Pioneers in patient care: consultants leading change
Midlands
Professor Hugh Barr
Gloucestershire Royal Infirmary, Gloucester
Job title: Consultant surgeon and professor of surgery
Specialty: Upper gastrointestinal surgery
Innovation: The use of photodynamic therapy, rather than surgery, to target cancerous tissue in patients with early oesophageal cancer
Oesophageal cancer, or cancer of the gullet, is a life threatening condition which can be most successfully treated in its early stages. Normally the cancerous tissue has to be removed surgically which is a highly dangerous operation, leaves the patient mutilated and has major side effects.
However at Gloucestershire Royal Hospital, Professor Hugh Barr, a specialist in gastrointestinal surgery, has pioneered the use of a much less invasive technique, photodynamic therapy.
Photodynamic therapy involves giving patients a light sensitive drug which targets the cancerous tissue and destroys it when activated by light. Professor Barr sees 20 to 30 patients a year who can benefit from this technique but estimates that if the technique was rolled out more widely and funded by the NHS, many more patients would benefit.
Professor Barr says that patient reaction to the innovation has been extremely positive. “Patients are delighted because it avoids the need for an oesophagectomy – a major and dangerous operation,” he says.
The technique has been audited by looking at survival rates since 1994 which are “favourable,” says Professor Barr. To survive, the service depends on charitable funding from two trusts, the Surgical Laser Trust Fund and the Betty Meredith Laser Fund, established by former patients who suffered from oesophageal disease.
Like so many of his consultant colleagues, Professor Barr is frustrated by shortages of resources and what he describes as “government spin”. He would no longer recommend medicine as a career and he sometimes feels he is letting his patients down because he does not have enough time for them individually. “More resources and facilities hold the key to future improvements in care for this group of patients,” he says.