Haematological Cancer

Services

Bedford Hospital NHS Trust

Haematological Cancer Services

Haematological cancer services at Bedford Hospital are provided by the Haematological Team

The Haematological Team

Consultants
Dr S Bitla 01234 355 122 ext:2446 Shekhar.Bitla@bedfordhospital.nhs.uk
Dr P M Cabrera 01234 355 122 ext:2446 Martin.Cabrera@bedfordhospital.nhs.uk

Outpatient Appointments

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

Outpatient clinics take place:

Day Morning Afternoon
Monday - -
Tuesday Dr Martin -
Wednesday - -
Thursday - -
Friday Dr Bitla  -

Who to Refer

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

Information

Be aware that haematological cancers can present with a variety of symptoms that may have a number of different clinical explanations.

Combinations of the following symptoms and signs warrant full examination, further investigation (including blood count and film) and possible referral:

  • Fatigue
  • Drenching night sweats
  • Fever
  • Weight loss
  • Generalised itching
  • Breathlessness
  • Bruising
  • Bleeding
  • Recurrent infections
  • Bone pain
  • Alcohol-induced pain
  • Abdominal pain
  • Lymphadenopathy
  • Splenomegaly

The urgency of referral depends on the symptom severity and findings of investigations.

Immediate Referral (within a few hours or even more quickly if required)

Refer immediately patients:

  • With a blood count/film reported as acute leukaemia.
  • With spinal cord compression or renal failure suspected of being caused by myeloma.

Urgent Referral within 2 Weeks (under 2 week rule)

Refer urgently patients:

  • with persistent unexplained splenomegaly.

Investigations

In patients with:

  • Persistent unexplained fatigue, carry out a full blood count, blood film and erythrocyte sedimentation rate, plasma viscosity or C-reactive protein (according to local policy).  Repeat at least once if the patient's condition remains unexplained and does not improve
  • Unexplained lymphadenopathy carry out a full blood count, blood film and erythrocyte sedimentation rate, plasma viscosity or C-reactive protein (according to local policy)
  • Any of the following additional features of lymphadenopathy:
    • Persistence for 6 weeks or more
    • Lymph nodes increasing in size
    • Lymph nodes greater than 2cm in size
    • Widespread nature
    • Associated splenomegaly, night sweats or weight loss

Investigate further and/or refer:

  • Unexplained bruising, bleeding and purpura or symptoms suggesting anaemia, carry out a full blood count, blood film, clotting screen and erythrocyte sedimentation rate, plasma viscosity or C-reactive protein (according to local policy).
  • Persistent and unexplained bone pain, carry out a full blood count and X-ray, urea and electrolytes, liver and bone profile., PSA test (in males) and erythrocyte sedimentation rate, plasma viscosity or C-reactive protein (according to local policy).

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 Luton & Dunstable Hospital

Resources

Map of Medicine Patient Pathway

Map of Medicine Patient Pathway - suspected myeloma
Map of Medicine Patient Pathway - suspected lymphoma

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

Multiple Myeloma NHS Choices:
http://www.nhs.uk/conditions/Multiple-myeloma/Pages/Introduction.aspx
Leukaemia Care:
http://www.leukaemiacare.org.uk/1/home.html
The Multiple Myeloma Research Foundation
http://www.themmrf.org/
Myeloma UK:
http://www.myeloma.org.uk/
Macmillan Cancer Support - Myeloma:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Myeloma/Myeloma.aspx
MacMillan Cancer Support - Leukaemia Overview:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Leukaemia/Leukaemiaoverview.aspx
MacMillan Cancer Support - Acute Lymphoblastic Leukaemia:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Leukaemiaacutelymphoblastic/ALL.aspx
MacMillan Cancer Support - Acute Myeloid Leukaemia:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Leukaemiaacutemyeloid/AML.aspx
MacMillan Cancer Support - Chronic Lymphocytic Leukaemia:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Leukaemiachroniclymphocytic/CLL.aspx
MacMillan Cancer Support - Chronic Myeloid Leukaemia:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Leukaemiachronicmyeloid/CML.aspx
Acute Lymphoblastic Leukaemia NHS Choices:
http://www.nhs.uk/conditions/leukaemia-acute-lymphoblastic/Pages/Introduction.aspx
MacMillan Cancer Support - Lymphoma Overview:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Lymphoma/Lymphomaoverview.aspx
MacMillan Cancer Support - Hodgkin Lymphoma:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/LymphomaHodgkin/Hodgkinlymphoma.aspx
MacMillan Cancer Support - Non-Hodgkin Lymphoma:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Lymphomanon-Hodgkin/Non-Hodgkinlymphoma.aspx
Action for Sick Children:
http://www.actionforsickchildren.org/
Anthony Nolan Trust:
http://www.anthonynolan.org/
Myeloma UK:
http://www.myeloma.org.uk/
Myeloma UK:
http://www.myeloma.org.uk/

Cancer Network

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



Last updated: 24/01/2013

Update due: 24/01/2014