Cancer services: new vague symptoms pathway introduced thromoboembolism (VTE), Our cancer services team have ischemic heart disease recently introduced a new (IHD), COPD or chest vague symptoms pathway that infection provides an assessment and diagnostics for patients with the z Unexplained thromboembolism following: z Abnormal laboratory findings not explained by established z Non-specific symptoms or self-limiting disease and that could indicate cancer not needing admission who do not fit other two week wait criteria for a Important note cancer referral, but there is a significant risk of an underlying malignancy Patients must be
fit and suitable for The pilot pathway has been investigation and not designed to ensure that our fit the criteria for any patients are referred to an other urgent referral appropriate pathway and a diagnosis is pursued, whether it pathway. is cancer or otherwise.
GPs are able to refer patients on the vague symptom pathway referral based on the following criteria: z New unexplained weight loss z New unexplained constitutional symptoms of four weeks or more z New unexplained vague abdominal pain of four weeks or more z New unexplained, unexpected or progressive pain, including bone pain, of four weeks or more z GP ‘gut feeling’ of cancer diagnosis – reasons to be clearly described at referral z New and unexplained breathlessness for more than three weeks not due to heart failure, venous
There are mandatory tests that should be carried out and reviewed in primary care before referring a patient to this pathway. This will rule out a more common diagnosis that would be better managed directly through the appropriate specialty multi-disciplinary team. The tests are available on ICE as a bundle under vague symptoms pathway tests, and a chest X-ray must be requested separately.
z ESR AND CRP z B12, folate and ferritin z FIT z MSU z HIV z GGT z U&Es, TFTs, LFTs z PSA/CA125 z HbA1c z CXR z Bone profile z Clotting screen z LDH There may be other diagnostics that are required after initial review of the patient – the responsible person who delivers the diagnostics would be asked to support a quick turnaround, ideally within 48 hours of the request. If you have any questions or would like any further information, please contact Dr Robert Ghosh, associate medical director and clinical lead for the referral pathway, email: robertghosh@nhs.net or Bernadette Roach, head of cancer services at bernadette. roach@nhs.net.
The following mandatory investigations must be completed prior to referral – the referral will be returned to the GP if the tests have not been completed: z FBC
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