Referral guidelines

The Bristol Testicular Cancer Team takes primary referrals from:

• Southmead Hospital
• Royal United Hospital Bath
• Weston General Hospital
• Yeovil District Hospital
• Musgrove Park Hospital Taunton.
• Referrals for men who have recently moved into the area or attending university/college in the ASWCS area.
• Complex referrals and for further advice The Peninsula and Three Counties networks
• Second opinions

How to refer to our service:

Referral to oncologist with 24 hours of surgery

Clinical Nurse Specialists Sue Brand and Liz Allison, Germ Cell CNS, will be notified of new patient referrals to offer support and advice.

On confirmation of a tumour by testicular USS then: Surgery to be arranged at local hospital.

• Tumour Markers to be taken. (AFP, LDH and HCG)
• Staging CT Scan (Chest, abdomen and pelvis) to be arranged. (Within two weeks of surgery)
• The CT Scan can be performed Pre Orchidectomy but should not delay treatment

Referral to Oncologist with 24 hours of surgery

Markers - AFP, LDH & HCG should be taken on the day of Surgery. (If not previously taken). Please arrange for patient to have weekly post operative tumour markers.

Contact Details:

Dr J Braybrooke Consultant Medical Oncologist 0117 923 0000 via BRI Switchboard if urgent.

Sue Brand & Liz Allison Germ Cell Clinical Nurse Specialists 0117 342 3472 or mobile 0782 708 2328.

Toni-Marie Harvey MDT Co-ordinator. 0117 342 7650 (Available Tuesday, Thursday and Friday).

Secretaries 0117 342 2418.

• BTCS MDT referral form

For all primary referrals, please refer to the service using the downloadable referral form above. This can be completed electronically and sent directly to
Toni-marie.harvey@UHBristol.nhs.uk

Please complete all sections of the form and speak to one of the team if you are unsure of any aspect of the form.

If pre-operative Tumour Markers are markedly raised and/or patient has severe back/abdominal pain please refer to the high risk guidelines

A staging CT Scan (chest, abdomen and pelvis) wil be arranged within two weeks of surgery. The CT Scan can be performed Pre Orchidectomy but should not delay treatment.

High risk patients

Sometimes Testicular Cancer shows signs that it has already spread to the lymph glands and lungs, to the degree that we would recommend chemotherapy before embarking on an orchidectomy. If your patient shows any of the following signs and symptoms please contact the Bristol Testicular Cancer Team immediately:

• AFP above 1000 ng/ml
• HCG above 5000 iU/L
• LDH 1.5 x ULN
• Severe back/abdominal pain requiring opiates
• Shortness of breath
• Symptoms of renal obstruction
• The Team are happy to give advice and arrange for emergency admission to BHOC

Referrals for men moving to the area and complex referrals:

Please complete the form above and send to Toni-Marie Harvey. We would be grateful if you could arrange for radiology and histopathology to be available to us.

Please contact the team if you have any questions regarding our referral processes.