Pathway for patients with suspected Upper GI (OG) Cancer Maximum Wait (Days) Provide information and psychological support throughout the pathway GP to ensure that patient stops PPI’s 2 weeks in advance Referral received in secondary care 14 Days History Physical examination WHO performance status Endoscopy & biopsy CT First Seen Rapid specialist assessment & one stop diagnostic service 14 Allocate UGI CNS Holistic assessment Is UGI cancer or HGD confirmed or suspected? Consider rehabilitation needs No Patient removed from cancer pathway 16-18 years old – refer to Paediatric Oncology (GNCC) for treatment and TYA MDT for discussion 19-24 years old – continue on tumour site specific pathway & refer to TYA MDT for discussion. See TYA pathway Yes Inform patient’s GP Local MDT discussion with Specialist MDT See OG rehabilitation care pathway liaise & involve healthcare professionals as required 17 Days Further diagnostic / staging investigations as appropriate Refer for PET scan if indicated Inter Provider Transfer Network Best Practice Specialist MDT discuss treatment & rehabilitation plan plus consideration for clinical trials 31 18 Days Laparoscopy EUS PET Scan MRI Assess fitness Bone Scan Decision to treat Staging investigations as indicated 49 13 Days Agree proposed treatment plan with patient Surgery Radiotherapy Chemo Radiotherapy Endoscopic treatment Neo Adjuvant Surgery First treatment HER2 testing for gastric & junctional tumours 62 Supportive & palliative care Radical treatment Earliest Clinically Appropriate Date for commencement of subsequent treatment Is further treatment required Yes No Appropriate after care UGI Cancer Pathway [Final]