Prostate cancer
ADULT
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If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
Emergency treatment required - needs discussion with on call specialist and/or emergency department.
- Significant bleeding – including haematuria particularly with clot retention.
- Uncontrolled or disabling pain or severe uncontrolled dyspnoea
- Suspected spinal cord compression or cauda equina syndrome
- Symptomatic malignant hypercalcaemia
- Patients with a visceral crisis from suspected but not malignant diagnosis (e.g. significant liver dysfunction from malignant infiltration)
- Acute urinary retention or ureteric obstruction secondary to malignancy
- Febrile neutropenia calcium (>3.0mmol/L)
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- Refer to local HealthPathways or local guidelines
- Patients with suspected but not confirmed prostate cancer should be referred to Urologists Specialist review optimally should be within 4 weeks
- If there are signs or symptoms suggestive of metastases consider:
- CT and bone scan, often after confirmation of a prostate cancer diagnosis, the patient’s Specialist may arrange a PSMA-PET scan and /or and MRI of the prostate depending on the stage of the disease and the patient, if appropriate.
- Most referrals for early, locally advanced and metastatic prostate cancer for antiandrogen therapy, chemotherapy and novel antiandrogen therapies come through the Urology team and after MDT review
- For patients with incurable (metastatic or recurrent) cancer, consideration of the following:
- documentation of discussions with the patient (and their carers where appropriate) regarding the intent of treatment (anti-cancer therapy to improve quality of life and/or longevity without expectation of cure or symptom palliation), the patient's prognosis and their understanding of their prognosis
- whether Advance Care Planning (ACP) conversations have been undertaken and their outcome
- specific patient goals and values that may impact on treatment choices
- whether the patient has been referred to a palliative or supportive care service
- Optimal care pathway for people with prostate cancer
- Quick reference guide
| Category 1 (appointment within 30 calendar days) |
Patients with new or suspected diagnosis of prostate cancer should be referred initially to the Urology service for a conclusive diagnosis and initial management and are usually discussed in a multidisciplinary team meeting and referred to a Medical oncologist for escalation of care if considered appropriate.
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| Category 2 (appointment within 90 calendar days) |
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| Category 3 (appointment within 365 calendar days) |
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Please insert the below information and minimum referral criteria into referral
1. Reason for request Indicate on the referral
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
2. Essential referral information Referral will be returned without this
- Past medical history, current medications
- Previous cancer treatment details
Histopathology - FBC, ELFT, prostate-specific antigen level , Lactate dehydrogenase (LDH) results
- Serial PSA results
- Either a PSMA PET scan results or CT chest abdomen and pelvis and bone scan
3. Additional referral information Useful for processing the referral
- Any relevant XR results and/or relevant CT results
4. Request
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Patient's Demographic Details
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
Referring Practitioner Details
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
Relevant clinical information about the condition
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
Reason for request
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can't order, or the patient can't afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Clinical modifiers
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Other relevant information
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.
- Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
- A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
- Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.
Last updated: 28 January 2025
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