If you are being seen at the Victoria Hospital you will be seen in an outpatient clinic as detailed in your letter.  Some people may be asked to attend Ward 34, the inpatient Haematology ward. You can find useful information by clicking on these links

Travel and car parking 

Facilities and amenities

Wards

If you are being seen at the Queen Margaret Hospital you will be seen at the Haematology/Oncology Day Unit. You can find useful information by clicking on these links

Travel and Car Parking

Facilities and Amenities

Wards

Due to our close relationship with NHS Lothian, many of our treatments and investigations are carried out between Fife and Lothian.

Some patients will required to go to the Western General Hospital or the Royal Infirmary in Edinburgh for scans, radiotherapy, stem cell collection or stem cell transplant. 

Tests

Sometimes we need to have more information and we might arrange for you to have more tests such as blood tests, heart scans, X-rays, scans or a bone marrow sampling procedure depending on what your symptoms.
You may receive an appointment for some of these tests before you are seen by the haematology team.

At your first appointment the Doctor or Specialist nurse will want to know about your symptoms and also about any other conditions that you have or medicines that you are taking. They will examine you and explain what they think may be wrong with you and the reason for any tests that they may want you to have. They will also explain the results of any blood tests or investigations that you have already had. You may have bloods taken for further tests at this appointment.

This appointment is a chance for you to ask any questions you may have so it is helpful to bring them written down and also to bring someone with you to help support you.

Asking your healthcare professional the right questions will help you decide the tests and treatments that are right for you. We therefore encourage you to ask the BRAN questions at your appointment.

What are the Benefits?

What are the Risks?

What are the Alternatives?

What if I do Nothing?

MDT meeting

When you have a confirmed diagnosis your case will be discussed at a Multi Disciplinary Team meeting which includes doctors, nurses, radiology doctors (who look at your scans) and doctors from the laboratories (who look at your blood/biopsies) from the South East of Scotland Cancer Network. They will discuss your case and make a treatment plan for you.

This meeting takes place on a Thursday by video link.

Following this meeting you will receive a telephone call or a face to face appointment with the Doctor or Specialist Nurse to discuss the outcome and proposed treatment plan. This will include what to expect, side effects, and the goal we are aiming for so you can make decisions about your treatment going forward. You will be given written information about your condition and the proposed treatment. You are welcome to bring someone with you to this appointment so you can both listen to the information.

We will give you as much or as little information about your cancer as you wish and will answer your questions openly and honestly. Please tell us if there is anything you do not want to talk about.

It is a good idea to write down any questions that you may want to have answered at that consultation and put them in order of importance to you.

Investigations

Will be varied and can include blood tests, X rays, ECG (tracing of your heart), heart scan, different types of scans (CT, MRI, PET, Ultrasound), biopsies of any swellings or lumps or a bone marrow biopsy. You can read more about these on our radiology pages.
It can take a few days or up to a few weeks for test results to be ready. We know that waiting for results can be a worrying time so we will let you know when to expect results.

Treatments

There are lots of different treatments for blood cancer and these will vary depending on your diagnosis.
Sometimes it may not be necessary to start treatment straight away and we will monitor you regularly to judge when the best time to start would be.

Blood Product Support

Your bone marrow may not be working properly or any treatment that you are having may cause you to become anaemic or have low platelets. You may need to attend the day unit for a blood or platelet transfusion. Blood tests would be taken in the community and depending on your results and how you feel, you may be asked to attend the Day Unit a day or so afterwards to receive this treatment. Some patients will attend regularly for blood or platelets and for others it may be a one off.

Systemic Anti-Cancer Therapy

This includes chemotherapy, immunotherapy and targeted treatments. These can be given into a vein, by injection or in tablet form. Some drugs will be given on their own but are frequently given in combination with others. Treatment is usually given in what we call cycles every few weeks for a determined amount of time or indefinitely. The drugs given and their frequency will depend on the type of cancer. The Doctor, nurses and pharmacy team will discuss the planned treatment with you and go over the possible side effects and what to do if they happen. You will be given written information about the medicines to take away with you. Treatment can be given in the Haematology/Oncology Day Unit, from clinic or in the Haematology Ward.

Radiotherapy

This is delivered at Edinburgh Cancer Centre at the Western General Hospital in Edinburgh. This can be given over several days or weeks depending on your condition. Your treatment plan will be discussed with you by your doctor.

Best Supportive Care

Sometimes we do not think that Systemic Ant-Cancer Therapy or radiotherapy will help you. 

Best Supportive Care focuses on quality of life and aims to help you live as well and as comfortable as possible, rather than curing the cancer. Best Supportive Care can:

• Help with symptoms such as breathlessness, pain, sickness or problems eating
• Help you and the people you care about come to terms with the diagnosis and what it means
• Help you talk about the future and plan ahead. This can be hard to do but can help you feel more prepared and in control
• Support you to manage at home

Best Supportive Care is usually provided by a combination of people, including: GPs and District Nurses, Cancer Specialist Nurses and Specialist Palliative Care.

Clinics are held throughout the week and you will be appointed to the clinic that is most appropriate for you. An appointment will be sent to you in the post.

Haematology Team

The team is made up of many different staff. This includes medical staff, pharmacists, advanced nurse practitioners, clinical nurse specialists, ward and day Unit nursing teams, secretarial and admin staff, pharmacy and laboratory staff. Haematology doctors are dual trained in both laboratory medicine and clinical haematology. They therefore have the advantage of being able to see patients as well as review their blood and bone marrow under the microscope. They work very closely with the staff in the laboratories.
When you attend the service the relevant contact numbers will be given to you with an explanation as to who you should contact and when.

Keep yourself as well as you can do. If you are able to go for a walk or exercise you should continue to do this.

If you have not had a recent check up at the dentist it would be good to have one done in case you need any dental work done especially if you are going to have Systemic Anti-Cancer treatment.

• Think about arranging transport, time off work or childcare for the day of your appointments.
• Make sure you know where you are going.
• Bring a pen and paper to take notes.
• Try to bring a friend or family member with you.
• Allow extra time in case it takes longer than expected.
• Make sure your mobile phone is charged.
• Don’t be afraid to ask questions

We would recommend bringing someone with you as it can be difficult to remember everything that is discussed. It is helpful if you can bring a list of your regular tablets and also of any tablets or vitamin supplements that you may also take.

Myeloma UK  www.myeloma.org.uk

Macmillan Cancer  www.macmillan.org.uk

Blood Cancer  www.bloodcancer.org.uk
Lymphoma Action - www.lymphoma-action.org.uk

Cancer Research www.cancerresearchuk.org

Myeloproliferative Neoplasms  www.mpnvoice.org.uk

Maggie’s centre 

Circle of Comfort charity

Fife Carers Centre

Fife Young Carers

SIGN Scottish Intercollegiate Guidelines Network

NICE National Institute for Health and Care Guidance

Mywishes.co.uk

The most effective way to feedback about your patient experience is to use the Care Opinion website.  Care Opinion allows you to truthfully share your experience with us and with others.  This site is moderated and your comments will be both seen and reviewed. 

Victoria Hospital/Haematology/ Oncology Day Unit