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Suspected Urological cancer

Referral for suspected urological cancer

Referral for suspected prostate cancer

When should I refer a person with suspected prostate cancer?

  • Refer men using a suspected cancer pathway referral (for an appointment within 2 weeks) for prostate cancer if their prostate feels malignant on digital rectal examination (new NICE recommendation for 2015).
  • Consider a prostate-specific antigen (PSA) test and digital rectal examination to assess for prostate cancer in men with:
    • Any lower urinary tract symptoms, such as nocturia, urinary frequency, hesitancy, urgency or retention or
    • Erectile dysfunction or
    • Visible haematuria (new NICE recommendation for 2015)
  • Refer men using a suspected cancer pathway referral (for an appointment within 2 weeks) for prostate cancer if their PSA levels are above the age-specific reference range (new NICE recommendation for 2015)
  • Referral for suspected bladder cancer

    When should I refer a person with suspected bladder cancer?

    • Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for bladder cancer if they are:
      • Aged 45 and over and have:
        • Unexplained visible haematuria without urinary tract infection or
        • Visible haematuria that persists or recurs after successful treatment of urinary tract infection, or
      • Aged 60 and over and have unexplained non-visible haematuria and either dysuria or a raised white cell count on a blood test (new NICE recommendation for 2015).
    • Consider non-urgent referral for bladder cancer in people aged 60 and over with recurrent or persistent unexplained urinary tract infection (new NICE recommendation for 2015)

      Referral for suspected renal cancer

      When should I refer a person with suspected renal cancer?

      • Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for renal cancer if they are aged 45 and over and have:
        • Unexplained visible haematuria without urinary tract infection or
        • Visible haematuria that persists or recurs after successful treatment of urinary tract infection (new NICE recommendation for 2015)

      Referral for suspected testicular cancer

      When should I refer a person with suspected testicular cancer?

      • Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for testicular cancer in men if they have a non-painful enlargement or change in shape or texture of the testis (new NICE recommendation for 2015).
      • Consider a direct access ultrasound scan for testicular cancer in men with unexplained or persistent testicular symptoms (new NICE recommendation for 2015).

        Referral for suspected penile cancer

        When should I refer a person with suspected penile cancer?

        • Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for penile cancer in men if they have either:
          • A penile mass or ulcerated lesion, where a sexually transmitted infection has been excluded as a cause, or
          • A persistent penile lesion after treatment for a sexually transmitted infection has been completed (new NICE recommendation for 2015).
        • Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for penile cancer in men with unexplained or persistent symptoms affecting the foreskin or glans (new NICE recommendation for 2015).

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