Providing patients with RAPID care (rapid access prostate Imaging and diagnostics) Urology

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1 Providing patients with RAPID care (rapid access prostate Imaging and diagnostics) Urology

2 Providing patients with RAPID prostate diagnostic care We have launched a new initiative to make sure patients who have suspected prostate cancer have the necessary tests and check-ups as soon as possible. The vast majority of people referred to us do not have cancer, but we appreciate that this can be a worrying time, and we want to reach a full diagnosis as soon as is possible. As such, when a GP refers a patient to hospital with a suspected cancer, you will have an appointment within two weeks. We have partnered with the Royal Marsden to make this process even faster for patients with suspected cancer of the prostate, and are streamlining the diagnostic tests you may need. This is known as the RAPID prostate pathway for patients (which stands for Rapid Access Prostate Imaging and Diagnosis). To be eligible for this method of providing care, you must be available and not on holiday for the next two weeks. What happens next? Once we have received your referral we will contact you to arrange a clinical assessment with a nurse specialist over the telephone (this is known as a Telephone Clinic Assessment). We aim for this to take place within a few days, so please do your best to fit the offered appointment time in with your schedule. What is a Telephone Clinic Assessment appointment? One of our expert urology nurses will contact you by telephone at the time of your scheduled appointment to complete an assessment of your urinary symptoms and gather some additional information about you. This will help us decide whether or not you require a Magnetic Resonance Imaging (MRI) scan of your prostate, or an appointment to see a urologist face-to-face at the hospital. 1

3 What can I do to help? Ensure your contact details are up-to-date Please try to avoid cancelling appointments at the last minute Arrange to take the telephone call in a private place If you would like someone else to speak on your behalf (you must still be present) please explain this to the nurse before your appointment Have a list of your medications with you. What if I need an MRI scan following my telephone assessment? You may be offered your scan appointment at the end of your telephone assessment. This will be followed by an appointment in an outpatient clinic, where you will meet a urologist to discuss the results of your MRI scan. We encourage you to bring someone with you to all your appointments. Please read the attached leaflet for detailed information on MRI and what to expect at your visit. Who can I contact if I am unsure or worried about an aspect of my care? We appreciate this can be an overwhelming time for both you and your family and are here to support you through this process. Should you require any additional information please do not hesitate to contact our Clinical Nurse Specialist Team on: at Epsom Hospital or at St Helier Hospital. 2

4 This section of our leaflet is to explain a little more about MRI scans, what is involved and what will happen. Not everyone who has a clinical assessment by phone or seen by the RAPID team will need an MRI. What is an MRI prostate scan and why might I need it? MRI means Magnetic Resonance Imaging. It s a type of scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body and is very useful for looking at soft tissue structures, such as the prostate. The scanner itself is a large tube that contains powerful magnets which you lie inside during the procedure. To help our clinical teams get a clearer image of the prostate, we use a new, more accurate way of using MRI called multiparametric (mp) MRI. This type of MRI is made up of three different MRI scans and is analysed by a team of doctors at the same time. The multiple images taken by the mpmri scanner can show us if there is clinically significant cancer in the prostate that requires further investigation and treatment. Is the scan safe? Due to the magnetic field, safety is very important. To make sure you are safe to have an MRI scan you need to inform us if you answer yes to any of the following: You have a cardiac pacemaker You have had any type of heart surgery You have a cochlear implant, neurostimulator or programmable hydrocephalus shunt You have any metal implants in your body You have had an injury to your eyes involving metal or metal fragments You have had any operations on your head, eyes, ears or spine. 3

5 Who will I see? A small team of radiographers will care for you during your visit for a scan. Radiographers are healthcare professionals who specialise in imaging the human body. Do I need an injection? Yes. We will need to give you an injection of substance known as contrast medium into a vein, to increase the information we can get from the scan. As with all injections there is a very small risk of an allergic reaction, ranging from minor reactions such as a skin rash to more serious such as the medication leaking from the vein. Please be assured that our medical teams will be on hand throughout the scan, and are trained to deal with this should it happen. If you have reacted to any other injection given for a kidney X-ray or a previous scan, please ensure you let the radiographer know before the injection takes place. Who will I see? We will ask you some safety questions when we book your scan appointment Please inform us if you have not had a recent blood test taken by your GP or at the hospital You can continue to eat and drink as normal and take any prescribed medication You should come dressed in clothes without zips or metal buttons if possible You should leave any valuable possessions, such as jewellery or watches at home You should arrive 10 minutes before your appointment You should tell us about any special circumstances (for example, if you need wheel-chair access, if you are hard of hearing or if you are claustrophobic) If you are diabetic please inform the nurse during your telephone assessment appointment. 4

6 What will happen during my appointment? When you arrive you should go to the reception desk and book in for your appointment A member of the team will greet you and explain the procedure to you We will complete a safety questionnaire with you We will ask you to change into a gown We will keep your clothing and personal items in a secure place We will give you a chance to ask any questions You will be asked to lie down on the MRI bed and we will make you as comfortable as possible. The radiographer will position you correctly for the scan and you will be asked to stay as still as possible The radiographer operating the scanner will help you through the procedure and talk to you between each scan If you experience any difficulty during the scan you will be able to use the emergency call bell for help. Will it be uncomfortable? The scan itself doesn t hurt, but you will need to lie still in the scanner for some time, which some people find uncomfortable. We will do all we can to make the scan as comfortable as possible. You will hear some loud mechanical sounds from the scanner which is completely normal. How long will it take? Most scans take around 45 minutes. After your scan You can eat and drink as normal You can drive home afterwards and return to work if needed. 5

7 Are there any side effects? There are no known side effects following an mpmri scan (although please see above about minor risks following the injection). When will I get the results? A radiologist and the urology team will look at and discuss your scan, finalising a report within a few days of it taking place. You should have already been given a clinic appointment (at the same time you were given your scan appointment) to come along and get your results. Can I bring a relative or friend with me for the scan? Yes, of course. The person you bring must complete a safety questionnaire on the day to ensure their own safety, and remove all metal objects before they enter the scan room with you. Useful sources of information: You can find a wealth of information, resources and educational videos on 6

8 Join our pursuit to put the Patient First! Be an #esthchampion and join our dedicated patient programme. You ll get all the latest news and exclusive invitations to special events, so sign up at epsom-sthelier.nhs.uk/patientfirst or call Date published: November 2017 Review date: November 2018 Great care to every patient, every day