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Referral
Sarcoma
Scope
This guidance covers the referral of a patient who presents with symptoms suggesting bone cancer or sarcoma to a team specialising in the management of bone cancer and sarcoma, or to a recognised bone cancer centre, depending on local arrangements.
If you have concerns about a patient's symptoms and/or signs, consider a discussion with the local specialist.
GPs can refer a patient they suspect of having cancer to be seen within 14 days by a specialist. GPs must send the referral within 24 hours of the decision to refer.
Please use the referral forms listed on this page to ensure appropriateness. They have been agreed by the Peninsula Cancer Network.
Urgently investigate increasing, unexplained or persistent bone pain or tenderness, particularly pain at rest (and especially if not in the joint), or an unexplained limp. In older people metastases, myeloma or lymphoma, as well as sarcoma, should be considered.
Refer patient for immediate x-ray with a suspected spontaneous fracture, if the x-ray:
- indicates possible bone cancer, refer urgently
- is normal but symptoms persist, follow up and/or request repeat x-ray, bone function tests or referral.
Referral Criteria
Bone Sarcoma
- X ray suggests the possibility of bone sarcoma (please include x-ray results)
Soft Tissue Sarcoma
- Unexplained lump increasing in size (will be triaged direct for ultrasound if appropriate)
- Ultrasound findings of sarcoma or findings are uncertain and clinical concern persists
- Location of Mass
The following recent blood results, less than 8 weeks old, would be extremely helpful:
- FBC
- eGFR
- U&Es
Referral Instructions
The GP should: use e-Referral Service to book an appointment or send the referral.
Please ensure you include:
- The patient's NHS number
- Tell the patient that this is an urgent referral and they will be seen within 14 days
e-Referral selection:
- Specialty: 2WW
- Clinic type: 2WW Sarcoma
- Service: Two week Wait Sarcoma-RDE-RH8
Please ensure that referrals are booked via NHS e-Referral Service. If no slots are available please defer to provider and the RDE will book the appointment and contact the patient. Please also ensure that referral letters are attached to the system within 24 hours to enable us to book pre appointment tests and scans timely.
For any patients that you are unable to process through NHS e-Referral please contact the drss.helpdesk@nhs.net
Referral Forms
Suspected Sarcoma referral form - No merge fields
Evidence
NICE referral guidelines for suspected cancer
GP Information
Suspected Cancer Guidelines A-Z
NICE referral guidelines for suspected cancer
bmj - New NICE guidance on referral for cancer
bmj - Assessing and referring adult cancers infographic
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
Patient Information
New Leaflet available for patients who are referred to exclude a diagnosis of cancer
Pathway Group
This guideline has been signed off by NHS Devon.
Publication date: November 2016
