2.3 Initial referral

2.3 Initial referral

If the cancer diagnosis is confirmed or the results are inconsistent or indeterminate, the general practitioner must refer the patient to an appropriate specialist (gastroenterologist, oncologist or hepatopancreaticobiliary [HPB] surgeon with professional expertise in pancreatic cancer management and access to a multidisciplinary team) to make the diagnosis. In patients with locally advanced, non-metastatic disease, if resectability needs to be determined, referral should be to an HPB surgeon.

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 options and informed financial consent), waiting periods, location and facilities, including discussing the patient’s preference for health care through the public or the private system.

Referral for suspected or diagnosed pancreatic cancer should include the following essential information to accurately triage and categorise the level of clinical urgency:

  • important psychosocial history and relevant medical history
  • family history, current symptoms, medications and allergies
  • results of current clinical investigations (imaging and pathology reports)
  • results of all prior relevant investigations
  • notification if an interpreter service is required.

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.

All patients with suspected or proven pancreatic cancer should be seen by a specialist (gastroenterologist, oncologist or HPB surgeon) with expertise in pancreatic cancer management and linked to a multidisciplinary team within one week of referral to the specialist.