2-week wait prostate pathway

Your GP has asked our Urology service to investigate your elevated prostate-specific antigen (PSA) on your recent blood test.

Read our guide below to help you understand what to expect once the urology department receives your referral.

You can also download a PDF version of this patient information by following the link on the right.

What is a PSA?

It’s a protein produced by both cancerous and non-cancerous tissue in the prostate, a small gland that sits below the bladder in men. It can be easily measured on a blood test.

What is a 2-week wait (2WW) prostate pathway?

It includes a series of investigations/appointments to help provide reassurance that your raised PSA is not caused by the underlying cancerous changes in your prostate.

However, if we discover underlying disease, we can provide timely diagnosis. We aim to achieve that within 28 days of the referral being received in hospital.

What happens once we get your referral?

You’ll have a telephone consultation with an Advanced Nurse Practitioner (ANP) within 24 hours. This is to discuss your current symptoms and suitability for a Magnetic Resonance Imaging (MRI) scan of the prostate, and any other scans that may be required.

If we receive the referral on Friday, you might get a call on Monday. Our service runs from Monday to Friday, 9am to 4pm.

During the consultation, you’ll get a date for a face-to-face appointment in 7 to 10 days’ time at Wycombe General Hospital in the Urology Investigations Unit (level 3). This appointment will include an examination and discussion of your MRI scan result if you needed one.

Depending on the clinical findings you may need prostate biopsies. The waiting time is currently a few weeks but we’re working to improve this.

What tests and procedures may I need?

Each patient’s pathway might be slightly different. You may need several investigations on the pathway.  We’ll discuss additional tests or investigations in detail during your telephone and face-to-face consultation.

Common tests and procedures include:

• an MRI scan
• a digital rectal examination (DRE)
• local anaesthetic transperineal prostate biopsies (LATP) or transrectal ultrasound scan (TRUS) and biopsy
• a flow rate test
• a urine test.

If appropriate, you may need further staging scans such as a PSMA PET or bone scans.

What happens next?

Once all results are available, our Multidisciplinary Team (MDT) will discuss your case to decide the best treatment plan for you. They’ll feed back to you at the results clinic with the Clinical Nurse Specialist (CNS).

You can bring someone with you to this appointment. If you need treatment, we will arrange appointments to see the appropriate specialist doctor.

Useful resources

Find out more about raised PSA and what to expect from tests and biopsies

Visit the Prostate Cancer UK website to find out more about signs and symptoms and what to expect if you have recently been diagnosed with prostate cancer.

Reducing associated healthcare infections

Find out how you can help to reduce healthcare associated infections when visiting hospital