Brain and CNS Cancer

Services

Luton & Dunstable Hospital

Cancer Services

The Luton and Dunstable Hospital NHS Foundation Trust's Cancer Unit is part of the Mount Vernon Cancer Network.  The Network covers a geographical area from North London to mid-Bedfordshire, west to Buckinghamshire and east to Hertfordshire, providing services to a population of two million people.  The Mount Vernon Hospital Cancer Centre provides specialist care, including radiotherapy and complex chemotherapy, with the local Cancer Units and the Primary Care Trusts providing routine and on-going care, including chemotherapy.

Oncology services are provided by consultant staff from Mount Vernon, taking part in combined clinics with the Luton and Dunstable hospital staff.

To access the service please visit your GP.

The lead clinician for cancer services is Mr. Mike Pittam, Consultant Surgeon.

Multi-Disciplinary Team (MDT) meetings for all tumour sites are held on a regular basis, mostly weekly, to discuss newly diagnosed or suspected cancer patients.  Some MDT meetings participate in video-conferencing with other Network Teams to encourage wider discussion and input to the patient pathway.  The MDT Office can be contacted on either: 01582 718 268 or 01582 718 099.

Who to Refer

Urgent Referral within 2 Weeks (under 2 week rule)

Refer urgently patients with:

  • Symptoms related to the CNS, including:
    • Progressive neurological deficit
    • New-onset seizures
    • Headaches
    • Mental changes
    • Cranial nerve palsy
    • Unilateral sensorineural deafness in whom a brain tumour is suspected
  • Headaches of recent onset accompanied by features suggestive of raised intracranial pressure, for example:
    • Vomiting
    • Drowsiness
    • Posture-related headache
    • Pulse-synchronous tinnitus or by other focal or non-focal neurological symptoms, for example blackout, change in personality or memory
  • A new, qualitatively different, unexplained headache that becomes progressively severe
  • Suspected recent-onset seizures (refer to neurologist)

Consider urgent referral (to an appropriate specialist) in patients with rapid progression of:

  • Subacute focal neurological deficit
  • Unexplained cognitive impairment, behavioural disturbance or slowness, or a combination of these
  • Personality changes confirmed by a witness and for which there is no reasonable explanation even in the absence of the other symptoms and signs of a brain tumour

Non-urgent referral

Consider non-urgent referral or discussion with specialist for:

  • Unexplained headaches of recent onset:
    • Present for at least 1 month
    • Not accompanied by features suggestive of raised intracranial pressure

Risk Factors

Refer urgently patients previously diagnosed with any cancer who develop any of the following symptoms:

  • Recent onset seizure
  • Progressive neurological deficit
  • Persistent headaches
  • New mental or cognitive changes
  • New neurological signs

Investigations

  • In a patient with new, unexplained headaches or neurological symptoms, undertake a neurological examination guided by the symptoms, but including examination for papilloedema.  Note that the absence of papilloedema does not exclude the possibility of a brain tumour
  • When a patient presents with seizure, take a detailed history from the patient and an eyewitness to the event.  Carry out a physical examination, including cardiac, neurological and mental state, and developmental assessment, where appropriate

Macmillan Cancer Support Rapid Referral Guidelines

Macmillan Cancer Support Rapid Referral Guidelines

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 via Bedford Hospital.

Resources

Map of Medicine Patient Pathway

Map of medicine - suspected brain tumour

NICE Guidelines

Website Resources

Cancer Networks

Patient Information Leaflets

Getting to the Luton & Dunstable Hospital



Last updated: 08/08/2014

Update due: 08/08/2015