How long it takes for treatment to start, and what to do while you wait

The short answer

There is no single timeframe: it depends on the type, the stage, which investigations are still missing, and the hospital. In many situations, a few weeks before treatment starts does not change the outcome, because that time is used to make sure the plan is correct. What you can actually do is find out what is being waited on and who decides the next step.

From the outside it looks like nothing is happening. Usually several things are happening at once.

• Missing investigations are completed, so the stage is clear.
• Laboratory results that take time are awaited, some more than a week.
• Opinions from several specialists are gathered, in the committee that decides the plan.
• Administrative matters are resolved: referrals, files, approvals.
• What needs to happen beforehand is prepared, from tests to a procedure.

A plan made on incomplete data changes along the way, and that costs more time than a correct wait at the start.

Two people from the same city can have very different waiting times, without either of them being neglected.

The type of disease and how quickly it progresses matter. Whether treatment starts with surgery, radiotherapy, or medication matters. Whether a test is done in only a few locations matters.

The hospital matters too: equipment, schedule, how many patients it has, how often the committee meets.

You cannot speed up a laboratory analysis or the committee. You can speed up the administrative part, and that is often where the most time is lost.

• Keep every document in a single folder, in order.
• Ask for copies of every result on the day you receive it.
• Ask exactly which document is missing and who issues it.
• Call to confirm appointments a few days ahead.
• Ask whether there is a waiting list for cancellations.

If you move to another hospital, take the complete file with you. Repeating investigations is the most common reason for delay.

Many people put off asking for a second opinion, afraid of losing time or upsetting the doctor.

Asking for a second opinion is a normal thing to do in oncology and is not an insult. Ask directly how much time you have without anything changing. Often the answer is "a few weeks," and that gives you the peace of mind to decide.

Call the team without waiting for the scheduled appointment if:

• several weeks have passed and no one has contacted you;
• you have been referred between services more than once, without a concrete step;
• symptoms have clearly worsened since the last assessment;
• new pain, fever, or bleeding has appeared.

The last point is not an organizational problem. It is a medical one.

• What exactly is being waited on now, and who will give the answer?
• What is the concrete next step, and on what date?
• What changes if treatment starts in two weeks instead of one?
• Who is my contact person, and at what number do I reach them?
• What documents can I prepare from now?
• Do I have time for a second opinion without losing anything?

Ask for two things in writing at your next discussion: what the next step is and who the contact person is. Most of the weeks lost in the system are not lost in the laboratory — they are lost between two people each waiting for the other to call.