New ultrasound diagnosis to be made in under an hour

health 22/11/2018

An Auckland cancer clinic is helping to take the stress out of waiting times with a 45-minute, fast-track service for neck lumps.

Patients at Mercy Radiology Neck Lump Clinic go from ultrasound to diagnosis in less than an hour - saving time, money, and worry.

"The fact that one person can turn up to one appointment, not need to go to five different appointments, and walk away with a diagnosis or a treatment plan, is huge for that patient," says Dr Lloyd McCann.

After the ultrasound, patients at Mercy Radiology undergo a needle sampling or biopsy, which is looked at by a pathologist there and then. That's immediately followed by a consultation with a surgeon.

"Fifty percent of our patients we can reassure after that appointment that they have a benign diagnosis, there's something there that doesn't need treatment and they can be discharged," says clinical director, Dr Rajan Patel.

"The remaining patients - approximately 10 percent of patients - have a cancer diagnosis."

Faster diagnosis means faster treatment.

"It's difficult to prove that one week, two weeks, five weeks is detrimental to a patient," says Dr Patel, "but inevitably if a patient has a cancer diagnosis they are very keen to have their treatment started as soon as possible."

Dr McCann says the fast-paced nature of the service "means there's less chance for the cancer to spread".

When Greg O'Shanassy had concerns about a lump on his neck last year, he wanted to know if it was cancer right away.

"The speed of which I was diagnosed was brilliant," says Mr O'Shanassy.

"It was a very numb feeling, but the first thing I thought about was my children and my wife and how I was going to tell them."

He was in surgery nine days later, and three months after that he was back playing cricket.

A thousand patients like Greg have been through the Neck Lump Clinic, and Dr McCann is presenting the findings at the Health Informatics (HiNZ) Conference. Held in Wellington from November 21 to 23, HiNZ is the country's largest digital health event.

"In 99 percent of the patients we see through the Neck Lump Clinic, we can give a definitive diagnosis as they walk out the door - and for that proportion of patients that do convert to a cancer diagnosis, you walk away with a treatment plan as well."

Dr McCann says not only does it save a lot of anxiety, it saves the system money too. The 45-minute one stop appointment at the private clinic costs in the region of $1000.

"The ability to condense something down from five appointments to one appointment means dollars are saved," says Dr McCann.

"So private insurers, DHBs, whoever is going to be paying for this service is effectively paying less."

Right now, the model is only being used for neck cancers, but Mercy Radiology is looking at similar one-stop clinics for breast cancer and prostate cancer.

It wants to encourage more hospitals and DHBs to streamline services.

Dr Suzanne Beuker, National Clinical Lead, Cancer Services for the Ministry of Health says "DHBs will be constantly seeking service improvements that benefit patients and optimise DHB resources".

"A number of innovative services have been set up to reduce the number of appointments that patients need and to reduce their waiting times, increase convenience and optimise their time to receive treatment," says Dr Beuker.

Figures show under the Faster Cancer Treatment programme, 90 percent of patients receive their first cancer treatment within 62 days of being referred.

Newshub.