Lung Cancer (Oncology)
Adult

On this page

Emergency Referrals

Useful Management Information

Suspected lung cancers (mass on chest XR or CT chest) needs to be referred to the appropriate specialist (usually respiratory physician) for work-up. Specialist review optimally should be within 2 weeks
Most referrals for locally advanced disease for concurrent chemotherapy and radiation come through respiratory or cardio-thoracic team and after Multidisciplinary Team (MDT) review
Lung cancer patients diagnosed and treated via an MDT have improved outcomes
If the referring clinician organises a biopsy – please ensure a core or excisional biopsy (not a FNA) is performed
Patients with some stages of lung cancer may receive chemotherapy and immunotherapy as their first cancer treatment / as neoadjuvant therapy prior to surgery. However, the referral for initial assessment should be made to the Respiratory service, not medical oncology, for evaluation and management planning initially.
Histology (biopsy or surgical specimen) for Non-small cell lung cancer usually include testing for common lung cancer mutations, and translocations and PDL1 immunohistochemistry
Serum tumour bio-markers should not be used as diagnostic tests
For women and men who have not completed their family, fertility preservation needs to be discussed
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
Investigating symptoms of lung cancer . A guide for GP's
Optimal care pathway for people with lung cancer
Quick reference guide

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Patients with suspected lung cancer should be referred to the Respiratory team for evaluation and further investigation. Patients are usually then presented in a multi-disciplinary meeting for treatment planning and further referral if required for Medical Oncology input. All small cell lung cancer that does not need emergency treatment (see emergency). For optimum care, patient should be seen within 2 weeks. Biopsy proven advanced non-small cell lung cancer (preferably seen within 2 weeks) Neoadjuvant treatment prior to curative surgery Adjuvant treatment following curative surgery Locally advanced disease for concurrent chemotherapy and radiation Recurrence following previous treatment (Patients on surveillance after previous treatment for lung malignancy may be referred directly to medical oncology)
Category 2 (appointment within 90 calendar days)	Patientswith previously treated stage 3 or stage 4 lung cancer requiring ongoing follow-up for five years post-diagnosis Transfer of care from another health service
Category 3 (appointment within 365 calendar days)	No category 3 criteria
If your patient does not meet the minimum referral criteria Assessment and management information may be found on a range of conditions at HealthPathways If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

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

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
All conservative options that have been pursued unsuccessfully prior to referral
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
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

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.)

Essential Referral Information

GP Essential Referral Information

Past medical history, current medications
Smoking history
Previous cancer treatment details
FBC
ELFT
Any relevant XR results +/- relevant CT reports
CT chest, upper abdomen and pelvis
If available attach CT or MRI of the brain and bone scan

Specialist Essential Referral Information (in addition to the criteria above)

Tissue pathology +/- cytology results
Physiological assessment - pulmonary function test if applicable
Bronchoscopy including endobronchial USS (EBUS) if applicable
PET scan reports for selected patients

Additional Referral Information

Other available imaging
If available attach CT or MRI of the brain and bone scan
Biopsy result if available
Include (GP) Essential referral information
Physiological assessment - pulmonary function test if applicable
Bronchoscopy including endobronchial USS (EBUS) if applicable
PET scan reports for selected patients

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Not Available

Internal Referrals

Medical Oncology (E-Blueslips)

Fax

(07) 5687 4497

Post

Cancer Referral Centre,
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

(07) 5687 2708

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Marcin Dzienis

Medical Director Radiation Oncology (ICON Cancer Care)

Facilities

Gold Coast University Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Lung Cancer (Oncology)Adult