Urological cancer

Definition/Description

Create and process referral request via Gateway

Red Flag Symptoms

Please tick on referral form any criteria that match the patient’s symptoms and give PSA results

Unexplained visible haematuria (adult over 45) where a UTI has been excluded or persists or recurs after treatment of UTI
Non-visible haematuria (aged 60 or over) AND either dysuria or raised white cell count on a blood test
Solid swellings in the body of the testis
Palpable renal mass
Solid renal tract masses found on imaging
Abnormal feeling prostate on examination (any age) and PSA level ng/ml
PSA over 10ng/ml (after exclusion of UTI) on one occasion in a man with a ten-year life expectancy ng/ml
PSA above age-specific reference range, but below 10ng/ml in a man with a likely ten-year life expectancy (after exclusion of UTI)
1st value ng/ml (date)
2nd value ng/ml (date) not less than 6 weeks later
(40-49y: 0-2, 50-59y: 0-3, 60-69y: 0-4, >70y: 0-5 ng/ml)
A UTI has been excluded (mandatory for 2ww pathway)
Any suspected penile cancer

Guidelines on Management

If your patient does not meet any of the NICE defined USC criteria please liaise (by phone or Advice and Guidance) with a specialist or send them in as an urgent referral. Please do not annotate USC forms with your own criteria.

Patient awareness

Confirm that your patient understands that they have been referred onto a “suspected cancer pathway”
Confirm that your patient has received the information leaflet
Confirm that your patient is available to attend an appointment within 2 weeks of this referral

Please tick to confirm U+Es have been requested (if none done in the last three months) They are needed to enable rapid MRI scanning

Please consider giving patients with raised PSA one of the information sheets here

An MRI form is appended to this referral template. It is not for GPs to complete or sign. It is to help the urologists rapidly order an MRI when they feel that’s indicated because most details will have been automatically completed by GP computer systems. Not all patients need an MRI but it will speed up secondary care investigations if primary care referrers complete blue boxes and secondary care will complete the grey boxes.