Hepatobiliary pancreatic cancers
Hepatobiliary pancreatic (HPB) cancers include bile duct/gall bladder, pancreas and secondary (metastatic) liver cancers. At King’s hepatobiliary service also see people with cancer of unknown primary, gastrointestinal stromal (GIST), and other rarer tumours.
If you have:
- hepatocellular carcinoma (HCC) you will be treated by our primary liver cancer team.
- neuroendocrine tumours (NETs) you will be treated by our NET team.
Go to the NHS website for more information about:
Macmillan Cancer Support has more information about:
The following charities also provide more information and support:
- Pancreatic Cancer UK
- AMMF (bile duct cancer)
- GIST Support UK (GI stomal cancer)
- Cancer of Unknown Primary Foundation
- Cancer52 (rare cancers)
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:
- 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-CT scans at King's or University College Hospital
- x-ray with contrast, such as hepatic (kidney) angiography, at King's
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.
Treatment may include:
- 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
Wendy Martin for pre-assessment and SIRT
Tel: +44 (0)20 3299 3854
If you have practical queries or want further information about support groups, contact the Macmillan Centre at King’s.
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.
- 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.