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Assessment and management of systemic therapies for adult malignancies (non-haematological).Close liaison with other specialist disciplines at the RHH to ensure access to all modalities relevant to the patient's type and stage of cancer in the appropriate time frame.
North South North West Statewide
THS Southern, Northern and North West Region
Medical Oncologists are also involved in multi-disciplinary diagnostic workup and overall care planning in concert with other relevant hospital-based specialists, particularly surgeons and radiation oncologists.
Exclusions: Early stage non-melanomatous skin cancers.
Lymphomas and myeloma are principally managed within Haematology Services although there is some overlap.
Long term survivors of multimodality cancer treatment with complications from this, or their cancer, may benefit from referral to Oncology Late Effects Clinic.
The common oncologic emergencies are:
- Febrile neutropenia (FN): FN is a common complication of systemic therapy. Relevant patients have been briefed on the detection and action required, if they suspect they have FN
- SVC obstruction
- Malignant hypercalcaemia (Serum Calcium > 3.0 mmol/l)
- Tumour lysis syndrome and malignant spinal cord compression
Malignant spinal cord compression may be the initial presenting symptom for some people with undiagnosed malignancy. In any adult with new onset back pain (particularly if it is not relieved by rest) and even subtle neurological symptoms in the lower limbs should undergo urgent MRI of the entire neuraxis and/or referral to the Emergency Department of the RHH.
In most instances referral to Medical Oncology is a secondary referral from another specialist discipline in the RHH who are primarily responsible for the management of the condition.
A referral (preferably faxed) is required for all new appointments and must conform to the Referral Standards as outlined on For Clinicians.
All referrals, regardless of origin, are triaged by the Medical Oncologist on call and presented to a weekly meeting of all Medical Oncologists. The patients are allocated in order of clinical priority to the Medical Oncologist with the earliest available appointment, usually over the ensuing one – three weeks.
This process ensures timely medical oncological input and shares the workload.
Where the on call Medical Oncologist judges there is a possibility of an oncological emergency or need for urgent therapy, the patient will be either seen within that week, or admitted to the RHH under the Medical Oncology Unit.
While each Medical Oncologist has interests in certain types of malignancies, it is not appropriate at this time to confine our clinical input to only those tumour types; therefore we are all responsible for the management of the entire spectrum of adult malignancies (excluding early skin cancers and haematological malignancies for the most part).
For use by health professionals only
For more information please see the Tasmanian Health Pathways website.