Bone Cancer and Sarcoma

Services

Bedford Hospital NHS Trust does not receive suspected sarcoma referrals from primary care, these patients are referred from the GP directly to Addenbrooke's Hospital

Addenbrooke's Hospital

Sarcoma Diagnostic Clinic for the diagnosis of soft tissue sarcoma of the extremities or proximal trunk only.  For any other site refer urgently on the 2 week wait site specific pathway.

Cancer Services - Sarcoma Unit

Sarcomas - types of Cancer of the bone

This Unit is also the regional centre for the treatment of sarcomas (types of cancers of the bone, muscle and connective tissue).

Contact: Box 193
General enquiries: 01223 217 074
Oncology Day Unit: 01223 216 395

Facilities in the Unit:

  • We liaise with local and national sarcoma centres for specialist surgery;
  • We have facilities for conformal radiotherapy planning;
  • We have facilities for all types of sarcoma chemotherapy.

Special clinical and research interests:

  • Primitive neuroectodermal tumours (PNET);
  • Ewing's sarcoma;
  • Adolescent and young-adult sarcomas.

Who to Refer

All patients can be referred; particularly those covered by the Anglia Cancer Network area - NHS Bedfordshire residents in North and East Bedfordshire.

Immediate X-ray - Bone Tumours

Refer for an immediate X-ray a patient with a suspected spontaneous fracture.

If the X-ray:

  • Indicates possible bone cancer, refer urgently.
  • Is normal but symptoms persist, follow up and/or request repeat X-ray, bone function tests or referral.

Urgent Referral within 2 Weeks - Soft Tissue Sarcomas

Refer urgently if:

  • A patient presents with a palpable lump that is:
    • Greater than about 5cm in diameter.
    • Deep to fascia, fixed or immobile.
    • Increasing in size.
    • Painful.
    • A recurrence after previous excision.

If patient has HIV, consider Kaposi's sarcoma and make an urgent referral if suspected.

Urgent Investigation

  • Urgently investigate increasing, unexplained or persistent bone pain or tenderness, particularly pain at rest (and especially if not in the joint), or an unexplained limp.  In older people metastases, myeloma or lymphomas, as well as sarcoma, should be considered.

All adults aged over 16 in the Anglia Cancer Network catchment area who present with sarcoma or suspected sarcoma in primary care.  The geographic area which makes up the Anglia Cancer Network is covered by the following PCTs:

  • NHS Peterborough
  • NHS Cambridgeshire
  • NHS Bedfordshire - Mid and North Bedfordshire
  • NHS Norfolk
  • NHS Great Yarmouth and Waveney
  • NHS Suffolk

Patients outside of the Anglia Cancer Network are usually referred to Hospitals within their Cancer Network area. NHS Bedfordshire residents in South Bedfordshire and NHS Luton residents are covered by the Mount Vernon Cancer Network area.

Site of suspected Soft Tissue Sarcoma Location of service Lead Clinician Method of referral
Extremities or Proximal Trunk Sarcoma Diagnostic Clinic Cambridge University Hospitals NHS Foundation Trust (CUHFT) Dr Helena Earl, Consultant Oncologist Choose and Book, or faxed referral to 01223 274409
Any other site Refer urgently on the 2 week wait site-specific pathway

Macmillan Cancer Support Rapid Referral Guidelines

Macmillan Cancer Support Rapid Referral Guidelines

Who not to Refer

Patients outside of the Anglia Cancer Network area are usually referred to Hospitals within their Cancer Network area.  NHS Bedfordshire residents living in North and East Bedfordshire are included under the Anglia Cancer Network.

South Bedfordshire patients are included under the Mount Vernon Cancer Network and usually referred to the Royal National Orthopaedic Hospital and University College London Hospital.

Resources

Map of Medicine Patient Pathway

Map of Medicine Patient Pathway

NICE Guidelines:

CG27 Referral for suspected cancer: full guideline
http://guidance.nice.org.uk/CG27/Guidance
CG27 Referral for suspected cancer: quick reference guide
http://guidance.nice.org.uk/CG27/QuickRefGuide/pdf/English
CG27 Referral for suspected cancer: information for the public
http://guidance.nice.org.uk/CG27/PublicInfo/pdf/English
CG27 Referral for suspected cancer: NICE guideline
http://guidance.nice.org.uk/CG27/NICEGuidance/pdf/English

Website Resources

Bone Cancer (Sarcoma)  NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-bone/Pages/Introduction.aspx
Bone Cancer Research Trust:
http://www.bcrt.org.uk/
Teen Info on Cancer:
http://www.click4tic.org.uk/understandit/typesofcancer/bonecancer
Teenage Cancer Trust:
http://www.teenagecancertrust.org/
Health Talk Online:
http://www.youthhealthtalk.org/Teenage_Cancer/People/Interview/1171/Category/130
Macmillan Cancer Support - Bone Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Bone/Bonecancer.aspx

Cancer Network

Anglia Cancer Network - for residents from Norfolk, Suffolk, Bedfordshire and Cambridgeshire
http://www.angliacancernetwork.nhs.uk/



Last updated: 25/09/2012

Update due: 25/09/2013