Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • spinal cord compression
  • severe uncontrolled bone or back pain
  • renal failure from ureteric or bladder outflow obstruction
  • severe haematuria
  • severe urinary retention
  • if referring doctor concerned about patient who may require urgent care

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network 

Southern Adelaide Local Health Network

Category 1 (appointment clinically indicated within 30 days)

  • locally advanced prostate cancer
  • metastatic prostate cancer
  • prostate cancer recurrence

As per Optimal Care Pathway for men with prostate cancer (PDF 427KB) surgery should be conducted/radiation therapy to begin within 3 months of diagnosis or within 4 weeks if significant local symptoms are present.

Category 2 (appointment clinically indicated within 90 days)

  • early stage localised prostate cancer
  • prostate cancer biochemical recurrence

Category 3 (appointment clinically indicated within 365 days)

  • nil

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • past medical and surgical history
  • medications and allergies
  • smoking, alcohol and other drug status
  • age
  • concerning features for example, nausea/vomiting, abdominal pain, bloating, unintentional weight loss
  • pathology:
    • complete blood examination (CBE)
    • electrolytes urea and creatinine (EUC)
    • liver function test (LFT)
    • prostate-specific antigen (PSA)
  • chest-abdomen-pelvis computed tomography (CT)
  • whole-body bone scan
  • copies of referrals/correspondence to Urologist

Additional information to assist triage categorisation

  • Histopathology from transperineal biopsy/transurethral resection of the prostate (TURP) /prostatectomy
  • PSMA PET (Prostate Specific Membrane Antigen) (Positron Emission Tomography) scan reports if available

Clinical management advice

If screen detected abnormal prostate-specific antigen (PSA) or digital rectal examination (DRE), referral to urology clinic recommended prior to diagnosis.

Majority of referrals for consideration of radiotherapy come from treating Urologist in localised disease however, GPs are welcome to refer once the diagnosis is established.

If a patient has a rising PSA following definitive radiotherapy and are no longer being followed up by a specialist unit, GPs are welcome to refer back to the treating radiation oncologist for further investigation or work up.

Patients previously treated for prostate cancer with suspicion of recurrence (presence of tumour related symptoms or metastasis) may be referred following preliminary investigations.

If your patient has severe psychological distress due to waiting for an appointment or commencing treatment, please contact the relevant Radiation Oncology Registrar or on-call Consultant to discuss your patient’s individual circumstances.

For people who have not completed their family, fertility preservation needs to be discussed in a culturally sensitive manner and gender of the practitioner considered. Links provided in the 'Consumer resources' sections of this CPC.

Patients with incurable (metastatic or recurrent) cancer

Consider the following for patients with incurable (metastatic or recurrent) cancer:

  • 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), their prognosis and their understanding of their prognosis
  • whether Advance Care Directive (ACD) 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
  • comprehensive clinical and consumer resources and advice regarding referral to Palliative Care outpatients can be found in the Palliative Care – Adult CPC

Clinical resources

Consumer resources

Reason for request

  • to establish a diagnosis
  • for treatment or intervention
  • for advice and management
  • for specialist to take over management
  • for a specified test/investigation the General Practitioner cannot order
  • for other reason (e.g. rapidly accelerating disease progression)
  • transfer of care from another tertiary service
  • clinical judgement indicates a referral for specialist review is necessary.

Patient demographic details

  • full name, including aliases
  • date of birth
  • residential and postal address
  • telephone contact number/s – home, mobile and alternative
  • Medicare number, where eligible
  • name of the parent or caregiver, if appropriate
  • preferred language and interpreter requirements
  • identifies as Aboriginal and/or Torres Strait Islander

Clinical modifiers

  • impact on employment
  • impact on education
  • impact on home
  • impact on activities of daily living
  • impact on ability to care for others
  • impact on personal frailty or safety
  • identifies as Aboriginal and/or Torres Strait Islander

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.
  • Relevant social history, including identifying if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf.
  • Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
  • Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
  • All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.