What does the 'two week' cancer pathway actually mean?

[drivinmecrazy]

I was referred on the two week path way a week ago.

Am still waiting on communication.

What should I expect at my first appointment?

It's regarding possible breast cancer 😢

They have units where they do everything in the same day in my area so maybe there is one of those . They will take a biopsy / scan and bloods usually .

Thankyou for that.

Silly question, but will I know on my first appointment whether cancer is likely?

I have my appointment tomorrow for a lump in my right breast.

I know each area varies, but I'm Manchester and got a letter within 4 days of my GP appointment, giving me an appointment 9 days later.

Sending you lots of love and well wishes for a good outcome 💛

I went with my mum and he said yes it's cancer there and then which took me by surprise . I guess they see so much that they just know . This was before the biopsy too , just after a scan .

Are there breast units in your area as I'm sure it's not unique to our area but maybe if it's all separate it will take longer .

Hello,

First of all I'm sorry that you are having to go through this. I have also been through this a few years ago.

The two week pathway is a fast track service and when I went they did a mammogram, an ultrasound sound and a chat with a consultant.

I then went for an MRI before being given the all clear.

I didn't have a lump but rather a dent in my breast so maybe that's why I had so many different things.

Hugs to you, it is a frightening time.

I was referred a couple of years ago. Got the appointment in time, had a consultation, two mammographies and an ultrasound.

Luckily for me it was a cyst, so no biopsy needed.

Just means you should have your first appt within 2 weeks. Simple as that.

Traditionally, and pre Covid, the aim was all suspected cancer patients to have their first appointment in 2 weeks (the 2 week wait), then there were a number of other targets for diagnosis, delivery of the diagnosis and treatment.

in many specialties in many areas this was failing/unachievable before Covid and Covid has since blown this target far out of the water. The rules are either changing or have changed recently re the target dates and whilst many will still refer to it as the 2 week wait, the target won’t be applied, I think (but happy to be corrected) that the target as lengthened maybe to 28 days?

when were you referred by your GP? Where abouts are you in the country, different areas have different waits. As per pp many centres especially in big hospitals have a one stop shop. They can do scans/examinations take bloods etc. depending on the set up and turn around for tests will determine how long you have to wait for diagnosis. They might for example see a mass with a scan but unable to diangose without a biopsy etc.

if you call or email the PALs department of the place you have been referred and ask for information on the pathway, what you can exect to happen and when, and when your appt is likely to be, they will be able to help you, or point you in the right direction of a department that can.

best of luck and everything crossed for a quick process and positive outcome for you xxx

Thankyou for all of your replies.

I'm feeling pretty alone at the moment amongst the sea of people telling me it'll be fine.

I'm planning to I go alone to my appointment, not sure if that's the right thing or not

If it's a breast unit you will be there a good while so prob best to go with a book .. also make sure you have enough parking so you don't flap or do it on the app so you can top it up

I was referred once under the 2 week pathway for a growth in my mouth, GP was at pains to say it probs wasnt cancerous but she was taking no risks. The guy I saw in hospital within 2 weeks was a bit pissed I'd been referred under that pathway! Nevertheless he put me forward for minor surgery about 2 days later and I had the piece chopped out. Results found it non cancerous.

No experience on boobs unfortunately but chances are it wont be anything sinister.

From my experience,

You'll get a letter with your appointment.
When you go they will examine you and feel for any possible lumps, they then mark them ready for an ultrasound.

You have the ultrasound and if there are any concerns, you then have them biopsied and sometimes they'll do a mammogram.

This is usually done all in one day in the same clinic.

I hope it's good news xxx

I've most definitely got a mass in my breast, quite large.

It appeared about a month ago and I put off going to the doctor until I got pain in the same area a week ago.
Pretty sure it's cancer.
Doctor obviously didn't say one way or the other, just that it needed to be further investigated.

So I'm not expecting a positive outcome e

I've supported my mum through her diagnosis/treatment. GP referred to breast clinic at out local hospital. She was seen at the clinic within a week and had bloods/mammogram/full MRI on the same visit. We had a chat with a surgeon who explained mum was not a candidate for surgery as her tumour was imbedded in her chest wall. She is 80 and ill with other things too so not strong enough for traditional chemo either.
It was a whirlwind of a day to say the least but everyone from the consultant down was so supportive and lovely. She had regular treatment with Letrozole to lower estrogen and the Herceptin injections every three weeks. 2 years on her tumour has shrank away to nothing and never spread to any other organs/bones etc. She though she would be written off due to her age but far from it.
If you have someone to go with you it can be useful- mum got overwhelmed with information sometimes and for me I wanted to be there as a support- between us we managed to digest/retain what was going on.
I just wanted to give you a positive story and wish you well- hope all is OK.

@mrsfollowill so glad you hear your Mum recovered well ❤️‍🩹

Why are you pretty sure it's cancer. Most lumps aren't. I had this a few years ago. Was referred under the two week pathway. Went by myself to the appointment as there was no point worrying anyone if it turned out to be nothing (completely fine to take someone though - everyone is different). They basically had a feel of the area and said it felt fine but said they'd do an ultra sound too which happened about 30 minutes later. They said everything looked fine with that too and said it was a fatty lump but to do a regular breast check myself at home.

Hi op. As @Catsonskis says the two week wait isn’t a thing anymore, it’s now just an urgent referral and hasn’t been since September. The target has been replaced with a target of getting a yes/no answer for cancer within 31 days which when you think about it is actually much better.

sometimes when they do the relevant scans it’s a clear yes or no cancer and they would tell you there and then what they think. However cancer is only ever confirmed by biopsy. So after your appt you will have one of 3 scenarios:

1. no cancer, no follow up appt
2. Possibly cancer, to be confirmed with biopsy
3. almost definitely cancer, biopsy to confirm.

biopsy is normally done the same day as all your scans and the results take 1-2 weeks.

Wishing you all the best. Having just been through this myself I find it so upsetting that gps are stil using the wording “two week refersll” and my gp didn’t even know that two week wait wasn’t a target anymore when I told her!

I didn’t get a call giving me my appt till day 10 and then the actual appt was 25 days after seeing the gp.

It's all just so overwhelming at the moment.
Just trying to work out what to expect.

All of your posts are helping me navigate what I can expect on the day.

I'm finding my family aren't the best people to talk to at the moment because they just want to believe it'll all be fine.
I feel as if no one is actuallly hearing me when I say that I'm scared

Being scared is understandable but to be honest there's not much point being worried until you know more information. It's highly likely to be nothing, these things usually are.

I am sorry you are so scared, OP. Sending you an un-Mumsnetty hug.

I'm going for my appointment on Thursday it was about a three week wait, the appointment is likely to last 4 hours they said and to bring pain relief. Other than that I don't want to know what they will do. My sil terrified me when I saw her last week.

Do you have a good friend that could go with you? The clinics sometimes take a while, from my experience they are very thorough. I'd did get my diagnosis on the day, so was glad my friend with was with me. The NHS in my area were very efficient and a plan was made for me asap. That was 6 years ago!
Hope your appointment goes well

I was recalled from a mammogram- I was very fearful.
on the day of the appointment they did another mammogram, an ultrasound and an examination with the consultant who showed me the small ‘masses’ on the ultrasound and said they were concerned due to the ‘unusual pattern’.
they then did biopsies and placed ‘markers’ into the breast and I had to return a week later for results.
luckily the masses were calcium and they said they would monitor through the usual 3 year mammogram. I have since had a further mammogram (3 years later) and all is ok.
it is understandable to be fearful and anxious, but the large majority of ‘issues’ do turn out to be non cancerous.
Sending strength x

Just means you should have your first appt within 2 weeks. Simple as that.

Yes, that was what it used to be, but I don't think everyone is seen within 2 weeks anymore.

Regarding 'knowing on the day' - I didn't. I had all the tests and the biopsy had to be tested. I had a 2nd appt about 10 days after the test day when the consultant broke the news. That is when dh came with me. I didn't see any point in him being there whilst I was having tests.

2ww target was abolished a while ago - now it's to have cancer diagnosed or excluded within 28 days.

It isn't being met for any of my patients. Breast first appts are running at 8-12 weeks in London.