New Patients: Flow chart

Here’s a flowchart for managing suspected new cancer cases arriving at the hospital. It provides a step-by-step guide on where the patient should go first and what to expect at each stage:

1. Initial Patient Arrival

→ Reception/Outpatient Registration

• Collect personal and insurance details.
• Create a medical record.

2. Triage by Oncology Nurse

→ Initial Assessment

• Review medical history.
• Determine urgency (e.g., if they have symptoms requiring immediate care).
• Schedule consultations and tests.

3. First Consultation: Oncologist

→ Oncologist Assessment

• Comprehensive evaluation.
• Discuss symptoms and any previous treatments.
• Perform a physical exam.
• Determine the need for imaging or biopsy.

4. Diagnostic Testing (Imaging and Lab Work)

→ Tests Ordered (CT, MRI, PET, Biopsy, etc.)

• Depending on the suspected type of cancer, imaging (CT, MRI, PET scans) and/or biopsy is scheduled.
• Blood tests and molecular testing may be done.

5. Multidisciplinary Tumor Board Discussion

→ Treatment Planning

• After diagnostics, case discussed by a multidisciplinary team: Oncologists, Radiologists, Pathologists, Surgeons.
• Determine the type and stage of cancer.
• Plan treatment (surgery, chemotherapy, radiation therapy, or a combination).

6. Second Consultation: Oncologist/Surgical Consultation

→ Discuss Treatment Plan

• Oncologist or surgeon reviews the diagnosis and discusses the proposed treatment.
• Explain side effects, expectations, and treatment goals.
• Obtain informed consent.

7. Treatment (Surgery, Chemotherapy, Radiation)

→ Treatment Commencement

• Patient undergoes scheduled treatments (surgery, chemotherapy, radiation therapy).
• Ongoing monitoring for side effects and efficacy.

8. Follow-Up Care

→ Post-Treatment Monitoring

• Regular check-ups to monitor response to treatment.
• Imaging tests and blood work to assess remission or recurrence.

9. Palliative Care (if needed)

→ Symptom Management and Support

• If cancer is advanced, initiate palliative care to manage symptoms and improve quality of life.

Patient Expectations at Each Step:

• First Consultation: The patient will provide their medical history and symptoms, followed by a comprehensive exam. They can expect to be educated about potential diagnostic tests and treatment options.
• Testing: This stage can involve a mix of imaging and lab work. Depending on the cancer type, it may involve waiting for results, which can take from hours to a few days.
• Multidisciplinary Discussion: The patient can expect a comprehensive review of their case by various specialists to ensure the best treatment plan.
• Treatment: They will be informed of the treatment options, which might include surgery, chemotherapy, radiation, or newer therapies like immunotherapy, and will be supported with information on managing side effects.
• Follow-Up: After treatment, they will have regular follow-up visits to monitor recovery, check for recurrence, and assess quality of life. For many cancer patients, long-term monitoring is a key aspect of care.

This workflow ensures that new patients receive timely and comprehensive care, addressing both medical needs and emotional support.