The Cancer Care Program has streamlined the referral process for hematology (benign and malignant), medical oncology and radiation oncology with one referral form and process across the province. For gynecology oncology referrals, see below.
To safely process, triage and schedule new patients, all referrals to medical oncology, radiation oncology, and hematology (benign and malignant) must include the following:
This provincial referral process is intended to ensure patients are triaged appropriately and receive their appointment as soon as possible and that cancer specialists have easy access to necessary test results and investigations prior to the initial consult appointment.
As part of the single intake, patients will seen by an appropriate specialist at the cancer centre (Halifax or Sydney) or community site closest to them. Some patients requiring subspecialist treatment may be seen in Halifax regardless of where they live.
Required information for all Gyne Oncology referrals:
Referrals for gynecologic radiation therapy follow the process above.
Referrals for cancer-related surgery should be sent directly to the appropriate surgical service through Ocean via an office Electronic Medical Record, the Ocean web portal or via fax.
Pathology
Blood work
Imaging
Other reports
Localized bladder cancer, for curative intent |
Semi-urgentAll pathology/cytology reports related to bladder cancer Blood work
Imaging
OR reports
|
Bladder cancer, symptomatic management of local symptoms |
Semi-urgentAll pathology/cytology reports related to bladder cancer Imaging
OR reports
|
Metastatic bladder carcinoma |
Semi-urgentAll pathology/cytology reports related to bladder cancer Blood work
Imaging
OR reports
|
Metastatic bladder cancer, for palliative radiation to metastases |
Pathology report Imaging of appropriate site |
Locally advanced/inflammatory, for NACT or adjuvant therapy | Pathology
Imaging
|
Early breast cancer, for NACT or adjuvant therapy | Pathology
Imaging
|
Confirmed/suspected metastatic disease | Pathology
|
Primary CNS tumours
All referrals come from Neurosurgery.
Ideally, all cases should be discussed at tumour board.
Patients with previous cancer history and metastatic tumours
Refer to local Colposcopy service.
Pathology
Pathology
Blood work
Imaging
Referral letter must specify if referral is for:
AND
Pathology
Blood work
Imaging reports
Operative reports
Pathology
Blood work
Imaging
OR reports
Prior to referring to medical or radiation oncology, all patients should be referred to Thoracic Surgery (fax referral to 902 473-6144 or via Ocean e-referral).
Pathology
Blood work
Imaging
OR reports
Fax to your local gynecologist.
Pathology
Blood work
Pathology
Blood work
Imaging
Other reports
Kidney, adjuvant
|
Pathology report Blood work
Imaging
OR report |
Kidney, metastatic
|
Pathology report
Imaging
|
Kidney, for palliative radiation |
Pathology report Imaging of appropriate body part |
Adjuvant:
Required information:
Metastatic:
Required information:
Any pathology, blood work, imaging and operative reports pertaining to diagnosis.
All patients should also be referred to HPB surgical service to determine resectability of disease. Referrals to HPB surgeons can be made through:
OR
Patients presenting with obstructive jaundice that is not stone-related should immediately and directly be referred to the QEII for Level 3 or 4 ERCP.
ERCP Central Booking Halifax
Information to accompany a referral for medical and radiation oncology:
Pathology
OR
Imaging
Localized, for curative radiation |
Pathology report
R report, if performed Blood work
Imaging
|
Locally advanced, for neoadjuvant or adjuvant chemotherapy |
Pathology report
Blood work
Imaging
OR report, if performed |
Metastatic | Pathology report
Blood work
OR report, if performed |
Metastatic, for palliative radiation | Pathology report
|
All other patients meeting the criteria below will be referred to the Atlantic Peritoneal Oncology Program through OCEAN (choose Peritoneal Oncology) or via fax to 1-902-423-1629. The Cancer Care Program Referral form is not required.
Required information for referral:
Localized, curative intent radiation |
Pathology
Blood work
NOTE: Imaging will depend on plan and PSA. Prostate size is required for decision re: brachytherapy |
Localized, adjuvant or salvage radiation |
Pathology Blood work
NOTE: Imaging will depend on plan and PSA Prostate size is required for decision re: brachytherapy |
Metastatic |
Pathology Blood work
Imaging
|
Metastatic, for palliative radiation |
Pathology It is rare that this is not obtained – if not available, note in referral letter. Appropriate imaging of involved area |
NOTE: All new diagnoses of rectal cancer are to be:
AND
Referral letter must include:
Pathology
Pathology report documenting cancer diagnosis, including:
Blood work
Imaging
Reports
Pathology
Imaging
Reports
Required information:
Prior to referring to medical or radiation oncology, all patients' cancer should be seen by Thoracic Surgery (fax referral to 902 473-6144 or via Ocean e-referral).
These diagnoses are considered urgent. Referrals and investigations should be expedited once histological diagnosis made.
Required:
Order but do not wait for results:
The referring physician must speak directly to a medical oncologist for urgent situations such as:
If Monday-Friday (08:00-04:00), please speak to the Cancer Care Program Referral Office (902-473-5140) to determine the medical oncologist assigned to the case. If after hours or on weekends, please speak to the medical oncologist on call.
Pathology
Blood work
Imaging
Pathology
Blood work
Imaging
OR reports
Pathology
Blood work
Pathology
Blood work
Imaging
Tumour markers:
This includes Vulvar Intraepithelial Neoplasia (VIN) and Vaginal Intraepithelial Neoplasia (VAIN).
Pathology
Other
Below is the list of conditions/diseases that are automatically processed as emergent. For these conditions/diseases, please contact the appropriate oncologist on call. The referral form must be submitted clearly indicating the disease/condition.
For any other patient whom the referring provider believes requires urgent attention, please contact the appropriate oncologist on call to discuss the case.
Condition/Disease | On-Call Oncologist |
---|---|
Anemia (<60) | Hematology |
Acute Leukemia (new diagnosis) | Hematology |
Thrombocytopenia (severe, platelets < 20,000) | Hematology |
Thrombotic thrombocytopenic purpura (TTP) | Hematology |
CNS lymphoma | Hematology |
Superior Vena Cava obstruction by small cell lung carcinoma | Medical Oncology |
Metastatic testicular cancer/germ cell tumors | Medical Oncology |
Spinal Cord Compression | Radiation Oncology |
Superior vena cava obstruction | Radiation Oncology |
Suspected Gynecologic Malignancy with associated bowel obstruction | Gynecology Oncology |
Suspected Gynecologic Malignancy with associated anemia <60 – gynecologic oncology | Gynecology Oncology |