Optimal timeframes & summary

Evidence-based guidelines, where they exist, should inform timeframes. Treatment teams need to recognise that shorter timeframes for appropriate consultations and treatment can promote a better experience for patients. Three steps in the pathway specify timeframes for care. They are designed to help patients understand the timeframes in which they can expect to be assessed and treated, and to help health services plan care delivery in accordance with expert-informed time parameters to meet the expectation of patients. These timeframes are based on expert advice from the Endometrial Cancer Working Group.

Timeframes for care

Step in pathway

Care point

Timeframe

Presentation, initial investigations and referral

Signs and symptoms

Presenting symptoms should be promptly and clinically triaged with a health professional

Initial investigations initiated by GP

Results should be available for patient review within 2 weeks of initial presentation

Referral to specialist

The patient should be referred to a specialist within 4 weeks of initial presentation

Diagnosis, staging and treatment planning

Diagnosis and staging

Pre-treatment diagnosis and relevant staging should be completed within 2 weeks of the initial specialist appointment

Multidisciplinary meeting and treatment planning

All newly diagnosed patients should be discussed in a multidisciplinary team meeting before starting treatment

Treatment

Surgery

Surgery should occur within 4 weeks of the MDM, provided the patient is medically fit

Radiation therapy

Radiation therapy should begin within 6 weeks of the MDM if primary treatment and within 8 weeks following surgery if adjuvant treatment

Systemic therapy

Systemic therapy should begin within 6 weeks of the MDM if a primary treatment and within 8 weeks following surgery if adjuvant treatment

Systemic therapy is often given in conjunction with radiotherapy in an adjuvant setting

For patients who have adjuvant chemotherapy, radiation therapy should begin 3–4 weeks after chemotherapy

Seven steps of the optimal care pathway

Step 1: Prevention and early detection

Step 2: Presentation, initial investigations and referral

Step 3: Diagnosis, staging and treatment planning

Step 4: Treatment

Step 5: Care after initial treatment and recovery

Step 6: Managing recurrent, residual or metastatic disease

Step 7: End-of-life care

Approximately 95 per cent of uterine cancer cases are endometrial cancer (Cancer Australia 2020b). The estimated number of new cases of uterine cancer diagnosed in Australia in 2019 is 3,115. In 2019, it was estimated that the risk of a female being diagnosed with uterine cancer by the age of 85 years is one in 40 (Cancer Australia 2020b).

The pathway describes the optimal cancer care that should be provided at each step for women with endometrial cancer.