Referrals: Suspected Cancers

Information on how to refer suspected pancreatic, thyroid, esophageal and lung cancers

There is no need to get a diagnosis or do extensive tests for suspected pancreatic cancer. This is best done under the guidance of an expert pancreas team.

MRI is not required for referral.

HPB surgeon will order MRI if necessary.

All suspected pancreas cancer should be referred to:

Hepatobiliary (HPB) Surgical Service at the QEII (fax consult to HPB Surgery, 902-473-5297) to determine resectability of the disease.

If there are questions about whether to refer a patient, HPB surgeons are available 24/7 (page 902-473-2222 and ask for the Liver Transplant Surgeon on call).

Only patients presenting with obstructive jaundice not stone related should be referred for ERCP. Suspected pancreas or ductal cancer or malignant obstruction should be immediately and directly referred to the QEII; ERCP Central Booking Halifax fax: 902-473-5548

Patients with pathologically confirmed adenocarcinoma de novo metastatic disease should be referred concurrently to both HPB surgery and medical oncology.

See pancreatic cancer workup algorithm.

Suspected Thyroid Cancer

Referral for Diagnostic Confirmation:
FNA is the procedure of choice in the evaluation of thyroid nodules.
Thyroid FNA should preferably be performed or supervised by an experienced
If a cytology result is diagnostic of or suspicious for PTC, surgery is recommended.

Confirmed Thyroid Cancer

Following a diagnosis of thyroid cancer, the patient should be referred to a surgeon experienced in thyroid surgery.
It is strongly recommended that all patients with a diagnosis of thyroid carcinoma be referred to the Interdisciplinary Thyroid Oncology Clinic (ITOC) based at the Queen Elizabeth II Health Sciences Centre (QEII), Halifax, for interdisciplinary review (Radiation Oncology, Endocrinology, Nuclear Medicine, Surgical Oncology and allied health professionals), patient education and supportive care. Referrals should be made within 6-8 weeks of surgery.

Fax referrals to the QEII Cancer Centre Referrals Office at 902-473-6079 (Phone: 902-473-5140) with the following documents:
If the referring physician would like to discuss a case with a thyroid oncology specialist, it is recommended that they call the appropriate specialist associated with the ITOC through the QEII locating service 902-473-2220. (Radiation Oncology: Dr. Mal Rajaraman, Endocrinologist: Dr. Ali Imran)

Suspected esophageal and lung cancer

Suspected esophageal or lung cancer should be referred to Thoracic Surgery at the QEII Health Sciences Centre.