The Upper GI Cancer Team

 

The Upper GI team 

Hello my name is Tracey Heslop.

I am the Upper GI  Clinical Nurse Specialist. I provide support and information for people diagnosed with upper gastrointestinal cancers.  These are cancers that affect the esophagus (gullet), stomach, pancreas, gall bladder and liver.

I work closely with consultants, nurses and other team members based at Tameside Hospital. 

I also works closely with the teams at the Christie Hospital and Manchester Royal Infirmary who are involved with the investigations and treatment for these cancers.

What is a Multi-disciplinary team (MDT)?

 

 

Your diagnosis and treatment of cancer involves a number of specialist health professionals. This team is called a multidisciplinary team or MDT for short. The team works together to ensure you receive the most appropriate treatment without delay. You will meet some of the members of the team during your investigations and treatment.

What is a MDT meeting?

The Team meet together weekly on a Wednesday to discuss all new patients diagnosed with Upper Gastrointestinal (esophagus or stomach) or Hepatobilary (pancreas, gall bladder or liver) cancer. The results from your investigations will be discussed at this meeting and possibly more investigations ordered.  

Your case is then discussed at what is called the Specialist MDT meeting on a Friday morning. Doctors from The Christie and Manchester Royal Infirmary are also present at this meeting. They review all the results of investigations and decide which treatments are most appropriate for you.  
You will be informed of the outcome of the meeting as soon as possible. You may be referred to a Consultant at The Christie or Manchester Royal Infirmary for their assessment before a treatment decision can be made.

Who are the members of the team?

The Consultant UGI Surgeon is Mr BenHamida. If you have an UGI cancer, you will usually be transferred under his care, even if you are not going to have surgery. Mr BenHamida and his team are specialised in the investigation, treatment and ongoing management of UGI cancers.

The Consultant Gastroenterologists are Dr Whatley, Dr Saleem and Dr Patel You may well have been seen and investigated by one of the consultants and/or members of their team prior to your diagnosis.

The Consultant Radiologists are Dr Brett and Dr Mahmood. They have a particular interest and experience in UGI and HPB cancers. They are specialised in interpreting X-rays, CT scans, MRI scans and Ultrasound scans.

The Consultant Pathologist is Dr Awad. She is part of a team of Consultants who examine biopsy specimens under the microscope.

The Oncologist. This is a doctor who specialises in the management of cancer  with chemotherapy or radiotherapy. The UGI Cancer Team oncologist is Dr Mansoor at The Christie. He specialists in treating UGI cancers with chemotherapy.  He may refer you to one of his colleagues if radiotherapy is thought to be of benefit.

The Clinical Nurse Specialist is Tracey Heslop. She is a nurse experienced in the treatment and care of people with cancer.  She is your Key Worker, and provides access to the UGI Consultants.

The Dietician is Jillian Barlow, who is part of the Department of Nutrition and Dietetics. She works as part of the UGI Team and will be involved in your care, possibly from the outset, providing information and advice to you about your diet 


Information following the MDT

As the MDT are making decisions about your treatment, you will obviously want information about this quickly. How you will be provided with this information will normally be agreed with you prior to the MDT meeting.


Where to get help and advice

You will be given information in your UGI Service pack. If you have concerns or need urgent advice, you can contact:

 

Tracey Heslop: 0161 922 4166
UGI Clinical Nurse Specialist

Julie Brodie:   0161 922 6123
Mr BenHamida’s secretary


 

 

Tameside Tappers Upper GI Support Group

Here to provide practical advice & Support to people affected by Upper GI cancers, Oesophageal (gullet) cancer and Stomach cancer. The support group is run by Tracey Heslop upper GI cancer nurse specialist.

A group providing support to adults affected by upper GI cancer through befriending, cancer information materials, cancer information in other languages, complementary therapies, dietary therapies, information, spoken interpretation service, support from health professionals, telephone helpline, written resources in other languages, and disabled access.

 

The group meets on the second Wednesday of the month from 1pm til 4pm and is facilitated by Tracey Heslop, Upper GI Nurse Specialist at Tameside Hospital. We have talks from health professionals and cater to both patients and carers, we also have regular social events.

 

We offer:

Befriending

Cancer information materials

Cancer information materials in other languages

Complementary therapies

Dietary therapy

Information

Spoken interpretation service

Support from Health Professionals

Telephone helpline

Written resources in other languages

 

Interested in joining us?

Check our events page here for details about thenext meeting

Just come along to our next meeting, or get in touch with us on the details below.

 

Find out more:

Tracey Heslop on 0161 922 4166 (Monday-Friday 7 am - 6 pm)

tracey.heslop@tgh.nhs.uk

 

About oesophageal cancer

A clinical oncologist talks about oesophageal cancer, how it is diagnosed and treated

The oesophagus

The oesophagus is also known as the gullet or food pipe. It’s part of the digestive system, which is sometimes called the gastro-intestinal tract (GI tract). The oesophagus is a long, muscular tube that connects your mouth to your stomach.

It’s around 25cm (10in) long in adults. When you swallow food, the walls of the oesophagus squeeze together (contract). This moves the food down the oesophagus to the stomach.

The upper part of the oesophagus is behind, but separate from, the windpipe (trachea). The windpipe connects your mouth and nose to your lungs, so you can breathe. The area where the oesophagus joins the stomach is called the gastro-oesophageal junction.

There are a number of lymph nodes close to the oesophagus.

The oesophagus has four layers:

  • The mucosa – the inner layer, which is moist to help food pass smoothly into the stomach.

  • The submucosa – this contains glands that produce mucus (phlegm), which keeps the oesophagus moist.

  • The muscularis – the muscle layer, which pushes food down to the stomach.

  • The adventitia – the outer layer, which attaches the oesophagus to nearby parts of the body.

Signs and symptoms of oesophageal cancer

The most common symptoms of oesophageal cancer include:

  • difficulty swallowing – feeling that your food is sticking in your throat or chest

  • weight loss

  • food coming back up before reaching the stomach (regurgitation) or being sick (vomiting)

  • pain when swallowing

  • indigestion or heartburn that doesn’t go away

  • a cough

  • a hoarse voice – caused by pressure on the nerve that supplies the voice box

  • dull pain or discomfort behind the breastbone or in the back.

There are other conditions that can cause these symptoms, but you should always have them checked out by your doctor.

How oesophageal cancer is diagnosed

You usually start by seeing your GP, who will examine you. You may have blood tests to check your general health.

If your GP is unsure what the problem is, or thinks you may have cancer, they will refer you to a hospital for an endoscopy, specialist advice and treatment. 

If a cancer is suspected, you should be seen at the hospital within two weeks.

At the hospital

Your first appointment at the hospital may be for an endoscopy. If the endoscopy suggests that you might have cancer, you will then see a specialist. They will ask you about your general health and any previous medical problems. They will also examine you. You may have blood tests and a chest x-ray to check your general health. In some hospitals, you will be seen by a specialist nurse before seeing a doctor.

 

Endoscopy

The doctor or a specialist nurse will put a thin, flexible tube (endoscope) into your oesophagus. There is a tiny light and camera on the end of the tube. This helps to see any abnormal areas. If necessary, they can take a small sample of cells (biopsy) to be examined under a microscope. This can usually confirm whether there is a cancer present. The biopsy is not painful.

You will usually have an endoscopy in the hospital outpatients department, but occasionally you’ll need to stay in hospital overnight. You’ll be asked not to eat or drink for at least four hours before the procedure. You’ll also be given instructions about any medicines you’re taking.

To have the endoscopy, you will be asked to lie on your side on a couch. A local anaesthetic may be sprayed on to the back of your throat. Or you may be given a sedative to make you feel sleepy and reduce any discomfort. The sedative is usually injected into a vein in your arm. Sometimes both an injection and the spray are used. The doctor or nurse then passes the endoscope down and examines the inside of the oesophagus.

An endoscopy can be uncomfortable but shouldn’t be painful. Let your doctor know if you have any chest pain during or after the procedure.

If you’ve had the local anaesthetic spray to the back of your throat, you may need to stay in hospital until it has worn off. This usually takes about an hour. You shouldn’t try to swallow anything during this time. After a few hours, the effect of the sedative will wear off and you’ll be able to go home. You shouldn’t drive for several hours after the test and should arrange for someone to travel home with you.

Some people have a sore throat afterwards. This is normal and should get better after a couple of days. If it doesn’t, let your doctor at the hospital know

The link above takes you to Macmillan Cancer Support`s Information and support for people affected by oesophageal (gullet) cancer.

This includes information on:

 

Understanding oesophageal cancer

and what it is

Diagnosis

Symptoms, causes and risk factors of oesophageal cancer. 

Types of oesophageal cancer

There are two main type of oesophageal cancer:  squamous cell carcinoma and adenocarcinoma.

organising

The practical, Work and financial side

Treating

oesophageal cancer and what to expect 

Coping

With and after treatment for oesophageal cancer

Resources

to download and print 

Useful links

Example text

Further information

Latest from Macmillans online community

Ask the experts

Gullet (oesophagus) cancer webchat transcript

Read this recent webchat transcript, in which specialist nurses John and Carol answered questions on gullet (oesophagus) cancer. They talk about treatment, eating and dry mouths.

A support group for anyone affected by gullet cancer (also known as oesophageal cancer) to come together, share experiences and ask questions.

 

Cancer is a disease of our cells. Sometimes cells go wrong and become abnormal. They keep dividing to make more abnormal cells which form a lump or tumour

A cancer doctor explains how cancer develops, how it can be treated and what might happen

Signs and Symptoms of Stomach Cancer

The early symptoms of stomach cancer are similar to the symptoms of some common stomach conditions. They include:

  • heartburn or indigestion that doesn’t go away

  • burping a lot

  • having no appetite

  • feeling full after eating only a small amount

  • losing weight.

Other possible symptoms are:

  • pain or swelling in the upper tummy area

  • feeling or being sick

  • having difficulty swallowing

  • blood in your stools (bowel motions) or black stools

  • feeling tired or breathless (due to anaemia, which is a reduced number of red blood cells).

These symptoms can be due to other conditions. But it’s important to get them checked. Your doctor can arrange tests if necessary. If you are over 55 and suddenly develop indigestion that doesn’t go away, you should always have an endoscopy

Being diagnosed with Stomach Cancer

Usually, you begin by seeing your GP (family doctor). Sometimes, people are diagnosed with stomach cancer after being admitted to hospital with a symptom that is making them unwell.

At your appointment, the GP will talk to you about any symptoms you have, examine you and arrange any tests that you need. If they think your symptoms may be serious, they will arrange immediate tests or an urgent referral to a specialist doctor at the hospital.

At the hospital you will usually see a doctor called a gastroenterologist. They specialise in treating stomach and digestive problems. The doctor will ask you about your symptoms and your general health before examining you. You may also see a surgeon or a gastrointestinal nurse specialist.

Your doctor will arrange for you to have a test called an endoscopy to look at the inside of your stomach.

You’ll have blood tests to check your general health and to find out if you’re anaemic (low amount of red blood cells).

Some people may also have a test called a barium meal. For this, you are asked to drink a liquid called barium, which helps to show the stomach more clearly on an x-ray.

 

Endoscopy (or gastroscopy)

An endoscopy, also called a gastroscopy, is the most common test used to diagnose stomach cancer. An endoscope is a thin, flexible tube with a tiny light and video camera at the end, which sends pictures to a screen. The doctor or nurse who does the test is called an endoscopist. They will use the endocope to look at your gullet (oesophagus), the inside of your stomach and the beginning of your small bowel.

You can have an endoscopy as an outpatient, so you can go home the same day. It usually takes about 10 minutes and although it can be uncomfortable, it’s not painful. You’ll be asked not to eat or drink anything for several hours before the test. You’ll be given instructions about any medicines you’re taking.

The nurse or doctor may give you a sedative to relax you and make you drowsy. This is given as an injection into a vein in your arm. Sometimes they spray a local anaesthetic on to the back of your throat.

To have the endoscopy, you lie on your side on a couch. The endoscopist will then gently pass the endoscope down your gullet and into your stomach. They may put some air down it to inflate your stomach and make it easier to see everything. After the test is done, they will gently remove the endoscope.

If you had a sedative, the effects should only last a few hours. But you’ll need someone to drive or travel home with you. If you only had the anaesthetic spray, you’ll need to wait until the numbness wears off before you eat or drink.

Some people have a sore throat after their endoscopy. This is normal and it should get better after a few days.

Biopsy

During the endoscopy, the endoscopist can remove small samples of tissue from any areas that look abnormal. This is called a biopsy. This is called a biopsy.

The tissue is examined under a microscope to find out if there are any cancer cells.

Information and support for people affected by stomach cancer

The link above takes you to Macmillan Cancer Support`s Information and support for people affected by stomach cancer.

This includes information on:

 

Understanding stomach cancer

and what it is

Diagnosis

Symptoms, causes and risk factors of stomach cancer. 

Types of stomach cancer

About 7,000 people are diagnosed with stomach cancer in the UK each year. This information is about the most common type of stomach cancer called adenocarcinoma. 95% of stomach cancers are adenocarcinoma. It starts in the glandular cells of the stomach lining.

Less common cancers that can start in the stomach include:

The tests and treatments for these cancers are different from those for adenocarcinoma.

organising

The practical, Work and financial side

Treating

Stomach cancer and what to expect 

Coping

With and after treatment for stomach cancer

Resources

to download and print 

Useful links

Example text

Further information

Our Online Community is always open and full of people ready to support you.

A support group for anyone affected by stomach cancer, including adenocarcinoma and GISTs (gastrointestinal stromal tumours) to come together, share experiences, and ask questions

Tracey Heslop

Tameside Macmillan Upper GI Team

Tameside Macmillan Unit

Tameside Hospital, Fountain Street

Ashton-under-Lyne OL6 9RW

Phone: 0161 922 4166

Email:  tracey.heslop@tgh.nhs.uk

Tameside and Glossop

Macmillan information and support service

Tameside Macmillan Unit

Tameside Hospital, Fountain Street

Ashton-under-Lyne OL6 9RW

Email Macmillan.info@tgh.nhs.uk

Call 0161 922 5640

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Open Monday to Friday 9:00am to 4:00pm 

(Except Bank Holidays).

Drop-in service, no appointment needed. However please contact us first if you are making a special journey, to ensure someone is available to see you.