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    Urology

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    ewen.cameron
    Cancer referral documents

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    © All Rights Reserved
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    Urology

    Uploaded by

    ewen.cameron
    2 views3 pages
    Cancer referral documents

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    urology

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    Cancer referral documents

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    2 views3 pages

    Urology

    Uploaded by

    ewen.cameron
    Cancer referral documents

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 3

    Loading Referral screen

    Past Risks
    Referral Referral Clinical Medi Military Patient Demo Admin
    Medical / /
    Guidelin Summa Examination / catio Vetera Transp graphi istrati
    Family Alert
    es ry Findings n ns ort cs on
    History s

    LAN HAIR Suspicion of Urology Cancer (v12.2 1.0)

    Referral Guidelines

    Urgent Referral

    Haematuria
    Macroscopic or frank haematuria in adults (unless obvious cause). Arrange MSSU, BP,
    biochemistry and haematology bloods. Discuss initially, if required in atypical cases
    Symptomatic non visible haematiria. Patients > 40 yrs (dip stick 2+ or flow cytometry >
    100 rbc

    The above patients will be seen urgently at the Haematuria Clinic

    Palpable renal masses


    Solid renal mass found on imaging
    The above patients will be booked for a CT and seen urgently at the Urology Clinic

    Swellings in the body of the testes


    The above patients will be booked for Radiology as required and seen urgently at the
    Urology Clinic

    Prostatic Cancer
    High PSA
    PSA should be checked only after counselling and only where a patient is symptomatic
    or a patient specifically request it.
    Please note age specific reference ranges

    <2.5 for under 50s


    <3.5 for 50 to 60
    <4.5 for 60 to 70
    <6.5 for for over 70

    Referr if abnormal or if a patient is likely to benefit from establishing a diagnosis of


    prostate cancer. Therefore if the PSA is under 20, and the patient is over 80, or has a
    life expectancy of under 10 years, they are unlikely to be investigated or treated
    aggressively and the referral may be downgraded to routine. Monitoring of PSA may be
    an option.
    Infection complicates PSA interpretation such that we prefer to see a sterile MSSU take
    the same week as the PSA. The easiest thing may be that when an abnormal PSA is
    picked up, it should be repeated and an MSSU sent of within a week of the result. If
    there is an infection present, this should be treated and the PSA repeated after six
    weeks.
    Clinically malignant prostate on PR examination

    Bone pain suspicious of metastatic prostate cancer

    The above patients will be seen at the 1 stop prostate biopsy clinic, where biopsy will be
    discussed and performed where appropriate and agreed.
    Patients having a prostate biopsy will require ciprofloxacin 500mg twice a day for 5 days
    starting the day before (if there is no contraindications). The patients appointment will
    be accompanied by a request for them to contact their GP practice to obtain a
    prescription.

    Any sustected penile cancer

    The above patients will be seen urgently at the Urology Clinic

    Non Suspicion of Cancer Referrals

    The following conditions should be referred through the normal urology referral route on
    the SCI Gateway, haematospermia, testicular mass clearly separate from testes with no
    suspicious features, symptomatic non visible haematuria in patients < 40, or
    asymptomatic , non visible haematuria. See urology referral guidelines for definitions of
    non visible haematuria.

    ___References: Scottish Referal Guidelines for Suspected Cancer. Scottish executive 2007

    _______________________________________SIGN 85: Management of bladder cancer


    Lead Clinician: Mr Ans Khan, NHS Lanarkshire ____Review Date Dec 2010

    Clinical Examination / Findings

    Frank
    Haematuria in Detail
    an adult
    (unexplained)
    Symptomatic,
    non visible
    haematuria Detail
    Patient > 40
    yrs
    Palpable renal
    mass +/- pain Detail
    +/- haematuria
    Solid renal
    mass found on Detail
    imaging
    PSA outwith
    age related Detail
    reference
    range
    Clinically
    malignant
    prostate on PR
    exam and/or
    bone pain Detail
    suspicious of
    metastatic
    prostate
    cancer
    Swelling in
    body of testis
    or other Detail
    suspicion of
    testis cancer
    Suspected Detail
    Penile Cancer

    Investigations -please indicate if


    any of these have been checked

    MSSU UE and FBC PSA

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