A rapid diagnostic clinic, cutting diagnosis times for those with potential cancers to less than two weeks, has been labelled a “Gold Standard” service.
The new neck lump clinic, covering the entire population of North Wales, will begin this summer at Glan Clwyd Hospital and promises a same-day diagnosis.
It’s a new clinic within the ear, nose and throat (ENT), radiology and maxillofacial services, which provides rapid assessment of an urgent suspected cancer patient presenting with a suspicious neck lump.
While not all lumps around the neck are suspicious, they can be a first sign to show cancer has entered into a patient’s lymph nodes. So getting people to treatment in a timely manner can improve outcomes.
Under the new system, a clinician can refer a patient to the new clinic and they will be seen the following week, before having access to all departments necessary for an interim diagnosis - all on the same day.
Within a fortnight the multi-disciplinary team will have formulated a treatment plan and communicated this to the patient.
The new system replaces three separate clinics for consultation, ultrasound scan/fine needle aspiration and result appointments.
A North Wales Cancer Patient Forum advocate, herself a survivor of thyroid cancer, has called it a “Gold Standard” service.
Having gone through a diagnosis six years ago, Cheryl Lockyer, a thyroid cancer representative on the forum, was full of praise for the new service.
She said: “Usually it would take weeks to get that diagnosis, so I think this is a gold standard service.
“While most lumps are not something bad you are worrying and worrying, so it really can cast a cloud over you. Even if it’s not good news at least you know – it’s the not knowing which is the worst thing.
“I think it’s difficult to put into words how anxious people are when they have a lump and have to go to hospital.
“The beauty of this rapid access clinic is you can go in on one day and get an initial diagnosis.”
Diagnosis and treatment planning can take upwards of six weeks in normal circumstances, so the three departments have worked hard to collaborate on the scheme.
Dr Muhammad Aslam, consultant pathologist and clinical director of North Wales managed clinical support services, explained how the new clinic would operate.
He said: “Normally your GP writes to our ENT department, then if an ultrasound is needed another appointment is made with radiology. Then they will decide if a fine needle aspiration (FNA) or biopsy is needed.
“Some patients will be sent back for another appointment. So we could lose three or four weeks in their journey.”
Initially the clinic will be held once a week at Glan Clwyd Hospital, for patients from across the region. However there are hopes it will increase to two clinics per week.
The new rapid diagnostic clinic follows a successful trial where patients were asked to opt-in to the new service.
If a cancer diagnosis is reported the head and neck cancer nurse specialist is immediately available to support the patient.
“Hospital-wise it’s saving a lot of time,” said Dr Aslam. “This clinic will also have an effect for various cancers which show their symptoms through neck lumps. These can be aggressive cancers because they could be in the lymph nodes.
“It is what’s called a hot pathway, where it’s strongly suspected cancer is the cause. So time is of the essence.”
Dr Aslam said there had been a lot of work behind the scenes to bring different departments together for the special clinic, backed up by health board funding.
He added: “It all means the patient will quickly know their treatment pathway because a multi-disciplinary team will have met and established this.
“If I get a suspicious neck lump I want this process, rather than one which could take six or eight weeks.”