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How to Make a Cancer or Acute Oncology Referral

“Is it cancer?” referrals

Two week wait (2WW) pathways

If you think that one of your patients has cancer, you should normally refer via a two week wait pathway. Select the pathway most appropriate to your patient. If you are unsure which is the most appropriate, please use the guides below. If a patient does not fit any of the two week wait pathways, see the “Suspected Cancer of an Unknown Origin” below.

In London 2WW referrals are made using the Pan London Cancer Referral Forms that are available through DXS and can be integrated into practice IT systems. These can be found on the Healthy London Partnership website.

For information about when to refer patients, the following guides are very helpful:

  1. Macmillan Rapid Referral Guidelines
  2. Cancer Research UK Reference Guide
  3. Further information from Macmillan
  4. Further information from Cancer Research UK

Suspected Cancer of Unknown Origin

If you are not sure of the most likely origin of a suspected cancer and your patient does not fit any of the specialty specific 2WW criteria, then please consider discussion with the St. George’s Acute Medical Unit. There is a consultant responsible for new referrals accessible via the switchboard.


If you suspect that a child may have cancer, please speak to the on-call Paediatric team at St. George’s urgently. They will arrange urgent assessment of the child, very likely on the same day.

Cancer in Wandsworth

For more information and guidelines about referrals please visit the Cancer in Wandsworth website.

“Already has cancer” Referrals

The UK Oncology Nursing Society (UKONS) guidelines provide a very useful first point of call in assessing a patient with symptoms relating to their cancer or treatment of their cancer.

They cover:

  • Fever
  • Anorexia
  • Bleeding
  • Bruising
  • Chest Pain
  • Constipation
  • Diarrhoea
  • Dyspnoea
  • Extravasation
  • Fatigue
  • Infection
  • Nausea
  • Neurological Symptoms
  • Stomatitis
  • Pain
  • Palmar +/- plantar erythema
  • Performance Status
  • Rash
  • Vomiting

Please see our electronic symptom guide taken from the UKONS for detailed symptom-specific information.

If you have any urgent medical concerns about a cancer patient which you think relates to their disease or their cancer treatment, then please call the 24h triage helpline:

(Mon-Fri 9-5): 07831 147653
Out of hours: 0208 672 1255 ask for the oncology out of hours service

If you have a non-urgent concern relating to a patient’s cancer or cancer treatment then please use Kinesis.