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Oxford University Hospitals NHS Foundation Trust
Cancer Services

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After referral to the Liver MDT

Referral and first appointments

Once you have been referred by your GP or hospital doctor, your case history and images will be discussed at the following multidisciplinary team meeting (Friday 10.00am). The aim is to have your case discussed as soon as is possible. However, patients referred after Wednesday are discussed the following week. This is because the consultant radiologist reviewing their images needs to go over all scans carefully prior to the MDT meeting, and this requires time.

A treatment plan is formulated for you. You will either be seen at the Liver Clinic soon after (on the same day), or we will ask for further tests/investigations to be done so that we can formulate a specific treatment plan. These will happen either in Oxford or your local hospital.

If you can be treated at your local hospital, you will be contacted by your local doctor in due course.

We have dedicated clinics for suspected cancer patients, who are usually seen within one week of us receiving a referral. Each new patient in the cancer clinic is seen by a consultant and receives a counselling session, first from the consultant and then the Nurse Specialist, who will maintain regular contact with each patient.

Further scans and tests

Any further scans and tests needed will be arranged for the same day as your visit to clinic, if at all possible, especially if you have to travel a long distance to the hospital.

Surgery

If you need cancer surgery you will be given a date for surgery within two to three weeks of us receiving all your test results. Surgery dates will be discussed with you and booked into the diary. There is no waiting list for cancer surgery.

Your surgery will take place at the Churchill Hospital. To prevent an unecessary stay in hospital, if appropriate, you will be asked to come into hospital on the morning of your surgery.

We have a range of patient information leaflets to explain different procedures and treatments, giving you details of what to expect before, during and after your treatment.

Follow-up care

If you are referred to Oxford from another hospital, we are able to share your follow-up care with your local hospital. This allows you to continue to receive specialist care closer to home.

Clinics

Liver Clinic

The usual waiting time to be seen at the clinic, from time of referral, is 7-10 days.

After we review the scans and other investigations, we tailor a treatment plan to each patient. Patients are seen (usually by a consultant surgeon or a senior member of the surgical team) the same morning, in the Outpatients' Clinic.

In the clinic we will discuss the diagnosis, stage of disease and treatment options with the patient. New patients will also meet the Clinical Nurse Specialist. A management plan is agreed. If the patient is offered surgery, the procedure is explained in detail so that they can give informed consent to treatment. We may also discuss participation in clinical trials and research.

Pre-operation Assessment Clinic

Before having an operation, patients are required to attend a Pre-operation Assessment Clinic.

This is usually within one week of the date of surgery. This clinic is at the John Radcliffe Hospital in Oxford. At this clinic general health and fitness for anaesthesia and surgery is assessed. Patients have the opportunity to ask questions about their hospital admission and surgery, and may also see an anaesthetist.

Admission to hospital for surgery

Unless otherwise indicated, patients will be asked to arrive at the Theatre Direct Admissions Ward on the morning of the operation.

Patients can meet the surgical team and the anaesthetic team before going to theatre.

Immediately after surgery patients are admitted to the High Dependency Unit (HDU) for monitoring. Following an overnight stay at the HDU, they are transferred to the Oxford Upper Gastrointestinal Centre.

Going home

Most patients can go home 6-12 days after their operation and will need painkillers for a few weeks. It may take up to six weeks to get back to normal.

If patients have concerns about going home (for example, if they live alone or have several flights of stairs to climb), they should let the nursing staff or their doctor know when they are admitted to the ward, so that help can be arranged.

The Nurse Specialist can offer or arrange support or counselling for patients and their families. Social workers are often available to give practical advice. Many are also trained counsellors.

Before leaving hospital patients are given an appointment to attend an Outpatient Clinic for a post-operative check-up. This is a good time to discuss any problems. If patients have any problems or worries before their appointment, they may speak to the ward nurses or hospital doctor.

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