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 Head and Neck Cancer Working Group.

Timeframes for care

Step in pathway

Care point


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

Signs and symptoms should be investigated if they persist for more than 3 weeks

Referral to specialist

Specialist appointment should be within 2 weeks of referral

Diagnosis, staging and treatment planning

Diagnosis and staging

Performed under supervision of a member of a head and neck multidisciplinary team and should be conducted within 2 weeks of the specialist appointment

Multidisciplinary meeting and treatment planning

The first MDM should be within 2 weeks of receiving the diagnosis and staging results



Surgery should be scheduled within 4 weeks of the MDM. Time from definitive surgery to beginning adjuvant treatment (plus concomitant systemic therapy when indicated) should be not more than 6 weeks

Radiation therapy +/- systemic therapy

If radiation therapy or systemic therapy is the primary treatment modality at the time from the MDM to starting treatment, it should begin within 4 weeks for curative intent and within 2 weeks for palliative intent

If systemic therapy is being used concurrently with radiation therapy, it should begin within 1 week of radiation therapy

Radiation therapy as an adjuvant treatment should begin within six weeks after surgery

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

Head and neck cancer is the seventh most commonly diagnosed cancer in Australia (Koh et al. 2019). The estimated number of new cases of head and neck cancer diagnosed in Australia in 2019 was 5,212 (Cancer Australia 2019b). Head and neck cancer is more prevalent in males than females, with 3,807 males diagnosed and 1,405 females diagnosed in 2019 (Cancer Australia 2019b).

The pathway covers the following head and neck cancers: mouth or oral cancer; salivary gland cancer; pharyngeal or throat cancer, incorporating nasopharyngeal, oropharyngeal and hypopharyngeal cancers; laryngeal cancer; and nasal or paranasal sinus cancer. The pathway is also applicable to thyroid cancer, cancers of the cervical oesophagus, cancers of unknown primary that first appear in the head and neck, and cancer in the skin of the head and neck in the context of high-risk and advanced skin cancer.