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Referral to a specialist

Find out when GPs refer people to see a specialist for hairy cell leukaemia.

Seeing your GP

It can be hard for GPs to decide who may have cancer and who might have a more minor condition. For some symptoms, your doctor may ask you to wait to see if the symptoms get better or respond to treatment, such as antibiotics.

There are guidelines for GPs to help them decide who needs a referral.

Guidelines for referral

The National Institute for Health and Care Excellence (NICE) and Healthcare Improvement Scotland (HIS) have produced referral guidelines for cancer. These guidelines help GPs decide who needs to see a specialist and how soon they should see them. 

An urgent referral means seeing a specialist within 2 weeks. For some people with leukaemia, this can mean seeing a specialist within a few hours.

Remember that chronic leukaemia, including hairy cell leukaemia, develops very slowly. Your GP can usually pick it up from a blood test and it doesn't often need an urgent referral.

When reading the guidelines, it is important to remember that:

  • your symptoms are more likely to be caused by something other than cancer, but it is important they are checked out
  • hairy cell leukaemia is rare
  • it is most common in middle aged men
  • it is very rare in people under 30 years old

Who should see a specialist urgently

The symptoms below are for blood cancers (leukaemias and lymphomas) in general and may not be a sign of hairy cell leukaemia in particular.

If you are an adult (25 years and above)

According to the guidelines your doctor should consider taking an urgent blood test (within 2 days) if you have any of the following symptoms:

  • looking unusually pale
  • constant tiredness (fatigue)
  • unexplained high temperatures (fever)
  • unexplained infections that won't go away or keep coming back
  • swollen lymph nodes
  • bruising or bleeding for no reason
  • red or purple spots on your skin – called petechiae
  • a swollen (enlarged) spleen or liver

If you are aged 24 or under

Your GP should refer you immediately - within a few hours - to a specialist if you have: 

  • unexplained red or purple spots on the skin – called petechiae
  • an enlarged liver or spleen on examination

Your GP should offer you an urgent full blood count (within 2 days) if you have any of the following symptoms: 

  • looking unusually pale
  • constant tiredness (fatigue)
  • unexplained high temperatures (fever)
  • infections that won't go away
  • swollen lymph nodes
  • bone pain that won't go away
  • bruising or bleeding for no reason

Your doctor should repeat the blood tests at least once if your condition doesn't improve and no cause for your symptoms has been found.

Which specialist

Depending on your symptoms and the results of blood tests, your GP is most likely to refer you to a doctor specialising in blood conditions. This includes blood cancers, such as leukaemia. The specialist doctor is called a haematologist.

What to expect

At the hospital the haematologist:

  • asks about your medical history and symptoms
  • examines you

They are likely to take more blood tests. They will arrange for further tests, such as a bone marrow biopsy, to confirm your diagnosis and help them plan your treatment.

Information and help

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