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 High-Grade Glioma 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 |
GP to consider an MRI For most patients, referral to a specialist is required within 24 hours |
|
|
Referral to specialist |
If high clinical suspicion of high-grade glioma, patients should be referred to an appropriate neurosurgeon within 24 hours of the patient presenting with symptoms |
|
|
Diagnosis, staging and treatment planning |
Diagnosis and staging |
Should be completed within 1 week of referral to a specialist |
|
Multidisciplinary meeting and treatment planning |
All newly diagnosed patients should be discussed in an MDM within 2 weeks of diagnosis (if appropriate) |
|
|
Treatment |
Surgery |
Surgery should occur immediately for most cases or within 4 weeks of diagnosis if not urgent (according to clinical need) |
|
Radiation therapy |
Should begin within 6 weeks after surgery |
|
|
Systemic therapy |
Should begin within 6 weeks after surgery or after radiotherapy |
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 or progressive disease
Step 7: End-of-life care
In 2019, brain cancer was ranked the 18th most commonly diagnosed cancer and the 11th cancer with the highest mortality rate (AIHW 2019). Despite increases in survival since the introduction of concurrent chemo-radiation for high-grade glioma, brain cancer remains in the category of low-survival cancers, with a five-year survival rate of about 25 per cent (AIHW 2017a).
