has been unbelievable and incredibly supportive.”