Regional Specialist Pancreatic Cancer Surgical centres

Specialists have agreed that in the UK pancreatic cancer surgery should only take place in specialist centres serving a population of at least 2million so that the team of surgeons deals with a high volume of patients - around 100 to 200 a year. The progress towards regionalization of pancreatic cancer surgery in the UK has been slow but is taking place.

Establishment of regional centres in England is due to be complete in 2007. Some centres are now established and in other areas the final location of the surgical centre has still to be decided so that the number of hospitals offering pancreatic cancer surgery will be reduced slightly. Centres are already agreed in Scotland but in Wales and Ireland the services have not yet been formally reorganized.

We provide a list of the current regional pancreatic cancer surgical centres and where possible we have provided links to the hospital web-sites and information on their services and consultants and medical teams treating pancreatic cancer. These services may be called HPB ie hepatopancreaticobiliary as the same specialists may deal with pancreatic, liver, gallbladder and bile duct cancers. As the regionalization of surgery is still being developed the hospitals designated to undertake surgery may change so we cannot guarentee that the list is totally up to date.

Tumour Specific Multidisciplinary Teams and Cancer Networks

A patient may initially be referred for diagnostic tests by their GP to see a specialist at the local hospital or be sent direct to the regional surgical centre.

The regional surgical centre should have formally established links with a network of surrounding district hospitals so that all patients within their network/region should have their cases considered by the regional surgical centre even if the patient never actually attends a clinic at that hospital.

Their case should be considered by meetings of multidisciplinary teams (MDT) of specialists including gastroenterologists, radiologists, surgeons, oncologists, specialist nurses etc who will look at the scans and other test information and decide on the best treatment options and in particular whether the patient may be suitable for surgery. These meetings are usually held once a week to consider all the latest cases. If a patient is seen at a hospital that isn't the surgical centre their case will first be discussed at the local MDT and then referred on to the regional centre MDT meeting. The patient should then be seen by a specialist at clinic at either the local hospital or surgical centre or both.

If a patient is considered a candidate for surgery they will be referred onto the regional surgical centre if not already under a consultant at that hospital.

If it is decided that surgery is not possible the patient will then remain under the management of the local hospital cancer centre or be referred to another centre providing specialist chemotherapy or radiotherapy and trials. If the patient is not fit enough for treatments such as chemotherapy or radiotherapy they may then return for palliative care under the care of their GP, Macmillan nurses, local hospices etc.

Cancer services are organized within regional cancer networks. The cancer network may not exactly coincide with the network of hospitals serving a regional pancreatic cancer surgical centre however they often do. The cancer network has tumour specific working groups of specialists with patient(or user/carer) representatives who agree the local guidelines for provison of services within the network within the framework of national guidelines eg NICE or DoH. The work of the cancer networks is subject to periodical peer review. These tumour groups may be called "Upper GI" ie include all upper gastorenterological cancers such as oesophageal, gastric (stomach), pancreatic, bile duct and liver or there may be separate groups for HPB and oesophageal plus gastric cancers.

Provision of Chemotherapy and Radiotherapy

Treatment for inoperable patients or treatment following surgery may include chemotherapy and/or radiotherapy within or outside trials. This may be provided at a local cancer centre, the surgical centre or specialist cancer centres such as Christies (Manchester), Clatterbridge(Wirral/Liverpool), Royal Marsden (Sutton and London), Beatson (Glasgow). These hospitals will be part of a regional network including the regional surgical centre.

Web-sites providing information on specialists

The www.specialistinfo.com web-site provides a subscription based searchable database of consultants special interests, clinics and contact information

Dr Foster consultant guide provides a free searchable list of consultants

None of the above lists include all consultants and many of the top consultants don't appear in those databases.

You can also find information on specialists in the list of current regional pancreatic cancer surgical centres which indicates all the main surgical centres that we are aware of and on some of the web-sites of the regional cancer networks.

This organization of services can be very confusing so do talk to your medical porfessionals about this or email us by clicking here and we will endeavour to get back to you as soon as possible.