Upper Gastrointestinal Cancer

Services

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.

OESOPHAGEAL AND GASTRIC Clinics

  • Surgical clinics (fortnightly)
  • Gastroenterology clinics (twice a week)
  • Endoscopy (weekly)
  • Joint surgical/oncology clinics (fortnightly)

Useful Numbers

Mr V Jain 01582 497472
Mr Jambulingham 01582 718332
Dr K Goodchild 01582 497513
Dr K Goodchild 01582 497513
Wendy Shearsmith/Heather Simpson (CNS) 01582 497971

Who to Refer

Urgent referral for endoscopy, or to a specialist within 2 weeks (under 2 week rule)

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

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 Networks

Mount Vernon Cancer Network - for residents of Hertfordshire and South Bedfordshire
http://www.mountvernoncancernetwork.nhs.uk/

Patient Information Leaflets available from Luton & Dunstable Hospital

Patient Information on 2 Week Wait

Macmillan Cancer Support - Luton



Last updated: 20/06/2013

Update due: 20/06/2014