Cancer
- Cancer treatment services
Cancer treatment services
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The cancer services page presents information for hospitals that provide the following cancer treatment services on a regular basis:
- Multidisciplinary care
- Surgery (for selected cancers)
- Chemotherapy
- Radiotherapy
- Palliative care
These selected services are a subset of cancer treatment services. Hospitals may also provide other cancer treatment services such as genetic services and haematological services and linkages to broader support services for people with cancer.
The selected cancer treatment services on MyHospitals only reflect services provided by hospitals and do not include non-hospital service providers.
MyHospitals presents information about cancer services for a hospital if that service is supplied by, or on behalf of, that hospital (admitted patients or outpatients) regardless of whether that service is delivered at the hospital or elsewhere (e.g. the patient's home). Where the services patients receive at a hospital are provided wholly or predominantly by staff from another public hospital, the hospital providing the service is shown as a satellite site.
Some services at some public hospitals are shown as being offered by a private provider. This indicates that the service is provided by specialists operating from a public hospital under right of private practice arrangements or delivered on the campus of a public hospital by a co-located private facility to private patients.
MyHospitals only reports cancer services provided by facilities deemed to provide multidisciplinary care. Multidisciplinary care fosters cooperative working between medical, nursing and allied health professionals and is characterised by regular structured team meetings to consider all care and treatment options, involving patients in decisions about their care and collaboratively developing individual care plans that best meet the needs of a patient.
The services deemed to provide multidisciplinary care were advised by states and territories and data was provided on 24 August 2012. Specifically, MyHospitals reports the following cancers when provided by multidisciplinary care facilities:
- Breast cancer – Cancer of the ducts or lobules of the breast
- Endocrine cancer (including thyroid) – Cancer originating in the endocrine system, including cancers of the thyroid, pituitary, and adrenal glands.
- Lower gastrointestinal cancer – Cancer of the lower gastrointestinal tract, including the colon, rectum and anus.
- Upper gastrointestinal cancer – Cancer of the upper gastrointestinal tract, including the oesophagus, stomach, small intestine, liver, gallbladder and pancreas.
- Gynaecological cancer – Cancer of the female reproductive system, including cancers of the vulva, vagina, cervix, uterus, ovary and placenta.
- Haematological cancer – Cancer of the blood and lymphatic systems, including leukaemia, myeloma and lymphoma.
- Head and neck cancer – Cancer of the mouth, nose, sinuses, salivary glands, throat or lymph nodes in the neck.
- Lung cancer (including mesothelioma) – Cancer originating in the lungs, including the trachea, pleura, bronchi, bronchioles and alveoli. This category also includes mesothelioma, a malignant tumour of the pleura.
- Melanoma - Cancer of the body’s cells that contain pigment (melanin), predominantly affecting the skin.
- Neurological cancer (including brain) – Cancer of the central nervous system, including the brain and spinal cord.
- Paediatric cancer – Cancers in infants and children. All types of cancer in infants and children are included.
- Urological cancer (including prostate) –Cancer of the renal system or urinary tract, including cancer of the kidney, bladder, urethra, paraurethral gland and renal pelvis. Prostate cancer is cancer of the prostate, the male organ that sits next to the urinary bladder and contributes to semen (sperm fluid) production.
- Sarcoma – Cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.
Data on surgery (for selected cancers), chemotherapy and palliative care are based on a combination of a hospital's activity between 1 July 2010 and 30 June 2011 and advice from states and territories as at 24 August 2012.
For surgery of these selected cancers, the underlying data source is the National Hospital Morbidity Database (NHMD). Hospitals are shown to provide the cancer surgery for selected cancers if they provided 10 or more surgical separations for those cancers during 2010–11. Data on non-admitted patients are not included.
Data for surgery are limited to patients with a principal diagnosis of a malignant neoplasm or in-situ neoplasm for selected cancers as defined by the ICD-10-AM (7th edition). Data on benign neoplasms and tumours of unknown or uncertain nature are not included.
For chemotherapy, the underlying data sources are the NHMD and National Outpatient Care Database. Hospitals are shown to provide chemotherapy to admitted or non-admitted patients in 2010–11.
For radiotherapy, data are only for external beam megavoltage radiotherapy delivered by linear accelerators. Other types of radiotherapy are not included. Data are based on information supplied by the Department of Health and Ageing and advice from states and territories as at 24 August 2012.
For palliative care, the underlying data sources are the NHMD and the National Public Hospitals Establishments Database. Hospitals are shown to provide palliative care if they provided 10 or more palliative care separations related to cancer during 2010–11 or if it has a hospice care unit.
- Cancer surgery waiting times
Cancer surgery waiting times
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For each hospital that provides information, the cancer surgery waiting times pages present two measures:
- the median waiting time (in days) for admission for elective surgery of selected types of cancer.
- the number of admissions for elective surgery of the selected types of cancer.
These measures are derived from the National Elective Surgery Waiting Times Data Collection (NESWTDC) and National Hospital Morbidity Database (NHMD). Elective surgery waiting times for cancer surgery have been generated using the same methodology as other elective surgery waiting times information on MyHospitals.
The NESWTDC covers most public hospitals that undertake surgery. Some of the reasons why hospitals are not included in this data collection include that they might not undertake cancer surgery, might not have had waiting lists, or might have had different waiting list characteristics compared with reporting hospitals.
Elective surgery is surgery that, in the opinion of the treating physician, is necessary and admission for which can be delayed for at least twenty-four hours.
The data do not include patients who were admitted for their cancer surgery on an emergency basis, that is, where admission was required within 24 hours.
Calculation of measures
Broadly, waiting times for cancer surgery refer to the number of days a patient spent on a public waiting list before being admitted for their surgery. The waiting time does not include time a patient waited between being referred by their general practitioner and the initial consultation with a specialist.
Waiting times are calculated by subtracting the listing date for care from the removal date, minus any days when the patient was 'not ready for care'. The calculation also excludes the following:
- any days the patient was waiting with a less urgent clinical urgency category than their clinical urgency category at removal
- people who were removed from a waiting list because they were admitted as an emergency patient for the awaited procedure
- people who were transferred to another hospital's waiting list
- people who were treated at any facilities not included in reporting
- people who were not contactable, died or declined surgery.
The median waiting time is the number of days within which 50% of patients waited before being admitted to hospital for their surgery.
The waiting times and volumes are calculated for cancer surgery for selected types of cancer, identified according to the patient's principal diagnosis (defined using ICD-10-AM codes):
- Bladder cancer (C67, D09.0)
- Bowel cancer (C18–C20, D01.0–D01.2)
- Breast cancer (C50, D05)
- Gynaecological cancer (C51–C58, D06, D07.0–D07.3)
- Kidney cancer (C64)
- Lung cancer (C33–C34, D02.1–D02.2)
- Melanoma (C43, D03)
- Prostate cancer (C61, D07.5).
These include cancers that are 'malignant primary' or an 'in-situ' carcinoma and exclude other types of cancer ('malignant secondary'; 'benign' or 'uncertain; or unknown behaviour types').
Interpretability and comparability
For each type of surgery, a hospital's median waiting times are presented.
Some smaller remote hospitals may have different patterns of service delivery compared with other hospitals because specialists providing cancer surgery services visit these hospitals only periodically.
Methods to calculate waiting times have varied across states and territories and over time. In some states and territories, the time patients spent on the waiting list of a hospital before being transferred to another hospital’s waiting list is not included in the total waiting time calculated using the NESWTDC. Therefore the number of days waited reported for hospitals in those jurisdictions reflects the waiting time on the list managed by the reporting hospital only.
Generally, New South Wales, Queensland, Tasmania and the Northern Territory do not report removals from waiting lists for transfer to another hospital's waiting list. This could have an effect of increasing the waiting times reported for some hospitals in those four jurisdictions relative to others.
Of 783 public hospitals reporting on MyHospitals, the number that reported cancer surgery waiting times data for 2010–11 for each cancer type was:
- Bladder cancer (98 public hospitals)
- Bowel cancer (96 public hospitals)
- Breast cancer (95 public hospitals)
- Gynaecological cancer (105 public hospitals)
- Kidney cancer (39 public hospitals)
- Lung cancer (30 public hospitals)
- Melanoma (79 public hospitals)
- Prostate cancer (84 public hospitals).