Do you need a referral for targeted therapy?

A doctor already involved in your diagnosis may refer you to a medical oncologist. Some oncology services allow direct appointment enquiries but still need diagnostic records and a formal clinical review before recommending or prescribing treatment.

Targeted medicines act on particular proteins or molecular changes involved in a cancer's growth. Treatment choice therefore depends on the cancer type and may require biomarker testing on tumour tissue or blood. Having cancer does not automatically make every targeted medicine appropriate.

The oncologist interprets the test result alongside pathology, the extent of disease, previous treatments, organ function, other illnesses and current medicines. The same molecular finding can have different treatment implications in different cancers, which is why specialist interpretation is necessary.

Ask whether adequate tumour tissue is available and whether biomarker testing has already been requested. Arrange transfer of the pathology report, molecular test results, scan reports, treatment history, recent laboratory results and a complete list of medicines and supplements.

Mention heart, liver, kidney, skin or bleeding problems because they can affect selection and monitoring. Keep taking prescribed therapy while waiting unless the treating clinician changes it. If the referral is for another opinion, ask whether the reviewing oncologist needs pathology slides or scan images as well as reports.

A pending referral is not a reason to postpone assessment of serious symptoms. Seek emergency care for severe breathing difficulty, chest pain, collapse, sudden confusion, uncontrolled bleeding or swelling of the face or throat.

If you already take a targeted medicine, contact the oncology team promptly about fever, a new widespread rash, persistent diarrhoea or vomiting, unusual bleeding, yellowing of the skin or eyes, or worsening shortness of breath. The team can advise whether to hold a dose; do not make that change without treatment-specific guidance unless emergency clinicians direct you.

Ask which biomarker or pathway the proposed medicine targets, whether your result supports its use and what other choices are reasonable. Discuss how the medicine is taken, which tests monitor it, possible interactions, side effects that require same-day contact and how the team will judge whether it is working.