Cancer Specialisms

The Acute Oncology Team (AOT) ensures that cancer patients who are admitted to our hospital have optimal management of their treatment, or cancer related complication, with timely discharge and onward referral to oncology/palliative care services.

If a patient presents with a new cancer diagnosis, but doesn’t currently fit on an existing cancer pathway, they will have a quick assessment and appropriate investigation of their condition with a rapid decision on management. This will be done as follows:

• Defining standardised patient pathways for common presentations
• Cooperation with medical, surgical, haematological and urgent care services to deliver robust clinical protocols for emergent problems
• Cooperation with radiology and pathology services to deliver a rapid diagnostic pathway
• Education and training to raise standards
• Prospective data collection and real-time performance management
• Regular clinical audit
• Implementation of local, national and international directives
• Engagement with clinical research protocols where feasible
• Provision of comprehensive information to patients and carers
• Involvement of patients and carers in appraisal and redesign of the service

This treatment service is available to men and women who have a diagnosis of bladder cancer. This condition is diagnosed by a Consultant urologist and treatment is then arranged by the Urology Nurse Practitioners.

Our clinic is held at Clatterbridge Hospital every Wednesday afternoon. The treatment consists of a therapeutic solution administered into the bladder of the patient. The treatment is initially given weekly then at the discretion of the Consultant Urologist.

We have five colorectal surgeons and one Associate Specialist, who are based at Arrowe Park Hospital (although we do carry out some clinics and surgery at Clatterbridge Hospital). They are supported by two Clinical Nurse Specialists (key workers), one Nurse Consultant, one Advanced Nurse Practitioner and three Stoma Nurses.

The team will get together each week in which all patients with suspected or diagnosed cancer are discussed. Plans for treatment are then agreed.

The team also work in the Endoscopy Unit and carry out diagnostic scopes of the bowel. Sometimes they will take samples of tissue as part of the procedure in order to diagnose your problem.

They also look after patients recovering from major bowel surgery who may need support with their nutrition post operatively. In addition, the team also run specialist clinics for inflammatory bowel disease, anaemia, pelvic floor and functional bowel disorders, abdominal wall hernias, as well as piles and fissures for patients who may need support with their nutrition both pre and post operatively.

We have four breast surgeons, who are based at the Wirral Breast Centre at Clatterbridge Hospital. They are supported by five Clinical Nurse Specialists (key workers), one Cancer Care Coordinator and one Advanced Nurse Practitioner.

The team will get together each week in which all patients with suspected or diagnosed breast cancer are discussed. Plans for treatment are then agreed.

The breast clinics are based within the Breast Unit. This allows the patient to be referred quickly from the screening department and also allows for diagnostic tests to be carried out on your first appointment with a breast surgeon.

Surgical procedures carried out by the breast team include mastectomy and breast reconstruction. We can also offer a nipple tattooing service.

We also provide family history clinics and assessment under the national guidance for entry in to the family history screening programme.

If you require any further information regarding your breast cancer please visit the Macmillan website (see link on left).

Colposcopy is a detailed examination of the cervix using a special microscope called a colposcope. It is required as part of the NHS Cervical Screening Program to investigate women who have had abnormal cervical smears and to help decide if treatment is needed.

Most women who have an abnormal smear will not develop cervical cancer, and the colposcopic examination helps to identify the women who are at high risk and arrange for them to be treated before the abnormality becomes serious.

The unit also sees women who have been noted to have an abnormality or abnormal symptoms of either the cervix vagina or vulva.

Services Available

• Colposcopy, vaginoscopy and vulvoscopy (Microscope examination of the cervix, vagina or vulva)
• Diagnosis and treatments including biopsy and loop excision

Routine Investigations:
Patients will be seen by a doctor or specialist nurse where an examination will be performed. If an abnormality is detected this will normally be removed on the same visit using local anaesthetic.

Appointments

If you have an abnormal smear then you should receive an appointment automatically from the screening laboratory. For other problems your GP or nurse will refer you directly and an appointment will be sent out to you. We regret that you will not be able to refer yourself.

Once we have received the colposcopy referral from your GP or clinic, you will receive details of your appointment within three to five days.

Your referral details are seen by a doctor who will then decide how soon you need an appointment, depending on the degree of abnormality and other factors in your medical history.

For urgent cases you will be seen within two weeks; ‘soon’ cases within two to four weeks; and routine cases within four and six weeks.

If you have any queries about being referred to the Colposcopy Unit please contact the clerks on 0151 604 7775.

Opening Times

Moday to Friday 8.00am to 6.00pm

All clinics, and most surgery, for gynaecological conditions are based at Arrowe Park Hospital, although any complex ovarian surgery is performed at Liverpool Women’s Hospital.

The gynaecology team meets on alternate weeks in which tests and investigations are reviewed and discussed and treatment plans agreed.

Services provided by the unit include, colposcopy clinic, vulval clinic, cancer clinic, pelvic mass clinic and outpatient hysteroscopy service.

The Haematology teams for Wirral University Teaching Hospital and the Countess of Chester Hospital work closely together to provide specialist services to the population of Wirral and Chester.

Our Trust has three Haematology Consultants, one Clinical Nurse Specialist for haematology and one Clinical Nurse Specialist for chemotherapy.

The haematology department is based on the third floor at Arrowe Park Hospital and has facilities for outpatients, day case patients and inpatients within the department.

The team meets weekly in which tests and investigations will be reviewed, discussed and treatment plans agreed.

We have three ear, nose and throat (ENT) Surgeons, who are based at Arrowe Park Hospital. They are supported by a Clinical Nurse Specialist (key worker).

The team meets weekly in which all patients with suspected or diagnosed cancer are discussed and plans for treatment agreed. Any patient diagnosed with a head and neck cancer at this meeting will be referred to Aintree Hospital for further treatment, as complex head and neck cancer surgery is currently not carried out within this Trust.

Our local lung cancer team consists of local chest physicians, specialist nurses, radiologists, pathologists and close links to Liverpool Heart and Chest Hospital,  Clatterbridge Centre for Oncology and Hospice services. We meet weekly as a team to discuss on-going management of all patients under our care (this includes consultant surgical and oncology colleagues).

Following referral to the service all cases are reviewed prior to the first outpatient appointment by one of our respiratory consultants. If required a CT scan is organised on receipt of referral; images reviewed with the clinical information supplied and further investigations are booked from a virtual review clinic on a daily basis.  If investigations are requested patients are contacted by one of our lung specialist nurses to explain the process and contact information is given.

Locally we offer a full range of diagnostic tests including bronchoscopy, endobronchial ultrasound (EBUS), dedicated pleural clinic and medical thoracoscopy. If required we will arrange the most appropriate test to investigate possible lung cancer. Very occasionally we may need to arrange investigations at another hospital if we cannot arrange locally. You may also require detailed lung function testing or occasionally exercise testing which are arranged in our dedicated respiratory laboratory.

As part of standard investigation and treatment you may be asked to be involved in clinical trials which are run locally. This will be explained at your outpatient appointments.

The dermatology service has three Consultants, an Associate Specialist and a Clinical Nurse Specialists. The dermatology department is situated at Clatterbridge Hospital and has an out-patient department that provides minor surgery and daily treatment therapies for dermatological conditions.

The multi disciplinary team meets weekly and discusses and agrees diagnosis in order to plan patient treatment.

The team consists of 3 consultants, who are Dr Tan, Dr Hashim and Dr Farrar. They have 2 associate specialists. The team also have Melanie Meredith as the skin cancer support nurse now too

If you require any additional information regarding skin cancer please refer to the British Association of Dermatologists patient information leaflets http://www.bad.org.uk

The Wirral Hepatobiliary (HPB) Service was introduced in 2008, is the only dedicated HPB cancer team within the Merseyside & Cheshire region and is a member of the Merseyside & Cheshire HPB Clinical Network Group.  The team is comprised of four Consultants (Drs Singhal, Lekharaju, Noorullah & Kia), 2 x Clinical Nurse Specialists and a valued support team consisting of Consultant Secretaries, MDT co-ordinator and administration clerk, all working collaboratively with health care professionals local and regionally, patients and their families.

Wirral University Teaching Hospital NHS Foundation Trust is a non-tertiary centre, working in close collaboration with the specialist regional centres which include University Hospital Aintree (suspected primary cancers affecting the liver, gall bladder or the bile duct (above the cystic duct)) and the Royal Liverpool University Hospital (suspected primary cancers affecting the pancreas and the bile duct (below the cystic duct)).  For patients requiring chemotherapy, effective collaboration with Clatterbridge Cancer Centre is also required again, ensuring timely referral for consultation and treatment. 

Patients are referred to the Wirral HPB service in the event of:

• Suspected cancer of the liver, gall bladder, bile duct, pancreas, duodenum
• Indeterminate lesion / dysplastic nodules
• Intra-ductal papillary neoplasm (IPMN)
• Follicular nodular hyperplasia (FNH)
• Adenoma / Haemangioma / Complex liver cysts

Following referral, discussion of the patient’s case at the appropriate MDT is arranged.   

Surveillance programmes are in operation for those with potentially pre-cancerous lesions including:

• intra-ductal papillary neoplasm (IPMN) (approximately 194 patients under active monitoring)
• Indeterminate lesion / dysplastic nodules, follicular nodular hyperplasia (FNH), adenoma, haemangioma, complex liver cysts

To refer to this service, please direct a detailed letter (which should include information regarding the reason for referral, past medical history, current medication, performance status and patient insight) to Joanne Kirkham (Secretary to Dr Singhal / Lekharaju), Second floor, Arrowe Park Hospital.

The upper gastrointestinal (UGI) cancer team consists of two consultants. The team has the support of two Clinical Nurse Specialists.

The team will meet every week. All patients with suspected or diagnosed UGI cancer are discussed and their plans for treatment agreed. Any patient diagnosed with a UGI cancer at this weekly meeting is referred to Aintree Hospital for further treatment, as UGI cancer surgery is currently not carried out at this Trust.

The urology team consists of 8 Consultant Urologists Mr Snehal Patel and Mr James Glendenning, 3 Uro-Oncology Nurses and 3 Advanced Nurse Practitioners. As well as the local area, the team also treats patients referred from Isle of Man and North Wales.

The urology team has clinics at Arrowe Park Hospital, Clatterbridge Hospital and Victoria Central Health Centre in Wallasey. Surgery is carried out at both Arrowe Park and Clatterbridge Hospitals.

The urology team will have weekly meetings for all the speciality areas within urology. These areas include; kidney, bladder, prostate, penile and testicular.

We are the specialist urology team for the South Mersey region. Patients from the Countess of Chester Hospital and Warrington Hospital will be referred here to our Trust. If you are diagnosed with penile cancer, we may refer you to the Christie Hospital in Manchester for your procedure.