Urological Cancer

Services

Bedford Hospital

Urological Cancer Services

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

The Urology Team

The Consultants and Clinical Nurse Specialists are:

Consultants
Mr H Sharma 01234 355 122 ext: 2262 Harbinder.Sharma@bedfordhospital.nhs.uk
Mr A Chaudry 01234 355 122 ext: 2717 Aasem.Chaudry@bedfordhospital.nhs.uk

Nurses
Norma Smith 01234 355 122 ext: 5770 Norma.Smith@bedfordhospital.nhs.uk
Maureen Daly 01234 355 122 ext: Maureen.Daly@bedfordhospital.nhs.uk

Outpatient Appointments

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

Outpatient clinics take place:

Day Morning Afternoon
Monday Mr Sharma, Mr Chaudry Mr Sharma, Mr Chaudry
Tuesday - -
Wednesday Mr Chaudry - Endoscopy Mr Chaudry - Endoscopy
Thursday - Mr Sharma - Endoscopy
Friday - -

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 within 2 weeks (under 2 week rule)

Prostate

Refer urgently patients:

  • With a hard, irregular prostate typical of a prostate carcinoma.  Prostate-specific antigen (PSA) should be measured and the result should accompany the referral.  (an urgent referral is not needed if the prostate is simply enlarged and the PSA is in the age-specific reference range).
  • With a normal prostate, but rising/raised age-specific PSA, with or without lower urinary tract symptoms.  (In patients compromised by other comorbidities, a discussion with the patient or carers and/or a specialist may be more appropriate.
  • With symptoms and high PSA levels.

Bladder and Renal

Refer urgently patients:

  • Of any age with painless macroscopic haematuria.
  • Aged 40 years and older who present with recurrent or persistent urinary tract infection associated with haematuria.
  • Aged 50 years and older who are found to have unexplained microscopic haematuria.
  • With an abdominal mass identified clinically or on imaging that is thought to arise from the urinary tract.

Testicular

Refer urgently patients:

  • With a swelling or mass in the body of the testis.

Penile

Refer urgently patients:

  • With symptoms or signs of penile cancer.  These include progressive ulceration or a mass in the glans or prepuce particularly, but can involve the skin of the penile shaft.  (Lumps within the corpora cavernosa can indicate Peyronie's disease, which does not require urgent referral).

Non-Urgent Referral

Refer non-urgently patients under 50 years of age with microscopic haematuria.  Patients with proteinuria or raised serum creatinine should be referred to a renal physician.  If there is no proteinuria and serum creatinine is normal, a non-urgent referral to an urologist should be made via Choose and Book.

Investigations

  • If an asymptomatic male with a borderline level of PSA, repeat the PSA test after 1 to 3 months.  If the PSA level is rising, refer the patient urgently
  • A digital rectal examination and a PSA test (after counselling) are recommended for patients with any of the following unexplained symptoms:
    • Inflammatory or obstructive lower urinary tract symptoms
    • Erectile dysfunction
    • Haematuria
    • Lower back pain
    • Bone pain
    • Weight loss, especially in the elderly
  • Exclude urinary infection before PSA testing.  Postpone the PSA test for at least 1 month after treatment of a proven urinary infection
  • In male or female patients with symptoms suggestive of a urinary infection and macroscopic haematuria, diagnose and treat the infection before considering referral.  If infection is not confirmed, refer them urgently

Consider an urgent ultrasound in men with a scrotal mass that does not transilluminate and/or when the body of the testis cannot be distinguished.

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 bladder cancer
Map of Medicine Patient Pathway - suspected kidney cancer
Map of Medicine Patient Pathway - suspected prostate cancer
Map of Medicine Patient Pathway - suspected testicular cancer

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

Bladder Cancer NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-bladder/Pages/Introduction.aspx
Cancer Research UK - Bladder Cancer:
http://cancerhelp.cancerresearchuk.org/type/bladder-cancer/
MacMillan Cancer Support - Bladder Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Bladder/Bladdercancer.aspx
MacMillan Cancer Support - Kidney Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Kidney/Kidneycancer.aspx
MacMillan Cancer Support - Prostate Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Prostate/Prostatecancer.aspx
MacMillan Cancer Support - Testicular Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Testes/Testicularcancer.aspx
Penny Brohn Cancer Care:
http://www.pennybrohncancercare.org/
Action on Bladder Cancer:
http://www.actiononbladdercancer.org/
Bladder Cancer Web Cafe:
http://blcwebcafe.org/
Kidney Cancer NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-kidney/Pages/Introduction.aspx
British Renal Society:
http://www.britishrenal.org/
James Whale Fund for Kidney Cancer:
http://www.jameswhalefund.org/index.html
Kidney Cancer UK
http://www.kcuk.org/
Kidney Patient Guide:
http://www.kidneypatientguide.org.uk/site/contents.php
Kidney Research UK:
http://www.kidneyresearchuk.org/home.php
Lab Tests Online UK:
http://www.labtestsonline.org.uk/understanding/analytes/aldosterone/tab/glance
National Kidney Federation:
http://www.kidney.org.uk/
The Renal Association:
http://www.renal.org/home.aspx
Penile Cancer NHS Choices:
http://www.nhs.uk/conditions/Penile-cancer/Pages/Introduction.aspx
MacMillan - Penile Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Penis/Penilecancer.aspx
Cancer Research UK - Penile Cancer:
http://cancerhelp.cancerresearchuk.org/type/penile-cancer/
Prostate Cancer NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-prostate/Pages/Introduction.aspx
Cancer Research UK - Prostate Cancer:
http://cancerhelp.cancerresearchuk.org/type/prostate-cancer/?script=true
Health Talk Online - PSA Test for Prostate Cancer:
http://www.healthtalkonline.org/Cancer/The_PSA_test_for_prostate_cancer_
Health Talk Online - Prostate Cancer
http://www.healthtalkonline.org/Cancer/Prostate_Cancer
Lab Tests Online UK - PSA Test
http://www.labtestsonline.org.uk/understanding/analytes/psa/tab/glance
Prostate Action:
http://www.prostateaction.org.uk/
Prostate Cancer Risk Management Programme:
http://www.cancerscreening.nhs.uk/prostate/index.html
The Prostate Cancer Charity:
http://www.prostate-cancer.org.uk/
UK Prostate Link:
http://www.prostate-link.org.uk/
Royal Marsden - Prostate Cancer:
http://www.royalmarsden.nhs.uk/cancer-information/types/pages/prostate-cancer.aspx
Male Care:
http://malecare.org/
Testicular Cancer - NHS Choices:
http://www.nhs.uk/conditions/Cancer-of-the-testicle/Pages/Introduction.aspx
Cancer Research UK - Testicular Cancer:
http://cancerhelp.cancerresearchuk.org/type/testicular-cancer/
Health Talk Online - Testicular Cancer
http://www.healthtalkonline.org/Cancer/Testicular_Cancer
Lab Tests Online UK - Testicular Cancer:
http://www.labtestsonline.org.uk/understanding/analytes/afp-tumor/tab/glance
Macmillan - Testicular Cancer:
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Testes/Testicularcancer.aspx
Orchid Male Cancer:
http://www.orchid-cancer.org.uk/
Royal Marsden - Testicular Cancer:
http://www.royalmarsden.nhs.uk/cancer-information/types/pages/testicular-cancer.aspx
Everyman Male Cancer:
http://www.everyman-campaign.org/

Cancer Network

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