A number of factors should be considered at this stage:

• the patient’s overall condition, life expectancy, personal preferences and decision- making capacity
• discussing the multidisciplinary team approach to care with the patient
• appropriate and timely referral to an MDM
• pregnancy and fertility
• support with travel and accommodation
• teleconferencing or videoconferencing as required.

Comorbidities and organ function assessment

It is important to evaluate and document relevant organ functions (e.g. respiratory, renal, hepatic and cardiac), overall functional status and physiological robustness for all patients. These issues are especially important in a geriatric context, where a geriatric assessment can be very useful.

Given the immunosuppressive effects of treatments used for these diseases, testing for occult infections should be performed (e.g. HIV, hepatitis B and C). In patients at risk, consider tuberculous testing.