Children

 

Referral Pathway

All children/adolescents with a suspected malignancy should be referred to East Kent Hospitals, who will provide the initial assessment and facilitate a direct referral to the paediatric oncology department at either the Royal Marsden Hospital or St George's Hospital in London

Referral Form

Paediatric Urgent Suspected Cancer Referral Form — do not send referral unless discussed with on call Paediatric Team.  Please ask on call Paediatric Team (details on form) for most appropriate route of referral (e.g. urgent admission, e-mail or via eRS)

Brain and CNS

Referral criteria

Consider very urgent referral for:

  • children and young people with newly abnormal cerebellar or other central neurological function

'very urgent' - within 48 hours

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Leukaemia

Referral criteria

Refer for immediate specialist assessment:

  • children and young people with unexplained petechiae (spots on the skin) or hepatosplenomegaly (may indicate severe marrow suppression therefore a medical emergency)

'immediate' - within a few hours

Offer Full Blood Count (FBC) within 48 hours for:

  • children and young people with any of the following:
    • pallor
    • persistent fatigue
    • unexplained fever
    • unexplained persistent infection
    • generalised lymphadenopathy
    • persistent or unexplained bone pain
    • unexplained bruising
    • unexplained bleeding

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Lymphoma (Non-Hodgkin)

Referral criteria

Consider very urgent referral (for appointment within 48 hours) for:

  • children and young people with unexplained lymphadenopathy or splenomegaly

Take into account any associated symptoms, particularly fever, night sweats, shortness of breath (from mediastinal mass), pruritus (itching), or weight loss

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Neuroblastoma

Referral criteria

Most neuroblastomas occur in children < 5 years

Consider specialist assessment within 48 hours for:

  • children with a palpable abdominal mass or unexplained enlarged abdominal organ

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Retinoblastoma

Referral criteria

Consider urgent referral (within 2 weeks) for ophthalmological assessment for:

  • children with an absent red reflex

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Wilms' Tumour

Referral criteria

Usually occur in children aged 1 - 3 years.  Embryonal tumour of the kidney

Consider specialist assessment within 48 hours for:

  • children with a palpable abdominal mass or unexplained enlarged abdominal organ or unexplained visible haematuria

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Non-site-specific symptoms in children

Referral criteria

Consider referral for children:

  • if their parent/carer has persistent concern or anxiety about the child's symptoms even if most likely to have a benign cause.  Take into account insight and knowledge of parents/carers when considering a referral

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Advice and Guidance is being made available for all specialties, and is being provided by consultant specialists at East Kent Hospitals.  To make a request or to check to if a query has been answered, you will need to log in via the electronic Referral System (eRS)

Click here for the "how to access" e-Referral Advice and Guidance Manual for instructions on how to make a request and check responses

Have a question or query?

Get in touch