Head and neck cancer
Adult

Medical Oncology

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Emergency Referrals

Useful Management Information

Patients with new or suspected diagnosis of head and neck cancer should initially be referred to ENT surgeons for comprehensive assessment of upper aerodigestive tract regardless of presence or absence of metastatic disease
Patients with airway compromise, symptomatic hypercalcaemia or significant bleeding should be referred to emergency department
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 patient’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
  Barium swallow as needed
- Optimal care pathway for people with head and neck cancer
- Quick reference guide

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Biopsy confirmed head and neck malignancy (oral and nasal cavity, larynx, pharynx, salivary glands) for combined chemo-radiotherapy or induction chemotherapy. For optimum care, patient should be seen within 2 weeks. Biopsy confirmed head and neck malignancy not amenable to surgery or radiotherapy and for palliative chemotherapy. For optimum care, patient should be seen within 2 weeks. Resected head and neck malignancy with high risk features for adjuvant radiation or chemo-radiotherapy
Category 2 (appointment within 90 calendar days)	Transfer of care for follow up of metastatic patients
Category 3 (appointment within 365 calendar days)	No category 3 criteria

Category 1 (appointment within 30 calendar days)

Biopsy confirmed head and neck malignancy (oral and nasal cavity, larynx, pharynx, salivary glands) for combined chemo-radiotherapy or induction chemotherapy. For optimum care, patient should be seen within 2 weeks.
Biopsy confirmed head and neck malignancy not amenable to surgery or radiotherapy and for palliative chemotherapy. For optimum care, patient should be seen within 2 weeks.
Resected head and neck malignancy with high risk features for adjuvant radiation or chemo-radiotherapy

Category 2 (appointment within 90 calendar days)

Transfer of care for follow up of metastatic patients

Category 3 (appointment within 365 calendar days)

No category 3 criteria

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

Past medical history, current medications, weight loss
Height & weight
Smoking and alcohol history
Previous cancer treatment details
Physical examination of the affected area, i.e. throat, neck
Pertinent social history/support
Biopsy results
Endoscopy results
Any relevant CT, PET scan +/- MRI results

Additional Referral Information

History of significant hearing impairment can help guide treatment

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.

Head and neck cancerAdult