Cancer services

Our cancer services department works closely with other teams and services across our hospitals, providing advice and support. This includes: colorectal, upper gastrointestinal, lung, urology, gynaecology, haematology, dermatology, head and neck, and other cancers.

The department plays a key role in ensuring that patients referred to our hospitals with a suspicion of cancer are offered their first appointment within 14 days, and progress along their care pathway in a timely way, ensuring first treatment starts within 62 days of the referral received.

The Trust works in close partnership with Macmillan Cancer Support and has a support centre at Epsom General Hospital for patients, families and carers.

The Trust works in partnership with The Royal Marsden NHS Foundation Trust and St George’s Healthcare NHS Trust and Epsom Medical, who provide and support cancer services for Merton, Sutton and Surrey locality patients.

Referrals

Please refer all patients who show symptoms of suspected cancer to the most appropriate cancer service. Epsom and St Helier NHS Trust is commissioned to run the followed cancer services:

2WW Brain
2WW Gynaecology: Cervical, Vaginal, Endometrial, Vulval & Ovarian
2WW Haematology
2WW Head and Neck: Laryngeal, Pharyngeal, Oral/Lip, Salivary, Ear, Nose & Sinus & Thyroid
2WW Lower GI
2WW Lung
2WW Ophthalmology Adults
2WW Ophthalmology Paediatrics
2WW Paediatrics
2WW Skin Adults
2WW Skin Paediatrics
2WW Upper GI
2WW Urology: Bladder/Haematuria/Renal, Prostate, Testicular & Penile

Epsom and St Helier NHS Trust is not commissioned to provide any service which is not listed above, including Breast Services or Sarcoma services. Referrals to these services must be made to an alternative Providers

On referral, all patients must be informed by their GP/Referring Clinician of the possible diagnosis of cancer and advised and confirmed that they will be available for an appointment within the next 14 days.

All referrals by GP’s must be made via the e-Referral Service, including attaching the referral within four working hours of the request being made.

All other referrals (e.g. from Dentists, Optometrists and Screening Centres) must be made via email to esthcancer.twoweekrule@nhs.net.

All referrals should be made on the tumour site specific referral forms which can be found using the link:

https://www.healthylondon.org/cancer/suspected-cancer-referrals/MS-word-referral-forms

Overview of services

Brain

You will initially be seen by a member of the Clinical Team in face to face outpatient appointment.

If you require treatment, your case will be discussed by the Neurology Team in their weekly multidisciplinary meeting which takes place at St George’s Hospital, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant.

Gynaecology

You will initially be seen by a member of the Clinical Team in face to face outpatient appointment. At your first appointment you may need to have some investigations carried out during your investigation, such as an outpatient hysteroscopy, colposcopy or transvaginal scan, depending on your symptoms.

If you require treatment, your case will be discussed by the Gynaecology Team in their weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant and nurse specialist

Haematology

You will initially be seen by a member of the Clinical Team in face to face outpatient appointment.

If you require treatment, your case will be discussed by the Haematology Team in their weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant and nurse specialist

Head and Neck

You will initially be seen by a member of the Clinical Team in face to face outpatient appointment. At your first appointment you may need to have a biopsy, which is a minor procedure that can be undertaken during your consultation.

If you require treatment, your case will be discussed by the Head and Neck Team in their weekly multidisciplinary meeting which takes place at St George’s Hospital, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant.

Lower Gastrointestinal (Bowel/Colorectal)

You will initially undergo a Telephone Assessment Consultant with a member of the Clinical Team. You will receive a scheduled, timed phone call for this assessment where you will assessed for your suitability of undertaking any diagnostic investigations, prior to a face to face outpatient appointment. These could be for OGD, Colonoscopy, CT Colonoscopy, Flexible Sigmoidoscopy, CT Colonoscopy or MRI scan. You will be informed of the test they need/next clinical steps on this call. If you are unsuitable to undertake a telephone consultation, you will be seen by a member of the Clinical Team in face to face outpatient appointment instead.

If you require treatment, your case will be discussed by the Lower Gastrointestinal Team in their weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant and nurse specialist.

Lung

You will initially be assessed by a member of the Clinical Team for suitability/requirement of a CT scan and blood tests prior face to face outpatient appointment.

If you require treatment, your case will be discussed by the Lung Team in their bi-weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant and nurse specialist

Ophthalmology

You will initially be seen by a member of the Clinical Team in face to face outpatient appointment.

You will be able to discuss your options directly with your consultant.

Paediatrics

You will initially be seen by a member of the Clinical Team in face to face outpatient appointment.

You will be able to discuss your options directly with your consultant.

Skin

You will initially be seen by a member of the Clinical Team in face to face outpatient appointment. At your first appointment you may need to have a biopsy which will be carried out under local anaesthetic.

If you require treatment, your case will be discussed by the Skin Team in their bi-weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant and nurse specialist

Upper Gastrointestinal

You will initially undergo a Telephone Assessment Consultant with a member of the Clinical Team. You will receive a scheduled, timed phone call for this assessment where you will assessed for your suitability of undertaking any diagnostic investigations, prior to a face to face outpatient appointment. These could be for OGD, Colonoscopy, CT Colonoscopy, CT scan, Ultrasound scan and/or MRI scan. You will be informed of the test they need/next clinical steps on this call. If you are unsuitable to undertake a telephone consultation, you will be seen by a member of the Clinical Team in face to face outpatient appointment instead.

If you require treatment, your case will be discussed by the Upper Gastrointestinal Team in their weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant and nurse specialist.

Urology

Urology Prostate

You will initially undergo a Telephone Assessment Consultant with a member of the Clinical Team. You will receive a scheduled, timed phone call for this assessment where you will assessed for your suitability of undertaking any diagnostic investigations, prior to a face to face outpatient appointment. These could be for a MRI scan and Transperineal Template Biopsy. You will be informed of the test they need/next clinical steps on this call. If you are unsuitable to undertake a telephone consultation, you will be seen by a member of the Clinical Team in face to face outpatient appointment instead.

If you require treatment, your case will be discussed by the Urology Team in their weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant and nurse specialist.

Urology Bladder

You will initially be assessed by a member of the Clinical Team for suitability/requirement of a CT scan, Ultrasound scan and blood tests prior to undertaking a flexible cystoscopy at your outpatient appointment.

If you require treatment, your case will be discussed by the Urology Team in their weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

You will be able to discuss your options directly with your consultant and nurse specialist

Urology Renal/Penile/Testicular

You will initially be seen by a member of the Clinical Team in face to face outpatient appointment.

If you require treatment for penile or testicular cancer, your case will be discussed by the Urology Team in their weekly multidisciplinary meeting, attended by staff from all the services that may need to be involved in your care.

If you require treatment for renal cancer, your case will be discussed by the Urology Team in their weekly multidisciplinary team (MDT) meeting at St George’s Hospital, attended by staff from all the services that may need to be involved in your care

You will be able to discuss your options directly with your consultant and nurse specialist.

Diagnosis of Cancer and Support

If you are diagnosed with a cancer, your GP will receive a notification within 24 hours.

All patients diagnosed with a cancer will be given a key worker, called a Clinical Nurse Specialist. They will meet with you and provide details of who to contact if you have any concerns between your appointments.

Your key worker will support you by:

providing reassuring one-to-one care
helping you to understand and get through your treatment, including managing any side effects or symptoms
helping you when you stay in hospital and when you visit as an outpatient
ensuring good communication between you and your multi-disciplinary team
communicating between members of your family or other members or your care team such as your GP (home doctor), community nurse or social worker
giving you details of support groups and other support organisations you may find helpful
one-to-one emotional support
giving you details of how to access our benefits adviser for financial and welfare advice.

Contact details for Cancer Clinical Nurse Specialist Team/ Key Workers at Epsom and St Helier NHS Trust are:

Contact details
Key worker name	Key worker role	Key worker contact details
Dawn Brewer Alison Massey Daisy Barrett	Acute Oncology Clinical Nurse Specialist	esth.aos-oncologyCNS@nhs.net 01372 735465 07825 385133
Fiona Lonergan	Gynaecology Clinical Nurse Specialist	esth.gynae-oncologyCNS@nhs.net
Tracy Reeman Jackie Mathers Catherine Brown	Haematology Clinical Nurse Specialist	01372 735465
Sian Parker	Head & Neck Clinical Nurse Specialist	esth.headandneck-oncologyCNS@nhs.net
Lovejoy Denke Paige Middleton Charlotte Hutchins	Lower Gastrointestinal Clinical Nurse Specialist	esth.lowergi-oncologyCNS@nhs.net 07659 123685 020 8296 2155
Faye Crathern Tolline Riley	Lung Clinical Nurse Specialist	esth.lung-oncologyCNS@nhs.net 020 8296 2409
Emma Thomas	Palliative Care Clinical Nurse Specialist	esth.palliative.care@nhs.net 07826 859570 020 8296 3830
Anita Webb Marjo Thomson	Skin Clinical Nurse Specialist	esth.skin-oncologyCNS@nhs.net 07975 232321 07975 232550
Lovejoy Denke Adebanke Odujinrin	Upper Gastrointestinal Clinical Nurse Specialist	esth.uppergi-oncologyCNS@nhs.net
Easter Espinosa Emma Howard Sarah Sowton Amy Abram Gillian Rackett Bernie Engutsamy	Urology Clinical Nurse Specialist	esth.uro-oncologyCNS@nhs.net 020 8296 2705 01372 735199 01372 735131

In addition to the support from your key worker, there are two cancer information and support centres: the Macmillan Butterfly Centre at Epsom Hospital and the Cancer Information and Support Centre at St Helier Hospital.

Our professional staff and experienced volunteers are available to help anyone affected by cancer. We can help you if you have cancer yourself, care for someone with cancer or want to simply find out more about cancer.

Our friendly and relaxed centres can help with:

Access to high-quality, comprehensive and appropriate information
Cancer awareness and prevention
Information about signs and symptoms to look out for
Emotional support
Confidential counselling
A range of complementary therapies
Links to other appropriate organisations
Macmillan Citizen Advice Bureau advice service for South West London.

Epsom and St Helier NHS Trust operate a drop-in service, so there is no need to make an appointment. Please feel free to contact is on for more information or to arrange an informal discussion. Contact details are:

Epsom Hospital

The Macmillan Butterfly Centre
First Floor, Bradbury Wing
Tel: 01372 735456
Open Hours: Monday - Friday (excluding public holidays), 9.30am - 4.30pm

St Helier Hospital

Cancer Information and Support Centre, Springall Unit
Ground Floor Ferguson House
Tel: 020 8296 4730
Open Hours: Thursdays and Fridays (excluding public holidays), 9.30am - 4.30pm

Cancer care and treatment

We are absolutely dedicated to providing the best possible treatment to our patients. All cancer patients have their care and treatment discussed by a meeting of experts known as a multidisciplinary team meeting. The cancer services department co-ordinates these meetings and ensures that all the relevant clinical information is available for discussion.

The members of these meetings are all experts in different areas of cancer care, and may travel from different treatment centres to attend. Members of the team can include:

Physicians
Surgeons
Oncologists (specialists in chemotherapy and radiotherapy)
Radiologists
Histopathologists
Clinical Nurse Specialists
Advanced Nurse Practitioners
Palliative Care Professionals
Dietitians
Speech and Language Therapists
Specialist Multidisciplinary Team Co-ordinators.

At the meeting, the multidisciplinary team will discuss and agree cancer treatments to recommend to the patient for the best prognosis and outcome.

The team can only recommend treatments – patients will always have a choice.

Epsom and St Helier Hospital NHS Trust provide a diagnostic service for all commissioned services. It also provides the following treatments in partnership with other Trusts/Providers:

Treatment locations
Cancer Type	Treatments at Epsom & St Helier NHS Trust	Treatment at other Trusts/Providers
Brain	Diagnostic	St George’s Hospital Surgery
Gynaecology	Diagnostic & low risk endometrial surgery	Royal Marsden Hospital Chemotherapy Radiotherapy Surgery
Head and Neck	Diagnostic	St George’s Hospital Surgery Royal Marsden Hospital Radiotherapy
Haematology	Chemotherapy	Royal Marsden Hospital Radiotherapy
Lower Gastrointestinal	Surgery	Royal Marsden Hospital Chemotherapy Radiotherapy
Lung	Diagnostic and palliative care	Royal Marsden Hospital Chemotherapy St George’s Hospital Surgery
Ophthalmology	Diagnostic	Moorfield’s Hospital Surgery
Paediatrics	Diagnostic
Skin	Surgery	Cobham Day Surgery (Epsom Medical) Complex Surgery
Upper Gastrointestinal	Diagnostic	Royal Marsden Hospital Surgery Radiotherapy
Urology	Surgery for Bladder, Testicular, Penile and Renal/Kidney	Royal Marsden Hospital Radiotherapy Surgery for Prostate St George’s Hospital Surgery for Renal/Kidney

Common cancer treatments are:

Chemotherapy

Chemotherapy is a term that we use to describe treatment that involves a number of different drugs.

Many drugs are used for different types of cancers and can be effective for different types of conditions. They can be given either as drips or intravenous infusions, or as tablets.

Chemotherapy drugs target cells that are dividing rapidly. This is what happens in many different types of cancer.

Radiotherapy

Radiotherapy is the use of high energy x-rays to treat cancer. It damages your body's cells within the treatment area, killing the cancer cells but allowing your normal cells to recover. The side effects are usually confined to the area you are having treated.

Radiotherapy treatment is painless. The experience is similar to having an x-ray or a scan.

Surgery

Many cancers can be treated effectively with surgery alone, but for some patients, results can be improved with additional treatments such as chemotherapy and radiotherapy.

Before you have surgery you will have a consultation with the surgeon. During that consultation, you may be asked to sign a consent form, agreeing to the operation.

The planned surgery will take place at Epsom General Hospital or at one the other Cancer Treatment Providers. Some patients have their surgery as a day case, which means they come in for surgery and leave hospital on the same day. Other patients need to stay in the hospital after the operation to recover.

Cancer Clinical Team

We have Lead Cancer Clinicians for each Specialty/Department. The Lead Clinician chairs the discussion at the multidisciplinary team meeting, and acts as the point of contact between the MDT co-ordinator and the rest of the team.

Cancer Clinical Leads

Clinical Director for Cancer & Radiology Services – Dr Nalin Khosla

Cancer Clinical Lead for the Trust - Dr Martine Meyer

Cancer Clinical Lead for Gynaecology - Mr Manish Maheswari

Cancer Clinical Lead for Lung - Dr Claire Wells

Joint Cancer Clinical Lead for Skin - Dr Daniela Piras & Mr Rahul Jayaram

Cancer Clinical Lead for UGI – Dr Asif Mahmood

Cancer Clinical Lead for LGI - Mr Ashish Gupta

Cancer Clinical Lead for POSCU - Dr Stephanie Kirk

Cancer Clinical Lead for Urology - Mr Pieter Le Roux

Cancer Clinical Lead for Head and Neck - Mr Andrew Stewart

Cancer Clinical Lead for Haematology - Dr James Croft

Cancer Clinical Lead for Chemotherapy – Dr Simon Stern

Macmillan Lead Cancer Nurse for the Trust – Louise O’Connor

Cancer Clinical Nurse Specialist Team/ Key Worker
Key Worker Name	Key Worker Role
Dawn Brewer Alison Massey Daisy Barrett	Acute Oncology Clinical Nurse Specialist
Fiona Lonergan	Gynaecology Clinical Nurse Specialist
Tracy Reeman Jackie Mathers Catherine Brown	Haematology Clinical Nurse Specialist
Sian Parker	Head & Neck Clinical Nurse Specialist
Lovejoy Denke Paige Middleton Charlotte Hutchins	Lower Gastrointestinal Clinical Nurse Specialist
Faye Crathern Tolline Riley	Lung Clinical Nurse Specialist
Emma Thomas	Palliative Care Clinical Nurse Specialist
Anita Webb Marjo Thomson	Skin Clinical Nurse Specialist
Lovejoy Denke Adebanke Odujinrin	Upper Gastrointestinal Clinical Nurse Specialist
Easter Espinosa Emma Howard Sarah Sowton Amy Abram Gillian Rackett Bernie Engutsamy	Urology Clinical Nurse Specialist