HNY Policy and Pathway Repository - North Yorkshire

This is a LESION BASED, not symptom only, pathway. Patients with unexplained anaemia, weight loss or fatigue not associated with a mass/lesion on imaging should not be referred via this route.

• Multiple lung metastases on CXR/CT
• Multiple brain metastases on CT/MR
• Multiple liver metastases on USS/CT/MRI with no obvious primary. [Normal AFP and normal CXR required pre-referral]
• Solitary or multiple bone metastases on XR/CT/MRI/bone scan with no obvious primary. [Normal PSA (in men), negative myeloma screen and normal CXR required pre-referral]
• Disseminated suspected malignancy on imaging and no site of primary identified
• Widespread peritoneal infiltration +/- ascites on USS/CT

Multiple lung metastases on CXR/CT

If radiology indicates lung primary then refer to suspected respiratory cancer pathway

 

Widespread peritoneal infiltration +/- ascites on USS/CT

If CA125 raised then refer to suspected gynaecological cancer

Refer as a USC if has any of the Red Flag Symptoms listed.

 

(See flowchart below)
 

• Harrogate and District