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Episode 5: Insights to molecular genomic testing from a health care professional’s view - Dany Bell

Mélanie Moxhet

Dec. 1, 2020


Dany Bell, Macmillan Cancer Suppport (UK)

Mrs. Dany Bell is a trained cancer nurse and strategic advisor for treatment, new personalised medicine and genomics at the Macmillan Cancer Suppport, UK’s leading cancer charity organisation.

In this episode of your ONCOmmunity podcast, Mrs. Bell describes her work experience as a health care professional, the need for nurses to understand the relevance of genomics in oncology, and the integral role they play in educating and guiding cancer patients along their treatment journey.

Over the last 10 years, we’ve seen a change in the treatment landscape of cancer patients. Thus, cancer nurses have to keep abreast of new drugs and new targeted therapies and also the side effects so, again, they know how to support people and also where people can seek help and support when they experience side effects.


0:06 Welcome to ONCOmmunity, the molecular oncology podcast by ONCODNA. We already discussed how to analyze and process genomic data from large panel testing in previous episodes. Today, we want to direct our attention to the patient and healthcare professionals and how this data-driven medicine affects them.


I’m happy to welcome Mrs. Dany Bell, trained cancer nurse and strategic adviser for treatment, new personalized medicine and genomics at the Macmillan Cancer Support, the UK’s leading cancer charity organization.


Dany Bell

0:40 Hello, everyone. Thank you for having me.



0:43 Dany, could you briefly describe your work experience as a healthcare professional? And do you think all nurses need to have an understanding of the relevance of genomics, particularly in oncology?


Dany Bell

0:54 Yes, so I’ve been a nurse for over 30 years, and my experience spans both cancer nursing and palliative care, both as a clinician and as managing services. Cancer nurses themselves are very experienced nurses who’ve usually undergone additional training post qualifying as nurses in cancer care.


However, today’s cancer nurses would not necessarily have received any education on genomics as part of their nursing training or even as part of their additional post registration training because it’s not embedded in core training. So any training that they may have received on genomics is likely to have been by choice and something they’ve sought out for themselves rather than embedded in any traditional training around cancer care.



1:56 Dany, is it possible to explain the difference between a normal nurse and a specialised cancer nurse? Do they have to undergo specific training or gain certain qualifications?


Dany Bell

2:07 So that’s a really interesting question. So generalist nurses generally have their three years of nursing training and then choose to work in medicine, surgery, care of the elderly, or some generalist healthcare setting.


Cancer nurses generally -- it takes several years for people often to become a very experienced cancer nurse, and they may have been nurses that have chosen to work in a chemotherapy suite or have worked on a surgical oncology ward and then become interested in what we call a cancer nurse specialist role, which are nurses that work within cancer multidisplinary teams with bespoke roles. They’ve usually got a degree in cancer care that they’ve done post their normal three years of nursing training.


3:09 And they are very focused within the MDT on that personalized direct patient support in terms of giving information, making sure that the patient’s journey, that they have good experience. So generally, they are nurses that have been qualified probably a minimum of a few years before actually going into that kind of expert cancer specialist nursing role.



3:41 Thank you very much for these explanations. How can nurses ensure they play a central role in the application of genomics in clinical practice?


Dany Bell

3:51 So their roles within clinical practice, as I’ve already stated, are really central to providing information and support to cancer patients as they go through their cancer journey. They also play quite an integral role often in pathway redesign to improve patient experience. So they would play a kind of integral role in embedding genomics within cancer pathways.


But the really important thing is that patients have understandable information, time to ask questions, and so cancer nurse specialists are quite integral. And this is part of their role within the MDT to take more time outside of a clinic environment with a clinician to spend time with cancer patients and ensure that they have understandable information, that they can ask questions, so that they can make good decisions about their treatment and their care.



4:59 Concerning the goal of integrating geonomics into routine clinical cancer care, is the involvement of charities and commercial entities a help or a hindrance?


Dany Bell

5:08 So it’s absolutely a help. Charities play a really big role aligned to healthcare and often will support funding of posts and redesign of pathways. They will work across their own networks and the networks in healthcare to kind of support and collaborate with education and training.


Macmillan can support because we recognize the importance of changing technology and genomics. And my role has evolved, and also, I chair a genomic medicine strategy group that spans other cancer charities and also our NHS organizations in England.


5:58 And also, we’ve been linking with organizations like ONCODNA to collaborate in order to bring together healthcare professionals and organizations and ensure that personalized diagnostics are embedded into cancer care by influencing, engaging, and having a learning and development offer for increasing knowledge and confidence of the workforce in genomics. So they play quite an integral role in that kind of support of mainstream healthcare providers.



6:31 And for a final question, how do you think genomics is changing and influencing nursing practice? And what are the applications for genomics in nursing practice?


Dany Bell

6:41 So definitely, over the last 10 years, we’ve seen a change in the treatment landscape with the new targeted therapies coming onboard. And nurses -- so existing cancer nurses, many of them would’ve gone through their training, and those types of treatments wouldn’t necessarily have existed. So they would be familiar obviously with the standard treatment for cancer in terms of chemotherapy, radiotherapy, and surgery.


So they have to keep abreast of the changing treatment landscape in order to be able to support their patients with the right information and so constantly need to undertake training to upskill them in new drugs and targeted therapies and also the side effects so, again, they know how to support people and also where people can seek help and support when they experience side effects.


7:39 So some cancer nurses may have been clinical trials nurses or work quite closely with their clinical trials team and so, again, would need to understand the relevance of genomic testing within the clinical trial arena. And they may even be coming involved in consenting or enrolling patients onto clinical trials. It really depends what their role is within the cancer setting.


And essentially, they play a huge role in educating their patients and the wider workforce. So if cancer nurses in the wider MDT have the right knowledge, they can work together to educate their colleagues and make sure that their roles in supporting patients with cancer is clear and so they understand as an MDT which roles are responsible for different aspects of that kind of diagnostic pathway and giving information to the patient.



8:54 Thank you, Dany, for your explanations and sharing your insights from your real world working routine. We will discuss the importance of networking and the role of molecular tumor boards in the next episode of ONCOmmunity, the molecular oncology podcast by ONCODNA.