To ask how long between cancer consultation and diagnosis?

[Gemmy96]

Posting here as the cancer board doesn't get a lot of traction and I really need some answers as soon as possible!

I was referred a week ago for an urgent cancer assessment at my local hospital and I'm being seen on Monday afternoon. On my letter it says that the appointment is for consultation only and no "treatment" will be carried out, which I assume means biopsies, scans etc. won't be taken either.

I don't really understand what the process is going forward and how long I can expect things to take-- my trust is quite good for this kind of thing apparently, hence being seen in under a week I suppose.

Generally speaking, what's the order I can expect things to go in from here on? Referral, initial consultation, biopsy, diagnosis/ruling out (fingers crossed!)? And what kind of time scale do these things work on?

Thank you

DH blood cancer, diagnosis same day after being sent to hospital as an emergency. Intense lot of tests.
Treatment took a further 5 months to arrange ( with weekly transfusions in the meantime) as they needed to find a stem cell donor and check DH would be able to withstand the process.

"consultation" will most definitely involve diagnostic tests. By treatment they mean surgery, chemo etc. Typical cancer pathway is two weeks urgent testing. When you get the test results will depend on a type of cancer they are looking for and how busy your local lab is.

My mum was on the cancer pathway last year - referred to hospital end of June, she had a consultation within 3 weeks. MRI the week after then a biopsy 2 weeks after that. She got the results 3 weeks later, in mid August. So 6/7 weeks between referral and results. She's had 2 more biopsies since and 1 ultrasound, still no diagnosis - they don't think it is cancer now but they can't rule it out. They are exploring if it is a different type of cancer now.

On the other hand my friend went to A&E on a Friday after a full week of work in November 2023 and she was diagnosed with lung cancer on the Sunday. She was absolutely riddled with it - it was terminal, so I guess easier to spot when it is in multiple places.

Dh was on the 2 week pathway just before Xmas, he has been diagnosed 2 weeks ago but he still doesn't know if he needs an operation or radiotherapy as he's waiting on results of a scan. If he needs an op he's been told it will be 6-8 weeks.

I used to work in oncology/cancer management and am now a medical student.

What will happen during your first appointment very much depends on which cancer pathway you are on. Some trusts will have 'one stop shop' clinics whereby you'll have a consultation and some initial tests on the day (breast, some colorectal, prostate for men) but it's very variable geographically and by cancer type. Some of these clinics will hold 'emergency/on the day' slots for things like imaging and biopsy only if minimally invasive. More commonly I'd say, imaging and further testing may be organised after your first appointment but you shouldn't have to wait a long time for them as the trust have targets to meet re making a diagnosis.

The 2 week wait (to first appointment) doesn't actually exist anymore but the general public don't really seem to know this. It has been superceded by the 28 day faster diagnosis standard which is 28 day from referral (from GP to hospital) to ruling cancer in or out. Google Cancer Waiting Times if you want to know more about the specific targets.

In order to have your referral accepted by the hospital, you've presumably already had some initial testing like bloods, physical examination or urine/faecal sample depending on cancer type? Even so, the vast vast majority of people referred on suspected cancer pathways of all types do not have cancer so try your best not to panic (I know it's extremely extremely difficult not to). Wishing you the best of luck and hope you get answers quickly.

In my experience, they arrange the tests pretty quickly after the consultation if they have concerns after examining you (which usually happens during the initial consultation, again in my experience). Then if your test results indicate or show cancer, you’ll have another consultation and then treatment/ further tests will happen after this. It’s pretty fast compared with, eg the wait for a knee transplant, but the gap between diagnosis and treatment can be longer than you’d ideally want, especially post-Covid (still usually talking weeks rather than several months).

Also blood cancer (waves @FuzzyPuffling) although it took longer for us to get a firm diagnosis and we were then on what's called watch and wait for a few years before SCT.

So generally I would say it is dependent on the type of cancer.

A colleague had to go for scans on her breast and they were able to tell her on the day it was highly unlikely to be cancer.

I guess it's consultant appointment/ tests / diagnosis/ treatment. But the gaps in that will be dependent on the exact cancer.

Fingers crossed.

My mum has endometrial cancer. From originally going to gp with heavy bleeding and pain, and then being referred "urgently " it's 6 months and she's only just had the MRI.

As has been said, this is going to depend on your local trust, and also on the cancer type.

My experience was I went to the GP after finding a small lump in my breast. This was on a Saturday morning. On Monday morning I got a phone call asking me to come in for tests on that Wednesday. (Unlike pp's information, there had been no prior tests, other than the GP also being able to feel the lump).
On that first appt, I had everything done - scans, blood tests, biopsy etc - then went home to wait.
They had made an appt for me to go back 12 days later to see the consultant and nurse for the diagnosis.

However - most referrals ^ turn out not to be cancer, so try not to assume the worst.

What sort of cancer are they investigating? I have melanoma. First appointment was for them to visually look at it and take some photos after which I was booked in to have it removed. The lesion was then sent for biopsy. I would say it was probably 5-6 weeks from that 1st hospital appointment to diagnosis (biopsy results), which was 3 weeks after biopsy taken. I’ve been told results can take 8 weeks from biopsy though.

I was a particularly squeaky wheel though, emailing the consultant’s secretary weekly, and I have a particularly aggressive cancer, so I think I’ve been moved along quite swiftly.

It is still a lengthy process after diagnosis. It was about another 5 weeks wait for a second surgery (during which I had another biopsy and lots of scans as it had spread). And then about 4 weeks recovery after that (it was a major surgery) before I started treatment. It seems like a lot of time, but I was well looked after and it moved along quickly.

I think it depends on where you live to an extent, but both me and my friend last year had urgent referrals. In my case treatment was about 3 weeks (possible skin cancer) with results "within 4 months" (actually about 2 months). My friend was tests initially then four months wait for results.

Thyroid was quick. Had Pet scan and was diagnosed within 24/48 hours. Had surgery within 6/8 weeks and then had to wait for radiation. Then had surgery again. Just waiting now to see oncologist for them to rerun tests as it was also in lymph nodes.

Bowel has been ongoing and long. Am at a specialist hospital and I can go a long time between surgery and appointments.

It took over 3 months for a surgical (in my case) intervention. But from the first intimation (a chest ex ray) to the operation I had many consultations.

The first one, as you describe was pretty much the same. From there I was sent for further tests, and a following consultation. This test confirmed the cancer.

Then, a further two tests to decide on the cancer type and spread, and two more consultation inbetween to up date me.

Finally I had a care plan. I had to wait for three weeks for the two surgeons (a thoracic one to do the actual op, and a spinal one to decide if, once on the operating table, it should go ahead).

It seemed like a life time to me, as it must be to you, but you are in the right hands. You can be diagnosed fairly quickly, but the best treatment may take a time to decide on.

Good luck

I think so much depends on what type of cancer it is. In my case it was breast cancer. I saw my GP in mid November, had a consultation about a week later, where I had a mammogram and a biopsy. I got a diagnosis there and then, although they did say they would need to confirm it. I had surgery early December, so it was all very quick. Fingers crossed for you.

Thank you all. If it is cancer it would be oral cancer, I'm booked in to see an oral surgeon.

The hospital will have a head and neck MDT coordinator or cancer pathway navigator who will be tracking all cases. I was one for 8 years. It would be good to ask for their details if possible as they may have an idea. If suspected ca you should be discussed at MDT meetings to decide on what to do to gain confirmation either way. You may also meet a CNS Cancer Nurse Specialist at your appointment xx

Two week pathway still exists in my Trust. I triage patients and urgent referral is two weeks (depending on availability), routine pathway is 28 days + (mostly 28 weeks, really, in my service). I also had two cancer investigations myself last year and had two weeks referral for both. I haven't see the official policy but, pragmatically, the pathway is still there.