Clinical oncology. Part 3.

London : University of London Audio-Visual Centre, 1974.

1 encoded moving image.

01:00:41

University of London

In English

With RL Morgan, Mr JA McKinna Professor T Symington and staff of the Royal Marsden Hospital. Participants: Dr DM Taylor, Dr TJ McElwain, Dr TJ Powles, Mr P Clifford and Dr DS Robbie. Produced by John Metcalfe. Made for British Postgraduate Medical Federation. Made by University of London Audio-Visual Centre.

This video is one of around 310 titles, originally broadcast on Channel 7 of the ILEA closed-circuit television network, given to Wellcome Trust from the University of London Audio-Visual Centre shortly after it closed in the late 1980s. Although some of these programmes might now seem rather out-dated, they probably represent the largest and most diversified body of medical video produced in any British university at this time, and give a comprehensive and fascinating view of the state of medical and surgical research and practice in the 1970s and 1980s, thus constituting a contemporary medical-historical archive of great interest. The lectures mostly take place in a small and intimate studio setting and are often face-to-face. The lecturers use a wide variety of resources to illustrate their points, including film clips, slides, graphs, animated diagrams, charts and tables as well as 3-dimensional models and display boards with movable pieces. Some of the lecturers are telegenic while some are clearly less comfortable about being recorded; all are experts in their field and show great enthusiasm to share both the latest research and the historical context of their specialist areas.

Segment 1 McKinna shows a lateral X-ray of a patient's neck and thorax following a laryngo-pharyngo oesophagectomy for cancer of the oesophagus. He explains how the oesophagus was replaced by a section of the colon. A short film is shown in which Clifford explains the technique of a deltopectoral flap to repair damaged skin during surgery to treat head and neck tumours. He demonstrates how this treatment works with reference to a male patient who he encourages to show his post-operative mouth mobility. Time start: 00:00:00:00 Time end: 00:05:16:14 Length: 00:05:16:14

Segment 2 The short film featuring Clifford continues. He now introduces a female patient who was treated with skin grafts following surgery for extensive cancer of the pharynx and larynx. He describes how she will be taught speech therapy to enable her to use an oesophageal voice. The film clip ends. McKinna introduces a further film clip which shows two patients being interviewed by a speech therapist who is not seen. Both patients describe how speech therapy has helped them following sugery. The film clip ends. Time start: 00:05:16:14 Time end: 00:11:39:19 Length: 00:06:23:05

Segment 3 McKinna moves on to discuss the rehabilitation of female cancer patients following mastectomy. He demonstrates different types of prosthetic breast and discusses wigs for patients who have lost their hair during chemotherapy. A short film is shown in which a female patient is shown by a nurse how to replace an ileostomy bag. The film clip ends. Time start: 00:11:39:19 Time end: 00:17:41:00 Length: 00:06:01:00

Segment 4 McKinna discusses further aspects of rehabilitation and follow-up care for cancer aptients. A short film is shown in which a female patient is assisted with standing up by a physiotherapist following a long convalescence. Powles then interviews a female patient about the management of her pleural effusion and chest drain. Powles describes how the chest drain works in depth to the patient. He asks her about the effects of her medication. The film clip ends. Time start: 00:17:41:00 Time end: 00:23:43:00 Length: 00:06:02:00

Segment 5 McKinna goes on to discuss terminal care and death. He introduces a film in which anaesthetist Robbie interviews a female patient about her pain relief regime during the last stage of her life. The film clip is shown of Robbie in conversation with the female patient. She talks about how much pain she was in and they recount the stages they went through to get her pain relief to an adequate level. Time start: 00:23:43:00 Time end: 00:29:07:00 Length: 00:05:24:00

Segment 6 The film clip of Robbie and the female patient discussing pain relief at the end stage of life continues. The patient also mentions that she is demoralised by the loss of her hair during treatment. Robbie sums up the conversation to camera, emphasising that pain relief and other care must be tailored to the individual. The film clip ends. Time start: 00:29:07:00 Time end: 00:34:09:00 Length: 00:05:02:00

Segment 7 McKinna is shown, seated in the studio, talking to Robbie. Robbie talks in more detail about the kinds of analgesic medicines available to terminally ill patients and shows a table listing them. He describes the action of each group and explains their pros and cons. McKinna and Robbie discuss the importance of getting and maintaining a pain relief programme that suits the individual patient's needs. Time start: 00:34:09:00 Time end: 00:41:40:00 Length: 00:07:31:00

Segment 8 McKinna introduces Professor Symington and asks him to help to summarise some of the main themes of the series of lectures. Symington asks Taylor to discuss the science aspects of the programme. Taylor runs through some of the key points made in the first few programmes in relation to the cancer cell and treatment options. He uses slides to illustrate his points. Time start: 00:41:40:00 Time end: 00:46:27:00 Length: 00:04:47:00

Segment 9 Taylor continues to summarise the findings of the first few programmes in the series. Symington then asks McKinna to talk about the surgical aspects discussed in the series. McKinna emphasisis that early diagnosis is a key factor in enabling surgery to work effectively. He describes a surgical team briefly and ends by saying that one subject has not been fully covered by the series, and that is the subject of prevention. Time start: 00:46:27:00 Time end: 00:51:52:12 Length: 00:05:25:12

Segment 10 Symington now asks Morgan to speak about radiotherapy. Morgan summarises what has been said in earlier programmes about radiotherapy as a treatment for cancer and stresses that surgery and radiotherapy should be seen as two parts of a whole treatment. Time start: 00:51:52:12 Time end: 00:55:02:00 Length: 00:03:09:35

Segment 11 Symington asks McElwain to speak about chemotherapy. McElwain echoes Morgan's concern that surgery and chemotherapy should be seen as working together. He describes how, at that time, chemotherapy had only really been successful in the treatment of some rare tumours - leukaemia and lymphoma, for instance and how with a multidisciplined result combining surgery and chemotherapy, larger tumours could be tackled. Time start: 00:55:02:00 Time end: 01:00:41:21 Length: 00:05:39:21