BLADDER CANCER PATHWAY (E&W) Version 1
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1 BLADDER CANCER PATHWAY (E&W) Version 1 Flexi cysto FU (via cystoscopy) ptag1/2 and OP instillations MMC ptag3/cis BCG BCG cancer One-stop Haematuria Clinic TURBT Histology presented Decision to refer to SMDT pt1g2/3 then 2nd look TURBT <pt1 >pt2 Options for Cystectomy Cystectomy +/- EUA beforehand Cystectomy +/- EUA beforehand Direct s for staging where appropriate Staging +/- CT/MRI/ GFR >pt2 Decision to treat Neoadjuvant SMDT /, +/- EUA beforehand e.g. meets NICE criteria; at first seen, MDT date & date + 62 days from these upgrade point dates. Please refer to the AngCN Consultant Upgrade Policy at Tertiary Referral (to SMDT) Referral to extended MDT at any point in pathway e.g. Palliative care specialists, Specialist Nurses and AHPs, education about adverse effects of ; access to help and advice from all specialists; staff alert to psychosocial needs; therapists/local healthcare teams, Community Matron, Pharmacists (medicines usage review), Social Services, Mental Health Services, Housing benefits (Social Care and other agencies), GPs, Expert Patient Programme, Smoking Cessation, Alcohol Service (NORCAS), Voluntary organisations, information on prescription, Homeshield (over 60s) (LMDT meeting) () (2nd ) Elapsed time for follow up or presentation of recurrence, mets or predetermined gap between s H:\Cancer Network\Tumour Site\Urology\Pathways\AngCN-SSG_U6_v1_Urology Pathways_E&W.xls Page 1
2 PROSTATE CANCER PATHWAY (E&W) Version 1 Tertiary Referrals Decision to treat Brachytherapy Cryotherapy cancer Prostate Clinic with biopsy Histology discussed. Staging investigations requested, if appropriate. Patient informed of ( / telephone) - - Patient referred to SMDT no later than day 31, if appropriate (i.e. if patient chooses brachytherapy/ surgery) RRP +/- Androgen Deprivation Therapy (ADT) ADT Adjuvant Staging MRI / Bone/CT LMDT MEETING Androgen Deprivation Therapy (ADT) e.g. meets NICE criteria; at first seen, MDT date & date +62 days from Referral to extended MDT at any point in pathway e.g. Palliative care specialists, Specialist Nurses and AHPs, education about adverse effects of ; access to help and advice from all specialists; staff alert to psychosocial needs; therapists/local healthcare teams, Community Matron, Pharmacists (medicines usage review), Social Services, Mental Health Services, Housing benefits (Social Care and other agencies), GPs, Expert Patient Programme, Smoking Cessation, Alcohol Service (NORCAS), Voluntary organisations, information on prescription, Homeshield (over 60s) (LMDT meeting) () (2nd ) Elapsed time for follow up or presentation of recurrence, me or predetermined gap between s H:\Cancer Network\Tumour Site\Urology\Pathways\AngCN-SSG_U6_v1_Urology Pathways_E&W.xls Page 2
3 PENILE CANCER PATHWAY (E&W) Version 1 Tertiary Referrals (to LMDT) MRI Norwich Partial / total penectomy +/- Partial / total penoctomy +/- cancer Penile Biopsy Histology discussed - Patient informed of - Referral to Supranetwork MDT no later than day 31 SUPRA- NETWORK MDT MEETING OPD Norwich Local Urological Follow Up e.g. meets NICE criteria; at first seen, MDT date & date + 62 days from Referral to extended MDT at any point in pathway e.g. Palliative care specialists, Specialist Nurses and AHPs, education about adverse effects of ; access to help and advice from all specialists; staff alert to psychosocial needs; therapists/local healthcare teams, Community Matron, Pharmacists (medicines usage review), Social Services, Mental Health Services, Housing benefits (Social Care and other agencies), GPs, Expert Patient Programme, Smoking Cessation, Alcohol Service (NORCAS), Voluntary organisations, information on prescription, Homeshield (over 60s) () (2nd ) Supra Network Elapsed time for follow up or presentation of recurrence, mets or predetermined gap between s H:\Cancer Network\Tumour Site\Urology\Pathways\AngCN-SSG_U6_v1_Urology Pathways_E&W.xls Page 3
4 KIDNEY CANCER PATHWAY (E&W) Version 1 Systemic Therapy Where indicated DMSA (Unit) Cryotherapy Venous inv Surgery Follow Up Metasteses excision cancer / Haematuria Clinic Staging CT / MRI Decision to refer to SMDT Patient informed of Uro- Clinic (UOC) Partial Nephrectomy Renal Where indicated DMSA (Unit) Palliative Surgery e.g. meets NICE criteria; at first seen, MDT date & date + 62 days from Referral to extended MDT at any point in pathway e.g. Palliative care specialists, Specialist Nurses and AHPs, education about adverse effects of ; access to help and advice from all specialists; staff alert to psychosocial needs; therapists/local healthcare teams, Community Matron, Pharmacists (medicines usage review), Social Services, Mental Health Services, Housing benefits (Social Care and other agencies), GPs, Expert Patient Programme, Smoking Cessation, Alcohol Service (NORCAS), Voluntary organisations, infor on prescription, Homeshield (over 60s) () (2nd ) Elapsed time for follow up or presentation of recurrence, met or predetermined gap between s Review Date: Reviewed and reissued, no changes August Next review 2 years H:\Cancer Network\Tumour Site\Urology\Pathways\AngCN-SSG_U6_v1_Urology Pathways_E&W.xls Page 4
5 TESTICULAR CANCER PATHWAY (E&W) Version 1 Sperm banking +/- CT cancer Outpatient Appointment and Ultrasound FDT Orchidectomy Supra Regional Network TEAM Patient informed of RPLND Inform supra-regional network e.g. meets NICE criteria; at first seen, during or after diagnostic tests; on or before MDT date & date +62 days from these upgrade point dates. Please refer the Referral to extended MDT at any point in pathway e.g. Palliative care specialists, Specialist Nurses and AHPs, education about adverse effects of ; access to help and advice from all specialists; staff alert to psychosocial needs; therapists/local healthcare teams, Community Matron, Pharmacists (medicines usage review), Social Services, Mental Health Services, Housing benefits (Social Care and other agencies), GPs, Expert Patient Programme, Smoking Cessation, Alcohol Service (NORCAS), Voluntary organisations, information on prescription, Homeshield (over 60s) - 28 (FDT) (Treatment) (2nd ) Supra Network Elapsed time for follow up or presentation of recurrence, mets or predetermined gap between s H:\Cancer Network\Tumour Site\Urology\Pathways\AngCN-SSG_U6_v1_Urology Pathways_E&W.xls Page 5
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