Oncology Clinic

Seton Infusion Center
A department of DSMC-UT
Oncology Criteria

Scope

• To evaluate and treat patients who have been diagnosed with cancer or treated for cancer.

Appropriate patients for referral include:

• Newly diagnosed cancers
• Recurrent cancers
• Patients receiving treatment for cancer
• Patients needing follow-up for previously treated cancer

Do NOT refer the following patients:

• Patients suspicious for malignancy but no biopsy (pathology) confirming cancer.

Biopsy Exception: Suspected Hepatocellular Carcinoma can be seen without a biopsy if liver imaging is diagnostic of HCC

• Thyroid cancer that has not spread (non-metastatic)
• Prostate cancer that has not spread
• Kidney cancer that has not spread
• Skin Cancer (except metastatic melanoma)

Documentation required for scheduling all appointments:

• Current medication list and co-morbidities or problem list
• Two most recent provider notes describing condition for which patient is being referred
• Original pathology report confirming tissue diagnosis
• If previously treated for cancer diagnosis, all oncology notes and treatment records (chemotherapy flow sheets, operative notes)
• If recurrence suspected, send supporting documentation (radiology, biopsies, pathology)

Additional information needed related to cancer (IF APPLICABLE)

• Notes from all consultants (inpatient and outpatient)
• All operative reports
• Diagnostic procedure reports (endoscopy, bronchoscopy)
• All radiology reports

Rev. 11/2018

Have questions or comments about the specialty referral guidelines? Submit them here.