These questions come from a large study of cancer services undertaken by the Commission for Health Improvement and the Audit Commission: NHS Cancer Care in England and Wales, published in December 2001.

They have been designed to help people with cancer and their families get the best care and information from cancer services.

You can ask these questions of your GP, community nurse, consultant, specialist cancer nurse or any professional involved in your cancer treatment and care.

The questions have been divided into three sections:

• Diagnosis
  
• Treatment and care
  
• Palliative care

Diagnosis (back to top)

Your GP should use the Department of Health guidelines to determine whether you need to see a consultant.

If your GP feels you need urgent attention you should get your first hospital appointment within two weeks.

Your hospital should organise your tests as quickly as possible. The people looking after you should tell you where the tests will be carried out.

You should be told about the nature and purpose of the tests, when you will receive the results and who will give them to you.

You should experience minimum discomfort during tests and receive good information and support.

Your tests should be organised at a time to suit you.

You should be referred to the appropriate cancer specialist.

Your test results should be passed quickly to the specialist who will be seeing you. The first meeting is normally to give you the diagnosis.

You should feel free to bring someone with you when your diagnosis and treatment options are being discussed.

The consultant discussing the diagnosis with you should be trained in communication skills and give you sufficient time to ask questions. You can also ask for a specialist nurse to be there to help you.

Someone should be available to discuss your diagnosis and its implications with you after the initial interview either by telephone or during another visit. You have the right to seek a second opinion.

GPs should be told quickly about your diagnosis and proposed treatment.

Treatment and Care (back to top)

Hospital staff should tell you how long you will need to wait for treatment.

You should be told what to expect with regard to your treatment.

If you have the kind of cancer where evidence shows that it is important, your surgery should be performed by a specialist or sub-specialist. You should feel free to ask your consultant whether this applies to you.

Chemotherapy, which is the use of drugs to kill cancer cells or prevent their growth, should be prescribed by a doctor who specialises in treating cancer (an oncologist). Its administration should be supervised by a nurse with appropriate training.

Chemotherapy should be provided in local cancer units for your convenience.

Your treatment should be carried out efficiently to avoid delays.

Your treatment plan should be discussed by a multidisciplinary team, which includes cancer nurses and all the main consultants.

If you attend more than one hospital, your records should be full and accurate in each.

Good supportive care should be available throughout your treatment. Those looking after you should tell you how to get help, including from sources outside the NHS.

Detailed plans should be drawn up to meet your needs at home after you have been discharged from hospital. You GP should be told when you have been discharged.

The people looking after you should tell you who is responsible for your follow-up care and provide contact details.

Each cancer network, which is the network of organisations you may visit during your treatment, should have agreed treatment guidelines and standards.

Palliative Care (back to top)

By palliative care, we mean care which alleviates symptoms but is not designed to bring about a cure.

Someone should take responsibility for making sure that your needs for palliative care are recognised. If you feel that you have any needs for care, you should ask someone, such as your GP or district nurse about this.

You should have access to specialist staff for palliative care.

Good arrangements should be in place for palliative care outside normal office hours and you should be told about these arrangements.

Your ongoing care should be co-ordinated and you should be told by those looking after you who is in charge.

You and your family should have good practical and emotional support whenever you or they need it.

You should be able to die where you and your relatives choose, with good support for terminal care.

The people looking after you should take responsibility for ensuring bereavement care is offered to your family.