Upper Gastrointestinal Cancer

Services

Bedford Hospital

Upper Gastrointestinal Cancer Services

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

The Team

The Consultants and Clinical Nurse Specialists are:

Consultants
Dr R Harvey 01234 355 122 ext:2872 Rory.Harvey@bedfordhospital.nhs.uk
Dr J Harvey 01234 355 122 ext: 2300 Ahmed.Eldin @bedfordhospital.nhs.uk
Dr S Al-Musa 01234 355 122 ext: 2872 Saif.AlMusa@bedfordhospital.nhs.uk
Dr Y Al-Naeeb 01234 355 122 ext: 2783 Yasseen.Al-Naeeb@bedfordhospital.nhs.uk

Nurse
Eleanor Church 01234 355122 ext 4038 Eleanor.Church@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 - Dr Y Al-Naeeb
Tuesday Dr R Harvey, Dr Al-Musa -
Wednesday Dr J Harvey -
Thursday - -
Friday - -

A patient may be referred directly to endoscopy if deemed appropriate for their first appointment. There are appointment slots on each day of the week.

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.

Urgent referral for endoscopy, or to a specialist within 2 weeks

Refer urgent for endoscopy, or to a specialist, patients of any age with dyspepsia and any of the following:

  • Chronic gastrointestinal bleeding.
  • Dysphagia.
  • Progressive unintentional weight loss.
  • Persistent vomiting.
  • Iron deficiency anaemia.
  • Epigastric mass.
  • Suspicious barium meal result.

Urgent referral within 2 weeks (under 2 week rule)

Refer urgently patients presenting with:

  • Dysphagia.
  • Unexplained upper abdominal pain and weight loss, with or without back pain.
  • Upper abdominal mass without dyspepsia.
  • Obstructive jaundice (depending on clinical state) - consider urgent ultrasound if available.

Consider urgent referral for patients presenting with:

  • Persistent vomiting and weight loss in the absence of dyspepsia.
  • Unexplained weight loss or iron deficiency anaemia in the absence of dyspepsia.
  • Unexplained worsening of dyspepsia and:
    • Barrett's oesophagus.
    • Known dyspepsia, atrophic gastritis or internal metaplasia.
    • Peptic ulcer surgery over 20 years ago.

Urgent endoscopy

Refer urgently for endoscopy patients aged 55 years and older with unexplained and persistent recent-onset dyspepsia alone.

Please Note: For patients under 55 years, referral for endoscopy is not necessary in the absence of alarm symptoms.

Patients being referred urgently for endoscopy should ideally be free from acid suppression medication including proton pump inhibitors or H2 receptor agonists, for a minimum of 2 weeks.

Investigations

When referring, a full blood count may assist specialist assessment in the outpatient clinic.  This should be carried out in accordance with local arrangements.

For all patients with new-onset dyspepsia, consider a full blood count to detect iron deficiency anaemia.

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

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

Oesophageal Cancer NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-oesophagus/Pages/Introduction.aspx
Barrett's Oesophagus Campaign:
http://www.barrettscampaign.org.uk/
Cancer Research UK - Stomach Cancer:
http://cancerhelp.cancerresearchuk.org/type/stomach-cancer/
Cancer Research UK - Oesophageal Cancer:
http://cancerhelp.cancerresearchuk.org/type/oesophageal-cancer/
World Cancer Research Fund:
http://www.wcrf-uk.org/cancer_prevention/types_of_cancer/index.php
Macmillan Support - Oesophageal Cancer
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Oesophagusgullet/Oesophagealcancer.aspx
Macmillan Support - Stomach Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Stomach/Stomachcancer.aspx

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