Brian is 55 and he presents to you with difficulty urinating, reduced urine flow and blood in his urine. He has no other health problems, takes no medications, there is no family history of note.
You take a detailed history which reveals no other symptoms; specifically, no dysuria, incontinence, or blood in his semen.
DRE examination feels normal. You arrange investigations and his PSA is elevated at 5.7, other investigations including an MSU and renal ultrasound are normal. You suspect prostate cancer and discuss this with Brian. He is not privately insured and requests a public referral.
What are the statewide referral criteria?
The Department of Health and Human Services Victoria has developed statewide referral criteria to assist GPs and clinicians referring patients to specialist clinics. The statewide referral criteria provide guidance to referring clinicians about which patients will be seen in adult public specialist clinics and what investigations are required to support triage.
Prostate Cancer
Prostate cancer is the second most common cancer diagnosed in men in Australia and the third most common cause of cancer death. One in seven men will be diagnosed with prostate cancer by the age of 85. It is more common in older men, with 63 per cent of cases diagnosed in men over 65 years of age (source).
Using the statewide referral criteria
Navigating public hospital outpatient services can be frustrating for general practice. Referrals can be rejected without providing a clear understanding of the criteria that have been used to reject them, leaving our patients in limbo.
Using the statewide referral criteria will hopefully ensure that Brian’s case is prioritised promptly without the referral being rejected or delayed while requesting further information.
The process for a suspected prostate cancer referral is:
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Reviewing Brian’s case, you have all the information you need.
You use the Prostate Cancer Pathway and referring for Urological Assessment on HealthPathways Melbourne to ensure you use the correct hospital referral form to ensure he is seen as quickly as possible. 
More information
If you do not have access to HealthPathways, please contact info@healthpathwaysmelbourne.org.au
Disclaimer: This article was provided by NWMPHN. While every effort has been made to ensure the information is accurate, North Western Melbourne Primary Health Network does not warrant or represent the accuracy, currency and completeness of any information or material included within.
