Julian Bloom was a consultant radiotherapist at the Royal Marsden Hospital for the 30 years between 1958 and 1987, and subsequently became an honorary visiting professor at the Institute of Cancer Research. Also, he was founder and co-chairman of the Radiotherapy and Oncology Centre at the Cromwell Hospital, London, where he continued to care for patients until shortly before his death.
He was born at Sheffield where his father, Arthur Bloom, was an engineer, and educated at Fleet School and the Middlesex Hospital, University of London. After house posts at the Middlesex, he was assistant pathologist for two years and was then called up for National Service and appointed a senior specialist in pathology in the RAMC from 1950-52. From 1952-56 he trained in radiotherapy in the Meyerstein Institute of the Middlesex Hospital; his first major contribution to oncology was at this early stage of his career with a seminal study, together with W W Richardson, on ‘Histological grading and prognosis in breast cancer: a study of 1409 cases of which 359 have been followed for 15 years.’ This grading of breast cancer remains in widespread use today.
Julian Bloom joined the department of radiotherapy at the Royal Marsden Hospital in 1958, at a time when high energy linear accelerators were becoming available for clinical practice, and he was one of the leaders of a generation of radiotherapists who developed current techniques of external beam radiation. His practice of radiotherapy was characterized by an exacting attention to detail; and proposed radiotherapy fields were frequently adjusted by him with millimetre precision. His trainees regarded approval of their initial radiotherapy plans as a high accolade. His dedication to patient care was uncompromising and his hours of work within the Royal Marsden Hospital soon became legendary. A 12-hour working day was routine, his afternoon clinic rarely finishing before 9pm and occasionally extending past midnight. The same attention to detail was brought to bear on administrative matters and he was twice elected chairman of the department of radiotherapy and oncology. His academic abilities, and his dedication to all aspects of his medical career, were more than matched by the warmth and charm of his personality; those many physicians who devoted long hours accompanying him in clinical or academic pursuits were willing victims of his enthusiasm.
Bloom specialized in the treatment of urological tumours and tumours of the brain, and he made major improvements in the management of both groups. In a series of articles in the 1960s he reported the hormone responsiveness of advanced renal carcinoma and, again, this pioneering work has stood the test of time and remains one of the first approaches to treatment for patients who cannot be cured by surgery. He was an authority on the radiotherapy of bladder cancer and linked the work of the Royal Marsden hospital and the Institute of Urology in the analysis of combined modality therapies for locally advanced tumours.
The major enterprise of Julian Bloom’s career was the establishment of a specialized brain cancer unit at the Royal Marsden Hospital, with the support of surgical colleagues at Atkinson Morley’s Hospital, the Hospital for Sick Children, Great Ormond Street, and the National Hospitals for Nervous Diseases, Queen Square. He saw the need for broadbased investigation of these rare and devastating diseases and his unit incorporated both child and adult patients, and medical specialists in endocrinology, psychology and rehabilitation. Additionally, the unit had strong links with the Institute of Cancer Research, and the cancer research fund which bears his name supported the investigation of brain tumour chemotherapy in a laboratory setting. Clinical investigations were based on the radiotherapy of brain tumours but characteristically encompassed also hypothermia, radiosensitizers, immune modulation and high dose chemotherapy in a series of collaborative research protocols. His personal series of patients with brain tumours validated the use of radiotherapy for pituitary tumours, craniopharyngioma and meningioma. He saw gratifying improvements in outcome for children with brain tumours, and as chairman of the brain tumour study group of the International Society of Paediatric Oncology (SIOP) he developed the role of adjuvant chemotherapy in medulloblastoma. His reported results in the management of childhood brain tumours have become benchmarks against which future progress must be measured, and his 30 years in the field were honoured by an International Neuro-oncology Conference held at the Royal Marsden Hospital in September 1988.
Amongst many professional honours were fellowships of the American Academy of Paediatrics, 1981; the Belgian Radiotherapy Society, 1983; the Royal College of Surgeons of England,1985, and the Venezuelan Cancer Society, 1978. The principal theatre in the new Royal Marsden Conference Centre was named ‘The Julian Bloom Lecture Theatre’.
Sir Gordon Wolstenholme
[The Times, 22 Dec 1988; The Independent, 2 January 1989; Lancet, 1989,1,171]