Hepatobiliary pancreatic cancers

Hepatobiliary pancreatic (HPB) cancers include bile duct/gall bladder, pancreas and secondary (metastatic) liver cancers.

NHS Choices has more information about:

Macmillan Cancer Support has more information about:

King’s hepatobiliary service also sees people with unknown primary, gastrointestinal stromal (GIST) and other rarer tumours.

If you have:

  • hepatocellular carcinoma (HCC) you will be treated by our primary liver cancer service.
  • neuroendocrine tumours (NETs) you will be treated by our NET service.

What to expect at your appointment

Your first appointment at hospital may take between 45 minutes and two hours. You may have tests and investigations on the same day or at a later date.

You will see one of our consultants. They will ask you about your symptoms, your medical history and general health and examine you. They may also discuss with you any tests and treatments you have had and your family medical history, if relevant.

You may also meet the HPB clinical nurse specialist (CNS) who will be your key worker during your care. They will explain your test and treatment options and support you and your family. You will also be given information about the type of cancer you have, your treatment options, and other sources of support, such as King's Macmillian Information and Support Centre.

Your consultant will discuss with you whether you need more tests and book them for you. They will also discuss your treatment plan with you if appropriate. They may refer you to another service for tests and treatment.

We usually send you appointment letters for tests, investigations or treatments by post.

Tests and investigations

At your first appointment you may have one or more of the following tests or you may be asked to return at a later date to have them. They help us to find out whether you have cancer and to assess your treatment options. They include:

At your first appointment you may have one or more of the following tests or you may be asked to return at a later date to have them. They help us to find out whether you have cancer and to assess your treatment options. They include:

  • biopsy such as fine needle aspiration (FNA) at King's
  • blood tests at King’s
  • CT scan at King’s
  • endoscopy including an endoscopic retrograde cholangio pancreatography (ERCP), a percutaneous transhepatic cholangiography (PTC), upper/lower endoscopy, video-capsule endoscopy (enteroscopy), endoscopic ultrasound (EUS) at King's
  • MRI scan at King’s
  • nuclear medicine scan including bone scan, octreotide and MIGB scan, and glomerular filtration rate (GFR) study at King’s
  • PET scan at King's or University College Hospital
  • x-ray with contrast, such as hepatic (kidney) angiography, at King's

Treatments

Your care and treatment depends on the type cancer you have, its size and where it is, how far it has advanced (the stage) and your overall health. The final decision about what treatment you have is yours.

After our team of specialists reviews the results of your tests and investigations, we will arrange another appointment so you can discuss your treatment options with your consultant and clinical nurse specialist.

Your care usually includes one or more or a combination of treatments. You may have them at King's, Guy's or St Thomas' hospitals as well as at your local oncology centre. You may also be asked if you would like to take part in medical trials.

  • Biological therapy such as Sorafenib.
  • Chemotherapy at Guy's or your local oncology centre.
  • Endoscopy including ERCP.
  • Interventional radiology, including radio frequency ablation (RFA).
  • Radiotherapy, including combined radiotherapy/nuclear medicine therapy such as SIRT (selective internal radiotherapy treatment). You have this at Guy's or St Thomas’ Hospitals or your local oncology centre.
  • Surgery such as a resection, where the affected part of your organ is removed.
  • Palliative care and symptom control.

Who to contact

At your first appointment, we will tell you who your key worker is, and how and when you can contact them. Your key worker is usually a clinical nurse specialist (CNS).

HPB clinical nurse specialists

For secondary liver cancer (metastatic disease) and pancreatic cancer
Tel: +44 (0)20 3299 1420
E-mail: kch-tr.hpb@nhs.net

Wendy Martin for pre-assessment & SIRT
Tel: +44 (0)20 3299 3854
E-mail: wendy.martin1@nhs.net

Non-clinical support

For practical queries you can contact the Macmillan Centre at King’s on +44 (0)20 3299 5228, 8.30am to 4.30pm, Monday to Friday.

Please note the Macmillan Centre cannot help with medical queries, as there are no nurses based at the Centre.

Our team

Your care will be provided by a group of experts called a multidisciplinary team (MDT). This is a team of doctors, nurses and other health professionals specialising in treating your type of cancer. You can discuss your care with them and ask them any questions you have about your treatment. Our team includes.

Consultant Surgeons
  • Mr Simon Atkinson
  • Mr Parthi Srinivasan

How we support you

We want to make sure that you get all the assistance you need to live well with – and after – cancer. There’s a wide range of support available to help you cope with cancer, including physical, emotional and practical advice for you, your family, friends and carers.