Urological 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.

UROLOGICAL Clinics

  • New patient and follow-up clinics (four days per week)
  • Joint urology/oncology clinics (weekly)
  • Nurse-led prostate cancer follow up (weekly)

Useful Numbers

Mr A Alam 01582 497007 Fax 01582 497007
Mr. Pittam 01582 497099 Fax 01582 497099
Mr. Saleemi 01582 718041 Fax 01582 718041
Tina Smith [CNS] 01582 718207 bleep 366
Brenda Hunt 0845 127 0127 ext 2889 bleep 032

Who to Refer

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 a urologist should be made.

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

Resources

Map of Medicine Patient Pathway

Suspected Bladder Cancer - Map of Medicine

Suspected Kidney Cancer - Map of Medicine

Suspected Prostate Cancer - Map of Medicine

Suspected Testicular Cancer - Map of Medicine

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 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