1. 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]