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Heather Simpson & Wendy Shearsmith Upper GI CNS, L & D Hospital. The Luton and Dunstable Hospital UPPER GI (OESOPHAGOGASTRIC) MDT CARE PATHWAY. GP REFERRAL/ ATTENDANCE AT A & E OPEN ACCESS GASTRO- UPPER GI GASTROSCOPY ENTEROLOGIST SURGEON ENDOSCOPY
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Heather Simpson & Wendy Shearsmith Upper GI CNS, L & D Hospital
The Luton and Dunstable HospitalUPPER GI (OESOPHAGOGASTRIC) MDT CARE PATHWAY GP REFERRAL/ ATTENDANCE AT A & E OPEN ACCESS GASTRO- UPPER GI GASTROSCOPY ENTEROLOGIST SURGEON ENDOSCOPY CLINICAL NURSE SPECIALIST DIAGNOSIS OF UPPER GI CANCER CONFIRMED FOLLOWING INVESTIGATIONS (OGD/ CT scan) IF INPT ‘Yellow Board’ TO GP NOTIFICATION PROFORMA MR P JAMBULINGAM (Lead Clinician) DISCUSSION AT LOCAL MDT MEETING Monday lunchtime 12 – 12:30pm
DIETICIAN SEEN IN PJ ONCOLOGY CLINIC (Alternate Mondays PM) TREATMENT OPTIONS RADICAL PALLIATIVE (See Radical Pathway) (See Palliative Pathway) MEDICAL AND NURSING SUPPORT & OUTPATIENT FOLLOW-UP IN ONCOLOGY CLINIC & DISCUSSION AT LOCAL MDT AS NECESSARY
RADICAL PATHWAY FURTHER STAGING: PET +/ - EUS +/- STAGING LAPAROSCOPY (Mt Vernon) (Hammersmith) (L & D) DISCUSSION AT SMDT MEETING Monday 12:30 – 13:00pm SEEN IN PJ ONCOLOGY CLINIC (Alternate Mondays PM) PALLIATIVE EMR SM CLINIC (See Palliative Pathway) (Endoscopic Mucosal (Every Wednesday AM) Resection) NEOADJUVANT At Watford or Hammersmith CHEMOTHERAPY
RADICAL CHEMORADIOTHERAPY SURGERY RESTAGE - SM CLINIC (Every Wednesday AM) PET CT (TREATMENT TAKES PLACE AT Mt VERNON) (following Neoadjuvant chemotherapy) DISCUSSION AT SMDT ADVANCED DISEASE SEEN IN PJ ONCOLOGY CLINIC (See Palliative Pathway) & DATED FOR SURGERY & PATHWAY FACILITATOR COMPLETES PAPERWORK (See MVCN Specialist Upper GI Surgery Referral Pathway) SURGERY AT WATFORD HOSPITAL
PALLIATIVE PATHWAY TREATMENT OPTIONS ENDOSCOPIC CHEMOTHERAPY RADIOTHERAPY MANAGEMENT At Mt Vernon/ L&D At Mt Vernon LASER Dr S MAWDSLEY is the At Watford UPPER GI CANCER CONSULTANT ONCOLOGIST and has a CLINIC on WEDNESDAY AM at the L & D PDT (PhotoDynamic Therapy) At Hammersmith/ UCLH STENTING Therapeutic Oesophageal List Alternate Wednesday mornings At The L & D (See Insertion of an Oesophageal Stent Pathway) SUPPORTIVE CARE