Specialists with an interest in cholangiocarcinoma and where they work (UK)

(Details will be updated and added to as more information becomes available)

Please note it is not appropriate for AMMF to give advice or recommendations, and all details provided are for information purposes only.

Importance of referral
Cholangiocarcinoma is a very serious illness and is relatively rare.  It is essential that patients are referred to specialists so that they can be properly assessed and offered the right treatment and care for their particular situation.

(Please note: Your healthcare is your choice. If you and your GP agree that you need to be referred to a specialist, you can choose to go to any Foundation Trust in the country, but your doctor will need to write a letter of referral.)

Ideally, cholangiocarcinoma patients should be cared for by a multidisciplinary team specialising in diseases of the hepatobiliary system, ie, the liver and bile ducts,  working together on one site with access to the full range of diagnostic investigations and treatment options.  The team should include

Hepatologists (specialists in liver medicine)
Liver surgeons
Oncologists (specialists in cancer medicine)

Information currently listed from:
King’s College Hospital, London
Imperial College Healthcare NHS Trust – Hammersmith and St Mary’s Hospitals
The Royal Marsden Hospital, London and Surrey
University College Hospital, London
Queen Elizabeth Hospital, Birmingham

King’s College Hospital, London

(King’s College Hospital NHS Foundation Trust)

The Liver Service at King’s College Hospital is probably the largest comprehensive clinical liver programme in the world. It provides an integrated investigation and treatment service for all types of acute and chronic liver diseases, including hepato-pancreato-biliary medicine and surgery.

King’s College Hospital suggest that referral is to the HPB Oncology Service as each of their core team is experienced in dealing with cholangiocarcinoma.  (They feel their team-based service, rather than person dependent service, allows for greater flexibility in meeting patient needs and can reduce delays.)

Referrals may be received from South East London Cancer Network, Kent and Medway Cancer Network, the rest of the UK, Ireland and elsewhere.

King’s College Hospital Liver Service staff with cholangiocarcinoma experience include:

Hepatologists
Dr John Devlin –
Consultant Hepatologist : speciality incl endoscopy incl EUS and Photodynamic Therapy

Dr John O’Grady – lead Consultant Hepatologist

Surgeons
Professor Nigel Heaton – Consultant HPB Surgeon and Professor of Liver Transplant Surgeon
Professor Mohamed Rela – Consultant HPB Surgeon and Professor of Liver Transplant Surgeon
Mr Andreas Prachalias – Consultant HPB and Liver Transplant Surgeon
Mr Parthi Srinivasan – Consultant HPB and Liver Transplant Surgeon
Mr Adrian O’Sullivan – Consultant HPB Surgeon
Mr Ameet Patel – Consultant HPB Surgeon
Mr Simon Atkinson – Consultant Pancreatic/UGI Surgeon

Oncologists
Dr Paul Ross – South East London Cancer Network
Dr Nick Maisey
Dr Andrew Gaya
Dr Justin Waters and Dr Mark Hill – Kent and Medway Cancer Network

(King’s College Hospital is the HPB Specialist Centre for the Kent and Medway Cancer Network as well as South East London)

Consultant Liver/HPB Histopathologists
Dr Alex Knisely
Dr Alberto Quaglia
Dr Zen Yoh
Interventional Radiologists
Dr John Karani
Dr Pauline Kane
Dr Praveen Peddhu
Dr Dylan Lewis

Palliative Care
King’s In-house Team Lead: Dr Polly Edmonds

Clinical Nurse Specialist
Nikie Jervis – Team Lead, Senior HPB Clinical Nurse Specialist –
Cholangiocarcinoma and Neuroendocrine Tumours

Cancer Services Manager (HPB & Colorectal)
Naomi Sheeter

Treatments available include:
Surgery
Chemotherapy
Endoscopic therapy – incl stenting and photodynamic therapy
Interventional radiology
Stenting
Biliary drainage
Portal vein embolisation
Hepatic artery embolisation and potentially SIRT

Contact details:
HPB Oncology Service
Institute of Liver Studies
King’s College Hospital NHS Foundation Trust
Denmark Hill
London   SE5 9RS

Department tel no (Clinical Nurse Specialist): 020 3299 3854

Central Service fax no: 020 3299 1778

Email:  hpbcns@kch.nhs.uk

Website:  http://www.kch.nhs.uk/services/liver/

(Imaging may be received either on DICOM compatible discs or via image-links with PACS system)

There is also a full referral guide section on the King’s website, “King’s Referral Guide” which is for GPs, practice managers and other referrers to King’s: http://referrals.kch.nhs.uk

Imperial College Healthcare NHS Trust – Hammersmith and St Mary’s Hospitals

Imperial College Healthcare NHS Trust – Hammersmith and St Mary’s Hospitals

(Hammersmith and St Mary’s Hospitals)

The hepato-pancreato-biliary (HPB) unit at Hammersmith Hospital provides holistic care for patients with liver, pancreatic and/or biliary disorders in west London, the UK and worldwide.

They have a world-renowned reputation for clinical practice and research and lead the field in cutting-edge technology. Three multidisciplinary weekly sessions ensure that patients receive rapid review and referral to the most appropriate service, including surgery, oncology (active and palliative care), gastroenterology, histopathology and interventional radiology.

(The unit has a strong academic bias and the research component (which includes cholangiocarcinoma research) ensures that it can provide the most modern and appropriate treatments.

 

Dr Shahid Khan, BSc Hons, MRCP, PhD, is a Clinical Senior lecturer in the Department of Hepatology and Gastroenterology at Imperial College London. His clinical activities include chronic and acute liver disease, cirrhosis, liver and hepatobiliary cancer, including cholangiocarcinoma and endoscopy. He is the Academic lead in the Department for Liver Cancer.  He is lead author on the UK Cholangiocarcinoma Guidelines and is actively researching proteomic, metabolomic and genomic profiles in hepatobiliary cancer.)

Hammersmith Hospital HPB services include:

Surgery

Liver/pancreatic and biliary tract surgery of malignant and benign disease
Radiofrequency ablation

Radiology/Nuclear Medicine
Angiography
CT
MRI/magnetic resonance cholangiopancreatography (MRCP)
Percutaneous biopsy
Percutaneous drainage
Percutaneous transhepatic cholangiography
PET/octreotide scan
Portal vein embolisation (PVE)
Selective internal radiation (SIR) therapy
Transarterial chemoembolisation (TACE)
Ultrasound

Histopathology
Specialised analysis of liver/biliary/pancreatic disease

Gastroenterology
Endoscopic retrograde cholangiopancreatography (ERCP) +/- stent/brush cytology
Endoscopic ultrasound scan (EUS) +/- biopsy/local resection

Oncology
Specific chemotherapeutic regimes
Radiotherapy
Research focusing on microarray analysis of pancreatic tumours
Development of national protocols and trials

Key members of staff include:

Surgical Team
Professor Nagy Habib (multidisciplinary team chair)
Mr Long Jiao
Mr Duncan Spalding
Professor Robin Williamson

HPB Medicine and Gastroenterology
Dr David Westaby (multidisciplinary team lead)
Dr Devinder Bansi
Dr Ashley Brown
Professor Simon Taylor-Robinson
Dr Andrew Thillainayagam
Dr Panagiotis Vlavianos

Oncology
Dr Harpreet Wasan (multidisciplinary team lead)
Dr Charles Lowdell
Dr Sarah Partridge
Dr Robert Phillips
Dr Danielle Power
Dr Alex Taylor

Radiology
Dr Paul Tait (multidisciplinary team lead)
Dr Adil Al-Nahhas (nuclear medicine)
Dr Alison Graham
Dr James Jackson (interventional radiology lead)

HPB Pathology
Professor Gordon Stamp (multidisciplinary team lead)
Dr Patrizia Cohen
Dr Roberto Dina

HPB Anaesthetics
Dr Stephen Brett
Dr David Harris
Dr Susan Kirby

Contact details:
Website: http://www.imperial.nhs.uk/liverandpancreas/index.htm

To discuss a possible referral or for further information on the HPB services at Hammersmith Hospital, contact details are:

HPB Services Reception
First floor, Area B
Hammersmith Hospital
Du Cane Road
London W12 0HS

Tel: 020 3313 3960

The Royal Marsden Hospital, London and Surrey

The Royal Marsden is a world-leading cancer centre specialising in diagnosis, treatment, care, education and research.

As a patient, government policy allows you to make decisions about your healthcare.  If your GP thinks that you need to be referred to see a cancer specialist, you can choose any hospital in the country. This means that regardless of where you live, you have the right to see one of The Royal Marsden’s world-class cancer experts.

At The Royal Marsden, you can be seen by a leader in their field with access to state-of-the-art facilities and technologies at one of the world’s premier comprehensive cancer centres.

The Royal Marsden Gastrointestinal Unit
http://www.royalmarsden.nhs.uk/diagnosis-treatment/cancer/upper-gastrointestinal

The Gastrointestinal (GI) Unit specialises in the diagnosis, staging and treatment of all cancers arising within the GI tract, including the associated organs of the liver, biliary system, pancreas and neuroendocrine system. A robust multidisciplinary approach is undertaken for each patient, ensuring that expertise from each clinical and diagnostic discipline is applied for each patient upon referral to the Unit.

Upper Gastrointestinal Cancer
The Royal Marsden offers a full range of services to facilitate the diagnosis, staging and treatment of upper gastrointestinal cancers (stomach, oesophagus, pancreas and liver cancers) at its hospitals in Chelsea and Sutton.

An individualised treatment plan is made for each patient by a specialist multidisciplinary team of medical oncologists, clinical oncologists, surgeons, histopathologists, molecular pathologists, gastroenterologists and clinical nurse specialists. Services available at the Royal Marsden hospital include:

specialist review / second opinion
staging and investigation
chemotherapy
radiotherapy
surgery, including minimally invasive surgery
critical care
palliative and supportive care
rehabilitation
cancer genetics
clinical trials
private care

Staging and Investigation
Accurate diagnosis and staging is central to the appropriate management of patients with upper gastrointestinal cancers. Available radiological tests at the Royal Marsden include:

contrast-enhanced spiral CT
MRI scans
PET/CT scans
endoscopic ultrasound (EUS)
endoscopic retrograde cholangiopancreatography (ERCP)
magnetic resonance cholangiopancreatography (MRCP)

The Team
The GI Unit has a multidisciplinary team of medical oncologists, clinical oncologists, upper and lower GI surgeons, gastroenterologists and specialist nurses, and is headed by Professor David Cunningham, Consultant Medical Oncologist, whose main research interests are clinical trials in gastrointestinal cancer and lymphoma, along with the development of translational research and novel molecular therapies.

Amongst the team, those with a particular interest in cholangiocarcinoma are:

Dr Maria Hawkins – Consultant Clinical Oncologist
Dr Hawkins specialises in the treatment of upper gastrointestinal (stomach and oesophagus) and hepatobilliary (pancreas and liver) malignancies, and colorectal (bowel) and skin cancers.
http://www.royalmarsden.nhs.uk/consultants-teams-wards/staff/consultants-g-l/dr-maria-hawkins

Dr Sheela Rao – Consultant Medical Oncologist
Dr Rao specialises in the treatment of upper gastrointestinal and hepatobiliary malignancies, and colorectal and neuroendocrine cancers.
http://www.royalmarsden.nhs.uk/consultants-teams-wards/staff/consultants-r-z/dr-sheela-rao

Dr Ian Chau – Consultant Medical Oncologist
Dr Chau specialises in the treatment of gastrointestinal cancers including hepatobiliary malignancies and neuroendocrine cancers.
http://www.royalmarsden.nhs.uk/consultants-teams-wards/clinical-units/Pages/gastrointestinal-unit.aspx

Mr Satvinder Mudan – Consultant Surgeon and Surgical Oncologist
Mr Mudan’s interests include surgery for cancers of the oesophagus and stomach, pancreas, bile ducts, liver and retroperitoneum.
http://www.royalmarsden.nhs.uk/consultants-teams-wards/staff/consultants-m-q/mr-satvinder-mudan

Dr Angela Riddell – Consultant Radiologist
Dr Riddell is a core member of the multidisciplinary teams for upper gastrointestinal cancers, lung cancer, haemato-oncology, melanoma and skin cancer.
http://www.royalmarsden.nhs.uk/consultants-teams-wards/staff/consultants-r-z/dr-angela-riddell

Clinical trials
At the Royal Marsden it is believed that research is essential in order to raise standards of cancer care, and to improve the prognosis of patients with gastrointestinal cancers. Not all patients are suitable or willing to participate in a clinical trial. However, the philosophy is to give patients the option of a research trial if one is available.

Referral Information
The Royal Marsden accepts referrals from both GPs and other hospitals for the diagnosis and treatment of common and rare cancers. Referrals are also accepted for second opinions on cases where either diagnosis or treatment is difficult or when patients feel that a second opinion would be helpful.

Patients can choose to be seen at either the Sutton or Chelsea sites, or at the Medical Daycare Unit at The Kingston Hospital.

Please see the informative referrals section on the RMH website for more details on making a referral:

http://www.royalmarsden.nhs.uk/diagnosis-treatment/referrals

Or RMH may be contacted at the Central Referral Office:
• Tel: 0800 180 81 82
• Fax: 020 8661 3149

http://www.royalmarsden.nhs.uk

University College Hospital, London
(University College London Hospitals NHS Foundation Trust)

UCLH multi-discipinary teams include internationally acclaimed consultants who work closely with colleagues in other disciplines throughout the Trust to deliver specialist patient centered care. The service treats commonly occurring cancers as well as specialising in some of the more unusual forms of cancer.

UCLH Foundation NHS Trust has strong ties to the Royal Free and University College Medical School, one of the country’s most prestigious medical schools. The relationship affords it the ability to be on the cutting edge of clinical trials and pioneering developments in the treatment of cancer.

Consultants with an interest in cholangiocarcinoma include:

Gastroenterologist and Hepatologist
Dr Stephen Pereira
Contact tel: tba, Fax: tba

Gastrointestinal Oncologist
Dr John Bridgewater
Contact Tel: 020 7380 9093, Fax: 020 7380 9055

UCLH Contact details:
University College London Hospitals NHS Foundation Trust
University College Hospital
Department of Gastroenterology
University College Hospital
Ground Floor West Wing
250 Euston Road
London NW1 2PG

Tel:  tba
Fax: tba
Website: http://www.uclh.nhs.uk

For information on referrals please see:
http://www.uclh.nhs.uk/GPs+healthcare+professionals/Clinical+services/Cancer/How+to+make+a+referral.htm

 

Queen Elizabeth Hospital, Birmingham
(University Hospital Birmingham NHS Foundation Trust)

University Hospitals Birmingham NHS Foundation Trust Liver and HPB Unit is one of the largest in the UK, providing a comprehensive range of hepatology (liver medicine) services.

Queen Elizabeth Hospital, Birmingham, has a very active multidisciplinary team for cholangiocarcinoma consisting of:

Hepatologists
Dr Tahir Shah
Dr Dennis Freshwater
Dr Andrew Holt
Dr David Mutimer
Dr Bertis Ekstein
Dr Geoff Haydon
Dr D Tripathi
Dr J Fergeson

Surgeons
Mr Simon Bramhall
Mr Darius Mirza
Mr John Isaac
Mr Paolo Muiesan

Oncologists
Professor Phil Johnson
Dr Dan Palmer
Dr Sayed Hussain

Endoscopists
Dr Brin Mahon (and EUS)
Dr D Freshwater
Dr A Holt

Radiologists
Dr Simon Olliff
Dr Brin Mahon
Dr Kam Mangat

Interventional Radiologists
Dr Simon Olliff
Dr Kam Mangat

Contact details:
3rd floor Nuffield house
Liver – University Hospitals Birmingham NHS Foundation Trust
Queen Elizabeth Hospital
Queen Elizabeth Medical Centre
Birmingham
B15 2TH

Tel:  0121 627  5762

Fax number for referrals (addressed to the concerning consultant) which reaches all members of the liver unit: 0121 414 1833

Website: http://www.uhb.nhs.uk/liver-unit.htm

Cholangiocarcinoma


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