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Q&A with Mark Foulkes

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Mark Foulkes: Macmillan Lead Cancer Nurse

mark foulkes

mark foulkes

Source: Macmillan


Job title

Macmillan Lead Cancer Nurse


Berkshire Cancer Centre

In post

Since 2009



Can you tell us about your professional background?

Before becoming a nurse, I completed a degree in biological sciences, but I knew I didn’t want to work in a lab. My mother was a nurse and was always saying it would suit me. I resisted for years but gradually came around to the idea. I applied to the London hospitals to train. St Mary’s was the only one to respond, probably because of my complete lack of experience at the time, but fortunately they took me on as a student nurse. Since starting my training in 1988, I have worked constantly as a cancer nurse.


What does your role involve?

I work partly in the clinical role of nurse consultant, and partly in the more strategic job of lead cancer nurse. As a nurse consultant, a significant part of my work is in clinical practice. I spend half of my week looking after the acute oncology service, doing ward rounds with colleagues. We see people who might be known to us already or who have come in with side effects from treatment, have developed metastases from their cancer, or are diagnosed with a new cancer through an emergency admission.

Our acute oncology service offers advice and support to doctors and nurses caring for people with cancer, as well as to the patients themselves. If needed, we can admit them to our own ward. In many hospitals across the country Macmillan has provided funding and support to set up these services.

I’ve been working with Macmillan for most of the time I’ve been in nursing. They funded my very first clinical nurse specialist job in head and neck cancer in London and many of our posts here at the Berkshire Cancer Centre. It’s good to see the organisation campaigning more, giving a voice to patients, as well as providing fantastic information. You can’t imagine cancer care now without Macmillan.


What is the most rewarding part of your job?

Working with people is very rewarding. Some people ask me if being a cancer nurse is depressing, and I always say no. I can help people, and even if their prognosis is not very good, they always appreciate it. I can’t take away their problems but I can listen to them and offer support.

I love my job and look forward to coming to work – it’s totally integrated into my life. I regard looking after people as a privilege. I think people can be at their very best when they are ill – at their most fantastically stoic and resourceful.

Last year I won the Pride of Reading Health Worker of the Year Award, which was a complete surprise. The person who nominated me was anonymous, but I think it must have been related to my charity work and the fact that I have a very public-facing role. I see a broad range of patients, from people who come to A&E with a cancer-related emergency through to people receiving treatment on the chemotherapy ward, so I’m very visible. The award nomination statement said ‘he’s always there, he works very hard and he’s a total legend!’. So that was very nice to hear.

mark foulkes article

mark foulkes article

Source: Macmillan


What are the challenges?

Not having enough time or resources. I like a bit of chaos and having worked in the health service for 29 years I know you need to be able to think on your feet and fight your corner, often with very limited resources. It always makes me smile that TV programmes like Casualty are so popular and yet the real thing is just outside and not adequately funded. There’s a lot of good work that goes on in the health service but we’ve been running on a shoestring for the past five or six years and that’s tough.


What have been the biggest improvements in cancer care that you have seen?

Survival rates have improved, people live longer, they are fitter, there are a lot more treatment options available and the facilities for patients have got better. There has been a sea change in the way professionals communicate with people. Now you can’t believe that when I first started out in nursing there were debates as to whether people should be told about their diagnosis. It was very common for doctors to be cautious with what they said. Another big change is the knowledgeable patient. Many people research their condition through the internet, which can be very helpful. Occasionally there are issues because of course there’s no filter on the net, but people want to be empowered. The more informed patients are the better, so that they can choose the treatment that’s best for them.


We’ve talked about what has changed over the years you’ve been in cancer nursing, but what would you like to see change in the future?

For me, caring for patients is the most important part of my job. People should always feel looked after. We’ve got very experienced nurses and doctors but there are other professionals who are missing. For example, we need more dietitians and speech therapists so that everyone has the chance to see one if they need to.

We are also moving towards having more cancer care services in the community, which I would like to see more of. There’s no reason why people should come into hospital to have chemotherapy for example. We’ve started to work towards this with mobile chemotherapy units. We’ve got one bespoke service in Bracknell and we are building another one in Thatcham where people can park more easily.


Finally, what are you most proud of?

I’m very proud of the team here, the work they do and the cancer centre. We recently received our Cancer Patient Experience Survey results and they were really good. I’m very proud of the fact that people feel well looked after here.


This article was featured in Mac Voice, our quarterly magazine for Macmillan health and social care professionals, showcasing their work and sharing good practice. Want to read more like this? Check the archives for more articles.

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