Pancreatic-biliary Cancer
Adult

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Emergency Referrals

Useful Management Information

Refer patients with acute obstructive jaundice with suspected primary pancreatic and biliary malignancy through to the Emergency department to expedite management and for further investigation
If the referring clinician organises a biopsy – a core or excisional biopsy is preferable to an FNA if available
Patients with some stages of pancreatic cancer may receive chemotherapy or chemotherapy and radiation as their first cancer treatment / as neoadjuvant therapy prior to surgery However, the referral for initial assessment should be made to the General or Hepato-biliary surgical service, not medical oncology
Serum tumour bio-markers such as CEA, CA19.9 or others 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 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 Women's and men'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
Quick reference guide

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Patients with suspected pancreatic or biliary tract cancer should be referred to the General or Hepato-biliary surgical 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 Patients with Multiple pancreatic cysts or IPMNs for investigation or surveillance should be referred to the General or Hepato-biliary surgical team Neoadjuvant chemotherapy prior to surgery (usually referred by Surgeon after MDT). For optimum care, patient should be seen within 2 weeks Adjuvant treatment after surgery (usually referred after MDT by surgeon) Metastatic or locally advanced unresectable pancreatic or biliary cancer with rapid progression of symptoms or organ dysfunction. For optimum care, patient should be seen within 2 weeks
Category 2 (appointment within 90 calendar days)	Transfer of care from another health service Pancreatic ductal adenocarcinoma or cholangiocarcinoma in continuous remission for ≥3 years
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

Detailed history of present signs and symptoms
Past medical history/pertinent social history
Current medications and allergies
Histology report
FBC U&E, LFT, LDH results
CT abdomen report

Additional Referral Information

Other available imaging

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.

Pancreatic-biliary CancerAdult