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Hellooo Friend!!!

Hema Here!

As a Doctor,

Don’t We Have a Crucial Role in the Detection of Cancer?

‘Two- week Referral’  Guidelines is one of the most important tools for this is.

This is one of the topics to freshen up just before your Big Day – CSA .***

Star*** marked means –  You need to give more attention!










Get NICE referral guidelines by clicking here.

We can have scenarios either –

To negotiate the plan to be referred for 2ww clinic or
To reassure that there is no need for 2ww referral.

Make sure the Patient understands –

Be unambiguous about the nature of the referral with the patient.
Patients sometimes findout that a clinical suspicion existed only after their hospital appointment.

This is understandably distressing and often leads to anger and shock.

Safety net and follow-up

Always advise patients to contact you if they have not heard from the hospital within two weeks.
It is good practice to see the patient after the diagnosis to offer emotional and psychosocial support.
Practise as many scenarios with your Trainer and Colleagues!

Top Ten Topics are :

  1. Lung                                }  See sheet 1 of 5 click – HERE
  2. GI – Upper & Lower   }
  3. Breast                      ]  See sheet 2 of 5. click – HERE
  4. Gynaecological   ]
  5. Urology   ———> Lets see in this post. Hoorayyyy!
  6. Haemotological    ====>> In the next blog 🙂
  7. Skin
  8. Head & Neck
  9. Brain & CNS
  10. Bone.

It is important to remember Paediatric cases as it can come not only in CSA but also in our normal surgery!

Now we will look into

5) Urology Cases.

We will cover the Great Prostate*** first.

Urgent Referral

– Hard, irregular mass*** + needs PSA level with referral.
– High PSA*** with normal prostate.
– Symptomatic and with High PSA.

These scenarios are vital and can definitely expect in CSA.

The Mantra is – Practise, Practise, Practise!

How to break the bad news?

See our blog post written by Dr Kashif Bhatti – Secret Steps for Breaking Bad news

Extra Tips 🙂

When PSA is Borderline –

Repeat in 1-3 months and if rising – Refer Urgently.

Wait for 1 month after UTI for PSA testing*** .

Urgent Urology Referral

Any Age with

1. Abdominal Mass from urinary tract origin.

2. Testicular Mass/ Swelling ***.

3. Penile cancer/ mass/Ulcer. (not Peyronie disease)

4. Painless Macroscopic Haematuria***.

40 or more yrs –
Recurrent /Persistent UTI with Haematuria.

50 or more yrs –
Unexplained Microscopic Haematuria***.

Non Urgent Referral

If Microscopic Haematuria in less than 50 yrs –

Next Step – Check Proteinuria and Creatinine***.

If above are Normal – Refer for Urology opinion.

If Increased – Refer for Renal opinion.

Thats all in this post – sheet 3 of 5.


It will be tooooo much to take in …

The Secret of Success in CSA is to Practise as many scenarios as possible… to remember the age, weeks etc…

Have FUN 🙂

Remember the star *** marked ones!

Can’t wait to see you in the next blog!

To Your Success,

Hema xoxo.



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