Sid J Arnott MB ChB, FRCS(Ed), DMRT, FRCR

Sid was educated at Roundhay School, Leeds, and Edinburgh University, where he graduated in 1962 and planned for a surgical career as a junior doctor at Edinburgh Royal Infirmary.  Whilst preparing for FRCS, he was appointed SHO in Radiotherapy, which was a well-recognised study job for aspiring surgeons. At the time, in the 1960s, chemotherapy was limited to nitrogen mustard: the vinca alkaloids had only just been discovered. Radiotherapy was the mainstay of treatment and the service was regional, covering south east Scotland.  Transport, including the ambulance service, was limited and many patients receiving radiotherapy were ward in-patients, due to travel difficulties.  Following the morning round, there was then very little left for a senior house officer to do, allowing plenty of time “to hit the books”.  But the job was more than a means to an end. This was where Sid first developed his passion for radiotherapy. He was fascinated by localisation and guided treatment of the tumour-bearing area.  Much of the philosophy was analogous to surgery.  Wisely he decided to complete his surgical training, latterly working as surgical registrar to Mr J S Jeffrey, a prominent Edinburgh surgeon and was duly rewarded FRCS(Ed) in 1966.  His rounded surgical training was a huge advantage in later years in the multidisciplinary management of colorectal and anal tumours and he fully realised the importance of joint attendance with the surgeon for assessment under anaesthesia (EUA) for treatment planning.

After gaining his FRCS, Sid turned his interest to Radiotherapy, attending Prof R McWhirter’s DMRT course, which he considered generically useful irrespective of any future career choice.  He then decided on a career in cancer management and obtained the FRCR in 1970.

A seminal stage of his career development was his appointment in 1974 as Senior Lecturer with Bill Duncan, working on the evaluation of Neutron Therapy.  During the first year of this appointment he worked with Mary Catterall in the Neutron Clinic at Hammersmith Hospital and with Neutron Therapy research colleagues in the USA.  He returned to Edinburgh in 1975, as the research programme properly got underway. 

Apart from clinical commitments, Sid was very much involved with education and research in Scotland and in the UK in general.  With his surgical background, he had a close working relationship with the Royal College of Surgeons of Edinburgh and became an examiner for the primary fellowship examination.  He held senior administrative positions with the Scottish Home and Health Department helping to establish consultant posts in Scotland and the co-ordination of radiological services.

At this point Sid developed a career-long interest in the place of radiotherapy, and subsequently chemotherapy, in the management of gastrointestinal tumours. His first publication of note in the Lancet was carcinoma of the oesophagus after gastric surgery and its association with chronic gastro-oesophageal reflux (1). In 1975, he published one of the earliest studies on the value of 5Fluorouracil and radiotherapy in patients with advanced rectal cancer and showed that the duration and dose of radiation required for palliation in advanced rectal cancer could be reduced significantly by the addition of 5-fluorouracil (2).   Nationally, he became involved with studies investigating cancer management in rectal, gastric and oesophageal cancers, serving on various MRC committees. A selection of his seminal publications is referenced (1-3, 5-8, 14-18).  He was visiting consultant radiologist and professor at various centres in the USA during this time.

Over the next decade his expertise centred on neutron therapy, with the publication of numerous papers, and a sample is referenced below (4, 7, 9-13). The sad conclusion was that neutron therapy was too harmful to be a viable alternative to x-ray therapy and the project was abandoned.  However the question remained as to whether a high energy neutron machine might overcome some of the problems encountered in Edinburgh and he sat on various advisory committees concerned with the establishment of new units at Clatterbridge and St Thomas’ Hospitals. 

In 1985 he moved to London to take up a consultant radiotherapist post at St Bartholomew’s Hospital. He became more involved with the Royal College of Radiologists, as an examiner in the primary fellowship, in education developing a new FRCR course for trainees, and a member of Council in 1989.

There were new clinical interests in gynaecological malignancy and lymphoma, working with Professors John Shepherd, JS Malpas and TA Lister.

Another interest was the treatment of brain tumours in conjunction with Mr F Afshar. Sid’s particular expertise was stereotactic insertion of radioactive sources into the tumour area. 

He developed a close working relationship with the surgeons at St Marks Hospital, where he became Honorary Consultant.

He had various roles on the Medical Research Council, advising on gastrointestinal and rectal cancer, neutron therapy, head and neck cancer and sarcoma management

Shortly after his appointment at St Bartholomew’s’ Hospital, he was awarded the Cochrane Shanks Travelling Professorship for 1985 in recognition of his contribution to research and teaching. The purpose of the Fellowship was to progress the development of cancer treatment in a developing country, in this case Malaysia. The remit was to deliver a series of lectures and participate in outpatient clinics. It was the start of a very long and fruitful relationship with his Malaysian colleagues, and many mutually enjoyable return visits to Kuala Lumpur.

Sid married Di in 1997 and my wife Tina had the honour of being asked to be his “best man”. We have remained close family friends since Hammersmith days and have shared some wonderful holidays together, and continue to do so, including the recent wonderful RAD51 trip to Myanmar, where Sid celebrated his 80th birthday in quite some style.

Sid and Di split their time between London, Spain and Edinburgh. Sid’s passion is music and he is a regular attender at the Proms and Edinburgh Festival. His son Ian is a well-known academic gastroenterologist in Edinburgh and his daughter Louise a senior nurse in the Borders. He has four grandchildren. He spends a lot of time in the kitchen at cordon-bleu level. Attention to detail comes to mind. He also loves a meal out.

Sid retired in 1997 with more than 70 publications and contributions to major oncology textbooks including the Oxford Textbook of Oncology and The Treatment of Cancer, edited by Keith Halnan and Karol Sikora.  His major contributions were the treatment of gastrointestinal cancers and the application of neutron therapy.  But education also featured prominently throughout his career.

Andrew J Shorthouse MBBS MS FRCS ARBSA

Sheffield, August 2019

References

  1. Shearman DC, Finlayson ND, Arnott SJ, Pearson JG. Carcinoma of the oesophagus after gastric surgery. The Lancet. 1970 Mar 21; 295(7647):581-2.
  2. Arnott SJ. The value of combined 5-fluorouracil and x-ray therapy in the palliation of locally recurrent and inoperable rectal carcinoma. Clinical radiology. 1975 Jan 1; 26:177-82.
  3. SJ Arnott. The MRC trial of low-dose preoperative radiotherapy in operable rectal cancer. In Henri J Tagnon and Maurice J Staquet (eds) (1979) Controversies in Cancer: design of trials and treatment Proceedings of an EORTC symposium held in Brussels, Belgium, April 26 –29, 1978 New York: Masson Publishing USA, Inc.
  4. Duncan W, Arnott SJ, Orr JA, Kerr GR. The Edinburgh experience of fast neutron therapy. International Journal of Radiation Oncology• Biology• Physics. 1982 Dec 1;8(12):2155-7.
  5. A trial of preoperative radiotherapy in the management of operable rectal cancer. First Report of an MRC Working Party. Brit J Surg 1982;69;Issue9: 513-518
  6. Duncan W, Smith AN, Freedman LS, Alderson MR, Arnott SJ, Bleehen NM, et al. The evaluation of low dose pre‐operative X‐ray therapy in the management of operable rectal cancer; results of a randomly controlled trial. Brit J Surg 1984; 71: 21-25.
  7. Duncan W, Arnott SJ, Jack WJL, Orr JA, Kerr GR, Williams JR. Results of two randomised clinical trials of neutron therapy in rectal adenocarcinoma.. Radiotherapy and Oncology.1987;8; 3: 191-198
  8. Clinico-pathological features of prognostic significance in operable rectal cancer in 17 centres in the U.K. (Third report of the M.R.C. Trial, on behalf of the Working Party). Br J Cancer. 1984 Oct; 50(4):435-42.
  9. Duncan W, Arnott SJ, Jack WJL, et al. A report of a randomized trial of d(15)+Be neutrons compared with megavoltage X ray therapy of bladder cancer. Int J Radiation Oncology*Biology*Physics.1985.11;12: 2043-2049
  10. Duncan W, Williams JR, Kerr GR, Arnott SJ, Quilty PM, Rodger A, MacDougall RH, Jack WJ. An analysis of the radiation related morbidity observed in a randomized trial of neutron therapy for bladder cancer. Int J Radiat Oncol Biol Phys. 1986; 12 :2085–92
  11. Duncan W, Orr JA. Arnott SJ, et al. Fast neutron therapy for squamous cell carcinoma in the head and neck region: Results of a randomized trial. Int J Radiat Oncol Biol Phys. 1987; 13:171-178
  12. Arnott SJ. Fast neutron therapy in pelvic malignancy. Brit J Radiol. 1987;60:317
  13. MacDougall HR & J, Arnott, S. The cyclotron saga.  BMJ (Clinical research ed.). 1990. 300. 1721.
  14. Arnott SJ, Cunningham D, Gallagher J et al. Epidermoid anal cancer: results from the UKCCCR randomised trial of radiotherapy alone versus radiotherapy, 5-fluorouracil, and mitomycin. Lancet 1996; 348: 1049 –1054.
  15. Arnott SJ. Radiotherapy. In: Colorectal Cancer 1982 (pp. 113-125). Springer, Berlin, Heidelberg.
  16. Duncan W, Smith AN, Freedman LS, Alderson MR, Arnott SJ, Bleehen NM, Bond WH, Crowther D, Deeley TJ, Duthie HL, Dykes PW. The evaluation of low dose pre‐operative X‐ray therapy in the management of operable rectal cancer; results of a randomly controlled trial. British journal of surgery. 1984 Jan; 71(1):21-5.
  17. Arnott SJ, Duncan W, Kerr GR, Walbaum PR, Cameron E, Jack WJ, Mackillop WJ. Low dose preoperative radiotherapy for carcinoma of the oesophagus: results of a randomized clinical trial. Radiotherapy and Oncology. 1992 Jun 1; 24(2):108-13.
  18. Arnott SJ, Stenning SP, Hardcastle JD, McAdam WA, Greaney MG, MacLeod DA, Starnatakis J, Eltringham WK, Espiner HJ, deCastella HC, Bardsley D. Randomised trial of surgery alone versus surgery followed by radiotherapy for mobile cancer of the rectum. Lancet. 1996 Dec 14; 348(9042):1610-4.