Referrals

Speciality

Cancer

Bedford Hospital Cancer Services

Gynaecological Cancer

Gynaecological Cancer

Services

Bedford Hospital NHS Trust

Gynaecological Cancer Services

Gynaecological cancer services at Bedford Hospital are provided by the Gynaecological Team which consists of Consultants and Clinical Nurse Specialists.

The Gynaecological Team

The Consultants and Clinical Nurse Specialists are:

Consultants
Mr J Brady 01234 355 122 ext: 5780 Jullien.Brady@bedfordhospital.nhs.uk
Miss H Nosib 01234 355 122 ext: 5782 Hema.Nosib@bedfordhospital.nhs.uk

Clinical Nurse Specialists
Lesley Gillon 01234 355 122 ext: 5779 Lesley.Gillon@bedfordhospital.nhs.uk

Outpatient Appointments

Following referral under the 2 week rule, patients will be seen in outpatients by a Consultant Gynaecological Surgeon or another member of the team with 1-2 weeks.

Outpatient clinics take place:

Day	Morning	Afternoon
Monday	-	-
Tuesday	-	-
Wednesday	-	-
Thursday	-	Miss Nosib
Friday	Mr Brady	-

Who to Refer

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

Urgent referral within 2 weeks (under 2 week rule)

Refer urgently patients:

With clinical features suggestive of cervical cancer on examination. A smear test is not required before referrals, and a previous negative result should not delay referral.
Not on hormone replacement therapy with postmenopausal bleeding.
On hormone replacement therapy with persistent or unexplained. postmenopausal bleeding after cessation of hormone replacement therapy for 6 weeks.
Taking tamoxifen with postmenopausal bleeding.
With an unexplained vulval lump.
With vulval bleeding due to ulceration.

Consider urgent referral for patients with persistent intermenstrual bleeding and negative pelvic examination.

Refer urgently for an ultrasound scan patients:

With a palpable abdominal or pelvic mass on examination that is not obviously uterine fibroids or not of gastrointestinal or urological origin. If the scan is suggestive of cancer, an urgent referral should be made. If urgent ultrasound is not available, an urgent referral should be made.

Investigations

A full pelvic examination, including speculum examination of the cervix, is recommended for patients presenting with any of the following:
- Alterations in the menstrual cycle.
- Intermenstrual bleeding.
- Postcoital bleeding.
- Postmenopausal bleeding.
- Vaginal discharge.
In patients with vulval pruritus or pain, a period of 'treat, watch and wait' is reasonable. Active follow-up is recommended until symptoms resolve or a diagnosis is confirmed. If symptoms persist, the referral may be urgent or non-regent, depending on the symptoms and the degree of concern about cancer.

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 Luton & Dunstable Hospital.

Resources

Map of Medicine Patient Pathways

Map of Medicine Patient Pathway - suspected cervical dysplasia and cancer; abnormal cytology
Map of Medicine Patient Pathway - suspected cervical dysplasia and cancer
Map of Medicine Patient Pathway - suspected endometrial cancer
Map of Medicine Patient Pathway - suspected ovarian cancer

NICE Guidelines:

Website Resources

Cervical Cancer NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-cervix/Pages/Introduction.aspx
Jo's Cervical Cancer Trust:
http://www.jostrust.org.uk//
NHS Cervical Screening Programme:
http://www.cancerscreening.nhs.uk/cervical/
Macmillan Cancer Support: Ovarian Cancer
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Ovary/Ovariancancer.aspx

Cancer Networks

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

Last updated: 10/10/2012

Update due: 10/10/2013