Patient Pathway

This page summarizes the developed patient pathway with a focus on the main activities to provide a basic understanding for the lung cancer pathway stages. A more detailed description is found in the Report on Task 6.4.2 describing the lung cancer patient pathway templated accompanied with patient-centred practices.

The main stages and activities of the lung cancer patient pathway template is outlined and detailed below, encompassing the following major phases: CCCN entry, staging diagnostics, treatment planning, treatment, follow-up/end-of-life care, and the conclusion of CCCN care.

Screening

Screening is integrated as a key interface, marking one of the starting points of the lung cancer patient pathway care in CCCNs. The patient pathway working group agreed to include screening not as a phase of the patient pathway itself but as an interface starting point. This decision was made because screening addresses not only lung cancer patients but also a broader population. Consequently, screening is depicted in light grey in the patient pathway, accompanied by additional information and references.

CCCN Entry

The lung cancer patient pathway has four entry points. These are, as represented in the figure,

• patients with symptoms,
• patients with histologically confirmed lung cancer,
• citizens with positive lung cancer screening results, and
• patients with suspicion of secondary metastases or recurrence.

Staging Diagnostics

After patient consultation, the phase of “staging diagnostics” is entered. An overview of this phase is given in the figure. If no lung cancer was confirmed, the patient will be discharged from CCCN care. Otherwise, the pathway continues with treatment planning.

Treatment Planning

After staging diagnostics, the phase of “treatment planning” is entered. This phase includes two sub-pathways – for the “standard tumorboard (TB) meeting” and for the “molecular tumorboard (MTB) meeting”. There is a patient consultation after the diagnosis which should include shared decision-making. Overall, four quality indicators are allocated to the steps of this pathway phase.

Treatment

After treatment planning, the patient pathway for lung cancer patients continues with the phase of “treatment”. It includes the actual treatment together with supportive care activities and an early integration of palliative care (if needed), as well as rehabilitation activities. Altogether, there are 18 quality indicators allocated to the steps of the treatment phase.

Follow-Up, End-of-Life Care and End of CCCN Care

After treatment, the patient pathway for lung cancer patients continues with the phase of follow-up or end-of-life care. Follow-up care should be performed according to national or European cancer follow-up guidelines/ recommendations. This phase includes one quality indicator.