Clinical approach to suspected cancer

Abstract

This chapter covers the clinical approach to suspected cancer, outlining warning features and indications for urgent and non-urgent referral according to the National Institute of Health and Care Excellence (NICE) recently updated 2005 guidance on referral for suspected cancer (NICE 2015). This guideline provides evidence-based indications for urgent referral from primary to secondary care for further investigations within two weeks of a suspected cancer. It also highlights a number of clinical situations where a very urgent (within 48 hours) or immediate referral (within a few hours) are needed. Indications for the cancer pathway and urgent referrals for various cancers are covered in this chapter. Topics include lung cancer, mesothelioma, breast cancer, urological cancer, nervous system tumours, upper and lower GI cancers, gynaecological cancer, haematological cancer, head and neck cancer, thyroid cancer, bone cancer and sarcoma, and skin cancer (melanoma and non-melanoma).