An Introduction To The Multi-Disciplinary Team For Bowel And Anal Cancer

An introduction to the Multidisciplinary team for bowel and anal cancer

At the Brighton and Sussex University Hospitals NHS Trust, which covers the Royal Sussex County and Princess Royal Hospitals, we have adopted a Multidisciplinary Team (MDT) approach to bowel and anal cancer care.

Who will be involved in my care?

You will be cared for by a Multidisciplinary team consisting of doctors and nurses who all have specialist training and experience in the diagnosis, care and treatment of colon, rectal and anal (lower gastrointestinal) cancers.

We work closely together to plan and deliver the most effective treatment and care for each individual patient. This is done in consultation with you and your family, and occurs at each stage of treatment pathway. The MDT meets on a weekly basis to discuss individual patients’ treatment and care. We call this meeting the Multidisciplinary Meeting or MDM meeting.

If there is anything about your care and treatment that you do not understand please don’t be afraid to ask, we are all here to help. We have listed some of the people in the team who may be involved in your care:

Specialist Colorectal Cancer Surgeons, trained to perform operations to manage cancer
Specialist Oncologists, (Cancer Doctors), trained to prescribe therapies such as chemotherapy and radiotherapy
Gastroenterologists, trained in the medical management of diseases affecting the bowel
Macmillan Clinical Nurse Specialist, (CNS) Key Workers, see below. An introduction to the Multidisciplinary team for bowel and anal cancer
Macmillan Support Worker, (MSW), see below
Radiologists, who will have special expertise interpreting scans in relation to bowel, rectal and anal cancers
Histopathologist, a specialist Doctor who analyses tissue under the microscope
Treatment Radiographer, who monitors and supports patients having radiotherapy treatment
Chemotherapy team, including specialist nurses who give medication such as chemotherapy
Patient Pathway Coordinator, who ensures patients care pathway is smooth and timely
Bowel Cancer Screening Team, who screen patients for bowel cancer
Follow Up Coordinator, who is the main point of contact when treatment is completed

Tell me more about the Specialist Nurses (Macmillan CNSs)

The CNSs are registered nurses with specialist education and training in cancer care, working alongside the multidisciplinary bowel cancer team, both on the wards and in the outpatient department.

The CNS will have a key role in coordinating your care with different members of the multidisciplinary team trying to ensure you have the guidance and support you require. You will normally meet them at the time of your diagnosis. The CNS’s offer expert advice on treatment options and give psychological support to you and those close to you throughout your illness, helping people with a possible or confirmed diagnosis of cancer to cope with the particular difficulties it may bring.

Tell me more about the Macmillan Support Worker (MSW)

The Macmillan Support Worker is often the person you will speak to on the phone and she can direct your inquiry to the most appropriate team member and maybe able to answer your questions, She may also arrange for a ‘Holistic Assessment’ to identify areas of concern or worries and plan care accordingly. The Macmillan Team does not provide a 24 hour service but if none of the team is available you can leave a voice message.

If you have an urgent enquiry please do contact your GP, Out of Hours GP service or Community Nurse.

What if I need support or information?

It can be a frightening and unsettling time for patients and their relatives. Whatever you are feeling at present, it may help to talk to someone who has the time to listen and to answer any questions you may have.

The CNS are here to help you at this time, and will be happy to see you, either alone or with your partner, family or friend, whichever you prefer. You can ask them about your diagnosis and disease, as well as your treatment plan and what it will involve. Please feel free to contact them if you feel a hospital appointment with one of them would be helpful.

They can explain the treatment options and make sure you know about the different kinds of help available to you each step of the way.

If the CNS can not answer all your questions, they will try to put you in touch with someone who can. Some other sources of support and information are listed below.

Investigations and Treatment

Investigations are usually carried out at The Royal Sussex County Hospital or Princess Royal Hospital, or occasionally at other centres to reduce waiting times.

Depending on the type of cancer, you may receive one or a combination of treatments. These can include surgery, radiotherapy (strong X rays), chemotherapy (drug treatment) or a treatment/procedure that will help with symptoms.

If you need radiotherapy your treatment will be based either at the Sussex Cancer Centre at the Royal Sussex County Hospital or at the Preston Park Centre in Brighton. Chemotherapy is given at the Cancer Centre, or sometimes it is possible to have it at the Princess Royal Hospital. These treatments are usually all given as an outpatient.

Pre Operation Assessment is usually done at the Princess Royal Hospital and surgery is usually carried out at the Royal Sussex County Hospital in Brighton and you would be cared for by the staff on Level 9A in the Millennium Wing.

Occasionally, you may need a referral to another hospital for a particularly highly specialised treatment. If this is the case the team looking after you will explain and go through this.

Research and Trials

These are research studies, which compare new or different treatment with existing ones. If you are asked to join a clinical trial, you are free to choose whether or not to take part in it.

Your Specialist Nurse and specially trained research nurses will provide you with the information you need to make that decision. The team will fully understand and be supportive if you do not want to take part in a trial.

We might also ask you for feedback about the care or treatment you have received, to help us improve or develop our services. This would be explained in more detail. If you are not happy for us to keep your contact details so we can contact you about service improvements in the future please let us know.

You can request a written summary of each consultation or copy of the letter we send to your GP.

What information will I be offered?

Your Clinical Nurse Specialist will offer you a range of information during your care and you can also access information via the Macmillan Horizon Centre, or refer to the resources below.

After your treatment

When your treatment is completed the team will let you know if continued monitoring may be helpful, and if so how this will be arranged.

We may also invite you to an ‘End of Treatment’ session called Moving On, Living Well or other services to support you so we would like to keep your contact details into the future. Please let us know if you do not want us to contact you in this way.

Our Follow Up Coordinator is there to help if you have questions or queries about how you will be cared for after treatment. You can speak to the coordinator on 01273 696955, extension 67476.

Many people benefit from increasing activity before, during and after treatment from the physical activity team Brighter Outlook who can offer direct support to those living in Brighton and Hove or a referral to local services outside these areas. To refer yourself, please call 01273 668591 or email: [email protected]

If you live outside of the Brighton area your GP can refer you to local sports centres at a reduced cost. Many centres have Cancer Rehabilitation Teams. Diet and food advice can be accessed through your Macmillan Team before and during treatment and via the Macmillan Horizon Centre after treatment.