Ovarian Cancer
Adult

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Emergency Referrals

Useful Management Information

Women with suspected Ovarian cancer are usually evaluated initially by the Gynaecology-Oncology service and their cases discussed in a multidisciplinary team meeting. Some patients may be recommended treatments for these cancers such as chemotherapy as their first cancer treatment / as neoadjuvant therapy prior to surgery. However, the referral for initial assessment should be made to the Gynae Oncology surgical service, not Medical Oncology
Depending on the subtype of ovarian cancer, treatment options vary, for patients with newly diagnosed ovarian cancer, from surgery and adjuvant chemotherapy for early-stage and well differentiated disease, to systemic therapy with chemotherapy or other drug therapy as neoadjuvant or adjuvant treatment, or as a primary treatment modality. The treatment course is decided through the Gynaecology-Oncology Multidisciplinary tumour meeting
Patients are often referred for Genetic counselling and testing following their diagnosis of some Ovarian cancer types (such as high grade serous ovarian cancer)
Serum tumour bio-markers such as CA125, CEA and, in some women, HCG, AFP, LDH may be used as part of the diagnostic evaluation
For women who have not completed their family, fertility preservation needs to be discussed
For patients with incurable (metastatic or recurrent) cancer consider 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 woman's prognosis and their understanding of their prognosis
- whether Advance Care Planning (ACP) conversations have been undertaken and their outcome
- whether the patient has been referred to a palliative or supportive care service

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Patients with early stage or locally advanced Ovarian cancer should be referred to the Gynaecology-Oncology surgical team for evaluation and further investigation / staging. Patients are usually then presented in a multi-disciplinary meeting for treatment planning and further referral if required for Medical Oncology input. For optimum care, patient should be seen within 2 weeks Patients presenting with uncomfortable and symptomatic ascites suspected of a new diagnosis of ovarian cancer may be referred through local Emergency department for immediate symptomatic management and further Specialist assessment for investigation and biopsy Patients requiring neoadjuvant chemotherapy as discussed in MDT (biopsy confirmed), for optimum care, patient should be seen within 2 weeks Patients requiring adjuvant chemotherapy following surgery, for optimum care, patient should be seen within 4 weeks Patients requiring chemotherapy for advanced disease (biopsy confirmed) for optimum care, patient should be seen within 4 weeks
Category 2 (appointment within 90 calendar days)	Previously treated patients with ovarian cancer requiring routine follow-up 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

Family history
Previous cancer treatment details including location; dates; treating doctor; details of prior treatment regimes and imaging / pathology results
pelvic ultrasound (preferably transvaginal)
Histology /cytology results – current +/- previous
Routine blood and tumour marker tests (CA125, CEA and, in younger women, HCG, AFP, LDH)
Chest x-ray
Contrast-enhanced CT scan of the abdomen and pelvis

Additional Referral Information

Any prior genetic testing results
Other available imaging (PET/CT scan or MRI of the abdomen/pelvis)
Other investigations may be considered including fluid aspiration for cytology (pleural or peritoneal) and image-guided biopsy however these are usually performed following Gynaecology-Oncology assessment
Patients with suspected diagnosis of ovarian cancer can be referred to the nearest Gynae-Oncology service for initial investigation and confirmation of diagnosis

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.

Ovarian CancerAdult