Inside Ward 6 with Dr Dan Yeomanson
Did you know that the overall childhood cancer survival rate in Yorkshire is among the best in the world? The ward at Sheffield Children’s sees between 90 and 100 patients every year from across South Yorkshire, Lincolnshire and North Derbyshire as well as undertaking bone marrow transplants for patients from further afield, including Nottingham, Northampton and Leicester.
Meet Dr Dan Yeomanson, Consultant Paediatric Oncologist
What makes Sheffield Children's special to you?
I’ve been working at Sheffield Children’s for almost 20 years, and I’ve been a consultant on our Cancer and Leukaemia Ward for more than a decade. I genuinely enjoy coming to work, it’s a fantastic place and there’s a great sense of camaraderie and friendship. We all support each other to do the work we do. It's a privilege to work here and I’m very proud to be a part of such a talented and dedicated team.
What does your role involve?
My role involves looking after patients, I enjoy meeting them and helping make them better. On a simple level, that often means making it fun for children to come to hospital wherever I can.
It means making sure that symptoms and side-effects are well-managed, and that they have the best available treatment. Survival rates are continuing to improve- since I started at the Trust, 13 more children out of every 100 are surviving cancer in Yorkshire.
Our aim is always to get children back to the life they had before they were diagnosed with cancer or as close to it as we possibly can.
How many patients do you see on the Cancer and Leukaemia Ward?
The ward at Sheffield Children’s sees between 90 and 100 patients every year from across South Yorkshire, Lincolnshire and North Derbyshire as well as undertaking bone marrow transplants for patients from further afield, including Nottingham, Northampton and Leicester.
Around a third of our patients are children with leukaemia and the rest have solid tumours. There are currently 75 children undergoing treatment now. Within Haematology, the most common condition we treat is Acute Lymphoblastic Leukaemia, which makes up around 90% of our diagnoses, with the remaining 10% Acute Myeloid Leukaemia.
For Oncology, the most common conditions we see are Hodgkin’s Lymphoma, bone and brain tumours in teenagers, while kidney tumours and neuroblastoma, are more common in younger children.
What treatment does the Haematology and Oncology Department offer?
The treatment offered at Sheffield Children’s includes chemotherapy for both inpatients and outpatients, surgery and high-dose chemotherapy for patients with solid tumours or leukaemia.
While on treatment, we try to keep our patients active and keep them engaged with their schools and friends as much as possible. When they’ve finished treatment, we focus on both rehabilitation and reintegration too.
We are one of 19 Principal Treatment Centres in the UK. This is a centre where a child will be diagnosed with cancer and their treatment plan decided. We work closely with a number of other Principal Treatment Centres to ensure that our patients receive an excellent standard of care, whatever their diagnosis, with the majority of their treatment being given here at Sheffield Children’s.
How successful is that treatment?
The overall childhood cancer survival rate in Yorkshire is among the best in the world, with 86 out of every 100 children diagnosed with the disease before their fifteenth birthday living for five years and many more.
That’s an important benchmark, as a child who lives beyond five years of diagnosis is considered to have been cured of their cancer, although in some children the disease does sadly recur.
Twenty years ago, the comparable figure was 73 out of 100 children. That means for every 100 children, 13 are now surviving who would not have done so 20 years ago. This matches the best figures reported by countries around the world, including Australia and Canada.
This improvement is the result of a combination of factors, including clinical trials which are now often international, and allow us to identify stepwise improvements in treatment for rare conditions. There’s also the sharing of expertise across the world and developments in areas including surgical techniques and critical care.
How do you deliver such an excellent standard of care?
It is a huge team effort to deliver this standard of care. The Haematology and Oncology team is made up of consultants, specialist trainees, junior doctors, play specialists, advanced nurse practitioners, allied health professionals as well as a large team of ward-based nurses, ward and clinic clerks, healthcare assistants and the secretarial team.
There’s also the research team, which includes data and quality managers, and research nurses. We also work with the Physiotherapy, Occupational Therapy, Dietetics, Dental and Psychology Teams at Sheffield Children’s, while our outreach nursing team delivers care in patients’ homes where appropriate.
How have donations from The Children's Hospital Charity supported your work?
We have all been moved by the support from the public to transform the environment in which we deliver that care. Thanks to donations to The Children’s Hospital Charity, we have recently moved onto a new state-of-the-art ward. It’s brilliant, complete with bright, open spaces, bigger bedrooms, views over Weston Park, a dedicated adolescent room, a new parent room and a bigger playroom.
Working on the new ward feels amazing, and families comment on how great it is all the time- it’s almost hard to remember what the old ward was like now. I’m hugely grateful to the Charity, the Trust and everyone who supported the appeal to ensure we realised our dreams within such a short timeframe.
What does the future look like for Cancer and Leukaemia care?
I think that the trend of improvement in survival will continue, because where survival rates remain poor the search continues to identify new treatments. However, in the conditions where cure rates are very high, the focus has now moved onto reducing the treatment side effects, both during treatment and in the longer term, which is just as important.
There has been a very gradual increase in childhood cancer diagnoses, although the causes are not yet well understood. We are seeing an increase in the complexity of treatment for a lot of patients, which is often now more intensive than in years gone by as our options increase.
As we look to the future, I believe there are two huge opportunities to change the way we deliver cancer treatment dramatically, with the potential to significantly improve survival whilst reducing side-effects. They are in personalised cancer therapy and immunotherapy.
Personalised cancer therapy means instead of treating every patient with a generic one-size-fits-all treatment based on their condition, we analyse the individual cancer to target their treatment with a specific drug.
It’s already starting to happen in adult cancer care, and those drugs are often given orally, have a lot less of the conventional chemotherapy side-effects and can be incredibly effective against childhood cancer.
The second major opportunity for improvement lies in immunotherapy, often called cancer vaccines. CAR-T therapy, which is where you train a patient’s immune system to target their own specific cancer, is already proving very successful in the treatment of leukaemia, and research is ongoing to see how the same techniques can be applied to patients with solid tumours.