Blood cancers

New optimal care pathways released for 3 haematological cancers

Updated optimal care pathways have been released that define and steer national best practice for three blood cancers.

The second edition of the care pathways, endorsed by Cancer Australia and the Cancer Council cover Acute Myeloid Leukaemia, Hodgkin lymphoma and diffuse large B-cell lymphomas (DLBCL).

The pathways outline nationally agreed best practice for the best level of care in areas such as prevention and early detection, initial investigations and referral, as well as diagnosis, staging and treatment planning. They also cover care after initial treatment, prevention and management of recurrence and metastatic disease, and end-of-life care.

According to the developers, the pathways “describe the standard of care that should be available to all cancer patients treated in Australia. The pathways support patients and carers, health systems, health professionals and services, and encourage consistent optimal treatment and supportive care at each stage of a patient’s journey.”

In his introduction to the second editions of the pathways, Professor Robert Thomas, Chair of the Project Steering Committee, says they should be read and understood by all those involved in cancer care.

“This includes all health professionals, from surgeons, oncologists, haematologists, radiologists, general practitioners and other doctors to allied health professionals, nurses and managers of cancer services. Trainees in all disciplines should absorb the messages contained in the optimal care pathways.”

Guidance is provided in relation to seven key principles of patient-centred care; safe and quality care; multidisciplinary care; supportive care; care coordination; communication; and research and clinical trials.

Each pathway comes with a summary section that outlines key actions for best practice, with a checklist and recommended timeframe.

For AML, the timeline recommendations include morphological assessment to identify APL to be conducted immediately and the result conveyed to the treating physician as soon as possible. For all patients with AML, other results necessary for immediate management decisions should be available within 72 hours of the patient presenting.

The pathway also recommends that induction therapy should begin promptly after diagnosis and confirmation of a treatment plan. Consolidation therapy should begin within six weeks of induction chemotherapy starting., and donor searches should begin as soon as the patient’s risk status is known.

However the authors say that while the pathways are government endorsed and intended to improve the quality of care, they are not prescriptive.

“It’s important to note that the optimal care pathways are cancer pathways, not clinical practice guidelines. The decision about ‘what’ treatment is given is a professional responsibility and will usually be based on current evidence, clinical practice guidelines and the patients’ preferences,” Professor Robert Thomas writes.

The pathways are accompanied by quick reference guides aimed at consumers.

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