2-Week Cancer Pathways Flashcards

1
Q

2-week cancer pathway - Brain and CNS Tumours? Children?

A

MRI Scan (CT if MRI CI) in adults with progressive, sub-acute loss of central neurological function

In children - appointment within 48 hours

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2
Q

2-week cancer pathway - Breast Cancer?

A

Appointment if:

> 30 and have unexplained breast lump

> 50 with discharge/retraction/other changes of concern in one nipple only

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3
Q

2-week cancer pathway - Oesophageal & Gastric Cancer?

A

Upper GI endoscopy if:

Dysphagia

> 55 with weight loss and any of - upper abdominal pain, reflux or dyspepsia

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4
Q

2-week cancer pathway - When to consider oesophageal & Gastric referral?

A

> 55 with:

Treatment resistant dyspepsia

Upper abdominal pain with low Hb

Raised platelet count with any of - nausea, vomiting, weight loss, reflux, dyspepsia, upper abdominal pain

N&V with any of - weight loss, reflux, dyspepsia, upper abdominal pain

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5
Q

2-week cancer pathway - Pancreatic Cancer? When to consider?

A

> 40 and have jaundice

Consider >60 with weight loss and any of - diarrhoea, back pain, abdominal pain, N&V, constipation, new-onset diabetes

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6
Q

2-week cancer pathway - Gallbladder Cancer?

A

Consider US if upper abdominal mass consistent of enlarged gall bladder

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7
Q

2-week cancer pathway - Liver Cancer?

A

Consider US if upper abdominal mass with enlarged liver

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8
Q

2-week cancer pathway - colorectal cancer?

A

> 40 with unexplained weight loss and abdominal pain

> 50 with unexplained rectal bleeding

> 60 with iron-deficiency anaemia or changes in bowel habit

Positive faecal occult blood

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9
Q

2-week cancer pathway - Anal Cancer?

A

Unexplained anal mass or ulceration

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10
Q

2-week cancer pathway - Ovarian Cancer?

A

Ascites and/or pelvic or abdominal mass (not uterine fibroids)

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11
Q

2-week cancer pathway - Endometrial Cancer?

A

> 55 with post-menopausal bleeding

Consider if <55 with PMB

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12
Q

2-week cancer pathway - when to consider US in endometrial cancer?

A

> 55 and:

Unexplained symptoms of vaginal discharge - presenting for 1st time, thrombocytosis, haematuria

Visible haematuria and - low Hb, thrombocytosis, high blood glucose

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13
Q

2-week cancer pathway - Cervical Cancer?

A

Cervix on examination consistent with cancer

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14
Q

2-week cancer pathway - Vulval Cancer?

A

Unexplained vulval lump, ulceration or bleeeding

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15
Q

2-week cancer pathway - Vaginal Cancer?

A

Unexplained palpable mass in or at entrance to vagina

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16
Q

2-week cancer pathway - Leukaemia? Children?

A

Very urgent FBC (within 48 hours) if:

Pallor
Persistent fatigue
Unexplained fever
Unexplained recurrent infection
Lymphadenopathy
Unexplained bleeding, bruising, petechiae
Hepatosplenomegaly

Children - Immediate specialist assessment if unexplained petechiae or hepatosplenomegaly

17
Q

2-week cancer pathway - Myeloma?

A

> 60 with persistent bone pain (particularly back) or unexplained fracture - FBC, Ca, plasma viscosity or ESR

> 60 with hypercalcaemia or leukopenia and presentation consistent of myeloma - within 48 hours protein electrophoresis and Bence-Jones protein urine test

Consider within 48 hours protein electrophoresis and Bence-Jones protein urine test if plasma viscosity or ESR and presentation consistent with myeloma

Refer if results of protein eletrophoresis or Bence-Jones protein urine test suggest myeloma

18
Q

2-week cancer pathway - Lymphomas?

A

Refer if unexplained lymphadenopathy or splenomegaly (NHL)

Children - within 48 hours

19
Q

2-week cancer pathway - Laryngeal cancer?

A

> 45 with:

Persistent unexplained hoarseness

Unexplained lump in neck

20
Q

2-week cancer pathway - oral cancers?

A

Unexplained ulceration in oral cavity >3 weeks or

Persistent and unexplained lump in neck

21
Q

2-week cancer pathway - Thyroid Cancer?

A

Unexplained thyroid lump

22
Q

2-week cancer pathway - Lung Cancer?

A

Appointment - CXR findings of lung cancer OR >40 with unexplained haemoptysis

CXR - >40 if 2 or more (1 or more if ever smoked):

Cough, fatigue, SOB, chest pain, weight loss, appetite loss

Consider if persistent or recurrent infections, finger clubbing, cervical/supraclavicular lymphadenopathy, chest signs, thrombocytosis

23
Q

2-week cancer pathway - Bone sarcoma?

A

XR suggests bone sarcoma

Child - within 48 hours

24
Q

2-week cancer pathway - Soft tissue sarcoma?

A

US if unexplained lump increasing in size

Child - within 48 hours

25
Q

2-week cancer pathway - Malignant Melanoma?

A

Weight 7-point checklist of 3 or more:

Major (2 points) - change in size, irregular shape, irregular colour

Minor (1 point) - diameter >7mm, inflammation, oozing, change in sensation

26
Q

2-week cancer pathway - BCC/SCC of skin?

A

SCC - 2 week referral if skin lesion suspicious of SCC

BCC - routine referral if lesion suspicious of BCC, only consider 2 week if concern that delay may have significant impact (site or size)

27
Q

2-week cancer pathway - Prostate Cancer?

A

Refer if PSA high or Prostate feels malignant on DRE

Perform PSA and DRE if:
Any LUT symptoms (nocturia, urinary frequency, hesitancy, urgency, retention), erectile dysfunction, visible haematuria

28
Q

2-week cancer pathway - Bladder Cancer?

A

> 45 with:

Unexplained visible haematuria without UTI

Visible haematuria persisting or recurring after treatment of UTI

> 60 with unexplained non-visible haematuria and either dysuria or raised WCC

29
Q

2-week cancer pathway - Renal Cancer?

A

> 45 with:

Unexplained visible haematuria without UTI

Visible haematuria persisting or recurring after treatment of UTI

30
Q

2-week cancer pathway - Testicular Cancer?

A

Appointment - non-painful enlargement or change in shape or texture of testis

US - unexplained or persistent testicular symptoms

31
Q

2-week cancer pathway - Penile Cancer?

A

Penile mass or ulcerated lesion, where STI excluded

Persistent penile lesion after STI treated

32
Q

2-week cancer pathway - Child neuroblastoma?

A

Appointment within 48 hours with palpable abdominal mass or unexplained enlarged abdominal organ

33
Q

2-week cancer pathway - Child retinoblastoma?

A

2-week referral in child with absent red reflex

34
Q

2-week cancer pathway - child Wilm’s Tumour?

A

Appointment within 48 hours if:

Palpable abdominal mass

Unexplained enlarged abdominal organ

Unexplained visible haematuria