Cancer patient pathways

If there is sufficient evidence to indicate that you may have cancer, your doctor will refer you to a cancer patient pathway. The cancer patient pathway is intended to provide predictability and security for you and your next of kin. Patient pathways are standard national patient pathways which are intended to contribute to expeditious investigation and the start of treatment without any unnecessary waiting.

Patient receiving follow-up care

Illustration: Øyvind Eide

The aim of the patient pathways is to ensure that cancer patients encounter a well-organised, integrated and predictable pathway, without any unnecessary non-medically justified delays in investigation, diagnosis, treatment and rehabilitation. 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.

The patient pathways include medical investigation, treatment and follow-up. The patient pathways also describe rehabilitation, palliative (symptom-relieving) treatment, supportive care and nursing care.

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.

When you attend your first investigation appointment at the hospital or a doctor, you will be given information about what investigations will be relevant to you and 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 doctor 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.

The pathway coordinator will be responsible for your follow-up

All health trusts/hospitals that investigate and treat cancer patients have their own pathway coordinators. Pathway coordinators are responsible for arranging your appointments and acting as your contact person.

Pathway coordinators are responsible for ensuring continuity throughout the patient pathway. This means that medical investigations, treatment and follow-up will take place without any unnecessary non-medically justified waiting.

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.

What forms of cancer are there patient pathways for?

Patient pathways have been developed for 28 different types of cancer. In the list below, you will find links to the Directorate of Health's brochures with patient information concerning medical investigations in patient pathways. These brochures can be downloaded as a PDF version and are available in Bokmål and English. Some are also available in Sámi.

More information from The Norwegian Directorate of Health