Bone Cancer and Sarcoma

Services

The London Sarcoma Service

The London Sarcoma Service is one of the largest sarcoma services in Europe with an international reputation for providing the highest quality of care to patients with sarcoma.  The Service provides a comprehensive service to patients of all ages from the first consultation, through investigation, to treatment, rehabilitation and follow-up, seeing about 500 new patients with sarcoma each year.  Most patients are treated on one or both of two sites:  Royal National Orthopaedic Hospital and University College London Hospital

Royal National Orthopaedic Hospital

For Soft Tissue and Bone (limb and trunk)

Royal National Orthopaedic Hospital located at Stanmore, Middlesex, is a dedicated specialist orthopaedic hospital, which incorporates the Institute of Orthopaedics and Musculoskeletal Science (University of London). It is also home to the Sarcoma Unit, which undertakes the surgical treatment of patients (children, young people and adults) with bone tumours and soft tissue sarcomas of the limb and trunk.  The RNOH is one of only two designated centres in the country which specialises in the care and treatment of patients who suffer from bone and soft tissue cancers.

University College London Hospital

For Soft Tissue (Non-limb/trunk including e.g. head & neck, retroperitoneal, abdominal, pelvic, urology, breast, skin etc)

University College Hospital, located in central London, is part of University College London Hospitals NHS Foundation Trust, a large teaching hospital associated with University College London, a recognised research centre of excellence. A large number of patients with cancer are treated in the Department of Oncology, which includes the Sarcoma Unit, offering radiotherapy and chemotherapy to patients with soft tissue and bone sarcomas.

Who to Refer

Patients covered by the Mount Vernon Cancer Network area only -  NHS Bedfordshire residents in South Bedfordshire and NHS Luton residents

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 (under 2 week rule) - 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

Macmillan Cancer Support Rapid Referral Guidelines

Macmillan Cancer Support Rapid Referral Guidelines

Royal National Orthopaedic Hospital (RNOH)

All adults (aged over 16) in the Mount Vernon Cancer Network (MVCN) catchment area who present with a Sarcoma or suspected Sarcoma in primary care.  The geographical area which makes up MVCN is covered by the following PCTs:

  • NHS Luton
  • NHS Hertfordshire
  • NHS Bedfordshire (South Bedfordshire locality only)

University College London Hospital (UCLH)

All adults (aged 16 and over) in the Mount Vernon Cancer Network (MVCN) catchment area who present with a Sarcoma or suspected Sarcoma in primary care.  The geographical area which makes up MVCN is covered by the following PCTs:

  • NHS Luton
  • NHS Hertfordshire
  • NHS Bedfordshire (South Bedfordshire locality only)

Please note: when seeking/receiving advice in regard to patient care and making referrals, NHS Connecting for Health Information Governance standards and policies must be adhered to.

Who not to Refer

Patients outside of the Mount Vernon Cancer Network area.  NHS Bedfordshire residents not living in South Bedfordshire, patients not resident in NHS Luton area.

North & East Bedfordshire patients are included under the Anglia Cancer Network and should be referred in most cases to Addenbrookes.

Resources

Map of Medicine Patient Pathway

Suspected bone sarcoma - map of medicine

NICE Guidelines

Website Resources

Cancer Networks

Other Information

Where to find the London Sarcoma Service:
http://www.londonsarcoma.org/location-rnoh.asp



Last updated: 20/09/2012

Update due: 20/09/2013