Cancer patient pathways

A patient pathway describes what is going to happen from the time cancer is suspected, until any treatment starts.

The aim of the patient pathways is to ensure that cancer patients encounter a well-organised, integrated and predictable pathway.  Strong emphasis is placed on ensuring that you as a patient receive appropriate information and are able to have a say in your own treatment.

What happens when I have been referred to a patient pathway?

If there is sufficient evidence to suggest that you may have cancer, your GP or other doctor will send a referral to the hospital requesting further investigations within the specialist health service. This is because the doctor is not able to rule out the possibility that you have cancer or another serious condition. The cancer patient pathway starts when the specialist health service receives the referral. You have the right to choose a hospital both when you have been referred for suspected cancer and if you have actually been diagnosed with cancer.

When you attend your first investigation appointment at the hospital or a doctor, you will be given information about

• which investigations are relevant for you
• when they will be carried out

The aim of these investigations is to determine whether or not you have cancer.

During the investigations, the possible cancer diagnosis will either be confirmed or disproven. Alternatively, you may be referred for further investigations concerning medical conditions other than cancer.

If the investigations show that you have cancer, you will be given information about possible treatment options and what will happen next. Decisions about your treatment will be made in consultation with you, normally based on an assessment carried out during a multidisciplinary team meeting.

The treatment you receive will depend on your diagnosis, but will include primary treatment and planned post-treatment care. This may include:

• Surgery
• Radiotherapy
• Drug treatment
• Active follow-up/monitoring
• Palliative treatment
• No treatment, if appropriate

Follow-up includes check-ups with your GP and/or in the specialist health service.

Pathway times in the cancer patient pathway

The number of days that each stage of the medical investigation should take has been defined for each pathway:

• Phase 1: The time between the hospital receiving your referral and you attending your first investigation appointment.
• Phase 2: The time between you attending your first investigation appointment and the completion of your investigations.
• Phase 3: The time between you being diagnosed as having cancer and completing all your investigations and tests and the start of your treatment.

These are known as ‘pathway times’. Pathway times are not legally binding. In other words, you will not have a right/be entitled to have your medical investigations completed within the pathway time for your diagnosis, but every effort will be made to meet these deadlines and avoid unnecessary non-medical delays.

For some people, there may be medical reasons why the pathway should be longer or shorter than the times specified for the patient pathway concerned. One reason may be that you have another medical condition that must be investigated, stabilised or treated before any investigations and treatment for cancer can be carried out. Patients themselves occasionally wish to postpone an investigation or treatment.

What forms of cancer are there patient pathways for?

Patient pathways have been developed for 26 different types of cancer. Here you will find  the Directorate of Health's  patient information concerning medical investigations in patient pathways (in Norwegian). 

The pathway coordinator will be responsible for your follow-up

The pathway coordinator is responsible for setting up your appointments, and is your contact person. All healthcare institutions/hospitals that investigate and treat cancer have their own pathway coordinators.

The pathway coordinator is to ensure continuity throughout the cancer pathway process. This means that investigation, treatment and follow-up takes place without unnecessary, non-medically justified, waiting time.

Who can answer questions about what?

You can contact the pathway coordinator if you have any practical questions about your investigations, appointments, etc. The pathway coordinator will often be a nurse, but they may also have a different professional background.

The doctor who refers you to the cancer pathway will explain what the patient pathway is and what you can expect. If you have any questions about the cancer patient pathway, you can contact your doctor, the pathway coordinator or a doctor in the specialist health service.

It will always be the doctor who answers medical questions.