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Gastrointestinal Cancers

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Gastro intestinal cancers is comprised of three teams

Colorectal Department
Gastroenterology Department
Upper Gastrointestinal Multidisciplinary Team

Colorectal Department

Concord Hospital has a nationally and internationally acknowledged centre of excellence in Colorectal Surgery. Concord Repatriation General Hospital has a close affiliation with the University of Sydney, maintaining links to ongoing education and professional development.

The mission of the Colorectal Service is to deliver first-class care using the best available technology and a multidisciplinary/interdisciplinary approach to optimise the patient journey for those requiring specialist colorectal cancer services. Specialist staff will provide integrated care and patients will have "rapid access" to the very best diagnostic techniques, treatment, support and advice for their cancer treatment. The availability of full outpatient support for colorectal patients will ensure continuity of care. Outpatient support includes; access to colorectal outpatient clinics; a designated colorectal cancer care coordinator; stomal therapy & wound care services; medical oncology; and a 24 hour Emergency Department.

Those accessing the colorectal cancer services available through Concord Hospital can elect to have treatment as a public or private patient.

A tailored management plan is established for each patient through a multidisciplinary meeting and the need for referral to other services is assessed. The Colorectal Service works with Gastroenterology, Urology and Medical Oncology departments to provide interdisciplinary care. Additionally, the services of members of the multidisciplinary allied health team may be incorporated into care including; nursing, stomal therapy/wound care, colorectal cancer care co-ordinator, physiotherapy, psychology, social work, dietitian, occupational therapy, and speech pathology.

Making a referral

A referral from a general practitioner (GP) or specialist is needed for all appointments.

Appointments can be made directly to the specialist rooms or clinic.

The Colorectal Multidisciplinary Team includes:

Head of Department, Associate Professor Matt Rickard
Colorectal surgeon - Dr Peter Stewart
Colorectal surgeon - Professor Pierre Chapuis
Colorectal surgeon - A/Professor Anil Keshava
Colorectal surgeon - Dr Matt Rickard
Colorectal surgeon - Professor Christopher Young
Colorectal surgeon - Dr Michael Suen
Medical oncologist - Professor Philip Beale
Medical oncologist - Dr Prunella Blinmar
Medical oncologist - Dr Annabel Goodwin
Radiation oncologist - Dr Susan Carroll
Colorectal Cancer Coordinator - Ms Sonia Khatri

Other departments including stomal therapy, Colorectal Cancer Coordinator and Allied Health can be contacted via switchboard on 02 9767 5000.

Patient Feedback

My reactions to chemotherapy and radiotherapy were not as severe as I expected. The hospital staff was extremely helpful and provided me with all the necessary information I needed. They were very understanding, helpful and friendly and I really appreciate all the help they have given me.

When I came to the hospital for my operation the hospital staff explained to me all the procedures and outcomes very thoroughly. I received a lot of support from the nurses and doctors. I also received ongoing support after my operation during the recovery period. They provided all my therapy, training and explanations I needed. The staff, especially the nurses were so friendly, I didn't even want go home! However, the menu could be improved.

After I left hospital, I constantly received calls from Sonia and other staff regarding my recovery. They just made me feel so warm and positive throughout my journey.

Bowel Cancer Support Group

Contact Details
Facilitator
Ms Sonia Khatri
Colorectal Care Nurse
9767 5943

The Bowel Cancer Support Group is a free service held monthly on the Concord Hospital campus. It offers professional support and advice for people with bowel cancer as well as their carers.

Joining a support group has many benefits and provides a friendly and welcoming environment where people with bowel cancer and their carers can keep up to date with information and share their experience with others.

The support group is run by an experienced Colorectal Nurse with a range of speakers from other health care professionals that provide information at the meetings. The Bowel Cancer Support Group encourages all carers and partners to attend.

Meeting Dates 2017

When: 3rd Monday of the Month   2 - 3pm
Where: Survivorship Cottage, Gate 4 - Nullawarra Ave, Concord Hospital Campus, Parking available
See Brochure

For more information please contact Ms Sonia Khatri on 9767 5943.

The Gastroenterology Department

A major part of the work of the Gastroenterology Department relates to cancer management. This involves the whole range of cancer services including screening and prevention, diagnosis and staging, therapeutic endoscopy to treat and/or palliate gut neoplasia and surveillance and monitoring after cancer therapy. Services are provided to ambulatory patients and in patients.

The Department provides a major diagnostic and screening service. This is delivered via clinical consultation and through diagnostic and therapeutic endoscopy services. The diagnostic services are allied closely to other Departments, especially oncology and surgery. In addition, the Gastroenterology Department has a major role in the surveillance and monitoring of patients with gut cancers after therapy.The Department is at the forefront of advanced diagnostic modalities for diagnosis and staging of gut cancers using sophisticated endoscopic techniques, such as fine needle biopsy using endoscopic ultrasound (which was pioneered in NSW in our Department).

Research

The Department is an active clinical research department. It has produced 60 publications in the last three years. The Department has collaborated with the University of Sydney Department of Public Health in a recently awarded a PhD (Dr Barbara Adelstein), which specifically explored issues related to the diagnosis of bowel cancer.

Collaboration

The Department has always had very close working relationships with members of the colorectal and upper gastrointestinal surgical teams. Much of this work relates to the diagnosis and treatment of follow-up of cancer patients. A similar relationship exists between the Gastroenterology department and the oncology services within the hospital.

Making a referral

A referral from a general practitioner (GP) or specialist is needed for all appointments.

Appointments can be made directly to the specialist rooms or clinic.

The Gastroenterology team includes:

Head of Department, Gastroenterologist - Dr Grace Chapman
Gastroenterologist - Dr James Cowlishaw
Gastroenterologist - A/Professor Peter Katelaris
Gastroenterologist - A/ Professor Alice Lee
Gastroenterologist - A/Professor Rupert Leong
Gastroenterologist - Dr Charles McDonald
Gastroenterologist - A/Professor Meng Ngu
Gastroenterologist - Dr Gordon Park
CNC Nursing Clinical Support - Ms Carol Wildbore

 

Upper Gastrointestinal Multidisciplinary Team

The Upper Gastrointestinal (GIT) surgical Unit at Concord Hospital consists of five surgeons, who are supported by a team of senior doctors, nurses, a physiotherapist, dietician, social worker, acute pain service, pharmacists, occupational therapist and psychology. Our surgeons are very experienced with between 10-40 years experience each.

There is a dedicated specialised surgical unit that has nursing staff with many years experience looking after the Upper GIT patient. Our nurse consultant is very experienced and is available to help patients before, during and after treatment.

Concord Hospital Upper Gastrointestinal Unit sees over twelve hundred patients per year. It is now well established that most gastrointestinal cancers are best treated, and have the highest cure rates in high-volume centres, by surgeons who perform these operations regularly. All the patients treated through Concord Hospital and the various affiliated private hospitals to the Concord Cancer Centre are managed through the multidisciplinary team approach. The multidisciplinary team meets once a week to discuss patients admitted to Concord and from the doctors' private practice. This team involves surgeons, oncologists, radiation oncologist, interventional radiologist, gastroenterologist, specialist nursing consultant, nurse unit manager of the ward and dietician.

Making a referral

A referral from a general practitioner (GP) or specialist is needed for all appointments. Appointments can be made directly to the specialist rooms or clinic.

The Upper Gastrointestinal Multidisciplinary Team includes:

Gastro-oesophageal surgeon - Associate Professor Gregory Falk (Specialities: oesophageal, gastric, gallbladder)
Hepatobiliary surgeon - Associate Professor John Hollinshead (Specialties: gastric, pancreatic, gallbladder)
Hepatobiliary surgeon - Dr David Martin (Specialties: oesophageal, pancreatic, gastric, gallbladder)
Hepatobiliary surgeon - Dr Craig Taylor (Specialties: gastric, liver, gallbladder)
Hepatobiliary and liver transplant surgeon - Dr David Joseph (Specialties: liver, pancreatic, gastric, gallbladder)
Gastroenterologist - Dr Grace Chapman
Radiation oncologist - Dr Regina Tse
Medical oncologist - Associate Professor Philip Beale (Appointments ph: 02 9767 6354)
Medical oncologist - Dr Prunella Blinman (Appointments ph: 02 9767 6354)
Cancer Nurse Consultant - Ms Carolyn Wildbore can be contacted on page 60273 by phoning 02 9767 5000.

Dietician - Felicia McGuire can be contacted on page 60789 by phoning 02 9767 5000.

 

Upper Gastrointestinal Cancer Information & Treatment

Cancers of the oesophagus

We have a specialised interest in treating cancer of the oesophagus for cure in association with a multidisciplinary team approach to improve overall results. Additionally some cancers may be treated by surgery or radiation alone for cure. The unit also has a strong focus on minimally invasive surgery and techniques which are very useful in the assessment of this condition. For example Concord Hospital had the first endoscopic ultrasound unit in Australia where the extent of disease is mapped out for surgery and oncological therapy. Laser treatment is also used which enables preoperative chemotherapy to be pursued without swallowing difficulties. Surgery for cure can be performed using minimally invasive techniques and new management using local anaesthetic pain pumps and other equipment has reduced the discomfort of standard surgery.

Some cancers may not be amenable to surgical treatment and then palliative care and treatment with endoscopic laser therapy, or endoscopic stenting may keep the swallowing excellent and relieve discomfort. Extension of survival is definitely possible and expertise in this area reduces the necessary attendance to hospital and continues normal life as much as possible.

Cancer of the stomach

Concord Hospital has had a long-standing interest in the management of gastric cancer with large series published in the past during the time of the repatriation commission where survival advantage was evident from the nature of surgery being performed. The surgical consultants within the hospital continue to benefit from this period of training. Extended lymph node resection is routinely performed as it is in the Japanese literature where survival is improved. Despite our long-standing interest in this area it has only become standard of care in some Western medical centres in recent times. Newer techniques of multidisciplinary management have offered even more extended survival. Minimally invasive resection of surgery is also utilised for appropriate conditions.

Cancer of the liver

The unit at Concord Hospital performs surgery for various cancers which occur in the liver either primary or metastasis (secondary deposits from other organs). Liver cancers also comes from the bile ducts and the gall bladder. Patients with bowel cancer can also get liver deposits which are amenable to treatment and increased survival. The combination of this alongside the colorectal surgical group enables patients with this condition to be treated by surgery, or indeed other oncology or radiological procedures.

Cancer of the pancreas

Management of cancer of the pancreas is pursued through multiple different modalities in our group. Some patients are suitable for curative resection by surgery and some patients are best managed by palliation with minimally invasive techniques where jaundice may be reduced by placing a tube in the blocked tubes from the liver or difficulty swallowing can be alleviated using keyhole surgery with minimal upset and discomfort to the patient. Patients are all managed in the multidisciplinary meeting and many patients are suitable for radiotherapy or chemotherapy. Many different sorts of pancreatic cancer may occur including adenocarcinoma, occasionally squamous cell carcinoma and neuroendocrine type tumours. All require different therapy and occasionally different multidisciplinary treatment including different chemotherapeutic agents. Various treatments are recommended by the multidisciplinary meeting using radiological study of the various investigations and extent of disease so that appropriate therapy can gain the best result.

Gastrointestinal GIST tumour

This small tumour usually is not life-threatening. Occasionally it can reach large sizes where there is a possibility of causing bleeding or major trouble for the patient.

Treatment is usually that of surgical resection which is often performed by keyhole surgery in our group. Occasionally patients may require management with a medical chemotherapeutic agent and this is always discussed and opinion sought in the multidisciplinary meetings.

Other Upper gastrointestinal cancer surgery, sarcoma, secondary tumours: rare conditions occur in the oesophagus stomach bile ducts and liver as well as in the small bowel and around the pancreas. All of these conditions are dealt with.

Research

It is only possible to perform adequate research in a group where relatively large numbers of patients are treated an appropriate collection of information can be made.

Patients who are part of a research study are looked after in much more detail than in peripheral smaller centres. Research tends to attract practitioners with great interest and knowledge of areas likely to lead to more intensive management and possibly better results. Concentration of patients allows ancillary services to be better facilitated and will allow patients access to the most modern treatments.