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The timeline for initial evaluation and treatment of gynecologic cancers is highly variable, depending on circumstances. For example, a woman in pain or severely bleeding should be seen rapidly, have her diagnosis confirmed with appropriate tests and have therapy instituted immediately. Generally, this process should be accomplished within a few days to a week. On the other hand, patients whose diagnosis arises without symptoms, perhaps as a result of participation in a screening program, may expect to wait for a convenient time to be seen by a specialist. Sometimes this can take weeks to months.
Many people are surprised that there is a delay in the diagnosis of cancer, because they are under the impression that cancers are easy to spot. Of course, it is easy in hindsight to look at a problem from the past and attribute it to an undiagnosed cancer. Many of my patients ask me when their cancer began. This question is unanswerable. It goes without saying that if the cancer were found at the instant it began, every effort would be made to stop it from progressing. Early diagnosis does indeed increase the odds of successful outcome.
Some cancers progress slowly, some more quickly. Some patients have rapid institution of treatment after evaluation, and others have extreme and inexcusable delays. Many delays are unavoidable. Sometimes the delay is due to the cumbersome health care system. Sometimes patients may not be able to get appointments for doctor's visits or x-rays. Unfortunately, many women do not have resources such as time off from their jobs, health insurance, transportation or child care so that they can obtain healthcare in a timely manner.
Any plan for managing a known diagnosis of cancer should be discussed with the patient and her support person at length within a day and implemented within the next several days. Patients who may have anxiety due to inadequate understanding about the risks associated with their diagnosis should not be allowed to increase that anxiety during the period of emotional adjustment. Instead they need to be given accurate, complete information about the benefits of methodical and thorough assessment of disease coupled with expeditious treatment appropriate to the specific clinical situation.
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"Answers from the Pros" are given in general terms, and are not intended
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give medical advice, but answers medical questions that always should
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in your treatment or medications, without consulting your doctor. If you
have an emergency, call 911 or your physician.
What is a typical and acceptable timeline for evaluation and initial treatment of gynecologic cancers?