2.3 Initial referral
If a low-grade lymphoma diagnosis is confirmed by biopsy, the general practitioner must refer the patient to a haematologist or medical oncologist with professional expertise in lymphoma management. If the general practitioner considers the likelihood of lymphoma as high based on
the initial consultation, referral for urgent tissue diagnosis and ongoing management at a specialist centre with access to lymphoma multidisciplinary team support should occur.
Patients should be enabled to make informed decisions about their choice of specialist and health service. General practitioners should make referrals in consultation with the patient after considering the clinical care needed, cost implications (see referral choices and informed financial consent on page 9), waiting periods, location and facilities, including discussing the patient’s preference for health care through the public or the private system.
Referral documentation for a suspected low-grade lymphoma should incorporate appropriate documentation to allow accurate triage regarding the level of clinical urgency. Where there is clinical urgency as indicated by the features described (see 2.1.1 Timeframe for general practitioner consultation), contact the relevant specialist for advice and to ensure prompt consultation.
Documentation includes:
- important psychosocial history and relevant past history, family history, current medications and allergies
- results of current clinical investigations (imaging and pathology reports)
- results of all prior relevant investigations including imaging
- notification if an interpreter service is
Many services will reject incomplete referrals, so it is important that referrals comply with all relevant health service criteria.
If access is via online referral, a lack of a hard copy should not delay referral.
The specialist should provide timely communication to the general practitioner about the consultation and should notify the general practitioner if the patient does not attend appointments.
Aboriginal and Torres Strait Islander patients will need a culturally appropriate referral. To view the optimal care pathway for Aboriginal and Torres Strait Islander people and the corresponding quick reference guide, visit the Cancer Australia website. Download the consumer resources – Checking for cancer and Cancer from the Cancer Australia website.
For patients with indicators of concern such as organ dysfunction or neurological involvement, urgent referral to a specialist centre is needed. Specialist healthcare providers should provide clear routes of rapid access to specialist evaluation to ensure patients with indicators of concern (outlined above) are contacted and reviewed urgently.
Where lymphoma is identified by biopsy or strongly suspected, referral to specialist should occur within 72 hours.
Where there are no indicators of concern, the initial investigations outline above should take place and referral to a specialist should occur within four weeks.
