Patient Information

  • Referrals must be sent by a licensed medical professional that includes a referral letter, most recent blood work, investigations and consultations. We currently accept referrals for Fraser Health residents in Surrey, Delta, White Rock, Langley, Abbotsford, Chilliwack, and Hope regions only. All referrals are triaged by medical need and hematologist availability. Wait times for non-urgent consultations can be up to 6 to 12 months.

  • Our clinic offers both in person and phone appointments. Many consultations are booked as phone appointments as our speciality primarily relies on blood work to guide investigations and management. Please be aware that the doctor’s call may come from a blocked phone number. If you request to be seen in person please let our clinic know.

  • Please let our clinic know if an interpreter is required for the appointment.

  • The hematologist will collect background medical information and discuss symptoms related to the reason for referral. Please have a list of current medications available for the appointment. Investigations such as blood work will be reviewed. A plan will be presented that may include a) follow up and additional investigations and treatment through the hematologist, b) discharge back to the referring or primary care provider, c) referral to BC Cancer if management through BC Cancer is required.

    Patients may be asked to complete blood work in advance of their appointment. Please complete the blood work when requested as some tests take a while to return and may not be available for the scheduled appointment.

Patient Resources

  • Your hematologist may order a bone marrow biopsy. A bone marrow biopsy is a procedure used to obtain a small sample of bone marrow for diagnostic. The bone marrow, found inside certain bones, is responsible for producing blood cells, and a bone marrow biopsy helps evaluate the health and functioning of the bone marrow.

    This procedure is done through the out patient lab at Abbotsford Regional Hospital, Surrey Memorial Hospital or Royal Columbian Hospital. During a bone marrow biopsy, a healthcare professional will numb the area near the back of your hip. A thin, hollow needle is then inserted through the skin and into the bone marrow. A small sample of bone marrow, as well as a small piece of bone, is extracted. The procedure usually takes about 15 to 30 minutes and is performed under local anesthesia.

    After the bone marrow biopsy, you may experience some tenderness or discomfort at the biopsy site, which can be managed with over-the-counter pain relievers. The collected bone marrow sample is then sent to a laboratory for analysis and follow up will be arranged to discuss the results.

    Each individual's experience with a bone marrow biopsy will vary.

  • Chronic lymphocytic leukemia (CLL) is the most leukemia diagnosed. It is typically identified on routine blood work. CLL occurs when these lymphocytes grow and multiply abnormally, gradually accumulating in the bone marrow and blood. Unlike acute leukemia, CLL progresses slowly, and many individuals may not require immediate treatment after diagnosis.

    Common symptoms of CLL include unexplained fevers, drenching night sweats, greater than 10% weight loss, significant fatigue, and enlarged lymph nodes, easy bruising or bleeding. The exact cause of CLL is not fully understood, but certain risk factors such as age and family history, may increase the likelihood of developing the condition.

    Diagnosing CLL involves blood tests a blood test called flow cytometry. Note, if there are a small number of CLL like cells in the blood the diagnosis may be ‘monoclonal b-cell lymphocytosis’ (MBL). MBL is not a cancer but associated with a 1-2% risk of progressing to CLL per year.

    Treatment for CLL varies depending on the stage and progression of the disease, as well as individual factors such as overall health and symptoms. Treatment options may include watchful waiting, targeted therapies, and chemotherapy. The goal of treatment is to manage symptoms, slow the progression of the disease, and improve quality of life.

    Please see the Leukemia and Lymphoma Society of Canada for additional resources.

  • Monoclonal gammopathy of undetermined significance (MGUS) is a common condition where an abnormal protein is detected in the blood. MGUS is not a cancer but can progress to a blood cancer such as myeloma or lymphoma.

    While there is no specific treatment for MGUS, your hematologist will provide recommendations for regular blood work to monitor the protein.

    Most individuals with MGUS will not develop a blood cancer. We advise patients with MGUS to watch for fevers, drenching night sweats, more than 10% weight loss in 6 months, lymph nodes, and new boney or back pain. These are important reasons to seek medical attention.

    Please see the Canadian Cancer Society’s information on MGUS.

  • Multiple myeloma is a type of cancer that affects plasma cells, which are a vital part of our immune system. These cells normally produce antibodies that help fight off infections, but in multiple myeloma, they become cancerous and multiply uncontrollably. As a result, the excess plasma cells crowd out healthy cells in the bone marrow and can cause various complications.

    Common symptoms of multiple myeloma include bone pain, fatigue, recurrent infections, weakness, and unexplained weight loss.

    Diagnosis of multiple myeloma involves various tests, including blood and urine tests, bone marrow biopsy, and imaging studies. Treatment options depend on several factors, such as the stage of the disease, overall health, and individual preferences. Treatment may include chemotherapy, stem cell transplant, targeted therapies, radiation therapy, and supportive care to manage symptoms and improve quality of life. Patients will have their care transitioned to BC Cancer if they are diagnosed with myeloma.

    Please see Myeloma Canada for additional resources.

  • Neutropenia is a condition characterized by a lower than normal level of neutrophils, a type of white blood cell that plays a crucial role in fighting off infections.

    Neutropenia can occur as a result of various factors, including underlying medical conditions, medications, radiation or chemotherapy treatments, autoimmune disorders, bone marrow disorders, or inherited conditions. It can be temporary or chronic, and the severity can vary from mild to severe.

    Common signs of infection may include fever, sore throat, mouth ulcers, skin infections, or respiratory symptoms. Depending on prior blood work completed, you may be asked to complete additional blood work for the hematologist to rule out additional causes of neutropenia.

    Management strategies for neutropenia may include monitoring of blood counts, adjusting medications that may be causing neutropenia, and addressing any underlying medical conditions. Many patients with neutropenia do not require any specific treatment.

  • Thrombosis is the formation of a blood clot within a vessel. The most common blood clots seen by hematologists are leg blood clots (deep vein thrombosis or DVT) and lung blood clots (pulmonary embolism or PE). Heart attacks, strokes, and arterial blood clots are typically managed by our colleagues in neurology, cardiology, vascular surgery, emergency medicine and primary care.

    Symptoms of a leg DVT include swelling, pain and redness in the involved leg. A pulmonary embolism can present with a sharp chest pain that is worse when breathing in, unexplained shortness of breath, or coughing up blood.

    Depending on the type of blood clot, blood thinners (anticoagulation) are typically required. A variety of anticoagulants are used including direct oral anticoagulants (apixaban, dabigatran, edoxaban, rivaroxaban), warfarin, or injection blood thinners (dalteparin, enoxaparin, tinzaparin).

    For additional patient information please see the resources available from Thrombosis Canada.