After referral to the Liver MDT

Referral and first appointments

Your GP or hospital doctor will refer you to the Liver MDT along with any investigations done. These may include scans and, at times, biopsy results. These will be looked at, along with your case history, at the Liver MDT.

We may require further investigations before deciding on the best treatment plan for you.

We aim to discuss your case as soon as possible, but patients referred after 12.00 noon on a Wednesday are discussed the following week, to allow our Consultant Radiologist enough time to go over their scans carefully.

If a patient has already had a biopsy, we may also need time to examine this carefully under a microscope.

After the MDT discussion we will formulate a treatment plan for you, and either see you at the Liver Clinic or ask for further tests or investigations.

A Clinical Nurse Specialist will be your point of contact with the team, act as your key worker and maintain regular contact with you.

Further scans and tests

We will try to arrange any further scans or tests in Oxford on the same day as your clinic appointment, if at all possible. However, these may be arranged at your local hospital instead - your local doctor will contact you, if this is the case.

Treatment

Your care and treatment depends on the type of cancer you have; its size, position, stage (how far it has advanced), the number of tumours in your liver, and, importantly, your overall health.

Although we will recommend the treatment plan that would benefit you the most, we will also inform you about other available therapies, and support you to choose which type of treatment you receive.

Your care may include one, or a combination, of the treatment modalities we offer. You could have all of these at Oxford. We may also offer you the opportunity to take part in clinical trials.

Surgery

If you need cancer surgery, we will give you a date for your operation as soon as possible after all necessary tests are done and results reviewed.

Your surgeon may decide that some time is needed to enhance your fitness before surgery, so that operating as soon as possible after your clinic visit is not appropriate (see Pre-operation assessment and Pre-habilitation, below).

Your surgery will take place at the Churchill Hospital. To prevent an unnecessary hospital stay we may ask you to come into hospital on the morning of your surgery.

We have a range of patient information leaflets to explain different procedures and treatments, giving you details of what to expect before, during and after your treatment.

Pre-operation assessment

Please see Pre-operation Assessment Clinic.

This appointment is usually within one to two weeks of the date of surgery.

Pre-habilitation

The Clinical Nurse Specialist, specialist Dietitian and Physiotherapist will talk to you about improving your fitness and exercise reserve with advice regarding diet and physical activity. This emphasis on improving physical performance to achieve better treatment outcomes is known as pre-habilitation.

Admission

Unless otherwise indicated, we will ask you to come to the Theatre Direct Admissions Ward on the morning of your operation.

Theatre Direct Admissions Ward
Level 2, Cancer and Haematology Centre
Churchill Hospital

How to find the Churchill Hospital

On the day of your surgery, you will meet the surgeon and the anaesthetic team again before going into theatre.

Immediately after surgery we admit patients to the Churchill Overnight Recovery Unit (CORU) for monitoring. Sometimes patients are admitted to the Churchill Intensive Care Unit (CICU) for closer monitoring or support.

Following an overnight stay on CORU, we normally transfer patients to the Oxford Upper Gastrointestinal (UGI) Centre.

Going home

In most cases patients remain in hospital for around eight to 15 days after their operation, and will need painkillers for a few weeks. Full recovery can take over three months.

If you have concerns about going home (for example, if you live alone, or have several flights of stairs to climb), please let the nursing staff or doctor know when you are admitted to the ward, so that help can be arranged.

The Clinical Nurse Specialist is available to help support patients and families, and social workers are often available to give practical advice regarding financial concerns.

Maggie's Oxford on the Churchill Hospital site provides additional support.

Two to three weeks after you leave hospital we will make you an appointment for a postoperative check-up. This is a good time to discuss any problems. If you have any concerns before the appointment, please call your Clinical Nurse Specialist for advice.

Out of hours please call the ward.

Oxford Upper Gastrointestinal Centre: 01865 235061 / 2 / 3

Please see Churchill Hospital wards

Follow-up

If you are referred to Oxford from another hospital, we are able to share your follow-up care with your local hospital. This allows you to continue to receive specialist care closer to home.