The phrase “Two Week Wait” was traditionally used for an urgent suspected cancer referral, where the aim was for you to have a first hospital appointment within 14 days. However, this is no longer the main national cancer waiting-time standard in NHS England.
Since 1 October 2023, the former two-week appointment target has been replaced by the Faster Diagnosis Standard. The current aim is for cancer to be diagnosed or ruled out within 28 days of the hospital receiving an urgent suspected cancer referral.
Some GPs, hospitals and appointment systems may still use the terms “Two Week Wait”, “2WW” or “urgent suspected cancer referral”. This does not mean that you are guaranteed a face-to-face specialist appointment within exactly two weeks. Your first step may instead be an MRI scan, telephone assessment, nurse-led review or another investigation.
An urgent referral does not mean that you have prostate cancer. It means that your GP believes cancer should be investigated or ruled out promptly. Many people referred urgently are found to have a non-cancerous prostate condition.
This article relates mainly to NHS England. Cancer referral terminology and waiting-time arrangements may differ in Scotland, Wales and Northern Ireland.
Who May Be Referred Urgently for Suspected Prostate Cancer?
Your GP may make an urgent suspected cancer referral if your prostate feels concerning during a digital rectal examination or if your PSA result and other clinical findings suggest that prostate cancer needs to be investigated promptly.
Urinary symptoms such as a weak flow, difficulty starting urination, needing to urinate more frequently or getting up during the night are commonly caused by benign prostate enlargement. These symptoms may lead your GP to arrange a PSA test, urine tests and an examination before deciding whether an urgent referral is appropriate.
Your GP will also consider your age, previous PSA results, family history, ethnicity, symptoms, examination findings and overall health. Local referral pathways may vary, and clinical judgement remains important.
An urgent referral does not confirm that you have cancer. It means that further assessment should take place through a suspected cancer pathway.
Understanding the Timeline
The current Faster Diagnosis Standard aims for you to be told whether cancer has been diagnosed or ruled out within 28 days of the hospital receiving your urgent referral. This is a national performance standard rather than an individual guarantee that every pathway will be completed within exactly 28 days.
If cancer is diagnosed and treatment is required, the NHS also monitors the time from urgent referral to first treatment and the time from the decision to treat to treatment beginning.
Your pathway may take longer if additional investigations are clinically necessary, if your case is complex or if you choose to delay an appointment. Your healthcare team should keep you informed about expected timings.
Current NHS England Cancer Waiting-Time Standards
| Stage | Current standard | What it means for you |
| Urgent suspected cancer referral | Diagnosis or cancer ruled out within 28 days | You may have an MRI, specialist assessment, telephone review or biopsy during this period |
| Referral to first cancer treatment | Treatment within 62 days where cancer is diagnosed and treatment is required | The period is measured from the urgent referral to the start of first treatment |
| Decision to treat to treatment | Treatment within 31 days | The period is measured from the agreed treatment decision |
| First hospital contact | No current national guarantee of a face-to-face appointment within 14 days | Some services may still arrange rapid appointments or use the term “Two Week Wait” |
These are NHS England performance standards. Individual waiting times can be affected by clinical complexity, hospital capacity, additional tests and patient choice.
How Will You Receive Your Results?
MRI and biopsy results are reviewed by the specialist team before they are explained to you. You may receive the results during a face-to-face appointment, telephone consultation or another agreed form of communication.
Test results can take a few weeks, although timings vary between hospitals and according to which investigations are required. Contact the hospital or your GP if you have not heard within the timeframe you were given or if your symptoms worsen while you are waiting.
If your MRI shows a suspicious area, your specialist may recommend a prostate biopsy. A biopsy is usually needed to confirm whether prostate cancer cells are present and to provide information about the cancer’s grade.
If cancer is diagnosed, your results may also be reviewed by a multidisciplinary team before treatment or monitoring options are discussed with you.
What Happens After an Urgent Referral?
Once the hospital receives your referral, the urology or diagnostic team will review the information provided by your GP. This may include your PSA result, symptoms, examination findings, medical history, medicines and relevant risk factors.
Your first hospital contact may not be a traditional consultant appointment. Some prostate cancer pathways use telephone triage, nurse-led assessment or a straight-to-test approach in which an MRI scan is arranged before you see a urologist.
The hospital may contact you by telephone, letter, text message or through an online patient portal. Make sure your GP has the correct contact details and respond promptly to appointment messages.
The order of tests and appointments varies between hospitals. The current national standard focuses on providing a diagnosis or ruling cancer out within 28 days rather than providing one particular type of appointment within 14 days.
What Happens If Prostate Cancer Is Confirmed?
If prostate cancer is diagnosed, your results will usually be discussed by a multidisciplinary team. This may include urologists, oncologists, radiologists, pathologists and clinical nurse specialists.
The team will consider the cancer’s grade, stage and risk group, together with your age, general health and preferences. Further scans may be required if there is concern that the cancer has spread beyond the prostate.
Depending on your diagnosis, options may include active surveillance, surgery, radiotherapy, hormone therapy, another treatment or a combination of approaches. Not every prostate cancer requires immediate treatment.
Your specialist should explain the likely benefits, side effects and uncertainties of each suitable option. You should have time to ask questions and take part in shared decision-making.
PSA Testing, MRI and Further Investigations
A PSA blood test measures the level of prostate-specific antigen in your blood. It can help identify a possible prostate problem, but it cannot diagnose or rule out prostate cancer by itself.
PSA can be raised because of prostate cancer, benign prostate enlargement, inflammation, infection and other factors. Some clinically significant prostate cancers may also occur without a clearly raised PSA result.
In many cases, your GP will have arranged a PSA test before making the referral. The hospital team will review the result alongside your age, symptoms, examination findings, previous PSA levels and individual risk factors.
If further investigation is appropriate, you will usually have an MRI scan of the prostate. The scan helps identify suspicious areas and allows the specialist team to decide whether a biopsy or other assessment is needed.
Not everyone with a raised PSA requires a biopsy. The decision may also take account of your MRI result, PSA density, general health and the likelihood that any cancer found would require treatment.
What Should You Expect During an MRI or Biopsy?
Before an MRI scan or biopsy, your healthcare team should explain why the test is recommended, how to prepare and when you are likely to receive the results.
An MRI is painless, although some people find the enclosed scanner uncomfortable. Tell the team beforehand if you have metal implants, severe claustrophobia, kidney problems or any other issue that may affect the scan.
If a biopsy is required, tissue samples are taken from the prostate and examined in a laboratory. Prostate biopsies are commonly performed through the skin between the scrotum and anus, known as a transperineal biopsy, although techniques vary between hospitals.
Possible biopsy effects include blood in the urine or semen, discomfort, temporary difficulty passing urine and infection. Your team should explain warning signs and how to obtain urgent advice after the procedure.
What to Do While Waiting for Appointments
While you are waiting for your specialist appointment, it can be helpful to keep a record of any symptoms you experience, the medications you take, and any relevant personal or family medical history. Having this information ready can help your specialist assess your situation more efficiently.
You should also attend any scheduled blood tests or investigations and make a note of any changes in your symptoms before your appointment. Writing down questions in advance can help you remember the topics you want to discuss with your healthcare team.
Maintaining healthy habits, such as staying physically active, eating a balanced diet, getting enough sleep, and managing stress, can support your overall wellbeing during this period. Although waiting can be difficult, focusing on your general health may help you feel more prepared while your assessment is underway.
When Should You Seek More Urgent Help?
Do not wait for your planned prostate appointment if you become acutely unwell. Contact your GP or NHS 111 urgently if you cannot pass urine or develop visible blood in your urine.
Call 999 or go to A&E if back pain is accompanied by weakness or numbness in both legs, loss of feeling around the genitals or anus, or changes in bladder or bowel control.
These symptoms can have several causes and do not necessarily mean that prostate cancer is present, but they require prompt medical assessment.
How Urgent Referrals Differ From Standard Referrals
An urgent suspected cancer referral is used when clinical findings suggest that cancer should be investigated or ruled out promptly. Standard referrals are still important, but they are used for conditions that are not considered to require the same level of urgency.
If your GP believes your symptoms or test results could indicate prostate cancer, you may be referred through the urgent pathway to help speed up specialist assessment. This allows investigations to begin sooner and reduces unnecessary delays in reaching a diagnosis.
The purpose of the urgent referral pathway is to identify potentially serious conditions as early as possible. Earlier assessment can help ensure that, if treatment is needed, decisions can be made promptly and the most appropriate care can begin without avoidable delays.
Communicating With Your GP and Specialist
Keeping in regular contact with your GP and specialist team is an important part of your care. If your symptoms change, become more severe, or you develop any new concerns while waiting for appointments, you should let your GP know as soon as possible.
It can also be helpful to keep a record of your symptoms and prepare any questions before your appointments. This allows you to make the most of your consultations and ensures that any important concerns are discussed.
Clear communication with your healthcare team helps keep your care on track throughout the urgent suspected cancer pathway. By sharing any changes promptly, you can help ensure that your treatment plan and investigations continue without unnecessary delays.
What to Expect After Initial Assessment
After your first specialist appointment, you may be advised to have further tests, scans, or ongoing monitoring, depending on your symptoms and initial findings. Your healthcare team will explain why these investigations are needed and what you can expect during the next stage of the process.
The aim is to complete any recommended investigations as efficiently as possible while keeping you informed throughout your care. You should receive clear information about upcoming appointments, expected waiting times, and when your results are likely to be available.
Once all the necessary information has been reviewed, your specialist will discuss the findings and explain the next steps. If prostate cancer is confirmed, this may include active surveillance or treatment options. If cancer is not found, you may be discharged, monitored or offered treatment for another prostate condition.
Understanding Active Surveillance
Active surveillance may be offered after a confirmed diagnosis of localised prostate cancer when the cancer is considered unlikely to cause harm in the near future. It is not used while doctors are still deciding whether prostate cancer is present.
- Suitable for low-risk cancer: Active surveillance may be recommended if your prostate cancer is considered low risk and unlikely to grow or spread quickly.
- May delay immediate treatment: This approach allows you to avoid or postpone treatments such as surgery or radiotherapy while the cancer remains stable.
- Regular PSA blood tests: PSA levels are monitored at scheduled intervals to look for any changes that may suggest the cancer is progressing.
- Routine scans and biopsies: MRI scans and, in some cases, repeat biopsies help assess the prostate and monitor the cancer over time.
- Ongoing specialist reviews: Your specialist will explain how often you need follow-up appointments and review your results regularly.
- Treatment if needed: If monitoring shows signs that the cancer is growing or becoming more aggressive, your specialist may recommend starting treatment.
Regular follow-up appointments are an important part of active surveillance and help ensure any changes are identified promptly. Your specialist will discuss your results with you and recommend treatment if there is evidence that the cancer has progressed.
How an Urgent Referral Supports Earlier Diagnosis
The urgent suspected cancer pathway is designed to investigate possible prostate cancer promptly. Earlier assessment can help diagnose cancer sooner or establish that another condition is responsible for your symptoms or test results.
If you are seen promptly, your specialist can arrange any recommended investigations, explain your test results, and assess your individual level of risk. This allows important decisions about further testing, monitoring, or treatment to be made at an earlier stage.
Earlier diagnosis can help your specialist discuss the most appropriate treatment options based on your individual cancer characteristics and overall health. An urgent suspected cancer referral is designed to prioritise people who need prompt investigation for possible prostate cancer.
Evidence Note
NHS England removed the former two-week first-appointment performance standard in October 2023. Urgent suspected cancer referrals are now principally measured using the Faster Diagnosis Standard, which aims for cancer to be diagnosed or ruled out within 28 days. NICE continues to provide clinical criteria for deciding when an urgent suspected cancer referral should be considered.
Managing Anxiety While You Wait
An urgent referral can feel frightening, but it is important to remember that it does not confirm that you have cancer. The purpose of the pathway is to investigate your symptoms or test results promptly.
Write down your questions, keep a record of appointment details and ask who you should contact if you have not received an update. Taking someone with you to an appointment may also help you remember the information discussed.
Speak with your GP, specialist nurse or hospital team if anxiety is becoming difficult to manage. Trusted organisations such as the NHS, Prostate Cancer UK and Macmillan Cancer Support can also provide information and emotional support.
How to Prepare for Your Specialist Appointment
Before your specialist appointment, it is helpful to gather any relevant medical records, recent test results, and a list of the medications you are currently taking. Having this information available allows your specialist to assess your situation more efficiently and make informed decisions about your care.
You may also find it useful to write down any symptoms you have experienced, when they started, and whether they have changed over time. Bringing a list of questions about investigations, possible treatments, or your diagnosis can help you make the most of your appointment.
Being well prepared can help you feel more confident during your consultation and ensure that important concerns are not overlooked. It also allows your specialist to provide clearer advice and discuss the most appropriate next steps based on your individual circumstances.
What Does It Mean If Prostate Cancer Is Ruled Out?
If your specialist team concludes that prostate cancer has been ruled out, it means that the investigations completed so far have not found evidence of prostate cancer at this time. Your team should explain the most likely reason for your symptoms or raised PSA and whether any further monitoring is needed.
You may be diagnosed with a non-cancerous condition such as benign prostate enlargement or prostate inflammation. Depending on your results, you may be discharged back to your GP, offered treatment for another condition or advised to have future PSA monitoring.
Having cancer ruled out does not mean that you can never develop prostate cancer in the future. Speak with your GP if your symptoms continue, your PSA rises further or you develop new concerns after being discharged.
What If Your MRI Does Not Show a Suspicious Area?
A low-risk or reassuring MRI result can reduce the likelihood that clinically significant prostate cancer is present, but an MRI cannot exclude every cancer. Your specialist will interpret the scan alongside your PSA result, PSA density, examination findings, family history and other individual risk factors.
Some men with a reassuring MRI may not need an immediate biopsy. Your specialist may instead recommend repeat PSA testing and continued monitoring, particularly when the overall level of concern is low.
A biopsy may still be discussed if your PSA density is raised, your examination is concerning or other factors suggest that further assessment is needed. Your specialist should explain the benefits and limitations of biopsy before you make a decision.
What If You Cannot Attend an Appointment?
Urgent prostate investigations may involve appointments arranged at relatively short notice. If you cannot attend an MRI, biopsy, telephone assessment or clinic appointment, contact the hospital as soon as possible rather than waiting until the appointment date.
The hospital can explain whether your appointment can be rearranged and whether changing it may affect the timing of your assessment. Do not simply miss the appointment, as this can delay tests, results and any treatment that may be required.
Make sure your GP and hospital have your correct telephone number, address and email details. Depending on local policy, repeated missed appointments without contact may result in your referral being returned to your GP.
What Information Should You Tell the Hospital Before Tests?
Tell the hospital before an MRI if you have a pacemaker, cochlear implant, metal fragments, certain surgical implants or another device that may affect MRI safety. You should also mention severe claustrophobia, previous reactions to contrast agents and any kidney problems if contrast may be considered.
Before a prostate biopsy, provide a complete list of your medicines, particularly anticoagulants or antiplatelet medicines such as warfarin, apixaban, rivaroxaban or clopidogrel. Do not stop any prescribed blood-thinning medicine unless the hospital team or the clinician responsible for it has given you clear instructions.
Contact the team before your biopsy if you develop symptoms of a urine infection, fever or another acute illness. The procedure may need to be delayed until it can be performed safely.
What If You Have Not Heard From the Hospital?
The hospital will usually confirm that it has received your urgent referral and provide information about the next step. This may be an MRI scan, telephone assessment, specialist consultation or another investigation.
Contact the hospital booking team or your GP practice if you have not received confirmation, cannot access your appointment details or are still waiting beyond the timeframe you were given. Check missed calls, voicemail messages, text messages, letters and any NHS patient portal you use.
You should also contact the hospital or your GP if your symptoms worsen while you are waiting or if you have not received test results when expected. Following up does not mean that cancer is more likely; it helps ensure that your referral and results have not been delayed by an administrative or communication problem.
Key Points to Remember About an Urgent Referral
The urgent suspected cancer pathway is designed to prioritise people who need prompt investigation for possible prostate cancer. It aims to reduce delays by supporting timely investigations, communication of results and appropriate follow-up care.
Although waiting for appointments or test results can be worrying, understanding how the pathway works can help you feel more prepared. Knowing what to expect at each stage allows you to approach the process with greater confidence and ask informed questions during your appointments.
Staying organised, attending all scheduled appointments, and keeping in touch with your healthcare team can help your care progress smoothly. If you have any concerns or notice changes in your symptoms while waiting, you should contact your GP or specialist promptly for further advice.
Key Takeaways
- “Two Week Wait” is an older term that may still be used for an urgent suspected cancer referral.
- NHS England no longer has a national target guaranteeing a first specialist appointment within two weeks.
- The current Faster Diagnosis Standard aims for cancer to be diagnosed or ruled out within 28 days of an urgent referral.
- Your first step may be an MRI, telephone assessment, nurse-led review or specialist appointment.
- An urgent referral does not mean that you have prostate cancer.
- A raised PSA cannot diagnose cancer by itself, and an MRI is usually used before deciding whether biopsy is needed.
- If cancer is diagnosed, your case is usually reviewed by a multidisciplinary team.
- Active surveillance is only considered after cancer has been confirmed and assessed.
- Contact the hospital or your GP if you have not received an expected appointment or result.
Myth vs Fact
| Myth | Fact |
| A Two Week Wait referral means that you definitely have prostate cancer. | It means that cancer should be investigated promptly. Many urgently referred people do not have cancer. |
| You are still nationally guaranteed a specialist appointment within 14 days. | In NHS England, the former two-week appointment standard was replaced in October 2023 by the 28-day Faster Diagnosis Standard. |
| Your first step will always be a face-to-face consultant appointment. | Some pathways begin with an MRI scan, telephone assessment or nurse-led review. |
| Urinary symptoms automatically qualify you for an urgent cancer referral. | Urinary symptoms are often caused by benign prostate enlargement. Your GP may first arrange PSA testing, examination and other checks. |
| A normal PSA result completely rules out prostate cancer. | PSA is useful but cannot diagnose or exclude every prostate cancer by itself. |
| Everyone diagnosed with prostate cancer needs immediate treatment. | Some localised, lower-risk cancers can be monitored through active surveillance. |
Frequently Asked Questions
1. Does a Two Week Wait referral mean you have prostate cancer?
No. An urgent suspected cancer referral means that your GP believes prostate cancer should be investigated or ruled out promptly. Many people referred urgently are found to have benign prostate enlargement, inflammation or another non-cancerous condition.
2. How long will you wait for your first specialist appointment?
The former national target for a first specialist appointment within two weeks was removed in NHS England in October 2023. The current Faster Diagnosis Standard aims for you to be told whether cancer has been diagnosed or ruled out within 28 days of the hospital receiving your urgent referral. Your first contact may be an MRI scan, telephone assessment or clinic appointment.
3. What tests might you have after an urgent suspected cancer referral?
You will usually have an MRI scan after referral. Depending on your previous results and assessment, the team may also review or arrange a PSA test, digital rectal examination or biopsy. Not everyone requires every test.
4. Can you choose private care after an NHS urgent referral?
Yes. You can choose to have a private consultation or further investigations if that suits your circumstances. Some people continue with NHS care, while others combine NHS and private services for different stages of their assessment. Tell both teams which investigations have already been arranged so that tests are not duplicated and important results are shared appropriately.
5. What should you bring to your specialist appointment?
It is helpful to bring a list of your medications, any recent test results, and details of your symptoms. Preparing questions in advance can also help you make the most of your consultation. This information supports a more thorough assessment.
6. What happens if your tests suggest prostate cancer?
If a biopsy confirms prostate cancer, the results are usually reviewed by a multidisciplinary team. MRI findings can help assess the location and possible extent of the disease but do not confirm cancer on their own. You may need further staging investigations before active surveillance or treatment options are discussed.
7. Can you continue your normal activities while waiting?
In most cases, you can continue your usual daily routine while waiting for appointments or results. Looking after your general health by staying active, eating well, and getting enough rest may help you feel better. You should contact your GP if your symptoms change or become worse. Seek urgent advice rather than waiting for your appointment if you cannot pass urine, develop visible blood in your urine or become acutely unwell.
8. What happens if your tests do not show prostate cancer?
If the specialist team concludes that prostate cancer has been ruled out, your specialist will discuss other possible causes of your symptoms. You may have a benign prostate condition or require further monitoring. Any recommended treatment or follow-up will depend on your individual diagnosis.
9. Can you ask questions throughout the urgent referral pathway?
Yes. You should feel comfortable asking questions at every stage of your assessment and treatment. Understanding your tests, results, and next steps can help you make informed decisions about your care.
10. How can you manage anxiety while waiting for results?
Waiting for appointments or results can be worrying, but staying informed often makes the process easier. Writing down your questions and discussing any concerns with your healthcare team can provide reassurance. Support from family, friends, or specialist nurses may also help during this time.
Final Thoughts: Moving Forward with Confidence
The term “Two Week Wait” is still widely recognised, but the national NHS England standard has changed. The current aim is for cancer to be diagnosed or ruled out within 28 days of an urgent suspected cancer referral rather than guaranteeing a first specialist appointment within 14 days.
Your first step may be an MRI scan, telephone assessment, nurse-led consultation or specialist appointment. Being referred urgently does not mean that you have prostate cancer, and many people receive reassuring results or are diagnosed with a benign prostate condition.
Attend appointments promptly, follow any preparation instructions and contact your hospital or GP if you have not heard within the expected timeframe. You should also seek advice earlier if your symptoms significantly worsen while you are waiting.
If you would like an expert assessment for prostate symptoms, a raised PSA level or concerns about the diagnostic process, you can contact Prostate Clinic London to discuss your circumstances and appropriate next steps.
References
- NHS England (2023) Changes to cancer waiting times standards from 1 October 2023. Available at: https://www.england.nhs.uk/long-read/changes-to-cancer-waiting-times-standards-from-1-october-2023/
- NHS England (2025) National cancer waiting times monitoring dataset guidance. Version 12.1. Available at: https://www.england.nhs.uk/long-read/national-cancer-waiting-times-monitoring-dataset-guidance/
- NHS (no date) Guide to NHS waiting times in England. Available at: https://www.nhs.uk/nhs-services/hospitals/guide-to-nhs-waiting-times-in-england/
- National Institute for Health and Care Excellence (2015, updated 2026) Suspected cancer: recognition and referral. NICE guideline NG12. Available at: https://www.nice.org.uk/guidance/ng12
- NHS (2025) Symptoms of prostate cancer. Available at: https://www.nhs.uk/conditions/prostate-cancer/symptoms/
- NHS (2025) Tests and next steps for prostate cancer. Available at: https://www.nhs.uk/conditions/prostate-cancer/tests-and-next-steps/
- National Institute for Health and Care Excellence (2019, updated 2021) Prostate cancer: diagnosis and management. NICE guideline NG131. Available at: https://www.nice.org.uk/guidance/ng131
- Prostate Cancer UK (no date) Prostate tests. Available at: https://prostatecanceruk.org/prostate-information-and-support/prostate-tests
- Prostate Cancer UK (2025) Prostate biopsy. Available at: https://prostatecanceruk.org/prostate-information-and-support/prostate-tests/prostate-biopsy
- British Association of Urological Surgeons (2024) Transperineal ultrasound-guided biopsy of your prostate. Leaflet O24/107. Available at: https://www.baus.org.uk/_userfiles/pages/files/patients/leaflets/Transperineal%20biopsies.pdf
- NHS (2023) Blood in urine. Available at: https://www.nhs.uk/symptoms/blood-in-urine/
- NHS (2025) Enlarged prostate. Available at: https://www.nhs.uk/conditions/enlarged-prostate/
- NHS (2026) Back pain. Available at: https://www.nhs.uk/conditions/back-pain/