English NHS patients will need to be referred by a GP for a second opinion or by a clinician in their local hospital (surgeon, gastroenterologist or oncologist). Please note that patients from Wales and Northern Ireland require additional local approval before we can offer an opinion and treatment. Patients from Scotland may require additional approval for certain pathologies.
The referral should be in the form of a letter with clinical history. Please include patient identifiers and contact details, CNS contact details, and your secretary contact details. Please also state whether or not the patient is aware of the referral. The letter should include diagnosis and treatments to date including chemotherapy and/or radiotherapy to date (when type, amount), past medical history, and performance status. Also provide the following supporting information:
- Histopathology reports from any biopsies/operations
- Operation notes
- Endoscopy reports
- recent blood tests including tumour markers
- imaging reports
Please note that we require there to be up-to-date imaging (CT/MRI) within 6 weeks of the date of the referral. Please download, complete and submit the attached checklist with the referral.
When we get your referral we'll acknowledge that it has been received. Our administrative team will collect all the relevant information to help us give our opinion. For patients referred to us with peritoneal tumours, we have a 'consultant of the week' system to make sure your referral is dealt with promptly.
We recommend referral for the following:
- Appendix neoplasms (pre or post appendicectomy) including low grade appendiceal mucinous tumours (LAMN), adenocarcinomas, neuroendocrine tumours (carcinoids), goblet cell carcinoids and MANEC tumours.
- Patients with suspected pseudomyxoma peritonei on CT scan (with or without biopsy)
- Patients with suspected pseudomyxoma peritonei at laparotomy
Peritoneal metastasis from colorectal cancer (PMCR)
- Cytoreductive surgery (CRS) and Hyperthermic Intra-peritoneal Chemotherapy (HIPEC) should be considered in the following scenarios:
- Colorectal primary in situ with synchronous peritoneal disease/ ovarian metastases.
- Resected primary with synchronous peritoneal/ ovarian metastases.
- Resected primary with metachronous peritoneal/ ovarian metastases
- Low volume resectable liver and/or lung metastases without evidence of active lymphadenopathy
For patients with non resectable extra-peritoneal metastatic disease or nodal disease outside the primary field initial systemic chemotherapy should be considered.
Rare Peritoneal Tumours
- CRS is not indicated if the patient needs urgent surgery for an acute abdomen. In these cases we are likely to recommend surgery in their local hospital and are happy to discuss cases on an individual basis.
- Attempting CRS in the form of peritoneal stripping especially in areas such as the diaphragm and pelvis makes subsequent surgery difficult and reduces the chance of achieving complete cytoreduction.
- Patients who are deemed medically unfit for colorectal resection would not be suitable for CRS & HIPEC.
If in doubt please contact us
We accept private patients who will be treated through The Christie Clinic.