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The Upper Gastro-Intestinal (UGI) Cancer Service at Chesterfield Royal Hospital (CRH) offers investigation, treatment planning and support to patients who are suspected or proven to have tumours affecting the oesophagus (gullet), stomach, pancreas, liver, gallbladder or bile ducts.
The UGI Cancer Service at CRH follows a Multi-Disciplinary Team (MDT) model and works in conjunction with the regional specialist cancer teams based in Sheffield. This means that all patients who are found to have an UGI cancer benefit from the opinion of a panel of experts when their treatment is planned.
The diagnosis of an UGI cancer and the assessment of its extent (staging) is organised from CRH whilst definitive treatment is usually provided in Sheffield. Operations are performed at the Northern General Hospital and chemotherapy or radiotherapy is delivered at Weston Park Hospital.
The precise treatment offered depends on the cancer type and its extent at the time of diagnosis.
Once staging is complete, patients are provided with full information to help them decide which of the choices in treatment they prefer.
The investigation of UGI cancers often involves multiple tests and the UGI Cancer Team at CRH recognises that this can be a challenging time for patients. The Team works hard to ensure that tests are performed in a co-ordinated fashion as quickly as possible. Cancer Nurse Specialists (CNSs) play a central role in keeping patients informed of their progress during this period. They are also readily available to contact by telephone to answer questions or provide general support.
Patients are referred to the Service via many routes depending on their symptoms. Some, for example, patients with swallowing difficulties, will be sent an appointment to attend an endoscopy; others, for example, patients who are jaundiced, will come to an outpatient clinic in the first instance.
Whatever the type of first attendance, all appointments are at the Chesterfield Royal Hospital main site.
Please bring a full list of any medication you are currently taking to your first appointment.
We realise that this can be a stressful time for patients and their families and we aim to ensure that every patient who receives a new diagnosis of likely cancer will be able to meet with a CNS at the time that diagnosis is given. The CNS will provide details of how you can keep in contact whilst your investigations continue.
Further tests are frequently necessary and we will ensure that these are completed as quickly as possible. We can keep you informed by telephone or by clinic review. We are happy to follow whichever method you prefer.
The exact sequence of tests varies depending on the type of cancer and we realise that the period whilst these are completed is often stressful. However, in order to be able to offer the best treatment, it is important that the investigations are performed. Patients suspected of having cancer are given the highest priority and their tests are completed as soon as possible. It is unlikely that any cancer will spread significantly during this period and so the chances of successful treatment are not reduced by the time which it takes to be fully staged.
Since treatment is usually offered in Sheffield, it may be that once your investigations are complete, your next appointment will be at another hospital. If this is the case, we will inform you accordingly. Our aim is to avoid unnecessary delay but we are always happy to see you again in CRH if you prefer to discuss things further before visiting Sheffield.
Can I bring someone with me?
Yes, please do.
We appreciate the need for patients to be fully supported and our aim is to enable this whenever possible. Please be aware that our consultation rooms are often small and we cannot accommodate large numbers of family members or friends under normal circumstances.
It is helpful if you can ensure that you are accompanied by the same family member or friend on each attendance.
Please note, even under non-pandemic conditions, relatives or friends are not able to be present whilst endoscopy or CT or MRI scans are performed.
The Endoscopy procedure only takes a few minutes but patients should expect to be in the Endoscopy Department for 2-3 hours.
Patients who are having an endoscopy will need to stop eating and drinking for four hours beforehand and this advice must be followed.
Most patients find the procedure easy to manage without sedation. If you do wish to be sedated for the procedure, please recognise that you will not be able to return home unsupervised.
For most patients who are referred directly for endoscopy, the test is reassuring and no cancer is found. However, if cancer is detected, the endoscopist will discuss this with you at the time and will arrange any further tests as required.
Other patients will be asked to attend a consultation before any specific tests are booked. Outpatient attendances usually last for 15-20 minutes but you should plan to be at the hospital for longer. Depending on symptoms, some patients will be offered further investigations which can be performed on the day of their attendance, for example, an ultrasound or CT scan.