SINCE the first Maggie's Centre opened in Edinburgh ten years ago, thousands of cancer patients and their families have benefited from its support. But the introduction of centres in Glasgow, Dundee, Inverness and Kirkcaldy have also made life very different for the doctors who deal with cancer patients every day.
The centres were the brainchild of the late Maggie Keswick, who was treated for cancer at the Western General Hospital in Edinburgh, and set about planning centres to help cancer patients.
Doctors working at the hospitals in which the Maggie's Centres are based are among those best-placed to judge their success. Here, five tell the story of the centres in Scotland.
MAGGIE'S CENTRE, WESTERN GENERAL HOSPITAL, EDINBURGH
• MIKE DIXON: the surgeon who first treated Maggie Jencks - the inspiration for Maggie's Centres - and who helped build the first centre:
"WHEN you come up for your chemotherapy, you spend a lot of time waiting around and Maggie realised that there was a need for somewhere people could go that wasn't the hospital.
The Maggie's Centre has such a good atmosphere because of the art, the architecture and the way it is designed to complement the garden. I think it has changed a lot of people's views about how much architecture can influence the way people feel.
"Maggie realised it is not just about living your life, it is about the quality of your life. She was keen on diet and in how things like relaxation can help people cope.
"But it is also important that the information available is good - that allows the patient to make decisions. Ten years ago, there were not such good sources of information - now our leaflets are not just good, they are the best.
"We as doctors help carry a really heavy burden for a short while and we are very aware of patients' needs and emotions but we spend a lot of our time trying to keep people alive. One of the great things about Maggie's is it allows us to concentrate on what we do best."
MAGGIE'S CENTRE, VICTORIA HOSPITAL, KIRKCALDY
• JOHN WILSON: consultant physician and gastroenterologist, who helped write the initial funding application for the latest Maggie's Centre, in Fife
"THE first time I became aware of Maggie's was when I went to visit the centre in Edinburgh, at that time I had the job of co-ordinating cancer services in Fife.
"It is an extraordinary building, like a TARDIS. It doesn't look that big from the outside, but every nook and cranny is carefully utilised.
"More than anything there was a sense of welcome, with a big wooden kitchen table and a well-used kettle and mugs.
"There was lots of information available and you didn't get the feeling anyone was breathing down your neck. There was a different atmosphere from the hospital, but it was almost part of the hospital - I found that inspiring.
"I think there is a strong need for that form of support. When people have a diagnosis of cancer it can be almost like a grief reaction - with disbelief, a feeling of "why me?", which can change to anger and sometimes depression. As medical clinicians we sometimes forget that this is not another person's daily bread. Somewhere like Maggie's helps them to come to terms early on with the diagnosis and to move them on to a new phase.
"I think Maggie's complements what the hospital does but it is also very different. The hospital focus is very much on tasks, whereas Maggie's is about starting from the point of view of the patient and responding to their situation. It's non-physical: you could almost say spiritual. Probably the best way to describe it is that it's about heart."
MAGGIE'S CENTRE, NINEWELLS HOSPITAL, DUNDEE
• ALASTAIR THOMPSON: surgical oncology professor, Dundee University
"WE WERE really proud that Frank Gehry did such a fantastic design for Maggie's Dundee. It's stunning, it's won so many prizes and it's even been used as an image on stamps. Some people within the NHS were slow to understand just how much better it can make things for patients, relatives and members of staff. We only have a limited amount of time to talk to patients, and faced with cancer people only take in so much at a time. Maggie's makes the information available when people are ready to use it. And there are other things which can improve people's quality of life, such as relaxation classes and discussion groups.
"Having a positive attitude and support from family and friends can make a huge difference to how people feel - and there is some evidence that mind-over-matter can improve the way treatment is tolerated.
Maggie's Centres are one of the best advances we have had in cancer care in many years. Any support people can give them is extremely worthwhile."
MAGGIE'S CENTRE, WESTERN INFIRMARY, GLASGOW
• ALAN RODGER: director of Beatson Oncology Centre
"MAGGIE'S Centre in Glasgow has such a welcoming ambience, I think it has changed the way people feel about buildings and design. It has shown you can put a colour on the wall that isn't magnolia, have nice furniture and use light.
"We can give information, but Maggie's also offers psychological support, relaxation, and benefits advice, which can be very useful.
"Patients are always aware of taking up your time. I have had so many patients saying: "Doctor, you're busy, I'm fine." At Maggie's people can take their time, and we know people are being offered support, information and safe complementary therapies.
"The thing that struck me about Maggie's the first time I went into the one in Edinburgh was seeing a bunch of men going into a discussion group. Seeing middle-aged Scottish men sitting around talking about their health and supporting each other made me think: 'There's an atmosphere here that works. There is really something different going on here."
MAGGIE'S CENTRE, RAIGMORE HOSPITAL, INVERNESS
• DR DAVID WHILLIS: head of service in the department of clinical oncology at Raigmore Hospital, in Inverness
"IN INVERNESS, our introduction to Maggie's came with a clinical psychologist to help cancer sufferers cope with the diagnosis and often quite long treatments that are involved. We weren't able to offer that service before so we were very pleased when Maggie's Centres funded the post.
"For some people, the kind of services offered by Maggie's are not for them, but for others it becomes very important.
I think since Maggie's arrived it has had an influence. We now take a much more proactive approach to talking through things people might expect.
"Maggie's Highland is a very clever design, like a boat. It's a completely different sort of space, none of the walls are straight, all the doors are curved. It's a really arty building. It's non-standard, non-authoritarian, a nurse and doctor-free zone. It brings calm to people at a really terrible time in their lives."