Urological Cancer - Prostate

Urgent Referral

Refer urgently patients

• with a hard, irregular prostate typical of a prostate carcinoma. Prostate specific antigen (PSA) should be measured and the result should accompany the referral (an urgent referral is not needed if the prostate is simply enlarged and the PSA is in the age-specific reference range)
• with a normal prostate, but rising / raised age-specific PSA, with or without lower urinary tract symptoms (LUTS). Note, in patients compromised by other comorbidities, a discussion with the patient or carers and / or a specialist may be more appropriate.
• with symptoms and high PSA levels

Urological Cancer - Bladder Cancer and Renal Cancer (Kidney Cancer)

Urgent Referral

Refer urgently patients

• of any age with painless macroscopic haematuria
• aged 40 years and older who present with recurrent or persistent urinary tract infection associated with haematuria
• aged 50 years and older who are found to have unexplained microscopic haematuria
• with an abnormal mass identified clinically or on imaging that is thought to arise from the urinary tract

Urological Cancer - Testicular

Urgent referral

Refer urgently patients

• with a swelling or mass in the body of the testis

Urological Cancer - Penile

Urgent referral

Refer urgently patients

• with symptoms or signs of penile cancer. These include progressive ulceration or a mass in the glans or prepuce particularly, but can involve the skin of the penile shaft. Note: Lumps within the corpora cavernosa can indicate Peyronie's disease, which does not require urgent referral.