Information
Malignant ascites is the accumulation of protein rich fluid containing cancer cells in the peritoneal cavity. Ascites typically develops in the setting of recurrent and/or advanced cancer, the commonest tumour sites being ovarian, breast, gastro-intestinal tract and pancreatic.
Most common symptoms are weight gain, dyspnoea, abdominal swelling, sense of fullness, bloating or heaviness.
M.A, K.E & J.W. 12-02-26
Who to refer:
Patients with a cancer diagnosis and symptoms suggestive of malignant ascites. You may be advised that assessment will be arranged electively depending on patient’s symptoms.
Who not to refer:
If in doubt please do not hesitate to call the on call oncology team. Palliative ascitic drainage is usually safe but can result in deterioration of some patients, particularly upper GI/ pancreas or patients of poor performance status. These patients will need to be carefully assessed before proceeding. We do not routinely perform diagnostic taps or drain non-malignant ascites.
How to refer:
Contact the Acute Oncology team at the Edinburgh Cancer Centre Acute Oncology team on 07798774842 or 0131 537 1000 and ask to speak to Acute Oncology team for oncology
All patients on or within six weeks of treatment should be encouraged to monitor symptoms and call The Cancer Treatment Helpline (CTH; 08009177711) with any treatment-related concerns. Please note, the CTH is a call operator service provided by NHS 24, who then refer on to an acute care specialist. They cannot give specialist advice.
If the patient has been assessed by a healthcare practitioner in Primary Care, and Oncology advice/input is felt to be required, the Primary Care clinician should call the Acute Oncology team at the Edinburgh Cancer Centre (based in the WGH) and discuss directly. The Acute Oncology team can be contacted during working hours (Mon-Fri 9-5) on 07798774842; If out of hours, please discuss with the Oncology Registrar On-Call via NHS Lothian Switchboard (0131 537 1000).
If the primary care clinician requires any further guidance on the suitability of referral to Acute Oncology, they can consult Pg 10 of the The UKONS Oncology/Haematology 24 Hour Triage Toolkit.
Note if a patient has presented to primary care for assessment, the patient should NOT be advised to call the CTH themselves to pass on this information or seek further advice.
Link to Acute Oncology Initial Management Guidelines:
UKONS | Acute Oncology Initial Management Guidelines (sundownsolutions.co.uk)
