Changes to our services in response to coronavirus (COVID-19)

Due to the increasing number of coronavirus cases across the UK, the Macmillan Information & Support Service has temporarily closed face to face enquiries to ensure visitors and staff remain safe. 
Telephone support is available only on Tuesday and Friday, till further notice: 0208 510519 between 8am – 4pm. We will continue to offer email support via madhu.agarwal@nhs.net.
Outside these days kindly leave your name and telephone number. We will return your call as soon as we can. You can also contact your cancer nurse specialist if your enquiry is urgent.

Other telephone support services
Macmillan Cancer Support: call free 0808 808 00 00 Monday to Friday 9am to 5pm for practical, emotional and financial information and advice.

Samaritans: call free 116123 24 hours, 7 days a week.

Cancer and coronavirus
For information on cancer and the coronavirus please visit:
Macmillan Cancer Support: Guidance for People with Cancer
Cancer Research UK: Talk to CRUK Nurses – Freephone 0808 800 4040

NHS website for helpful videos:

home workout-videos 
fitness studio
coronavirus covid-19 staying at home tips
Youtube videos produced by St. George’s Hospital

A Quick video guide to managing anxiety around Coronavirus

What if I am not feeling well?
If you are a Homerton Hospital cancer patient and having or have recently had chemotherapy or other anti-cancer treatment and are experiencing symptoms please call Chemotherapy Hotline 07917093738 to speak to the team for advice. You MUST seek medical advice URGENTLY

The department treating you
Our nurses, doctors and other health professionals are continuing to support people living with cancer. If you have an urgent question about your cancer care, please contact your relevant Clinical Nurse Specialist.

Patient information website links
Macmillan Cancer Support

Breast Cancer Now
Bowel Cancer UK
Oesophageal Patient Association
Ovarian Cancer Action
Prostate Cancer UK
Pancreatic Cancer UK
Roy Castle Lung Cancer Foundation
St. Jo’s Cervical CancerTrust

Breast

Our breast service consists of a highly qualified multidisciplinary team including consultant breast surgeons and experienced nurses who have specialist knowledge and skills in caring and supporting both women and men with breast problems.

Services available
All new breast referrals (suspected cancer and symptomatic referrals) are seen within two weeks of referral and can be seen on Tuesday and Friday mornings in One Stop Breast Clinics that takes place in the main outpatient department.

The one stop assessment of care provides the following:

  • mammography 
  • ultrasound 
  • fine needle aspiration (FNA) 
  • core biopsy tests if required 
  • breast MRI

Patients attending breast clinic appointment; the results of imaging will be available on the same day however pathology results can often take up to two weeks.

Sentinel Node Biopsy (SNLB) is now embedded in our breast services. SNLB is just when one or two lymph nodes need to be removed to determine if the cancer has spread to axilla (armpit). Use of this technique will spare many women unnecessary surgery, and in turn, lead to a shorter stay in hospital and a faster overall recovery. 
SNLB is now the standard of care for all patients.

We offer full surgical options including wire guided surgery, oncoplasty and breast reconstruction. All patients undergoing mastectomy have the opportunity to discuss their breast reconstruction and are offered immediate reconstruction.

There are in addition weekly specialist outpatient clinics at Homerton Hospital in the following areas:

  • medical oncology clinic on Thursday afternoon and Friday morning 
  • breast nurse specialists hormone injections for medical oncology patients
  • breast prosthesis fitting service run by breast clinical nurse specialists
  • breast nurse led follow up telephone clinic

Intravenous chemotherapy and radiotherapy treatments are given at Barts health (St Bartholomew’s Hospital NHS Trust).

Other breast conditions treated at the Homerton Hospital

  • non-cancer breast lumps 
  • breast pain 
  • nipple discharge 
  • male breast lumps and gynaecomastia 
  • large breast requiring reduction (augmentation)
  • other breast symptoms that are of concern including breast abnormalities

Early discharge from hospital after breast surgery
The 23 hour stay model is now firmly embedded in the trust. The aim of the one night stay breast surgical pathway is to improve the quality of care for all breast patients, by improving clinical outcomes and reducing unnecessary lengths of stay. Some patients are even able to be discharged home on the same day as their surgery.

Our breast patients are assessed prior to surgery and if appropriate are discharged under the day stay or one night stay care pathway. It is now recognised that the vast majority of operations for breast cancer (excluding operations for breast reconstruction) can be safely undertaken as a day case procedure or with a single overnight stay.

We have a Macmillan cancer information and support manager, based in our Health and Cancer Information Centre who provides information, support and advice to all patients, family members and carers affected by breast cancer.

Making an appointment
We hold outpatient clinics on Tuesday all day, Wednesday afternoons and Friday mornings.
We hold outpatient clinics on Monday and Thursday mornings for new patients only.

All new appointments can be made by you or your GP via The Electronic Referral Service (e-RS)

How to contact us
To change or cancel an appointment, please contact central booking department 
tel: 020 8510 5544

For urgent enquiries contact the breast unit secretary 
tel: 020 8510 7930 

Waiting times
The average waiting time for a breast outpatient clinic appointment is one to two weeks for all new patients referred by their G.P. The average operation waiting time is three to four weeks.

Madhu Agarwal
Macmillan cancer information and support manager
tel: 020 8510 5191

Colorectal

Making an appointment
Patients are referred into the colorectal service by their GP, A&E, gastroenterology department and other hospital consultants. They are seen in the outpatients department.

Routine investigations

  • Colonoscopy, test which uses a colonoscope (thin, flexible telescope) to look into the large intestine endoscopy, test which uses an endoscope (long, flexible tube with a light attached to it) to look inside the body.
  • CT scan, uses x-rays to takes images at different angles, it is more detailed than a normal x-ray
  • Sigmoidoscopy (rigid or flexible), uses a small tube with a light at the end to look into the rectum and sigmoid colon (lower part of the large bowel). Air is introduced into the intestine through the sigmoidoscope to inflate it for better viewing.

Some of the investigations shown above may take place prior to the outpatient appointment.

What to expect
Urgent suspected cancer GP referrals are seen within two weeks through the fast-track system via our cancer referral office. We will tell your GP immediately if a cancer diagnosis is made.
Non-urgent referrals will be seen during a routine outpatient appointment. Patients can be discharged or an open appointment will be given.
Following the investigation, patients return to the outpatient clinic to receive their results. The consultant and Colorectal Cancer CNS will both be present.  In the case of patients who are diagnosed with a colorectal cancer, initial treatment or surgery takes place within two to four weeks of the diagnosis being confirmed and discussed with the patient.
Patients who require surgery for colorectal cancer will be operated on at Homerton and chemotherapy and radiotherapy treatment will take place at St Bartholomew’s Hospital.

Ongoing support
After surgery the follow-up in the outpatients department is with a surgeon who will inform you of your pathology/ histology results. If you need further treatment , you will be referred to an oncologist to discuss possible further treatment.
If you do not need further treatment after your surgery you will then be followed up by the Colorectal Cancer CNS either in a face to face clinic or via telephone contact.
There is a designated colorectal nurse specialist who sees all patients diagnosed with colorectal cancer.

Colorectal, stoma and palliative care clinical nurse specialist teams provide ongoing practical and emotional support and referral to other health care professionals where appropriate. We provide a telephone support service as well as a colorectal support group, helping patients cope with their physical and emotional issues.

How to contact us
020 8510 7852 
07785 577 55

Gynaecological

We offer a comprehensive pathway for all patients suspected of having, or diagnosed with, gynaecological cancer. This service utilises specialist skills from Homerton and St Bartholemew’s, allowing patients to be assessed and treated between these two hospitals, depending on the type of treatment they require.

We provide diagnosis of cancers of the female uro-genital tract (cervix, uterus, ovary and vulva). At the outpatients appointment, patients will be offered a range of investigations based on their symptoms to enable a diagnosis to be made.

Making an appointment
Patients are referred into the gynaecological service by their GP via The Electronic Referral Service (e-RS). A&E, well women’s clinic and other hospital consultants. They are seen in the outpatients department.

Routine investigations
Depending on the type of gynaecological cancer a patient may have the following investigations performed:

  • ultrasound scan, uses sound waves to build a picture of inside the body
  • colposcopy, uses a binocular microscope called a coloscope to examine abnormalities in the cervix, it is similar to a smear test
  • hysteroscopy, looks into the canal of the cervix and lining of the uterus using a think lighted flexible telescope 
  • blood tests, to help diagnose your condition.

Some investigations may take place prior to the outpatient appointment.

What to expect
Urgent suspected cancer GP referrals received by the cancer referral office are seen within two weeks.
The gynaecological consultant team will see all women with abnormal cervical smears within two weeks of receiving the smear test result.
After diagnosis treatment will begin within two weeks of the first clinic. Surgery, if required, will take place at St Bartholomew’s Hospital.
Advice and information is available from the colposcopy nurse on 020 8510 5727 or the colposcopy administrator. Patients may telephone for test results two weeks after the clinic visit.

Ongoing support
A gynaecological nurse specialist is available for gynaecological cancer patients for support and advice.

Madhu Agarwal
Macmillan cancer information and support manager
tel: 020 8510 5191

 

Lung

A joint multi-disciplinary lung cancer clinic is available which includes oncology, palliative care and thoracic surgery. Patients are referred for diagnosis, staging and surgical treatment of cancer to the relevant speciality.

Making an appointment
GPs may send their patients for a routine chest x-ray in the chest clinic. Any x-rays reported as suspicious for cancer will be immediately recalled to the chest outpatient clinic. They may also be referred by other teams when admitted initially to hospital.

Routine investigations 

  • blood tests to help diagnose your condition 
  • computerised tomography (CT) scan, uses computerised x-rays to take images of the body at different angles 
  • bronchoscopy, uses a long flexible tube with a light attached to it (bronchoscope) to look inside the lungs and a special type of bronchoscopy known as Endobronchial Ultrasound (EBUS)
  • CT guided biopsy, biopsies of pulmonary and pleural nodules/masses under CT fluoroscopic guidance 
  • lung function tests, which measure the lungs’ capacity and how quickly air can move in and out, as well as a looking at how well lungs add oxygen and remove carbon dioxide from the blood.

Some investigations may take place prior to the outpatient appointment and further tests may include:

  • fine needle aspiration of glands in the neck, a thin needle is used to take out some material from the glands; this feels like a blood test from the neck but takes a little longer 
  • pleural aspiration and biopsy, needles are used to draw out fluid from the chest (if there is any) and small samples are taken for testing from inside the chest wall 
  • a positron emission tomography (PET) scan, shows how body tissues are working and what they look like, this is usually done at St Bartholomew’s Hospital 
  • ultrasound scan, is an investigation that uses sound waves to build up a picture of the inside of the body 
  • magnetic resonance imaging (MRI) scan, uses strong magnetic field and radio waves to build up a picture of soft tissues inside the body, instead of X-rays 
  • ventilation–perfusion V/Q scan, is a radiological procedure used to confirm or exclude the diagnosis of pulmonary embolism, it may also be used to monitor treatment. This is usually done at the London Independent Hospital 
  • bone scan, looks for abnormalities in the bones, in cancer diagnoses the whole body is scanned. This is usually done at the London Independent Hospital.

What to expect
Patients will be sent an urgent appointment within two weeks of the date of the chest x-ray to be seen in the chest clinic. For the initial appointment, 2 – 3 hours may be needed as a blood test, CT scan and lung function tests may occur on the day (if not already done earlier).
Investigations may take place at Homerton, Barts Hospital or the London Independent Hospital.
Patients who require surgery, chemotherapy and radiotherapy for lung cancer will be referred to St Bartholomew’s Hospital.

Ongoing support
There is a designated lung clinical nurse specialist to see patients diagnosed with lung cancer, providing ongoing advice and support.
Patients are also followed up by the chest physician in outpatient clinics; the number of appointments will depend on the patient’s need and disease/treatment stage.
We have a Macmillan cancer information manager, based in our Health Shop, who provides support and advice for all patients who are diagnosed with lung cancer.

Madhu Agarwal
Macmillan cancer information and support manager
020 8510 5191

Upper gastro-intestinal

Making an appointment
Patients are referred by their GP or by a hospital consultant and are seen in the outpatients department. Appointments can be made by you or your GP via The Electronic Referral Service (e-RS)

If a GP suspects upper GI cancer, a patient will receive a fast-track referral through the system, via our cancer referral office. 

Routine investigations

There are a variety of tests that can diagnose cancer and they will depend on the specific symptoms experienced by the patient. The common investigations undertaken are:

  • endoscopy, uses a thin, flexible telescope to look into the upper part of the gut (oesophagus, stomach and duodenum) for any abnormalities
  • endoscopic ultrasound, a method of combining endoscopy and ultrasound imaging to obtain high quality images of the digestive tract
  • CT (computerised tomography) scan, uses x-rays to take images of the body at different angles, they are more detailed that normal x-rays
  • endoscopic retrograde cholangiopancreatography (ERCP), examines the ducts (drainage routes) of the gall bladder, pancreas and liver (the drainage routes of the liver are known as bile ducts)
  • ultrasound scan, is an investigation that uses sound waves to build up a picture of the inside of the body.

Some investigations may take place prior to the outpatient appointment.

What to expect
There are various treatments available, depending on the type of cancer. Patients who need surgery for their cancer will be seen at Homerton or referred to the Royal London Hospital. Chemotherapy and radiotherapy treatment will take place at St Bartholomew’s Hospital.

Ongoing support
There is a designated upper gastro-intestinal nurse specialist who supports patients throughout their investigations and treatment.
We have a Macmillan cancer information manager who provides support and advice for all patients who are diagnosed with upper gastro-intestinal cancer.

Madhu Agarwal
Macmillan Cancer Information and Support Manager
tel: 020 8510 5191

Urology

We diagnose cancers of the kidney, ureters, bladder, testes, penis and prostate. We treat cancers at this hospital, although some treatments take place at other hospitals.

Making an appointment
Most patients will come into contact with our urology team after being referred by their GP. Appointments and referrals can be made by you or your GP via The Electronic Referral Service (e-RS). If necessary the GP will make a hospital appointment within two weeks.

An appointment letter will be sent explaining what will happen at the outpatients clinic appointment. Sometimes patients may be referred via our A&E department or other hospital consultants.

Routine investigations

  • ultrasound scan, uses sound waves to build up a picture of inside the body
  • CT scan, uses x-rays to take pictures of the body from different angles, they are more detailed than normal x-rays
  • cystoscopy
  • prostate biopsy, tissue is surgically removed from the suspected lump using a needle
  • blood tests, to measure PSA (prostate specific antigen) levels in the blood, high PSA can indicate problems with the prostate gland
  • urine tests, to see if there are any traces of blood in the urine
  • MRI (magnetic resonance imaging) scan, uses magnetic field and radio waves to build up a picture of soft tissues inside the body, instead of x-rays.

What to expect
Active monitoring takes place at Homerton, this is where the situation is monitored on a regular basis by our clinical teams, unless a patient presents any changes.
Surgery will be carried out at Homerton, St Bartholomew’s Hospital or Whipps Cross Hospital, depending on the cancer diagnosis.
Intravesical (given directly into the bladder) chemotherapy for bladder cancer is provided at Homerton, all other chemotherapy is provided at St Bartholomew’s Hospital.
Hormonethearpy, a tablet therapy for prostate cancer, is carried out at Homerton; whilst radiotherapy is undertaken at St Bartholomew’s Hospital.

Ongoing support
After surgery, follow up appointments are held in the outpatients department with a surgeon or oncologist, depending on the treatment plan.
Urology, stoma and palliative care clinical nurse specialists provide ongoing practical and emotional support and referral to other health care professionals where appropriate.
We have a Macmillan cancer information manager, based in our Health Shop, who provides support and advice for all patients who are diagnosed with urological cancer.

Madhu Agarwal
Macmillan cancer information and support manager
tel: 020 8510 5191

 

Palliative care

Overview
The palliative care team provides specialist palliative and end of life care to any patient living with serious or life-limiting illness (this includes patients with cancer and non-cancer diagnoses) and offers support to families and carers. We manage complex symptoms such as pain, nausea, breathing difficulties, and fatigue among others. We recognise that the spiritual, emotional, psychological, and practical worries can be as important as the physical problems, and we provide support with these aspects of care.

Palliative care can help in all stages of the illness, but it is particularly important to consider when curative treatment is no longer an option as it may help patients to live longer and more comfortably. It can be provided alongside medical care and other therapeutic treatments earlier in the stage of illness to achieve the best possible quality of life. For patients reaching the end of life, our aim is ensure that they die comfortably, with dignity, and with respect to their wishes and preferences.

Our service
Our team includes a medical consultant, a lead nurse palliative care, clinical nurse specialists, a social worker, and clinical psychologists. We are an advisory service and we cover all areas of the hospital, and Mary Seacole Nursing Home. All patients we see remain under the care of their referring medical or ward team. We work closely with other health and social care professionals including GPs, community nurses, hospital doctors, and other local hospitals and hospices to support our patients and those important to them.

Key clinical staff