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Benstead, Kim
Biography
I trained as a clinical oncologist at the Christie Hospital, Manchester and Addenbrookes Hospital, Cambridge undertaking an MD investigating photodynamic therapy. I was appointed as a consultant clinical oncologist in Cheltenham and took an MSc in Medical Education at Cardiff University, when I studies what it is valuable for SPRs to learn in order to be good consultant clinical oncologists. I was PI in multiple trials in the fields of lower GI, breast cancer and lymphomas. I was a member of the Education Board of the Royal College of Radiologists (RCR) and chaired the Curriculum Committee developing our first competency based curriculum for SPRs. I led on the development of the oncology competencies that all medical students needed to develop in order to be good F1 doctors. I chaired the European Society for Radiotherapy and Oncology (ESTRO) Curriculum Committee, leading on the revision of the curriculum in radiation oncology and the development of a new module in the curriculum on clinical oncology. I was invited to review oncology training in Estonia. As secretary to the radiation oncology branch of the European Union of Medical Specialists (UEMS) I organised the adoption of the ESTRO radiation oncology curriculum as the European Training Requirement. During this time I participated in studies looking at the variation in training of oncologists across Europe, the adoption of the ESTRO curriculum, the development of joint competencies for all doctors caring for cancer patients and the feasibility of an exit examination in radiation oncology across the EU. I participated in the design of, co-directed and taught on the Interdisciplinary Foundations of Leadership in Radiation Oncology programme with colleagues from Europe, Canada and Australasia. Following my retirement from clinical practice in 2021, I contributed to the City Challenge initiative advising Tblisi, Georgia on its plans for structuring oncology services. I co-chaired the INTERACT, project hosted by the European Cancer Organisation (ECO) and funded by the EU, that developed a curriculum aimed at enabling all the different professions that care for cancer patients to work more effectively together. I worked with the International Atomic Energy Authority (IAEA) to develop a radiation oncology curriculum for mid and lower income countries. At present I chair the Accreditation Council for Oncology in Europe and have moved us from a body that only accredits events aimed at doctors to a multi-professional accreditation body. I am an author in 55 peer reviewed papers. I was awarded the Exceptional Contribution Award by the RCR 2020 and the Lifetime Achievement Award by ESTRO in 2024.
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Publication Open Access Interprofessional education in cancer care – a scoping review(Springer, 2024-07-16) Sulosaari, Virpi; Dodlek, Nikolina; Brandl, Andreas; De Munter, Johan; Eriksen, Jesper Grau; McInally, Wendy; O'Higgins, Niall; Benstead, Kim; Díez de Los Ríos de la Serna, Celia; Benstead, Kim; Medical and DentalBackground: Comprehensive cancer care requires effective collaboration by interprofessional healthcare teams. The need to develop educational initiatives to improve interprofessional collaboration is increasingly recognised. However, there is no agreement regarding the interprofessional competencies required for effective cancer care leading to much variation on the focus of research, planning and managing change. A scoping review was conducted to identify the current status of IPE in cancer care and to summarise the results of previous research in order to guide the development of interprofessional education in cancer care. Methods: The JBI Scoping Review guidelines were used to guide the process of the review. A search of the available literature was conducted in CINAHL, MEDLINE (Ovid), PubMed, PsycInfo, Scopus databases from January 2012 to March 2023 to investigate IPE for health professional clinicians working in cancer care. Results: Of the 825 initial references and 153 studies imported for screening, a total of 28 studies were included in the final review. From those studies, seven focused on the need for IPE and interprofessional competence for oncology healthcare professionals, four reviewed existing IPE programs and 17 described the development and evaluation of interprofessional education. Findings show variation and lack of concept definitions underpinning research in IPE in cancer care settings. Variation also exists in the range of research activities in IPE, most notably related to communication, teamwork and the development of interprofessional practice. The evaluation of impact of IPE is mainly focused on health care professionals' self-evaluation and general feedback. Impact on patient care was only evaluated in one study. Conclusions: Based on the results, interprofessional education research in the field of cancer care is limited in Europe. Thus, there is a significant increase in publications in the last five years. A more systematic focus on the theoretical framework and definition of concepts would be of value. Research and programme development should be based on a shared understanding on what constitutes the interprofessional competences and IPE. Programmes to develop interprofessional practice should be developed and implemented systematically with inclusion of validated assessment methods, and evaluated and improved regularly.Publication Open Access Training in Radiation and Clinical Oncology in Europe(SAGE Publications, 2023-09-06) Lara, Pedro; Benstead, Kim; Erikssen, Jesper; Benstead, Kim; Medical and DentalThe European population is strongly affected by cancer. Radiotherapy is roughly used in 50% of cancer patients in European countries. The increased cancer burden demands a new generation of radiation/clinical oncologist (RO/CO) that, besides a strong evidence-based oncological knowledge, will be ready for leadership in cancer care. The mutual recognition of professional qualifications of Radiation/Clinical Oncology in the EU needs training harmonization. The European Society of Radiotherapy and Oncology (ESTRO) and the European Union for Medical Specialties (UEMS) made important efforts toward a European Common Curriculum for RO/CO leadership in cancer care. If qualifications are mutually recognized, the training supporting these qualifications should be also harmonized. Since 1991, ESTRO produced several editions of the Core Curriculum in Radiation Oncology (1991, 2004, 2012, 2019). These Core Curricula were endorsed as European Training Requirements by the UEMS in 2004, 2013, and 2019. A core curriculum for clinical oncology was also produced to provide this harmonization tool to countries where radiation oncology is practiced inside the broader specialty of clinical oncology. New initiatives are in place to continuously adapt the training programs to the rapidly evolving cancer care organization.Publication Open Access Evaluation of multiple transcriptomic gene risk signatures in male breast cancer(Nature Research, 2021-07-26) Bayani, Jane; Poncet, Coralie; Crozier, Cheryl; Neven, Anouk; Piper, Tammy; Cunningham, Carrie; Sobol, Monika; Aebi, Stefan; Benstead, Kim; Bogler, Oliver; Dal Lago, Lissandra; Fraser, Judith; Hilbers, Florentine; Hedenfalk, Ingrid; Korde, Larissa; Linderholm, Barbro; Martens, John; Middleton, Lavinia; Murray, Melissa; Kelly, Catherine; Benstead, Kim; Medical and DentalMale breast cancer (BCa) is a rare disease accounting for less than 1% of all breast cancers and 1% of all cancers in males. The clinical management is largely extrapolated from female BCa. Several multigene assays are increasingly used to guide clinical treatment decisions in female BCa, however, there are limited data on the utility of these tests in male BCa. Here we present the gene expression results of 381 M0, ER+ve, HER2-ve male BCa patients enrolled in the Part 1 (retrospective analysis) of the International Male Breast Cancer Program. Using a custom NanoString™ panel comprised of the genes from the commercial risk tests Prosigna®, OncotypeDX®, and MammaPrint®, risk scores and intrinsic subtyping data were generated to recapitulate the commercial tests as described by us previously. We also examined the prognostic value of other risk scores such as the Genomic Grade Index (GGI), IHC4-mRNA and our prognostic 95-gene signature. In this sample set of male BCa, we demonstrated prognostic utility on univariate analysis. Across all signatures, patients whose samples were identified as low-risk experienced better outcomes than intermediate-risk, with those classed as high risk experiencing the poorest outcomes. As seen with female BCa, the concordance between tests was poor, with C-index values ranging from 40.3% to 78.2% and Kappa values ranging from 0.17 to 0.58. To our knowledge, this is the largest study of male breast cancers assayed to generate risk scores of the current commercial and academic risk tests demonstrating comparable clinical utility to female BCa.Publication Open Access A new wave of leaders: Early evaluation of the interdisciplinary Foundations of Leadership in Radiation Oncology (FLiRO) program(Elsevier, 2022-11-01) Turner, Sandra; Benstead, Kim; Millar, Barbara-Ann; Morris, Lucinda; Seel, Matthew; Leech, Michelle; Eriksen, Jesper; Giuliani, Meredith; Benstead, Kim; Medical and DentalPurpose Effective leadership across all areas of radiation oncology (RO) is vital to fully realise the benefits of radiation therapy in cancer care. We report outcomes of a novel interdisciplinary leadership program designed for RO professionals under a global joint society initiative. Methods The Foundations of Leadership in RO (FLiRO) program was designed for aspiring RO leaders. Initially delivered in a blended learning format, it was adapted to fully virtual in 2021. It comprised a webinar tutorial, on-line modules and homework followed by ‘live’ in-person/virtual workshops over an approximately 6-week period. Topics included personal awareness, effective teamwork, quality improvement skills, leading change and conflict management. An immediate post-program online survey was performed using Likert scales to measure self-reported educational value, interaction with others and the likely application of learning to practice. Open comments were invited. Results 170 participants from 36 countries and 6 continents took part from 2018 to 2021 (99 doctors, 36 physicists, 32 radiation therapists/RTTs and 3 others). 141 (83%) participants responded to the post-program survey. Average weightings for responders’ views on whether pre-determined learning objectives were met ranged from 4.30 to 4.61 on a 5-point scale (1 = ‘not met at all’ and 5 = completely met). For the question addressing potential value of learning for application to their workplace, 124 of 130 (95%) of responders indicated that FLIRO would be ‘very useful’ or ‘extremely useful’. Conclusion Initial evaluation of the FLiRO program supports its continuation and expansion with ongoing evolution based on emerging evidence around leadership education and participant feedback.Publication Metadata only A New Prognostic Index (CLIPI) for Advanced Cutaneous Lymphoma Enables Precise Patient Risk Stratification(American Society of Hematology (ASH Publications), 2025-07-15) Scarisbrook, Julia; Quaglino, Pietro; Whittaker, Sean; Bagot, Martine; Guenova, Emmanuella; Papadavid, Evangelia; Prince, Miles; Sanches, Jose; Miyashiro, Denis; Benstead, Kim; Benstead, Kim; Medical and DentalAdvanced mycosis fungoides (MF) and Sézary syndrome (SS) have a poor prognosis with overall survival <5 years. Studies have found the current clinical staging (IA-IVB) inadequate for risk stratification. Developing a prognostic index in MF/SS will identify patients with poor outcomes and may allow better management decisions and improved survival.PROCLIPI (Prospective Cutaneous Lymphoma International Prognostic Index) Study was launched in 2015 at 46 international expert MF/SS Centers, prospectively collecting pre-defined datasets in newly diagnosed MF/SS patients to determine a cutaneous lymphoma IPI (CLIPI).552 advanced stage MF/SS patients were recruited. The 5-year overall survival (OS) was IIB=50.0%, IIIA=64.8%, IIIB=43.9%, IVA1=50.8%, IVA2=25.9%, IVB=36.9%. Factors at diagnosis associated with a significantly worse survival were N3 status; p<0.001, age>60yrs; p<0.001, raised serum lactate dehydrogenase; p=0.005 and large-cell transformation in skin; p=0.006. Modelling these 4 independent risk-factors into a CLIPI found there was a statistically significant worse OS in high-versus low-risk p<0.001, high-versus intermediate-risk p=0.002 as well as intermediate-versus low-risk p=0.010. 5 Year OS were 63.3%, 44.7% and 18.3% in the low-, intermediate- and high-risk PROCLIPI cohort respectively.In advanced stage MF/SS there was a low 5-year survival rate and increasing stage was not associated with worsening survival. The use of CLIPI to stratify patients into low, intermediate, and high-risk prognostic groups has the potential to improve patient outcomes by helping guide optimal treatment selection. CPMS ID 17662 (PROCLIPI), RRK4970, ClinicalTrials.Gov ID: NCT02848274.Publication Open Access An inter-specialty cancer training programme curriculum for Europe(Elsevier, 2023-07-28) Benstead, Kim; Brandl, Andreas; Brouwers, Ton; Civera, Jorge; Collen, Sarah; Csaba, Degi; De Munter, Johan; Dewitte, Marieke; Diez de Los Rios, Celia; Dodlek, Nikolina; Eriksen, Jesper; Forget, Patrice; Gasparatto, Chiara; Geissler, Jan; Hall, Corinne; Juan, Alfons; Kalz, Marco; Kelly, Richard; Klis, Giorgos; Kulaksiz, Taibe; Lecoq, Carine; Marangoni, Francesca; McInally, Wendy; Oliver, Kathy; Popovics, Maria; Poulios, Christos; Price, Richard; Rollo, Irena; Romeo, Silvia; Steinbacher, Jana; Sulosaari, Virpi; O'Higgins, Niall; Benstead, Kim; Medical and DentalIntroduction: Multidisciplinary and multi-professional collaboration is vital in providing better outcomes for patients The aim of the INTERACT-EUROPE Project (Wide Ranging Cooperation and Cutting Edge Innovation As A Response To Cancer Training Needs) was to develop an inter-specialty curriculum. A pilot project will enable a pioneer cohort to acquire a sample of the competencies needed. Methods: A scoping review, qualitative and quantitative surveys were undertaken. The quantitative survey results are reported here. Respondents, including members of education boards, curriculum committees, trainee committees of European specialist societies and the ECO Patient Advisory Committee, were asked to score 127 proposed competencies on a 7-point Likert scale as to their value in achieving the aims of the curriculum. Results were discussed and competencies developed at two stakeholder meetings. A consultative document, shared with stakeholders and available online, requested views regarding the other components of the curriculum. Results: Eleven competencies were revised, three omitted and three added. The competencies were organised according to the CanMEDS framework with 13 Entrustable Professional Activities, 23 competencies and 127 enabling competencies covering all roles in the framework. Recommendations regarding the infrastructure, organisational aspects, eligibility of trainees and training centres, programme contents, assessment and evaluation were developed using the replies to the consultative document. Conclusions: An Inter-specialty Cancer Training Programme Curriculum and a pilot programme with virtual and face-to-face components have been developed with the aim of improving the care of people affected by cancer.Publication Open Access A new wave of leaders: Early evaluation of the interdisciplinary Foundations of Leadership in Radiation Oncology (FLiRO) program(Elsevier, 2022-10-25) Turner, Sandra; Benstead, Kim; Millar, Barbara-Ann; Morris, Lucinda; Seel, Matthew; Leech, Michelle; Eriksen, Jesper; Giulani, Meredith; Benstead, Kim; Medical and DentalPurpose Effective leadership across all areas of radiation oncology (RO) is vital to fully realise the benefits of radiation therapy in cancer care. We report outcomes of a novel interdisciplinary leadership program designed for RO professionals under a global joint society initiative. Methods The Foundations of Leadership in RO (FLiRO) program was designed for aspiring RO leaders. Initially delivered in a blended learning format, it was adapted to fully virtual in 2021. It comprised a webinar tutorial, on-line modules and homework followed by ‘live’ in-person/virtual workshops over an approximately 6-week period. Topics included personal awareness, effective teamwork, quality improvement skills, leading change and conflict management. An immediate post-program online survey was performed using Likert scales to measure self-reported educational value, interaction with others and the likely application of learning to practice. Open comments were invited. Results 170 participants from 36 countries and 6 continents took part from 2018 to 2021 (99 doctors, 36 physicists, 32 radiation therapists/RTTs and 3 others). 141 (83%) participants responded to the post-program survey. Average weightings for responders’ views on whether pre-determined learning objectives were met ranged from 4.30 to 4.61 on a 5-point scale (1 = ‘not met at all’ and 5 = completely met). For the question addressing potential value of learning for application to their workplace, 124 of 130 (95%) of responders indicated that FLIRO would be ‘very useful’ or ‘extremely useful’. Conclusion Initial evaluation of the FLiRO program supports its continuation and expansion with ongoing evolution based on emerging evidence around leadership education and participant feedback.Publication Metadata only Brachytherapy training survey among radiation oncology residents in Europe(Elsevier, 2022-10-31) Sturdza, Alina; Stephanides, Marianne; Jurgenliemk-Schulz, Ina; Eriksen, Jesper; Benstead, Kim; Hoskin, Peter; Vlad, Stefanel; Escande, Alexandre; Corradini, Stefanie; Knoth, Johannes; Westerveld, Henrike; Tagliaferri, Luca; Najari-Jamali, Dina; Konat-Baska, Katarzyna; Plesinac, Vesna; Tan, Li; Nout, Remi; Strnad, Vratislav; Niehoff, Peter; Pieters, Bradley; Tanderup, Kari; Kamrava, Mitchell; Benstead, Kim; Medical and DentalWe aim to investigate the current state of brachytherapy (BT) training among the radiation oncology trainees in Europe. Material and methods: A 22-question online survey based on the one by the American Association of Radiation Oncology Residents (2017) with added queries pertinent to training in Europe was sent to 1450 residents in two iterations. These included site-specific training, volume of experience, barriers to training, institutional support, and preferences for further education. Responses to individual statements were given on a 1 to 5 Likert-type scale. The answers were reported by junior (≤3 years of training) and senior years of training (year of training 4/5/6 and junior staff). Descriptive statistics were used to describe frequencies. Results: Residents from 21 European countries participated, 445 (31%) responded. 205 (47%) were senior residents. 60% residents consider that performing BT independently at the end of residency is very or somewhat important. Confidence in joining a brachytherapy practice at the end of residency was high or somewhat high in 34% of senior residents. They reported as barriers to achieving independence in BT to be lack of appropriate didactic/procedural training from supervisors (47%) and decreased case load (31%). 68% reported their program lacks a formal BT curriculum and standardized training assessment. Conclusions: Residents in Europe, feel independent BT practice is very or somewhat important, but do not feel confident they will achieve this goal. To address this gap, efforts are needed to develop and implement a formal and comprehensive BT curriculum with easy access to trained instructors.Publication Metadata only Implementing butterfly volumetric modulated arc radiotherapy (VMAT) with deep inspiration breath hold (DIBH) for mediastinal lymphomas(Elsevier, 2020-01) Salmon, Clare; Benstead, Kim; Bulmer, Naomi; McKenna, Anne; Bestwick, Gillian; Addis, Lisa; Webster, Sharon; Salmon, Clare; Benstead, Kim; Bulmer, Naomi; McKenna, Anne; Bestwick, Gillian; Addis, Lisa; Webster, Sharon; Allied Health Professional; Medical and DentalIntroduction: Radiotherapy for mediastinal lymphomas is associated with significant long term side effects particularly to the heart, lungs and breasts1&2. Studies have shown that the butterfly technique can reduce dose to these organs3. This technique was implemented in combination with voluntary DIBH to manage target volume motion and reduce dose to the heart. Voluntary DIBH allowed the target volume to contract left/right and elongate anterior/posterior so that the main mediastinal volume was positioned away from the lungs and heart. Voluntary DIBH does not involve costly equipment and is well tolerated by patients. The technique was adapted from the breast protocol previously implemented in the department. Method and Materials: Patients were scanned in a modified 7 point thermoplastic shell, made with the patient in voluntary DIBH (patient breathing after every 20seconds before going back into breath-hold). Measurements from the alignment tattoos to in room lasers during voluntary DIBH at CT were recorded and DIBH stability maintained during treatment by visual alignment of lasers to reference marks drawn on using the recorded measurements. Organs at risk and clinical volumes were outlined. Field placement was considered carefully as the angles were limited due to the large head of the Varian LINACS. Routinely superior/inferior, anterior, and posterior arcs were used. Depending on the size and position of target volume another lateral beam may utilised. Planned using Pinnacle SmartArc with arcs split to keep within a 20second limit. Results: Implementation: A Day 0 was introduced for a dummy run. Patients practiced holding their breath for 20seconds, however the CBCT/arcs took longer. CBCT/treatment was interrupted to allow the patient to breathe normally before commencing breath hold again. Pitch caused set-up issues in 7 cases. Most patients were able to comply with consistent breath hold. CT, planning and Treatment times are longer which can have an impact on a busy department. Conclusion and Discussion: A total of 13 patients have been treated with this technique. Further work is being undertaken to investigate the average treatment times, DVHs and imaging.Publication Metadata only European Cancer Summit 2022 submission for Workforce Network What is it valuable for trainees in Interprofessional education in cancer care: a qualitative approach(Elsevier, 2023-03-05) Díez de los Ríos, Celia; McInally, Wendy; Benstead, Kim; O'Higgins, Niall; Benstead, Kim; Medical and DentalBackground The INTERACT Europe project is developing an inter-specialty oncology curriculum. As part of this project the team wanted to explore, “What is it valuable for trainees to learn in order to work more effectively with different specialties and professions to deliver better care and to provide psychosocial and nutritional support for cancer patients?”. To answer some of the concerns a learning needs analysis with a questionnaire was distributed to develop the curriculum on what health care professionals require to care for people affected by cancer and their family. This study reports the qualitative aspects of this questionnaire. Methods The qualitative data which consisted of eight questions and was transcribed verbatim using thematic analysis1. The transcripts were read until the project team were familiar with the content and analysed to identify emerging themes. The themes were compared, and any discrepancies discussed in more detail with all the participants from the INTERACT working package. The team then conducted a cross analysis and mapped the themes to derive overlapping concepts which then informed the curriculum. Results 115 respondents from the 219 participants answered some or all the qualitative survey questions. Respondents were from all around Europe and had representation from different professions including doctors, nurses and patient advocates and from a large range of clinical experience (from newly qualified to more than 15 years of experience). Fifteen themes were initially identified during initial coding. After comparison and discussion with all the co-investigators they were merged into 5 themes that included: “Unsure of Interprofessional education meaning”, “Barriers and challenges”, “open channels of communication and respect”, “support throughout the cancer journey “and “new way of working” Conclusions The results of the survey alongside the quantitative part will serve to build the curriculum of interprofessional training in cancer care. Participants identified many obstacles in their actual practices to use interprofessional training, but the value to improve teamwork, communication and to improve patient experience and treatment was also captured.