How your treatment plan is decided

Somewhere in the first week, someone will tell you that your case will go to the tumour board. It is said quickly, as though everyone already knows what that means, and most families do not. It is worth understanding, because it is the meeting where your treatment is actually decided.

One case, one table

A tumour board is a meeting. The practice's surgical oncologists sit down together with the same scans and the same pathology report in front of all of them, one patient's case at a time. Nobody is working from a summary of what someone else saw.

What the board works through

• What the scans show, and what they do not settle.
• What the biopsy tissue is, under the microscope.
• Whether an operation is the right first step, or whether something should happen before it.
• What that operation would involve, and what it would mean afterwards.
• What the plan is if the tissue turns out to be something other than expected.

Then they agree on one plan

This is standard practice at major cancer centres, and it is standard practice here. The reason it helps is plain. A case discussed by one person is a case seen one way, and there is nothing wrong with that until it is the only reading in the room. A plan agreed out loud, in front of colleagues who have the same films and the same report, has had to answer questions before it reaches you.

What you should know by the end of the conversation

• What the plan is, in words you could repeat to someone at home.
• Why this plan, and what the alternatives were.
• Roughly how long it will take, and how many visits.
• Roughly what it will cost, including scans.
• Who to call, and when.

If any of those five is missing at the end, ask for it. Asking a doctor to repeat something is not rude; it is how you end up understanding your own treatment. Writing the answers down in the room is normal, and so is bringing someone with you to write them down for you.

The wait before the board meets

The board cannot meet until the results it needs are in front of it. Most of the gap between a biopsy and a plan is exactly that — the pathology being read properly rather than quickly. If the wait is sitting heavily on you, phone and ask where your case has reached. That is a reasonable question to ask.