Thyroid Cancer
Emergency department referrals
If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.
- Anaplastic thyroid cancer – ensure referral to appropriate surgical team if surgery team and/or Radiation Oncology if external beam radiation is a consideration.
- Patients with airway compromise or other urgent complications. Ensure referral to appropriate surgical team and/or Radiation Oncology if external beam radiation is a consideration.
These patients can be referred to the service after appropriate emergency management.
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Patients with other aggressive or advanced thyroid cancer (e.g. poorly differentiated carcinoma, or evidence of local invasion or distant metastases) after appropriate surgical management.
- Recurrent or residual disease detected clinically or on imaging.
- Patients requiring urgent radioactive iodine therapy (Refer to American Thyroid Association guidelines high risk of recurrence criteria (2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer | Thyroid® – figure 2 – estimated risks of structural recurrence) and/or external Radiation Therapy.
- Suspicion or confirmation of medullary thyroid carcinoma with elevated calcitonin levels requiring specialised endocrinology/oncology care.
Category 2
Appointment within 90 days is desirable
- Patients with differentiated and medullary thyroid cancers who do not meet Category 1 criteria
Category 3
Appointment within 365 days is desirable
- No category 3 criteria
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
About the service: The RBWH Thyroid Cancer Service (‘the Service’) is a service provided for patients who have thyroid cancer following diagnosis (either recent or past) by a surgeon. The Service is Queensland’s only provider of radioactive iodine (the main post-operative treatment for thyroid cancers) and the hospital’s multi-disciplinary team is the only dedicated service for thyroid cancer in Queensland.
The main objectives of the service are:
- Provide consultation services through the multidisciplinary team (MDT) meeting involving endocrine, radiation oncology, nuclear medicine and surgical specialities
- Identify patients who may be suitable for radioactive iodine treatment
- Provide clinic consultations for eligible patients
- Provide radioactive iodine treatment and follow up care
Exclusion criteria:
- Patients who haven’t had assessment by a surgeon and/or haven’t had surgical intervention for their thyroid cancer.
- Patients with anaplastic thyroid cancer and/or patients with airway compromise (can be referred only after appropriate emergency management/care)
- Non-invasive follicular tumour of papillary type (NIFTP) – a benign thyroid lesion formally known as the follicular variant of papillary thyroid carcinoma.
RBWH Thyroid Cancer Multidisciplinary Case Conference (MDCC)
The MDCC meets weekly on a Tuesday 12.00pm-1.30pm. The Thyroid Cancer MDCC welcomes referring clinicians to participate in MDCC discussion regarding referred patients to enhance shared decision making and continuity of care and a TEAMS link can be requested. Patients do not attend this meeting. Patients needing post-op bloods will be contacted by the Service advising them to contact their referrer for the required blood test before their case can be reviewed by the MDCC. An MDCC summary is completed and will appear on the Health Provider Portal/The Viewer under the ‘Event Summaries’ tab. An outpatient letter will be dictated and typed after the case conference. This can take 1-2 weeks to be typed. Please wait this time and check Health Provider Portal/The Viewer prior to contacting the clinic.
RBWH Thyroid Multidisciplinary Team (MDT) Cancer Clinic
Your patient will only be contacted by the clinic if they are to be seen in clinic for further risk stratification and/or planning for radioactive iodine. They will be sent an appointment letter after the MDCC discussion. The wait to get into thyroid clinic varies according to service demand and clinical urgency. Appointments can be provided face to face at RBWH or via telehealth if your patient is outside of southeast Queensland.
Referral requirements
A referral may be rejected without the following information.
Essential referral information
- Question for the multidisciplinary team e.g. consideration for radioactive iodine
- For all patients, provide all applicable imaging, histology reports, and thyroid function tests
- In addition to the above:
- for patients with differentiated thyroid cancer – provide any thyroglobulin/thyroglobulin antibody results
- for patients with medullary thyroid cancer – provide calcitonin and CEA
- for post-op patients – provide a blood test form to the patient for 6-week post op bloods:
- post-op patients with differentiated thyroid cancer – provide thyroglobulin/thyroglobulin antibody and thyroid function tests
- post-op patients with medullary thyroid cancer – calcitonin and CEA (medullary)
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
Clinical Modifiers (where relevant)
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
Reason for Referral (essential)
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
Clinical Information (essential)
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
Patient’s Demographic Details (essential)
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
Referring Practitioner Details (essential)
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
Other Information (where relevant)
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Send referral
Hotline: 1300 364 938
Medical Objects ID: MQ40290004P
HealthLink EDI: qldmnhhs
Mail:
Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways@brisbanenorthphn.org.au
Login to Brisbane North Health Pathways:
brisbanenorth.healthpathwayscommunity.org