Transcript How to manage suspected cancer

How to manage
suspected cancer
Sarah Slater
Model of Care

Setting out 104 recommendations across 13 care pathways, the
Model of Care’s key recommendations were to:

Help diagnose cancer earlier : Late diagnosis of cancers with many
cancers diagnosed at a late stage when successful treatment is less
likely;

Improve patient care and reduce inequalities in access to and
uptake of services

Improve patient outcomes

Improve patient experience.
Hence development of fast track
referrals
 Pathways
for Upper GI/ Urology/ Haem
Oncology/ Bone and Sarcoma/ Brain/
Ovary/ Lung/Skin/Breast
 Some patients don’t fit into these
pathways.
What to do for suspected cancer
 My
role=Lead for CUP
 Peer review measure for Acute Oncology
 Fast track pts with suspicious imaging:
lung nodules; bone lesions.
 Lead on appropiate next steps
MUO
 15%
cancer diagnoses present as
metastases
 In 2/3, will find the primary.
 For the rest (5%)=provisional CUP
 Most common sites- pancreas and lung,
then
colon,stomach,oesophagus,ovary,prostate
,breast
Clinical management of patients presenting with CUPs.
Fizazi K et al. Ann Oncol 2011;22:vi64-vi68
Recommendation
• Offer the following investigations to patients with MUO, as
clinically appropriate, guided by the patient’s symptoms:
− comprehensive history and physical examination including
breast, nodal areas, skin, genital, rectal and pelvic
examination
− full blood count; urea, electrolytes and creatinine; liver
function tests; calcium; urinalysis; lactate dehydrogenase
Section 3 CLINICAL INFORMATION
THERE MUST BE IMAGING SUGGESTIVE
OF METASTATIC DISEASE BEFORE ANY
REFERRAL USING THIS FORM, AND
PLEASE SEND REPORT.
*If patient has a history of cancer please
consider whether this is more likely to be
a recurrence than a true unknown
primary cancer. Patients with suspected
recurrence should be referred back to the
site specific team.
[ ] USS: Specify site
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[ ] CT scan: Specify site
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[ ] MRI: Specify site
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Symptoms accompanying suspected
cancer imaging eg
[ ] Progressive unintentional weight loss
[ ] anorexia
[ ] Pain: Specify site
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[ ] other:
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Examination findings and blood tests if the
latter performed.
Specify site:
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