DAVID SAFFER meets a dedicated doc who is excited about the future . . . but bemoans the price of disease-busting drugs which the NHS just cannot afford
THE worlds of medicine and football have been intrinsically linked throughout consultant haematologist Professor Anthony Goldstone's life.
A passionate Manchester City supporter, he says: "Football is never far away from conversations with patients and medical associates.
"I have a Manchester City mug on my desk and it becomes an extraordinary connecting point with some patients, not because they're City supporters but because they connect to me as a person.
"They realise I'm not just a professor but someone they can talk to.
"It absolutely helps to break the ice."
Recently retired from his NHS practice, Prof Goldstone is honorary consultant at University College Hospital and chairman of the Royal National Orthopaedic Hospital.
A former director of the North London Cancer Network, he has also published around 300 original research papers on haematology.
Born in Glasgow, Prof Goldstone is the middle child of Edith and Norman Goldstone.
The family moved to the Lancashire town of Leigh when the future medic's father took up a post as a general practitioner before the Second World War.
"My mother was from a prominent Glasgow Jewish family," he recalled.
"Apart from being the first Jewish woman from Glasgow to attend university, studying religious studies and Hebrew, she was also Talmud Torah headmistress and a distinguished teacher and scholar.
"In Leigh it was difficult for a Jewish household.
"There were no other Jews locally but my father's family was from Cheetham Hill in Manchester so we commuted regularly to buy kosher food.
"We attended the old Central Shul where I was barmitzvah."
Prof Goldstone, his late sister, Iris and younger brother Phil went to Bolton School.
Medical studies soon ensued at St John's College, Oxford, but it was not a case of following in his dads' footsteps.
"My father was assistant to an elderly English-style GP who had a chauffeur to take him round town," he recalled.
"He did not say medicine was the thing to do but there was an indirect influence.
And after qualifying as a doctor in 1968, a move into haematology was fortuitous after he began his medical career with a senior house officer post in Edinburgh.
"One day during a chat over career choices, a senior guy in haematology told me they had a registrar job and felt it was an area that would be a future speciality," he said.
"It sounded sensible and I wanted to be a physician rather than a surgeon because I never felt I had the manual dexterity for surgery.
"I took the job for 12 months and never left it."
Awarded a CBE for a variety of clinical, academic and managerial contributions in 2008, Prof Goldstone always tries to put patients at ease.
In leukaemia one of the greatest advancements for haematology has been the emergence of Glivec.
"By taking a tablet every day, 80 to 90 per cent of people are alive 10 years later," Prof Goldstone continued.
"It's a drug that hits the lesion of the cancer alone without doing damage to normal cells.
"You get a massive leap in advancement of therapy accompanied by a massive reduction in the toxicity of the treatment."
Another major advancement is the development of bone marrow transplantation as a treatment for leukaemia, which resulted in a Nobel Prize in physiology and medicine for pioneer Dr Don Thomas.
"When you are using new techniques you get the most difficult end-stage patients," Prof Goldstone said.
"So even if you are using a good drug, results may be invisible as it's too late for those patients.
"This is what happened to Thomas. He spent years curing no more than about five per cent of patients sent to him until people realised things had to be done much earlier in the disease.
"By not waiting till the very end, the toxicity of the treatment was much improved."
Performing these procedures is complex and requires a dedicated team of skilled medics and nurses.
Dealing with young patients is always emotive, but the success rate has increased enormously and Prof Goldstone has the skills to treat all types of patients.
"I'm lucky that one of my skills is to connect with almost anybody," he said.
"But I'm more anxious dealing with a young person because if it doesn't work out, although loss of life is equal it can feel worse if someone is 25 rather than 75."
"Patients and doctors have to be resilient.
"Sometimes you can do an enormous amount of work for months but a patient gets sick and goes to intensive care inside 24 hours.
"You have to be the kind of person who can get up off the canvas and come back fighting.
"That ability and a strong home and family life keep me sane and strong."
Looking ahead, Prof Goldstone believes further advancements will occur - but spending cuts are an issue.
"Patients want to know when they see me what caused the disease and whether it can be cured," he said.
"We are finding in more and more haematology diseases I deal with that its emergence relates to specific alterations in some genes.
"There will be more targeted therapy and a steady improvement in the outcome of those diseases and I have truly been involved for bringing 'hotshot science' to the bedside.
"It's exciting, but we are going through a terrible phase where when a drug company produces a drug everybody wants, the price is extortionate at the outset.
"We feel enormously deprived in the NHS when we do not get the latest drugs available.
"We go to international meetings, present and listen to studies, and feel like poor relations.
"I get people referred from Turkey or Cyprus for a second opinion and they have already been given drugs we cannot even give our own patients. It promotes great anger.
"Nevertheless, I think there will be continued improvements in all the major areas in which I work."
And the most common question he is asked by his Arsenal-supporting patients?
"Will we cure cancer before City win anything?"